Revista de la Facultad de Medicina Humana 2021-01-26T22:28:51+00:00 Dr. Jhony A. De La Cruz Vargas PhD, MCR, MD Open Journal Systems <p><span id="result_box" class="" lang="en" tabindex="-1"><span class=""><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">The "Revista de la Facultad de Medicina Humana" of the Ricardo Palma University (Rev. Fac. Med. Hum.) is the organ of scientific diffusion of the faculty and a publication for the medical community as a whole. This comunity includes students, graduates, academics, researchers and national and international institutions. It covers current issues, with original and unpublished articles, related to the various specialties of the biomedical and Public Health area.</span></span></span></span></p> First University Chair of Lifestyle Medicine in Peru and Latin America 2021-01-16T06:59:20+00:00 Jhony A De La Cruz-Vargas Iván Rodríguez Chávez <p>Lifestyle Medicine is the new global medical discipline considered the seventh era of public health. 1,2 In 2004, the American College of Lifestyle Medicine emerged in the United States of America (<a href=""></a>). In Europe, the European Organization for Lifestyle Medicine (<a href=""></a>) was created. Since 2014 the Latin American Association of Lifestyle Medicine (<a href=""></a>) has been working in more than 12 countries in the region. Currently, Lifestyle Medicine has a presence on five continents.</p> 2021-01-11T00:23:00+00:00 ##submission.copyrightStatement## Effect of SARS-CoV-2 variants on the transmission of COVID-19 in Peru 2021-01-13T04:24:36+00:00 Manuel J. Loayza-Alarico Jhony A. De La Cruz Vargas <p>SARS-CoV-2 is the coronavirus that causes the COVID-19 pandemic and is made up of a rapidly evolving RNA. This virus presents continuous genomic mutations as it is transmitted. A major focus of current research on the genetics of SARS-CoV-2 is whether any of these mutations have the potential to significantly alter important viral properties, such as the mode or rate of transmission, or the ability to cause increased lethality. Important mutations have already been reported in the United Kingdom, where out of 25,000 genome sequencing, the D614G mutation was identified in SARS-CoV-2, a mutation that results in a displacement of aspartic acid with glycine at position 614 of the spike protein ( S) of the virus that, although it is true, are not associated with greater mortality or clinical severity due to COVID-19, but 614G is associated with a higher viral load and a younger age of the patients.</p> 2021-01-11T00:00:00+00:00 ##submission.copyrightStatement## Hypoalbuminemia as a predicator of mortality of sepsis from COVID-19. Hospital II Chocope, 2020. 2021-01-13T04:24:36+00:00 Alex Brandon Lopez Graciela Marilyn Aguilar Murillo Alicia Pamela Muñoz Neciosup Evelyn Goicochea Rios <p>A correlational type investigation was carried out evaluating 145 patients with covid-19 sepsis. Objectives: To determine whether hypoalbuminemia is a predictor of mortality and to identify the serum albumin value most frequently related to lethality. Method: Patients older than or equal to 18 years seen at Hospital II Chocope during May to August 2020 were included. Patients with oncological pathologies and incomplete medical records were excluded. The documentary analysis technique was used, by reviewing medical records. Results: There was a statistically significant association between hypoalbuminemia and mortality (p = 0.00), patients with hypoalbuminemia had 3 times the risk of dying. (OR = 3.97 95% CI). Likewise, the highest sensitivity and specificity of the test was when the cut-off point for hypoalbuminemia was 1.38 g / dl. Finally, the most frequent comorbidity was arterial hypertension. Conclusions: hypoalbuminemia is a predictor of mortality and the lower the albumin value, the higher the mortality.</p> 2020-12-21T06:25:53+00:00 ##submission.copyrightStatement## Risk Factors for Mortality from COVID-19 in Hospitalized Patients: A Logistic Regression Model 2021-01-25T18:33:09+00:00 Irma Luz Yupari Lucia Bardales Aguirre Julio Rodriguez Azabache Jaylin Barros Sevillano Angela Rodríguez Díaz <p><strong>Introduction</strong>: The population is susceptible to COVID-19 and knowing the most predominant characteristics and comorbidities of those affected is essential to diminish its effects. <strong>Objective:</strong> This study analyzed the biological, social and clinical risk factors for mortality in hospitalized patients with COVID-19 in the district of Trujillo, Peru. <strong>Methods:</strong> A descriptive type of study was made, with a quantitative approach and a correlational, retrospective, cross-sectional design. Data was obtained from the Ministry of Health’s database, with a sample of 64 patients from March to May 2020. <strong>Results:</strong> 85,71% of the total deceased are male, the most predominant occupation is Retired with an 28,57% incidence, and an average age of 64,67 years. When it came to symptoms of deceased patients, respiratory distress represents the highest percentage of incidence with 90,48%, then fever with 80,95%, followed by malaise in general with 57,14% and cough with 52,38%. The signs that indicated the highest percentage in deaths were dyspnea and abnormal pulmonary auscultation with 47,62%, in Comorbidities patients with cardiovascular disease were found in 42,86% and 14,29% with diabetes. The logistic regression model to predict mortality in hospitalized patients allowed the selection of risk factors such as age, sex, cough, shortness of breath and diabetes. <strong>Conclusion:</strong> The model is adequate to establish these factors, since they show that a fairly considerable percentage of explained variation would correctly classify 90,6% of the cases.</p> 2020-12-21T06:26:18+00:00 ##submission.copyrightStatement## Trend in gastric cancer mortality rate in Peru: Segmented regression model 1995 - 2013 2021-01-13T04:24:36+00:00 Diego Rolando Venegas Ojeda Ysela Dominga Agüero Palacios <p>Objective: To analyze the trends in gastric cancer mortality in Peru from 1995 to 2013 and their differences by sex, age groups, natural regions and political regions. Materials and methods: Ecological time-series study based on 49,690 death records from the Ministry of Health, from 1995 to 2013; Crude, specific and standardized mortality rates (SMR) were calculated by year; according to sex; age group; political and geographic regions, to analyze trends by estimating joinpoints and annual percentage changes (CPA); using segmented regression models, adjusted using Joinpoint Regression Desktop software version, Results: The SMR trend due to gastric cancer in Peru was decreasing, falling from 16.1 x 100 000 inhabitants. in 1995 to 11.4 x 100 000 inhabitants. in 2013 (CPA: -2.3), observing decreasing trends by age groups, sex and in 17 of 25 political regions. Differences were found when comparing by subgroups: a more accelerated decrease in women (CPA -2.5) versus men (-2.0) and in age groups (CPA for 75 - 79 years: -2.57 versus CPA for 40 - 44: -1.39); Three geographical areas with high mortality were identified: central Andes (Huancavelica, Huánuco, Ayacucho, Pasco and Junín), northern area (Lambayeque, La Libertad and Cajamarca) and central coast (Ica, Callao, Ancash and Lima), in addition trends were observed growing in Huancavelica, Ayacucho and Pasco. On the coast, mortality has decreased since 1998; however, in the Sierra and Selva it decreases significantly as of 2009. Conclusions: The trend of SMR due to gastric cancer in Peru is decreasing and statistically significant for the period 1995 - 2013 (-2.3% per year). The departments with an increasing trend in mortality are Huancavelica, Ayacucho and Pasco. Greater reduction in SMR is observed in women compared to men.</p> 2021-01-06T18:19:12+00:00 ##submission.copyrightStatement## APGAR perinatal predictors persistently low at 5 minutes in a Peruvian Hospital 2021-01-25T18:51:27+00:00 Marco Antonio Chilipio Chiclla Karla Estefany Atencio Castillo John Paul Santillán Árias <p><strong>Objective: </strong>To determine the perinatal predictors of persistently low Apgar at 5 minutes in an EsSalud hospital. <strong>Material and methods: </strong>Observational, analytical case-control study. A census analysis of 889 neonates with low Apgar (&lt;7) at the first minute treated at the Octavio Mongrut Muñoz Hospital from 2009-2018 was carried out, after verification of the inclusion and exclusion criteria. The EsSalud Perinatal Surveillance System (SVP) was used. The Chi square test and crude odds ratio (ORc) were used as a measure of association. Likewise, binary logistic regression was applied to estimate adjusted odds ratios (ORa).<strong> Results:</strong> There were 17,780 live births during the study period, of which 889 (11.9%) had low Apgar scores at one minute. The incidence of persistently low Apgar score at five minutes was 5.68 per 1,000 live births. In the multivariate analysis, the only perinatal predictors of a persistently low Apgar score at 5 minutes were aspiration of meconium amniotic fluid (ORa = 7.82; p &lt;0.01) and the presence of a congenital anomaly (ORa = 3.19; p &lt;0.01). <strong>Conclusion: </strong>meconium amniotic fluid aspiration and the presence of a congenital anomaly are perinatal predictors of a persistently low Apgar score at the fifth minute of extrauterine life in an EsSalud hospital.</p> 2020-12-16T17:42:05+00:00 ##submission.copyrightStatement## Management of glycemic crises in adult patients with diabetes mellitus: Evidence-based Clinical Practice Guideline, Lima - Peru. 2021-01-26T17:04:00+00:00 Fradis Gil-Olivares Helard Manrique Luis Castillo-Bravo Laura Perez Giovanny Campomanes Karina Aliaga José Lagos Alfredo Aguilar Guillermo Umpierrez <p>The manuscript summarizes the process of elaboration of the Clinical Practice Guide (CPG) for the management of glycemic crises in adult patients with diabetes mellitus of the AUNA Clinic Network. A multidisciplinary team of medical assistants and methodologists carried out the development of the CPG and then there was an external review by a specialist in the field. The Elaboration Group of the CPG (GEG) concluded on 10 PICO questions. A systematic search for CPG, systematic reviews and primary studies was carried out to answer these PICO questions.&nbsp; To make recommendations we used the "GRADE-Adolopment" methodology and the guidelines of the national regulations. Ten recommendations were made (nine strong and one weak), 18 points of good clinical practice and two flowcharts for management (one for diagnosis and the other for the treatment of glycemic crises), 04 consensus tables on management and 01 table for surveillance and monitoring. The topics covered by the recommendations for the management of glycemic crises were hyperglycemic crises (glycosylated hemoglobin evaluation; b-hydroxybutyrate evaluation; insulin, potassium, 0.9% sodium chloride, phosphorus, sodium bicarbonate treatments) and hypoglycemic crises (carbohydrate administration, monitoring, educational program to avoid reentry)</p> 2021-01-06T23:37:28+00:00 ##submission.copyrightStatement## Application of the Integrated Autoregressive Method of Moving Averages for the analysis of series of cases of COVID-19 in Peru 2021-01-25T19:09:11+00:00 Daniel Angel Cordova Sotomayor Flor Benigna Santa Maria Carlos <p><strong>Objective:</strong> To estimate an Integrated Autoregressive Moving Average model (ARIMA) for the analysis of series of COVID-19 cases, in Peru. <strong>Methods:</strong> The present study was based on a univariate time series analysis; The data used refer to the number of new accumulated cases of COVID-19 from March 6 to June 11, 2020. For the analysis of the fit of the model, the autocorrelation coefficients (ACF), the unit root test of Augmented Dickey-Fuller (ADF), the Normalized Bayesian Information Criterion (Normalized BIC), the absolute mean percentage error (MAPE) and the Box-Ljung test. <strong>Results:</strong> The prognosis for COVID-19 cases, between June 12 and July 11, 2020 ranges from 220 596 to 429 790. <strong>Conclusions:</strong> The results obtained with the ARIMA model, compared with the observed data, show an adequate adjustment of the values; And although this model, easy to apply and interpret, does not simulate the exact behavior over time, it can be considered a simple and immediate tool to approximate the number of cases.</p> 2020-12-16T17:43:36+00:00 ##submission.copyrightStatement## Low back pain related to anxiety and depression in police officers at a police station in Lima 2021-01-25T19:24:44+00:00 Cristhian Santiago Bazan Arleen Yesenia Espinoza Ventura <p><strong>Introduction</strong>. Low back pain is a public health problem which entails some type of functional limitation in the individual, affecting the quality of life of police personnel.&nbsp;<strong>Objective</strong>. Relate lumbar pain with anxiety and depression in police officers from a police station in Lima.&nbsp;<strong>Material and methods</strong>. It is a research with a quantitative, descriptive, analytical and correlational cross-sectional approach, with the participation of 110 participants, which was obtained through a probabilistic sample where all participants had the same opportunity to participate, it was carried out at the commissary from Monserrat, a questionnaire survey to measure lumbar pain in police personnel ¨CDLPP¨ was used to measure low back pain, whose reliability was 0.914 crombach alpha and the Zung test to measure anxiety and depression.&nbsp;<strong>Results</strong>. 75.5% of police officers were found to suffer from lumbar pain. Likewise, a statistically significant relationship was evidenced between anxiety and low back pain (p = 0.028). Likewise, no statistically significant association was found between low back pain and depression (P&gt; 0.05).&nbsp;<strong>Conclusion</strong>. Low back pain is associated with depression in police officers at a police station in Lima. Likewise, a high percentage of policemen who suffer from low back pain, taking into account that it is a public health problem, which could lead to some type of disability in the future affecting their quality of life.&nbsp;</p> 2020-12-16T17:44:41+00:00 ##submission.copyrightStatement## Factors related to left ventricular hypertrophy in adult persons living at altitude 2021-01-13T04:24:37+00:00 Anibal Valentin Diaz Lazo Carlos Barrientos Huamani Carlo Cordova Rosales <p>Objective: to determine the factors related to left ventricular hypertrophy (LVH) in adults living high. Methods: An observational, cross-sectional and analytical study was carried out in the Echocardiography Laboratory of the Hospital Regional Docente Clínico (HRDCQ) Daniel Alcides Carrión (HRDCQ) of Huancayo, Peru at 3,259 m.s.n.m. The sample was determined with a formula and the sampling was simple random. The inclusion criteria were: be 18 years of age or older; have an echocardiography study with a diagnosis of LVH. The exclusion criteria were: having valvular disease, congenital heart disease, dilated cardiomyopathy, acute cardiovascular event, and cardiac arrhythmia. The data were collected in a file. For the statistical analysis, the X2 test, student's t test, binary and multivariate logistic regression, odds ratio, 95% confidence interval were applied. P &lt;0.050 was considered significant. Results: 488 patients were included, the average age was 64 years (range: 18-98). In 58.9% (370) they were women. The factors related to LVH were arterial hypertension (OR = 5.90; 95% CI = 3.57-9.75), age 60 years and older (OR = 3.13; 95% CI = 2.04-4 , 81), diabetes mellitus (OR = 2.92; 95% CI = 1.03-8.21), and obesity (OR = 2.25; 95% CI = 1.16-4.35) compared to patients without LVH. In patients with LVH, a higher left atrial volume index and left ventricular diastolic dysfunction were found. Conclusions: the factors related to LVH in adults living at height were arterial hypertension, advanced age, diabetes mellitus and obesity.</p> 2020-12-16T17:45:32+00:00 ##submission.copyrightStatement## Anemia and Cancer Survival, A Peruvian study with a 5-year follow-up 2021-01-26T19:12:33+00:00 Jennyfer E. Garcia Arispe María Loo-Valverde Willer Chanduví Jose M. Vela-Ruiz Rocio Guillen-Ponce Jhony A. De la Cruz-Vargas <p><strong>Introduction:</strong>&nbsp;Anemia is a serious public health. Several studies indicate that anemia status is a factor that might influence survival and response to cancer treatment in patients.&nbsp;<strong>Objective:</strong>&nbsp;To determine the relationship between anemia and 5-year survival in cancer patients.&nbsp;<strong>Methods:</strong>&nbsp;Observational, analytical, and retrospective cohort study. The sample population consisted of novel diagnosed cancer patients registered for hospital care with their respective follow up from 2014 until 2019. Time to death, presence of anemia, and other variables were evaluated. Survival was determined using Kaplan Meier curves and analyzed using the log-rank test. Hazard ratio and risk were determined in turn using the Cox regression model.&nbsp;<strong>Results:</strong>&nbsp;72 patients were included in the study, 79.2% of which correspond to solid neoplasms. Anemia was present at the time of diagnosis in 45.8% of patients. Statistically significant differences were found on survival curves for anemia, severity graded anemia, age, and clinical stage. Anemia showed a significant relation with survival (HR: 3.03; CI: 95; p &lt;0.05) on the adjusted bivariate and multivariate analysis for age over 70 years. Likewise, on the respective adjusted analysis for age and clinical stage, anemia showed a significant relation with survival on patients with solid neoplasms. Overall, 30.3% of patients received some type of treatment for anemia.&nbsp;<strong>Conclusion:</strong>&nbsp;Anemia is frequently found in cancer patients and is significantly related to 5-year overall survival. Age over 70 and severe anemias were related to higher mortality of cancer patients</p> 2020-12-26T22:30:08+00:00 ##submission.copyrightStatement## Relationship between pregnant women with anaemia of maternal age at risk and low birth weight in a social security hospital in Peru 2021-01-26T19:06:04+00:00 José Luis Villalva Luna Jhonattan Jesús Villena Prado <p><strong>Introduction:</strong>&nbsp;Anemia and low birth weight are very important public health problems.&nbsp;<strong>Objective:</strong>&nbsp;To determine the association between anemia in pregnant women with risk maternal age and low birth weight in the Obstetrics-Gynecology service of the Guillermo Almenara Irigoyen Hospital, in the period from October to December of the year 2018.&nbsp;<strong>Methods:</strong>&nbsp;A study of non-experimental, retrospective, cross-sectional, analytical, case-control type. In the period from October to December 2018, a total of 312 pregnant women with maternal age at risk (teenage and elderly pregnant women) were registered, of which 72 were anemic (Hb &lt;11 g / dl), being the number of cases, and in order to improve statistical power, the relationship between cases and controls of 1: 2 was established, with the number of controls or non-anemic pregnant women with risk maternal age 142. The general characteristics are analyzed by group of anemic pregnant women and non-anemic, and its association with risk maternal age. The association of anemia in separately pregnant adolescents and elderly women with low birth weight is determined by Chi-square test and Odds ratio.&nbsp;<strong>Results:</strong>&nbsp;Among the variables studied anemic pregnant women, the highest frequency of nulliparity and vaginal delivery, and the lowest frequency of a history of abortion and adequate prenatal control. Teenage pregnant women with anemia were not associated with an increased risk of low birth weight (p = 0.056). Pregnant women who were anemic were associated with a 6-fold increased risk of low birth weight (95% CI: 2,219 to 18,026; p = 0.000).&nbsp;<strong>Conclusions:</strong>&nbsp;Elderly pregnant women have a higher risk of presenting products with low birth weight.</p> 2020-12-16T17:47:35+00:00 ##submission.copyrightStatement## Association between health care provider factors and the number of prenatal visits in Peruvian Hospital users 2021-01-26T19:13:41+00:00 Karina Elizabeth Diez Quevedo Maritza Dorila Placencia Medina <p><strong>Introducción:</strong>&nbsp;Maternal and child health care is a priority for health services, it is essential that all pregnant women comply with the necessary amount of prenatal care for proper supervision of pregnancy and the detection of possible warning signs or complications in a timely manner.&nbsp;<strong>Objective:</strong>&nbsp;To identify the association between the health provider factors and the number of prenatal care in the users of the Carlos Lanfranco La Hoz hospital attended in 2019.&nbsp;<strong>Methods:</strong>&nbsp;quantitative, relational and non-experimental design study. 342 pregnant users attended from January to December 2019, who were selected through a systematic probability sampling. For the statistical analysis, a descriptive statistic was used through the distribution of absolute and relative frequencies and an inferential statistic through the use of Poisson regression.&nbsp;<strong>Results:</strong>&nbsp;The age from 18 to 35 years (74%) predominated, the degree of secondary instruction (62.9%), the cohabiting marital status (71.1%) and the comprehensive health insurance (92.7%). The factors associated with the number of prenatal care were, as a scientific technical factor, receiving guidance on the results of analysis in prenatal care ”(p = 0.000; expB = 1.2 95% CI 1.10–1.39), and the doctor or obstetrician if recommended medications in their prenatal consultation (p = 0.003; expB = 1.2 95% CI 1.05-1.27); As a human factor, the doctor or obstetrician calls her by name during the prenatal visit (p = 0.000; expB = 1.5 95% CI 1.19–1.77).&nbsp;<strong>Conclusion:</strong>&nbsp;There is an association between the health provider factors and the number of prenatal care in the users of the Carlos Lanfranco La Hoz Hospital attended in 2019.</p> 2020-12-16T17:46:11+00:00 ##submission.copyrightStatement## Association between C-reactive protein and metabolic syndrome in the Peruvian population of the PERU MIGRANT study 2021-01-26T19:14:41+00:00 Víctor Juan Vera-Ponce Liliana Cruz-Ausejo Jenny Raquel Torres-Malca <p><strong>Introduction:</strong>&nbsp;Metabolic syndrome (MetS) is a group of cardiovascular risk factors characterized by the presence of low-grade chronic inflammation. Among all the inflammatory biomarkers associated with MetS, the best characterized and well standardized is C-Reactive protein (CRP).&nbsp;<strong>Objectives:</strong>&nbsp;To evaluate the association between C-Reactive protein and metabolic syndrome in the Peruvian population of the PERU MIGRANT study.&nbsp;<strong>Methods:</strong>&nbsp;Secondary database analysis of the PERU MIGRANT study. MetS was considered according to the Harmonizing the Metabolic Syndrome criteria. For CRP, a cutoff point of ≥ 3 mg/L was established.&nbsp;<strong>Results:</strong>&nbsp;We worked with a total of 958 subjects. The prevalence of MetS was 24.53%. In the simple regression analysis, it was found that people with high CRP levels had a 75% higher frequency of having MetS, compared to those who did not present high CRP levels (PR = 2.21, 95% CI: 1.40 - 2.18). In multiple regression, it was observed that patients with high CRP levels had a 31% greater frequency of having MetS, compared to those with normal CRP levels; adjusting for the rest of the covariates (PR = 1.31, 95% CI: 1.05 - 1.62).&nbsp;<strong>Conclusions:</strong>&nbsp;Plasma CRP was positively associated with MetS. This suggests that a low-grade inflammatory process may be related to the presence of MetS. Against this, physicians should pay attention to glucose, lipid profile, and central obesity in patients with elevated plasma CRP levels.</p> 2020-12-21T06:25:25+00:00 ##submission.copyrightStatement## Somatotype differences between Mapuche and non-Mapuche children of 12 - 13 years old from Malleco - Araucania - Chile. 2021-01-26T19:34:48+00:00 José Bruneau-Chávez Valeria Maldonado-Hernández Roberto Iván Lagos-Hernández <p>Somatotypic studies and their description of the human morphological configuration allow to appreciate impacts on eating habits and sedentary lifestyle. This study determined the somatotypic difference in Mapuche (NM) and non-Mapuche (NNM) children from Malleco, Chile. Through the ISAK protocol, 160 children with a mean age of 12.5 years, height 145.5 ± 3.5 cm and weight 43.7 ± 3 kg were evaluated, obtaining the following classifications: Group 12 years, Mapuche; mesoendomorphs. Non-Mapuche group 12 years; Endomesomorph. Group 13 years old, Mapuche; Mesoendomorphs. Non Mapuche group 13 years old; endomesomorph. The results indicate that for the age of 12 years, the NM presented lower values of endomorphy and higher values of mesomorphy (p≤0.01) than NNM. The 13-year-old NMs presented lower endomorphy and mesomorphy values (p≤0.01) than NNM. In conclusion, Mapuche schoolchildren present a mesomorphic predominance, however, NNM present a predominance of the endomorphic component.</p> 2020-12-16T17:49:13+00:00 ##submission.copyrightStatement## Factors associated with the level of knowledge of COVID-19 preventive measures in pregnant and puerpal women in two peruvian communities 2021-01-26T19:15:05+00:00 Fatima Paucar Osorio Estefani Ireci Rodriguez-Lecaros Selene Montalvo Molero Alfredo Tapahuasco Arones Janny Salazar Cruz Ricardo Kamiyama Arakawa Dante Quiñones Laveriano <p>The factors associated with the level of knowledge of the preventive measures of COVID-19 in pregnant and postpartum women from two Peruvian communities were determined. Quantitative, prospective, cross-sectional and analytical study. They worked with the entire population. The level of knowledge was measured through a previously validated instrument. Bivariate and multivariate analysis was performed, using linear regression with a 95% confidence interval. The results indicate that the 3 majority (64.7%) considered the use of rubber gloves as a preventive measure, while 33.8% considered the use of homemade masks incorrect and considered that domestic animals transmitted COVID-19. In the multivariate analysis, the level of knowledge was associated with having received information from their health center. There is a good level of knowledge about COVID-19 prevention in pregnant and postpartum women from two Peruvian communities, and that the main associated factor is having received information from their Health Center.</p> 2021-01-06T23:44:49+00:00 ##submission.copyrightStatement## Quality of life in patients with advanced cancer according to place of care in a referral hospital. 2021-01-26T19:46:35+00:00 Jose Amado Tineo Moises Apolaya Segura Elizabeth Che Hidalgo Otto Vargas-Tineo Jessika Solis Sarmiento Teodoro Oscanoa Espinoza <p>The quality of life perceived by patients with advanced cancer from a tertiary hospital is compared according to home care versus hospital care. Observational, cross-sectional study, included patients older than 18 years with cancer with multiple metastases. EORTC QLQ-C15-PAL quality of life survey was applied to patients with adequate cognitive level (Pfeiffer questionnaire). Chi square and Mann-Whitney, p &lt;0.05, and SPSS 24.0 were used. 83 patients in the hospital group and 69 at home. Median age 66 and 76 years respectively (p &lt;0.01); the female sex predominated (p = 0.60). They presented moderate or severe cognitive impairment, 25% hospital group and 58% home (p &lt;0.01). The median quality of life score was 49.5 in the hospital group and 48 in the home group (p = 0.60), the physical functional aspect had a lower score in the hospital group (p &lt;0.01).&nbsp;The perceived quality of life is acceptable, the home group is older and has cognitive impairment.</p> 2021-01-11T03:40:09+00:00 ##submission.copyrightStatement## Clinical profile trial of patients cared with diabetes mellitus type 2 in a reversion program. 2021-01-25T19:27:02+00:00 Eymard Torres Rodriguez Helbert Arévalo Idania Suarez Narelcy Vega <div class="page" title="Page 1"> <div class="layoutArea"> <div class="column"> <p>Diabetes is a chronic disease that appears when the pancreas does not produce enough insulin or when the body does not use the insulin it produces effectively. Insulin is a hormone that regulates blood sugar. The effect of uncontrolled diabetes is hyperglycemia (increased blood sugar), which over time severely damages many organs and systems, especially nerves and blood vessels.</p> </div> </div> </div> 2021-01-17T04:27:52+00:00 ##submission.copyrightStatement## The COVID-19 pandemic: The importance of being alert to zoonoses. 2021-01-25T19:28:17+00:00 Manuel E. Cortés <p>The pandemic of Coronavirus Disease - 2019 (COVID) has produced hundreds of thousands of deaths and millions of infected people worldwide, with the consequent collapse of health systems. SARS-CoV-2, the coronavirus causing COVID-19, is a pathogen with a zoonotic origin. The objective of this article is to highlight the importance of being alert to zoonoses, with special reference to COVID-19. First, the general chronology of the COVID-19 pandemic is described, then the characteristics of the coronaviruses are described in detail, especially regarding those of SARS-CoV-2. Subsequently, the One Health concept is highlighted as an appropriate approach to face this zoonosis and other related ones. Furthermore, the importance of unequivocally identifying the SARS-CoV-2 reservoir and intermediate animals as part of the knowledge necessary to develop treatments and a vaccine for COVID-19 and related diseases is highlighted. It is concluded that it is important that the One Health approach be known, communicated and integrated by all health centres and health professionals because, considering the severity of zoonoses such as COVID-19, we should not forget that human health is linked to animal health, and both with environmental health. Finally, it is recommended that health agencies maintain preventive measures and personal distancing to avoid more infections.</p> 2020-12-17T21:23:07+00:00 ##submission.copyrightStatement## Tobacco Use and Cervical Intraepithelial Neoplasia 2021-01-26T21:09:37+00:00 Noemí Rojas Cisneros Rony Ruíz Saucedo <p><strong>Objective:</strong>&nbsp;To determine the effect of tobacco consumption with the development in women of cervical intraepithelial neoplasia.&nbsp;<strong>Methods:</strong>&nbsp;A systematic review was conducted. The electronic search was carried out, using the research question: What is the association between smoking and the development of cervical intraepithelial neoplasia? whose PEO question was: Population: Women. Exposure: Tobacco use. Outcome: Cervical intraepithelial neoplasia. Articles published from January 1, 2014 to December 2019 were selected.&nbsp;<strong>Results:</strong>&nbsp;71 articles were found, 55 being excluded because they did not meet the selection criteria, leaving 16 articles for this paper analysis. Those women who smoked tobacco had a significant association for the development of high-grade intraepithelial neoplasia (OR = 1.43, 95% CI = 1.14-1.80). Likewise, synergy was observed between severe smoking and the use of oral contraceptives, with a greater risk of grade II and III intraepithelial neoplasia (OR = 11.5; 95% CI, 1.88-70.40).&nbsp;<strong>Conclusion:</strong>&nbsp;The available evidence suggests the association between tobacco use and the development of cervical intraepithelial neoplasia, particularly high-grade cervical intraepithelial lesions.</p> 2020-12-17T21:22:28+00:00 ##submission.copyrightStatement## Hospital security. A vision of multidimensional security 2021-01-26T19:18:21+00:00 Augusto Flavio Figueroa Uribe Julia Hernández Ramírez <p>The risks during the performance of work is an inherent situation to any human activity. Hospital Safety is defined as: “the condition that guarantees that the workers, patients, visitors, infrastructure and equipment within a health care center are free of risk or danger of accidents”. The construction of the prevention culture starts from the knowledge of the risks, the safety culture is directly related to the quality of care of the service provided, which is why these terms are of special interest in health institutions. Talking about comprehensive risk management, either, involves determining all the risks that could cause considerable damage to these systems, given by the interaction of three factors, the presence of a threat, the existence of vulnerabilities and the time they are exposed to. Thus we can distinguish that hospital safety must be an internal policy of every health institution and that it can be divided into three main axes: 1. Patient safety, 2. Comprehensive risk management for major emergencies and disasters, 3. Internal safety and external to violence.</p> 2020-12-28T05:39:19+00:00 ##submission.copyrightStatement## Cross-sectional studies 2021-01-25T19:31:14+00:00 Aleksandar Cvetković Vega Jorge L. Maguiña Alonso Soto Jaime Lama-Valdivia Lucy E. Correa López <p>Cross-sectional studies are epidemiological design which can be considered as descriptive or analytical designs depending on the general objective. This is a quickly and economical design and allows to calculate the prevalence of a condition. Also, the relationship of temporality between the exposition and the outcome is being measured simultaneously on a unique period, not being possible to identify a directionality in the temporality. When there is an analytic objective, the association measure used is the Prevalence Ratio (PR), specially when the prevalence of the outcome is more or equal to 10% or the Odds Ratio (OR) when that prevalence is lower. To quantify this association different regression models like Binomial log or Poisson log can be used, including generalized lineal models. If the association measure is OR, the most common used model is the multiple logistic regression.</p> 2020-12-16T20:40:45+00:00 ##submission.copyrightStatement## Risk factors associated with Barrett's esophagus in hospitalized patients 2021-01-25T19:32:44+00:00 Gerard Martín Gómez <p><strong>Objective:</strong>&nbsp;The objective of this article is to carry out a systematic review of scientific articles that reveal the risk factors associated with Barrett's esophagus in hospitalized patients.&nbsp;<strong>Methods:</strong>&nbsp;The review was performed by electronic search for articles related to risk factors associated with Barrett's esophagus in hospitalized patients. The PEO question was: What are the risk factors associated with Barrett's esophagus in hospitalized patients? The search sources were in PUBMED. The search terms were: Risk Factors; Barrett's esophagus; hospitalized patients. For this review, articles published from 2010 that had research experiences and theoretical-conceptual aspects were selected.&nbsp;<strong>Results:</strong>&nbsp;Of the 389 results found with indexing sources, a total of 25 articles were selected where 22 articles contained research results and 3 were considered for theoretical-conceptual aspects that are related to the purpose of the study. The search resulted in risk factors associated with Barrett's esophagus according to demographic characteristics and patient traits, presentation, and clinical data and lifestyles.&nbsp;<strong>Conclusion:</strong>&nbsp;An association of various risk factors with Barrett's esophagus is evidenced in hospitalized patients. The most concordant risk factors associated with Barrett's esophagus in the review were male sex, increased age, metabolic syndrome, hiatal hernia, use of proton pump inhibitors, gastroesophageal reflux (GER), obstructive sleep apnea, and erosive esophagitis.</p> 2020-12-16T20:52:01+00:00 ##submission.copyrightStatement## Skin manifestations in young military personnel diagnosed with Covid 19 - Peru 2021-01-26T19:20:13+00:00 Richard Jeremy Febres Ramos Stephany Keila Vilchez Bravo <p>COVID-19 is a highly contagious respiratory tract infection caused by severe acute respiratory syndrome coronavirus 2. The infection has been reported to demonstrate different types of skin manifestations including urticarial, maculopapular, papulovesicular, purpuric, livedoid, and thrombotic-ischemic lesions. Given the high mortality rate of the infection, timely and accurate identification of relevant skin manifestations can play a key role in early diagnosis and management.Skin manifestations, a well-known effect of viral infections, are beginning to be reported in patients with COVID-19 disease. These manifestations most often are morbilliform rash, hives, vesicular rashes, acral lesions, and livedoid rashes. Some of these skin manifestations arise before the signs and symptoms most commonly associated with COVID-19, suggesting that they may be showing signs of COVID-19 Bibliographic reports showed great heterogeneity in the skin manifestations associated with COVID-19, as well as in their latency periods and associated extracutaneous symptoms. Pathogenic mechanisms are unknown, although the functions of an overactive immune response, complement activation and microvascular injury have been hypothesized. Based on our experience and bibliographic data, we subdivide reported skin lesions into six main clinical patterns: (I) urticarial rash; (II) erythematous-maculopapular-morbilliforma confluent rash; (III) papulovesicular exanthemum; (IV) chilblain-like acral pattern; (V) livedo reticularis–livedo racemosa-like pattern; and (VI) purpurico "vasculytic" pattern. These six patterns can be fused into two main groups: the first – inflammatory and exanthemum – includes the first three groups mentioned above, and the second includes vasculopathic and vasculytic lesions of the last three groups.We can conclude that skin manifestations are similar to skin involvement that occurs during common viral infections.</p> 2020-12-17T21:25:59+00:00 ##submission.copyrightStatement## IgA (Henoch Schönlein Purpura) Vasculitis in a Pediatric Patient with COVID-19 and Strongyloidiasis 2021-01-26T19:21:15+00:00 Mayron David Nakandakari Gomez Hamilton Marín Macedo Raúl Seminario Vilca <p>Vasculitis is a rare disease in children, with IgA Vasculitis being its most common presentation.&nbsp;One condition that has been associated with the development of vasculitis is the invasion of the vascular endothelium by&nbsp;<em>Strongyloides stercoralis&nbsp;</em>in cases of hyperinfestation.&nbsp;Another condition that is not yet under-researched is the likely association of IgA vasculitis-like processes with&nbsp;SARS-CoV-2 and COVID-19 infection itself.&nbsp;It is presented the case of a four-year-old patient who healed with palpable purplish lesions to lower limb predominance, acute abdominal pain, and episodes of high digestive hemorrhage.&nbsp;Initially listed as a possible severe dengue and leptospirosis, but clinically and laboratorially associated with IgA vasculitis.&nbsp;It&nbsp;was SARS-CoV-2 IgM and IgG: Reactive.&nbsp;And in parasitological study was identified <em>Strongyloides stercoralis.</em>&nbsp;Symptomatology subsided after administration of corticotherapy and the evolution was favorable.</p> 2020-12-17T21:25:35+00:00 ##submission.copyrightStatement## Granulomatous Neutrophilic Cystic Mastitis, Case Report 2021-01-26T19:22:06+00:00 Katherine Luisa Contreras Gala María del Carmen Kapsoli <p>Cystic neutrophilic granulomatous mastitis (CNGM) is a recently characterized entity, with specific histopathological details that differentiate it from other types of chronic idiopathic mastitis. The presence of gram-positive bacilli within cystic-like spaces surrounded by neutrophils, in a context of suppurative granulomatous inflammation, define this entity. The importance of its recognition in the diagnostic report lies in its association with infection by corynebacterial species, so that treatment with antibiotics can be targeted, beyond the anti-inflammatory treatment that is usually administered to idiopathic mastitis.<br>We describe the case of a 35-year-old female patient with no related history, with intermittent breast pain, associated with the presence of multiple hard, palpable nodules in both breasts, with results from multiple previous private biopsies that described chronic granulomatous mastitis with a tubercular reaction, for which she received treatment for tuberculosis. Despite this, the clinical response was partial. Histological slides were reviewed at the institution and the diagnosis of CNGM was then established.<br>The presentation of this case was considered important due to its low recognition among pathologists, despite presenting characteristics already defined by previous studies.</p> 2020-12-17T21:24:12+00:00 ##submission.copyrightStatement## Congenital malformation of the pulmonary airway (MCVAP), Case Report 2021-01-26T19:22:33+00:00 José Luis Medina Valdivia <p>Pulmonary malformations include different abnormalities of the respiratory system, including congenital pulmonary airway malformation (MCVAP), formerly known as cystic adenomatous malformation, which is a rare disease with an incidence of 1 in 8,300 to 35,000 live births. Five classification patterns have been described according to the number and size of the cyst, in addition to their histological characteristics, with type 1 MCVAP being the most frequent, showing displacement of adjacent structures according to size, associated with brochioalveolar carcinoma, and good prognosis after resection surgical. We present the case of a four-year-old female patient with recurrent hospitalizations for pneumonia and bronchial obstructive syndrome. The thorough anamnesis and physical examination supplemented with the chest x-ray and tomography allowed the diagnosis to be suspected. Later, the patient underwent surgery, there were no complications and the respiratory symptoms disappeared. The histopathological study confirmed the diagnosis.</p> 2020-12-28T05:04:48+00:00 ##submission.copyrightStatement## Compartment syndrome due to liquid extravasation in a pediatric patient. Case report and bibliographic review 2021-01-17T02:57:44+00:00 Juan Sebastián Rueda Mojica Jose Alfredo Neira Garza Arturo García Galicia Álvaro José Montiel Jarquín <p>Extravasation Compartment Syndrome (SCE) is an infrequent pathology, with an incidence of 0,01-6,5%, whom 1,8-11% are children. Communication in children is usually difficult, with high risk of development of SCE. A case about a 9 month old male patient with an over-infected viral pneumonia and a triggered SCE is presented. He received compartmental decompression of right forearm and right hand; however he presented mild sequelae. Treatment of extravasation injury is not always sufficient enough. Mild-to-moderate complications or SCE can be presented. Recognizing clinical manifestations and risk factors and the use of auxiliary studies is fundamental for a good diagnosis and as prevention in children. Faciotomies, gold standard for treatment, are not completely safe, and have an impact on morbidity. Early protocols against extravasation, early examination by surgeon and investigation about SCE in chil-dren are recommended.</p> 2021-01-06T22:01:46+00:00 ##submission.copyrightStatement## Clinical spectrum of systemic lupus erythematosus in children. Case report. 2021-01-26T19:23:38+00:00 Giuliana Reyes-Florián Martín Seminario-Aliaga Sandra Mendoza-Cernaqué Consuelo Luna-Muñoz <p>Systemic lupus erythematosus is an autoimmune disease with multisystem involvement, an alternating clinical course, and which constitutes a diagnostic challenge, with a greater disease activity in the pediatric age group, which also darkens its prognosis. In this article, we report the case of a ten year old female patient who debuted with systemic lupus erythematosus with gastrointestinal, renal and hematological involvement; the chronic course coupled with the varied clinical spectrum suggested the diagnostic possibility.</p> 2021-01-14T16:18:51+00:00 ##submission.copyrightStatement## Preventive measures against SARS-CoV-2 in the community: What does the evidence say? 2021-01-26T22:15:14+00:00 Jhonattan Jesús Villena Prado <p>Se realiza un comentario acerca de las medidas preventivas comunitarias difundidas para evitar la propagación de contagios por SARS-COV-2, que se sustentan en la evidencia, como pilares para disminuir la tasa de contagio en nuestro país.</p> 2020-12-16T20:53:48+00:00 ##submission.copyrightStatement## Clinical presentations associated with SARS-CoV-2 in a Covid pediatric intensive care unit of a national hospital in Lima 2021-01-18T22:05:03+00:00 Edgar Coila Paricahua Ricardo Rodriguez Portilla Liliana Cieza Yamunaqué Pedro Baique Sánchez Claudia Guerra Ríos <p>The coronavirus disease 2019 (COVID-19) affects more adults than children. Later, the Pediatric Multisystemic Inflammatory Syndrome (SIMS) associated with SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) was described, whose peak incidence was 4 weeks after the maximum peak of infections, so it is postulated that it is a post-infectious entity, and is characterized by affecting several organs and systems. In response to this new need, the Pediatric Intensive Care Unit (PICU) of the Edgardo Rebagliati Martins National Hospital set up a differentiated environment with two beds for the care of children with SARS-CoV-2 infection, to reduce the risk of in-hospital infections.</p> 2021-01-06T22:17:10+00:00 ##submission.copyrightStatement## Vanity galleries, Pay Drivers and predatory journals: Profitting on discredit 2021-01-26T22:21:37+00:00 David Fabian Ramirez 2020-12-17T21:27:30+00:00 ##submission.copyrightStatement## Communicating medical reports to family members in times of COVID-19 2021-01-13T04:48:17+00:00 Waldo Augusto Taype Huamani Lucila Amelia De La Cruz Rojas 2020-12-16T20:54:38+00:00 ##submission.copyrightStatement## Economic impact on the quality of health services in the framework of the COVID-19 pandemic in Peru 2021-01-13T04:51:38+00:00 Alfonso Gutierrez-Aguado Mitsy Pinares-Bonnett Walter Salazar-Panta José Guerrero-Cruz 2020-12-16T20:55:08+00:00 ##submission.copyrightStatement## Covid-19 and tuberculosis: the encounter between new threats and old diseases 2021-01-13T04:24:39+00:00 Carolina Marley Suárez Benites Carmen Miluska Silva Lopez <p>A storm called COVID-19 has been destabilizing the health systems of almost everything the world. In almost 8 months it has gone from being a report of atypical pneumonia with etiology unknown to be the pandemic of the 21st century. In Peru, the first confirmed case was March 6, and until the beginning of July has been claiming the lives of more than 10,000 people.</p> 2021-01-06T22:41:30+00:00 ##submission.copyrightStatement## Penile Synovial Sarcoma: Clinical and Radiological findings 2021-01-26T22:28:51+00:00 Jossué Espinoza-Figueroa Ana Karla Uribe Rivera Jorge Luna-abanto <p>A 22-year-old man presented with a 6-month-old 8 cm hard tumor at the base of the penis, whose biopsy was consistent with synovial sarcoma (<a href="">Figure 1</a>). The magnetic resonance imaging (MRI) showed a tumor that compromises the base of the penis, the left pillar and partially the right pillar, extending to the distal 2/3, without ruling out urethral infiltration (<a href="">Figure 1</a>).</p> 2020-12-17T21:23:41+00:00 ##submission.copyrightStatement##