Factors Associated with the Development of Chronic Kidney Disease in Patients with Arterial Hypertension.

Introduction: Chronic kidney disease affects a large part of the population with hypertension, diabetes mellitus as well as those over 50 years of age. Research reported that male sex and other comorbidities such as obesity and anemia are more frequent in Chronic kidney disease, as well as uncontrolled diabetes mellitus or hypertension. Objective: To determine the risk factors associated with the development of chronic kidney disease in adults with arterial hypertension. Material and Methods: Retrospective cohort study of 455 patients with hypertension treated in a primary health care hospital. Medical records and laboratory information were reviewed for the diagnosis of chronic kidney disease and its staging. Patients aged 40 years and older, of both sexes and evaluated between the years 2015 -2017 were included. Logistic regression analysis allowed the identification of risk factors associated with the development of chronic kidney disease. Results: 63.7% were female and 36.3% male. The average age for 2015 was 69.79 ± 9.03, more than half of participants had diabetes mellitus and controlled hypertension and the predominant nephroprotection was with Losartan (53%) that year. Male sex (OR 1.68, CI 1.03-2,76), age: 60 years or older (OR 6.38, CI 2.65-15,37) and anemia (OR 1.71, CI 1.03-2,85), were risk factors for the development of chronic kidney disease (p < 0.05), whereas nephroprotection (OR 0.39, CI 0.18-0,88) and controlled diabetes mellitus (OR: 0.18, CI 0.07-0,47) were shown to be protective factors (p < 0.05). The prevalence of chronic kidney disease between 2015 and 2017 was 19% and 45%, respectively, with predominance of category G2. The comparison group is the same cohort analyzed in each year under study. Conclusion: Male sex, age over 60 years, and anemia are risk factors for chronic kidney disease. Nephroprotection, controlled diabetes mellitus, and patient follow-up are factors that prevent its development.

Differences in family functioning before and during the COVID-19 pandemic: an observational study in Peruvian families.

The COVID-19 pandemic has had a major impact on family relationships, as several families have lost family members due to COVID-19 pandemic and become physically and emotionally estranged due to lockdown measures and critically economic periods. Our study contrasted two hypotheses: (1) family functioning changed notably before and after the COVID-19 pandemic initiation in terms of cohesion, flexibility, communication and satisfaction; (2) balanced families have a greater capacity to strictly comply with quarantine (i.e., social confinement), compared to unbalanced families. We performed an observational study comparing family functioning between two independent groups, evaluated before and during the first wave of the COVID-19 pandemic in Peru. A total of 7,980 participants were included in the study. For the first hypothesis, we found that, during the pandemic, families became more balanced in terms of cohesion (adjusted before-during mean difference or ß1 = 1.4; 95% CI [1.0-1.7]) and flexibility (ß2 = 2.0; 95% CI [1.6-2.4]), and families were less disengaged (ß3 = -1.9; 95% CI [-2.3 to -1.5]) and chaotic (ß4 = -2.9; 95% CI [-3.3 to -2.4]). Regarding the second hypothesis, we confirmed that families with balanced cohesion (adjusted prevalence ratio or aPR = 1.16; 95% CI [1.12-1.19) and flexibility (aPR = 1.23; 95% CI [1.18-1.27]) allowed greater compliance with quarantine restrictions; while disengaged (aPR = 0.91; 95% CI [0.88-0.93]) and chaotic families (aPR = 0.89; 95% CI [0.87-0.92]) were more likely to partially comply or not comply with the quarantine. Finally, family communication (aPR = 1.17; 95% CI [1.11-1.24]) and satisfaction (aPR = 1.18; 95% CI [1.11-1.25]) also played a role in favouring quarantine compliance. This new evidence enlightens the family systems theory while informing future interventions for improving compliance with quarantine measures in the context of social confinement.

Post-infection sequelae by COVID 19 in patients at Hospital I Florencia de Mora. Trujillo - Peru / Secuelas post infección por COVID 19 en pacientes del Hospital I Florencia de Mora. Trujillo - Perú

Objetivos: Identificar secuelas post COVID-19 en pacientes con alta médica para dicha patología. Métodos: se realizó un estudio descriptivo prospectivo entre el segundo y cuarto trimestre 2021 con una población de 330 pacientes diagnosticados con COVID-19. Al inicio del estudio se estableció la línea de base y luego se realizó seguimiento y consulta de control para identificar secuelas post COVID-19 y realizar espirometría de control. Resultados: La frecuencia de COVID 19 fue de 29.78% (330 casos/1108 atendidos). El 43.94% de casos positivos se presentó en el grupo de 40-59 años, el 28.8% (95/330) refirieron como comorbilidad: la enfermedad cardiovascular, diabetes mellitus II y asma bronquial. Predominaron las secuelas post COVID-19: respiratorias (61%), osteomusculares (43%) y neurológicas (20%), con disnea, dorsalgia y cefalea respectivamente. La duración de las secuelas fue de 21 días a siete meses, la espirometría mostró un patrón restrictivo leve en pacientes de 41 a 50 años, todas de sexo femenino. Conclusiones: Es importante identificar secuelas post COVID-19 para el tratamiento que permita recuperar la salud integral de las personas.

Objectives: To identify post COVID-19 sequelae in patients with medical discharge for this pathology. Methods: A prospective descriptive study was conducted between the second and fourth quarter of 2021 with a population of 330 patients diagnosed with COVID-19. Baseline was established at the beginning of the study, followed by follow-up and control consultation to identify post-COVID-19 sequelae and to perform control spirometry. Results: The frequency of COVID-19 was 29.78% (330 cases/1108 attended). The 43.94% of positive cases were in the 40-59 years age group, 28.8% (95/330) referred as comorbidity: cardiovascular disease, diabetes mellitus II and bronchial asthma. Post COVID-19 sequelae predominated: respiratory (61%), musculoskeletal (43%) and neurological (20%), with dyspnea, dorsalgia and headache, respectively. The duration of sequelae ranged from 21 days to seven months, spirometry showed a mild restrictive pattern in patients aged 41 to 50 years, all female. Conclusions: It is important to identify post-COVID-19 sequelae for treatment to recover the integral health of individuals.

Nivel de resiliencia del personal de salud frente a la pandemia por Covid-19 / Resilience level in health personnel facing the Covid-19 pandemic

Introducción: La resiliencia es un factor determinante para ayudar a afrontar alguna situación de estrés, por ello el objetivo de nuestro estudio, fue medir el nivel de resiliencia en el personal de salud en dos hospitales de la ciudad de Trujillo frente a la pandemia por Covid-19. El estudio: Se realizó un estudio descriptivo transversal con 106 trabajadores de salud, a quienes mediante una entrevista se les administró un cuestionario compuesto de 25 ítems. Hallazgos: Se encontró que la mayor parte de participantes fueron del sexo femenino (67,9% vs 32,1%) y 40,6%, personal médico. En ambos hospitales se halló un nivel alto de resiliencia, 95% en el Hospital La Noria y 98% en EsSalud-La Esperanza. Conclusiones: El personal de salud presentó nivel alto de resiliencia frente a la pandemia del Covid-19.

Introduction: Resilience is a determining factor in helping to face some stressful situation, therefore the objective of our study, was to measure the level of resilience in health personnel in two hospitals in the city of Trujillo in the face of the Covid-19 pandemic. The study: A cross-sectional descriptive study was conducted with 106 health workers, who were administered a questionnaire composed of 25 items by means of an interview. Findings: It was found that the majority of participants were female (67.9% vs 32.1%) and 40.6%, medical personnel. A high level of resilience was found in both hospitals, 95% in Hospital La Noria and 98% in EsSalud-La Esperanza. Conclusions: Health personnel presented high level of resilience in the face of the Covid-19 pandemic.

Características clínico epidemiológicas de pacientes con diagnóstico de SARS-CoV-2. Hospital I Florencia de Mora EsSalud ­ La Libertad, 2020 / Clinical epidemiological characteristics of patients diagnosed with SARS-CoV-2. Hospital I Florencia de Mora EsSalud ­ La Libertad, 2020

Introducción: La pandemia por SARS-CoV-2 afectó a gran parte de la población liberteña, entre ellas, la población de Florencia de Mora, cuyo hospital tuvo un importante rol en la atención de pacientes con diagnóstico de COVID-19. Ojetivos: Determinar las características clínico-epidemiológicas de los pacientes con diagnóstico por SARS-CoV-2 atendidos en dicho centro asistencial. Métodos: Estudio descriptivo observacional, retrospectivo, con una población de 2622 pacientes atendidos en el triaje de COVID-19, considerando la prueba molecular y la prueba serológica rápida para la detección de SARS-CoV-2. Resultados: Se detectó SARS-CoV-2 en 74.90% (1155) de los pacientes. Los meses con mayor número de casos fueron junio y julio con el 29.4% (340) y 37.4% (432), respectivamente. El grupo etario predominante fue de 27-59 años con el 77.9% (900), así como el sexo masculino con un 57.5% (664). En cuanto al perfil clínico, la comorbilidad más frecuente fue la hipertensión arterial con 6.9% (80), la obesidad y sobrepeso con 3.7% (43); mientras que la sintomatología más frecuente fue la tos con 62.9% (726), y la odinofagia con 55.7% (643). Conclusión: 75 de cada 100 pacientes tamizados tuvieron SARS-CoV-2; predominando el sexo masculino, el grupo etario de 27-59 años, hipertensión arterial, obesidad y sobrepeso como comorbilidad, tos y la odinofagia como síntomas más frecuentes.

Introduction: The SARS-CoV-2 pandemic affected a large part of the population of La Libertad, among them, the population of Florencia de Mora whose hospital played an important role in the care of patients diagnosed with COVID-19. Objectives: To determine the epidemiological clinical characteristics of patients diagnosed with SARS-CoV-2 treated at treated at the center. Methods: Retrospective observational descriptive study, with a population of 2622 patients treated in the COVID Triage, considering the molecular test and the rapid serological test for the detection of SARS-CoV-2. Results: SARS-CoV-2 was detected in 74.90% (1155), the months with the highest number of cases were June and July with 29.4% (340) and 37.4% (432) respectively, the predominant age group was 27- 59 years with 77.9% (900) and males with 57.5% (664). Regarding the clinical profile, the most frequent comorbidity was arterial hypertension with 6.9% (80), obesity and overweight with 3.7% (43) and the most frequent symptoms were: cough 62.9% (726) and odynophagia 55.7% (643). Conclusions: 75 out of 100 screened patients had SARS-CoV-2; predominantly males, the age group of 27-59 years, hypertension, obesity and overweight as comorbidity, cough and odynophagia as the most frequent symptoms.

Competencias docentes para la enseñanza y el aprendizaje en un entorno virtual / No disponible

No disponible

Hipoalbuminemia Como Predictor De Mortalidad De Sepsis Por COVID-19. Hospital II Chocope, 2020. / Hypoalbuminemia as a predicator of mortality of sepsis from COVID-19. Hospital II Chocope, 2020.

Se realizó una investigación de tipo correlacional evaluando a 145 pacientes con sepsis por covid-19. Objetivos: Determinar si la hipoalbuminemia es predictor de mortalidad e identificar el valor sérico de albumina más frecuentemente relacionado con la letalidad. Métodos: Se incluyeron a pacientes mayores o igual de 18 años atendidos en el Hospital II Chocope durante mayo a agosto del 2020. Se excluyeron a pacientes con patologías oncológicas, e historias clínicas incompletas. La técnica empleada es la de análisis documental, mediante la revisión de historias clínicas. Resultados: Hubo asociación estadísticamente significativa entre la hipoalbuminemia y mortalidad (p = 0.00), los pacientes con hipoalbuminemia tuvieron 3 veces más riesgo de fallecer. (OR=3.97 IC al 95%). Así mismo, la sensibilidad y especificidad más alta de la prueba fue cuando el punto de corte de la hipoalbuminemia estuvo en 1.38 g/dl. Finalmente, la hipertensión arterial es la enfermedad asociada más frecuente. Conclusiones: la hipoalbuminemia es predictor de mortalidad y a menor valor de albumina mayor mortalidad.

A correlational type investigation was carried out evaluating 145 patients with covid-19 sepsis. Objectives: To determine whether hypoalbuminemia is a predictor of mortality and to identify the serum albumin value most frequently related to lethality. Method: Patients older than or equal to 18 years seen at Hospital II Chocope during May to August 2020 were included. Patients with oncological pathologies and incomplete medical records were excluded. The documentary analysis technique was used, by reviewing medical records. Results: There was a statistically significant association between hypoalbuminemia and mortality (p = 0.00), patients with hypoalbuminemia had 3 times the risk of dying. (OR = 3.97 95% CI). Likewise, the highest sensitivity and specificity of the test was when the cut-off point for hypoalbuminemia was 1.38 g / dl. Finally, the most frequent comorbidity was arterial hypertension. Conclusions: hypoalbuminemia is a predictor of mortality and the lower the albumin value, the higher the mortality.

Diabetes mellitus tipo 3c secundaria a pancreatitis crónica: reporte de un caso / Type 3c diabetes mellitus secondary to chronic pancreatitis: a case report

RESUMEN La diabetes mellitus secundaria a enfermedades pancreáticas está clasificada como diabetes pancreatogénica o tipo 3c (DM3c), y es clínica y metabólicamente distinta de las otras formas de diabetes. Se presenta el caso de una paciente de 35 años de edad con historia de dolor abdominal superior episódico crónico, que consume alcohol desde los 17 años y ha sido diagnosticada de diabetes mellitus tipo 2. Consulta por una infección urinaria complicada y por dolor agudo en el abdomen superior. Durante la hospitalización presentó episodios de hiperglicemia seguidos de hipoglicemias, con insulinoterapia administrada bajo supervisión. Este caso nos motiva para estudiar a los pacientes diabéticos con historia de dolor abdominal mal referido o signos de malabsorción y mejorar la intervención sanitaria para prevenir o tratar la desnutrición, controlar la esteatorrea y minimizar la hiperglucemia inducida por las comidas o estilos de vida.

ABSTRACT Diabetes mellitus secondary to pancreatic diseases is classified as pancreatogenic diabetes or type 3c diabetes mellitus (T3cDM), which is clinically and metabolically different from the other types of diabetes. We present the case of a 35-year-old female patient with a history of chronic episodic upper abdominal pain, alcohol consumption since she was 17, and type 2 diabetes mellitus. She sought medical attention because of a complicated urinary tract infection in addition to acute upper abdominal pain. During hospitalization, she presented episodes of hyperglycemia followed by hypoglycemia with insulin therapy administered under supervision. This case encourages us to delve into the study of diabetic patients with a history of poorly referred abdominal pain or malabsorption signs, thus improving health intervention to prevent or treat malnutrition, control steatorrhea, and reduce hyperglycemia induced by meals or lifestyles.

Perfil clínico-epidemiológico del síndrome metabólico en adultos atendidos en el hospital I Florencia de Mora EsSALUD / Clinical and epidemiological profile of the metabolic syndrome among adults treated at the Hospital I Florencia de Mora EsSalud

RESUMEN Objetivo Determinar el perfil clínico-epidemiológico del síndrome metabólico en adultos atendidos en el Hospital I Florencia de Mora EsSALUD. Materiales y métodos Estudio de tipo descriptivo, observacional y retrospectivo en una población de 4752 pacientes tamizados en el programa Reforma de Vida. Se aplicaron los criterios diagnósticos del síndrome metabólico de la Federación Internacional de Diabetes. Resultados La prevalencia del síndrome metabólico es de 38,97 %. En el perfil clínico, las variables más frecuentes fueron la obesidad central (97,50 %), un valor bajo de colesterol HDL (86,40 %) y la hipertrigliceridemia (80,10 %). Todas ellas mostraron significación estadística. En el perfil epidemiológico, las variables sexo femenino (68,10 %) y la edad "adulto maduro" (48,30 %) fueron las más frecuentes. Conclusiones Más de la tercera parte del total de la población estudiada presenta síndrome metabólico. En este grupo predominan la obesidad, el colesterol HDL bajo, la hipertrigliceridemia, la edad del adulto maduro y el sexo femenino.

ABSTRACT Objective To determine the clinical and epidemiological profile of the metabolic syndrome among adults treated at the Hospital I Florencia de Mora EsSalud. Materials and methods A retrospective, observational and descriptive study conducted in a population of 4,752 patients screened for the Reforma de Vida program. The International Diabetes Federation's diagnostic criteria for metabolic syndrome were used. Results The prevalence of metabolic syndrome is 38.97 %. The most frequent variables of the clinical profile were central obesity (97.50 %), low levels of HDL cholesterol (86.4 %) and hypertriglyceridemia (80.10 %). All these variables showed statistical significance. The most frequent variables of the epidemiological profile were female sex (68.10 %) and middle- age adult (48.30 %). Conclusions More than one third of the study population has metabolic syndrome. Obesity, low levels of HDL cholesterol, hypertriglyceridemia, middle-age adult and female sex prevailed in this group.

Características clínico epidemiológicas de la enfermedad renal crónica en pacientes con hipertensión arterial y/o diabetes mellitus II. Hospital I Albrecht –Essalud, 2008 / Clinical epidemiology profile of chronic kidney disease with hypertension, diabetes mellitus II, or both diseases. Albrecht's Hospital of EsSALUD, 2008

Se realizó un estudio descriptivo transversal en el Hospital I Albrecht de EsSALUD en La Libertad durante el 2008 para conocer el perfil clínico epidemiológico de la enfermedad renal crónica (ERC). La población fue de 1291 pacientes con hipertensión arterial, diabetes mellitus II o ambas patologías. Se utilizó la ficha epidemiológica del servicio y la fórmula de Cockcroft Gault (CG) para determinar los estadios de la ERC. La edad promedio fue 67 +/- 11.49 años, con predominio del género femenino y el grupo de 61 a 80 años. El 32.69% de la población en estudio no tuvieron antecedentes familiares de las patologías ya descritas, en tanto que 29.2% tuvo antecedentes familiares de HTA, 16.3% antecedente de DMII y 11.31% de ambas patologías, 1.78% de ERC + HTA, y 1.47% de ERC + DMII. Los antecedentes personales más frecuentes fueron la obesidad, el uso de AINES y el tabaquismo. El diagnóstico más frecuente fue HTA con 71.18% seguido de DMII con 16,57%; y 12,25% con ambas patologías. %). La prevalencia de ERC en la población estudiada fue de 37%, predominando el estadio 3 (41%) y el estadio 2 (34%). Del total de estos pacientes, 78% tienen HTA y más del 80% de ellos tiene nefroprotección, siendo el fármaco más utilizado el Enalapril.

We conducted a descriptive study in the Albrecht's Hospital of EsSALUD, La Libertad in 2008 to meet the clinical epidemiology profile of chronic kidney disease (CKD). The population was 1291 patients with hypertension, diabetes mellitus II, or both diseases. We used epidemiological record of service and Cockcroft Gault (CG) to determine the stages of CKD. The average age was 67 +/- 11.49 years, and predominantly female and the group of 61 to 80 years. The 32.69% of the population under study had no family history of the diseases described above, while 29.2% had family history of hypertension, history of NIDDM 16.3% and 11.31% of both conditions, 1.78% of ERC + AHT, and 1.47 % of CKD + NIDDM. The most common antecedents were obesity, NSAID use and smoking. The most frequent diagnosis was hypertension with 71.18%, NIDDM with 16.57% and 12.25% with both conditions. The prevalence of CKD in the study population was 37%, predominantly stage 3 (41%) and stage 2 (34%). Of all these patients, 78% have hypertension and more than 80% have nephroprotection, being the most widely used drug Enalapril.

Niveles de logro en la elaboración de material educativo por alumnos del modulo I de la Escuela de Medicina de la Universidad César Vallejo durante el primer semestre 2003 / Achievement levels on the development of educational materials for students of module I of the School of Medicine of the Universidad César Vallejo during the first half of 2003

Se desarrolló una investigación descriptiva para conocer los niveles de logro en la elaboración de material educativo de alumnos del Módulo 1 de la Escuela de Medicina de la Universidad César Vallejo de Trujillo. El universo estuvo conformado por 82 alumnos matriculados en el semestre 2003 -1, de los cuales se excluyeron 14 alumnos por no reunir los criterios de inclusión del estudio. La unidad de análisis fue el material educativo elaborado por cada alumno y la información se recolectó en un formulario diseñado por la investigadora que; complementado con una escala de calificación para material educativo utilizada por los docentes de Salud Comunitaria de la Escuela; permitió cuantificarlos niveles de logro en la elaboración de material educativo. Se consideró nivel de logro "A" cuando el alumno alcanzó de manera óptima la competencia (80-100%), "B" cuando alcanzó el nivel mínimo de logro (60-79%) y "C" (menor igual a 59%) cuando el alumno no logró la competencia en el diseño y ejecución de material educativo. Los resultados más importantes son aquellos que muestran; siguiendo el análisis de serie temporal; que los alumnos alcanzaron de manera progresiva y sostenida la competencia programada en Salud Comunitaria para el diseño y ejecución de material educativo (significancia estadística alta: p

A descriptive investigation was developed to know the achievement levels in the elaboration of students' Module 1, School of Medicine Cesar Vallejo University of Trujillo. The universe was conformed by 82 students registered in the semester 2003-1, of which 14 students were excluded by not gathering the approaches of inclusion of the study. The analysis unit was the educational material elaborated by each student and the information was gathered in a form designed by the investigator that; supplemented with a qualification scale for educational material used by the educational of Community Health of the School; it allowed to quantify the achievement levels in the elaboration of educational material. It was considered achievement level "TO" when the student reached in a good way the competition (80-100%), "B" when it reached the minimum level of achievement (60-79%) and "C" (smaller similar to 59%) when the student didn't achieve the competition in the design and execution of educational material. The most important results are those that show; following the analysis of temporary series; that the students reached in a progressive and sustained way the competition programmed in Community Health for the design and execution of educational material (statistical significancy p< 0.00 1).

Complicaciones póst-episiotomia / Complications post-episiotomy

El presente estudio prospectivo fue realizado en 130 puérperas del Centro de Salud Materno Infantil Santa Isabel-El Porvenir desde abril a julio de 1997. El trabajo realizado se basó en la entrevista y examen a la puérpera post episiotomía, datos que fueron recopilados en la sala de partos, puerperio, consulta externa y domicilio. Se programaron 3 controles post parto: inmediato (primeras 24 horas), entre 7 a 15 días ya los 50 días. Las complicaciones inmediatas post episiotomía fueron las siguientes: dolor en zona operatoria (50 por ciento), edema y dolor (29 por ciento), desgarro perineal (16 por ciento) y hematoma (1 por ciento) . En tanto que el 4 por ciento restante no presentó ninguna complicación. Las complicaciones mediatas post episiotomía (entre los 7 a 15 días) post parto fueron: dolor en zona operatoria (45 por ciento), dehiscencia y dolor (23 por ciento), dehiscencia más infección(5 por ciento) . Sólo el 27 por ciento de las puérperas estudiadas no presentaron ninguna complicación. El 30 por ciento de puérperas refirió dolor en las relaciones coitales aún a los 50 días post parto; en tanto que el 70 por ciento restante no presentó ninguna molestia en las relaciones coitales. Existe una asociación estadística altamente significativa con la presencia de complicaciones mediatas post episiotomía (P menor que 0.01).

The Present prospective study was carried out in 130 puerperal she gives the Center she gives Infantile Maternal health Santa Isabel-the Future from April to July gives 1997. The realized work you bases on the interview and exam to the puerperal post episiotonies, data that were gathered in the room give childbirths, puerperal, consults external and I domicile. 3 controls were programmed post childbirth: immediate(first 24 hours), among 7 to 15 days and the 50 days. The immediate complications post episiotomies were the following ones: pain in operative area (50 per cent), edema and pain (29 per cent), I tear perinea (16 per cent) and hematoma (1 per cent). As long as 4 remaining per cent doesn't present any complication. The mediate complications post episiotomies (among the 7 to 15 days) post childbirth they were: pain in operative area (45 per cent), dehiscence and pain (23 per cent), dehiscence but infection(5 per cent). Alone 27 per cent gives the studied puerperal they didn't present anycomplication. 30 per cent gives puerperal he/she even referred pain in the relationships coitales to the 50 days post childbirth; as long as 70 remaining per cent doesn't present any nuisance in the relationships coitales. A highly significant statistical association exists with the presence he/she gives mediate complications post episiotomies (P less than 0.01).