• Impacto de la intervención farmacéutica en la adherencia al tratamiento antirretroviral en pacientes de un hospital de Lima (Perú).

      Tafur Valderrama, E.J.; Ortiz Alfaro, C.; García-Jiménez, E.; Faus Dader, M.J.; Martínez Martínez, F. (Fundación Pharmaceutical Care España, 2014-03-20)
      Introduction: Pharmaceutical care improves medication adherence that is why is important that the pharmacist uses instruments to evaluate and improves it through pharmaceutical intervention at pharmaceutical care. Objective: To evaluate the impact of the pharmaceutical intervention in the improvement of the medication adherence of the patients with HIV and AIDS, and to identify the factors that infl uence on medication adherence and which one could be modifi ed by the pharmaceutical intervention during pharmaceutical care. Methods: Pharmacotherapeutic follow-up was realized for 23 months to 52 patients, older than 18 years, with antiretroviral treatment for up to three months, consent informed was obtained from patients. Medication adherence was evaluated with CEAT-HIV (questionnaire to evaluate the adhesion to the antiretroviral treatment) at the beginning and at the end of the study (6 months). Results: The fi nal score from CEAT-HIV (p <0.05; 95% IC), treatment compliance (p <0.001) and patient’s beliefs to the disease and antiretroviral treatment (p <0.001) improved signifi cantly with the pharmaceutical intervention. The more frequent pharmaceutical intervention was education to the patient to increment the adherence to the treatment (46%). Conclusion: These results demonstrate that the pharmacists’ intervention through pharmacotherapeutic follow-up improves the adherence to the antiretroviral treatment. The pharmacist was able to improve aspects of compliance and patient’s beliefs about the treatment and disease. The pharmacist could utilize CEAT-VIH as an instrument to evaluate the adherence in HIV/AIDS patients.
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    • Impacto de las revistas de salud colombianas: comparación de Publindex versus Google Scholar Metrics, SciELO y SCOPUS

      Rodríguez Morales, Alfonso J.; Ochoa Orozco, Sergio Andrés; Mayta-Tristan, Percy (Centro Nacional de Información de Ciencias Médicas. CUBA., 2014-04-30)
      The citation based indicators are recognized by the scientific community to assess the quality of scientific journals. Colombia has a rating system called the National Journal magazines Index (IBN) / Publindex. The objective of this study is to evaluate the impact of the Colombian health journals according to Google ScholarMetrics (GSM), SciELO, and SCOPUS, compared with the IBN classification for 2007-2011. In analyzing journals by GSM H index, we find that among the worst journals classified "C" by Publindex, there are publications with higher H5 index and H5 median than those top-ranked journals by IBN as "B" and "A2". There are journals such as The Colombian Anesthesiology that without being in IBN, has SciELO higher impact factor than several IBN "A1" journals. There are indexed journals in Scopus which despite being quartile 3 (Q3) are rated "A2" by IBN but they are Q4 journals classified as "A1" by IBN. This shows that Publindex classification is not consistent with journal impact indicators in three systems: GSM, Scopus, and SciELO, as it has been previously suggested by other authors. It is required to improve the Publindex classification and such classification should take into account citation and impact parameters so that the quality reflected in international indicators would be consistent with the national classification.
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    • Impacto del fenómeno "El Niño" de 1997-1998 en la salud de la población peruana, riesgo potencial para el 2015

      Suárez Ognio, Luis; Estela Ayamamani, David Gerardo; Cáceres Mejía, Brenda; Gambirazio Carbajal, Carlos; Cabrera, Rufino (Instituto Nacional de Salud (INS), 2015-07-06)
      Sr. Editor. El National Oceanic and Atmospheric Administration de los Estados Unidos y el Servicio Nacional de Meteorología e Hidrología del Perú han comunicado que en el 2015 se presentará un nuevo fenómeno “El Niño” (El Niño Oscilación Sur-ENSO). Este fenómeno produce elevación de la temperatura ambiental y un incremento de las precipitaciones pluviales (1); ocasionando inundaciones y aluviones (“huaycos”) como consecuencias inmediatas y posteriormente alteración del ecosistema favoreciendo el incremento de la vegetación y la aparición de plagas de insectos y roedores.
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    • Importance of analysis of complex sample survey in a probabilistic study stratified by stages

      Zumaeta, Nixon; Mendoza, Aylen; Hernandez, Adrian V.; nixonzg@gmail.com (Elsevier B.V., 2016-10)
      Carta al Editor
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    • Importancia de la enseñanza de la medicina basada en evidencias.

      Rodríguez Morales, Alfonso J.; Mezones-Holguín, Edward; Tolentino Silva, Marcus; Puebla, Sergio; Orellana, Juan J.; Cárcamo, Daniel; Nunes da Silva, Everton; Risquez Parra, Alejandro; Echezuria Marval, Luis; Mayta-Tristan, Percy (Organo de la Academia Nacional de Medicina y del Congreso Venezolano de Ciencias Médicas., 2014-03-24)
      Cartas al editor.
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    • La importancia del índice de masa corporal en la fuerza muscular

      Aliaga-Vega, Raúl; Altuna-Venegas, Sofia; Maguiña, Jorge Luis; raulav95@outlook.com (Ediciones Doyma, S.L, 2017-03)
      Carta al Editor
    • In response to fluid resuscitation with lactated Ringer’s solution vs. normal saline in acute pancreatitis: A triple-blind, randomized, controlled trial

      Calamo-Guzman, Bernardo; De Vinatea-Serrano, Luis; Piscoya, Alejandro; Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru; Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru; Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru (SAGE Publications, 2018-01-11)
      Cartas al editor
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    • In Vitro Sealing Properties of Calcium-Enriched Mixture and Mineral Trioxide Aggregate Orifice Barriers during Intra-Coronal Bleaching

      Valverde Huaranga, J.C; Baldeon, G.L; Caballero-García, S.; pcodccab@upc.edu.p (Iranian Association of Endodontics, 2017-10)
      Carta al Editor
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    • Incidence of Pneumonitis With Use of Programmed Death 1 and Programmed Death-Ligand 1 Inhibitors in Non-Small Cell Lung Cancer

      Khunger, Monica; Rakshit, Sagar; Pasupuleti, Vinay; Hernandez, Adrian V.; Mazzone, Peter; Stevenson, James; Pennell, Nathan A.; Velcheti, Vamsidhar; velchev@ccf.org (Elsevier Inc, 2017-08)
      Background Programmed death 1 (PD-1) programmed death-ligand 1 (PD-L1) inhibitors show significant clinical activity in non-small cell lung carcinoma (NSCLC). However, they are often associated with potentially fatal immune-mediated pneumonitis. Preliminary reports of trials suggest a difference in the rate of pneumonitis with PD-1 and PD-L1 inhibitors. We sought to determine the overall incidence of pneumonitis and differences according to type of inhibitors and prior chemotherapy use. Methods MEDLINE, Embase, and Scopus databases were searched up to November 2016. Rates of pneumonitis of any grade and grade ≥ 3 from all clinical trials investigating nivolumab, pembrolizumab, atezolizumab, durvalumab, and avelumab as single agents in NSCLC were collected. The incidence of pneumonitis across trials was calculated using DerSimonian-Laird random effects models. We compared incidences between PD-1 and PD-L1 inhibitors and between treatment naive and previously treated patients. Results Nineteen trials (12 with PD-1 inhibitors [n = 3,232] and 7 with PD-L1 inhibitors [n = 1,806]) were identified. PD-1 inhibitors were found to have statistically significant higher incidence of any grade pneumonitis compared with PD-L1 inhibitors (3.6%; 95% CI, 2.4%-4.9% vs 1.3%; 95% CI, 0.8%-1.9%, respectively; P =.001). PD-1 inhibitors were also associated with higher incidence of grade 3 or 4 pneumonitis (1.1%; 95% CI, 0.6%-1.7% vs 0.4%; 95% CI, 0%-0.8%; P =.02). Treatment naive patients had higher incidence of grade 1 through 4 pneumonitis compared with previously treated patients (4.3%; 95% CI, 2.4%-6.3% vs 2.8%; 95% CI, 1.7%- 4%; P =.03). Conclusions There was a higher incidence of pneumonitis with use of PD-1 inhibitors compared with PD-L1 inhibitors. Higher rate of pneumonitis was more common in treatment naive patients. © 2017 American College of Chest Physicians
    • Incidence of Respiratory Viruses in Peruvian Children With Acute Respiratory Infections

      Del Valle Mendoza, Juana; Cornejo Tapia, Ángela; Weilg, Pablo; Verne, Eduardo; Nazario Fuertes, Ronald; Ugarte, Claudia; del Valle, Luis J.; Pumarola, Toma´ s (John Wiley & Sons, 2015-03-23)
      Acute respiratory infections are responsible for high morbi–mortality in Peruvian children. However, the etiological agents are poorly identified. This study, conducted during the pandemic outbreak of H1N1 influenza in 2009, aims to determine the main etiological agents responsible for acute respiratory infections in children from Lima, Peru. Nasopharyngeal swabs collected from 717 children with acute respiratory infections between January 2009 and December 2010 were analyzed by multiplex RT-PCR for 13 respiratory viruses: influenza A, B, and C virus; parainfluenza virus (PIV) 1, 2, 3, and 4; and human respiratory syncytial virus (RSV) A and B, among others. Samples were also tested with direct fluorescent-antibodies (DFA) for six respiratory viruses. RT-PCR and DFA detected respiratory viruses in 240 (33.5%) and 85 (11.9%) cases, respectively. The most common etiological agents were RSV-A (15.3%), followed by influenza A (4.6%), PIV-1 (3.6%), and PIV-2 (1.8%). The viruses identified by DFA corresponded to RSV (5.9%) and influenza A (1.8%). Therefore, respiratory syncytial viruses (RSV) were found to be the most common etiology of acute respiratory infections. The authors suggest that active surveillance be conducted to identify the causative agents and improve clinical management, especially in the context of possible circulation of pandemic viruses
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    • Incidence, Predictors, and Impact on Survival of Left Ventricular Systolic Dysfunction and Recovery in Advanced Cancer Patients

      Oliveira, Guilherme H.; Mukerji, Siddarth; Hernández, Adrian V.; Qattan, Marwan Y.; Banchs, Jose; Durand, Jean-Bernard; Iliescu, Cezar; Plana, Juan Carlos; Tang, W.H. Wilson (Elsevier B.V., 2014-06-09)
      Although left ventricular (LV) dysfunction occurs not uncommonly in the course of cancer therapy, little is known about its natural history and prognostic impact on patients. To investigate the incidence, predictors, and impact on survival of LV systolic dysfunction and recovery during cancer therapy, we conducted a retrospective cohort observational study over 1 year at the University of Texas MD Anderson Cancer Center. We enrolled patients with a decrease in ejection fraction by echocardiography to <50% while undergoing cancer therapy from January 2009 to December 2009.We collected and analyzed their chart data. Of 7,648 patients with echocardiograms in 2009, 366 (4.8%) had ejection fraction <50% and 104 met study criteria. LV systolic dysfunction was associated with cardiotoxic therapy in 53 patients (51%). Recovery occurred in 57 patients (55%) and was independently predicted by younger age, smaller left atrial volume index, and lower B-type natriuretic peptide. At last follow-up, 69 patients (66%) were dead, and 35 (34%) were alive. There was a 20% advantage in 2-year survival among patients with LV systolic recovery compared with those without (95% confidence interval 4% to 41%, p [ 0.02). In this retrospective study, LV systolic dysfunction recovery occurred in over half of the patients, appeared independent of cardiotoxic etiology, and associated with a 20% survival benefit at 2 years. Multivariable predictors of recovery are younger age, a small left atrial volume index, and lower B-type natriuretic peptide.
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    • Inclusion of persons with disabilities in systems of social protection: a population-based survey and case–control study in Peru

      Bernabe-Ortiz, Antonio; Diez-Canseco, Francisco; Vasquez, Alberto; Kuper, Hannah; Walsham, Matthew; Blanchet, Karl (British Medical Journal, 2016-08-26)
      OBJECTIVE: This study aims to assess the needs of people with disabilities and their level of inclusion in social protection programmes. DESIGN: Population based-survey with a nested case-control study. SETTING: Morropon, a semiurban district located in Piura, northern Peru. PARTICIPANTS: For the population survey, a two-stage sampling method was undertaken using data from the most updated census available and information of each household member aged ≥5 years was collected. In the nested case-control study, only one participant, case or control, per household was included in the study. PRIMARY AND SECONDARY OUTCOME MEASURES: Disability was screened using the Washington Group short questionnaire. A case, defined as an individual aged ≥5 years with disabilities, was matched with one control without disabilities by sex and age (±5 years). Information was collected on socioeconomic status, education, health and rehabilitation and social protection participation. RESULTS: The survey included 3684 participants, 1848 (50.1%) females, mean age: 36.4 (SD: 21.7). A total of 290 participants (7.9%; 95% CI 7.0% to 8.7%) were classified as having disability. Adults with disabilities were more likely to be single (OR=3.40; 95% CI 1.54 to 7.51) and not to be working (OR=4.36; 95% CI 2.26 to 8.40), while those who did work were less likely to receive the national minimum wage (ie, 750 PEN or about US$265; p=0.007). People with disabilities were more likely to experience health problems. There was no difference between those enrolled in any social protection programme among participants with and without disabilities. CONCLUSIONS: People with disabilities were found to have higher needs for social protection, but were not more likely to be enrolled in social protection programmes. The Peruvian social protection system should consider adding disability status to selection criteria in their cash transfer programmes as well as implementing disability-specific interventions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
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    • Incremento de Linfocitos Intraepiteliales en pacientes con Síndrome de Intestino Irritable

      Arévalo, F.; Aragon, V.; Montes, P.; Guzmán, E.; Monge, E. (Sociedad de Gastroenterología del Perú (SGP), 2014-08-11)
      Several studies have shown increased numbers of intraepithelial lymphocytes (IEL), mast cells, enterochromaffin cells in colonic mucosa of patients with Irritable Bowel Syndrome (IBS). Many of these findings are based is based on immunohistochemistry results, which is not available in general hospitals. Our objective is to study the histological findings observed in colon biopsies from patients with IBS compared with a group without IBS, using only histochemistry. Twenty five (25) patients were included: 16 with IBS and 9 without IBS. We found increased numbers of IEL in patients with IBS (p=0,002). A group of patients with IBS (41.9%) who fulfilled histological criteria for lymphocytic colitis were excluded. There was no significant difference in mast cells, enterochromaffin cells or eosinophils.
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    • Infective endocarditis due to Bartonella bacilliformis associated with systemic vasculitis: a case report

      Peñafiel-Sam, Joshua; Alarcón-Guevara, Samuel; Chang-Cabanillas, Sergio; Perez-Medina, Wilkerson; Mendo-Urbina, Fernando; Ordaya-Espinoza, Eloy; Universidad Peruana de Ciencias Aplicadas, Peru; Universidad Peruana de Ciencias Aplicadas, Peru; Universidad Peruana de Ciencias Aplicadas, Peru; Hospital Nacional Edgardo Rebagliati Martins, Perú; Universidad Peruana de Ciencias Aplicadas, Peru; Hospital Nacional Edgardo Rebagliati Martins, Perú; Universidad Peruana de Ciencias Aplicadas, Peru; University of Minnesota, USA; eeordaya@umn.edu (Sociedade Brasileira de Medicina Tropical - SBMT, 2017-09)
      Infective endocarditis due to Bartonella bacilliformis is rare. A 64-year-old woman, without previous heart disease, presented with 6 weeks of fever, myalgias, and arthralgias. A systolic murmur was heard on the tricuspid area upon examination, and an echocardiogram showed endocardial lesions in the right atrium. Bartonella bacilliformis was isolated in blood cultures, defining the diagnosis of infective endocarditis using Duke’s criteria. Subsequently, the patient developed clinical and laboratory features compatible with antineutrophil cytoplasmic antibody-associated vasculitis. This case presents an uncommon complication of B. bacilliformis infection associated with the development of systemic vasculitis.
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    • Influence of Erosive and Abrasive Cycling on Bonding of Diferent Adhesive Systems Enamel: An in situ study

      Ciccone Giacomini,Marina; Casas-Apayco, Leslie; Moreira Machado,Camila; Carvalho de Almendra Freitas,Maria Cristina; Atta,Maria Teresa; Wang, Linda; wang.linda@uol.com.br (216-08-04)
      This study evaluated the impact of orange juice on the bond strength (BS) of dentin bonding systems (DBSs) to enamel surface after simulation with an in situ/ ex vivo erosive cycling. One hundred and ninety two bovine enamel fragments (4x4x2 mm) were obtained and randomized regarding superficial microhardness and distributed to palatal devices for 8 volunteers, in three phases (one for each DBS), containing 8 blocks, which were, allocated in 4 pairs. Daily, these pairs were subjected extraorally to the following conditions: CONTneither erosive nor abrasive challenge; ERO- erosive challenge only; ABR- abrasive challenge only and ERO + ABR- with erosive and abrasive challenges. Erosive cycles (immersion in orange juice, 3 times/day/5 min/5 days) or/and abrasive challenges (electric toothbrush, 3 times/day/1 min/5 days) were performed. After these cycles, all specimens were restored with the adhesive systems Adper Scotchbond Multi Purpose (MP), Adper Single Bond 2 (SB) or Clearfil SE Bond (SE), and the composite resin Filtek Z250. After 7 days, sticks (area ≅1 mm2) were obtained and subjected to the microtensile bond strength test (μTBS) at 0.5 mm/min. Data was statistically analyzed by ANOVA and Tukey tests (a=0.05). Failure modes were determined using a digital microscope (40×). DBS was the only statistical significant factor. SE was the unique DBS not affected in any challenge, whereas MP and SB performed according to the scenario. The adhesive and mixed failures were predominant in all groups. Overall performance suggested that BS to enamel after erosive /abrasive challenged by orange juice was not affected and it was material-dependent
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    • Influence of parental education on Honduran medical students' labour perspectives: rural work and emigration.

      Zambrano, Lysien I; Pereyra Elías, Reneé; Reyes García, Selvin Z; Fuentes, Itzel; Mayta-Tristan, Percy; percy.mayta@upc.edu.pe (The Society of Rural Physicians of Canada, 2015-10)
      INTRODUCTION: We sought to evaluate the intentions of Honduran medical students to emigrate or to work in a rural setting, and their association with parental education. METHODS: We performed a cross-sectional, analytic study at a Honduran medical school. Student participants completed a structured questionnaire, which assessed their intentions to emigrate or work in a rural setting after finishing medical school and the highest level of education achieved by their parents. We calculated crude and adjusted prevalence ratios with their respective 95% confidence intervals. RESULTS: Of 868 surveys distributed, 564 were completed. The mean age of the participants was 21 (standard deviation 3) years, and 62.2% were female. Of the respondents, 16.6% intended to emigrate to work and 11.2% intended to work in a rural setting. Higher paternal education (i.e., technical, university and postgraduate training) was associated with a higher rate of intention to emigrate. Students whose fathers underwent postgraduate education were less likely to intend to work in a rural setting. For maternal education, only the postgraduate level was associated with the outcomes in some of the tested models. CONCLUSION: The frequency of students intending to emigrate was relatively low. However, the frequency of students being willing to work in rural settings was also low. Students whose parents had higher levels of education were more likely to intend to work abroad and less likely to intend to work in a rural area. These factors should be considered in medical schools' selection processes to improve retention and ensure adequate distribution of physicians.
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    • Influencia de los factores socioculturales en el Trastorno de Conducta Alimentaria

      Zevallos Delzo, Carolina Mercedes; Catacora Villasante, Manuel M. (Sociedad de Neurología, Psiquiatría y Neurocirugía, 2015-07-30)
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    • Influenza tetravalent vaccines in national immunization programs for Latin-American countries

      Macías Hernández, Alejandro E.; Santos, Fortino Solórzano; Aguilar Velasco, Hugo M.; Ávila Agüero, María L.; Rubio, Fernando Bazzino; Junqueira Bellei, Nancy C.; Bonvehí, Pablo E.; Del Castillo, José Brea; Leguizamón, Héctor Castro; Allan Santos Domingues, Carla M.; García García, María D.L.; Trujillo, Darío Londoño; Lópe, Pío López; De León Rosales, Samuel Ponce; Cervantes Powell, Patricia G.; Suárez Ognio, Luis A.N.; Ruiz-Palacios y Santos, Guillermo M. (Comunicaciones Cientificas Mexicanas S.A. de C.V., 2020-07-01)
      Since 2012-2013 influenza season, World Health Organization (who) recommends the formulation of tetravalent vaccines. Globally, many countries already use tetravalent vaccines in their national immunization programs, while in Latin America only a small number. Two Influenza b lineages co-circulate, their epidemiological behavior is unpredictable. On average they represent 22.6% of influenza cases and more than 50% in predominant seasons. The lack of concordance between recommended and circulating strains was 25 and 32% in the 2010-2017 and 2000-2013 seasons, respectively. There are no clinical differences between influenza A and B. It occurs more frequently from five to 19 years of age. Influenza b has a higher proportion of attributable deaths than influenza a (1.1 vs. 0.4%), or 2.65 (95% ci 1.18-5.94). A greater number of hospitalizations when the strains mismatch (46.3 vs. 28.5%; p <.0001). Different evaluations have demonstrated its cost effectiveness. The compilation of this information supports the use of quadrivalent vaccines in Latin American countries.
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    • Ingresos económicos en médicos peruanos según especialidad: Un análisis transversal de la ENSUSALUD 2015

      Taype-Rondan, Alvaro; Torres-Roman, J. Smith; Herrera-Añazco, Percy; Alva Diaz, Carlos; Brañez-Condorena, Ana; Moscoso-Porras, Miguel G.; alvaro.taype.r@gmail.com (Instituto Nacional de Salud (INS), 2017-06)
      Objectives. To evaluate the relationship between having a medical specialty and the monthly income of Peruvian doctors, and to compare the economic incomes among areas with higher and lower density of medical doctors in Peru. Materials and methods. We analyzed data of the National Satisfaction Survey of Health Users (in Spanish: ENSUSALUD) carried out in Peru in the year 2015. This survey, with a national level of inference, was performed on physicians working at health facilities in Peru. Monthly income was measured considering all paid activities of the physician. Crude and adjusted prevalence ratios (PR and aPR) and their 95% confidence intervals (95% CI) were calculated through Poisson regression models with robust variance, taking into account the complex sampling of the survey. Results. Out of 2 219 Physicians surveyed, 2 154 (97.0%) observations were analyzed. The probability of earning > S/5 000 (1 572.3 USD) per month was 29.1% for general practitioners; 65.6% for specialists; 63.0% for clinical specialists; 70.5% for surgeons, and 55.7% for other specialties. Compared to general practitioners, physicians with clinical, surgical, and other specialties were more likely to earn > S/5 000 per month (aPR = 1.44, 1.49, and 1.26, respectively). The probability of earning > S/5 000 was higher in those working in departments with low medical density. Conclusions. Monthly incomes were higher for specialist physicians than for non-specialists. Economic incomes were higher in departments with lower density of physicians, which may encourage physicians to work in these departments.
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    • Inhibidores de tirosin quinasa para el tratamiento de cáncer pulmonar de células no pequeñas: una necesidad desatendida

      Ximena Gómez; Valdez, Nella; Paredes, Ricardo; nellavandez91@gmail.com (Instituto Nacional de Salud (INS), 2017-06)
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