Pneumonic and non-pneumonic exacerbations in bronchiectasis: Clinical and microbiological differences.

Objectives: Despite the clinical relevance of exacerbations in bronchiectasis (BE), little is known about the microbiology and outcomes of pneumonic (CAP) vs. non-pneumonic (NOCAP) exacerbations.

Methods: This study compares clinical and microbiological characteristics of CAP vs.

Reliability and Validity of the Functional Outcomes of Sleep Questionnaire - Spanish Short Version (FOSQ-10SV) in Peruvian Patients With Obstructive Sleep Apnea.

Study Objectives: The aim of this study was to verify the reliability and validity of the Spanish short version of the Functional Outcomes of Sleep Questionnaire (FOSQ-10SV) in Peruvian patients with obstructive sleep apnea (OSA).

Methods: Participants underwent physical examinations, completed the FOSQ-10SV, and polysomnography tests were carried out.

Results: A total of 672 patients were analyzed, 75 females (11%), mean age 50.

Risk factors for multidrug-resistant pathogens in bronchiectasis exacerbations.

Background: Non-cystic fibrosis bronchiectasis is a chronic structural lung condition that courses with recurrent infectious exacerbations that lead to frequent antibiotic treatment making this population more susceptible to acquire pathogens with antibiotic resistance. We aimed to investigate risk factors associated with isolation of multidrug-resistant pathogens in bronchiectasis exacerbations.

Methods: A prospective observational study was conducted in two tertiary-care hospitals, enrolling patients when first exacerbation appeared.

Factors associated with hospitalization in bronchiectasis exacerbations: a one-year follow-up study.

Background: Bronchiectasis (BE) is a chronic structural lung disease with frequent exacerbations, some of which require hospital admission though no clear associated factors have been identified. We aimed to evaluate factors associated with hospitalization due to exacerbations during a 1-year follow-up period.

Methods: A prospective observational study was performed in patients recruited from specialized BE clinics.

The Role of Neutrophil Elastase Inhibitors in Lung Diseases.

In many respiratory diseases characterized by an intense inflammatory response, the balance between proteolytic enzymes (proteases, including elastases) and their inhibitors (proteinases inhibitors) is not neutral. Excess activity of neutrophil elastase (NE) and similar proteases has been reported to cause tissue damage and to alter the remodeling process in many clinical conditions such as pneumonia, respiratory distress, and acute lung injury (ALI). Several experimental NE inhibitors have been tested in preclinical and clinical studies of different conditions of inflammatory lung injury such as ALI and pneumonia, with contrasting results.

Comparison of two prognostic scores (BSI and FACED) in a Spanish cohort of adult patients with bronchiectasis and improvement of the FACED predictive capacity for exacerbations.

Bronchiectasis (BE) is a chronic and heterogeneous respiratory disease that requires a multidimensional scoring system to properly assess severity. The aim of this study was to compare the severity stratification by 2 validated scores (BSI and FACED) in a BE cohort and to determine their predictive capacity for exacerbations and hospitalizations. Moreover, we proposed a modified version of FACED which was created to better predict the risk of exacerbations in clinical practice.

Ventilatory Cycle Measurements and Loop Gain in Central Apnea in Mining Drivers Exposed to Intermittent Altitude.

Study Objectives: By measuring the apnea length, ventilatory phase, respiratory cycle length, and loop gain, we can further characterize the central apneas of high altitude (CAHA).

Methods: Sixty-three drivers of all-terrain vehicles, working in a Peruvian mine located at 2,020 meters above sea level (MASL), were evaluated. A respiratory polygraph was performed in the first night they slept at high altitude.

Microbiology and outcomes of community acquired pneumonia in non cystic-fibrosis bronchiectasis patients.

Background: It is general belief that Non-cystic fibrosis bronchiectasis (NCFB) is characterized by frequent community-acquired pneumonia. Nonetheless, the knowledge on clinical characteristics of CAP in NCFBE is poor and no specific recommendations are available. We aim to investigate clinical and microbiological characteristics of NCFBE patients with CAP.

[Sleep habits and traffic accidents in inter-provincial bus drivers of Arequipa, Peru].

In order to determine sleep habits in bus drivers and their relationship to accidents in the city of Arequipa, Peru, a cross-sectional descriptive study was conducted in a non-probabilistic sample of 166 drivers. Driving hours per day were 9.4 ± 3.

Epidemiology of road traffic incidents in Peru 1973-2008: incidence, mortality, and fatality.

Background: The epidemiological profile and trends of road traffic injuries (RTIs) in Peru have not been well-defined, though this is a necessary step to address this significant public health problem in Peru. The objective of this study was to determine trends of incidence, mortality, and fatality of RTIs in Peru during 1973-2008, as well as their relationship to population trends such as economic growth.

Methods And Findings: Secondary aggregated databases were used to estimate incidence, mortality and fatality rate ratios (IRRs) of RTIs.

The management of severe community acquired pneumonia in the intensive care unit.

Severe CAP (SCAP), accounting for 6% of admissions to intensive care units (ICUs) needs early diagnosis and aggressive interventions at the most proximal point of disease presentation. The prognostic scores as the ATS/IDSA rule, the systolic blood pressure, multilobar infiltrates, albumin, respiratory rate, tachycardia, confusion, oxygen and pH or SCAP system are appropriate in early identification of eligible patients requiring admission to ICU. Then the recommended initial resuscitation in SCAP in the ICU consists of fluid volume intake titrated to specific goals after a fluid challenge and hemodynamic optimization.

Pharmacotherapy for hospital-acquired pneumonia.

Introduction: Hospital-acquired pneumonia is the most common life-threatening hospital-acquired infection, and the majority of cases are associated with mechanical ventilation. Once pneumonia develops, the appropriateness of the initial antibiotic regimen is a vital determinant of outcome. The slow rate of development of newer antimicrobials has led to the rediscovery of the 'old' and 'forgotten' antibiotic 'Colistin', and it is increasingly being used as salvage therapy in patients with multidrug-resistant gram-negative bacteria infections.

Patient perspectives on the promptness and quality of care of road traffic incident victims in Peru: a cross-sectional, active surveillance study.

Background: Road injuries are the second-leading cause of disease and injury in the Andean region of South America. Adequate management of road traffic crash victims is important to prevent and reduce deaths and serious long-term injuries.

Objective: To evaluate the promptness of health care services provided to those injured in road traffic incidents (RTIs) and the satisfaction with those services during the pre-hospital and hospital periods.

Clinical and polysomnographic differences between OSAH patients with/without excessive daytime sleepiness.

Purpose: The purpose of this study is to describe the clinical and polysomnographic differences found in patients diagnosed with obstructive sleep apnea-hypopnea (OSAH), with or without excessive daytime sleepiness (EDS) measured by the Epworth Sleepiness Scale (ESS).

Methods: A physical examination, ESS, and polysomnography were applied to all the participants, considering an ESS score of >10 to indicate EDS and an ESS score of ≥ 16 to indicate severe EDS. Univariate (chi-squared or Student's t test) and multivariate (multiple logistic regression) analysis approaches were used.

Depressive symptoms in patients with obstructive sleep apnea/hypopnea syndrome.

Objective: The objective of this study was to determine the frequency of depressive symptoms in Peruvian patients with obstructive sleep apnea/hypopnea (OSAH) and the association between the presence of depressive symptoms and OSAH severity.

Methods: Physical examination, Beck Depression Inventory (BDI), and Epworth Sleepiness Scale (ESS) were applied, and a polysomnography test was performed.

Results: Data on 312 patients, 12 % females, 46.

[Clinical and polysomnographyc differences between obese and non obese patients with obstructive sleep apnea-hypopnea syndrome].

Objectives: To describe the clinical and polysomnographyc differences between obese and non- obese patients with obstructive sleep apnea-hypopnea (OSAH) syndrome.

Materials And Methods: A physical examination, the Epworth Sleepiness Scale (ESS) and a polysomnography were performed to all included patients. Obesity was defined as a body mass index (BMI) of ≥ 30 kg/m(2).

[Resources and capacity of emergency trauma care services in Peru].

The objectives of this study were to evaluate the resources and capacity of emergency trauma care services in three Peruvian cities using the WHO report Guidelines for Essential Trauma Care. This was a cross-sectional study in eight public and private healthcare facilities in Lima, Ayacucho, and Pucallpa. Semi-structured questionnaires were applied to the heads of emergency departments with managerial responsibility for resources and capabilities.

Validation and modification of the Epworth Sleepiness Scale in Peruvian population.

Purpose: The main purpose of this study was to develop a cross-cultural adaptation of the Epworth Sleepiness Scale for Peruvian population (ESS-VP) and to provide evidence of reliability and validity to this scale. We also modified the ESS-VP for non-driving Peruvian population (ESS-MPV).

Methods: Participants were Peruvians between 18 and 65 years.

[Assessment of the structure, dynamics and monitoring of information systems for road traffic injuries in Peru--2009].

Objective: A baseline assessment of the structure, dynamics, and monitoring capabilities of the information systems for road traffic injuries was conducted in three Peruvian cities: Lima, Huamanga and Pucallpa.

Material And Methods: 50 in-depth interviews were performed with key stakeholders, including managers and operators of information systems. The instrument was developed taking into account international standards and recommendations for information systems.

[Sleep monitoring in bus and truck drivers: relevant factor to consider for the renewal of the driving license].

The available information indicates that up to one third of the road traffic accidents are produced by the driver's sleepiness. Sleep apnea-hypopnea syndrome (SAHS) is an organic disease that causes sleepiness. It can be diagnosed by a sleep register and can be controlled by different therapeutic means, varying their complexity according to its severity, which determines the final cost of the management of SAHS.

[Tiredness and sleepiness in rural bus drivers during their job performance: Peruvian experience and proposals].

The information indicates that the traffic accidents caused by bus drivers' sleepiness or tiredness are frequent in our country. A driver that falls asleep while driving cannot perform evasive maneuvers in order to avoid crashes or getting off the track, being the result of this kind of accidents a great number of victims and infrastructure destruction. In this article we discuss the original data published in Peru up to date and make general proposals to face the problem.

[Coverage of the Emergency Health Care Law and the Compulsory Insurance against Road Traffic Crashes (SOAT)].

Objective: The aim of this study was to ascertain, from patients' perspective, the degree of knowledge and the actual coverage of the Emergency Health Care Law and the Compulsory Insurance against Road Traffic Crashes (SOAT).

Material And Methods: A cross-sectional, active surveillance of emergency wards of selected health facilities in three Peruvian cities (Lima, Pucallpa y Ayacucho) was conducted.

Results: Out of 644 surveyed victims, 77% did not know about the law about provision of emergency health care (81% in Lima, 64% in Pucallpa y 93% in Ayacucho; p<0.

Using a generic measure of quality of life in patients with obstructive sleep apnea.

Purpose: To evaluate the utility of a Multicultural Quality of Life Index (MQLI) in patients with Obstructive Sleep Apnea-Hypopnea (OSAH).

Methods: Physical examination, MQLI and the Epworth Sleepiness Scale (ESS) were applied to participants. In addition, a polysomnography or a respiratory polygraphy was carried out.