a Estudiante de medicina; b médico salubrista Recibido: 12/01/2016 Aprobado: 20/04/2016 Citar como: Maticorena-Quevedo J, Beas R, Anduaga-Beramendi A, Mayta-Tristán P. Prevalencia del síndrome de burnout en médicos y enfermeras del Perú, Ensusalud 2014. Rev Peru Med Exp Salud Publica. 2016;33(2):241-7. RESUMENObjetivos. Estimar la prevalencia del síndrome de burnout (SB) en los médicos y enfermeras del Perú en el año 2014, según los diferentes puntos de corte establecidos en la literatura. Materiales y métodos. Estudio transversal y descriptivo basado en la Encuesta Nacional de Satisfacción de Usuarios en Salud del año 2014 (ENSUSALUD-2014) que cuenta con un muestreo probabilístico bietápico. El SB fue identificado mediante el Maslach Burnout Inventory -Human Services Survey (MBI-HSS) utilizando diferentes puntos de corte para establecer su prevalencia: valores predeterminados, terciles y cuartiles. Resultados. De los 5062 profesionales de salud, 62,3% eran mujeres, 44,0% eran médicos, 46,0% pertenecían al MINSA y 23,1% laboraban en Lima. Se obtuvo una prevalencia global del SB de 2,8% (IC95%: 2,19-3,45) usando valores predeterminados; 7,9% (IC95%: 6,93-8,95) para puntos de corte según cuartiles; y 12,5% (IC95%:11,29-13,77) usando terciles. La prevalencia es mayor en médicos que en enfermeras, independientemente del punto de corte usado (3,7% vs 2,1% en valores predeterminados; 10,2 vs 6,1% con cuartiles, y 16,2 vs 9,5% mediante terciles). Conclusiones. La prevalencia del síndrome en personal sanitario es distinta en una misma población, según se utilicen los distintos puntos de corte descritos. Se recomienda el uso de los valores predeterminados por el creador del instrumento, hasta obtener puntos específicos para nuestro país. ABSTRACT Objectives.To estimate the prevalence of burnout syndrome (BOS) in Peruvian physicians and nurses in 2014 according to different cutoff points established in the literature. Materials and methods. This was a cross-sectional and descriptive study based on the National Survey on User Satisfaction of Health Services for 2014 (ENSUSALUD-2014), which features two-stage probability sampling. BOS was identified by the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) using different cutoff points to establish prevalence, including default values, terciles, and quartiles. Results. Of the 5062 health professionals, 62.3% were women, 44.0% were physicians, 46.0% belonged to the MINSA, and 23.1% worked in Lima. The overall BOS prevalence was 2.8% (95% CI, 2.4-3.2), when default values were used; the prevalence was 7.9% (95% CI, 7.3-8.6) when quartiles were used as cutoff points and 12.5% (95% CI, 11.4-13.6) when terciles were used as cutoff points. The prevalence was higher in doctors than in nurses, regardless of the cutoff point used (3.7% vs. 2.1% using default values, 10.2 vs. 6.1% using quartiles, and 16.2 vs. 9.5% using terciles). Conclusions. The prevalence of BOS in health workers differs within the same population when different cutoff points are used. The use of default va...

Thymosin alpha 1 is a peptide naturally occurring in the thymus that has long been recognized for modifying, enhancing, and restoring immune function. Thymosin alpha 1 has been utilized in the treatment of immunocompromised states and malignancies, as an enhancer of vaccine response, and as a means of curbing morbidity and mortality in sepsis and numerous infections. Studies have postulated that thymosin alpha 1 could help improve the outcome in severely ill corona virus disease 2019 patients by repairing damage caused by overactivation of lymphocytic immunity and how thymosin alpha 1 could prevent the excessive activation of T cells. In this review, we discuss key literature on the background knowledge and current clinical uses of thymosin alpha 1. Considering the known biochemical properties including antibacterial and antiviral properties, time-honored applications, and the new promising findings regarding the use of thymosin, we believe that thymosin alpha 1 deserves further investigation into its antiviral properties and possible repurposing as a treatment against severe acute respiratory syndrome coronavirus-2.

Factores de riesgo para el abandono del tratamiento de tuberculosis pulmonar sensible en un establecimiento de salud de atención primaria, Lima, Perú Risk factors for drug-sensitive tuberculosis therapy failure in a primary care health center in Lima, Peru RESUMEN Objetivo: Identificar los factores asociados al abandono del tratamiento antituberculoso en un centro de salud de atención primaria del distrito de Chorrillos, Lima, Perú. Materiales y métodos: Estudio de casos y controles retrospectivo no pareado. Se definió como caso a los pacientes que abandonaron el tratamiento por un periodo de 30 días consecutivos o más y como controles a los pacientes que terminaron el tratamiento antituberculoso. Se evaluó el puntaje de riesgo de abandono que se realiza en el centro de salud (≥22), así como variables demográficas. Se calculó el odds ratio (OR) e intervalos de confianza al 95% (IC95%) usando regresión logística. Resultados: Se incluyó 34 controles y 102 casos. En el análisis multivariado se encontró que quienes cursaron menos de seis años de educación (OR: 22,2; IC95%: 1,9-256,1) así como quienes tenían un puntaje ≥ a 22 puntos en la prueba de riesgo de abandono (OR= 21,4; IC95%: 6,3-72,4) tenían mayor probabilidad de abandonar el tratamiento antituberculoso. Conclusión: El abandono del tratamiento antituberculoso está asociado con tener menos de seis años de educación y un score mayor a 22 puntos en la prueba de abandono de tratamiento antituberculoso. Palabras clave:Tuberculosis; Factores de riesgo; Adhesión a la medicación; Tratamiento (fuente: DeCS BIREME). Suárez-Ognio L. Factores de riesgo para el abandono del tratamiento de tuberculosis pulmonar sensible en un establecimiento de salud de atención primaria, Lima, Perú. Acta Med Peru. 2016;33(1):21-8 Acta Med Peru. 2016;33(1):21-8Abandono del tratamiento antituberculoso Anduaga-Beramendi A, et al. ABSTRACTObjective: To identify associated factors with failure of antituberculous therapy in a primary health center in Chorrillos, Lima, Peru. Material and methods: Retrospective case control study with a 1:3 case-control ratio. A case was defined as a patient who discontinued the treatment for a period of 30 consecutive days or more, and a control as a patient successfully completing antituberculous therapy. The score for risk of failure measured in the health center (≥22) and demographic variables were assessed. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression. Results: Thirty-four cases and 102 controls were included. In the multivariate analysis, factors associated to a greater likelihood for a failure in antituberculous therapy were to have less than six years of education (OR: 22,2; 95% IC: 1,9-256,1) and to obtain a score greater or equal than 22 points in the test for risk of failure (OR= 21,4; 95% IC: 6,4). Conclusions: Failure of antituberculous therapy was associated with having less than six years of education and a score greater than or equal to 22 points in the test for risk of failure.

The coronavirus disease 2019 (COVID-19) pandemic is provoking a global public health crisis. Even though the academic world is intensively pursuing new therapies, there is still no ''game changer'' in the management of COVID 19. The Mammalian Target of Rapamycin (mTOR) is an ancient signaling system that has been proposed as a molecular tool used by coronaviruses and other RNA and DNA viruses in order to replicate and persist in the host cell. In recent years, Intermittent Fasting (IF), a practice consisting on a strict calorie restriction during a prolonged period of time during the day, has gained popularity due to its potential benefits in multiple health systems and in regulating inflammation. IF inhibits the mTOR pathway which is similar to the effects of Rapamycin in some animal models. mTOR inhibition and promotion of autophagy could potentially be the link between the possible direct benefits of IF in COVID-19 due to the interruption of the viral cycle (protein synthesis). Besides, IF has shown to be a strong anti-inflammatory in multiple prior studies, and may play a role in attenuating COVID -19 severity. This review hypothesizes the possible intersection between viral, immunological, and metabolic pathways related to mTOR and the potential mechanisms through which IF may improve clinical outcomes. Future prospective randomized controlled clinical trials to evaluate intermittent fasting (IF) regimens in order to prevent and treat moderate to severe forms of COVID-19 in humans are needed.

BackgroundEmigration of health-care workers is a problem within global health systems which affects many countries, including Peru. Several factors have caused health-care workers to emigrate, including burnout syndrome (BS). This study aims to identify the association between BS and its dimensions with the intention of physicians and nurses to emigrate from Peru in 2014.MethodsA cross-sectional study, based on a secondary analysis of the National Survey of Health Users (ENSUSALUD - 2014) was conducted. Sampling was probabilistic, considering the 24 departments of Peru. We include the questionnaire for physicians and nurses, accounting for 5062 workers. BS was measured by the Maslach Burnout Inventory-Human Services Survey. Adjusted odds ratio (OR) was calculated using multiple logistic regression.ResultsOf the study population, 44.1% were physicians, 37.7% males, and 23.1% were working in Lima. It was found that 2.8% [95% confidence interval (CI): 2.19–3.45] of health-care workers had BS. The overall prevalence of intention to emigrate among health-care workers was 7.4% (95% CI: 6.36–8.40). Association was found between BS and intention to emigrate in Peruvian health-care workers (OR = 2.15; 95% CI: 1.05–4.40). Emotional exhaustion was the BS dimension most associated with intention to emigrate (OR = 1.80; 95% CI: 1.16–2.78).ConclusionPhysicians and nurses from Peru who suffered from BS were more likely to have intention to emigrate. Policies should be established to reduce BS as a strategy to control “brain drain” from health-care workers of Peru.