Revista de la Facultad de Medicina Humana <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 It covers current issues, with original and unpublished articles, related to the various specialties of the biomedical and Public Health area.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> Universidad Ricardo Palma en-US Revista de la Facultad de Medicina Humana 1814-5469 <center> <p style="text-align: center;"><a href="" rel="license"><img style="border-width: 0;" src="" alt="Licencia Creative Commons"></a></p> <p><strong>This work is under a&nbsp;<a href="" rel="license">Creative Commons license Attribution 4.0 International (CC BY 4.0)</a>.</strong></p> </center> Rapid response teams for epidemiological surveillance: Mitigation of the coronavirus pandemic in Peru, 2020 <p>On January 30, 2020, with more than 9,700 confirmed cases in China, the World Health Organization declared the coronavirus outbreak to be a public health emergency of international concern. At the end of January, the National Center for Epidemiology, Prevention and Control of Diseases (CDC-Peru) of the Ministry of Health prepared the “National Plan of Preparation and Response to the Introduction of the coronavirus 2019-nCoV”, where one of the strategic components was strengthen the epidemiological response through mitigation actions that allow early identification of cases, diagnosis, follow-up of contacts and identification of people with risk conditions.</p> Manuel J. Loayza-Alarico Jhony A. De La Cruz -Vargas Willy Ramos ##submission.copyrightStatement## 2020-06-10 2020-06-10 20 4 3 3 10.25176/RFMH.v20i4.3045 COVID-19: The world on pause. How we face this new pandemic? <p>The Covid-19 pandemic, popularly known as coronavirus, was announced in an article by the American Society of Microbiology that already in 2007 warned about the dangers of the consumption of exotic animals in different Chinese communities. The background of SARS and MERS helps us understand that humanity is not prepared for such severe contingencies. Economies are sold out and there is no leadership; health systems are deficient: the result of years of underinvestment, low salaries and lack of qualified personnel to attend, follow, control and direct infectious diseases.</p> Gabriel Lapman ##submission.copyrightStatement## 2020-06-10 2020-06-10 20 4 2 2 10.25176/RFMH.v20i4.3043 COVID-19: Socio-cultural influences and adherence to governmental strategies for social isolation in Peru <p>On March 15, Peruvian President Martín Vizcarra, in a message to the nation, announced that, with 71 positive cases, he was declaring a state of emergency, just 9 days after announcing on national television the presence of the first positive case, a worker of a well-known airline. In hindsight, we all forget that it was considered at the time a very drastic decision, even a hasty one; but the Head of the Nation was definitely already completely soaked in the world's reality, just four days away from the late declaration by the WHO, on March 11, 2020, of COVID-19, as a Pandemic.</p> R Dammert-Elejalde ##submission.copyrightStatement## 2020-06-10 2020-06-10 20 4 3 3 10.25176/RFMH.v20i4.3044 Fever, Cough and Cold What else do you have? Impact of the Sars-Cov-2 Pandemic in the consultation for respiratory diseases in the pediatric emergency <p>When fall arrives, pediatric emergency services (SEP) professionals know before the trees decide to change their leaves. The increase in the number of patients is as important as the repetition of the reasons for consultation and the explanations about the futility of ¨treatments for viruses¨. In addition to colds with and without fever that lead EPS to collapse, there are severe symptoms of bronchiolitis, laryngitis, asthma attacks and pneumonia that demand specialized care.</p> Viviana Pavlicich ##submission.copyrightStatement## 2020-08-09 2020-08-09 20 4 10.25176/RFMH.v20i4.3189 Kidney biopsy. Clinicopathological description, complications and evolution in a general hospital in Peru <p><strong>Introduction</strong>: Kidney biopsy is one of the essential tests for the characterization of chronic kidney disease (CKD). <strong>Objective</strong>: To determine the most frequent primary and secondary glomerulonephritis, complications of renal biopsy and the number of patients on hemodialysis when undergoing renal biopsy. <strong>Methods</strong>: Observational, descriptive, case series, retrospective and cross-sectional study, carried out at the E. Rebagliati Matins-Peru national hospital. The medical records of patients older than 15 years of age who underwent kidney biopsy between 2008-2016 were reviewed. The data were processed in Stata 16.1 <strong>Results</strong>: Of 2278 medical records, they corresponded to 1234 women and 1044 men. The most frequent primary and secondary glomerulonephritis were focal and segmental glomerulosclerosis (FSGS) 683 (29.98%) and systemic lupus erythematosus (SLE). ) 434 (19.04%) respectively. Of 1644 biopsied patients, 36 (2.19%) and 241 (14.66%) had major and minor complications respectively. Major complications were more frequent when the procedure was performed by radiology with ultrasound guidance compared to that performed by the nephrologist without ultrasound guidance (p = 0.03694). In 1,324 patients, 329 underwent kidney biopsy while on hemodialysis; of them 43 (13.07%) managed to get out of this therapy and 144 (51.99%) had major or minor complications. <strong>Conclusions</strong>: GEFyS and SLE were the most frequent primary and secondary glomerulonephritis, respectively. In 1644 patients the major and minor complications were 36 (2.19%) and 241 (14.66%) respectively. In 1,324 patients, 329 (24.8%) were biopsied while on hemodialysis and 144 (51.99%) of them had major or minor complications.</p> VH Meneses-Liendo MC Medina-Chávez M. Gómez-Lujan ##submission.copyrightStatement## 2020-08-09 2020-08-09 20 4 10.25176/RFMH.v20i4.3188 Instrument for the evaluation of climacteric and menopause in the first level of care <p><strong>Introduction:</strong>The middle-aged female population will increase in the coming years and will require more medical care to relieve climacteric symptoms&nbsp;<strong>Objective:</strong>&nbsp;To validate an instrument for evaluating climacteric and menopause in primary care&nbsp;<strong>Methods:</strong>&nbsp;Prospective, cross-sectional, instrument-validation study. The sample was composed of women attending primary care centers. Our research consisted of three stages: initial review (literature review, translation), validation (content validity, pilot study) and psychometric properties (internal consistency and confirmatory factorial analysis). We analyzed the data using SPSS version 20.&nbsp;<strong>Results:</strong>&nbsp;136 patients participated, with an average age of 48,6 years ± 5,3 and an average body mass index of 27,8 kg/m2 ± 4,4. In the first stage, we identified the most relevant symptoms: menstrual irregularities, hot flashes, vaginal problems, urinary incontinence, quality of sleep, and mood issues. The instrument was then translated by four professionals. For the second stage, we assessed content validity by expert judgment, obtaining an internal consistency of 0,77 and an initial reliability of 0,79. In the third stage, internal consistency was 0,69 and confirmatory factorial analysis was 0,7. The instrument consists of six questions; obtaining four or more positive answers warrants specialized care.&nbsp;<strong>Conclusion:</strong>&nbsp;We present a short instrument with adequate content validity and internal consistency, useful for managing climacteric symptoms at the primary care level.</p> Juan P. Matzumura-Kasano Hugo F. Gutiérrez-Crespo José Isaac Wong Mac Isabel J. Alamo-Palomino ##submission.copyrightStatement## 2020-08-09 2020-08-09 20 4 10.25176/RFMH.v20i4.3057 Anxiety level of first-year medical students from a private university in Peru in times of Covid-19 <p><strong>Introduction:</strong> The current pandemic due to a new coronavirus (SARS-Cov-2) has claimed the health and lives of many people worldwide. This has a negative impact on the mental health of health personnel, which includes medical students. <strong>Objective:</strong> To determine the degree of anxiety present in first-year medical students from a private university, Lima-Peru. <strong>Methods:</strong> The sample consisted of 57 students from private university in Lima Perú. The scale was applied to measure Generalized Anxiety Disorder-7 (GAD-7). The data were analyzed using frequency and contingency tables, in addition bivariate analysis was performed applying the statistical tests X2 and Student's t. <strong>Results: </strong>75.4% of the medical students manifested some degree of anxiety. A statistically significant association was found between female sex and anxiety (p = 0.045). Likewise, there was no association between the variables age and anxiety (p = 0.058). <strong>Conclusion:</strong> First-year medical students showed high levels of anxiety during the current pandemic, with women being among those who anxiety occurs more frequently. The development of intervention strategies in university centers for the care of mental health of health sciences students is timely.</p> María M. Saravia-Bartra Patrick Cazorla-Saravia Lucy Cedillo-Ramirez ##submission.copyrightStatement## 2020-08-27 2020-08-27 20 4 10.25176/RFMH.v20i4.3198 Comparison of the APACHE II and BISAP scales in the prognosis of acute pancreatitis in a hospital of Peru <p><strong>Introduction:</strong>&nbsp; Acute pancreatitis continue to be a disease with significant morbidity and mortality. It is diagnosed by clinical criteria and the inflammatory process can lead to organ failure. The objective of the present study was to compare the scales of APACHE II and BISAP in the development of organic failure in acute pancreatitis from a public hospital of Perú. <strong>Pacients</strong><strong> and methods:</strong> An analytical from validation of a diagnostic test. There were clinical records of patients who were hospitalized with the diagnosis of acute pancreatitis in the Internal Medicine service and the Intensive Care Unit were evaluated. The APACHE II and BISAP scales were applied and the ROC curve, the sensitivity, the specificity, the positive and negative predictive value was calculated for each one. SPSSv23 was used for statistical analysis. <strong>Results:</strong> Were reviewed 146 stories that met the inclusion criteria. An area under the curve of 0.957 was obtained for BISAP and 0.996 for APACHE II; with a sensitivity and specificity for APACHE II of 83% and &nbsp;99%,&nbsp; for BISAP of 66% and 99%. In addition, the positive and negative predictive value for APACHE II is 83% and 99% , &nbsp;for BISAP 80% and 98% . <strong>Conclusion:</strong> The APACHE II scale was superior for detecting organ failure. It was determined that both scales have high specificity, however the APACHE II scale presented a higher sensitivity than the BISAP scale.</p> Omar V. García-Revilla Lucy E. Correa-López Richard I. Rubio-Ramos Maria Loo-Valverde ##submission.copyrightStatement## 2020-08-09 2020-08-09 20 4 10.25176/RFMH.v20i4.2873 Relationship between pregnant women with anemia at risk maternal age and low birth weight in a social security hospital in Peru <p><strong>Objective:</strong> 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. <strong>Methods:</strong> 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. <strong>Results:</strong> 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). <strong>Conclusions:</strong> Elderly pregnant women have a higher risk of presenting products with low birth weight.</p> Jose L. Villalva-Luna Jhonattan J. Villena- Prado ##submission.copyrightStatement## 2020-08-09 2020-08-09 20 4 10.25176/RFMH.v20i4.3192 Knowledge of routes of transmission, attitudes and prevention measures of COVID-19 in medical students of the Universidad Nacional del Nordeste <p><strong>Introduction:&nbsp;</strong>In 2020, the COVID-19 pandemic emerged, caused by SARS-CoV-2, associated with higher morbidity and mortality, impacting the lives of the world population.&nbsp;<strong>Objective:&nbsp;</strong>Determine knowledge of transmission routes, prevention measures and attitudes about COVID-19 in 5th and 6th year students of the Facultad de Medicina of the Universidad Nacional del Nordeste in the months of May to June 2020.&nbsp;<strong>Methods:&nbsp;</strong>A descriptive, cross-sectional study was carried out with the students of the last years of the Medicine career. The instrument was validated by expert judgment. A pre-designed ad hoc questionnaire was used through the Google Forms platform. The data were analyzed using Epi Info version 7 software.&nbsp;<strong>Results:&nbsp;</strong>A total of 153 surveys were analyzed (N = 153). The mean age was 24.8 years. 42% of the students surveyed refer to information about talks with doctors, 15% through social networks, television channels and blogs and the remaining 13% do so through friends and / or family. 95.4% of the population studied had changes in attitude, increasing the way of cleaning / disinfecting surfaces and environments. 70% responded that it is through the air (Flügge Drops), while talking, coughing or sneezing as the most frequent route of infection. 84.4% mention being calm, 13% are nervous and worried and 2.6% tired.&nbsp;<strong>Conclusion:&nbsp;</strong>Adequate knowledge and positive attitudes are found in the studied population.</p> Facundo Vargas Capará Ignacio Pinedo Cecilia Villalba Rosana Gerometta ##submission.copyrightStatement## 2020-08-09 2020-08-09 20 4 10.25176/RFMH.v20i4.3172 Dental Biofilm, a reservoir for Helicobacter Pylori in patients with chronic gastritis <p><strong>Objectives</strong>: To determine the prevalence of helicobacter pylori in dental biofilm in patients with chronic gastritis in the gastroenterology service of Hospital María Helper.&nbsp;<strong>Methods</strong>: A cross-sectional descriptive observational study was carried out, working with a population of patients attended in 1 calendar year, of the of which only 100 patients met the inclusion and exclusion criteria. It has been made a collection for the variables age, sex, helicobacter pylori in dental biofilm and helicobacter pylori in gastric mucosa biopsy. The relative frequency of Helicobacter Pylori in dental biofilm in patients with chronic gastritis and so exploratory a chi2-square test was performed for helicobacter in dental biofilm and helicobacter in gastric mucosa biopsy. <strong>Results</strong>: A prevalence of helicobacter pylori was detected in dental biofilm from 66% in patients with chronic gastritis, in turn 48% of the total in this group I present a positive helicobacter pylori in gastric mucosa biopsy. From the patients positive for helicobacter pylori in gastric mucosa 83.33% presented positivity in dental biofilm. An association was found for the variables helicobacter pylori in dental biofilm and helicobacter pylori in gastric mucosa biopsy with a p value = 0.002. <strong>Conclusions</strong>: A high prevalence of helicobacter pylori was found in biofilm of patients with chronic gastritis and an association between dental biofilm and gastric mucosa biopsy for helicobacter pylori.</p> Israel Armando Guerra Cuyutupac ##submission.copyrightStatement## 2020-08-27 2020-08-27 20 4 10.25176/RFMH.v20i4.3217 Red blood cell distribution width an inflammatory biomarker related to proliferative diabetic retinopathy <p><strong>Objective</strong>: The aim of this study was to determine the association between Red Blood cell Distribution width and Proliferative Diabetic Retinopathy in patients with type 2 diabetes.&nbsp;<strong>Methods: </strong>We conducted a hospital-based case-control study. Adult patients (≥ 18 years old) with the diagnosis of Diabetic Retinopathy who underwent medical check-ups at the ophthalmology department where enrolled in our study. We selected a total sample size of 262 patients, of which 131 cases had Proliferative Diabetic Retinopathy and 131 controls had Non Proliferative Diabetic Retinopathy. Data about age, gender, body mass index, history of hypertension, diabetic nephropathy, Congestive heart failure, Hemoglobin and HbA1c were registered for individuals who met inclusion criteria. Odds ratio model was used to test the relationship between Red Blood Cell Distribution Width and Proliferative Diabetic Retinopathy.&nbsp;<strong>Results:</strong> Mean Red Blood cell Distribution width +/- SD of the cases was 14.41+/-0.84 and the controls was 13.49+/-1.26. According to bivariate analysis, an association was found between Red Blood cell Distribution width and Proliferative Diabetic Retinopathy (OR 3.79, <em>P</em>=0.000, IC=2.12-6.78). Multivariate logistic regression analysis indicated that Red Blood cell Distribution width (OR 2.15, <em>P</em>=0.037, IC= 1.05-4.43) was an independent risk factors for the development of Proliferative Diabetic Retinopathy.&nbsp;<strong>Conclusion</strong>: Elevated values of Red Blood cell Distribution width were related to Proliferative Diabetic Retinopathy, suggesting the potential application of Red Blood cell Distribution width as an accessible predictive biomarker of disease progression in patients with diabetic retinopathy.</p> Juan Carlos Roque Gabriela Quezada Claudia Saldaña Carolina Carrillo José Arturo Vargas ##submission.copyrightStatement## 2020-08-27 2020-08-27 20 4 10.25176/RFMH.v20i4.3218 Characteristics and evolution of patients with urinary lithiasis in a tertiary hospital emergency <p><strong>Background</strong>: The symptoms and complications of urinary lithiasis are a frequent cause of emergency care. Objectives: To determine characteristics and evolution of patients with urinary lithiasis attended in the emergency room of a tertiary social security hospital. <strong>Methods</strong>: Observational study carried out at the Rebagliati hospital Lima-Peru, during the first quarter of 2019. Sociodemographic variables, time and emergency indicators of the institutional statistical system were evaluated, performing descriptive statistics with IBM SPSS 25.0. <strong>Results</strong>: 583 attentions for urinary lithiasis (194 per month) were registered, corresponding to 14% of the genito-urinary pathology seen in the evaluated service. 55% male, average age 48 years (range 14 to 92). Mainly attended by surgical topic and priority 3, most frequent causes pain, infection and hematuria. Time of first attention 4.8 hours, leaving 70% of discharge. Observation rooms were admitted to 10.5% with an average stay of 77 hours (3.2 days), with 51% hospitalized, discharge 31%, operated 3% and 2% died. <strong>Conclusion</strong>: Urinary lithiasis occurs in 1 out of 7 genitourinary pathologies of the emergency room evaluated, predominantly in middle-aged men, 10% are admitted to the observation room, with a short stay and low mortality.</p> Waldo Taype-Huamaní Ricardo Ayala-Garcia Ricardo Rodriguez-Gonzales Jose Amado-Tineo ##submission.copyrightStatement## 2020-08-27 2020-08-27 20 4 10.25176/RFMH.v20i4.2922 Validation of scale of changes in lifestyles during the quarantine period in a population of university students from Lima, Peru <p><strong>Introduction:</strong> Due to the presence of Covid-19 in the world, several countries, including Peru, have taken measures, including compulsory social isolation (quarantine). The inability of people to carry out their daily activities has directly affected their lifestyles. A population quite susceptible to these changes are university students. <strong>Objectives:</strong> To develop a validation scale to know what are the changes in lifestyles during the quarantine period in a population of university students from Lima, Peru. <strong>Results:</strong> The final scale was made up of 25 items. Bartlett's sphericity test was significant (3514.19, gl = 300, p &lt;0.001) and the Kaiser-Meyer-Olkin sample size adequacy indicator was adequate (0.845). The four thematic areas were changes with respect to 1) Eating habits; 2) Harmful habits; 3) Physical activity; and 4) Use of communication media. As it was a Likert-type ordinal measurement scale, the results were confirmed through the Factor Analysys program, obtaining a KMO of 0.80 (reliable) and the significant Bartlett sphericity test (5528.8; p &lt;0.001; gl = 300). confirming the existence of 7 components that explain 63% of the variance. <strong>Conclusions:</strong> This scale gathers the psychometric properties to be considered a useful, valid and reliable instrument to measure these changes in students of health science careers, being necessary to validate it prospectively in other careers and countries.</p> Víctor Juan Vera-Ponce Jenny Raquel Torres-Malca Edith Katherine Tello-Quispe Eder Jesús Orihuela-Manrique Jhony A. De La Cruz-Vargas ##submission.copyrightStatement## 2020-08-09 2020-08-09 20 4 10.25176/RFMH.v20i4.3193 Surgical complications in patients with complicated acute appendicitis in open and laparoscopic surgeries in a national referral center <p><strong>Objective:&nbsp;</strong>To determine the incidence and type of complications after an appendectomy in patients with appendicitis complicated by peritonitis in relation to the type of surgical intervention and the time elapsed from the onset of the symptoms to surgery.&nbsp;<strong>Methods:&nbsp;</strong>157 medical records of patients from the Pediatric Surgery Service of HNGAI and diagnosed with acute appendicitis complicated with peritonitis were evaluated. The patients were between 2 and 14 years old. They were separated into two groups - 81 open surgeries and 76 laparoscopic. The variables of age, sex, type of surgery, duration of surgery, length of hospitalization and postoperative complications were evaluated. Chi square and Mann-Whitney analysis was used.&nbsp;<strong>Results:&nbsp;</strong>From the total number of medical records, only 157 medical records met the inclusion criteria, of which 81 appendectomies were open and 76 laparoscopic. Laparoscopic surgery was longer. Complications were more frequent in open surgeries with an incidence of 30.8%, as well as prolonged hospitalization time of 12.7%.&nbsp;<strong>Conclusion:&nbsp;</strong>Laparoscopic surgeries have a longer duration compared to open surgeries, however, complications and prolonged hospitalization occurred more frequently in open surgeries. This data could be due to the experience of the operator.</p> Carolina Fabiola Paz Soldán Mesta Hilda Liliana Gonzales Carlos Enrique Paz Soldán Oblitas ##submission.copyrightStatement## 2020-08-09 2020-08-09 20 4 10.25176/RFMH.v20i4.2951 Economic and health aspects in times of quarantine for COVID 19 in the Peruvian population, year 2020. <div><strong>Objective</strong>: To identify the economic and health aspects in times of quarantine COVID 19 Peruvian population in 2020. <strong>Methods</strong>: The study had a quantitative approach, descriptive level and non-experimental design, with a sample of 1,064 Peruvians from all regions of Peru surveyed in the month of March to April of the year 2020. For the statistical analysis, the distribution of absolute and relative frequencies was used. <strong>Results</strong>: Regarding the economic situation, 57.3% refer that they have presented many or some economic problems to buy basic necessities, 69.8% say they have food today for less than seven days; 56.8% have enough money for less than two weeks. In addition, 79.5% reported have not been benefited with some bonus or subsidy status and 65.8% say that bonds are little or subsidies to acquire the basics. Regarding health aspects, 10.5% of those surveyed stated that some of the members of their household had symptoms; and 1.1% report that there is a confirmed carrier of COVID -19 in their family. 88.3% have altered the feeling generated by social isolation, and 56.4% have felt stress due to social isolation. <strong>Conclusion</strong>: In the end it is concluded that there are economic problems to buy food and medicine, that food is sufficient only for 7 days, money is only enough for two weeks, the bonds are few to acquire the basic and most of the family it has not been benefited by any bonus. And as regards health, most of them have a feeling altered by social isolation and they present stress from quarantine.</div> Cintia Rosmeri Cuenca Jaque Milagros Lucila Osorio Tarrillo José Leonardo Pastor Ramos Gloria del Pilar Peña Pasapera Lissette Estefany Torres Vásquez ##submission.copyrightStatement## 2020-06-17 2020-06-17 20 4 10.25176/RFMH.v20i4.3067 Body Mass Index an anthropometric measure associated with TG / HDL Index, a novel cardio-metabolic risk factor <p><strong>Objectives</strong>: to determine the relationship between obesity and the TG / HDL index in patients treated at the endocrinology outpatient service of the Sergio Bernales national hospital in 2018. <strong>Methods</strong>: the study was observational, analytical, case-control type not matched to ratio of 4: 1, with a total of 288 study subjects, 230 controls and 58 cases who met the selection criteria, involved the patients treated in the endocrinology outpatient service. The sample was simple random, the variables were included: Sex, age, Body mass index, Total cholesterol, Total triglycerides, HDL-c, LDL-c, TG / HDL index. A logistic regression model was used to obtain an Odds Ratio for the strength of association. <strong>Results</strong>: The relative frequency of obesity was 65.52% and 29.13%, for cases and controls respectively, in turn a statistical significance with Fisher's exact test, P-value 0.000. A bivariate logistic regression found a relationship between Obesity and TG / HDL-c Index (OR 4.62, p = 0.000, 95% CI 2.51-8.52). <strong>Conclusions</strong>: a relationship was found between Obesity and the TG / HDL-c index, which can be extrapolated to the adult population treated in the endocrinology service of Metropolitan Lima, this is the first article published in this regard at the national level, prospective studies are recommended to determine causality.</p> Pamela Vasquez Rafael Ricra Liliana Cruz Nathalie Vargas ##submission.copyrightStatement## 2020-08-27 2020-08-27 20 4 10.25176/RFMH.v20i4.3219 Estimate of the excess of the total deaths reported in 2020 versus the reported deaths from COVID-19 (SARS-CoV2) in Peru during the months of March, April and May 2020. <p><strong>Methods</strong>: We compared the gap between the National Death System (SINADEF) with the oficial reported deaths from COVID -19 from march 1st to &nbsp;may 31th, 2020; Violent deaths (homicide, suicide, traffic accident; other accidents and unknown deaths) were excluded. To estimate the deaths baseline was used a seasonal linear regression,&nbsp; from January 1st, 2017 to December 31th, 2019 with a 95% confidence intervals. The deaths reported in the National Death System was compared with the baseline deaths. The excess of deaths reported was estimated by “Simple Difference method”. <strong>Results</strong>: The research outcomes showed that the excess of total deaths, from 1st March to 31th may, 2020 is 2.24 times greater than the oficial number of deaths reported by COVID-19. <strong>Conclusions</strong>: The finded differences may be associated directly with a unregistered deaths by COVID-19 and another general death causes related with failures in our Public Health Sistem during the Pandemic period.</p> Pedro Fidel Grillo Rojas Roberto Romero Onofre ##submission.copyrightStatement## 2020-08-27 2020-08-27 20 4 10.25176/RFMH.v20i4.3220 Participatory Communication Strategies, Basic Sanitation and Public Health of the People of Paucartambo-Cusco <p><strong>Objectives</strong>: To analyze the influence that the application of participatory communication strategies has on the adequate use of basic sanitation services and its impact on the public health of the residents of communities in Paucartambo. Explore the political and cultural dimensions immersed in the communication processes between populations and health promoters of the study communities. Analyze the intervention processes in the field of health communication. <strong>Methods</strong>: The type of research is qualitative and observational, with a cross-sectional design based on unstructured interviews and in-depth interviews. Data from the National Population and Housing Censuses 2017, 2007 - National Institute of Statistics and Informatics were used. (INEI) - PERU. <strong>Results</strong>: In-depth interviews, as well as direct observation, result in the fact that although efforts have been made to improve the situation of basic sanitation through the installation of a public sewage network, and other forms such as latrines and septic tanks In addition to being insufficient, they were not used properly, because participatory communication strategies were not applied from the diagnostic stage to the final evaluation, even more so due to the permanent lack of monitoring and surveillance activities, which have a very decisive role in the quality of life and therefore in public health <strong>Conclusion</strong>: The communication strategies most used by institutions that have the role of promoting the adequate use of basic sanitation services such as public sewage networks have been of a vertical nature such as those talks, radio, the use of pictures, precisely for this reason, adequate knowledge, attitudes and practices were not generated s for their use and conservation, a situation that had negative impacts on public and environmental health.</p> Guisela Yábar T Krupuskaya Figueroa Y. ##submission.copyrightStatement## 2020-08-27 2020-08-27 20 4 10.25176/RFMH.v20i4.3191 Analysis of the potential of innovation in dressings to treat chronic wounds in the city of Lima, Peru. <p><strong>Objective:</strong> To analyze the potential for innovation in dressings to treat chronic wounds in the City of Lima.&nbsp;&nbsp;<strong>Methods:&nbsp;</strong>A qualitative study was carried out by means of interviews to medical experts and purchasing managers of medical supplies for the treatment of difficult-to-resolve wounds in 8 representative public health institutions with categories 1-4 within the only &nbsp;54 of Lima, Peru - 2018.&nbsp;<strong>Results:&nbsp;</strong>It was determined that an average of 17 patients is treated in public health institutions on a monthly basis (60% from hospitalization and 40% from an outpatient office). It is equivalent to say that 11,016 patients present chronic wounds of difficult resolution each year, which will require specialized treatment and an average annual demand of 110,160 dressings in stock. The dressings with the highest demand correspond to the Hydrogels and Hydrocolloids, respectively; used because of the positive results they offer in wound healing, despite economic limitations. The market &nbsp;price per unit ranges between 20 and 90 soles (S/.), representing an economic investment of 1500 soles on average per patient, in some cases causing complications or abandonment of treatment when resources are scarce.&nbsp;<strong>Conclusions:&nbsp;</strong>There is a high demand for patients with chronic wounds of difficult resolution in the public health institutions of Lima. It is important to promote and incentivize the investigation of new therapeutic alternatives and / or biomedical devices that favor its treatment.</p> Fanny L. Casado Y Hinostroza-García I. Hernandez-Patiño G. Rossani D. Guevara-Mendoza ##submission.copyrightStatement## 2020-08-09 2020-08-09 20 4 10.25176/RFMH.v20i4.3195 Effect of the aqueous solution of "mashua" on the reproductive capacity of male mus musculus and its implication in preimplantation embryonic development. Preclinical test <p>The "mashua", Tropaeolum tuberosum Ruiz &amp; Pavón, 1802 is a plant species native from Peru and a resource of great nutritional value. In addition, there are several investigations carried out in the last decade in which its effects on mammal fertility have been verified. In this work, we evaluate the effect of the aqueous extract of <em>T. tuberosum</em> on the development of the preimplantation embryos of <em>Mus musculus</em>. The aqueous extract was administered <em>ad libitum</em>, in a concentration of 50 g / Kg of body weight, to three groups of mice (n = 24) during 8, 16 and 35 days; the control group drank only tap water. Each group of males were crossed with females of fertile age, the presence of a vaginal plug indicated the 0th day of embryonic development. At 72 h the uterine horns were perfused and the stage of development, condition and embryonic morphology were evaluated. Differences were found between the control and treatment groups. Our results demonstrate that the aqueous extract of <em>T. tuberosum</em> alters the quality of the mouse sperm, affecting the ability of the embryo to develop normally to the blastocyst stage.</p> José Gonzales-Daga Rafael Alvis-Dávila José Luís Rafael Pino-Gaviño Roger Iziga-Goicochea ##submission.copyrightStatement## 2020-08-09 2020-08-09 20 4 10.25176/RFMH.v20i4.3187 Genetic basis of pulmonary arterial hypertension <p>Pulmonary arterial hypertension (PAH) is a heterogeneous disease where genes play an important role. Hereditary PAH (PAH) is defined as a genetic condition of autosomal dominant manner, incomplete penetrance, variable expressivity, and which cases of familial PAH are defined by the presence of two or more family members with PAH with or without an identified germline variant and cases of idiopathic PAH corresponding to isolated cases in the family with an identified germline variant. To establish the diagnosis of hAPH, it is necessary to confirm the diagnosis in at least two relatives (HAPf) or identify the germline variant in an isolated case in the family (HAPi).</p> Maria del Carmen Castro-Mujica Hugo Abarca Barriga ##submission.copyrightStatement## 2020-08-09 2020-08-09 20 4 10.25176/RFMH.v20i4.2946 Usefulness of chest radiography in the context of the SARS-CoV-2 pandemic <p>In the current SARS-COV-2 pandemic, the choice of an imaging modality to aid diagnosis is based on the patient's clinical conditions, laboratory tests, and the availability of imaging equipment in health facilities. Tomography (CT) and chest radiography (CXR) are the most widely used imaging modalities; CXR, with less sensitivity than CT, is an accessible method, less expensive and less exposure to health personnel, its use is recommended in emergencies and in hospital services. The objective of the article is to guide decision-making to choose an imaging modality according to scenarios, taking into account its potential benefits and deepening in the description of the radiographic characteristics of suspected SARS-COV-2 infection that may serve in emergencies and we assess disease progression using a scoring system.</p> Silvia Lucía Mayanga-Sausa Raúl Max Steve Guerra-Tueros Daniel Alcides Lira-Villasante Dayana Kim Pastor-Gutiérrez ##submission.copyrightStatement## 2020-06-08 2020-06-08 20 4 5 5 10.25176/RFMH.v20i4.3034 Importance of genetics as a science in relation to the COVID-19 pandemic <p>The current COVID-19 pandemic has become a major global public health problem with almost one and a half million cases and tens of thousands of deaths until now. Genetics is playing a leading role in the identification, management and treatment of diseases. This article details the importance of genetics as a science to face the global threat of COVID-19, from different approaches. The contributions that genetics have had and will continue to have in the identification of the new SARS-CoV-2 virus, in the development of new diagnostic techniques, in the prevention of infections and development of severe symptoms, as well as in the design of vaccines and in the proposal and evaluation of treatments for COVID-19.</p> Enrique Eduardo Sanchez-Castro Cecilia Pajuelo-Reyes ##submission.copyrightStatement## 2020-06-10 2020-06-10 20 4 3 3 10.25176/RFMH.v20i4.2944 Nursing care for the management of the patient diagnosed with COVID19 in the hospitalization area <pre id="tw-target-text" class="tw-data-text tw-text-large tw-ta" dir="ltr" data-placeholder="Traducción"><span lang="en">Objective: To compile the information for the management of the patient who is hospitalized by COVID19 to establish concrete and effective nursing care actions that allow the objectives of nursing care to be conducted, as well as its results. Method: Documentary review of the evidence regarding nursing management and isolation guidelines for patients with COVID19 in the hospitalization service, determining the main isolation and protection measures for health workers. Conclusions: The constant updating allows nursing professionals and the health team to articulate guidelines that allow establishing concrete care actions for patients hospitalized by COVID19, as well as strengthening the isolation and care measures of the interdisciplinary team to reduce the risk of infection. and spread. Key words: Hospitalization, isolation, COVID19, nursing.</span></pre> Geraldine Almanza ##submission.copyrightStatement## 2020-06-10 2020-06-10 20 4 3 3 10.25176/RFMH.v20i4.2963 Plasma convalescent therapy for COVID-19 patients: A literature review. <p>The coronavirus disease 2019 (COVID-19) caused by novel coronavirus (SARS-CoV-2) infection has created a pandemic leading to a global struggle to cope with the sheer numbers of infected persons, many of whom require intensive care support. To date, there is no specific antivirus treatment for COVID-19. The use of convalescent plasma transfusions could be of great value in the current pandemic. Recently recovered SARS-CoV-2 patients who may be suitable donors undergo apheresis in order to obtain convalescent plasma containing high-titer antibodies, granted they meet blood donation criteria. In this review, we summarize existing literature around convalescent plasma as a therapeutic option for COVID-19. It is important to note that the appropriate timing on convalescent plasma administration and the severity of its adverse effects needs to be further studied. Convalescent plasma provides the potential to render an immediate promising treatment option while evaluating existing drugs and developing new specific vaccines and therapies.</p> Tania Platero-Portillo Sussan Llocclla-Delgado Nehemias Guevara-Rodriguez ##submission.copyrightStatement## 2020-09-06 2020-09-06 20 4 10.25176/RFMH.v20i4.3247 Electrospinning: Advances and applications in the field of biomedicine <p>Nanofiber production in scaffolds using electrospinning technology encompasses many physical and chemical parameters that have been studied and have not yet been fully elucidated. Both the use of natural polymers, which due to their characteristics have a higher affinity and a greater biocompatibility with cellular processes, as well as a biomimetization similar to the structure of the body's natural cellular matrix; however, the lack of control over some of its physical characteristics directly affects the biological characteristics of the cell. On the other hand, the use of synthetic polymers allows us to control physical characteristics, but this affects the development of cells. For this reason, this article presents a brief review of scientific articles about Electrospinning and the most used materials for obtaining scaffolds in the field of biomedicine.</p> Hugo Mauricio Gonzales Molfino Alexander Alcalde Yañez Valery Veronica Valverde Morón Dulce Virghynia Villanueva Salvatierra ##submission.copyrightStatement## 2020-09-06 2020-09-06 20 4 10.25176/RFMH.v20i4.3004 Sepsis by escherichia coli of uncommon starting in patient with T and NK cell lymphoma <p>Sepsis occurs in the presence of an infectious focus; in this case by Escherichia coli (E. coli), that toxins &nbsp;can cause severe damage to the organism's functionality and morphology, being worsened in patients with diseases that affect the immune system; as is this case in the presence of hematological malignancy. A 42-year-old female patient with a diagnosis of T-NK non-Hodgkin lymphoma presented with a necrotic plaque on the palate, temperature above 38 ° C, respiratory rate exceeding 20 breaths per minute, and heart rate exceeding 90 beats per minute. , on examination of a positive pharyngeal culture for E. coli, negative urine culture, confirming a pharyngeal infectious starting point; Treat with amikacin endovenously for 7 days with good response to antibiotic therapy. An infrequent case is reported for this type of bacteria in the oral area and a review of the subject.</p> Carlos Noriega-Baella Eliana Valera Vásquez Ilan Vargas Torres José M. Vela-Ruiz ##submission.copyrightStatement## 2020-08-27 2020-08-27 20 4 10.25176/RFMH.v20i4.3221 Acute appendicitis in intestinal malrotation. Case report. <p>Intestinal malrotation is a congenital abnormality of the embryological rotation of the intestine, it is estimated that more than 90% of patients with intestinal malrotation will be presented in the first 12 months of life. The clinical presentation in adults is manifested in a progressive way that usually occurs during the postprandial period, presenting: intermittent vomiting, abdominal pain, weight loss, chronic diarrhea, peritonitis, food intolerance, among Another. Treatment will depend on presentation, either acute or chronic, requiring emergency laparotomy to determine the cause. There is a case of acute surgical abdomen for acute appendicitis in a 27-year-old patient with intestinal malrotation, with initial clinical presentation of severe abdominal pain, diarrhea, positive lumbar percussion fist, which finally reached a Proper resolution and a good prognosis.</p> Richard J. Febres Ramos Nelson Fidel Diaz Reyes ##submission.copyrightStatement## 2020-08-09 2020-08-09 20 4 10.25176/RFMH.v20i4.2927 Tomographic diagnosis of adrenal tuberculosis and addison - height <p>We report the case of a 23-year-old male, natural and resident of height, with hyperpigmentation. Asthenia, fatigue, nausea, vomiting, weight loss, abdominal pain, hiporexia and hypotension, with decreased cortisol dosage and elevated ACTH.&nbsp; Normal chest X-Ray, smear in sputum and negative urine. Negative TB-LAM Antigen. In contrasted abdomen computed tomography, an increase in dimensions and small calcifications is shown in both adrenals suggestive of specific type granulomatous infiltration. In endemic areas of tuberculosis as in Peru, in the absence of the adrenal biopsy, it can be used early, as a diagnostic alternative to the tomography to rule out the adrenal commitment.&nbsp; In conclusion, this report described as the tomography can be used as an alternative diagnostic method in hospitals where it is not feasible to perform the biopsy in a rapid manner.</p> Juan Amilcar Tinoco Solorzano Valeria Córdova Valenzuela Gonzalo Carrilo Sanabria Francisco Meza Legua Brayan Dávila Aranda ##submission.copyrightStatement## 2020-08-09 2020-08-09 20 4 10.25176/RFMH.v20i4.2953 Severe pneumonia of torpid evolutión in a young patient with a negative molecular test for a new coronavirus <p>The coronavirus disease originated in the year 2019 (COVID-19), has spread rapidly throughout the world, wreaking havoc on the health system and society. We report the case of a 26-year-old man with a history of asthma and obesity, who returned from the US and went to the emergency room with respiratory symptoms, hypoxemia and interstitial infiltrate on chest radiography, he was admitted to the isolation room The nasopharyngeal swab RT-PCR molecular test was negative, so he was transferred to a common emergency room. Initial management was conservative, however the patient evolved unfavorably requiring ventilatory support, but died on the fifth day of hospitalization. A second positive result for SARS-CoV-2 was received the day after the patient died, being one of the first young victims in Peru.</p> Josef Rivera Ricardo Ayala José Amado ##submission.copyrightStatement## 2020-08-09 2020-08-09 20 4 10.25176/RFMH.v20i4.3190 COVID-19 and Influenza: Report of five cases in a peruvian hospital <p>La enfermedad de COVID-19 es una infección de fácil transmisión al igual que otros virus respiratorios, reportándose casos de coinfección de Influenza en épocas estacionales. Se presentan 5 casos de coinfección de COVID-19 y el virus de la Influenza siendo el más frecuente el virus de la Influenza A, los síntomas odinofagia y congestión nasal pueden hacer pensar en coinfección existente entre estos dos virus, esta coinfección no se relacionan con peor pronóstico ni mortalidad aparentemente.</p> Kenneth G. Vargas Ponce Antonio Salas López Felix Llanos Tejada Antonio Morales Avalos ##submission.copyrightStatement## 2020-08-09 2020-08-09 20 4 10.25176/RFMH.v20i4.3158 Cardiac tamponade and intracranial hemorrhage in a COVID-19 pediatric patient: Case Report <p>The new coronavirus disease (COVID-19) is actually a pandemic according to the World Health Organization. It affects both the adult and pediatric population, however the most published information correspond to the first one, generating a knowledge gap regarding children. Pulmonary involvement appears to be the most frequently manifestation of the disease, although extrapulmonary complications such as pericardial effusion and cerebrovascular diseases have been reported in adults, and according to our review none have been reported in children. We present a case of a 7 year old patient with previous history of asthma and overweight that present COVID-19, and was admitted through the pediatric emergency department for pneumonia and developed a respiratory failure that requires ventilatory support. During its hospitalization presents cardiac tamponade and intracerebral hemorrhage with adverse evolution and fatal outcome.</p> Ricardo Enrique Rodríguez Portilla Manuel Eduardo Munaico Abanto Rosa Perlita Paredes Zevallos Gaudi Amelia Quispe Flores ##submission.copyrightStatement## 2020-09-10 2020-09-10 20 4 10.25176/RFMH.v20i4.3263 Advances on the prevention of cancers attributed to infectious agents <p>Currently, cancers of infectious origin, represent a public health problem, especially in emergent countries. After its discovery more than 50 years ago, arduous efforts have been made to identify the agents involved, their routes of transmission and their carcinogenesis mechanisms, in order to develop effective prevention measures.</p> Joseph Alburqueque Melgarejo ##submission.copyrightStatement## 2020-08-09 2020-08-09 20 4 10.25176/RFMH.v20i4.2326 Physical activity and metabolic syndrome: "A lifestyle" <p>At present some of the diseases with greater concern are diabetes, obesity, insulin resistance, cardiovascular, high glucose; all together as the metabolic syndrome caused by multiple factors including sedentary lifestyle, physical inactivity, this being the fourth risk factor with regard to global mortality.<br>The risks of having the metabolic syndrome have been increasing in the last decade, related to insulin resistance and obesity, so that obtaining a mechanism that can counteract this problem is urgent; of which the intake of pharmaceutical products is the most widely used, but the practice of moderate exercises is neglected, which have highlighted the beneficial impact against this disease.</p> Luis Moscoso Arpasi ##submission.copyrightStatement## 2020-08-09 2020-08-09 20 4 10.25176/RFMH.v20i4.3051 Healthy eating with fruits and vegetables: A more complex issue than your own consumption <p>In the article published by Huamancayo-Espíritu and Pérez-Cárdenas on the consumption of fruits and vegetables in medical students, the authors estimated a prevalence of low consumption of fruits and vegetables of 60.1% in a sample of 371 students. The most frequent reasons found were the difficulty of obtaining them in the university cafeterias, insufficient time for their selection, purchase and preparation and the fact of living with their father or mother who is in charge of their feeding; the second being the only associated factor, and the last being a protective factor. The study has many strengths, among which the importance of the thematic axis that it develops stands out: healthy lifestyles are one of the great determinants of health, highlighting that one in every 5 deaths in the world is associated with unhealthy eating.</p> Joana Magallanes Cabrera ##submission.copyrightStatement## 2020-08-27 2020-08-27 20 4 10.25176/RFMH.v20i4.3222 Technology as an ally to fight COVID-19 <p>The infectious disease COVID-19, or commonly called coronavirus disease, has put the whole world on alert and even more so now that the World Health Organization (WHO) has declared it a pandemic.</p> <p>Worldwide, countries are looking for a cure and applying new ways of prevention to flatten the curve of those infected, so both the area of medicine and the area of technology are doing their best to find effective solutions to this pandemic. The fields of artificial intelligence and big data, seek to contribute technologically using the existing information of the citizens and of which it is possible to have confidence, in which many of these services will have a purpose with impact, since they have had exponential advances in the last decades.</p> Abel José Tarazona Reyes César Jefferson Ochoa Grados ##submission.copyrightStatement## 2020-06-10 2020-06-10 20 4 2 2 10.25176/RFMH.v20i4.3046 Robotics and Biomedical Innovative Applications in Public Health during the COVID-19 Pandemic <p>In the current situation of the large-scale spread of COVID-19, whereas contagion increases, the role of robots (designed with Teleoperation and Artificial Intelligence technology) in society becomes essential, because they need to be used in hospital settings, urban environment, and also using Telemedicine consultancy to have access to all communities in the world, in order to avoid the spread of the virus. In addition, multidisciplinary work could be promoted, among the engineering and health sciences in the American Continent and Worldwide, through research, development and innovation projects in Biomedical Engineering, with the proposal of being ready to face a global and national emergency like the current Pandemic caused by SARS-CoV-2.</p> José Cornejo Mariela Vargas Jorge A. Cornejo-Aguilar ##submission.copyrightStatement## 2020-06-17 2020-06-17 20 4 10.25176/RFMH.v20i4.3042