Mood and Sleep Quality in Peruvian Medical Students During COVID-19 Pandemic.

INTRODUCTION: The prolongation and consequences of the COVID-19 pandemic have led to an uncertain and devastating panorama in many populations, and the evidence shows a high prevalence of mental health problems in medical students. The objective was to evaluate the association between mood disorders and sleep quality (SQ) in Peruvian medical students during the COVID-19 pandemic. METHODS: A cross-sectional study was conducted on 310 medical students from a private university in Peru. The SQ was measured using the Pittsburgh Sleep Quality Index (PSQI), while mood disorders were evaluated using the Depression Anxiety and Stress Scale-21 (DASS-21). All information was collected by online surveys and then analysed in the R programming language. RESULTS: The SQ results measured by PSQI were poor in 83.9% of the medical students. In the Poison regression analysis, the results of the bivariate analysis in men show that all mood disorders found the prevalence of poor SQ. However, in the multivariate analysis only stress (PRa=1.30; 95% CI, 1.08-1.57; P<0.01) and anxiety (PRa=1.34; 95% CI, 1.09-1.56; P <0.01) increased the prevalence of poor SQ. Women had a similar pattern in bivariate analysis, whereas in multivariate analysis, only severe stress (PRa=1.15; 95% CI, 1.01-1.29; P <0.05) increased the prevalence of poor SQ. CONCLUSIONS: This study allows us to observe the consequences that the COVID-19 pandemic is having on medical students in Peru. It also revealed a population group vulnerable to poor quality of sleep and bad mood, which in the future will impact on health. It is suggested to educate medical students about the importance of proper sleep hygiene and the consequences of poor sleep hygiene practices.

Analysis of adherence to a healthy lifestyle among vegetarian and non-vegetarian Peruvian university students: A cross-sectional survey.

BACKGROUND: Evidence shows that a healthy lifestyle can promote physical and mental well-being in the general population. However, there are few studies that assess the adherence to a healthy lifestyle in vegetarian and non-vegetarian university students. The purpose of this study was to evaluate the differences in adherence to a healthy lifestyle between vegetarian and non-vegetarian university students in Peru. METHODS: A cross-sectional study was carried out considering data from 6,846 students selected by non-probabilistic convenience sampling. The Diet and Healthy Lifestyle Scale (DEVS), the Peruvian validation of the Vegetarian Lifestyle Index (VLI), was used. In addition, sociodemographic and anthropometric data such as weight and height were collected. Body mass index (BMI) was also calculated. RESULTS: Semi-vegetarian and vegetarian students had a high healthy lifestyle score compared to non-vegetarians. In addition, vegetarian diets showed a significantly higher proportion among students with a lower BMI (normal and underweight). Students with excess body weight (overweight and obesity) were less likely to report healthy lifestyle. In the overall population analyzed, it was observed that the levels of health and lifestyle behaviors, such as daily exercise and sunlight exposure, were mostly moderate and low. Additionally, sweets intake was high, while healthy food consumption such as fruits, vegetables, legumes, and whole grains was low. CONCLUSION: The current findings show that although vegetarians had better adherence to a healthy lifestyle, interventions in the university setting are needed to improve healthy lifestyle in university students.

Dietary practices and nutritional status of children served in a social program for surrogate mothers in Colombia.

BACKGROUND: Dietary practices are acquired in the family context and in turn can affect the health of family members, especially the nutritional status of children. The objective of this study was to determine the relationship between nutritional status and feeding practices in children from foster families served by the SOS Children's Villages program in Cartagena, Colombia. METHODS: The study had a cross-sectional design. Through a non-probabilistic purposive sampling, 139 children from 0 to 5 years of age from the SOS Children's Villages Cartagena program were involved. The sociodemographic background of the participants was recorded and the nutritional status of the children was evaluated through anthropometric and biochemical measurements. Dietary practices were measured by means of a standardized questionnaire. Analyses were performed with Poisson regression models with robust variance. These regression models provided prevalence ratios (PR) with their respective 95% confidence intervals (95%CI). RESULTS: Among dietary practices, it was observed that most families eat together at home (63.3%), watch television when they eat (55.4%), and have dietary norms (80.6%). Consumption of plant foods was predominantly high, especially vegetables (86.3%), fruits (92.1%), cereals (84.9%), root vegetables, and bananas (93.5%). Consumption < 4 times/week of soft drinks and industrialized juices increases 14.3 times the probability of low weight-for-height in the study population compared to the group that does not consume them. On the other hand, watching television while eating (PR: 2.82, 95%CI 1.32-4.69) and consumption of sweet snacks (PR: 2.24, 95%CI 1.03-4.87) increased the probability of low height-for-age; while having eaten norms at home decreased the probability of low height-for-age in the study population by 50%. CONCLUSION: It is necessary to develop and implement interventions such as preventive measures and early diagnosis of inappropriate feeding behaviors to ensure adequate nutritional status among children under 5 years of age.

Association between Copeptin and Metabolic Syndrome: A Systematic Review.

Background: Copeptin, a reliable marker for vasopressin release, has been associated with cardiometabolic diseases including metabolic syndrome (MetS). This systematic review aims to evaluate the association between copeptin and MetS. Methods: We searched in Pubmed, Scopus, EMBASE, and Web of Science databases until March 2021 and included observational studies (cohort studies, cross-sectional, and case-control) reporting the risk or prevalence of having MetS in patients with elevated copeptin levels compared to patients without elevated copeptin levels. The risk of bias was evaluated with the Newcastle-Ottawa Scale. Meta-analysis was not performed because of the heterogeneity of the copeptin cut-off values. Results: A total of 7 studies (5 cross-sectional, 1 case-control, and 1 cohort) were included comprising 11,699 participants. Most of them were performed in the adult general population. Two cross-sectional and one case-control studies found a positive significant association between higher levels of copeptin and MetS. While three cross-sectional and one cohort studies found no association. The case-control study had several methodological limitations, most cross-sectional studies were methodologically adequate and the cohort study had no methodological issues. Conclusions: The association between copeptin and MetS is inconsistent. However, the arginine-vasopressin system impairment contributes to metabolic disorders, expressing plasma copeptin changes. Thus, more longitudinal studies are required to corroborate the association of copeptin and MetS.

Glycosylation is key for enhancing drug recognition into spike glycoprotein of SARS-CoV-2.

The emergence of COVID-19 caused by SARS-CoV-2 and its spread since 2019 represents the major public health problem worldwide nowadays, which has generated a high number of infections and deaths. The spike protein (S protein) is the most studied protein of SARS-CoV-2, and key to host-cell entry through ACE2 receptor. This protein presents a large pattern of glycosylations with important roles in immunity and infection mechanisms. Therefore, understanding key aspects of the molecular mechanisms of these structures, during drug recognition in SARS-CoV-2, may contribute to therapeutic alternatives. In this work, we explored the impact of glycosylations on the drug recognition on two domains of the S protein, the receptor-binding domain (RBD) and the N-terminal domain (NTD) through molecular dynamics simulations and computational biophysics analysis. Our results show that glycosylations in the S protein induce structural stability and changes in rigidity/flexibility related to the number of glycosylations in the structure. These structural changes are important for its biological activity as well as the correct interaction of ligands in the RBD and NTD regions. Additionally, we evidenced a roto-translation phenomenon in the interaction of the ligand with RBD in the absence of glycosylation, which disappears due to the influence of glycosylation and the convergence of metastable states in RBM. Similarly, glycosylations in NTD promote an induced fit phenomenon, which is not observed in the absence of glycosylations; this process is decisive for the activity of the ligand at the cryptic site. Altogether, these results provide an explanation of glycosylation relevance in biophysical properties and drug recognition to S protein of SARS-CoV-2, which must be considered in the rational drug development and virtual screening targeting S protein.

Online academic satisfaction during the COVID-19 pandemic in medical students: role of sleep, psychological issues, college adjustment, and digital skills.

Background: The measures taken to contain the COVID-19 pandemic, led to significant changes in university education, resulting in the new normal standard of virtual teaching in many undergraduate medical schools worldwide. Therefore, the aim of this paper was to determine the factors related to academic satisfaction with virtual teaching in medical students during the COVID-19 pandemic. Methods: A cross-sectional-analytical study was conducted on medical students at a private university in Peru, through self-reported questionnaires divided into sociodemographic data and variables of interest that could influence academic satisfaction during the pandemic. To evaluate possible factors related to academic satisfaction, stepwise regression models were performed for both sexes. Results: In total, data from 310 medical students, 117 males and 193 females, were analyzed. Academic satisfaction reached a score of 11.2 ± 2.9, which was similar in both sexes. The best regression model for males (AIC: 544.32; RMSE: 2.42; R 2: 0.30) showed that adaptation to university life (favorable change) and depression (unfavorable change) explained 30% of changes in students' academic satisfaction. While in females (AIC: 907.59; RMSE: 2.49; R 2: 0.22) the model integrated favorable factors such as adjustment to college life and anxiety; while depression and poor sleep quality were unfavorable factors. Conclusion: Factors that contributed to academic satisfaction in medical students were determined in this study, which differed by gender. Thus, it is important to take into account the particularities of male and female medical students in order to improve their academic satisfaction during their university careers.

Changes in Eating Habits and Lifestyles in a Peruvian Population during Social Isolation for the COVID-19 Pandemic.

BACKGROUND: Peru has one of the highest infection and death rates in the world for the COVID-19 pandemic. The government implemented house confinement measures with probable consequences on lifestyle, particularly affecting eating habits, physical activity, sleep quality, and mental health. OBJECTIVES: The aim of this study was to assess the lifestyles, physical activity, and sleep characteristics, as well as changes in eating habits in a Peruvian population during the first wave of the COVID-19 pandemic. METHODS: A cross-sectional descriptive study was performed. We analyzed Peruvian adults based on an online self-administered questionnaire divided into sociodemographic, anthropometrics, COVID-19 diagnosis reported, lifestyle habits, and frequency of consumption of foods. RESULTS: During confinement for COVID-19, 1176 participants were studied. Of these, most reported weight gain (1 to 3 kg) and 35.7% were overweight. The lifestyles habits showed that 54.8% reported doing physical activity and 37.2% sleep less. The Peruvian sample presented a main meal pattern of breakfast (95.7%), lunch (97.5%), and dinner (89.1%). Likewise, eating habits before and during COVID-19 pandemic showed that vegetables (OR:1.56, CI95% 1.21-200), fruit (OR: 1.42, CI95% 1.10-1.81), legumes (OR:1.67, CI95% 1.23-2.28), and eggs (OR: 2.00, CI95% 1.52-2.65) presented significant consumption increase during social isolation, while bakery products (OR: 0.74, CI95% 0.56-0.97), meat, snack, refreshment, and fast food decreased in consumption. Other foods showed no significant differences. CONCLUSION: This study showed an important frequency of overweight and sleep changes. There was a slight increase in physical activity despite the social isolation measures and an increase in healthy eating habits; nevertheless, the majority reported gaining weight.

[Mood and sleep quality in Peruvian medical students during COVID-19 pandemic]. / Estado de ánimo y calidad del sueño en estudiantes de medicina peruanos durante la pandemia de COVID-19.

INTRODUCTION: The prolongation and consequences left by the covid-19 pandemic generate an uncertain and devastating panorama in many populations, evidence shows a high prevalence of mental health problems in medical students. OBJECTIVE: The study's aim was to evaluate the association between mood disorders and sleep quality (SQ) in Peruvian medical students during the COVID-19 pandemic. METHODS: A cross-sectional study was performed on 310 medical students from a private university in Peru. The SQ was measurement through the Pittsburgh Sleep Quality Index (PSQI), while mood disorders were evaluated through the Depression Anxiety and Stress Scale - 21 (DASS-21). All information was collected by online surveys and then analyzed in programming language R. RESULTS: The SQ results measured by PSQI were bad in 83.9% of the medical students. In the Poison regression analysis, the results of the bivariate analysis in men show that all mood disorders found the prevalence of bad SQ, however, in the multivariate analysis only stress (PRa: 1.30; 95% CI 1.08 - 1.57; p <0.01) and anxiety (PRa: 1.34; 95% CI 1.09 - 1.56; p <0.01) increased the prevalence of poor SQ. Women had a similar pattern in bivariate analysis, whereas in multivariate analysis, only severe stress (PRa: 1.15; 95% CI 1.01 - 1.29; p <0.05) increased the prevalence of poor SQ. CONCLUSIONS: This study allows us to observe the consequences that the COVID-19 pandemic is leaving in medical students in Peru. And so it disclosed are a vulnerable population to poor quality of sleep and a bad mood, which in the future will impact on health. It is suggested to educate medical students about the importance of proper sleep hygiene and the consequences of poor sleep hygiene practices.

Problematic Internet Use Associated with Symptomatic Dry Eye Disease in Medical Students from Peru.

PURPOSE: Dry eye is a multifactorial ocular surface disease (DED) characterized by a loss of tear film homeostasis, which is widely associated with alterations in mental health. Problematic internet use (PIU) is defined as the feeling of concern about using this tool irresistibly, for longer periods than usual, accompanied by anguish that results from not doing so without reaching mania or hypomania behaviors. Both PIU and DED present a theoretical link; however, there are no published studies that report its relationship with problematic internet use. Therefore, this study aims to determine the association between PIU and symptomatic DED in Peruvian medical students. PATIENTS AND METHODS: Analytical cross-sectional study that included human medical students from Peru. For the measurement of main variables, the Ocular Surface Disease Index (OSDI) and the Internet Addiction Test (IAT) were used. To study their relationship, the Poisson regression analysis was used, we consider a p-value <0.05 as significant. RESULTS: Data from 844 medical students were analyzed, 35.7% male and 64.3% female, with an average age of 21.8 ± 3.3 years. Likewise, the prevalence of symptomatic DED was 70.9%, and the internet's controlled use was 85.3%. In the analysis adjusted for symptomatic DED, the men showed significant differences in the controlled use of the internet (p <0.003), of which those who had PIU, 50% had severe symptomatic DED, as well as 80% of those addicted to the internet. The adjusted model showed that the PIU increases the prevalence of symptomatic DED in men (PR = 1.17, 95% CI: 1.06-1.29); however, in women, no association was found between both variables. CONCLUSION: PIU and symptomatic DED showed a significant association in male medical students from Peru.

Serum Uric Acid Is Associated with Metabolic Syndrome and Insulin Resistance among Health Personnel from Peru.

We explored the association between serum uric acid (SUA) and metabolic syndrome (MetS) and insulin resistance (IR) among health personnel from a public hospital in Peru in a cross-sectional study with data from the Plan for the Prevention and Surveillance of Communicable and Noncommunicable Diseases of Huaycán Hospital. MetS was defined according to Latin American Diabetes Association (ALAD) criteria and IR with surrogate IR markers, triglyceride-to-HDL-C ratio (TG/HDL-C), and triglyceride-to-glucose index (TyG). The association between SUA and MetS and IR was determined using Poisson regression models in a sample of 292 participants with an average age of 46.2 ± 10.6 years. The total prevalence of MetS was 38%, and the individuals with MetS presented mainly alterations in anthropometric parameters (obesity and body fat). Finally, the adjusted regression models showed that women with SUA in the highest tertile increased the prevalence of MetS (PR: 1.71, 95% CI: 1.07-2.74) compared to the lowest tertile of SUA in women, while SUA increased hypertriglyceridemia and IR (TG/HDL-C and TyG) in both sexes. We concluded that SUA is strongly associated with MetS in women, and SUA increases hypertriglyceridemia and IR in both sexes. On the contrary, more research is required regarding the female population.

Association and diagnostic value of a novel uric acid index to cardiovascular risk.

OBJECTIVES: Cardiovascular diseases (CVD) are the leading cause of death and disability worldwide. The aim of this study was to assess the association and diagnostic value of a novel uric acid index (UA index) to cardiovascular risk (CVR). DESIGN: and Methods: An analytical cross-sectional study was performed. We analyzed data from the Plan for Prevention and Surveillance of Communicable and Non-Communicable Diseases at the Hospital de Huaycan, Peru. The QRISK model was used to measure the CVR. Stepwise regression models were performed to determine significant factors to predict CVR and formulate the UA index, then the association of UA index and high CVR was evaluated by Poisson regression models, and the diagnostic accuracy was verified through ROC curves. RESULTS: In total 291 participants (206 women and 85 men) were analyzed. The correlation between UA index to CVR was stronger (R 2 :0.31, p < 0.001) than uric acid (UA) alone (R 2 :0.19, p < 0.001), and the contribution of UA was stronger than triglycerides or glucose in the stepwise regression model. In the Poisson models, the UA index adjusted model (PRa: 1.58, CI95% 1.11-2.24) presented significant independent association to CVR. The diagnostic accuracy was similar in men (cut-off: 10.8, AUC:0.81; 0.75-0.87) and women (cut-off: 10.0; AUC: 0.77, 0.71-0.84). CONCLUSION: UA index presented a good diagnostic accuracy and independent significant association to high CVR in adults from Peru. This marker can be used to assess CVR and follow therapeutic progress in primary health care.

Association between lifestyles, anthropometric measurements and peripheral arterial disease in public sector health workers.

Introduction: Peripheral arterial disease (PAD) occurs when there is a narrowing of the blood vessels outside the heart; this disease is concentrated in low and middle income countries such as Peru. Objectives: To determine the association between lifestyles, anthropometric measurements and PAD in health workers at the Hospital de Huaycan, 2020. Methods: Cross-sectional analytical study that recruited health workers of both sexes, who had no history of cardiovascular disease, type 2 diabetes mellitus nor were pregnant. Lifestyle was measured through a questionnaire and PAD through the ankle-brachial index <0.90 in any leg. Results: In total 184 health workers, 53 men and 131 women with an average age of 46.0 ± 10.0 years were analyzed. The prevalence of PAD was 31% in the total sample. Both the bivariate and multivariate analyses showed that an inadequate lifestyle (PRa = 1.62; 95% CI: 1.08-2.44), high waist-hip ratio (PRa = 1.90; 95% CI: 1.19-3.03) and increased body fat (PRa = 1.03; 95% CI: 1.00-1.07) present an independent and statistically significant association with PAD. Conclusion: There is an association between lifestyles, waist-hip ratio, and body fat percentage with PAD in health workers.

Insulin Resistance Indexes as Biomarkers of Lifetime Cardiovascular Risk among Adults from Peru.

BACKGROUND: Cardiovascular disease (CVD) is the most prevalent cause of death from disease and disability in the world. Reliable markers are needed to assess and reduce cardiovascular risk. This study aimed to determine if insulin resistance indexes, triglycerides to HDL-cholesterol ratio (TG/HDL-C), and triglyceride glucose index (TyG) are biomarkers for lifetime cardiovascular risk (CVR). METHODS: This analytical cross-sectional study was performed on health personnel from Huaycan Hospital in Peru. The QRISK model was used to measure lifetime CVR. The association and diagnostic accuracy for TyG calculated as Ln (TG (mg/dL) × glucose (mg/dL)/2) and TG/HDL-C ratio were determined using Poisson regression models and ROC curves with Youden index. RESULTS: In total, 291 adults (207 women and 84 men) were analyzed. In the adjusted Poisson models, each unit of TG/HDL-C increased 1.22-fold and 1.16-fold the probability of high lifetime CVR in men and women, respectively. However, each unit of TyG increased 1.98-fold in men and 3.25-fold in women the probability of high lifetime CVR. The optimal cutoff values of TG/HDL-C were 2.64 (AUC: 0.77), 3.90 (AUC: 0.80), and 2.64 (AUC: 0.74) for the overall population, men, and women, respectively. Likewise, the optimal cutoff values of TyG were 9.04 (AUC: 0.80), 8.95 (AUC: 0.79), and 9.04 (AUC: 0.80) for the overall population, men, and women, respectively. CONCLUSION: TG/HDL-C and TyG presented a significant association with lifetime CVR. However, TyG presented a stronger association than TG/HDL-C. Both TG/HDL-C and TyG are shown to be reliable markers for CVR in adults.

Cambios hematológicos relacionados con componentes del síndrome metabólico en personal de salud con alimentación balanceada / Hematological changes related to metabolic syndrome components in healthpersonnel with a balanced diet

INTRODUCCIÓN: El síndrome metabólico (SM) es un conjunto de trastornos interrelacionados que produce alteraciones en diversos sistemas biológicos. OBJETIVO: El objetivo de este estudio fue evaluar los cambios hematológicos en presencia de síndrome metabólico en personal de salud con alimentación balanceada. Materiales y MÉTODOS: Se realizó un estudio transversal donde se analizó la base de datos del personal de salud que participó del Plan de Prevención de Enfermedades Transmisibles y no Transmisibles del Hospital de Huaycán, Perú. La evaluación del SM se realizó usando los criterios de la Asociación Latinoamericana de Diabetes (ALAD) en los trabajadores que presentaron alimentación balanceada según el cuestionario "FANTÁSTICO". La relación entre los cambios hematológicos y componentes del SM se realizó a través de la correlación de Spearman mientras que la comparación de grupos acumulados de componentes de SM y cambios hematológicos se realizó con el test de Kruskal-Wallis y posterior análisis pos hoc de Bonferroni. RESULTADOS: Se analizaron los datos de 285 participantes, 31.2% hombres y 68.8% mujeres con una edad media de 46.1 ± 10.5 años. La prevalencia del SM fue de 36.2%, solo las mujeres presentaron cambios en los parámetros hematológicos en presencia de SM. La relación entre los componentes del SM y cambios hematológicos fue fuerte con el aumento del perímetro abdominal y los niveles séricos de triglicéridos; de igual manera, el acúmulo de más de 2 componentes del SM aumenta significativamente los niveles de hemoglobina y hematocrito en mujeres. CONCLUSIONES: En nuestro estudio las mujeres presentaron cambios hematológicos principalmente en la serie roja relacionados al SM y determinados componentes del mismo. Se requieren más estudios poblacionales para corroborar nuestros hallazgos

INTRODUCTION: Metabolic syndrome (MS) is a set of interrelated disorders that produce alterations in various biological systems. OBJECTIVE: This study aimed to evaluate the hematological changes in the presence of metabolic syndrome in health personnel with a balanced diet. MATERIALS AND METHODS: A cross-sectional study was conducted where the database of health personnel who participated in the Plan for the Prevention of Communicable and Non-Communicable Diseases of the Hospital of Huaycan, Peru, was analyzed. The evaluation of the SM was carried out using the criteria of the Latin American Association of Diabetes (ALAD) in the workers who presented a balanced diet according to the questionnaire "FANTASTIC". The relationship between hematological changes and SM components was made through Spearman's correlation while the comparison of accumulated groups of SM components and hematological changes was made with the Kruskal-wallis test andlater Bonferroni's post hoc analysis. RESULTS: Data from 285 participants were analyzed, 31.2% men and 68.8% women with a mean age of 46.1 ± 10.5 years. The prevalence of MS was 36.2%, only women presented changes in hematological parameters in the presence of MS. The relationship between the components of MS and hematological changes was strong with the increase in abdominal circumference and triglycerides; likewise, the accumulation of more than 2 components of MS significantly increases the levels of hemoglobin and hematocrit in women. CONCLUSIONS: In our study the women presented hematological changes mainly in the red series related to MS and certain components of it. Further population-based studies are needed to corroborate our findings