Analysis of Survival in Patients with End-End Chronic Kidney Disease Switching from Peritoneal Dialysis to Hemodialysis Due to Refractory Peritonitis

Introduction: Peritonitis associated with peritoneal dialysis (PD) has complications such as transfer from PD to HD and increased morbidity and mortality. In our environment, there is little information regarding survival in this population. Method(s): Retrospective cohort, 147 PD patients, 18 years, with PD catheter removal between 2018-2021. Clinical, biochemical and technique-related variables were measured. Patients who died of cancer and other unrelated causes were excluded. Descriptive statistics, Kaplan-Mayer analysis and Cox regression analysis were used Results: Age 42 +- 17 years, 65% men, 65% unknown cause of CKD. The time between peritonitis diagnosis and catheter removal was 37 (25-61) days. Nine patients (6%) returned to PD, the rest (94%) remained on HD due to unfit abdomen (55%), patient decision (9%), unknown (17%), others (19%). Mortality was 31% and the causes of death were: sepsis (33%), COVID-19 (29%), pneumonia (19%), pulmonary edema (5%), hyperkalemia (5%), CVD (5%), others (4%). Survival after the refractory peritonitis event was 25 (95% CI 22-28) months. Survival at 3, 12, 24, and 36 months was 87%, 71%, 61%, and 35%. In the bivariate analysis, age, DM, time on dialysis, and serum albumin were associated with a higher risk of death. However, in the multivariate analysis, only time on dialysis was significant (OR 1.014, 95% CI 1.002-1.027). [Formula presented] Conclusion(s): Mortality was 31% and the most frequent cause of death was sepsis. Patient survival was 25 (95% CI 22-28) months. Time on dialysis was associated with a higher probability of death. It is necessary to compare these results with a group of patients who do not present failure of the technique. No conflict of interestCopyright © 2023

Burnout and stressors in teachers during the COVID-19 pandemic

INTRODUCTION. Due to the COVID-19 pandemic, a series of restrictive measures were taken to help curb contagion, including the closure of public places. In order to ensure educational continuity, the virtual modality was introduced;however, a large number of teachers were unable to cope with such demands because they were not prepared. For this reason, the aim of the study was to test an explanatory model of burnout in teachers based on job stressors during the pande-mic. METHOD. An applied study with explanatory design of latent variables was proposed, using structural equations (SEM). The participants were 504 teachers (Mage = 42.18;SD = 10.2) of regu-lar basic education from state (62.7%) and private (37.3%) institutions, from three Peruvian re-gions, who responded to a sociodemographic form, the Scale of stressors in teachers in times of pandemic and the Maslach Burnout Inventory (MBI). RESULTS. It was found that the dimensions of burnout, emotional exhaustion and cynicism are explained by the stressors: work environment and work overload, the use of new technologies, uncertainty about the duration and consequences of the pandemic, the organizational aspect of the educational institution, and the relation-ships with the student’s environment. DISCUSSION. The findings suggest that the COVID-19 pandemic has generated a series of stressors that have had a negative impact on the mental health of teachers, who experience a feeling of emotional exhaustion, loss of strength and insufficient energy to continue facing the job;as well as insensitive or distant responses to different features of the job. In this regard, it is proposed to strengthen the teachers’ personal and logistical resources to face educational demands and counteract the negative effect of stressors. © Sociedad Española de Pedagogía.

Factors related to post-traumatic stress in patients with medical discharge due to COVID-19

Introduction: Hospitalization due to COVID-19 can predispose to the appearance of possible long-term psychological sequelae. Objective: To determine the relationship between hospital and non-hospital factors with post-traumatic stress in patients discharged for COVID-19 from a hospital in Peru. Methods: Cross-sectional study and correlational design. The non-probabilistic sample consisted of 126 participants, evaluated through a self-administered questionnaire and the Davidson Trauma Scale. For data processing, the chi-square test and Cramer's V were used as measures of the magnitude of effect. Results: Post-traumatic stress disorder presents moderate associations with hospital factors: hospitalization time (p<0.001) (Cramer's V = 0.33), clinical type of COVID-19 (p<0.001) (Cramer's V = 0 .49) and invasive ventilatory support (p<0.001) (Cramer's V = 0.39);and with non-hospital factors: oxygen therapy in rehabilitation (p<0.001) (Cramer's V = 0.33), neurological sequelae (p<0.001) (Cramer's V = 0.41), respiratory distress (p<0.001) (Cramer's V = 0.53), perception of social discrimination (p<0.05) (Cramer's V = 0.29), difficulty returning to daily activities (p<0.001) (Cramer's V = 0.40) and family members infected with COVID-19 (p<0.001) (Cramer's V = 0.30). Conclusions: There are both in-hospital and out-of-hospital factors associated with post-traumatic stress disorder following discharge from COVID-19. © 2022, Editorial Ciencias Medicas. All rights reserved.

Translation and validity of the Scale of beliefs about the use of masks to prevent the spread of COVID-19

Introduction: The use of a mask is essential to reduce the spread of COVID-19, however, a significant percentage of people refuse to use it. Beliefs may play an important role in accepting or rejecting their use. Objective: To translate and determine the evidence of validity of internal structure and reliability of the self-report of beliefs about the use of masks. Methods: The self-report of beliefs about the use of masks was administered to 1218 people from different provinces of Peru (M age = 27,4 years, SD = 12,6), chosen in a non-probabilistic way. The instrument was subjected to a process of double translation from English to Spanish and vice versa;In addition, using the Jamovi Project version 1.6 program, the internal structure was determined with factor analysis (exploratory and confirmatory), and finally reliability was estimated. Results: The exploratory factor analysis identified four emerging factors that explained 53.7% of the variance. The model was verified and obtained acceptable fit indices (χ² = 154 gl = 46;p < 0,01;CFI = 0,96;TLI = 0,942;RMSEA = 0,602). In addition, standardized factor loadings greater than 0,30 were observed. Conclusions: The Spanish version of the self-report of beliefs about the use of masks shows evidence of validity of structure and reliability due to adequate internal consistency. © 2022, Editorial Ciencias Medicas. All rights reserved.

Fear of COVID-19 infection, as a mediator between exposure to news and mental health, in the Peruvian population

Introduction: In this COVID-19 pandemic, protective measures against the disease and government-imposed policies should be known. However, the media also report on deaths and health service shortages, but their impact on the mental health of the population is ignored. Objective: To determine whether fear of COVID-19 infection acts as a mediator between exposure to news about the pandemic and mental health in the Peruvian population. Method: Explanatory study with observable variables in which 541 persons selected by non-probabilistic sampling participated. They responded to a sociodemographic file and the following scales: Mental Health Inventory-5 (MHI-5) and Fear of COVID-19 Scale. Data were processed using IBM SPSS Statistics 25 and Macro PROCESS for SPSS programs;linear regression and bootstrapping of 10 000 simulations were used. Results: The number of hours watching and/or listening to covid-19 information is a good predictor of the COVID-19 fear mediator variable (β=, 75;t = 3.77, p<.001**). In turn, this has a predictor effect on mental health (β= -,24;t = -13.57, p<.001**). However, the number of hours of exposure to COVID-19 information had no direct positive effect on mental health (β= -.10;t = -1.184, p=.23). Conclusion: Fear of COVID-19 has a total mediating effect between exposure to pandemic news and mental health in the Peruvian population. © 2022 Servicio de Publicaciones - Universidad de Murcia. All Rights Reserved.

Risk factors for AKI and mortality in COVID-19 in Western Mexico

Background: Acute kidney injury (AKI) in COVID-19 is associated with disease severity. The aim of this study was to identify risk factors associated with the development of AKI and its clinical impact, such as need for RRT and mortality. Methods: Retrospective cohort study of hospitalized adult patients COVID-19, with normal kidney function, from April to December 2020 in Western Mexico. Results: 882 patients (60.8% men) with a mean age of 58.9y were included. 342 (38.8%) had a prior diagnosis DM, 412 (46.7%) HTN, 161 (18.3%) obesity, 59 (6.7%) heart diseases, 25 (2.8%) neurological disease, 47 (5.3%) lung disease. 216 (24.5%) smoking history. 270 patients (30.6%) developed AKI, 95 (10.77%) KDIGO stage 1, 44 (4.98%) stage 2, and 84 (9.52%) stage 3. 59 patients required RRT (6.23%), and 111 patients (12.6%) mechanical ventilation. Overall mortality was 30.6% (270 patients). Risk factors for mortality were: DM, HTN, neurological disease, age > 65 y, need for MV, and MAP < 65 mmHg, hyperNa, increased D-dimer or decreased HCO3 at admission. Risk factors for AKI were: DM, HTN, heart disease, age > 65 y, need for MV, and MAP < 65 mmHg, hyperNa, increased D-dimer or decreased HCO3 at admission. Image shows risk factors, ORs with CI. Conclusions: A high incidence of AKI in the Mexican population compared to reports from other countries, with a significantly high risk for death.

Mortality in COVID-19 patients with CKD with and without kidney replacement therapy in Western Mexico

Background: COVID-19 is a new disease of pandemic proportions. Currently, there are no reports on clinical outcomes in patients with CKD with and without KRT in the Mexican population. Our aim was to describe the clinical outcomes in patients with CKD. Methods: Retrospective cohort study of hospitalized adult patients COVID-19 confirmed with RT-PCR, from April to December 2020 in a second-level hospital in Western Mexico. Information was obtained from medical records. Results: 1012 patients were included, of which 130 patients (12.8%) had CKD (65.3% men), with a mean age of 53.8 years, 43.8% with Diabetes Mellitus and 82.3% with Hypertension. 84 patients (64.6%) were on KRT, within which 47 patients were on hemodialysis, 31 on peritoneal dialysis and 6 with a kidney transplant. 46 patients had no KRT, in stages ranging from KDIGO 3b to 5. 78.4%. 14 patients (10.7%) required mechanical ventilation. In our study, mortality among patients with normal kidney function was 30.6%. Regarding patients with CKD, patients on hemodialysis had a mortality of 25.5% (OR 0.74, 95% CI 0.39-1.5), patients on peritoneal dialysis had a mortality of 54.8% (OR 2.75, 95% CI 1.33-5.66), patients with CKD and no KRT had a mortality of 43.5% (OR 1.74, 95% CI 1.15-3.17). Conclusions: In our population, an increased mortality was found in patients with CKD with and without KRT, highlighting the mortality of patients on PD.