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.

Objective: To identify factors associated with the increase of liver enzymes in the HIV patient receiving HAART treated at the National Hospital Arzobispo Loayza. Materials and Methods A sample size of 660 patients was calculated based on previous studies. For the univariate analysis, the variables were summarized as relative and absolute frequencies. Likewise, the numerical variables were considered as mean and standard desviation,. In the bivariate analysis, the variables were analyzed with chi 2 or t-student tests. For the multivariate analysis, a linear regression model was applied. Results In this study the majority of the population was male. 52.8% of the population received a main treatment scheme consisting of TDF + FTC + EFV. At control, 30.4% of patients who received HAART presented elevation of liver enzymes. The bivariate analysis showed that the elevation of liver enzymes is more in patients who followed the main scheme. The multivariate analysis showed that the increase in 1 U / L of GPT, led to the elevation in 0.978 U / L of GOT (p = 0.001). Finally this analysis shown that the increase in 1 U / L of GOT generated an increase of 0.934 U / L of GPT, and the increase in 1 mg / dL of glucose generate an increase of 0.241 U / L. of GPT . Conclusion The elevation of glucose increases the risk of elevation only of GPT,. Also a elevation of GOT that is directly proportional to the increase in GPT, was shown.

Objetivos La calidad de vida en pacientes VIH positivo puede verse afectada por enfermedades como la osteoporosis u osteopenia. Múltiples estudios han investigado las causas de la disminución de densidad mineral ósea en esta población. El objetivo fue realizar una revisión sistemática y meta análisis para determinar la asociación entre el uso de TARGA (Tratamiento Antirretroviral de Gran Actividad) y la baja densidad mineral ósea en pacientes infectados. Métodos Se realizó una búsqueda en diversas bases de datos para identificar estudios transversales, casos y controles, cohortes y ensayos clínicos aleatorizados. Dos investigadores independientemente revisaron las bases de datos y un tercero intervino en caso de discrepancias. Se identificaron ocho estudios transversales y una cohorte que reportan la asociación entre la densidad mineral ósea en pacientes con VIH en TARGA versus paciente con VIH sin tratamiento. Resultados Ocho estudios transversales y una cohorte que reportan la asociación entre baja densidad mineral ósea y VIH en pacientes tratados versus pacientes sin tratamiento fueron obtenidos; la mayoría de baja calidad. Se realizó un meta análisis y los siguientes resultados fueron obtenidos. Los odds de osteopenia y osteoporosis en pacientes con VIH recibiendo TARGA versus pacientes sin tratamiento fue OR 1.03 CI 95%: 0.69-1.55; I2: 17% y OR 1.27 CI 95%: 0.67-2.38; I2: 5% respectivamente. Conclusión Nuestros resultados muestran que la evidencia no es suficientemente fuerte para determinar si el TARGA tiene un efecto verdadero sobre la DMO. Los resultados no fueron estadísticamente significativos, sin embargo la baja calidad de los estudios puede alterar las conclusiones. Se requirieren mayores estudios como cohortes con seguimiento a largo plazo y ajustados a datos antropométricos y propios de la enfermedad.

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

Introducción: El diagnóstico de tuberculosis (TBC) en niños es un reto para el personal de salud, el 85% tienen BK negativo. La inversión en el diagnóstico temprano de estos niños requiere evidencia para su implementación. Nuestro objetivo mediante la revisión sistemática y meta análisis es determinar la asociación entre el resultado del BK y los resultados del tratamiento antituberculoso en niños con tuberculosis pulmonar. Métodos: La búsqueda se realizó en las bases de datos de Medline, Global Health Library y Embase. Los estudios elegidos fueron usados para comparar los resultados al tratamiento antituberculoso en niños menores de 15 años BK positivos con los BK negativos. Se realizó un meta análisis con modelo de efectos aleatorios para estimar el peso y los intervalos de confianza (IC). Resultados: Los niños que antes del tratamiento presentaban BK negativo y fallecieron presentaron un RR de 1.35 (IC 95%: 1.02-1.78). Los niños que fracasaron al tratamiento con BK negativo antes del tratamiento presentaron un RR de 0.14 (IC 95%: 0.04-0.48). No se encontró asociación entre mal resultado al tratamiento y presentar antes del tratamiento BK negativo; sin embargo, sí se encontró asociación entre los niños que antes del tratamiento presentaron BK negativo y la suma de niños fallecidos y niños que abandonaron el tratamiento con un RR de 1.29 (IC 95%: 1.01-1.65). Conclusiones: Existe asociación entre fallecer y tener BK negativo, por ello es necesario realizar un diagnóstico temprano a los niños que presenten baciloscopía negativa; de esta manera, no se retrasa el inicio del tratamiento antituberculoso. Introduction: The diagnosis of tuberculosis (TB) in children is a challenge for health personnel, 85% have smear negative. Investing in the early diagnosis of these children requires evidence for their implementation. Our objective through the systematic review and meta-analysis is to determine the association between the smear result and the results of tuberculosis treatment in children with pulmonary tuberculosis. Methods: The search was performed in the databases of Medline, Global Health Library and Embase. The studies chosen were used to compare the results of antituberculosis treatment in children younger than 15 years with smear positive and with smear negative. A meta-analysis with random effects model was performed to estimate weight and confidence intervals (CI). Results: Children who presented smear negative and died before treatment had a RR of 1.35 (95% CI: 1.02-1.78). Children who failed treatment with smear negative before treatment had a RR of 0.14 (95% CI: 0.04-0.48). Was not found asociation between poor treatment outcome and presenting smear negative before treatment; However, there was association between children who presented smear negative before the treatment and the sum of children who died and children who left treatment with a RR of 1.29 (95% CI: 1.01-1.65). Conclusions: There is association between die and having smear negative, so it is necessary to make an early diagnosis in children who present smear negative; In this way, the initiation of antituberculosis treatment is not delayed.

Introduction: it is estimated that Pediatric stroke is in the top ten causes of death in this age group.3 It is an infrequent disease; nevertheless, is considered one of the principal causes of disability in children. 2,13 Cardiac congenital malformations are to be known as a predisponent factor for ischemic stroke. In the case of hemorrhagic stroke, the principal predisponent factor is artheriovascular cerebral malformations. Objective: describe the frequency of ACV type and scale of disability at discharge after a pediatric stroke in a Peruvian national hospital. Methodology: a descriptive transversal study will be applied to hospitalized patients due to a stroke at the “Instituto Nacional de Salud del Niño”. Results: a total of 140 clinical history charts were analyzed, stroke was more frequent in infants (33,6%) and the male group (67,9%). The intracerebral hemorrhage was the principal typo of stroke (43%). The frequency of severe disability according to PSOM scale was 32,2% and 22,1% with KOSCHI scale. Conclusion: the presence of predisponent factors such as vascular diseases or coagulopathies are frequent. Thus the importance to stablish risk factors in order to determine which patient has more risk and give an early treatment.

Introducción: Las medidas de control de la Tuberculosis (TB) deben incluir a los grupos de riesgo como las personas privadas de la libertad (PPL) que presentan una elevada prevalencia y mayor proporción de casos resistentes de TB. Este estudio busca estimar la prevalencia de TB auto-reportada en Establecimientos Penitenciarios (EP) Peruanos y factores asociados. Métodos: Nuestro manuscrito corresponde a un estudio transversal en base al Censo Nacional Penitenciario 2016 de los 66 EP del Perú. Nuestra variable resultado fue definida como el autoreporte de tuberculosis (TBa) diagnosticado en PPL de EP peruanos. Ejecutamos un análisis bivariado seguido de regresión multivariada de Poisson para ajustar las razones de prevalencia (RPa). Adicionalmente utilizamos un modelo multinivel de efectos mixtos. Resultados: Un total de 77 086 penitenciarios en 66 EP participaron en el censo, de los cuales sólo 69 890 registros fueron incluidos en nuestro análisis. De estos, 1 754 PPL autoreportaron tuberculosis de diagnóstico intrapenitenciario, originando una prevalencia de TBa de 2 510/100 000 PPL. En el modelo final, la prevalencia de tuberculosis autoreportada se encontró asociada a la edad de 18 a 35 años (RPa 1,80), sexo masculino (RPa 9,56), no tener educación escolar (RPa 2,60), no tener pareja estable (RPa 1,18), encarcelamiento previo (RPa 1,31) e historia de familiar encarcelado (RPa 1,15). También se encontró asociación con VIH/SIDA (RPa 2,82), Infección de transmisión sexual (ITS) (RPa 2,21), Diabetes Mellitus (DM) (RPa 2,16), Hepatitis viral, el consumo de drogas (RPa 1,41) y alcohol (RPa 1,14). El modelo mixto mostró una varianza significativa para hacinamiento intrapenitenciario (Varianza: 1,97; 0,97 – 3,98) y pertenecer a diferentes EP (Varianza: 3,02; 1,30 – 7,01). Conclusiones: La prevalencia de tuberculosis autoreportada intrapenitenciaria encontrada fue más alta que la de otros países en desarrollo. Factores sociodemográficos, antecedentes patológicos, historia de hábitos nocivos y hacinamiento intrapenitenciario incrementan la probabilidad de tuberculosis autorreportada.

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.

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.

Title: Erectile dysfunction: prevalence, associated factors and quality of life in Tumbes Introduction: Erectile dysfunction (ED) is a public health problem defined as the inability to maintain an erection sufficient to obtain sexual satisfaction. The main organic factor is Diabetes Mellitus (DM). Besides, it has been described that it affects the quality of life. Objective: The aim of the study is to evaluate an association between erectile dysfunction and quality of life in men from the urban-marginal zone of Tumbes; as well as the prevalence and risk factors associated with ED. Materials and methods: This was a cross-sectional study of population-based secondary data. We have included men between 30 and 69 years old. The erectile dysfunction was self-reported and Quality of life was evaluated with the EuroQol-5D scale. To determinate the relationships between independent variables was used Poisson and robust regression. Results: The analysis was performed in 342 men, the mean age was 48.1 years (Standard Desviation: 10.6 years) and the prevalence of ED was 9.1% of the population. According to the study being 50 years old or older (PR: 3.8 IC95% 1.6-8.9), depressive symptoms (RP: 3.3 IC95% 1.2-8.5), and diabetes mellitus (RP: 3.8 IC95% 1.8-8.4) were factors associated with ED. However, presence ED was not associated with low quality of life. Conclusion: One out of ten men reports erectile dysfunction in the study population, similar to the global prevalence. The ED increases with age, one out of three patients with diabetes mellitus (DM) has ED and depression increases 3 times the probability of having ED. However, ED was not associated with quality of life in the sample.