Recent Submissions

  • Parto no institucional y no cumplimiento de vacunas correspondientes al primer año de vida en el Perú: un análisis a partir de la encuesta demográfica y de salud familiar (ENDES) 2014

    Maguiña Quispe, Jorge Luis; Guevara Jurado, Karol Ingrid; Zevallos Gutierrez, Erika del Pilar (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-03-22)
    Objective: To evaluate the association between non-institutional delivery and incomplete vaccine program during the first year of age in Peru. Materials and Methods: A secondary cross-sectional analysis of the 2014 National Demographic and Health Survey was performed. The outcome variable was incomplete vaccine program, defined as the absence of at least one vaccine during the first year of life according to the vaccine schedule of “Ministerio de Salud”. The exposure variable was non institutional delivery, which included home of the interviewee and midwife, community center, church and private physician's office. Poisson regression was the generalized linear model controlling the multistage study design and potential confounders. It was used to estimate Prevalence Ratio (PR). Results: A total of 6837 women were included in the analysis. The prevalence of incomplete vaccine programs was 52.24% (CI 95% 50.57 – 53.91). Women who reported non-institutional delivery were more likely to have children with incomplete vaccine schedule, PR(c) 1.43 (CI 95% 1.34 – 1.53) and PR(a) 1.61 (CI 95% 1.50 – 1.73). Conclusions: Peruvians women with non-institutional delivery was associated with not comply of vaccine program during the first year of age. These findings can provide strategies to improve vaccine program.
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  • Frecuencia y factores asociados a viremia intermitente en personas viviendo con VIH/SIDA en el programa de un hospital de Lima, Perú

    Benites Zapata, Vicente A.; Pinto Dongo, Claudia Estefany (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-03-31)
    Objectives: To identify the factors associated with intermittent viremia in PLWHA who entered the HIV / AIDS program of the Edgardo Rebagliati Martins National Hospital between 2010 and 2014. Materials and methods: A secondary analysis of a database of PLWHA assisted the National Hospital Edgardo Rebagliati Martins; calculated considering that the base has 520 participants in TARGA, a frequency of intermittent viremia in patients on treatment with a protease inhibitor base of 48%. In this study it was not necessary to use an instrument, since it is based on a secondary basis. Results: When performing the statistical analysis of the variables, no association was found. The participants who had co-infection with tuberculosis were 46, representing 8.8%; and received prophylaxis with CMX 226 (43.5%) participants. The participants who presented an intermittent viremia were 37, representing an incidence of 7.12%. Conclusions: No factor associated with the variable intermittent viremia was found. The identification of associated factors would have been important to reduce the transmission of HIV and the development of resistance to TARGA.
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  • Factores asociados a la portación de armas en adolescentes peruanos

    Alvarado Cutipa-Flores, German Felipe; Barrientos Matta, Viviana Lucía; Ugas Burranca, Deborah Ximena (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-03-06)
    Objectives: To determine associated factors of weapon carrying in adolescents from Peru. Materials and Methods: Secondary analysis from the Young Lives cohort, in which round three from the older cohort was used, 640 participants were included. The outcome was measured with the question “During the last 30 days, on how many days did you carry a weapon such as a knife, machete or gun to be able to protect yourself?” Sociodemographic characteristics were also assessed. Poisson Regression with robust variance was used to compute Prevalence Ratios (PR) with 95% CI. Results: We found that 45,94% were women. The mean age for round 3 was 15 years of age. 8,12% [8,10-8,14] of the adolescents carried a weapon. In adjusted analysis, age, drug use and smoking cigarettes (p<0,05) were associated with the outcome. We did not find association with gender, socioeconomic status and being hurt by a family member. Conclusions: Age, being hurt by a family member, smoking and drug consumption were associated with weapon carrying. Further evaluations with different instruments and longitudinal designs should be performed.
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  • Factores asociados a autorreporte de haber sido arrestado en jóvenes peruanos

    Alvarado Cutipa-Flores, German Felipe; Montoya Romero, Luciana Lorena (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-02-24)
    Objectives: To determine the associated factors of being arrested in youth from Peru. Materials and Methods: Cross sectional analysis from the Young Lives study, in which fourth round from the older cohort was used. Independent variables were sex, age, substance use (smoking and alcohol consumption), socioeconomic status, origin, belonging to a gang, friends members of a gang, weapon carrying, physical and sexual abuse (family, boyfriend, stranger, teacher, friend, partner/spouse). Self-report of being arrested was measured with a standardized question: “Have you been arrested by the police or taken into custody for an illegal or delinquent offense?” Poisson Regression with robust variance was used to compute Prevalence Ratios (PR) with 95%. Results: We found that 54% were men. The mean age was 18.4 years. The 5, 81% (CI with 95% 5.6-6.0) reported been arrested. In adjusted analysis, having friends members of a gang and being part of a gang were associated with the outcome (p<0.05). We did not find an association with sex, age, weapon carrying, socioeconomic status, being hurt by a family member or by a boyfriend. Conclusions: Being part of a gang and having friends members of a gang were associated with self-report of being arrested. Further evaluations –with longitudinal designs-should be performed.
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  • Asociación entre el riesgo de adicción de sustancias psicoactivas y la adherencia a la terapia antiretroviral de gran actividad en personas que viven con VIH en un hospital de Lima, Perú en el periodo de 2015 – 2016

    Lucchetti Rodríguez, Aldo Javier; Fiestas Saldarriaga, Fabián Alejandro; Huertas Tirado, Sheila María; Zegarra Buitrón, Elizabeth (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-02-01)
    Introducción La adherencia al tratamiento es el factor más importante para lograr éxito en la terapia anti – retroviral. Sin embargo, aquella podría verse afectada por el consumo de sustancias psicoactivas. Objetivo Evaluar la asociación entre el riesgo de adicción a sustancias psicoactivas, medido por el “Alcohol, Smoking and Substance Involvement Screening Test” (ASSIST) y la adherencia a la terapia anti - retroviral de gran actividad (TARGA) medido por el “Simplified Medication Adherence Questionnaire” (SMAQ) en personas que viven con el virus de inmunodeficiencia humana (VIH). Métodos Se desarrolló un estudio transversal en el Hospital Nacional Edgardo Rebagliati Martins (HNERM). Se aplicó una ficha de datos, y las encuestas ASSIST y SMAQ. Resultados Se obtuvo un total de169 personas que viven con VIH. El sexo masculino predomino (79,3%), la mediana de edad y tiempo en TARGA fueron 43 años (IQR 35 - 50) y 63 meses (IQR 20 – 156), respectivamente. El consumo de alcohol de bajo riesgo fue más frecuente (84,6%), y se encontró un riesgo moderado a alto de tabaco (35,5%). La adherencia global al TARGA para nuestro estudio fue baja (23,1%). Los pacientes de mayor edad presentaron mayor adherencia (42,9%), con asociación significativa en el modelo regresión logística (edad ≥ 53 años) (p=0,004; OR 8,55; IC 95% 2,00 – 36,57). Conclusiones No se encontró asociación entre el riesgo de adicción a sustancias psicoactivas y adherencia al TARGA. Se encontró una baja adherencia al TARGA según el SMAQ. Además, la edad es un factor asociado positivamente a la adherencia al TARGA.
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  • Purificación del dominio N-terminal del Factor de Iniciación 3 de Escherichia coli para la selección de Aptámeros

    Milón Mayer, Pohl Luis; Loayza Guzmán, Mariana (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-03-06)
    The present study focuses on the initiation phase of protein synthesis and the generation of aptamers as candidates to reduce the physiological function of the isolated N terminal domain (NTD) of initiation factor 3 (IF-3). Through molecular biology techniques, the correct cloning of the gene coding for IF-3 NTD in plasmid pET24a was verified. This plasmid was used to transform the bacterial model organism Escherichia coli BL21 and thus the massive production of the IF-3 NTD was assessed. Using affinity chromatography techniques, the NTD of the IF-3 was isolated, obtaining high purity degrees and production yields. The purified NTD was used to generate aptamers with the SELEX technique (Systematic Evolution of Ligands by Exponential Enrichment). Five molecules with binding potential to the NTD of IF-3 were found. The present investigation provides the bases to study the interaction of the NTD of IF-3 with the aptamers in cell-free system and thus to evaluate their inhibitory potential. It is expected that these molecules behave as potential new drugs, and therefore they might contribute to cope for the need of new antibiotics.
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  • Factores asociados a sobrevida en una cohorte de pacientes con VIH que iniciaron terapia antirretroviral (Targa) en el Hospital Nacional Arzobispo Loayza en Lima

    Suarez Ognio, Luis Antonio Nicolás; Lucchetti Rodriguez, Aldo Javier; Espinoza Morales, Diego Raúl (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-02-01)
    Objetivos: Determinar factores asociados a la sobrevida a 3 años de pacientes con infección por VIH que iniciaron terapia antirretroviral (TARGA) en el Hospital Nacional “Arzobispo Loayza” (HNAL) en Lima, Perú, durante los años 2004-2012. Materiales y métodos: Estudio retrospectivo de una cohorte de 2171 pacientes con diagnóstico de VIH que iniciaron tratamiento en el HNAL. Para evaluar los factores asociados a la sobrevida se compararon las características clínicas de los pacientes según el sexo, edad, la presencia de condición de SIDA al inicio y el esquema de terapia antirretroviral inicial. Realizamos un análisis multivariado de regresión de Cox para evaluar factores sociodemográficos, epidemiológicos y clínicos, obteniéndose los Hazard ratio (HR) y su IC 95%. Resultados: De 2171 pacientes, la población mayoritariamente fue masculina, soltera y con secundaria completa. En el grupo de sobrevivientes la mediana de CD4+ al inicio del TARGA fue de 132 células/ml y de 67 células/mL en el grupo no sobreviviente. A los tres años, 87% de los pacientes en TARGA sobrevivían (13% de Mortalidad). Se encontró como factores asociados a la sobrevida: El uso de Zidovudina/ Lamivudina/Efavirenz en comparación con otros esquemas de TARGA utilizados (HR: 0,51; IC95%:0,39-0,66), iniciar TARGA con más de 350 células/mL de CD4+ (HR: 0,29; IC95%: 0,12-0,71), tener algún grado de educación (HR: 0,48; IC95%: 0,26- 0,92) y ser casado (HR: 0,45; IC95%: 0,27-0,76). Conclusiones: La condición de ser casado, tener menos de 36 años, tener algún grado educativo e iniciar terapia con recuentos de CD4+ mayores a 350 células/mL aumenta la sobrevida durante los primeros 3 años.interventions to avoid this phenomenon can take place.
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  • Efecto de la paratiroidectomía en los niveles de PTH, calcio y fósforo de pacientes con hiperparatiroidismo asociado a enfermedad renal crónica

    Soto Tarazona, Alonso Ricardo; Valdivia Vega, Renzo Pavel; Nina Martínez, Cinthia Ruth (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-01-18)
    There is controversy about the benefit of parathyroidectomy in patients with renal insufficiency and severe hyperparathyroidism, with little information available. Objective: To evaluate the effect of parathyroidectomy on the levels of parathyroid hormone (PTH), phosphorus and calcium in patients with hyperparathyroidism associated with chronic kidney disease with PTH greater than 800 pg / ml, seen at a peruvian reference hospital in the period 2000-2015. Methods: Retrospective analytical historical cohort study that included patients with hyperparathyroidism with surgical indication (PTH> 800). Baseline PTH, calcium and phosphorus levels were compared at 3, 6 and 12 months of patients, sometimes parathyroidectomy with respect to non-parathyroidectomized patients. Results: We included 84 patients, followed during 3606 people-month, of which 24 (28.57%) were parathyroidectomized. During the follow-up showed statistically significant reduction in the levels of parathyroid hormone at 3 (p < 0.001), 6 (p < 0.001) and 12 months (p < 0.001) follow-up in the group of parathyroidectomized patients compared with those not parathyroidectomized, as well as in calcium levels at 3 (p < 0.001), 6 (p < 0.001) and 12 months (p < 0.001) and phosphorus at 3 (p <0.03), 6 (p <0.001) and 12 months (p <0.001). Conclusions: Patients undergoing parathyroidectomy showed significant reductions in levels of PTH, calcium and phosphorus compared to those not paratiroidectomizados, achieving the levels recommended by the KDIGO Guide at 3, 6 and 12 months of follow.
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  • Prevalencia y factores asociados a la compra de antimicrobianos sin receta médica en usuarios de farmacias y boticas, Perú ENSUSALUD 2016

    Gutiérrez Sierra, Manuel Eduardo; Rojas Adrianzén, Carolay Stephany (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-02-05)
    Objectives: To describe the prevalence of the purchase of antimicrobials without medical prescription (PAWMP) and its associated factors in users of drugstores/pharmacies according to the National Survey on User Satisfaction of Health Services (ENSUSALUD) 2016. Materials and Methods: We performed a secondary data-analysis of ENSUSALUD 2016; a two-stage population-based study carried out in health care centes of the Ministry of Health and Regional Governments , Social Security, Armed Forces and Police and the private sector. Generalized linear models for complex survey sampling were fit to estimate prevalence ratios (PR) and 95% confidence intervals (CI). Results : The prevalence of PAWMP was 56.00%. The prevalence of PAWMP in the Mountains/Jungle was 69.00% (PR : 1.69 ; 95% CI: 1.34-2.14) and 61,00% (RP=1.61 IC95%:1.31-1.99) greater, respectively, than the prevalence of PAWMP in Lima. The prevalence of PAWMP in those with Integral Health Insurance (SIS) was 28.00% lower, than in those with PAWMP who did not have health insurance (RP=0.72 IC95%:0.59-0.88). The prevalence of PAWMP in those who bought for their spouse or child was 34.00% (RP=0,66 IC95%:0,56-0,78) and 35.00% (RP=0.65 IC95%:0.50-0.86) lower, respectively, than in those that bought for themselves. Conclusions: More than half of users of drugstores/pharmacies who bought antimicrobials, did it without a medical prescription. In Peru, PAWMP is associated with being from the Mountains or Jungle, having SIS and purchase antimicrobials for their spouse or child. We suggest strategies to promote the adequate use and dispensing of antimicrobials, and increase the access to health services in the Peruvian population.
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  • Factores asociados a retención en el cuidado de personas viviendo con VIH/SIDA en el programa de un hospital de Lima, Perú

    Mendo Urbina, Fernando Cruz; Tejada Caminiti, Romina Arely; Parra Baltazar, Isabel Mónica; Quispe Iporra, Sara Grecia Esperanza; Universidad Peruana de Ciencias Aplicadas (UPC) (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-02-01)
    Introduction: The retention in the care is considered a crucial step to maximize the results in people who is living with HIV/AIDS (PLWHA), however, there is still limited information about its associated factors. Objectives: To identify the factors associated with retention in the care of PLWHA in the HIV/AIDS program of the Edgardo Rebagliati Martins National Hospital between 2010 and 2014. Materials and methods: A retrospective cohort study was conducted in a Social Security Hospital in Peru, where 624 participants were included through a census. Both clinical records and PLWHA program records were reviewed. In the multivariate analysis a generalized linear model of the binomial family and link log was used, since there was no convergence the Poisson family and link log with robust variance were used. Results: The incidence of retention was 52.6%, in addition, association with age was found, being significant in the adjusted model (RRa = 1.01, 95% CI 1.00 - 1.02) and with the distance to the establishment <5km (RRa = 1.18, 95% CI 1.00-1.38). Conclusions: In a hospital level IV (category III-1) of Lima, Peru, an incidence of retention in the care of 52.6% was registered, being below the figures recommended by the WHO (90%). Age older than 35 years and living at a distance <5km from your health facility, were the only factors associated with retention in care.
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  • Actividad física en el trabajo y su asociación con síndrome metabólico: un estudio de base poblacional en Perú

    Bernabé Ortiz, Antonio; Arsentales Montalva, Valeria; Tenorio Guadalupe, María Del Rosario; Universidad Peruana de Ciencias Aplicadas (UPC) (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-01-15)
    Introduction: The priority role of physical activity, both in the prevention and in the management of the components of the metabolic syndrome, has been widely established in the last decade. Objectives: To evaluate the association between physical activity levels at work and the presence of metabolic syndrome among individuals aged ≥20 years in different geographical settings of Peru. Materials and methods: A secondary analysis of a population-based survey was conducted. Five population strata of Peru were included. The data were in accordance with the methodology of the National Institute of Statistics and Informatics. The diagnosis of metabolic syndrome was established according to internationally consensus criteria, based on the anthropometric, biochemical and clinical parameters that are involved in its diagnosis. The exposure of interest was physical activity at work, split into high, moderate and low levels. To evaluate the association of interest, the Poisson regression model was used and crude and adjusted models were created. Results: The data of 4029 individuals were analyzed, average age of 42.1 years (SD 15.3) and 2013 (50.0%) were women. A total of 1011 (25.1%; 95% CI: 23.8% - 26.5%) subjects presented metabolic syndrome, and this percentage varied according to the study region. Metabolic syndrome was more frequent in Lima (29.6%) and the rest of the Coast (30.8%), and less frequent in the rural Sierra (17.4%, p<0.001). The multivariate model showed evidence of association between physical activity at work and the presence of metabolic syndrome. When compared to those who had high physical activity levels at work, those who reported moderate levels of physical activity were 1.51 (95% CI: 1.25-1.81) more likely to have metabolic syndrome, whereas among those with low levels of physical activity levels at work the association was stronger (1.71, 95% CI: 1.42 - 2.07). Conclusions: Low levels of physical activity at work are strongly associated with the presence of metabolic syndrome. For this reason, measures to increase the performance of physical activity at work should be promoted to contribute to the reduction of the prevalence of MS in our population.
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  • Motivación para estudiar Medicina e intención de trabajo en zonas rurales en universitarios de 11 países de Latinoamérica

    Gutierrez Sierra, Manuel; Sinche Flores, Jorge Erick; Escalante Valdivia, Bryan Kevin Aldo; Universidad Peruana de Ciencias Aplicadas (UPC) (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-02-01)
    Objective. To evaluate the association between the motivations to study medicine and the intention to work in rural areas in medical students from 11 Latin American countries. Methods. Cross-sectional research in 63 medical schools of 11 Latin American Spanish-speaking countries. The intention of rural work at 10 years of graduation and the altruistic and economic motivation was evaluated by means of the MEM-12 scale, comparing the lower tercil with the others. Prevalence ratios were calculated using Poisson regression. Results. There were 4200 participants included in the study, 51,4% were female, 40.6% were between 15 and 19 years old. We found approximately 11.1% of medical students in Latin America intend to work in a rural location. The students in the tertiary superior of economic motivation had lower probability of job intention in rural area (PR = 0.52, CI 95% 0.41 to 0.66), in the multivariate analysis. We found no association between altruistic motivation and job intention in rural areas (PR = 1.28, IC95% 0.88 to 1.85). Conclusion. Medical students in Latin America have a low intention of rural job. We found the economic motivation to study a medical career is negatively associated with the intention to work in rural areas. On the other hand, it is necessary to carry out more studies to explore the association between the altruistic motivation to choose the career of medicine and the intention of rural job in Latin American population
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  • Inequidades en el tamizaje para Diabetes Mellitus: estudio transversal de base poblacional en Perú, 2014

    Gutierrez Sierra, Manuel; Aedo Tito, Karla Paola; Conde Bazán, Leslye Fiorella; Universidad Peruana de Ciencias Aplicadas (UPC) (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-01-18)
    Objective: To determine the prevalence of lack of screening for diabetes mellitus and their association with social determinants in Peruvian population ≥45 years old in the last 12 months according to the 2014 Demographic and Family Health Survey (ENDES). Methods: Cross sectional desing. Using a secondary data base of the 2014 ENDES. The original design of the ENDES was two-stage, probabilistic, independent and self-weighted. An analysis of complex samples for a specific subpopulation was carried out, and the crude and adjusted prevalence ratio were calculated. Results: A sample size of 10 232 was obtained. Mean age was 60.1 years. The prevalence of lack of screening for DM in a year was 69,4% (IC95%: 67,9 – 70,8). An association was found between the lack of screening and social determinants of inequity; not having insurance, living in a rural area and having a low level of income and, of education. Conclusions: Approximately 70% of Peruvians were not receive a screening for DM in the last 12 months. Screening prevalence declined with decreasing socioeconomic quintile and level of education. Social factors should be the target of the reforms to improve access to health services in Peru. The result is generalizable in populations with similar characteristics, such us Latin and developing countries.
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  • Asociación entre actividad física y auto-percepción de pérdida de la memoria

    Bernabé Ortiz, Antonio; Arana Chiang, Alejandra; Universidad Peruana de Ciencias Aplicadas (UPC) (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-01-29)
    Introduction: Memory is the information stored in neurons so that it can be recovered in the future to be used in adaptive conditions. Self-perception of memory loss itself can be an useful indicator for the screening of cognitive impairment. However, there are few studies about self-perception of memory loss and its associated factors. Objectives: To assess whether there is association between low levels of physical activity and self-perception of memory loss. Methods: Secondary data analysis from the study “Launching a salt substitute to reduce blood pressure at the population level: a cluster randomized stepped wedge trial in Peru” in which participants from 6 villages from Tumbes, Peru were collected between April to July 2014, In this study, the exposition was physical activity which has been evaluated with IPAQ and the outcome was memory loss self-perception evaluated by the British Regional Heart Study Questionnaire. Results: 2376 participants were included. Average age was 43.3 years (SD: 17.2) and 1196 (50.4%) were female. On the other hand, 293 (12.3%; IC 95% 11.0%-13.7%) participants self-perception of memory loss and 219 (74.7%) presented low physical activity. In multivariate model association between low physical activity and self-perception of memory loss was found (RP = 1.20; IC 95% 1.01 – 1.44). Conclusions: Our study evidenced association between low physical activity and self-perception of memory loss in adult population of a semiurban area of Tumbes.
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  • Características clínicas, histopatológicas y factores asociados a adenomas de alto grado y adenocarcinoma colorrectal en un hospital oncológico de Lima, Perú.

    Carreazo Parsiaca, Nilton Yhuri; Parra del Riego Freundt-Thurne, Angela; Olivares Sparks, Andrea Sofía; Universidad Peruana de Ciencias Aplicadas (UPC) (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-01-30)
    Clinical and histopathological features associated with high grade dysplasia and colorectal adenocarcinoma. Aim: The aim of this study is to determine the associated factors to develop high-grade dysplasia and colorectal adenocarcinoma. Methods: This is a retrospective analytical cross-sectional study, which included all the polyps found in patient’s colonoscopies between 2014 and 2015 at Instituto Nacional de Enfermedades Neoplásicas (INEN). The primary outcome was the presence of high-grade dysplasia or colorectal adenocarcinoma. Multivariate analysis was done using the Generalized Estimating Equation (GEE) to analyze variables such as size, location, age, gender, number of polyps, personal history with the primary outcome. Results were reported in prevalence ratios (PR) and 95% confidence intervals. Results: From the 2439 patients who underwent a colonoscopy between 2014 and 2015, a total of 621 polyps from 416 patients (41.3% males and 58.7% females) were included in this study. The prevalence of high-grade dysplasia and colorectal adenocarcinoma found was 47,6%. The location of the polyps was 52,5% in the left-side and 47,5% in the right-side. Multivariate analysis showed that polyp size ≥1cm (RP=5,57, IC 95%: 4,16-7,47) and left-sided polyps (RP=1,20, IC 95%: 1,01-1,41) had higher probability to develop high-grade dysplasia or colorectal adenocarcinoma. Conclusions: An increase in polyp size and left-sided lesions are associated with high-grade dysplasia or colorectal cancer.
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  • Mortalidad en pacientes con hemorragia digestiva alta variceal y no variceal: Estudio de cohorte retrospectivo en una unidad especializada de un hospital de la seguridad social en Lima, Perú, 2012-2013

    Segura Paucar, Eddy Roberto; Patiño Valderrama, Lía Aliosha; Tello Velásquez, Ana Claudia; Universidad Peruana de Ciencias Aplicadas (UPC) (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-01-30)
    Background and aim: In Peru, mortality due to Upper Gastrointestinal Bleeding (UGB) is still high. Our aim was to determine the risk factors for mortality after 30 days of UBG episode and its prediction using the Rockall score, according to type of UGB (variceal and non-variceal). Methods: A retrospective cohort study was performed from pre-existing data from 339 patients with clinical and endoscopic diagnosis of UGB admitted to the UHD from HNERM between June 2012 and December 2013. Clinical features and endoscopic findings were evaluated as risk factors associated with mortality using: chi square tests and Poisson regression analysis. We plot the ROC curve and calculate the area under the curve to analyze the Rockall scale as a mortality predictor. Results: A total of 339 patients were divided in two groups: variceal UGB (33%) and nonvariceal UGB (67%%). Mortality was greater in the first group (10.8% vs 7.9%), although without statistically significant difference. The factors associated with mortality in the non-variceal HDA were: heart rate, blood pressure, hematocrit, erosive esophagitis and treatment with argon plasma and clips. While in the HDA variceal were: heart rate, urea and treatment with variceal sclerotherapy. The ROC curve for non-variceal HDA mortality showed an area under the curve of 0.64 (95% CI 0.49-0.79), similar to the group with variceal HDA 0.43 (95% CI 0.27-0.59). Conclusions: In both UGB groups, different factors associated with mortality were found. In addition, the full Rockall scale does not predict mortality in either of the two subgroups with UGIB
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  • Agresión y victimización entre pares y su asociación con depresión en escolares

    Soto Tarazona, Alonso Ricardo; Veramendi Granados, Abid Mary; Lau Gutiérrez, Valeria Johanna; Universidad Peruana de Ciencias Aplicadas (UPC) (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-02-07)
    The teenage population is one of the age groups most likely to suffer from depression and are different factors that play an important role in the development of this, within them the "bullying". Objective: To establish the association between depression and aggressors and victims of bullying in high school students of public schools of Chorrillos. Methods: A secondary analysis of a study "Association between victimization by bullying and Internet addiction in Lima schoolchildren" was carried out. The variables depression, and victimization and aggression between pairs were measured, as well as sociodemographic variables. Results: Of a total of 860 students, 63.1% were male, with an average age of 14.5 +/- 1.6 years and it was found that 95.2% lived with at least one of the parents at home. 51.9% presented some degree of depression, 64.2% were categorized as medium and superior tertile of aggressors of the total them, and 62.7% as médium and superior tertile of victims of them. In the adjusted model, moderate-severe depression had a strong association with superior tertile of aggression (PR: 5.37, 95% CI: 2.98-9.66) and with victimization (PR: 4.33, 95% CI: 2.43). - 7.71). Conclusion: Depression was associated with both profiles, of the aggressor and victim of bullying.
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  • Características clínicas y demográficas de los pacientes con Cáncer de Mama Triple Negativo que recibieron quimioterapia neoadyuvante y tratamiento quirúrgico en el Instituto Nacional de Enfermedades Neoplásicas entre los años 2009-2014

    Morante Cruz, Zaida; Neciosup Delgado, Silvia Patricia; Soto Tarazona, Alonso Ricardo; Fortes Fortes, Pedro Pablo; Universidad Peruana de Ciencias Aplicadas (UPC) (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-02-06)
    Objective: Describe the sociodemographic and clinical characteristics of patients with triple-negative breast cancer, who underwent neoadjuvant chemotherapy and subsequent surgical intervention treated at the Instituto Nacional de Enfermedades Neoplásicas (INEN). Methods: A retrospective cohort study that included 175 patients with triple negative breast cancer, treated between 2009 and 2014, who underwent neoadjuvant chemotherapy and surgical intervention at the INEN. Through the development of a data collection form, we proceeded to obtain sociodemographic and clinical information. Pathological response was recorded from patient charts, based on the Miller-Payne classification, which assigns a histological grade based on the presence or absence of tumor cells. We used measures of central tendency and dispersion for the description of numerical variables, while absolute frequencies and percentages were used for categorical variables. Results: 175 patients were included, with an average age was 47.5 years (SD ±11.1). 47.4% of the patients had a positive family history of cancer. 45.7% of patients treated had a stage IIIB breast cancer. The most used chemotherapy regimen was paclitaxel, adriamycin and cyclophosphamide (52.6%). Of the 175 patients treated 22.9% had pathological complete response. The 5-year overall survival rate was 53.1%, with a median survival time of 2.87 years. Conclusions: The prevalence of breast cancer is high amongst the Latin-American population, especially young women. Triple negative breast cancer is exceedingly aggressive in comparison to other types of breast cancer. Despite advances in targeted therapy for breast cancer, the overall survival in triple negative breast cancer is inferior to other subtypes of breast cancer.
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  • Factores asociados a la sobrevida global y sobrevida libre de enfermedad en pacientes con cáncer de mama triple negativo con quimioterapia neoadyuvante y tratamiento quirúrgico en el Instituto Nacional de Enfermedades Neoplásicas entre los años 2009-2014

    Morante Cruz, Zaida; Neciosup Delgado, Silvia Patricia; Soto Tarazona, Alonso Ricardo; Ruiz Huaranga, Edita Guadalupe; Barrantes Carmen, Adriana Lucero; Universidad Peruana de Ciencias Aplicadas (UPC) (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-02-06)
    Objective: The aim of this study is to identify associated factors with overall survival and disease-free survival in the Peruvian population attended at the Instituto Nacional de Enfermedades Neoplásicas (INEN) with triple-negative breast cancer that received neoadjuvant chemotherapy, and subsequent surgical treatment. Methods: A retrospective cohort study that included 175 patients with triple negative breast cancer with neoadjuvant chemotherapy and surgical treatment attended in the INEN between 2009 and 2014. A data collection form was drawn up to obtain sociodemographic and clinical information. For the measurement of the variable Pathological Response, defined by degrees that determine the absence, partial or total presence of neoplastic cells, the Miller-Payne classification was used, consigned in the patient's surgery report. Kaplan-Meier curves were constructed for the description of overall survival and disease-free survival. A hazard ratio (HR) was estimated in a bivariate and multivariate manner through the Cox Regression Model. Results: The factors that were associated with a lower overall survival were tumor size (HR= 1.09; 95% IC, 1.03 - 1.14; p<0.01) and lymph node involvement (HR=3.63; 95% IC, 1.98 - 6.67; p<0.00). A greater overall survival was associated with a complete pathological response (HR=0.36; 95% IC, 0.14 - 0.90; p=0.03). A total of 22.8% of patients presented complete pathological response, which corresponds to the absence of cancer cells through histological studies after neoadjuvant treatment, which was associated with a smaller tumor size (p <0.01) and conservative surgical intervention (p <0.01). No factors significantly associated with disease-free survival were found. Age was associated with disease-free survival in the bivariate analysis; however, in the multivariate analysis no statistically significant associated factors were found. Conclusions: The overall survival of patients with triple negative breast cancer in this population is negatively affected by a larger tumor size and lymph node involvement. The complete pathological response is associated with greater overall survival. No factors were found to be significantly associated with disease-free survival.
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  • S13 y L33 como proteínas sensoras de movimientos de las subunidades ribosomales durante la iniciación de la síntesis proteica en bacterias

    Milon Mayer, Pohl Luis; Cuestas Quiroz, Flavia Alejandra; Sánchez Ato, Luis Andrés; Universidad Peruana de Ciencias Aplicadas (UPC) (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-02-01)
    The ribosomal proteins S13 and L33 belong respectively to the 30S and 50S subunits of the bacterial ribosome. S13 is positioned close to the initiation factors (IF1 and IF3). L33 is opposite and near to S13 in the major subunit. The present study, the aim is to evaluate the fluorescently labeled S13 and L33 proteins during the initiation of protein synthesis, aiming to build an experimental system that allows the analysis of structural changes in the ribosomal subunits, especially during the initiation of translation and with the binding of antibiotics. Using recombinant techniques and ion exchange chromatography, both ribosomal proteins were expressed and purified. Production yields of pure proteins of L33 were obtained in the range of milligrams per g of Escherichia coli, in addition, of 98% purity indices. S13 was produced in a similar manner, obtaining milligrams of pure protein per g of Escherichia coli with a purity of 99%. Both ribosomal proteins were modified with fluorescent compounds compatible with measurements of FRET (Föester Resonance Energy Transfer). Under controlled conditions S13 was able to insert into the 30S subunit, while sedimentation experiments indicated that fluorescent L33 did not bind to the 50S subunit. The 30S subunit modified with fluorescent S13 showed various FRET signals in combination with the initiation factors IF1 and IF3. These signals were used to measure the interaction of streptomycin, spectinomycin and GE81112, antibiotics that bind to the minor subunit of the ribosome. Streptomycin binds rapidly to the 30S subunit and causes an approximation of S13(Atto-540Q) to IF3-CTD(Atto-488) while GE81112, and to a lesser extent spectinomycin, promote a distancing of the ribosomal protein from the initiation factor. Both movements can account for rotations of the head of the 30S subunit, previously described as fundamental for the functioning of the ribosome. The present research provides a novel approach to study structural changes in the minor subunit according to the binding of antibiotics to the ribosome.
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