• National trends of hepatocellular carcinoma mortality registered by the ministry of health in Peru, from 2005 to 2016

      Piscoya, Alejandro; Atamari-Anahui, Noé; Ccorahua-Rios, Maycol Suker; del Riego, Angela Parra (Sociedad Argentina de Gastroenterologia, 2020-12-01)
      Background. Hepatocellular carcinoma results in most cases from underlying chronic liver disease. The most common causes are the Hepatitis B virus and the Hepatitis C virus in-fections, the alcoholism and the aflatoxin. Mortality statistics of liver cell carcinoma in Peru is limited. Objectives. Update statistics on hepatocellular carcinoma mortality in Peru between the years 2005 and 2016. Methods. Observation-al, descriptive studyand secondary analysis of the Ministry of Health database. Records with the basic cause of death ICD 10: C22, the liver cell carcinoma were reviewed. Mortality was calculated according to the age, the sex and the department in which death was recorded; Also, standardized mortality by age was calculated. Results. 2,170 people were registered as deceased due to hepatocellular carcinoma. The 50.1% were male and the 67.5% older than 60 years. The standardized mortality rate in Peru decreased from 1.1 to 0.7 per 100,000 population from 2005 to 2016. The raw cup of mortality per 100,000 population shows that when comparing the first period (2005-2010) with the second (2011-2016), the tendency in Peru has decreased. The only region that presented a decrease in mortality was the Mountains (% change =-40.1). Conclusions. Standardized mortality by age had a slight decrease from 2005 to 2016; however, this difference does not show considerable variations. Mortality from this neoplasm seems to remain high and stable since the period from 1995 to 2000.
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    • Necesidad de una aproximación integral al estado nutricional del adulto mayor

      Yataco Vicente, Javier Alberto; Araujo Castillo, Roger Vladimir; javieryataco22@gmail.com (Editorial Ciencias Medicas, 2018-07)
      “Cartas al editor”
      Acceso restringido temporalmente
    • Need to review sanitary interventions promoted by the government for women in Peru

      Romero-Albino, Zoila Olga; Domínguez-Samamés, Rafael Omar; Ortiz-Arica, Maritza; Cuba-Fuentes, María Sofía (Instituto Nacional de Salud, 2020-01-01)
      The main health interventions for health promotion and disease prevention that should be performed in women in the Peruvian health system are described. A review of normative technical documents and the recommendations of the main organizations for worldwide prevention was carried out. The prevention activities included physical activity, healthy eating, tobacco counseling, immunizations; In addition, the main screening for women, such as depression, violence, cardiovascular risk, cervical cytology, mammography, colon cancer, are detailed; and within the spectrum of quaternary prevention, interventions that have not shown evidence of benefit to women are detailed. The health interventions that are offered from the Peruvian health system for women, being merely focused on reproductive aspects, lose the conception of integrality that should prevail for the maintenance of health. In that sense, it is proposed to develop strategies that not only have evidence, but also know how to respond to the needs of women in the Peruvian context.
      Acceso abierto
    • Nefrologia: uma especialidade pouco atrativa para os médicos peruanos?

      Herrera Añazco, Percy; Mezones-Holguín, Edward; Hernández, Adrian V. (Sociedade Brasileira de Nefrologia, 2015-05-19)
      Embora a Comissão Nacional de Especialização Médica (CONAREME) tenha aumentado o número de vagas para Nefrologia no Peru, não houve um aumento proporcional do número de participantes para esta especialidade, o que é preocupante em um contexto no qual são necessários mais nefrologistas no país. A Sociedade Peruana de Nefrologia (SPN) deve tomar medidas para tornar a nossa especialidade mais atraente para os médicos peruanos.
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    • Nefropatía por poliomavirus en un paciente inmunosuprimido por trasplante renal secundario a la enfermedad de arteritis de Takayasu

      Godoy Carrillo, María Claudia; Meneses Saco, Alejandra; Torrealva, C. Víctor; Pastor, A. César; c.pastor12@gmail.com (Elsevier B.V., 2016-03)
      La nefropatía por poliomavirus es una enfermedad que predomina en los pacientes con trasplante renal por el tratamiento inmunosupresor para manutención del injerto renal. La prevalencia actual de esta enfermedad oscila entre el 1 y el 14%. La sospecha de la enfermedad se da por la presencia de decoy cells en el examen de orina y el diagnóstico, mediante el hallazgo de inclusiones virales en la biopsia renal. Se describe el caso de un paciente con trasplante renal secundario a arteritis de Takayasu, que presenta disfunción renal evidenciada por elevación progresiva de creatinina sérica, por lo que se le realiza una biopsia renal en donde se observaron inclusiones nucleares virales que permitieron concluir el diagnóstico
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    • Neurinoma del acústico bilateral como diagnóstico de neurofibromatosis tipo 2: reporte de caso clínico

      Urdániga-Hung, Mónica; Luza-Dueñas, Anais Casandra; Chipana-Sotomayor, Marco Enrique; anais.cld.102@gmail.com (Ediciones Doyma, S.L., 2017-06)
      Neurofibromatosis type 2 (NF2) is an autosomal dominant genetic disease that is characterized by the presence of bilateral schwannomas, meningiomas and gliomas. This is a case report of a woman of 34 years who has bilateral hipoacusia, left facial paralysis and consciousness loss in who it has been realized magnetic resonance imaging (MRI) and it has been found two mases scavenging contrast in the angle pontocerebellar. It has been established NF2 as presumptive diagnostic by diagnostic criteria. The bigger lesion was resected surgically and it has been obtained histopathologic specimens that showed acoustic schwannomas.Conclusion: The findings of MRI can be used as diagnostic method.
    • Niños hospitalizados con neumonía por influenza AH1N11/2009 pandémico en un hospital de referencia de Perú.

      Miranda-Choque, Edwin; Ramírez, Carlos; Candela-Herrera, Jorge; Díaz, Javier; Fernández, Ana; Kolevic, Lenka; Segura, Eddy R.; Farfán-Ramos, Sonia (Instituto Nacional de Salud (INS), 2014-03-25)
      ObjectiveTo determine the clinical and demographic characteristics of pneumonia with influenza virus AH1N1/2009 pandemic at the National Institute of Child. Methods. Retrospective case series in children hospitalized for influenza pneumonia pandemic AH1N1/2009 in a pediatric hospital. Reviewed the medical records between the months of June to September 2009. All cases had virological confirmation, we describe the clinical characteristics and conditions of severity. Results. A total of 74 children of pneumonia with influenza virus AH1N1/2009 pandemic (NVIp), of those 50 were community acquire pneumonia viral (NACv) and 24 pneumonia nosocomial viral (NNv), 16 required mechanical ventilation. 12 died, all had preexisting factors. NN cases showed statistical association with mortality. The most frequent factors were malnutrition, respiratory infections, congenital heart disease and neurological deficits In NACv cases the children under 6 years accounted for 72% (36/50). The median disease duration was 5 days. The most frequent symptoms were fever, cough, runny nose. Received oseltamivir 82%. The chest radiograph 48% of cases showed patchy infiltrates and 44% interstitial infiltrate on chest radiograph. Protein c reactive (CRP) more than 10mg / L was significantly associated with respiratory failure (p <0.05). Conclusions. Cases of NN found who had more mortality, even those who had the highest PCR and those with preexisting condition.
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    • Niveles de estrés y formas de afrontamiento en estudiantes de Medicina en comparación con estudiantes de otras escuelas

      La Rosa-Rojas, Gessely de; Chang-Grozo, Silvana; Delgado-Flores, Luis; Oliveros Lijap, Leila; Murillo Pérez, Diego; Ortiz-Lozada, Ricardo; Vela-Ulloa, Gundi; Carreazo, Nilton Yhuri (Academia Nacional de Medicina de México, 2015-09-30)
      Objetivo: Evaluar los niveles de estrés y formas de afrontarlo en alumnos de las facultades de Medicina, Derecho y Psicología de una universidad privada de Lima. Material y métodos: Estudio transversal analítico que involucró a estudiantes de tres carreras universitarias. Se utilizó el inventario SISCO de estrés académico y el cuestionario de afrontamiento del estrés (CAE). Se realizó la comparación de las medianas entre los puntajes obtenidos de ambos cuestionarios. Para el análisis inferencial se utilizaron las pruebas estadísticas de Kruskall Wallis, el test de Dunn (comparaciones múltiples post hoc) y el coeficiente de correlación por rangos de Spearman. Resultados: La edad media fue 19.5 ± 2.5 años, el 33.9% realizaba la carrera de Medicina y el 92.4% del total presentó preocupación o nerviosismo como manifestaciones de estrés. Los estudiantes de Medicina presentaron mayores niveles de estrés (mediana = 46.7) en comparación con los estudiantes de Psicología (mediana = 39.1) y Derecho (mediana = 40.2) (p < 0.05). Las formas de afrontamiento más frecuentes fueron la focalización en la solución del problema, la reevaluación positiva y la búsqueda de apoyo social. La forma de afrontamiento menos frecuente fue la religión. Conclusión: Los estudiantes de Medicina presentan mayores niveles de estrés. Las formas de afrontamiento más comunes son las denominadas activas: focalización en la solución del problema, reevaluación positiva y búsqueda de apoyo social.
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    • Niveles de resistencia a quinolonas y otros antimicrobianos en cepas de Escherichia coli comensales en niños de la zona periurbana de Lima, Perú

      Pons, Maria J; Mosquito, Susan; Ochoa, Theresa J.; Vargas, Martha; Molina, Margarita; Lluque, Angela; Gil, Ana I.; Ecker, Lucie; Barletta, Francesca; Lanata, Claudio F.; Del Valle, Luis J.; Ruiz, Joaquim; joruiz@clinic.ub.es (Instituto Nacional de Salud (INS), 2014-08-11)
      The main aim of this study was to establish the resistance levels to antimicrobial agents, in 222 non-pathogenic E. Coli strains of fecal origin in Peru. The proportion of resistance found to the evaluated antimicrobials was ampicillin (62.6%), cotrimoxazole (48,6%), tetracycline (43,0%) and chloramphenicol (15,8%). We emphasize the high resistance levels found for quinolones: 32% for nalidixic acid (NAL) and 12% for ciprofloxacin (CIP). These high levels of quinoloneresistance in non-pathogenic strains isolated from children in this age group highlight the extensive use and the impact of the intake of this kind of antimicrobials in the community, showing the potential risk of the loss of their utility in the area.
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    • Niveles de resistencia a quinolonas y otros antimicrobianos en cepas de Escherichia coli comensales en niños de la zona periurbana de Lima, Perú.

      Pons, Maria J; Mosquito, Susan; J. Ochoa, Theresa; Vargas, Martha; Molina, Margarita; Lluque, Angela; Gil, Ana I.; Ecker, Lucie; Barletta, Francesca; Lanata, Claudio F.; Del Valle, Luis J.; Ruiz, Joaquim (Instituto Nacional de Salud (INS), 2014-03-21)
      The main aim of this study was to establish the resistance levels to antimicrobial agents, in 222 non-pathogenic E. Coli strains of fecal origin in Peru. The proportion of resistance found to the evaluated antimicrobials was ampicillin (62.6%), cotrimoxazole (48,6%), tetracycline (43,0%) and chloramphenicol (15,8%). We emphasize the high resistance levels found for quinolones: 32% for nalidixic acid (NAL) and 12% for ciprofloxacin (CIP). These high levels of quinoloneresistance in non-pathogenic strains isolated from children in this age group highlight the extensive use and the impact of the intake of this kind of antimicrobials in the community, showing the potential risk of the loss of their utility in the area.
      Acceso abierto
    • NLR and microalbuminuria: Are these markers significantly associated?

      Umeres-Francia, Gianfranco E.; Rojas-Fernández, María V.; Benítes-Zapata, Vicente A. (Bucuresti : Editura Academiei Române, 2017-11-27)
      Carta al Editor
      Acceso abierto
    • Nosocomial infections increase the length of hospital stay

      Carpio-Zevallos, Marcelo Sebastián; Sobrado-Jara, Katherine Susana; Carreazo, Nilton Yhuri (Elsevier Ltd, 2019-04-30)
      Cartas al editor
      Acceso restringido temporalmente
    • Novel 2019 coronavirus infection in children

      Llaque Quiroz, Patricia Beatriz (Instituto Nacional de Salud, 2020-01-01)
      COVID-19 is rarely reported in children and they are mildly affected in most cases. The most common clinical presentation of COVID-19 is cough, fever and sore throat; severe cases show tachypnea. The course of the disease is from one to two weeks. Laboratory findings are nonspecific; lymphopenia, elevation of C-reactive protein and procalcitonin have been described. Early chest X-ray is usually normal, and the most common tomographic findings are consolidations with halo, ground-glass opacities and tiny nodules which mainly affects subpleural areas. Management of the disease is supportive; in severe cases, it should be focused on respiratory support. It is recommended to limit the handling of respiratory secretions and to follow the same preventive measures provided to adults.
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    • Un nuevo virus A/H1N1, una nueva pandemia: Influenza un riesgo permanente para una humanidad globalizada

      Osores Plenge, Fernando; Gómez Benavides, Jorge; Suárez Ognio, Luis; Cabezas Sánchez, César; Alave Rosas, Jorge; Maguiña Vargas, Ciro (Colegio Médico del Perú, 2014-07-16)
      Influenza is a highly contagious disease. There are some historical descriptions of this condition by ancient Greek physicians, and the etiological agents have been known only for the last eight decades. The causative agent is the influenza virus, which has three main types: A, B, and C. Type A is capable of circulating within many different biological reservoirs, including humans, swine, and birds. It also has high genetic variability, which allows it to have minor antigenic drifts or mutations which are responsible of epidemics in humans. Sometimes changes are quite marked, leading to pandemics. In a globalized world, with more than 6 billion inhabitants, with many social inequities and evident climate changes, influenza viruses are a permanent risk for mankind. Clinical features for the different viral subtypes may vary from subtle infections to full blown and severe, life-threatening forms. Event with the great advances in diagnostics and immunization, the manufacture and distribution of new diagnostic kits may take some time, and new vaccines are not always readily available. Specific therapies against influenza are not well developed. There are two groups of drugs, the so called adamantane derivatives, such as amantadine and rimantadine, and the neuraminidase inhibitors, such as oseltamivir and zanamivir. Most vulnerable areas for the new flu pandemics include developing countries, particularly the poorest ones, so that the greatest effort must be made for helping these areas.
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    • Obesidad abdominal y ausentismo por causa médica en una empresa de la industria metalmecánica en Cali, Colombia.

      Agredo Zúñiga, Ricardo A.; García Ordoñez, Emily S.; Osorio, Carlos; Escudero, Natalia; López-Albán, Carlos A.; Ramírez-Vélez, Robinson (Instituto Nacional de Salud (INS), 2014-03-25)
      Con el objetivo de examinar la frecuencia de obesidad abdominal y el ausentismo laboral por causa médica, se realizó un estudio transversal en 185 varones pertenecientes a una industria metalmecánica. En ellos, además de datos sociodemográficos, se recogió datos antropométricos y se midió la circunferencia de cintura (CC) en centímetros como indicador de obesidad abdominal. Se encontró, además de una alta frecuencia de obesidad abdominal (28,7%), que los trabajadores con obesidad abdominal presentaron mayor frecuencia, mayor tiempo y mayores costos por las incapacidades médicas. Se concluye que la obesidad abdominal en esta muestra fue altamente frecuente; no obstante, al tratarse de un riesgo reversible, las empresas podrían beneficiarse, en términos de ausentismo laboral, de programas preventivo promocionales destinados a controlar este problema.
      Acceso abierto
    • Obesity-related insulin resistance in adolescents: a systematic review and meta-analysis of observational studies

      Thota, P.; Perez-Lopez, F. R.; Benítes-Zapata, Vicente A.; Pasupuleti, V.; Hernandez, Adrian V.; School of Medicine, Case Western Reserve University, Cleveland, OH, USA,; Department of Obstetrics and Gynecology, University of Zaragoza Faculty of Medicine and Lozano Blesa University Hospital, Domingo Miral s/n, Zaragoza, Spain,; Center for Public Health Research, Research Institute, Faculty of Medicine, University of San Martin de Porres, Lima, Peru,; School of Medicine, Case Western Reserve University, Cleveland, OH, USA,; School of Medicine, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru, and; adrianhernandezdiaz@gmail.com (Taylor and Francis Ltd, 2017-01-19)
      Insulin resistance is common among obese adolescents; however, the extent of this problem is not clear. We conducted a systematic review of PubMed-Medline, CINAHL, The Web of Science, EMBASE and Scopus for observational studies evaluating components defining insulin resistance (insulin, C-peptide and homeostatic model assessment-insulin resistance [HOMA-IR]) in obese adolescents (12–18 years) versus non-obese adolescents. Our systematic review and meta-analysis followed the PRISMA guidelines. Data were combined using a random-effects model and summary statistics were calculated using the mean differences (MDs). 31 studies were included (n = 8655). In 26 studies, fasting insulin levels were higher in obese adolescents when compared to non-obese adolescents (MD = 64.11 pmol/L, 95%CI 49.48–78.75, p < 0.00001). In three studies, fasting C-peptide levels were higher in obese adolescents when compared to non-obese adolescents (MD = 0.29 nmol/L, 95%CI 0.22–0.36, p < 0.00001). In 24 studies, HOMA-IR values were higher in obese adolescents when compared to non-obese adolescents (MD = 2.22, 95%CI 1.78–2.67, p < 0.00001). Heterogeneity of effects among studies was moderate to high. Subgroup analyses showed similar results to the main analyses. Circulating insulin and C-peptide levels and HOMA-IR values were significantly higher in obese adolescents compared to those non-obese.
    • Oferta y composición nutricional de ensaladas en patios de comida de centros comerciales de Lima Metropolitana, 2014

      Bustamante García, Marifé; Martinez Feliu, Montserrat; Servan, Karin; Mayta-Tristan, Percy (Instituto Nacional de Salud (INS), 2016-01-25)
      Objetivos. Evaluar la oferta y composición nutricional de las ensaladas ofrecidas como plato principal en los patios de comida de los centros comerciales de Lima, Perú. Materiales y métodos. Se revisó las cartas de comida de todas las franquicias presentes en los patios de comida de los once centro comerciales de Lima, luego se evaluó la composición nutricional de las ensaladas ofertadas como plato principal calculando su contenido calórico, proteico, carbohidratos, grasas, colesterol, fibra y sodio, y la adecuación de ingesta para una cena (30% de una dieta de 2000 kcal). Resultados. Las ensaladas como plato principal representaron el 4,7% de la oferta, solo 7/17 franquicias ofrecían al menos una ensalada. El costo promedio de las ensaladas fue superior a los otros platos ($5,3 vs 4,7; p<0,001). El contenido calórico promedio fue de 329 kcal y de 2,7 g de fibra; con relación a una cena, se encontró un alto porcentaje de adecuación proteica (172,9%), de colesterol (121,0%), y bajo para calorías (54,8%), carbohidratos (23,1%) y fibra (36,4%). Conclusiones. Las ensaladas que se ofertan en patios de centros comerciales de Lima son escasas y más costosas, presentan poco aporte de fibra y altos contenidos de colesterol. Se deben revisar estrategias para mejorar la accesibilidad de ensaladas de calidad en escenarios donde solo ofertan comidas rápidas.
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    • Older adults with disability in extreme poverty in Peru: How is their access to health care?

      Flores-Flores, Oscar; Bell, Ruth; Reynolds, Rodney; Bernabé-Ortiz, Antonio (Public Library of Science, 2018-12-01)
      Background Disability rates increase with age. In 2012, Peruvian older adults ( 65 years) represented 9% of the population. Additionally, older population reported disabilities at about 5 times the rate of Peruvians between 36 and 64 years old, and 30% of older population lived in poverty. Peruvian seniors living in extreme poverty experience disabilities and the extent of their access to healthcare is unknown. Objective This study assesses associations between disability and access to healthcare among Peruvians older individuals living in extreme poverty. Methods Secondary analysis of a national representative population based survey that utilizes information from Peru’s 2012 survey Health and Wellbeing in Older Adults (ESBAM), which includes older adults living in extreme poverty. We define disability in terms of the Activities of Daily Living (ADL disability) framework. Healthcare access was assessed as having any of Peru’s available health insurance schemes combined with preventive health services (vision assessment, influenza vaccination, blood pressure assessment, diabetes screening, and cholesterol assessment). Poisson robust regression models were used to evaluate the associations among relevant variables. Prevalence Ratios and 95% confidence intervals (95%CI) were reported. Results Data from 3869 individuals (65 to 80 years old), of whom 1760 (45.5%) were females, were analyzed. The prevalence of ADL disability was 17.3% (95%CI: 16.0%-18.4%). In addition, more than 60% had never received any of the preventive measures evaluated, except for the blood pressure assessment. In the adjusted model, people with ADL disability had 63% less probability of having extensive insurance, compared to those without disability (p<0.05). Conclusions This study shows that this Peruvian older population living in extreme poverty has limited access to healthcare services. Although there was no consistent association between ADL disability and the healthcare access, there is an urgent need to reduce the inequitable access to healthcare of this poor Peruvian older population.
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    • Olga and olgim stage distribution according to age and helicobacter pylori status in a public hospital in Lima, Peru

      Ronquillo, Andrea Carlin; León, Alex Ventura; Ríos, Jorge L.Espinoza; Paredes, Eduar A.Bravo; Hinojosa, Paúl Gómez; Solis, Shirley Alva; Valdivia, José L.Pinto; Silva-Caso, Wilmer (Sociedad Argentina de Gastroenterologia, 2021-01-01)
      Introduction. The operative link for gastritis assessment (OLGA) and the operative link on gastric intestinal meta-plasia assessment (OLGIM) staging systems have been sug-gested to provide risk of assessment for gastric cancer. Objec-tive. To evaluate the distribution of OLGA and OLGIM staging by age and Helicobacter pylori status. Material and methods. We studied 197 subjects undergoing elective upper gastrointestinal endoscopy. The presence of the H. pylori and histological changes were evaluated using the updated Sydney system. Stages III and IV of OLGA/OLGIM were considered high risk stages. Results. The H. pylori rate was 56.85% (112/197). High-risk OLGA/OLGIM cases were rare: 7/112 (6.5%) cases of OLGA in the H. pylori positive group and 6/85 (7%) in the H. pylori negative group; 5 (4.4%) cases of OLGIM in the H. pylori positive and 6 (7%) in the H. pylori negative. The proportion of advanced stages of OLGA and OLGIM increased with age (p < 0.001). High-risk OLGA was not found before age 40 regardless of the presence of H. pylori, but increased to 16.2%, 10.3%, 17.3% and 40.8% in subjects in the fourth, fifth, sixth and seventh decade of life respectively. The OLGIM high risk showed a similar trend: 0% before 40 years and up to 22.6% in people of 70 years. Conclusions. High-risk OLGA/OLGIM cases are infrequent before age 40 and increase significantly with age. No relation was found with the presence of the H. pylori. According to these protocols, only a fifth of the patients would strictly require endoscopic control.
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