• Baja adherencia al régimen de hemodiálisis en pacientes con enfermedad crónica renal en un hospital de referencia del Ministerio de Salud en Perú

      Herrera Añazco, Percy; Palacios Guillen, Melissa; Mezones-Holguín, Edward; Hernández, Adrian V.; Chipayo Gonzales, David (Facultad de Medicina Humana de la Universidad Nacional Mayor de San Marcos (UNMSM), 2014-12-05)
      Introducción: La ausencia a una sesión mensual en un esquema de diálisis convencional puede incrementar la mortalidad en 30%. Objetivos: Describir la frecuencia y la percepción de las causas de falta de adherencia a diálisis en una población prevalente de un hospital público de referencia nacional en Perú. Diseño: Estudio descriptivo. Institución: Servicio de Nefrología, Hospital Nacional 2 de Mayo, Lima, Perú. Participantes: Pacientes con más de un año en diálisis Intervenciones: Se determinó el número de faltas y se aplicó un cuestionario para describir su percepción respecto a las causas de las faltas, validado por juicio de expertos. Principales medidas de resultados: Baja adherencia a diálisis definida como: pacientes con más de una falta al mes o más de 12 faltas, entre julio de 2012 y julio de 2013. Resultados: Se incluyó 54 pacientes, 27 eran varones, con una edad y tiempo de diálisis promedio de 57 ± 16,4 años y 40,6 ±11,5 meses, respectivamente; 7/54 pacientes tenían educación superior. Hubo 504 faltas (5,45%). El segundo día de la programación semanal fue el día con mayor frecuencia de faltas (292), seguido del tercer día (145); 13/54 tuvieron baja adherencia. Las principales causas reportadas fueron: una residencia alejada (6/13), la sensación de bienestar (6/13), el contar con escasos recursos económicos para solventar el traslado (5/13). Conclusiones: Uno de cada cuatro pacientes tuvo baja adherencia. El residir lejos o que se sintiera bien fueron las principales causas de la baja adherencia.
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    • Baja frecuencia de positividad serológica en pacientes con biopsias histológicamente compatibles con enfermedad celiaca en Perú.

      Arévalo, F.; Roe, E.; Arias-Stella Castillo, J.; Cárdenas, J.; Montes, P.; Monge, E. (Sociedad Española de Patología Digestiva, 2014-03-24)
      Objective: to study the frequency of positive serology for celiac disease (CD) in patients with duodenal biopsies suggestive of this disease. Material and methods: cross sectional study. We included patients with duodenal biopsies histologically compatible with CD and antigliadin, antiendomysial and IgA antitransglutaminase antibodies. We defined a “case” of CD if there was a positive biopsy and either antiendomisial or antitransglutaminase positive antibodies. Results: thirty one patients were included in our study. Six were antiendomysial positive and 5 antitransglutaminase positive while the antigliadin was positive in 14 cases. Therefore, out of 31 patients only 10 had a serology compatible with CD and only one had positive both antibodies, antiendomysial and antitransglutaminase. Conclusions: a) we have found that most of the duodenal biopsies compatible with CD are not diagnosed with positive serology; and b) we found a low correlation between serological diagnostic tests.
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    • Baja prevalencia de enfermedad inflamatoria intestinal en el Perú.

      Kossuth-Cabrejos, Stefano; Alcedo, Sami; Piscoya, Alejandro (Sociedad Argentina de Gastroenterología (SAGE), 2014-03-26)
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    • Baja publicación de los trabajos presentados a los Congresos de la Sociedad de Gastroenterología del Perú 1998-2008.

      Pereyra Elías, Reneé; Ng-Sueng, Luis Fernando; Toro-Polo, Luis Miguel; Nizama Vía, Ayar; Piscoya, Alejandro; Mayta-Tristan, Percy (Sociedad de Gastroenterología del Perú (SGP), 2014-03-24)
      OBJECTIVES: To determine the proportion of abstracts presented at the Congreso Peruano de Gastroenterología (the major Peruvian gastroenterological scientific meeting), that had been published in scientific journals, the date of publication and its associated factors. MATERIALS & METHODS: Longitudinal retrospective and analytic study; the publication rate of all the abstracts presented in the biennial Congreso Peruano de Gastroenterología between 1998 and 2008 was assessed. Google Scholar engine was used. The searching strategy performed included: (“Study location” AND “population studied” AND “main outcome”) AND (autor:First OR autor:Second OR autor:Last). Logistic regression was used, considering p<0.05 statistically significant. RESULTS: Publication rate was 8.2% (34/217), statistically significant differences were found among meeting years (p<0.001). There were also differences between study design, objectives (more in analytic studies) and measurement (more in longitudinal studies)(p<0.001). 82.4% were published in the Revista de Gastroenterología del Perú. The median time for publication was 10.8±10.4 months; this variable and the meeting year, study type, journal of publication or accordance between the abstract and publication characteristics showed no statistical differences. The mean authors’ number was 5.02±2.4; analytic studies have less authors than the descriptive ones (3.6 vs 6.1; p=0.012) CONCLUSION: The Congreso Peruano de Gastroenterología presents a low publication rate of the abstracts presented, which can be used as a quality indicator of the abstracts and the reviewing process.
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    • Bajo nivel de conocimientos y actitud de rechazo hacia el tratamiento de tuberculosis*.

      Antón Neyra, Robert; Mezones-Holguín, Edward (Instituto Nacional de Salud (INS), 2014-03-21)
      Cartas al editor.
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    • Balance trabajo-vida: un nuevo indicador del bienestar de profesionales de la salud

      Valentina Muñoz-Araya; Mayta-Tristan, Percy (Sociedad Médica de Santiago, 2017-10)
      Cartas al Editor
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    • Bilateral endogenous ophthalmitis due to Candida glabrata after complicated bariatric surgery

      Pizango, O.; Tejeda, E.; Buendia, M.; Lujana, S. (Elsevier B.V., 2015-03-24)
      Case report: A 43-year-old female presented with decreased visual acuity in the right eye.“Snowball-like” retinal lesions were found in both eyes on examination. Due to a lackof improvement with intravitreal antifungal empirical treatment, vitreous culture wasperformed and Candida glabrata was isolated. The patient then received intravitreal ampho-tericin B, as well as systemic treatment with caspofungin and amphotericin B lipid complex.Discussion: Endogenous fungal endophthalmitis is a sight-threatening condition. There arefew reports of C. glabrata endogenous endophthalmitis. Treatment regimens for Candidaendophthalmitis include combinations of systemic and/or intravitreal antifungals, as wellas vitrectomy.
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    • Biliary peritonitis due to a ruptured amebic liver abscess mimicking a periampullary tumor and liver metastases with the elevation of CA 19-9 and CA 125: a case report

      Marin-Leiva, Javiera; Jeri-Yabar, Antoine; Hernandez Fernandez, Wendy; Damian Bello, Edwin; U201314846@upc.edu.pe (S. Karger AG, 2018-06)
      Introduction: An amebic liver abscess is the most common presentation of extraintestinal amebiasis. This condition is the result of a parasite infection caused by Entamoeba histolytica. Materials and Methods: We report a case of a 53-year-old male who presented with abdominal pain in the right upper quadrant, jaundice, and a 10-kg weight loss within a 1-month span. Results and Conclusion: A wide range of symptoms and findings in the imaging tests suggestive of neoplasia, elevated levels of CA 19-9 and CA 125, and the presentation of biliary peritonitis as a complication makes this case a challenge for its approach and management.
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    • Bioimpedance markers and tuberculosis outcome among HIV-infected patients

      Montalvo, R; Kirwan, D; Gilman, R; Bernabe-Ortiz, Antonio; otivo3@hotmail.com (Obafemi Awolowo University, 2018)
      ackground: The changes in body composition markers (weight, fat mass, lean mass, and BMI) over time can be associated with TB treatment outcome among HIV-infected patients. The aim of this study was to investigate whether changes in fat mass and lean mass were associated with the treatment response among patients with HIV infection and pulmonary tuberculosis. Materials and Methods: This was a prospective cohort study. Data from HIV-infected patients commencing TB therapy were analyzed. This included body weight measurement using bioimpedance equipment at baseline, one month, and two months after starting TB treatment. Results: The study was conducted in 125 patients, 17 patients (13.6%) died during treatment, of which 5 died during the first month of treatment, 4 during the second month and 8 after the second month. The group of patients with good response, increased their weight by 1.3 kg (p <0.001) at the end of the first month of TB treatment and 2.6 kg in the second month (p <0.001), and body fat increase was 1.2 Kg (p <0.001) and 2.3 kg (p <0.001), the first and second month respectively. The group of patients who died had lost 2.1 kg fat mass after the first month (p <0.001) and 3.7 kg in the second month (p <0.001). Conclusions: Our results show that the weight change during TB treatment (increased fat mass) helps us predict therapeutic response. Weight loss during the first month of starting therapy should be evaluated thoroughly to identify the probable cause of treatment failure.
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    • BISAP-O: obesidad incluida en el score BISAP para mejorar la predicción de severidad en pancreatitis aguda

      Guzmán Calderon, Edson; Montes Teves, Pedro; Monge Salgado, Eduardo (Sociedad de Gastroenterología del Perú (SGP), 2014-08-11)
      INTRODUCTION: Most patients with acute pancreatitis exhibits a self-limiting clinical course and relatively free of major complications. Several scores have been created with the intention of achieving adequate and early predict the severity of pancreatitis in order to reduce this mortality. BISAP score was validated in 2008 as a predictor of mortality for acute pancreatitis, obesity is an independent risk factor that increases the risk of severity in patients with acute pancreatitis. The aim of this study is to determine whether obesity BISAP added a score improves prediction of severity in patients with acute pancreatitis MATERIAL AND METHODS: This study was conducted in Daniel Alcides Carrión Hospital, Lima, Peru. The patient data were collected in the Emergency Service, it was a cross-sectional retrospective study, between January 2009 and June 2010. RESULTS: We evaluated a total of 99 patients with acute pancreatitis. Etiology of the 99 were biliary pancreatitis. Only 2 ended in death (2%). Most cases occurred in female patients 77/22 (77.8%). Sixteen of the 99 patients (16%) were considered severe acute pancreatitis. 90% (89/99) had a BISAP <3, 10% a BISAP ≥ 3, fifteen of the 99 patients had a BISAP-O> 3, of them 12 were actually considered a severe pancreatitis. Of 16 patients with severe pancreatitis, 14 patients had a BMI> 25. (P = 0.03, OR = 4.39). BISAP-O has a sensitivity, specificity, PPV and NPV of 75%, 96.4%, 80% and 95.2% respectively, with an accuracy of 92.3%. The area under the curve for BISAP-O was 0.94 (95% CI 0.89 to 0.99). There was no difference when compared with the other studied scores (p = 0.45). CONCLUSIONS: BISAP The score is a simple method that can be used to predict the severity of acute pancreatitis. Obesity associated BISAP (BISAP-O) provides higher sensitivity and diagnostic accuracy to score BISAP and can serve as a parameter to help predict severity in patients with acute pancreatitis. It was not possible to assess the BISAP-O score as a predictor of mortality for patients with acute pancreatitis, due to the low mortality rate in the present study. Further studies are required to validate the score BISAP associated with obesity in predicting severity.
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    • Body Image Dissatisfaction vs Muscle Dysmorphia

      Wiegereing Rospigliosi,Andrés; Poletti Jabbour,Jamil; Pereira Elias, José; jamilpoletti@gmail.com (Universidad de Teherán de Ciencias Médicas, 2016-09-27)
      Cartas al Editor
    • Body mass index and vigorous physical activity in children and adolescents: an international cross-sectional study.

      Braithwaite, Irene E; Stewart, Alistair W; Hancox, Robert J; Murphy, Rinki; Wall, Clare R; Beasley, Richard; Mitchell, Edwin A; irene.braithwaite@mrinz.ac.nz (Blackwell Publishing Ltd, 2017-08-01)
      Aim: To examine the relationship between reported vigorous physical activity (VPA) and body mass index (BMI) in children (6–7 years) and adolescents (13–14 years). Methods: In the International Study of Asthma and Allergies in Childhood Phase Three, 75 895 children's parents and 199 502 adolescents answered questions relating to VPA, height and weight. The association between VPA and BMI was analysed using general linear models, adjusting for country gross national index. Results: Compared to children who undertook no VPA, those in the infrequent group (once or twice per week) and those in the frequent group (three or more times per week) had mean (95% CI) BMI values 0.07 kg/m 2 (0.03–0.11) and 0.09 kg/m 2 (0.03–0.15) greater, respectively (p = 0.001). Compared to adolescents reporting no VPA, those in the infrequent group had a BMI 0.19 kg/m 2 (0.15–0.23) greater while those in the frequent group had a BMI 0.01 kg/m 2 (−0.03–0.05) greater (p < 0.0001). Conclusion: Reported VPA is not associated with lower BMI among children and adolescents. Investigation of VPA and BMI may be best undertaken in conjunction with other variables in the energy expenditure equation. A focus on VPA alone may be an inefficient way to manage BMI.
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    • Body Parts Matter: Social, Behavioral, and Biological Considerations for Urethral, Pharyngeal, and Rectal Gonorrhea and Chlamydia Screening Among MSM in Lima, Peru

      Passaro, R. Colby; Segura, Eddy R.; Perez-Brumer, Amaya; Cabeza, Jeanne; Montano, Silvia M.; Lake, Jordan E.; Sanchez, Jorge; Lama, Javier R.; Clark, Jesse L. (American Sexually Transmitted Diseases Association, 2018-02)
      Background Gonorrhea (GC) and chlamydia (CT) disproportionately affect men who have sex with men (MSM), and public health implications vary by anatomic site and bacterial agent. Urethral and rectal GC and CT can increase risk of HIV transmission, while pharyngeal GC may be a reservoir for antimicrobial resistance. To define screening priorities in Latin America, we compare differences in the prevalence and correlates of urethral, pharyngeal, and rectal GC and CT among MSM in Peru. Methods A cross-sectional sample of 787 MSM from Lima was screened between 2012-2014. We described prevalence of urethral, pharyngeal, and rectal GC and CT infection and conducted bivariate analyses of associations with social, behavioral, and biological characteristics. Poisson regression analyses assessed the correlates of each infection at each anatomic site. Results The most commonly symptomatic infection (urethral GC; 42.1%) was the least prevalent (2.4%). The most prevalent infections were rectal CT (15.8%) and pharyngeal GC (9.9%). Rectal CT was the least commonly symptomatic (2.4%) infection, and was associated with younger age (aPR, 95% CI: 0.96, 0.94-0.98), HIV infection (1.46, 1.06-2.02), and pasivo (receptive; 3.59, 1.62-7.95) and moderno (versatile; 2.63, 1.23-5.60) sexual roles. Conclusions Results highlight limitations of current syndromic screening strategies for STDs in Peru, wherein urethral CT and rectal GC and CT may be missed due to their frequently asymptomatic presentations. Successful management of GC and CT infections among MSM in low-resource settings requires differentiating between bacterial agent, symptomatic presentation, associated risk factors, and public health implications of untreated infection at different anatomic sites.
    • Bordetella pertussis diagnosis in children under five years of age in the Regional Hospital of Cajamarca, Northern Peru

      Del Valle Mendoza, Juana Mercedes; Casabona Oré, Veronica; Petrozzi Helasvuo, Veronica; Cornejo Tapia, Angela; Weilg, Pablo; Pons, Maria J; Cieza Mora, Erico; Bazán Mayra, Jorge; Cornejo Pacherres, Hernan; Ruiz, Joaquin (The Journal of Infection in Developing Countries (JIDC), 2015-11-30)
      Introduction: Bordetella pertussis is an important human pathogen that causes whooping cough (pertussis), an endemic illness responsible of significant morbidity and mortality, especially in infants and children. Worldwide, there are an estimated of 16 million cases of pertussis, resulting in about 195,000 child deaths per year. In Peru, pertussis is a major health problem that has been on the increase despite immunization efforts. The objective of this study was to determine the prevalence of B. pertussis among children under five years of age suspected to have whopping cough in Cajamarca, Peru. Methodology: Children diagnosed with whooping cough admitted to the Hospital Regional de Cajamarca from August 2010 to July 2013 were included. Nasopharyngeal samples were obtained for B. pertussis culture and polymerase chain reaction (PCR) detection. Results: In 133 children, the pertussis toxin and IS481 gene were detected in 38.35% (51/133) of the cases by PCR, while only 9.02% (12/133) of the Bordetella cultures were positive. The most frequent symptoms in patients with positive B. pertussis were paroxysm of coughing 68.63% (35/51), cyanosis 56.86% (29/51), respiratory distress 43.14% (22/51), and fever 39.22% (20/51). Pneumonia and acute bronchial obstructive syndrome were present in 17.65% (9/51) and 13.72% (7/51) of the cases, respectively. Conclusions: B. pertussis is responsible for an important proportion of whooping cough in hospitalized children in Cajamarca. Epidemiologic surveillance programs for B. pertussis are essential in Peru, especially in children who could most benefit from the vaccine.
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    • Bordetella pertussis in children hospitalized with a respiratory infection: clinical characteristics and pathogen detection in household contacts

      del Valle-Mendoza, Juana; Silva-Caso, Wilmer; Aguilar-Luis, Miguel Angel; del Valle-Vargas, Cristina; Cieza-Mora, Erico; Martins-Luna, Johanna; Aquino-Ortega, Ronald; Silva-Vásquez, Andrea; Bazán-Mayra, Jorge; Weilg, Pablo; juana.delvalle@upc.pe; gian_will@hotmail.com; ma23aguilar@gmail.com; cristina.del.valle88@gmail.com; ericocieza@yahoo.es; johmarlu14@gmail.com; ronaldaquino.one@gmail.com; silvavasquezandrea@mail.com; jorgebazan7@gmail.com; pablo.weilg@gmail.com (BioMed Central Ltd., 2018-05)
      Objective: Describe the prevalence of Bordetella pertussis via PCR in children under 5 years old hospitalized as probable cases of pertussis and report the most common clinical features among them. Results: A positive PCR result for B. pertussis was observed in 20.5% of our samples (18/88), one-third of them were from infants between 2 and 3 months old. The most common symptoms were paroxysms of coughing (88.9%), difficulty breathing (72.2%), cyanosis (77.8%) and fever (50%). The mother was the most common symptomatic carrier (27.8%), followed by uncles/aunts (22.2%) among children with pertussis.
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    • Breast implant-associated anaplastic large cell lymphoma: a review

      Quesada, Andrés E.; Medeiros, L. Jeffrey; Clemens, Mark W.; Ferrufino-Schmidt, Maria C.; Pina-Oviedo, Sergio; Miranda, Roberto N.; Roberto.miranda@mdanderson.org (Nature Publishing Group, 2018)
      Breast implant-associated anaplastic large cell lymphoma is a newly recognized provisional entity in the 2017 revision of the World Health Organization Classification of Tumors of Hematopoietic and Lymphoid Tissues. It is an uncommon, slow growing T-cell lymphoma with morphology and immunophenotype similar to anaplastic lymphoma kinase-negative anaplastic large cell lymphoma. However, the presentation and treatment are unique. Breast implant-associated anaplastic large cell lymphoma often presents as a unilateral effusion confined to the capsule of a textured-surface breast implant, a median time of 9 years after the initial implants have been placed. Although it follows an indolent clinical course, breast implant-associated anaplastic large cell lymphoma has the potential to form a mass, to invade locally through the capsule into breast parenchyma or soft tissue and/or to spread to regional lymph nodes. In most cases, an explantation with a complete capsulectomy removing all disease, without chemotherapy is considered to be curative and confers an excellent event free and overall survival. Here we provide a comprehensive review of breast implant-associated anaplastic large cell lymphoma, including history, epidemiology, clinical features, imaging and pathology findings, pathologic handling, pathogenic mechanisms, model for progression, therapy and outcomes as well as an analysis of causality between breast implants and anaplastic large cell lymphoma.
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    • Brief Report: HIV-1 Seroconversion Is Not Associated With Prolonged Rectal Mucosal Inflammation

      Blair, Cheríe S.; Lake, Jordan E.; Passaro, Ryan C.; Chavez-Gomez, Susan; Segura, Eddy R.; Elliott, Julie; Fulcher, Jennifer A.; Shoptaw, Steven; Cabello, Robinson; Clark, Jesse L. (NLM (Medline), 2021-04-15)
      OBJECTIVE: Determine the impact of HIV-1 seroconversion on inflammatory cytokines in the rectal mucosa. SETTING: Secondary analysis of data from men who have sex with men and transgender women who participated in a HIV prevention trial Lima, Peru. METHODS: From July to December 2017, 605 men who have sex with men and transgender women were screened for rectal gonorrhea/chlamydia (GC/CT). Fifty GC/CT-positive cases were randomly selected and matched with 52 GC/CT-negative controls by age and number of receptive anal intercourse partners in the last month. All participants were HIV-negative at baseline and those with GC/CT at baseline and/or follow-up received appropriate antibiotic therapy. Participants underwent sponge collection of rectal secretions for the measurement of inflammatory cytokines (IL-1β, IL-6, IL-8, and TNF-α) and were screened for rectal GC/CT and HIV at baseline, 3 months, and 6 months. Wilcoxon rank-sum tests compared inflammatory cytokine levels between participants diagnosed with HIV during follow-up and persons who remained HIV-negative. RESULTS: Eight participants were diagnosed with HIV at the 3-month (n = 6) or 6-month (n = 2) visit. The median number of receptive anal intercourse partners in the month before HIV diagnosis was the same for those who acquired HIV and those who did not. There were no significant differences in inflammatory cytokine levels in rectal mucosa between participants who did and did not experience HIV seroconversion at any time point. CONCLUSIONS: Despite a surge in viral replication during acute infection, findings from this study suggest that there is no prolonged effect of HIV-1 seroconversion on inflammatory cytokine levels in the rectal mucosa. Copyright
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    • Burnout syndrome among medical students in Mexico: considerations about its measurement with the Maslach Burnout Inventory

      Maticorena Quevedo, Jesús; Anduaga Beramendi, Alexander; Beas, Renato; jesus.maticorena@gmail.com (Medwave Estudios Limitada, 2016-05-17)
      Cartas al editor
      Acceso abierto
    • Burnout syndrome in athletes and their association with body image dissatisfaction at a private university

      Baella-Vigil, Gilda V.; Hurtado-Bocanegra, Mayra; Marroquín-Quintana, Julio; Rojas-Fernández, María V.; Rosales-Medina, Jessica M.; Urbina-Rodríguez, Juan C.; Tarabay-Barriga, Ana P.; Carreazo, Nilton Y. (Edizioni Minerva Medica, 2020-04-01)
      BACKGROUND: Burnout syndrome, from the sporting point of view, is the integration of both physical and emotional signs, caused by the high demands in competition. According to several studies, the prevalence of burnout syndrome is influenced by several factors that would lead to athlete’s body image dissatisfaction. METHODS: The study design is cross-sectional analysis. The study sample was 352 athletes selected from the Universidad Peruana de Ciencias Aplicadas (UPC). The main variables of this study are the burnout syndrome; which was measured by Athlete Burnout Questionnaire (ABQ) and body image dissatisfaction, through thirteen Scale drawings contour figure Gardner. To find the association between body image dissatisfaction and burnout syndrome Poisson regression was used. RESULTS: Athletes with burnout syndrome have 1.08 times more likely having body image dissatisfaction with a value P=0.011 (95% CI: 1.02-1.15). It was also found that a sport collectively practiced is a protective factor for Burnout Syndrome with P=0.015 (95% CI: 0.4-0.9). CONCLUSIONS: Relation between burnout syndrome and body image dissatisfaction in athletes was found. In addition, a relationship between practicing an individual sport and burnout syndrome was also found. More studies are necessary to confirm these relationships.
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    • ¿Calcificaciones valvulares en ERC: enfermedad mineral ósea o riesgo cardiovascular previo?

      Bocanegra Jesús, Alejandra; Guinetti Ortiz, Katia; Gómez de la Torre del Carpio, Andrea (Elsevier B.V., 2015-12)
      Cartas al editor
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