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Introducción: La pandemia por la COVID-19 trajo consigo cambios en el comportamiento humano y afecciones psíquicas que afectan la salud mental. Objetivo: Estimar la adicción a los teléfonos inteligentes en adolescentes mujeres tras la pandemia por la COVID-19. Métodos: Estudio transversal realizado en noviembre y diciembre del 2022, en una institución educativa pública de Ica, Perú. Participaron 581 adolescentes que respondieron a un cuestionario con variables generales y la Escala de Adicción a los Teléfonos Inteligentes. Se aplicó un análisis estadístico descriptivo y multivariado mediante modelos lineales generalizados de la familia Poisson para evaluar la asociación entre las variables. Resultados: De las participantes, el 21,7 por ciento reveló adicción a los teléfonos inteligentes y el 48,7 por ciento se encuentra en riesgo alto de dependencia. Los conflictos familiares en el hogar (razón de prevalencia ajustada - RPa= 1,41; intervalo de confianza -IC 95 por ciento: 1,00-1,99) y los sentimientos de vergüenza (RPa= 1,44; IC 95 por ciento: 1,01-2,03), se asociaron a mayor adicción a los teléfonos inteligentes. No obstante, el sentimiento de tristeza, ansiedad o depresión y el hecho de sentirse rechazado por la sociedad presentaron asociación, no ajustada. Conclusiones: La adición a los teléfonos inteligentes y el riesgo de padecer este trastorno es alto en las adolescentes; existen variables generales susceptibles de ser modificadas que podrían mermar dicha afección comportamental inducida o potenciada por la pandemia de la COVID-19(AU)

Introduction: The COVID-19 pandemic brought with it changes in human behavior and psychic conditions that affect mental health. Objective: Estimate smartphone addiction in female adolescents after COVID-19 pandemic. Methods: Cross-sectional study, conducted during November to December 2022, in a public educational institution in Ica, Peru. A total of 581 adolescents participated and answered a questionnaire with general variables and the Smartphone Addiction Scale. A descriptive and multivariate statistical analysis was applied using Poisson family generalized linear models to evaluate the association between variables. Results: Of the participants, 21.7 percent revealed addiction to smartphones and 48.7 percent were at high risk of dependence on these devices. Family conflicts at home (adjusted prevalence ratio-RPa = 1.41; 95 percent confidence interval-CI: 1.00-1.99) and feelings of shame (RPa = 1.44; 95 percent CI: 1.01-2.03), were associated with higher smartphone addiction. However, feelings of sadness, anxiety or depression and feeling rejected by society showed an unadjusted association. Conclusions: Smartphone addiction and risk for this disorder is high in adolescent girls; there are general variables amenable to modification that could diminish such a behavioral condition induced or potentiated by the COVID-19 pandemic(AU)

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INTRODUCTION: Socioeconomic factors have been recognized by the WHO as determinants of health, and it is important to consider these factors in decision making to curb existing inequality in vaccination for SARS-CoV-2, which causes COVID-19. OBJECTIVE: We aimed to determine whether there is a correlation between socioeconomic factors and vaccination worldwide and measure inequality. METHOD: A study of secondary sources was carried out to assess inequality in vaccination against COVID-19 worldwide and its association with socioeconomic factors. For this assessment, 169 countries were chosen from January 2020 to March 2022 using LibreOffice and JASP 0.16.1.10. Several mathematical models and statistical tests were used, including a normality test, an analysis of frequencies and proportions, a Kruskal-Wallis test, Spearman's correlations, a Lorenz curve, a Concentration Index, and a slope. RESULTS: Correlations were found between socioeconomic factors and vaccination with one, two, and three doses. As the GDP showed correlations of 0.71 for one dose and 0.82 for three doses, we found that the greater the competitiveness of the countries, the higher the percentage of vaccinated individuals in their populations. According to the Concentration Index, there was greater inequality in vaccination with regard to receiving a higher number of doses, as reflected in the life expectancy indices of 0.16-0.19 and 0.50. The continent with the highest degree of inequality was Africa, and the continent with the lowest degree was America. South Americans were vaccinated with two doses at a rate of 6.19%/month, which was 4.3 times faster than Africans, with 72% of the population being vaccinated in South America, compared to only 16% in Africa. CONCLUSION: There is inequality in vaccination against COVID-19 with one, two, and three doses, which is associated with socioeconomic factors.

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Objetivo: Determinar los factores de riesgo que influyen en el fracaso al tratamiento individualizado de Tuberculosis Multidrogorresistente en la provincia de Ica. 2000-2014. Materiales y métodos: Estudio observacional, retrospectivo, tipo analítico, de casos y controles. La muestra estuvo conformada por 19 casos de fracaso al tratamiento individualizado, y por cada caso se tuvo dos controles de pacientes que curaron con tratamiento individualizado. Se realizó el análisis bivariado con un nivel de significancia del 5% se calculó del Odds Ratio (OR) con intervalo de confianza (IC) al 95%. Se realizó análisis de regresión logística. Resultados: En el análisis multivariado resultaron 4 factores de riesgo asociados a fracaso al tratamiento individualizado: resistencia a 5 o más drogas (OR=6,67, p=0,027), tener IMC menor de 18.5 al inicio del tratamiento (OR=7,61 p=0,023), presentar hemoptisis durante el tratamiento (OR= 19,89, P=0,001) y la presencia de cavernas en la radiografía de tórax inicial (OR=27,95, p=0,005). Conclusiones: Los pacientes con resistencia a 5 o más drogas antituberculosas, con IMC menor a 18.5, con hemoptisis durante el tratamiento y los que presentan caverna en la radiografía de tórax, tienen mayor riesgo de fracasar al tratamiento individualizado. (AU)

Objective: To determine the risk factors that influence the failure to individualized treatment of multidrug-resistant tuberculosis in the province of Ica. 2000-2014. Materials and methods:Observational, retrospective study, analytical type, of cases and controls. The sample consisted of 19 cases of failure to individualized treatment, and for each case there were two controls of patients who cured with individualized treatment. The bivariate analysis was performed with a level of significance of 5% was calculated from the Odds Ratio (OR) with 95% confidence interval (CI). Logistic regression analysis was performed. Results: In the multivariate analysis, there were 4 risk factors associated with failure to individualized treatment: resistance to 5 or more drugs (OR = 6.67, p = 0.027), having a BMI less than 18.5 at the beginning of treatment (OR = 7, 61 p = 0.023), presenting hemoptysis during treatment (OR = 19.89, P = 0.001) and the presence of caverns on the initial chest radiograph (OR = 27.95, p = 0.005). Conclusions: Patients with resistance to 5 or more antituberculous drugs, with a BMI less than 18.5, with hemoptysis during treatment and those who have a cavern on chest radiography, have a higher risk of failing individualized treatment. (AU)

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We are presenting an case of a patient with upper gastrointestinal bleeding presented as hematemesis preceded by profuse vomiting secondary to a duodenal obstruction, caused by an impacted giant biliary stone in the duodenal bulb (Bouveret syndrome). The diagnosis was made during an upper gastrointestinal endoscopy and confirmed by surgery. We report and discuss this case as it is the first presentation in our institution.

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Se presenta un caso de paciente con sangrado digestivo alto en forma de hematemesis precedido de vómitos profusos secundarios a obstrucción duodenal, causada por un cálculo gigante impactado en el bulbo duodenal (síndrome de Bouveret). El diagnóstico se realizó mediante video-endoscopía digestiva alta y se confirmó en el acto operatorio. Se presenta y discute el caso al reportarse por primera vez en nuestra institución.

We are presenting an case of a patient with upper gastrointestinal bleeding presented as hematemesis preceded by profuse vomiting secondary to a duodenal obstruction, caused by an impacted giant biliary stone in the duodenal bulb (Bouveret syndrome). The diagnosis was made during an upper gastrointestinal endoscopy and confirmed by surgery. We report and discuss this case as it is the first presentation in our institution.

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Objetivo: Identificar la percepción del Clima Organizacional en trabajadores de un Hospital General de Ica. Materiales y Métodos: Estudio descriptivo transversal, que incluyó 7 grupos ocupacionales.Se incluyó a 178 trabajadores del hospital, seleccionados mediante muestreo aleatorio proporcional a grupos ocupacionales. El instrumento fue un cuestionario con 55 preguntas a través de las cuales se valoró el Potencial humano, Diseño organizacional y Cultura organizacional, con sus 11 dimensiones. Se calificó según puntuación como clima no saludable de 55 a 128, clima por mejorar de 129 a 202, y clima saludable de 203 a 275. Resultados: El clima organizacional percibido por los trabajadores del Hospital tuvo un puntaje promedio de 164 es decir un clima por mejorar. El 12.9% de trabajadores percibió un clima saludable. De las 11 dimensiones estudiadas, el clima que se percibió fue por mejorar, excepto en identidad, dimensión en la cual se tuvo, en promedio, un clima saludable. Sin embargo, la identidad según grupos ocupacionales, tuvo un clima por mejorar en el grupo de enfermeras, técnicos, otros profesionales y artesanos. Conclusiones: Este estudio claramente indica que es necesario mejorar el clima organizacional de la institución, aplicando un plan de intervención con proyectos de mejora del entorno organizacional. (AU)

Objective: To identify worker's perception of the organizational climate at General Hospital in Ica. Materials and Methods: A cross sectional study that included 7 different occupational groups within the institution was used. Participants, 178 hospital workers in total, were selected by random sampling proportional to each occupational group. Participants were asked 55 questions that addressed 11 dimensions of organizational culture. The organizational climate was rated as unhealthy with score of 55 to 128, intermediate from 129 to 202 or healthy of 203 to 275. Results: The score for organizational climate was 164 points, which is considered an intermediate climate that needs improvement. Approximately 12.9% of respondents considered the climate to be healthy. Of the 11 dimensions studied, only the identity dimension was considered healthy, although nurses, technicians, artisans and other professionals considered it in need of improvement as well. Conclusions: This study clearly indicates it is necessary to improve the organizational climate of the institution. This could be achieved by developing and implementing proper intervention projects. (AU)

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Objetivo: Determinar los factores de riesgo para resistencia a medicamentos antituberculosos en pacientes con tuberculosis pulmonar multidrogorresistente. Material y Métodos: El dise±o del estudio es analítico, de casos y controles, pareados por edad, procedencia y sexo. Se incluyó en el estudio 51 casos y 102 controles. Se definió como caso, a todo paciente con diagnóstico de tuberculosis pulmonar multidrogorresistente, y como controles a los pacientes con diagnóstico de Tuberculosis Pulmonar que egresaron al término de tratamiento como curados. Todos los pacientes fueron registrados en el Comité de evaluación de retratamiento del Programa de control de Tuberculosis. Resultados: Los factores de riesgo encontrados en este estudio fueron los abandonos de tratamiento (OR= 7.54,P = 0.0001), tener antecedentes de tratamiento (OR= 6.91, P = 0.0000001) , haber tenido tratamiento inicial con drogas de segunda línea para Tuberculosis (OR = 10.98, P = 0.008) , tener tratamiento con esquemas diferentes al normado por el Programa de Control de Tuberculosis (OR= 7.07, P = 0.001), tomar medicamentos en casa sin supervisión(OR=5.19, P =0.000008), tener contacto domiciliario con pacientes con Tuberculosis Multidrogorresistente, (OR = 15.09, P = 0.000005), tener contacto extradomiciliario con pacientes con Tuberculosis multidrogorresistente (OR12.49, P =0.000005) y tener un familiar fallecido de Tuberculosis (OR= 8.78,p= 0.000008). Conclusiones: Es importante tener presente los factores de riesgo para Tuberculosis Multidrogorresistente encontrados en el presente estudio, para evitar nuevos casos dentro de los contactos, y usar esquemas basados en los lineamientos del Programa de control de Tuberculosis.

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