Rodriguez Vasquez, Mery

Preferred name
Rodriguez Vasquez, Mery
Main Affiliation
Email
meryrv@upeu.edu.pe
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  • Publicacion
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    Gene score to quantify systemic inflammation in patients with acutely decompensated cirrhosis
    (2025-02-26)
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    Ferrán Aguilar
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    Alberto Queiróz Farias
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    Juan José Lozano
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    Cristina Sánchez-Garrido
    BACKGROUND AND AIMS: Quantifying systemic inflammation (SI) in acutely decompensated cirrhosis (ADC) is of major importance because SI is a driver of the most severe forms of ADC, including acute-on-chronic liver failure (ACLF). Blood biomarkers of SI already evaluated in ADC failed to appropriately assess SI in ADC. We aimed to investigate whether gene expression related to circulating immune cells could quantify SI in ADC. METHODS: Standard biomarkers (white cell count, C reactive protein, cytokines) and genome-wide RNA expression (RNA-sequencing) were obtained in blood from 700 patients with ADC at the time of their hospital admission. A composite score based on standard biomarkers of SI (Chronic Liver Failure-Standard Biomarkers Composite (CLIF-SBC) score) and a gene score (CLIF-Systemic Inflammation Gene (SIG) score) composed of the 28 top differentially expressed immune cell-related genes in the comparison between high-severity and low-severity clinical phenotypes were computed. Among the 700 patients, the CLIF-SIG score was repeated once during follow-up in 375 patients, and 3 times or more in 46 patients. RESULTS: The CLIF-SIG score was more accurate in reflecting clinical severity induced by SI than the CLIF-SBC score (area under the curve 0.803 vs 0.658). A CLIF-SIG score of 0.386 (Youden Index) was the best cut-off level discriminating patients with poor outcomes from the others, in all clinical scenarios. Sequential measurement of the CLIF-SIG score showed that 78% of patients were admitted at the peak or descending part of the SI-wave. ACLF developed during hospitalisation in 80% of patients with a CLIF-SIG score >0.386 on admission. CONCLUSIONS: In patients with ADC, the CLIF-SIG score is an accurate estimator of SI, clinical course severity and prognosis.
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    Consumo de alimentos ultraprocesados en estudiantes de secundaria durante la pandemia de COVID-19 Lima, Perú
    (2025-01-22)
    Dante Roel Andrada Fernandez
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    Los alimentos ultraprocesados son aquellos productos que se encuentran en los supermercados y que pasaron por un extenso proceso industrial. A menudo, estos alimentos incluyen ingredientes artificiales y aditivos. Objetivo: Este estudio tuvo como objetivo evaluar el consumo de alimentos ultraprocesados en estudiantes de secundaria durante la pandemia de COVID-19 Materiales y Métodos: Se realizó un estudio transversal con 135 estudiantes de secundaria en Lima, Perú. Se utilizó un cuestionario autoadministrado para medir la frecuencia de consumo de alimentos ultraprocesados. Las asociaciones entre las variables sociodemográficas y el consumo de los alimentos ultraprocesados se evaluaron mediante la prueba de chi-cuadrado de independencia, considerando un nivel de significancia del 5%. Resultados: El consumo permanente de alimentos ultraprocesados fue bajo, inferior al 10% en la mayoría de las categorías. Los estudiantes varones mostraron un mayor consumo regular y frecuente en comparación con las mujeres, mientras que los estudiantes de grados superiores (4to y 5to) y los de mayor edad (16-17 años) presentaron un consumo más constante. Además, los estudiantes adventistas reportaron un mayor consumo nulo o esporádico en comparación con los no adventistas. Sin embargo, no se encontraron diferencias estadísticamente significativas entre los grupos sociodemográficos evaluados. Conclusión: Aunque el consumo permanente de alimentos ultraprocesados fue bajo, el consumo esporádico y regular sigue siendo preocupante. Las intervenciones educativas deberían enfocarse en reducir el consumo de estos productos entre los adolescentes, especialmente en aquellos con mayor riesgo.
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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)
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    Willy Jesús Neumann Ordoñez
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    Gabriela Zavala Wong
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    Manuel J Rodríguez
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    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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    Consumo de alimentos ultraprocesados en estudiantes de secundaria durante la pandemia de COVID-19, Lima, Perú
    (2025-07-23)
    Dante Roel Andrada Fernandez
    ;
    Fundamentos: Durante la pandemia de COVID-19, los hábitos alimentarios de los adolescentes han sufrido cambios significativos, con un aumento en el consumo de alimentos ultraprocesados. Este estudio tuvo como objetivo evaluar el consumo de alimentos ultraprocesados en estudiantes de secundaria durante la pandemia de la COVID-19. Métodos: Se realizó un estudio transversal con 135 estudiantes de secundaria en Lima, Perú. Se utilizó un cuestionario autoadministrado para medir la frecuencia de consumo de alimentos ultraprocesados. Las asociaciones entre las variables sociodemográficas y el consumo de los alimentos ultraprocesados se evaluaron mediante la prueba de chi-cuadrado, considerando un nivel de significancia del 5%. Resultados: El consumo permanente de alimentos ultraprocesados fue bajo, inferior al 10% en la mayoría de las categorías. Los estudiantes varones mostraron un mayor consumo regular y frecuente en comparación con las mujeres, mientras que los estudiantes de grados superiores (4to y 5to) y los de mayor edad (16-17 años) presentaron un consumo más constante. Además, los estudiantes adventistas reportaron un mayor consumo nulo o esporádico en comparación con los no adventistas. Sin embargo, no se encontraron diferencias estadísticamente significativas entre los grupos sociodemográficos evaluados. Conclusiones: Aunque el consumo permanente de alimentos ultraprocesados fue bajo, el consumo esporádico y regular sigue siendo preocupante. Las intervenciones educativas deberían enfocarse en reducir el consumo de estos productos entre los adolescentes, especialmente en aquellos con mayor riesgo.
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    ¿Qué necesita nuestra región para fortalecer políticas públicas sobre bebidas azucaradas? diálogo de decisores
    (2023-03-31)
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    Lucas Perelli
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    Belén Rodríguez
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    Alfredo Palacios
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    Ariel Bardach
    In order to prioritize public policies to reduce the consumption of sugar-sweetened beverages in Argentina, Brazil, El Salvador and Trinidad and Tobago and to identify information gaps related to the burden of disease attributable to their consumption, a policy dialogue was held with government members, civil society organizations, researchers and communicators from Latin American and Caribbean countries. Presentations and deliberative workshops were conducted using semi-structured data collection tools and group discussions. The prioritized interventions were tax increases, front labeling, restriction of advertising, promotion and sponsorship, and modifications regarding the school environment. The main perceived barrier was the interference from the food industry. This dialogue among decision-makers led to the identification of priority public policies to reduce the consumption of sugar-sweetened beverages in the region.
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    Short-term repeat HPV testing for triaging HPV-positive women in cervical cancer screening
    (2025-10-03)
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    Marı́a Alejandra Picconi
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    Laura Mendoza
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    Annabelle Ferrera
    ;
    David Mesher
    BACKGROUND: Persistent HPV infection causes cervical cancer, but most infections are transient. Triage methods identify high-risk women needing further evaluation or treatment. We assessed short-term repeat HPV testing as an alternative triage option. METHODS: In ESTAMPA, women aged 30-64 years were screened with HPV testing (HC2 or Cobas) and cytology. Screen positives were referred to colposcopy approximately two months after screening, where cervical samples were collected again for repeat HPV testing. We evaluated the performance of repeat HPV for CIN3+ among HPV-positive women and explored its combination with limited HPV genotyping (HPV16/18). RESULTS: Among 5390 HPV-positive women (including 629 CIN3 cases and 53 cancers), 61% retested positive at ~2 months (median: 1.8, interquartile range: 1.2-2.8). Repeat HPV sensitivity for CIN3+ was 81.5% (95% CI 77.2-85.2) for HC2 and 87.7% (83.7-90.8) for Cobas. Specificity was <50% with referral rates of 57.4% (55.7-59.0) and 68.2% (66.1-70.2) for HC2 and Cobas. HPV16/18 genotyping followed by repeat HPV among non-HPV16/18-positive women did not greatly improve performance. However, HPV16/18 positivity doubled the risk of CIN3+, supporting its combination with repeat HPV when available. CONCLUSIONS: Short-term repeat HPV testing could be a practical option for triaging HPV-positive women, either alone or in combination with limited HPV genotyping. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01881659.
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    Estilo de vida saludable, nivel de glucosa e IMC en adultos del Valle de Amauta – Ate Vitarte – Lima - 2020
    (2020-12-30)
    Carla Hurtado Casanca
    ;
    Noelene Atoc Ventocilla
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    Objetivo: Determinar la relación entre los estilos de vida saludable, glucosa e IMC en adultos del Vallede Amauta – Ate Vitarte – Lima – 2020. Metodología: Diseño no experimental, enfoque cuantitativo,de corte transversal y de tipo correlacional. La muestra está compuesta por a 175 adultos de ambossexos de edades entre 18 a 64 años. Se recolectaron los datos a través de un cuestionario sobre estilode vida; además, se tomaron medidas antropométricas como peso y talla para determinar el Índice demasa corporal (IMC), así mismo, se evaluó el nivel de glucosa. Resultados: El 82.7% de la poblaciónevaluada presentó un estilo de vida saludables y solo el 17.7% una condición poco saludable; asímismo, el 77.2% no realizaba actividad física, encontrando que el 52.6% realiza actividad ligera. Encuanto al consumo de alcohol y otras drogas, el 94.2% es saludable; también, el 76.0% informó tenerun sueño adecuado y el 24.0% tenía una mala calidad de sueño. En cuanto a los hábitos alimentarios,81.2% es saludable, un grupo de 18.9% no tiene hábitos saludables, también el 68.0% no tenía unautocuidado. Se encontró que el 42.3% presentó diabetes. Finalmente, el 34.3% tenía un IMC normal,42.3% presentó sobrepeso y 23.4% presentó obesidad. Conclusión: Existe relación entre el estilo devida, los niveles de glucosa y el IMC de los participantes. Además, el estudio demuestra que la falta deactividad física está relacionado al aumento del IMC, que a la vez se asocia a los niveles de glucosaelevados. Por lo tanto, si se hace una modificación del estilo de vida, condición física y deporte,recreación y manejo del tiempo libre, consumo de alcohol y otras drogas, sueño, hábitos alimentariosy autocuidado, y cuidado médico, puede ser de gran ayuda para la prevención de enfermedadesmetabólicas.
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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)
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    Jacksaint Saintila
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    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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    [Food intake of students graduating from basic education in the metropolitan area of Santiago, Chile].
    (1986-09-01)
    Daniza Ivanovic
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    M Aguayo
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    I Trufello
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    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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    Physician experiences with clinical uncertainty in the trauma setting: making clinical guidance accessible to those in need
    (2026-01-01)
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    E J Lee
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    Gianni Aragon
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    Giuliano Borda‐Luque
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    Gabriela Zavala Wong
    Introduction: Globally, trauma patients suffer from high rates of preventable deaths, in part driven by low rates of access to and application of resource-relevant evidence-informed clinical guidance. This mixed-methods study assessed the accessibility (barriers to attempting to use guidance), clarity (ease of comprehension), utility (based on resources and time), and implementation of trauma guidance for Peruvian injury providers. Methods: Semistructured qualitative interviews were conducted in Spanish at three hospitals in Lima, Peru. Interviews were analyzed in Dedoose V.9.1.12 using an iteratively developed codebook; quantitative self-administered surveys were then developed and distributed at the Pan American Trauma Society Conference. Surveys were analyzed using descriptive statistics and frequencies. Results: 38 interviews and 83 surveys were conducted with surgical attendings, emergency physicians, and surgical and emergency residents across all years of training. Access barriers included paywalls, language barriers, low user-friendliness, and technology limits (poor internet, few computers). A mobile app and portable physical guidance are preferred potential solutions. Utility barriers included low equipment maintenance and high patient volumes. Resource-based guidance, conciseness (eg, flowcharts), and standardization are perceived to potentially increase utility. Implementation barriers included limited training time, reliance on more experienced colleagues rather than guidance, low enforcement, and low funding. Potential facilitators are increased administrative support and staff willingness to use guidance improving patient mortality, clinical errors, and length of stay. No barriers to clarity were reported. Conclusion: Barriers to using clinical guidance included low user-friendliness, low local applicability, and an unsupportive culture. Mobile apps, resource stratification, and administrative involvement are priorities to address these needs. Trauma guidance adapted to local realities may reduce preventable deaths in acute care. Further work is needed to identify how to create and distribute updated clinical guidance to better serve trauma providers worldwide. Level of evidence: Economic and Value-based Evaluations Level 2.