Exercise-based training programs for patients with chronic Chagas cardiomyopathy: A systematic review and meta-analysis.

Background: We assessed the effects of exercise-based training programs (EBTP) in patients with chronic Chagas cardiomyopathy (CCC) through a systematic review and meta-analysis. Methods: We conducted a search in Pubmed/Medline, Embase, Scopus, Web of Science, Cochrane Library, Virtual Health Library, and SciELO until January 2023. Randomized controlled trials (RCTs) and non-randomized intervention studies (NRIS) investigating the effects of EBTP in CCC patients were included. The primary outcomes were all-cause mortality, cardiovascular mortality, and health-related quality of life (HRQoL), and the secondary outcomes were exercise capacity by peak VO2, heart failure-related hospital admissions (HFRHA), and left ventricular ejection fraction (LVEF). Results: The search strategy yielded 3617 studies. After removing duplicates and screening, eight studies (3 RCTs and 5 NRIS) involving 222 patients were included. Seven studies were conducted in Brazil. The age range was from 30 to 71 years, and 47.1% were male. Data on mortality, HRQoL, LVEF, and HFRHA were scarcely reported. The meta-analysis pooling four studies showed that the peak VO2 was significantly higher (mean difference 4.45, 95% confidence interval 3.50 to 5.39 mL/kg/min, I2 = 0%) in the EBTP group compared to the control group. Conclusion: The evidence available was limited and heterogeneous. While EBTP has shown to improve HRQoL and exercise capacity, there is no conclusive information about the other proposed outcomes. These positive effects present an opportunity to provide treatment to CCC patients in low- and middle-income countries. Further studies are needed to ascertain the effects of EBTP on hard outcomes in this population.Registration number: CRD42022334060.

Factors Associated with Adequate Breastfeeding: Evidence from the Peruvian Demographic and Health Survey, 2019.

OBJECTIVE: To assess the factors associated with adequate breastfeeding (ABF) among Peruvian mothers during 2019. MATERIALS AND METHODS: We performed a secondary analysis of the 2019 Demographic and Family Health Survey (ENDES) database of Peru. ABF was defined based on the recommendations of the World Health Organization, which defined it as starting breastfeeding within the first hour of life and continuing with exclusive breastfeeding for up to 6 months. To determine the factors associated with ABF, a Poisson generalized linear models with log-link function was used. Adjusted prevalence ratios (aPR) with their respective 95% confidence intervals (95% CI) were calculated. RESULTS: A prevalence of ABF of 48.1% was identified among 11,157 women who reported at least one child in the last five years. Most of them were young (68.6%) and lived in urban areas (65.5%). Furthermore, being unemployed (aPR:1.02; 95% CI:1.00-1.04); residing on the coast, except for Metropolitan Lima (aPR:1.08; 95% CI:1.04-1.11), the highlands (aPR:1.14; 95% CI:1.11-1.18), and the jungle (aPR:1.20; 95% CI: 1.16-1.24); having had a vaginal delivery (aPR:1.30; 95% CI:1.27-1.05); and having two children (aPR:1.03; 95% CI:1.01-1.05) or three or more children (aPR:1.03; 95% CI:1.01-1.05) were associated with a higher frequency of ABF. CONCLUSIONS: One out of two women between 18-59 with children performed ABF. The factors associated with ABF were the current occupation, region of residence, type of delivery, and parity. Health policies and strategies should be implemented, considering our results, to promote maternal counseling by health personnel in order to increase the prevalence of ABF in the Peruvian population.

Efficacy of Colchicine in the Treatment of COVID-19 Patients: A Systematic Review and Meta-Analysis.

OBJECTIVE: We assessed the efficacy of colchicine in COVID-19 patients through a systematic review. METHODS: Six databases were searched until March 2022 for studies assessing colchicine versus control in hospitalized patients with COVID-19. The primary outcome was mortality, and secondary outcome was length of hospitalization. Inverse variance and random effect meta-analyses were performed. The strength of evidence was assessed using GRADE. RESULTS: Nine studies (five randomized clinical trials (RCTs) and four non-randomized studies of intervention (NRSI); n = 13,478). Colchicine did not reduce mortality in comparison with the standard of care in RCTs (RR 0.99; 95%CI 0.90 to 1.10; p = 0.90); however, it did reduce mortality in NRSI studies (RR 0.45; 95%CI 0.26 to 0.77; p = 0.02). In the analysis of RCTs, colchicine did not reduce the length of hospitalization in comparison with the standard of care (MD: -2.25 days; 95%CI: -9.34 to 4.84; p = 0.15). Most studies were scored as having a high risk of bias. Quality of evidence was very low for primary and secondary outcomes. CONCLUSION: Colchicine did not reduce the mortality and length of hospitalization in comparison with the standard of care in hospitalized patients with COVID-19. The published evidence is insufficient and of very low quality to recommend treatment in patients with COVID-19.

Prevalence and factors associated with adolescent pregnancy among sexually active adolescent girls in Peru: Evidence from Demographic and Family Health Survey, 2015-2019.

Background: The objective of this study was to estimate the prevalence of adolescent pregnancy among sexually active adolescents, and identify the factors associated with this problem. Methods: A population-based analytical cross-sectional study was conducted using pooled data from the Demographic and Family Health Surveys of Peru, 2015-2019. A total sample of 8850 adolescent girls aged 12 to 19 years who reported a history of sexual intercourse were included. To identify factors related to adolescent pregnancy, the study employed adjusted prevalence ratios (aPR) with 95% confidence intervals (95% CI). The aPR were obtained from a multivariable logistic regression model. Results: The prevalence of adolescent pregnancy among sexually active adolescents in Peru was 30.9% (95%CI: 29.4-32.4%). In the multivariable analysis; being 17-19 years (aPR: 1.48; 95%CI:1.33-1.64), being married or cohabitant (aPR: 4.01; 95%CI: 3.48-4.61) and belonging to the Quechua ethnicity group (aPR: 1.16; 95%CI: 1.07-1.25), were associated with a higher prevalence. Conversely, the following factors were associated with a lower prevalence of pregnancy: being employed (aPR: 0.81; 95%CI: 0.76-0.86), being currently studying (aPR: 0.43; 95%CI: 0.38-0.49), belonging to the second (aPR: 0.91; 95%CI: 0.85-0.97), third (aPR: 0.81; 95%CI: 0.74-0.89), fourth (aPR: 0.79; 95%CI: 0.69-0.91) and fifth (aPR: 0.59; 95%CI: 0.47-0.75) wealth quintile, initiating sexual relations in middle adolescente (aPR: 0.76; 95%CI: 0.69-0.83) or late adolescence (aPR: 0.40; 95%CI: 0.35-0.46), perceiving a future pregnancy as a problem (aPR: 0.77; 95%CI: 0.72-0.83) and having knowledge of the moment in the cycle when pregnancy can occur (aPR: 0.84; 95%CI: 0.77-0.92). Conclusions: Approximately three out of ten adolescents who initiated a sexual life had at least one pregnancy. Age, marital status, employment, education, wealth, ethnicity, age at first intercourse, knowledge of when in the cycle she may become pregnant, and perception of future pregnancy were associated with adolescent pregnancy. To decrease the prevalence of teenage pregnancy in Peru, it is imperative to enhance national policies concerning family planning and provide comprehensive sex education targeted at adolescents.

Características de las cartas al editor de las revistas biomédicas indizadas en SciELO-Perú / Characteristics of letters to the editor published in biomedical journals indexed in SciELO-Peru

Este artículo tuvo como objetivo describir las características de las cartas al editor publicadas durante el período 2014-2018 en las revistas biomédicas indizadas en SciELO-Perú en el año 2020. Se realizó un estudio descriptivo de las publicaciones ubicadas en la sección Cartas al editor de cada una de las revistas biomédicas indizadas en SciELO-Perú desde el año 2014 al 2018. Las variables fueron: frecuencia anual, colaboración académica, grado académico, filiación institucional, número de citaciones y de autores, así como propósito general y específico. Se hizo un análisis de las frecuencias en Google Sheets y STATA 14. El 12,40 por ciento del total de las publicaciones eran cartas al editor (9,95 por ciento en el año 2014 y 12,18 por ciento en el 2018). La participación estudiantil individual representó el 9,47 por ciento y las publicaciones realizadas en colaboración con profesionales fue del 18,68 por ciento. Predominaron las cartas de comentarios generales (38,68 por ciento), seguidas de hallazgos propios (34,74 por ciento) y comentarios sobre un artículo previo (26,58 por ciento). Aumentaron las publicaciones de hallazgos propios, las cuales resultaron las más citadas (media: 3,15). Las críticas sobre cuestiones metodológicas fueron del 9,21 por ciento, de las que solamente el 60 por ciento presentó réplica de los autores. Aquellas que denunciaban faltas éticas eran solo del 1,05 por ciento y ninguna comentaba la política editorial de la revista. La publicación de cartas al editor aumentó en los últimos años; sin embargo, su empleo como medio de revisión crítico y ético pospublicación es bajo, y la presentación de hallazgos propios fue uno de sus principales usos(AU)

The purpose of the present study was to describe the characteristics of letters to the editor published in the period 2014-2018 in biomedical journals indexed in SciELO-Peru in the year 2020. A descriptive study was conducted of publications included in the section Letters to the editor of each one of the biomedical journals indexed in SciELO-Peru in the period 2014-2018. The variables studied were yearly frequency, academic collaboration, academic degree, institutional affiliation, number of citations and authors, and general and specific purpose. Frequency analysis was based on Google Sheets and STATA 14. Of the total publications, 12.40 percent were letters to the editor (9.95 percent in the year 2014 and 12.18 percent in 2018). Contributions by individual students accounted for 9.47 percent, whereas publications developed in collaboration with professionals represented 18.68 percent. A predominance was found of general comments letters (38.68 percent), followed by personal findings (34.74 percent) and comments on a previous paper (26.58 percent). An increase was observed in personal findings publications, which were the most commonly cited (mean: 3.15). Critiques about methodological questions were 9.21 percent, of which only 60 percent received a reply from the authors. Letters denouncing ethical breaches were only 1.05 percent and none commented on the journal's editorial policy. Publication of letters to the editor has increased in recent years. However, their use as a critical and ethical post-publication review is low, and the presentation of personal findings was one of their main uses(AU)