• ¿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
      Acceso abierto
    • Cannabinoids for Medical Use A Systematic Review and Meta-analysis

      Whiting, Penny F.; Wolff, Robert F.; Deshpande, Sohan; Di Nisio, Marcello; Duffy, Steven; Hernández, Adrian V.; Keurentjes, J. Christiaan; Lang, Shona; Misso, Kate; Ryder, Steve; Schmidlkofer, Simone; Westwood, Marie; Kleijnen, Jos (American Medical Association, 2015-06-24)
      Importance Cannabis and cannabinoid drugs are widely used to treat disease or alleviate symptoms, but their efficacy for specific indications is not clear. Objective To conduct a systematic review of the benefits and adverse events (AEs) of cannabinoids. Data Sources Twenty-eight databases from inception to April 2015. Study Selection Randomized clinical trials of cannabinoids for the following indications: nausea and vomiting due to chemotherapy, appetite stimulation in HIV/AIDS, chronic pain, spasticity due to multiple sclerosis or paraplegia, depression, anxiety disorder, sleep disorder, psychosis, glaucoma, or Tourette syndrome. Data Extraction and Synthesis Study quality was assessed using the Cochrane risk of bias tool. All review stages were conducted independently by 2 reviewers. Where possible, data were pooled using random-effects meta-analysis. Main Outcomes and Measures Patient-relevant/disease-specific outcomes, activities of daily living, quality of life, global impression of change, and AEs. Results A total of 79 trials (6462 participants) were included; 4 were judged at low risk of bias. Most trials showed improvement in symptoms associated with cannabinoids but these associations did not reach statistical significance in all trials. Compared with placebo, cannabinoids were associated with a greater average number of patients showing a complete nausea and vomiting response (47% vs 20%; odds ratio [OR], 3.82 [95% CI, 1.55-9.42]; 3 trials), reduction in pain (37% vs 31%; OR, 1.41 [95% CI, 0.99-2.00]; 8 trials), a greater average reduction in numerical rating scale pain assessment (on a 0-10-point scale; weighted mean difference [WMD], −0.46 [95% CI, −0.80 to −0.11]; 6 trials), and average reduction in the Ashworth spasticity scale (WMD, −0.36 [95% CI, −0.69 to −0.05]; 7 trials). There was an increased risk of short-term AEs with cannabinoids, including serious AEs. Common AEs included dizziness, dry mouth, nausea, fatigue, somnolence, euphoria, vomiting, disorientation, drowsiness, confusion, loss of balance, and hallucination. Conclusions and Relevance There was moderate-quality evidence to support the use of cannabinoids for the treatment of chronic pain and spasticity. There was low-quality evidence suggesting that cannabinoids were associated with improvements in nausea and vomiting due to chemotherapy, weight gain in HIV infection, sleep disorders, and Tourette syndrome. Cannabinoids were associated with an increased risk of short-term AEs.
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    • Características de la lonchera del preescolar y conocimiento nutricional del cuidador: un estudio piloto en Lima, Perú, 2016

      Arévalo-Rivasplata, Lupe; Castro Reto, Susan; García Alva, Geraldine; Segura, Eddy R.; gerig1296@gmail.com (Elsevier España S.L., 2016-08-17)
      Cartas al Editor
      Acceso abierto
    • Características de las úlceras gastroduodenales en pacientes con biopsia negativa para Helicobacter pylori.

      Montes Teves, Pedro; Salazar Ventura, Sonia; Monge Salgado, Eduardo (Sociedad Argentina de Gastroenterología, 2014-03-24)
      Objetives. To evaluate the clinical, epidemiological and endoscopic characteristics of the Helicobacter pylori (Hp) negative peptic ulcer disease. Methods. In this cross sectional study we included 651 patients diagnosed of peptic ulcer disease between January 2000 and December 2005. The diagnosis of Hp infection was established by histology. Clinical and epidemiological characteristics of patients with and without Hp infection were compared. Results. Males prevailed (69%). Hp negative ulcers were older (57,73 +/- 19,44 years old vs 50,26 +/- 18, 64 years old, P < 0.001). Clinical characteristics did not differ among both groups. Duodenal ulcer prevailed in Hp positive patients (56,5%) and gastric ulcer in Hp negative patients (53,5%). Multiple ulcers and intestinal metaplasia were more frequently found in Hp negative cases [9.3% vs 4.5 % (P = 0,015) and 34.5% vs 22.1% (P = 0,001), respectively]. Conclusion. Hp negative peptic ulcer disease is found in older patients, with a higher frequency of gastric ulcers, multiple lesions and intestinal metaplasia.
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    • Características de los cursos de investigación en escuelas de medicina del Perú

      Taype Rondán, Á; Huaccho Rojas, J.; Pereyra Elías, Reneé; Mayta-Tristan, Percy; Mejia, Christian R. (Insight Medical Publishing, 2015-05-23)
      Objetivo: Describir las características de los cursos de investigación y la producción científica de sus docentes en las escuelas de medicina del Perú. Métodos: Se realizó un estudio descriptivo, con los datos de las 32 escuelas de medicina del Perú existentes al 2011, las currículas de los cursos de investigación de estas escuelas, y los docentes de dichos cursos. Se evaluó el número de cursos, docentes y sus publicaciones. Resultados: La mediana de créditos de investigación fue 5,5 [rango 2 a 18] por escuela, y la mediana del porcentaje del total de créditos fue de 1,75% [rango 0,6 a 6,3]. En 18/32 (56%) escuelas existió algún curso en el que se solicitó al estudiante la presentación de un informe final, pero solo una escuela tuvo algún curso que incluyó prácticas de envío a publicación. Además, solo 5 (15,6%) escuelas contaron con algún docente que haya publicado al menos un artículo original como autor corresponsal en Scopus alguna vez en su vida. Conclusión: Los cursos de investigación de las escuelas de medicina del Perú no enseñan el proceso de publicación en revistas indizadas y los docentes de estos cursos tienen una baja producción científica.
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    • Características del diagnóstico y tratamiento de la tuberculosis pulmonar en pacientes con y sin diabetes mellitus tipo 2

      Carrión Torres, Omar Jesús; Cazorla Saravia, Patrick Sebastian; Torres Sales, José William; Carreazo, Nilton Yhuri; De La Cruz Armijo, Frank Enrique (Instituto Nacional de Salud (INS), 2016-02-01)
      To determine whether there are demographic, clinical and radiological differences among patients with pulmonary tuberculosis (TB) and patients with TB and type 2 diabetes mellitus (DM2 + TB).
      Acceso abierto
    • Características del maltrato hacia estudiantes de medicina de una universidad pública del Perú

      Munayco Guillén, Fernando; Cámara Reyes, Anaís; Muñoz Tafur, L. Jaime; Arroyo Hernández, Hugo; Mejia, Christian R.; Lem Arce, Felix; Miranda Soberón, Ubaldo E.; fernando.munayco.guillen@gmail.com (Instituto Nacional de Salud (INS), 2016-03)
      Objetivos. Determinar las características del maltrato hacia estudiantes de Medicina de una universidad pública en la provincia de Ica, Perú. Materiales y métodos. Investigación transversal realizada el 2012 en una muestra probabilística de estudiantes de Medicina de primer a sexto año de la Universidad Nacional San Luis Gonzaga. Se elaboró una encuesta con un total de 23 ítems en una escala likert, para medir la percepción de maltrato de tipo psicológico, físico, académico y sexual; se usaron análisis estadísticos univariados y bivariados. Resultados. Se encuestaron 281 estudiantes. La percepción de maltrato psicológico fue 96,8%, académico 86,8%, físico 62,6% y sexual 20,6%; el maltrato físico se incrementó durante el ciclo de estudio clínico-quirúrgico (p=0,001). Los médicos docentes y médicos residentes fueron los principales agresores. Estudiantes hombres reportaron con mayor frecuencia haber recibido tareas como castigo, no recibir los créditos por su trabajo, maltrato físico, amenazas verbales, insultos o recibir burlas con respecto a su etnia; mientras que el maltrato sexual fue mayor en mujeres. El reporte de maltrato sexual fue más frecuente en la universidad (45,3%, p=0,002) y el hospital (45,0%, p=0,046). Las mujeres reportaron con mayor frecuencia no saber a quién o dónde acudir para denunciar el maltrato (54,6%, p=0,042) y no denunciarlo porque se detuvo el maltrato (56,9%, p=0,048). Conclusiones. Existe una alta prevalencia de maltrato, donde las características de los estudiantes según el sexo, los ciclos de estudio y el agresor permiten identificar los tipos de maltrato que reciben los estudiantes de medicina.
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    • Características histológicas y endoscópicas del cáncer gástrico diagnosticado en un Hospital Nacional del Callao, Perú.

      Rodríguez-Vargas, Briny; Arévalo-Suarez, Fernando; Monge-Salgado, Eduardo; Montes-Teves, Pedro (Instituto Nacional de Salud (INS), 2014-03-19)
      Objetivos. To describe the histologic and endoscopic characteristics reported among patients diagnosed with gastric cancer in “Daniel Alcides Carrion” National Hospital in Callao. Materials and methods. We performed a case series including all patients with histological diagnosis of gastric cancer from January 2009 to December 2011. Data were obtained from the registers of the pathology service of Daniel Alcides Carrion National Hospital. Factors such as age and gender of patients, histologic type, endoscopic location, presence of intestinal metaplasia, histologic degree, and cancer morphology were evaluated. Results. 120 patients were included. Mean age was 65.4 ± 13.6 years; 59 (49%) were male. Based on the histologic type, intestinal type was found among 68 (56%); diffuse type among 45 (38%), and a mixed type in 7 (6%). Regarding the site, 23 (19%) of gastric cancers were located in the fundus; 52 (43%) in the body; 39 (33%) in the antrum, and 6 (5%) in the pylorus. Patients with gastric cancer of the intestinal type were in average older than those with a diffuse type (69.1 ± 10.3 versus 59.3 ± 15.3). 60.3% of intestinal-type gastric cancers were located proximally, versus 66.6% of diffuse-type cancers. Conclusion. Among the studied population, diffuse-type gastric cancer appears at an earlier age than the intestinal type, and its most common location is proximal.
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    • Carbamazepine and oxcarbazepine: reflections after an oxcarbazepine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis overlap.

      Poletti Jabbour, Jamil; Wiegering Rospigliosi, Andrés; Pereyra Elías, Reneé; Elías Barrera, Carmen Cecilia; renee.pereyra.elias@gmail.com (Springer International Publishing, 2016-04-29)
      Letters to editor
      Acceso restringido temporalmente
    • Carcinoma epidermoide de pene en un varón adulto

      Morales Luna, D.; Manrique Chávez, Manuel; Weilg, P.; manuel.manrique.chavez@gmail.com (Organo oficial del Colegio Ibero-Latino-Americano de Dermatología, 2014-11-03)
      The penile carcinoma is rare neoplasia representing 1.3% of all malignancies in men. We report a 52 years old man with epidermoid cancinoma of penis that start with a local ulceration. The tumor presented a fast progression involving the entire penis shaft in 6 months. Radical surgical procedure was performed. The diagnosis was confirmed by the histopathological study. We emphasize the short period of the evolution of the tumor, its histopathological characteristics and the treatment.
      Acceso abierto
    • Carcinoma medular de tiroides metastásico en mama en una paciente con diagnóstico clínico de neoplasia endocrina múltiple subtipo 2B: reporte de un caso

      D’Angelo Piaggio, Lorenzo; Echecopar Sabogal, José; Chanamé Baca, Diego M.; Teruya Gibu, Alberto; dmchaname@gmail.com (Elsevier B.V., 2016-07-29)
      El carcinoma medular de tiroides (CMT) es un tipo de neoplasia maligna infrecuente, con alto índice metastásico. Se presenta como un solo nódulo en más del 70% de los casos, y los principales órganos de metástasis a distancia son el hígado, el pulmón y el hueso. La metástasis en mama es rara, debido a que dentro de los tumores mamarios, solo entre el 0.2-1.3% son secundarios. El CMT se relaciona íntimamente con la neoplasia endocrina múltiple subtipo 2B (NEM2B), la cual es un desorden autosómico dominante caracterizado por la presencia de CMT y feocromocitoma en ausencia de hiperparatiroidismo. Rara vez, en el contexto de un NEM2B ocurre una metástasis de CMT en la mama, motivo por el cual se está presentando este caso
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    • Cardiac amyloidosis secondary to waldenström macroglobulinemia

      Lachira-Yparraguirre, Lizbeth; Al-kassab-Córdova, Ali; Quispe-Silvestre, Edgar; Enriquez-Vera, Daniel (Editorial Ciencias Medicas, 2020-01-01)
      Introduction: Waldenström's macroglobulinemia is a hematological neoplasm belonging to the group of monoclonal gammopathies, which includes systemic symptoms and those related to an increase in M paraprotein. Objective: To describe a case of cardiac amyloidosis associated with macroglobulinemia. Clinical case: Male patient who was admitted for asthenia, dysphonia, and who, during his evolution, developed progressive dyspnea, heart failure and pleural effusion. Additionally, echocardiography showed myocardial granular pattern, while pleural biopsy was positive for Congo red staining. Subsequently, he received treatment with bortezomib, dexamethasone and rituximab, with favorable evolution. Conclusions: In this disease, early diagnosis is an important advantage for survival. Therefore, its management is palliative of cardiac manifestations. The present case shows a diagnostic challenge, in which the less frequent etiologies of heart failure must be taken into account.
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    • Cardiovascular disease in human immunodeficiency virus-infection as a cause of hospitalization: a case-series in a General Hospital in Peru

      Valenzuela Rodríguez, Germán; Mezones-Holguín, Edward; Mendo Urbina, Fernando; Rodríguez Morales, Alfonso J. (Brazilian Society of Infectious Diseases, 2015-04-22)
      Acceso abierto
    • Carrion's disease after blood transfusion.

      Pons, Maria J; Lovato, Pedro; Silva, Jaquelyne; Urteaga, Numan; Del Valle Mendoza, Juana; Ruiz, Joaquim; joruiz@clinic.ub.es (SIMT, 2015-11-05)
      Bartonella bacilliformis is a pathogen that is endemic in some areas of the Andean region of Peru, southern Ecuador and southern Colombia. This pathogen causes so-called Carrion's disease, a biphasic disease with acute and chronic phases (called Oroya fever and "Peruvian wart" respectively1-3). In the absence or delay of antibiotic treatment, the mortality rate in the acute phase is up to 88%1. The acute phase is characterised by fever and severe anaemia and may be followed, several weeks or months later, by the chronic eruptive phase due to endothelial cell proliferation2. No animal reservoir has been identified to date and it is considered that healthy carriers act as a pathogen reservoir in endemic areas
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    • Carrion’s disease: an eradicable illness?

      Gomes, Cláudia; Pons, Maria J.; Del Valle Mendoza, Juana Mercedes; Ruiz, Joaquim; ma.pons.cas@gmail.com (BioMed Central Ltd., 2016-12-01)
      Carrion’s disease is a neglected tropical disease caused by Bartonella bacilliformis, a vector-borne pathogen restricted to the Andean valleys of Peru, Ecuador and Colombia. Carrion’s disease is a biphasic illness; in the acute phase the case-fatality rate can be as high as 88 %, related to high parasitemia, arriving to almost all erythrocytes, and secondary bacterial infections close related with the development of transient immunosuppression in the earlier illness phases. In addition, there are an undefined number of asymptomatic carriers that are reservoirs of the etiological agent of Carrion’s disease in endemic areas, they make take into account due to they are the perpetuators of this disease. The actual scenario of Carrion’s disease, in which the illness is arriving to new areas, due to the expansion of the vector’s distribution, suggests that now may be a crucial time to design a strategy focusing on its elimination.
      Acceso abierto
    • Carrion’s Disease: More Than a Sand Fly–Vectored Illness

      Pons, Maria J.; Gomes, Cláudia; del Valle-Mendoza, Juana; Ruiz, Joaquim (Public Library of Science, 2016-10-01)
      No presenta resumen.
      Acceso abierto
    • Carta al editor en relación al artículo: “Estrategia de uno en uno para mejorar la técnica correcta de higiene de manos”

      Carpio Rodríguez, Antonella; Mercado Gonzáles, Sofía (Instituto Nacional de Pediatria, 2018-01-18)
      Hemos leído con interés el artículo titulado: “Estrategia de uno en uno para mejorar la técnica correcta de higiene de manos” de Orozco Hernández y colaboradores, publicado en el volumen 38, número 5.1 Aunque consideramos que el estudio puede ser importante en la búsqueda de estrategias para mejorar la técnica de lavado de manos en personal de salud, nos gustaría expresarle algunas dudas que surgen y que requieren clarificación.
      Acceso abierto
    • Carta al editor en relación al artículo: “Estrategia de uno en uno para mejorar la técnica correcta de higiene de manos”

      Carpio-Rodríguez A; Mercado-Gonzáles S. (Instituto Nacional de Pediatría, 2018-01)
      Carta al Editor
      Acceso abierto
    • Carvacrol: An in silico approach of a candidate drug on HER2, PI3Kα, mTOR, HER-α, PR, and EGFR receptors in the breast cancer

      Herrera-Calderon, Oscar; Yepes-Pérez, Andres F.; Quintero-Saumeth, Jorge; Rojas-Armas, Juan Pedro; Palomino-Pacheco, Miriam; Ortiz-Sánchez, José Manuel; Cieza-Macedo, Edwin César; Arroyo-Acevedo, Jorge Luis; Figueroa-Salvador, Linder; Peña-Rojas, Gilmar; Andía-Ayme, Vidalina (Hindawi Limited, 2020-01-01)
      Carvacrol is a phenol monoterpene found in aromatic plants specially in Lamiaceae family, which has been evaluated in an experimental model of breast cancer. However, any proposed mechanism based on its antitumor effect has not been reported. In our previous study, carvacrol showed a protective effect on 7,12-dimethylbenz[α]anthracene- (DMBA-) induced breast cancer in female rats. The main objective in this research was to evaluate by using in silico study the carvacrol on HER2, PI3Kα, mTOR, hERα, PR, and EGFR receptors involved in breast cancer progression by docking analysis, molecular dynamic, and drug-likeness evaluation. A multilevel computational study to evaluate the antitumor potential of carvacrol focusing on the main targets involved in the breast cancer was carried out. The in silico study starts with protein-ligand docking of carvacrol followed by ligand pathway calculations, molecular dynamic simulations, and molecular mechanics energies combined with the Poisson–Boltzmann (MM/PBSA) calculation of the free energy of binding for carvacrol. As result, the in silico study led to the identification of carvacrol with strong binding affinity on mTOR receptor. Additionally, in silico drug-likeness index for carvacrol showed a good predicted therapeutic profile of druggability. Our findings suggest that mTOR signaling pathway could be responsible for its preventive effect in the breast cancer.
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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.
      Acceso abierto