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  Mortalidad precoz en pacientes con enfermedad renal crónica que inician hemodiálisis por urgencia en una población peruana: Incidencia y factores de riesgo

  Andrea, Gómez de la Torre-del Carpio (Sociedad Española de Nefrología, 2018-07-01)

  Resumen ObjetivosEstimar la mortalidad precoz en pacientes con enfermedad renal crónica que iniciaron hemodiálisis por urgencia entre los años 2012-2014 en un hospital de referencia nacional en Lima, Perú, e identificar los factores de riesgo. Diseño, características, participantes y medicionesSe estudió una cohorte retrospectiva mediante la revisión de historias clínicas de todos los pacientes admitidos a la Unidad de Hemodiálisis del hospital en el periodo de tiempo señalado. Se evaluó mortalidad precoz, definida como la muerte dentro de los primeros 90 días luego de iniciar hemodiálisis, así como edad, sexo, etiología de enfermedad renal crónica, comorbilidades, causa de muerte, tasa de filtración glomerular estimada, acceso vascular, entre otras variables, en los pacientes que iniciaron hemodiálisis por urgencia. Se estimó la mortalidad precoz mediante frecuencias y se utilizó regresión de Poisson con varianza robusta para determinar los factores de riesgo. ResultadosSe encontró que el 43,4% fueron mujeres, el 51,5% tenían≥65 años y una mortalidad precoz del 9,3%. Los principales factores de riesgo fueron tasa de filtración glomerular estimada>10mL/min/1,73m2 (RR: 2,72 [IC 95%: 1,60-4,61]); edad≥65 años (RR: 2,51 [IC 95%: 1,41-4,48]); infección de catéter venoso central, RR: 2,25 (IC 95%: 1,08-4,67); sexo femenino, RR: 2,15 (IC 95%: 1,29-3,58); y albúmina<3,5g/dL (RR: 1,97 [IC 95%: 1,01-3,82]). ConclusionesLa mortalidad precoz fue del 9,3%. El principal factor de riesgo fue iniciar hemodiálisis con una tasa de filtración glomerular estimada>10mL/min/1,73m2.

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  Apoyo organizacional percibido y compromiso organizacional en una empresa privada de Lima, Perú

  Flores M., Jessica; Ingrid, Gómez V. (Ajayu, 2018-03)

  En la presenta investigación se busca determinar la correlación entre las variables Apoyo Organizacional Percibido y Compromiso Organizacional en una institución privada de Lima. Se utilizó una muestra representativa de 135 teleoperadores de una empresa dedicada a un call center. La muestra estuvo conformada por un 56% de mujeres y un 44% de hombres, la edad promedio de ambos sexos fue de 24 años, el 73% ha nacido en Lima, el 26% en provincia y el 1% en el extranjero. Asimismo, en esta investigación se empleó la escala de Apoyo Organizacional Percibido de Eisenberger (1986) y la escala de Compromiso Organizacional de Meyer y Allen (1991). En esta investigación se concluyó que efectivamente el apoyo organizacional percibido y el compromiso organizacional presentan una relación positiva. La permanencia de un colaborador en la empresa dependerá de la percepción positiva de apoyo organizacional y la conformidad con el trabajo. Asimismo, si la persona tiene una percepción negativa de apoyo organizacional es muy probable que se sienta disconforme con su trabajo y por ende, abandone su puesto de trabajo.

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  Contemporary Perspective on Addictive Behaviors: Underpinning Mechanisms, Assessment, and Treatment

  Cimino, Silvia; Almenara, Carlos A.; Cerniglia, Luca; Desousa, Avinash; Maremmani, Angelo G. I. (Hindawi, 2018-06)

  Carta al editor

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  Espiritualidad e Inteligencia Emocional en estudiantes universitarios de la ciudad de Ayacucho

  Vílchez Quevedo, Edwin Jesús; Miguel-Rojas, Josselyn; Vílchez-Quevedo, Edwin Jesús; Reyes Bossio, Mario (Instituto Peruano de Orientación Psicológica – IPOPS, 2018-05)

  Esta investigación pretende hallar la correlación existente entre Inteligencia Emocional (IE) y Espiritualidad en estudiantes universitarios de la ciudad de Ayacucho. Se optó por un método cuantitativo, de diseño transaccional de tipo correlacional. Para ello se contó con una muestra de 195 estudiantes universitarios de dos universidades privadas ayacuchanas, de los cuales el 41% son varones y el 59% son mujeres, con un rango de edad entre 18 a 38 años (m = 20.43). Se aplicó el Cuestionario del Trait Meta-Mood Scale-24 para y el Cuestionario de Espiritualidad; ambos adaptados a la población peruana. Se analizaron las correlaciones de las dimensiones de ambas variables; obteniendo correlaciones positivas entre todas las dimensiones de IE con las dimensiones de Espiritualidad. Asimismo, los análisis realizados evidencian que se encuentra diferencias significativas en la valoración explícita de la espiritualidad según sexo; específicamente las mujeres puntúan más en este aspecto. También se puede destacar que la dimensión de autoconciencia del cuestionario de Espiritualidad presenta las correlaciones más fuertes con las dimensiones de Inteligencia Emocional.

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  Adaptación de la Escala de Percepción Global de Estrés en estudiantes universitarios peruanos

  Guzmán-Yacaman1, Jaime Enrique; Reyes Bossio, Mario (Pontificia Universidad Católica del Perú, 2018-06)

  El objetivo del presente estudio consistió en validar la Escala de Percepción Global de Estrés en una muestra peruana de universitarios de un programa nacional de becas. El proceso de adaptación consideró la doble traducción a partir de la versión original, la comparación lingüística con la adaptación chilena y mexicana, así como la revisión por jueces. Asimismo, se aplicó una prueba piloto. Los participantes fueron 332 becarios universitarios. Los resultados del Análisis Factorial Confirmatorio confirmaron el modelo bifactorial de la EPGE-13. Asimismo, se obtuvieron evidencias de validez divergente y convergente utilizando el SPANAS. La confiabilidad estimada de los puntajes generados por el instrumento fueron α=.79 para el factor de eustrés y α= .77 para el factor de distrés. Los resultados demográficos indicaron mayor presencia de estrés percibido en mujeres que en hombres. No se observaron diferencias entre el estrés y el lugar de procedencia.

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  Sweetened beverages, snacks and overweight: findings from the Young Lives cohort study in Peru

  Alviso-Orellana, Claudia; Estrada-Tejada, Dayna; Carrillo-Larco, Rodrigo M; Bernabe-Ortiz, Antonio (Cambridge University Press, 2018-03-20)

  Objective: To determine the association between consumption of snacks and sweetened beverages and risk of overweight among children. Design: Secondary analysis of the Young Lives cohort study in Peru. Setting: Twenty sentinel sites from a total of 1818 districts available in Peru. Subjects: Children in the younger cohort of the Young Lives study in Peru, specifically those included in the third (2009) and the fourth (2013) rounds. Results: A total of 1813 children were evaluated at baseline; 49·2 % girls and mean age 8·0 (sd 0·3) years. At baseline, 3·3 (95 % CI 2·5, 4·2) % reported daily sweetened beverage consumption, while this proportion was 3·9 (95 % CI 3·1, 4·9) % for snacks. Baseline prevalence of overweight was 22·0 (95 % CI 20·1, 23·9) %. Only 1414 children were followed for 4·0 (sd 0·1) years, with an overweight incidence of 3·6 (95 % CI 3·1, 4·1) per 100 person-years. In multivariable analysis, children who consumed sweetened beverages and snacks daily had an average weight increase of 2·29 (95 % CI 0·62, 3·96) and 2·04 (95 % CI 0·48, 3·60) kg more, respectively, than those who never consumed these products, in approximately 4 years of follow-up. Moreover, there was evidence of an association between daily consumption of sweetened beverages and risk of overweight (relative risk=2·12; 95 % CI 1·05, 4·28). Conclusions: Daily consumption of sweetened beverages and snacks was associated with increased weight gain v. never consuming these products; and in the case of sweetened beverages, with higher risk of developing overweight.

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  Latin American Consensus for Pediatric Cardiopulmonary Resuscitation 2017

  López-Herce, Jesús; Almonte, Enma; Alvarado, Manuel; Bogado, Norma Beatriz; Cyunel, Mariana; Escalante, Raffo; Finardi, Christiane; Guzmán, Gustavo; Jaramillo-Bustamante, Juan C.; Madrid, Claudia C.; Matamoros, Martha; Moya, Luis Augusto; Obando, Grania; Reboredo, Gaspar; López, Lissette R.; Scheu, Christian; Valenzuela, Alejandro; Yerovi, Rocío; Yock-Corrales, Adriana (Lippincott Williams and Wilkins, 2018-03)

  Objectives: To develop a Latin American Consensus about Pediatric Cardiopulmonary Resuscitation. To clarify, reinforce, and adapt some specific recommendations for pediatric patients and to stimulate the implementation of these recommendations in clinical practice. Design: Expert consensus recommendations with Delphi methodology. Setting: Latin American countries. Subjects: Experts in pediatric cardiopulmonary resuscitation from 19 Latin American countries. Interventions: Delphi methodology for expert consensus. Measurements and Main Results: The goal was to reach consensus with all the participating experts for every recommendation. An agreement of at least 80% of the participating experts had to exist in order to deliver a recommendation. Two Delphi voting rounds were sent out electronically. The experts were asked to score between 1 and 9 their level of agreement for each recommendation. The score was then classified into three groups: strong agreement (score 7–9), moderate agreement (score 4–6), and disagreement (score 1–3). Nineteen experts from 19 countries participated in both voting rounds and in the whole process of drafting the recommendations. Sixteen recommendations about organization of cardiopulmonary resuscitation, prevention, basic resuscitation, advanced resuscitation, and postresuscitation measures were approved. Ten of them had a consensus of 100%. Four of them were agreed by all the participants except one (94.7% consensus). One recommendation was agreed by all except two experts (89.4%), and finally, one was agreed by all except three experts (84.2%). All the recommendations reached a level of agreement. Conclusions: This consensus adapts 16 international recommendations to Latin America in order to improve the practice of cardiopulmonary resuscitation in children. Studies should be conducted to analyze the effectiveness of the implementation of these recommendations.
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  Serious Game for the Virtual Practice of the Emplantillado in the Constructive System of adobe with reinforced cane

  George, Centeno; Carlos, Egusquiza; David, Mauricio; Peruvian University of Applied Sciences, Lima, Perú; Peruvian University of Applied Sciences, Lima, Perú; Peruvian University of Applied Sciences, Lima, Perú (Association for Computing Machinery, 2017-12-20)

  At present, the training of university students and the specialization of professionals are accompanied by a series of educational tools based on digital environments and applications for specific areas in education; In this process of application of the technology exists a methodology called Serious Game oriented towards some specific areas like Simulation in subjects of building and construction; Since this field is new in higher education, there are not many specific applications, such as the case of emplantillado for simulation of constructions using adobes reinforced with cane. The objective of this study is to demonstrate that the Serious game methodology, oriented to the teaching the course of the Preliminary Works of the Faculty of Architecture, can improve students learning and optimize their skills for the emplantillado in construction systems using the application for iPad. The application has been tested in a group of twelve students who were part of the experimental group in relation to the execution time, attempts made and qualification obtained; In contrast to evaluate the time to solve the test for emplantillado into de groups that performed the same exercise; an ANCOVA was used to evaluate the main effects and interactions to answer the null hypothesis. This ANCOVA model for balanced cases of type III includes a covariate that is correlated with the dependent variable and means on the dependent variables adjusted due the to the effect the covariate had on it.
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  Association between perceived social support and induced abortion: A study in maternal health centers in Lima, Peru

  Sánchez-Siancas, Luis E.; Rodríguez-Medina, Angélica; Piscoya, Alejandro; Bernabe-Ortiz, Antonio (PLoS ONE, 2018-04-12)

  Objectives This study aimed to assess the association between perceived social support and induced abortion among young women in Lima, Peru. In addition, prevalence and incidence of induced abortion was estimated. Methods/Principal findings A cross-sectional study enrolling women aged 18–25 years from maternal health centers in Southern Lima, Peru, was conducted. Induced abortion was defined as the difference between the total number of pregnancies ended in abortion and the number of spontaneous abortions; whereas perceived social support was assessed using the DUKE-UNC scale. Prevalence and incidence of induced abortion (per 100 person-years risk) was estimated, and the association of interest was evaluated using Poisson regression models with robust variance. A total of 298 women were enrolled, mean age 21.7 (± 2.2) years. Low levels of social support were found in 43.6% (95%CI 38.0%–49.3%), and 17.4% (95%CI: 13.1%–21.8%) women reported at least one induced abortion. The incidence of induced abortion was 2.37 (95%CI: 1.81–3.11) per 100 person-years risk. The multivariable model showed evidence of the association between low perceived social support and induced abortion (RR = 1.94; 95%CI: 1.14–3.30) after controlling for confounders. Conclusions There was evidence of an association between low perceived social support and induced abortion among women aged 18 to 25 years. Incidence of induced abortion was similar or even greater than rates of countries where abortion is legal. Strategies to increase social support and reduce induced abortion rates are needed.

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  Comentario de Terrones Arias AE en: Incidencia del periodo vacacional de Navidad en el estado ponderal de escolares de Primaria

  Terrones Arias, Angel Eduardo; Carbajal Huamani, Oliverio (Asociacion Espanola de Dietistas-Nutricionistas, 2018-03-16)

  Carta al editor

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  Comment to: “Laser-Assisted Liposuction (LAL) Versus Traditional Liposuction: Systematic Review”

  Centurion, P.; Caballero, G.; Weiss, M. (Springer New York LLC, 2018-03-02)

  Carta al editor
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  An evaluation of distal hair cortisol concentrations collected at delivery

  Orta, Olivia R.; Tworoger, Shelley S.; Terry, Kathryn L.; Coull, Brent A.; Gelaye, Bizu; Kirschbaum, Clemens; Sanchez, Sixto E.; Williams, Michelle A.; Harvard T.H. Chan School of Public Health, Harvard University, MA, USA;; Harvard T.H. Chan School of Public Health, Harvard University, MA, USA;; Harvard T.H. Chan School of Public Health, Harvard University, MA, USA;; Harvard T.H. Chan School of Public Health, Harvard University, MA, USA;; Harvard T.H. Chan School of Public Health, Harvard University, MA, USA;; Technische Universität Dresden, Dresden, Germany;; Facultad de Medicina, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru;; Harvard T.H. Chan School of Public Health, Harvard University, MA, USA; (Taylor and Francis Ltd., 2018-04-04)

  Distal hair segments collected at delivery may allow for the assessment of maternal cortisol secretion in early pregnancy, an important time window for fetal development. Therefore, an investigation of the validity of distal hair cortisol concentrations is warranted. We examined the concordance between proximal and distal hair cortisol concentrations (HCC), both representing the first trimester of pregnancy. The study population was comprised of a random sample of 97 women participating in the Pregnancy Outcomes Maternal and Infant Study, a prospective cohort study of pregnant women attending prenatal clinics in Lima, Peru. Each participant provided two hair samples: once at enrollment [mean gestational age (GA) = 13.1 weeks] and again at full-term delivery (mean GA = 39.0 weeks). Hair segments reflecting the first trimester were: 3 cm hair segments closest to the scalp on the first hair sample (proximal) and 6–9 cm from the scalp on the second hair sample (distal). HCC was determined using Luminescence Immunoassay. A subset (N = 28) had both hair segments additionally analyzed using liquid chromatography tandem mass spectrometry (LC-MS/MS). HCC values were log-transformed (logHCC), and proximal–distal differences tested using paired sample t-tests. Concordance was evaluated within and across assay types. LogHCC, measured using immunoassay, in distal hair segments was lower compared to proximal hair segments (1.35 versus 1.64 respectively; p = .02). No difference was observed using LC-MS/MS (1.99 versus 1.83, respectively; p=.33). Proximal–distal concordance was low within assay (immunoassay: Pearson = 0.27 and κ = 0.10; LC-MS/MS: Pearson = 0.37 and κ = 0.07). High correlation was observed across assays for both distal (Pearson = 0.78, p < .001; κ = 0.64) and proximal segments (Pearson = 0.96, p < .001; κ = 0.75). In conclusion, distal first-trimester hair segments collected at delivery have lower absolute HCC compared to HCC in proximal first trimester hair segments collected in early pregnancy, and are poorly concordant with HCC in proximal segments. Findings may inform the design of future studies.
• Ingesta de arsénico: el impacto en la alimentación y la salud humana

  Medina-Pizzali, María; Robles, Pamela; Mendoza, Mónica; Torres, Celeste (Instituto Nacional de Salud (INS), 2018-04-09)

  Arsenic is an element that is widely distributed throughout the environment. Its compounds are mainly in the state of pentavalent and trivalent oxidation; and in inorganic and organic forms. Arsenical species vary in their degree of toxicity, with inorganic compounds being more political than organic, and trivalent compounds more toxic than pentavalent compounds. There would be interconversion between the less toxic species and other more toxic species and the cooking and processing methods could affect it. Arsenic is a carcinogenic agent and causes multiple negative effects on human health in the short and long term. Non-occupational human exposure to arsenic occurs mainly through water and food. The regulation is variable for each country and is based on WHO standards, the Codex Alimentarius, and the European Union. Many studies focus on determining the total arsenic content but do not identify arsenical species in foods. Globally, fish and seafood, chicken, meat, rice, and seaweed have high levels of arsenic. In Peru, there are few studies on total arsenic content and arsenical species in food despite the fact that we have areas with high levels of environmental contamination. The objective of this review is to discuss exposure to arsenic through food and water intake, related regulations, toxicity, consequences on human health and main foods that contribute to its intake.

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  Letter to the Editors regarding the paper: Sociodemographic Characteristics of Indigenous Population According to the 2000 and 2010 Brazilian Demographic Censuses: A Comparative Approach

  Casella-Fernández, Alfredo; Limas-Haro, Daniela; Lucchetti, Aldo; Universidad Peruana de Ciencias Aplicadas, Peru; Universidad Peruana de Ciencias Aplicadas, Peru; Universidad Peruana de Ciencias Aplicadas, Peru; Hospital Nacional Arzobispo Loayza, Perú (Fundacao Oswaldo Cruz, 2018-03-08)

  Carta al editor

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  Additional results on integrals of beam eigenfunctions

  Morales, César A; Facultad de Ingeniería, Universidad Peruana de Ciencias Aplicadas, Lima, Perú (SAGE Publications Ltd, 2018-03-14)

  New simplest expression beam mode integrals are presented, including further simplifications and corrections of previous results; this type of integrals appear in computational methods in structural dynamics and vibrations of diverse structures and machines, and in aircraft dynamics methods.
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  Perceived stress and high fat intake: A study in a sample of undergraduate students

  Vidal, E. Jair; Alvarez, Daily; Martinez-Velarde, Dalia; Vidal-Damas, Lorena; Yuncar-Rojas, Kelly A.; Julca-Malca, Alesia; Bernabe-Ortiz, Antonio (Public Library of Science, 2018-03-09)

  Objectives Different studies have reported the association between perceived stress and unhealthy diet choices. We aimed to determine whether there is a relationship between perceived stress and fat intake among undergraduate medical students. Methods/Principal findings A cross-sectional study was performed including first-year medical students. The outcome of interest was the self-report of fat intake assessed using the Block Screening Questionnaire for Fat Intake (high vs. low intake), whereas the exposure was perceived stress (low/ normal vs. high levels). The prevalence of high fat intake was estimated and the association of interest was determined using prevalence ratios (PR) and 95% confidence intervals (95% CI). Models were created utilizing Poisson regression with robust standard errors. Data from 523 students were analyzed, 52.0% female, mean age 19.0 (SD 1.7) years. The prevalence of high fat intake was 42.4% (CI: 38.2%–46.7%). In multivariate model and compared with those with lowest levels of stress, those in the middle (PR = 1.59; 95%CI: 1.20–2.12) and highest (PR = 1.92; 95%CI: 1.46–2.53) categories of perceived stress had greater prevalence of fat intake. Gender was an effect modifier of this association (p = 0.008). Conclusions Greater levels of perceived stress were associated with higher fat intake, and this association was stronger among males. More than 40% of students reported having high fat consumption. Our results suggest the need to implement strategies that promote decreased fat intake.

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  Endoscopic Treatment for Vesicoureteral Reflux in Recurrent Urinary Tract Infections in Kidney Transplant: Experience of One Center

  Gomez Lujan, M.; Velarde, L.; Cruzalegui, C.; Berrios, C.; Sifuentes, E.; Gálvez, J.; Soto, H.; Castañeda, E.; Bazán, G.; Nakachi, A.; Chambi, M.; Medina, C.; Torres, A. (Elsevier USA, 2018-03)

  Vesicoureteral reflux (VUR) after renal transplantation in adult patients has been reported. In renal transplant recipients, symptomatic urinary tract infection can cause high morbidity despite improved immunosuppressive and antibiotic treatment. In our country there have been few reported cases about use of copolymer of dextranomer and hyaluronic acid (DX-HA) injection in a renal transplant. We present 3 cases of recurrent or complicated infections with evidence of high-grade VUR, which were treated with DX-HA. Only 1 case had a partial remission; however, there were no episodes of urinary tract infection in 12 months of follow-up. Suburethral injection is an endoscopic treatment modality with low morbidity in our country.
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  Identification of infection by Chikungunya, Zika, and Dengue in an area of the Peruvian coast. Molecular diagnosis and clinical characteristics

  Sánchez-Carbonel, José; Tantaléan-Yépez, Derek; Aguilar-Luis, Miguel Angel; Silva-Caso, Wilmer; Weilg, Pablo; Vásquez-Achaya, Fernando; Costa, Luis; Martins-Luna, Johanna; Sandoval, Isabel; del Valle-Mendoza, Juana (BioMed Central Ltd., 2018-03-14)

  Objective: To assess the presence of Dengue, Chikungunya, and Zika in serum samples of patients with acute febrile illness in Piura, Peru and describe the most common clinical features. Results: Dengue was the most common arbovirus detected in 170/496 (34.3%), followed by Zika in 39/496 (7.9%) and Chikungunya in 23/496 (4.6%). Among the 170 samples positive for Dengue, serotype 2 was the most predominant type present in 97/170 (57.1%) of samples, followed by the serotype 3 in 9/170 (5.3%). Headaches, muscle pain, and joint pain were the most common symptoms associated with fever in patients with Dengue and Zika. No symptoms predominance was observed in patients with Chikungunya.Dengue is considered the most frequent arbovirus in Peru and the number of cases has increased dramatically in the last 5 years. However, it is not the only arbovirus that circulates along the northern coast of Peru. It has also been determined the presence of Zika and Chikungunya in our population, which may suggest the circulation of other arboviruses that have not been detected.

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  Development of a clinical prediction rule for the diagnosis of pleural tuberculosis in Peru

  Solari, Lely; Soto, Alonso; Van der Stuyft, Patrick (Elsevier B.V., 2018-04)

  Objectives: To develop a clinical prediction rule (CPR) for the diagnosis of pleural tuberculosis (PT) in patients with pleural exudates in Peru. Methods: Clinical and laboratory information was collected from patients with exudative pleural effusion attending two reference hospitals in Lima, Peru. Predictive findings associated with PT in a multiple logistic regression model were used to develop the CPR. A definite diagnosis of PT was based on a composite reference standard including bacteriological and/or histological analysis of pleural fluid and pleural biopsy specimens. Results: A total of 238 patients were included in the analysis, of whom 176 had PT. Age, sex, previous contact with a TB patient, presence of lymphadenopathy, and pleural adenosine deaminase (ADA) levels were found to be independently associated with PT. These predictive findings were used to construct a CPR, for which the area under the receiver operating characteristics curve (AUC) was 0.92. The single best cut-off point was a score of ≥60 points, which had a sensitivity of 88%, specificity of 92%, a positive likelihood ratio of 10.9, and a negative likelihood ratio of 0.13. Conclusions: The CPR is accurate for the diagnosis of PT and could be useful for treatment initiation while avoiding pleural biopsy. A prospective evaluation is needed before its implementation in different settings.

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  Case report: Clitoromegaly as a consequence of Congenital Adrenal Hyperplasia. An accurate medical and surgical approach

  Fernandez-Aristi, Augusto Rafael; Taco-Masias, Andre Alonso; Montesinos-Baca, Luis (Elsevier Inc, 2018-05)

  We present a case of a woman with a history of Congenital Adrenal Hyperplasia (CAH) diagnosed at the age of 12, who was referred to our unit for surgical treatment. Despite the initial diagnosis was an indirect inguinal hernia, it was a misdiagnosis. Once in our service, this was corrected into clitoromegaly secondary to CAH. Physical examination and imaging test discarded other abnormalities, such as secondary effects androgenization. Regarding surgical treatment, the techniques used were Spencer and Allen combined with Kumar, which are the most used for clitoroplasty but also less used in Peru.

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