Rodriguez Vasquez, Mery

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Rodriguez Vasquez, Mery
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meryrv@upeu.edu.pe
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    Performance of cervical cytology and HPV testing for primary cervical cancer screening in Latin America: an analysis within the ESTAMPA study
    (2023-09-20)
    Arianis Tatiana Ramírez  
    ;
    Joan Valls
    ;
    Armando Baena
    ;
    Freddy David Rojas
    ;
    Katherine Ramírez
    Background: Cervical cytology remains widely used as the initial tool in cervical cancer screening worldwide. WHO guidelines recommend replacing cytology with primary HPV testing to reach cervical cancer elimination goals. We assessed the performance of cytology and high-risk HPV testing to detect cervical precancer, cervical intraepithelial neoplasia (CIN) grade 3 or worse (CIN3+) among women aged 30-64 years participating in the ESTAMPA study. Methods: Women were screened with cytology and HPV across ESTAMPA study centres in Latin America. Screen-positives were referred to colposcopy with biopsy collection and treatment as needed. Those with no evident precancer were recalled at 18-months for a second HPV test to complete disease ascertainment. Performance indicators for cytology and HPV to detect CIN3+ were estimated. Findings: 30,606 participants with available cytology and HPV results were included in the analysis. A total of 440 histologically confirmed CIN3s and 30 cancers were diagnosed. Cytology sensitivity for CIN3+ was 48.5% (95% CI: 44.0-53.0), whereas HPV testing had a sensitivity of 98.1% (95% CI: 96.3-96.7). Specificity was 96.5% (95% CI: 96.3-96.7) using cytology and 88.7% (95% CI: 88.3-89.0) with HPV. Performance estimates varied substantially by study centre for cytology (ranging from 32.1% to 87.5% for sensitivity and from 89.2% to 99.5% for specificity) while for HPV results were more consistent across sites (96.7%-100% and 83.6-90.8%, respectively). Interpretation: The limited and highly variable sensitivity of cytology strongly supports transition to the more robust and reproducible HPV-based cervical screening to ensure progress towards global cervical cancer elimination targets in Latin America. Funding: IARC/WHO, UNDP, HRP/WHO, NCI and local funders.
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    Does Access to Point-of-Care Medical Information Improve Trauma and General Surgeons’ Clinical Knowledge in a Middle-Income Country? A Mixed-Methods Study with Random Assignment
    (2022-12-15)
    Helen E. Noble  
    ;
    Willy Jesús Neumann Ordoñez
    ;
    Gabriela Zavala Wong
    ;
    Manuel J Rodríguez
    ;
    David Ortega Checa
    BACKGROUND: Investing in continued medical education strengthens surgical systems. This study assessed the effectiveness of an evidence-based practice (EBP) tutorial and access to UpToDate (UTD) to improve EBP and understand how and why providers practice using evidence. STUDY DESIGN: This is a mixed-methods, implementation study at 9 public hospitals in Peru consisting of a didactic session for surgeons on EBP and Google Translate and support of applications for UTD access. Change in clinical knowledge scores (CKS), access and use of UTD, and impact of language pre-and postintervention were measured. Qualitative interviews uncovered reasons for these changes. RESULTS: Intervention participants had lower CKS at follow-up compared with baseline (odds ratio [OR] of higher score 0.41 [0.18,0.98]; p = 0.044), and this effect was modified (p = 0.003) to the extent that the reverse was true for control participants (OR 2.30 [1.13,4.71]; p = 0.022). Participants with 1 to 20 years of experience had significantly improved CKS compared with students/residents (1 to 10 years: OR 4.5 [1.1,18]; 11 to 20 years: OR 4.9 [1.4,17]); there was no evidence of a different CKS between providers with >20 years of experience compared with students/residents (OR 1.3 [0.5,3.7]). Administrative disconnect, usability, motivation, education, time, resources, and age influenced point-of-care medical information systems impact on knowledge and EBP. Participants reporting low English proficiency translated medical literature mostly used Google Translate. Those with low/no English reading proficiency had higher odds of reporting a negative impact on research than those with working (p = 0.007) or professional (p < 0.001) proficiency. CONCLUSIONS: Providing education on EBP, free UTD access, and translation solutions did not correlate with increased CKS due to complex barriers to using point-of-care medical information systems.
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    [Food intake of students graduating from basic education in the metropolitan area of Santiago, Chile].
    (1986-09-01)
    Daniza Ivanovic
    ;
    M Aguayo
    ;
    Mery Rodríguez Vásquez  
    ;
    I Trufello
    ;
    D Ballester
    This study pursued to evaluate the adequacy of the dietary intake of students graduating from Basic Education in the Metropolitan Area of Santiago, Chile. A random sample of 258 students from public and non-public schools (1:1), of both sexes (1:1) and from high, medium and low socioeconomic level (SEL) (1:1:1), was selected. Standard procedures for 24-hr dietary recall individual interviews were used to collect data. The students' dietary intake was then compared with the FAO/WHO 1973 Recommended Dietary Allowances. Results revealed that 53.5% and 62.0% of the sample registered a deficient and excessive intake for energy and protein, respectively. Protein contributed 13.2% of the dietary energy, fat, 27.1%, and carbohydrates, 59.8%. Animal and vegetable protein intake was found in the proportion of 1:1. As findings indicated, the dietary intake of students differed significantly according to SEL. Deficiencies in energy, vitamin A, riboflavin, niacin and calcium intake were observed, in both sexes, besides iron deficiency in the female group. It is considered that results could be useful for food and nutrition planning in school feeding programs.
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    [Food habits of high school graduates in the metropolitan area of Santiago, Chile].
    (1986-06-01)
    Isabel Zacarías
    ;
    M Aguayo
    ;
    Mery Rodríguez Vásquez  
    ;
    D Ballester
    ;
    Daniza Ivanovic
    The purpose of this study was to determine the food habits of Chilean high-school graduates, and measure the effect that socioeconomic level (SEL), type of school (public and private school), sex and age exerts on those habits. A random and stratified sample of 283 schoolers, according to type of school, sex and SEL, measured through the Graffar Modified Scale was selected for the study. Food habits were defined by the frequency of consumption of food, expressed as days per week and were compared with the Model Allowance established by the Ministry of Health of Chile. A food habits questionnaire was administered to students by duly trained interviewers, and were defined by the frequency of consumption of food groups. Data were analyzed by the chi-square procedure, analysis of variance and Student's "t" test. In accordance with the results, the most consumed foods (over 90% of students) were meat, poultry, eggs, potatoes, apples, bread, rice, oil and butter or margarine. On the other hand, the most disliked foods (40% and more of students) were fresh cheese, viscera, radish and chickpeas. The high SEL students showed a significantly greater frequency of consumption of dairy products, and of meat products and eggs (p less than 0.001). No differences were found according to type of school, sex and age of students. We conclude, therefore, that SEL exerts a significant effect on food habits, in spite of which they were adequate according to the Model Allowance.
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    Long-Range Transverse-Momentum Correlations and Radial Flow in Pb-Pb Collisions at the LHC
    (2025-11-17)
    S. Acharya  
    ;
    G. Aglieri Rinella
    ;
    L. Aglietta
    ;
    M. Agnello
    ;
    N. Agrawal
    This Letter presents measurements of long-range transverse-momentum correlations using a new observable, v_{0}(p_{T}), serving as a probe of event-by-event radial-flow fluctuations, the underlying radial expansion, and the medium's properties in heavy-ion collisions. Results are reported for inclusive charged particles, pions, kaons, and protons across various centrality intervals in Pb-Pb collisions at sqrt[s_{NN}]=5.02 TeV, recorded by the ALICE detector. A pseudorapidity-gap technique, similar to that used in anisotropic-flow studies, is employed to suppress short-range correlations. At low p_{T}, a characteristic mass ordering consistent with hydrodynamic collective flow is observed. At higher p_{T} (>3 GeV/c), protons exhibit larger v_{0}(p_{T}) than pions and kaons, in agreement with expectations from quark-recombination models. Comparisons to viscous hydrodynamic calculations with varying bulk viscosity and equation of state demonstrate the sensitivity of the v_{0}(p_{T}) observable to these key medium properties. The findings establish v_{0}(p_{T}) as a valuable addition to the set of observables used in Bayesian analyses for extracting the transport properties and constraining the equation of state of strongly interacting matter, while also helping to systematically explore its sensitivity and impact within such global studies.
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    Changes in Eating Habits and Lifestyles in a Peruvian Population during Social Isolation for the COVID-19 Pandemic
    (2021-12-01)
    Salomón Huancahuire‐Vega
    ;
    Edda E. Newball‐Noriega  
    ;
    Ricardo Rojas-Humpire  
    ;
    Jacksaint Saintila
    ;
    Mery Rodríguez-Vásquez  
    BACKGROUND: Peru has one of the highest infection and death rates in the world for the COVID-19 pandemic. The government implemented house confinement measures with probable consequences on lifestyle, particularly affecting eating habits, physical activity, sleep quality, and mental health. OBJECTIVES: The aim of this study was to assess the lifestyles, physical activity, and sleep characteristics, as well as changes in eating habits in a Peruvian population during the first wave of the COVID-19 pandemic. METHODS: A cross-sectional descriptive study was performed. We analyzed Peruvian adults based on an online self-administered questionnaire divided into sociodemographic, anthropometrics, COVID-19 diagnosis reported, lifestyle habits, and frequency of consumption of foods. RESULTS: During confinement for COVID-19, 1176 participants were studied. Of these, most reported weight gain (1 to 3 kg) and 35.7% were overweight. The lifestyles habits showed that 54.8% reported doing physical activity and 37.2% sleep less. The Peruvian sample presented a main meal pattern of breakfast (95.7%), lunch (97.5%), and dinner (89.1%). Likewise, eating habits before and during COVID-19 pandemic showed that vegetables (OR:1.56, CI95% 1.21-200), fruit (OR: 1.42, CI95% 1.10-1.81), legumes (OR:1.67, CI95% 1.23-2.28), and eggs (OR: 2.00, CI95% 1.52-2.65) presented significant consumption increase during social isolation, while bakery products (OR: 0.74, CI95% 0.56-0.97), meat, snack, refreshment, and fast food decreased in consumption. Other foods showed no significant differences. CONCLUSION: This study showed an important frequency of overweight and sleep changes. There was a slight increase in physical activity despite the social isolation measures and an increase in healthy eating habits; nevertheless, the majority reported gaining weight.
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