Soriano Moreno, Anderson Nelver Elías

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  • Publicacion
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    Síndrome de burnout y calidad de sueño en estudiantes de Medicina en la etapa clínica de la Universidad Peruana Unión (UpeU) durante 2022
    (2024-11-19)
    Calderon Ramos, Luis Denys
    ;
    Villalba Arestigue, Tatiana Marjori
    ;
    Soriano Moreno, Anderson Nelver Elías  
    ;
    Cabanillas León, Abel Ricardo
    el síndrome de burnout entre estudiantes de Medicina se caracteriza por agotamiento emocional y fracaso percibido, con causas multifactoriales, incluyendo factores organizacionales. La calidad del sueño es crucial para prevenirlo. El objetivo de este estudio fue determinar la asociación entre el desarrollo del síndrome de burnout y la calidad del sueño de estudiantes de Medicina. este estudio incluyó 253 estudiantes de Medicina en etapa clínica de la Escuela de Medicina Humana de la Universidad Peruana Unión. Se utilizaron cuestionarios para evaluar el burnout (MBI-URPMSS) y la calidad del sueño (PSQI), calculamos el coeficiente de Spearman para evaluar la asociación entre las puntuaciones de agotamiento y las puntuaciones de calidad del sueño. Creamos modelos de regresión lineal simple y múltiple para evaluar la puntuación de las dimensiones del síndrome de burnout y la calidad de sueño. se incluyeron 253 estudiantes. Se encontró que por cada punto adicional en agotamiento emocional y despersonalización, la puntuación del sueño aumentó en 0,18 y 0,16 (IC 95%, 0,12–0,24; p < 0,001), (IC 95%, 0,12–0,29; p < 0,001). Por cada punto adicional en la dimensión de realización personal en promedio se disminuyó la puntuación del PSQI en 0,04 (IC 95%, − 0,11–0,03; p = 0,261) Este patrón se mantuvo en el modelo de regresión ajustado. se ha encontrado que la mala calidad del sueño es común entre los estudiantes de Medicina, con una puntuación promedio en el PSQI de 8,7. Además, se ha observado una asociación estadísticamente significativa entre el agotamiento emocional y la despersonalización del síndrome de burnout con la mala calidad del sueño, mientras que no se encuentra una asociación significativa con la dimensión de realización personal. Burnout syndrome among medical students is characterized by emotional exhaustion and perceived failure, with multifactorial causes, including organizational factors. Sleep quality is crucial for its prevention. The objective of this study was to determine the association between the development of burnout syndrome and sleep quality among medical students. This study included 253 clinical-stage medical students from the School of Human Medicine at Universidad Peruana Unión. Questionnaires were used to assess burnout (MBI-URPMSS) and sleep quality (PSQI). Spearman's coefficient was calculated to evaluate the association between burnout scores and sleep quality scores. Simple and multiple lineal regression models were created to assess the dimensions of burnout syndrome and sleep quality. A total of 253 students were included. It was found that for every additional point in emotional exhaustion and depersonalization, the sleep score increased by 0.18 and 0.16 (95% CI, 0.12–0.24; p < 0.001), (95% CI, 0.12–0.29; p < 0.001). For each additional point in the personal accomplishment dimension, the PSQI score decreased by 0.04 on average (95% CI, − 0.11−0.03; p = 0.261). This pattern was maintained in the adjusted regression model. Poor sleep quality is common among medical students, with an average PSQI score of 8.7. Moreover, a statistically significant association was observed between emotional exhaustion and depersonalization in burnout syndrome and poor sleep quality, while no significant association was found with the personal accomplishment dimension.
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    Retos y prioridades en la Seguridad y salud en el Trabajo en Chile, 2025
    (2025-07-22)
    Pia Delano  
    ;
    Santiago Mansilla
    ;
    Claudia Muñoz
    ;
    Cristián Villarroel
    ;
    Patricia Silva
    El objetivo de esta Editorial es ofrecer un resumen sobre los principales hallazgos y desafíos identificados en el Perfil de Seguridad y Salud en el Trabajo de Chile, 2024. Este perfil ha sido desarrollado en colaboración con entidades gubernamentales, universidades y expertos en salud ocupacional a nivel nacional e internacional. Se destaca los principales desafíos presentes en el país, y se proponen prioridades para mejorar las condiciones laborales y salud de la población trabajadora chilena.
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    Percutaneous coronary intervention versus optimal medical therapy for stable coronary artery disease: An umbrella review
    (2024-03-01)
    Soriano‐Moreno, David R.
    ;
    Fernandez‐Guzman, Daniel
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    Tuco, Kimberly G.  
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    Soriano Moreno, Anderson Nelver Elías  
    ;
    Ccami‐Bernal, Fabricio
    Background: Invasive management of stable coronary artery disease is still a controversial topic. The purpose of this umbrella review was to synthesize systematic reviews (SRs) that evaluate the benefits and harms of percutaneous coronary intervention (PCI) versus optimal medical therapy (OMT) in patients with stable coronary artery disease. Methods: We systematically searched PubMed/MEDLINE, Embase, and CENTRAL from 2018 to August 7, 2022. We included SRs with meta-analyses of randomized controlled trials (RCTs) that evaluated the question of interest. We assessed the methodological quality of the SRs with the AMSTAR-2 tool. We summarized the results of the outcomes for each SR. We calculated the degree of overlap of the RCTs included in the SRs using the corrected covered area (CCA). Results: We found 10 SRs with meta-analyses. The SRs included 3 to 15 RCTs. The degree of overlap among the SRs was very high (CCA > 15%). No SR evaluated the certainty of the evidence using the GRADE system and 9 out of 10 had critically low methodological quality. The SRs reported heterogeneous results for the outcomes of all-cause mortality, myocardial infarction, revascularization, and angina. On the other hand, for the outcomes of cardiovascular mortality and stroke, all SRs agreed that there were no differences between PCI and OMT alone. Conclusions: We found 10 SRs on the use of PCI compared to OMT alone for patients with stable coronary artery disease. However, none had high methodological quality, none evaluated the certainty of the evidence using the GRADE approach, and the results were inconsistent for several outcomes. This variability in evidence may result in divergent clinical decisions for the management of stable coronary artery disease among healthcare professionals. It is necessary to perform a high-quality SR using the GRADE approach to clarify the balance of benefits and harms of PCI.
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    Prevalence and incidence of hypothyroidism and hyperthyroidism in patients with chronic kidney disease on dialysis: a systematic review and meta-analysis
    (2026-04-21)
    Castro Diaz, Sharong Dayan  
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    Castro-Diaz, Jennifer D.
    ;
    Ruiz-Vargas, Viviana M.
    ;
    Soriano Moreno, Anderson Nelver Elías  
    ;
    Soriano‐Moreno, David R.
    BACKGROUND AND HYPOTHESIS: Chronic kidney disease (CKD) affects thyroid metabolism, increasing the risk of hypothyroidism and hyperthyroidism. Dialysis further alters hormone levels through impaired synthesis, iodine imbalance, and treatment-related factors. This study aimed to evaluate the prevalence and incidence of hypothyroidism and hyperthyroidism in patients with CKD on dialysis. METHODS: We conducted a search in the Scopus and PubMed databases up to November 29, 2024. We included studies reporting prevalence or incidence data on hypothyroidism or hyperthyroidism (clinical or subclinical) in CKD patients on dialysis (hemodialysis or peritoneal dialysis). A random-effects model meta-analysis of proportions was used to calculate pooled prevalence estimates. RESULTS: A total of 39 studies were included, with sample sizes ranging from 40 to 8840 participants. The prevalence of hypothyroidism was 15.9% (95% CI: 13.0 to 19.0; I²: 96.2%), with 5.6% for clinical hypothyroidism and 11.2% for subclinical hypothyroidism (notably higher in peritoneal dialysis). The prevalence of hyperthyroidism was 5.1% (95% CI: 2.7 to 8.2; I²: 93.8%), with 0.9% for clinical hyperthyroidism and 3.3% for subclinical hyperthyroidism. Meta-regression analyses indicated that a longer mean duration on dialysis was associated with a lower prevalence of hypothyroidism (p = 0.008). Only one study reported the incidence of hypothyroidism (10.9%) and hyperthyroidism (4.9%), thus evidence on incidence remains scarce. CONCLUSION: The prevalence of hypothyroidism and hyperthyroidism in patients with CKD on dialysis is high, although with high heterogeneity among studies. Evidence on incidence remains limited and should be interpreted as exploratory. These findings support increased clinical vigilance and consideration of early detection strategies rather than definitive screening policies.
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    Prevalencia del síndrome de fragilidad y factores asociados en adultos mayores
    (2020-06-03)
    Herrera-Perez, Dennis
    ;
    Soriano Moreno, Anderson Nelver Elías  
    ;
    Rodrigo-Gallardo, Paola K.
    ;
    Toro‐Huamanchumo, Carlos J.
    RESUMEN Introducción: En Latinoamérica, la prevalencia del síndrome de fragilidad en adultos mayores no institucionalizados de 60 años a más oscila entre 7,7 y 39,3 %. En Perú, pocos estudios han abordado este tema y sus factores asociados en poblaciones similares. Objetivo: Identificar la prevalencia de fragilidad y los factores asociados en adultos mayores pertenecientes a siete centros de atención primaria. Métodos: Estudio transversal analítico cuya variable desenlace fue la presencia de fragilidad, según criterios de Fried. Se incluyeron también datos sociodemográficos (para la ocupación se usó la clasificación SEE y Sem FyC), tamizaje de depresión (con la escala de Yesavage), grado de funcionalidad (con el índice de Barthel) y las comorbilidades (usando el índice Geriátrico de Comorbilidad y el índice de severidad de Greenfield). Resultados: Se evaluaron 116 adultos mayores, la prevalencia de fragilidad fue de 20,7 %. Los factores asociados fueron tener dos o más enfermedades (RPa = 3,33; IC 95 %: 1,04 - 10,68), tener depresión moderada (RPa = 6,50; IC 95 %: 2,52 - 16,75) y dependencia moderada para la realización de AVD (RPa = 2,63; IC 95 %: 2,63 - 14,15). Los factores protectores fueron haber tenido una ocupación clase III (RPa = 0,11; IC 95 %: 0,02 - 0,54), IV (RPa = 0,07; IC 95 %: 0,01 - 0,35) o V (RPa = 0,24; IC 95 %: 0,09 - 0,60) y el vivir con algún familiar (RPa = 0,25; IC 95 %: 0,08 - 0,74). Conclusión: Uno de cada cinco adultos mayores fue frágil. Los síntomas depresivos, tener dos o más comorbilidades y el ser dependiente para las actividades de la vida diaria fueron factores asociados a la fragilidad. Por su parte, trabajar en cargos no directivos y el vivir acompañado de algún familiar fueron factores protectores.
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    Metabolic Syndrome and Risk of Peripheral Arterial Disease: A Systematic Review and Meta-Analysis
    (2022-09-21)
    Soriano‐Moreno, David R.
    ;
    Fernandez-Morales, Jared
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    Medina Ramirez, Sebastian Andre  
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    Coico-Lama, Abdiel H.
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    Soriano Moreno, Anderson Nelver Elías  
    This systematic review aimed to evaluate metabolic syndrome as a risk factor for the development of peripheral arterial disease (PAD). We searched in four databases: (1) PubMed, (2) Web of Science, (3) Scopus, and (4) Embase until March 2021. We included cohort studies that evaluated the risk of PAD in patients with and without metabolic syndrome. Study selection, data extraction, and risk of bias analysis were performed independently by 2 authors. We used a random-effects model to conduct a meta-analysis of effect measures [hazard ratio (HR), risk ratio (RR), and odds ratio (OR)]. Individual analyses were performed according to the diagnostic criterion used for metabolic syndrome. We included 7 cohort studies with a total of 43 824 participants. Most of the studies were performed in the general adult population. The metabolic syndrome and PAD diagnostic criteria used in the individual studies were heterogeneous. Almost all studies using RR found an association between metabolic syndrome and the development of PAD (RR: 1.31; confidence interval 95%: 1.03-1.59; I 2 : 15.6%). On the other hand, almost all the studies that used HR found no association between the two variables. All studies had a low risk of bias. In conclusion, available evidence on the association between metabolic syndrome and the risk of developing PAD is inconsistent. However, given the high prevalence of risk factors that patients with metabolic syndrome have, testing to rule out PAD could be recommended. Future studies should analyze each component of the metabolic syndrome separately and according to the severity of PAD.
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    P-2059. Perceptions and Factors Associated with Uptake of Monovalent XBB.1.5 BNT162b2 COVID-19 Vaccine among Healthcare Workers in Peru
    (2025-01-29)
    Gonzales-Zamora, Jose A
    ;
    Araoz-Salinas, Julieta M
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    Quispe‐Vicuña, Carlos
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    Reátegui García, Martín Ernesto
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    Ortiz-Saavedra, Brando
    Abstract Background The implementation of the XBB.1.5 BNT162b2 COVID-19 vaccine (updated vaccine) occurred in Peru in January 2024, since then, many questions about its efficacy and safety have been raised. Addressing these concerns is crucial, especially among healthcare workers, given their high risk of acquiring COVID-19 and their role in promoting vaccination. This study investigated the factors and perceptions associated with healthcare workers’ uptake of the updated vaccine.Figure 1:Perceptions about the updated monovalent vaccine among healthcare workers in Peru Methods We conducted a cross-sectional study based on an online survey from March 21 to May 1, 2024. Healthcare workers (physicians, nurses, etc.) living and practicing in Peru were included. We calculated crude prevalence ratios with 95% confidence intervals to determine the associated factors and perceptions using Poisson regression with robust variance.Table 1:Factors associated with uptake of the updated monovalent vaccine among healthcare workers (Page 1) Results We included 393 healthcare workers, predominantly female (55.2%) and physicians (63.9%), almost half aged 30-49 years (50.9%). The majority (72.8%) reported not being vaccinated with the updated vaccine, but 65% of them intended to do it. Regarding perceptions, more than 70% of respondents thought the updated vaccine was necessary and protective against severe COVID-19 and mortality, but only 16.5% believed it caused severe adverse events. Only 24.7% felt the Peruvian Ministry of Health was informing well about the vaccines (Figure 1). In the bivariate analysis, the uptake of this vaccine was significantly higher among those who had a history of COVID-19 (p = 0.005), had received the bivalent vaccine (p< 0.001), or more than five vaccine doses (p< 0.001), and among those who felt the vaccine should be recommended (p=0.015) or even mandatory for high-risk people (p=0.04). On the other hand, the uptake was lower in those who thought the vaccine was not necessary (p=0.043) or did not protect against mortality (p=0.037) (Table 1).Table 1:Factors associated with uptake of the updated monovalent vaccine among healthcare workers (Page 2) Conclusion History of COVID-19, receiving multiple vaccine doses, and recommending the updated vaccine for high-risk people are factors associated with vaccine uptake. There are still major concerns about the government's communication regarding vaccination. These findings underscore the importance of targeted interventions and communication strategies to improve the poor vaccination rate among healthcare workers in Peru.Table 1:Factors associated with uptake of the updated monovalent vaccine among healthcare workers (Page 3) Disclosures All Authors: No reported disclosures
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    Viral–bacterial codetection and clinical and laboratory characteristics in children hospitalized with lower respiratory tract infections in a private hospital in Lima, Peru: a cross-sectional study
    (2026-05-08)
    Rojas-Cosi, Ana F.
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    Soriano‐Moreno, David R.
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    Soriano Moreno, Anderson Nelver Elías  
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    Diaz Reyes, Nelson Fidel  
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    Bobadilla, Fernando
    BACKGROUND: Viral-bacterial codetection is common and may increase clinical severity, but evidence in the Peruvian pediatric population is limited. The objective of the present study was to evaluate the clinical, laboratory, and seasonal characteristics associated with viral-bacterial codetection in children hospitalized for lower respiratory tract infections (LRTIs). METHODS: Cross-sectional secondary database study from a private hospital in Lima, Peru. We included patients < 13 years hospitalized for LRTIs with RT-qPCR results for respiratory viruses and/or bacteria. Viral-bacterial codetection was compared against other detection patterns using Poisson regression for binary outcomes and linear regression for continuous outcomes, with false discovery rate (FDR) correction for multiple comparisons. RESULTS: A total of 548 patients were included (median age 2.0 years; 50.5% female). Viral-bacterial codetection was identified in 21.5% of patients (n = 118), with RSV + Haemophilus influenzae being the most frequent combination. Compared with other detection patterns, viral-bacterial codetection was significantly associated with a higher prevalence of crackles (aPR: 1.30; 95% CI: 1.08-1.57), lower oxygen saturation at admission (β: -0.57; 95% CI: -1.04 to - 0.10), higher platelet counts (β: 30,452; 95% CI: 5,113-55,792), higher hemoglobin levels (β: 0.29 g/dL; 95% CI: 0.03-0.56), and longer hospital stay (β: 0.66 days; 95% CI: 0.02-1.29). However, after FDR correction for multiple comparisons, none of these associations reached statistical significance (q-values: 0.056-0.113). No difference was detected according to seasonality. CONCLUSIONS: Viral-bacterial codetection was common and was associated with crackles, lower oxygen saturation, longer hospital stay, and higher platelet counts; however, after FDR correction, none of these associations remained statistically significant, underscoring the exploratory nature of these findings and the need for larger, confirmatory studies.
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    Physical Inactivity is Associated with Job Burnout in Health Professionals During the COVID-19 Pandemic
    (2023-04-01)
    Plaza-Ccuno, Jhoes Naylin R
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    Vasquez Puri, Cristabel
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    Calizaya Milla, Yaquelin Eveling  
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    Morales Garcia, Wilter Charming  
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    Huancahuire Vega, Salomon  
    Background: The pandemic has drastically impacted lifestyles, including the frequency, duration, and intensity of physical activity, which, in turn, leads to negative effects on job burnout among healthcare workers. Objective: This study evaluated the association between the level of physical activity and job burnout in a sample of health professionals during health emergency. Methods: In this cross-sectional study, 300 workers working in a public hospital, located in the city of Rioja, Department of San Martin, Peru, were considered. Data were collected through an online and face-to-face survey. Job burnout was assessed using a validated questionnaire adapted to the Peruvian population and physical activity was assessed based on a single item. Crude and adjusted linear regression models were created to assess the association between the frequency of physical activity performed weekly and the level of job burnout. Results: In the crude models, it was observed that participants who performed physical activity 1-2 times, 3-4 times, or more than 4 times per week had, respectively, 6.29 (95% CI, 11.00-1.59), 14.28 (95% CI, 21.70-6.85), and 14.95 (95% CI, 25.17-4.72) lower job burnout points compared to those who never performed physical activity. In the model adjusted for confounding variables, the association of this result was maintained, showing a dose-response effect. Conclusion: These findings suggest the need for the implementation of health education programs that include physical activity to minimize the negative effects of job burnout and ensure better medical care by health professionals for the benefit of patients.
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    Comorbilidades asociadas a la mortalidad por COVID-19 en adultos en Lima, Perú: un estudio de cohorte retrospectiva
    (2023-06-30)
    M. Gabriela Soto-Cabezas
    ;
    Mary F. Reyes-Vega
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    Anderson N. Soriano-Moreno  
    ;
    Luis Ordoñez Ibargüen
    ;
    Kevin S. Martel
    OBJECTIVES.: Motivation for the study. During the COVID-19 pandemic, the mortality rate from this disease was higher in adults and the elderly. Therefore, it is important to identify the factors that were associated with mortality from COVID-19 in adults, by age group. Main findings. Chronic neurological disease, kidney disease, liver disease, and cancer increased the risk of dying from COVID-19 in the three age groups we analyzed, which were made up of hospitalized patients from Lima and Callao. The risk of mortality associated with comorbidities was higher in patients aged 18 to 29. Implications. This study helps to identify the groups of patients with the highest risk of death from COVID-19, according to age group and type of comorbidity. . To evaluate comorbidities associated with mortality in adult patients hospitalized due to COVID-19 in hospitals in Lima and Callao. MATERIALS AND METHODS.: In this retrospective cohort study, we analyzed data from adult patients hospitalized due to COVID-19 reported to the National Epidemiological Surveillance System of the Peruvian Ministry of Health from March to October 2020. We estimated relative risks with 95% confidence intervals using Poisson regression models with robust variance to assess comorbidities associated with mortality by age group: young adults (18-29 years), adults (30-59 years) and older adults (≥60 years). RESULTS.: We included 2366 young adults, 23,781 adults and 25,356 older adults. Older adults had the highest mortality (63.7%) compared to adults (27.1%) and young adults (8.5%). Regardless of age group, the presence of neurological disease, renal disease, liver disease, and cancer was associated with an increased risk of mortality. Additionally, cardiovascular disease was also a risk factor in young adults; obesity, diabetes, cardiovascular disease, chronic lung disease, and immunodeficiency in adults; and obesity and chronic lung disease in the elderly. CONCLUSIONS.: Regardless of age groups, individuals with chronic neurologic disease, renal disease, liver disease, and cancer were at high risk of death from COVID-19.
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