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 It covers current issues, with original and unpublished articles, related to the various specialties of the biomedical and Public Health area.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> First University Chair of Lifestyle Medicine in Peru and Latin America <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> Jhony A De La Cruz-Vargas Iván Rodríguez Chávez ##submission.copyrightStatement## 2021-01-11 2021-01-11 21 1 10.25176/RFMH.v21i1.3605 Effect of SARS-CoV-2 variants on the transmission of COVID-19 in Peru <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> Manuel J. Loayza-Alarico Jhony A. De La Cruz Vargas ##submission.copyrightStatement## 2021-01-11 2021-01-11 21 1 10.25176/RFMH.v21i1.3606 Hypoalbuminemia as a predicator of mortality of sepsis from COVID-19. Hospital II Chocope, 2020. <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> Alex Brandon Lopez Graciela Marilyn Aguilar Murillo Alicia Pamela Muñoz Neciosup Evelyn Goicochea Rios ##submission.copyrightStatement## 2020-12-21 2020-12-21 21 1 10.25176/RFMH.v21i1.3437 Risk Factors for Mortality from COVID-19 in Hospitalized Patients: A Logistic Regression Model <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> Irma Luz Yupari Lucia Bardales Aguirre Julio Rodriguez Azabache Jaylin Barros Sevillano Angela Rodríguez Díaz ##submission.copyrightStatement## 2020-12-21 2020-12-21 21 1 10.25176/RFMH.v21i1.3264 Trend in gastric cancer mortality rate in Peru: Segmented regression model 1995 - 2013 <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> Diego Rolando Venegas Ojeda Ysela Dominga Agüero Palacios ##submission.copyrightStatement## 2021-01-06 2021-01-06 21 1 10.25176/RFMH.v21i1.3592 APGAR perinatal predictors persistently low at 5 minutes in a Peruvian Hospital <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> Marco Antonio Chilipio Chiclla Karla Estefany Atencio Castillo John Paul Santillán Árias ##submission.copyrightStatement## 2020-12-16 2020-12-16 21 1 10.25176/RFMH.v21i1.3345 Management of glycemic crises in adult patients with diabetes mellitus: Evidence-based Clinical Practice Guideline, Lima - Peru. <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> Helard Manrique Fradis Gil-Olivares Luis Castillo-Bravo Laura Perez Giovanny Campomanes Karina Aliaga José Lagos Alfredo Aguilar Guillermo Umpierrez ##submission.copyrightStatement## 2021-01-06 2021-01-06 21 1 10.25176/RFMH.v21i1.3194 Application of the Integrated Autoregressive Method of Moving Averages for the analysis of series of cases of COVID-19 in Peru <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> Daniel Angel Cordova Sotomayor Flor Benigna Santa Maria Carlos ##submission.copyrightStatement## 2020-12-16 2020-12-16 21 1 10.25176/RFMH.v21i1.3307 Low back pain related to anxiety and depression in police officers at a police station in Lima <p><strong>ABSTRACS</strong></p> <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.</p> <p><strong>Objective</strong>. Relate lumbar pain with anxiety and depression in police officers from a police station in Lima</p> <p><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.</p> <p><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)</p> <p><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.</p> <p>Keywords. Lumbar region pain, anxiety, depression, police. (Source: DeCS BIREME)</p> Cristhian Santiago Bazan Arleen Yesenia Espinoza Ventura ##submission.copyrightStatement## 2020-12-16 2020-12-16 21 1 10.25176/RFMH.v21i1.3229 Factors related to left ventricular hypertrophy in adult persons living at altitude <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> Anibal Valentin Diaz Lazo Carlos Barrientos Huamani Carlo Cordova Rosales ##submission.copyrightStatement## 2020-12-16 2020-12-16 21 1 10.25176/RFMH.v21i1.3270 Anemia and Cancer Survival, A Peruvian study with a 5-year follow-up <p><strong>Objective</strong>: To determine the relationship between anemia and 5-year survival in cancer patients.</p> <p><strong>Materials and methods</strong>: 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.</p> <p><strong>Results:</strong> 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.</p> <p><strong>Conclusion</strong>: 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> Jennyfer E. Garcia Arispe María Loo-Valverde Willer Chanduví Jose M. Vela-Ruiz Rocio Guillen-Ponce Jhony A. De la Cruz-Vargas ##submission.copyrightStatement## 2020-12-26 2020-12-26 21 1 10.25176/RFMH.v21i1.3460 Relationship between pregnant women with anaemia of maternal age at risk and low birth weight in a social security hospital in Peru <p><strong>Objetivo:</strong> Determinar la asociación entre anemia en gestantes con edad materna de riesgo y bajo peso al nacer. <strong>Métodos: </strong>Se realizó un estudio de tipo no experimental, retrospectivo, transversal, analítico, de casos y controles. En el periodo de octubre a diciembre del 2019, se registraron un total de 312 gestantes con edad materna de riesgo (gestantes adolescentes y añosas), de los cuales 72 eran anémicas (Hb &lt; 11 g/dl), siendo este el número de casos, y con el fin de mejorar la potencia estadística se estableció la relación entre casos y controles de 1:2, siendo el número de controles o gestantes no anémicas con edad materna de riesgo 142. Se analizaron características generales por grupo de gestantes anémicas y no anémicas, y su asociación con edad materna de riesgo. Se determinó mediante prueba de Chi-cuadrado y Odds ratio la asociación de anemia en gestantes adolescentes y añosas por separado con bajo peso al nacer. <strong>Resultados:</strong> Entre las variables estudiadas las gestantes anémicas presentaron mayor frecuencia de nuliparidad y parto vaginal, y en menor frecuencia antecedente de aborto y control prenatal adecuado. Las gestantes adolescentes que cursaron con anemia no se asociaron a mayor riesgo de bajo peso al nacer (p=0.056). Las gestantes añosas que cursaron con anemia se asociaron a 6 veces mayor riesgo de bajo peso al nacer (IC:95%: 2,219 a 18,026; p=0,000). <strong>Conclusiones: </strong>Las gestantes añosas tienen mayor riesgo de presentar productos con bajo peso al nacer</p> José Luis Villalva Luna Jhonattan Jesús Villena Prado ##submission.copyrightStatement## 2020-12-16 2020-12-16 21 1 10.25176/RFMH.v21i1.3155 Association between health care provider factors and the number of prenatal visits in Peruvian Hospital users <p><strong>ABSTRACT</strong></p> <p><strong>Objective:</strong> 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. <strong>Methods:</strong> The study had a quantitative approach, relational level and non-experimental design, had a sample participation of 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.</p> <p><strong>Results:</strong> The age was from 18 to 35 years in 74%, secondary in 62.9%, cohabiting in 71.1% and with comprehensive health insurance in 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 = 1,238 95% CI 1,099–1,394), and the doctor or obstetrician if recommended medications in their prenatal consultation (p = 0.003; expB = 1.154 95% CI 1.051-1.268); As a human factor, the doctor or obstetrician calls her by name during the prenatal visit (p = 0.000; expB = 1.45 95% CI 1.19–1.77).</p> <p><strong>Conclusion: </strong>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> <p><strong>Keywords<em>:</em> </strong>Health provider factors, number of prenatal care, users, pregnant women..</p> Karina Elizabeth Diez Quevedo Maritza Dorila Placencia Medina ##submission.copyrightStatement## 2020-12-16 2020-12-16 21 1 10.25176/RFMH.v21i1.3200 Association between C-reactive protein and metabolic syndrome in the Peruvian population of the PERU MIGRANT study <p><strong>Introduction</strong>: 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).</p> <p><strong>Objectives</strong>: To evaluate the association between C-Reactive protein and metabolic syndrome in the Peruvian population of the PERU MIGRANT study. <strong>Methods</strong>: 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.</p> <p><strong>Results</strong>: 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).</p> <p><strong>Conclusions</strong>: 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> Víctor Juan Vera-Ponce Liliana Cruz-Ausejo Jenny Raquel Torres-Malca ##submission.copyrightStatement## 2020-12-21 2020-12-21 21 1 10.25176/RFMH.v21i1.3320 Somatotype differences between Mapuche and non-Mapuche children of 12 - 13 years old from Malleco - Araucania - Chile. <p><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">Los estudios somatotípicos y su descripción de la configuración morfológica humana permitir apreciar impactos en hábitos alimentarios y sedentarismo. </span><span style="vertical-align: inherit;">Este estudio determinó la diferencia somatotípica niños mapuche (NM) y no mapuche (NNM) de Malleco, Chile. </span><span style="vertical-align: inherit;">Se evaluaron a través del protocolo ISAK, 160 niños con edad media de 12,5 años, talla 145,5 ± 3,5 cm y peso 43,7 ± 3 kg., Obteniendo las siguientes clasificaciones: Grupo 12 años, Mapuche; </span><span style="vertical-align: inherit;">Meso-endomorfos. </span><span style="vertical-align: inherit;">Grupo no mapuche 12 años; </span><span style="vertical-align: inherit;">Endo-mesomorfo. </span><span style="vertical-align: inherit;">Grupo 13 años, mapuche; </span><span style="vertical-align: inherit;">Meso-endomorfos. </span><span style="vertical-align: inherit;">Grupo no mapuche 13 años; </span><span style="vertical-align: inherit;">Endo-mesomorfo. </span><span style="vertical-align: inherit;">Los resultados indican que para la edad de 12 años, los NM presentan valores más bajos de endomorfía y valores más altos de mesomorfía (p≤0.01) que NNM. </span><span style="vertical-align: inherit;">Los NM de 13 años presentaron valores más bajos de endomorfía y mesomorfía (p≤0.01) que NNM. </span><span style="vertical-align: inherit;">En conclusión,</span></span></p> José Bruneau-Chávez Valeria Maldonado-Hernández Roberto Iván Lagos-Hernández ##submission.copyrightStatement## 2020-12-16 2020-12-16 21 1 10.25176/RFMH.v21i1.3439 Factors associated with the level of knowledge of COVID-19 preventive measures in pregnant and puerpal women in two peruvian communities <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> Fatima Paucar Osorio Estefani Ireci Rodriguez-Lecaros Selene Montalvo Molero Alfredo Tapahuasco Arones Janny Salazar Cruz Ricardo Kamiyama Arakawa Dante Quiñones Laveriano ##submission.copyrightStatement## 2021-01-06 2021-01-06 21 1 10.25176/RFMH.v21i1.3600 Quality of life in patients with advanced cancer according to place of care in a referral hospital. <p><strong>Introduction</strong>: In Peru more than 50% of cancer cases are diagnosed late and their quality of life is poorly studied.</p> <p><strong>Objectives:</strong> To compare the quality of life perceived by patients with advanced cancer in a referral hospital according to home care versus hospital care.</p> <p><strong>Material and methods</strong>: Observational study carried out in a tertiary social security hospital. Patients older than 18 years with cancer with multiple metastases were included. EORTC QLQ-C15-PAL quality of life survey was applied to patients with adequate cognitive level (according to the Pfeiffer questionnaire). Using Chi square and Mann-Whitney tests, considering p &lt;0.05 and using SPSS 24.0. Previous approval of the institutional ethics committee.</p> <p><strong>Results:</strong> 83 patients were included in the hospital group (GH) and 69 in the home group (GD). Age ranged from 30 to 94 years, with a median of 66 years in the GH and 76 in the GD (p &lt;0.01); female sex 56.6 and 60.9% respectively (p = 0.60). The most frequent locations of cancer were digestive, genitourinary, and respiratory in both groups (p = 0.68). 25% of GH and 58% of GD had moderate or severe cognitive impairment (p &lt;0.01). The median quality of life score was 49.5 in the GH and 48 in the GD (p = 0.60), the physical functional aspect had a lower score in GH (p &lt;0.01).</p> <p><strong>Conclusion:</strong> The perceived quality of life is acceptable, with intermediate control of symptoms in both groups and better physical functionality in the hospital group; however, the home group are older and have cognitive impairment.</p> Jose Amado Tineo Moises Apolaya Segura Elizabeth Che Hidalgo Otto Vargas-Tineo Jessika Solis Sarmiento Teodoro Oscanoa Espinoza ##submission.copyrightStatement## 2021-01-11 2021-01-11 21 1 10.25176/RFMH.v21i1.3603 Clinical profile trial of patients cared with diabetes mellitus type 2 in a reversion program. <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> Eymard Torres Rodriguez Helbert Arévalo Idania Suarez Narelcy Vega ##submission.copyrightStatement## 2021-01-17 2021-01-17 21 1 10.25176/RFMH.v21i1.3432 The COVID-19 pandemic: The importance of being alert to zoonoses. <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> Manuel E. Cortés ##submission.copyrightStatement## 2020-12-17 2020-12-17 21 1 10.25176/RFMH.v21i1.3451 Tobacco Use and Cervical Intraepithelial Neoplasia <p>Objetivo: Determinar el efecto del consumo de tabaco en el desarrollo de neoplasia intraepitelial cervical.</p> <p>Métodos: Se realizó una revisión sistemática. Se realizó la búsqueda electrónica, utilizando la pregunta de investigación: ¿Cuál es la asociación entre el tabaquismo y el desarrollo de neoplasia intraepitelial cervical? cuya pregunta de PEO fue: Población: Mujeres. Exposición: uso de tabaco. Resultado: neoplasia intraepitelial cervical. Se seleccionaron los artículos publicados desde el 1 de enero de 2014 hasta diciembre de 2019. Resultados: se encontraron 71 artículos, de los cuales 55 fueron excluidos por no cumplir con los criterios de selección, quedando 16 artículos para el análisis de este artículo. Aquellas mujeres que fumaban tabaco tenían una asociación significativa para el desarrollo de neoplasia intraepitelial de alto grado (OR = 1,43, IC del 95% = 1,14-1,80). Asimismo, se observó sinergia entre el tabaquismo severo y el uso de anticonceptivos orales, con mayor riesgo de neoplasia intraepitelial grado II y III (OR = 11,5; IC 95%, 1,88-70,40). Conclusión: La evidencia disponible sugiere la asociación entre el consumo de tabaco y el desarrollo de neoplasia intraepitelial cervical, particularmente lesiones intraepiteliales cervicales de alto grado.</p> Noemí Rojas Cisneros Rony Ruíz Saucedo ##submission.copyrightStatement## 2020-12-17 2020-12-17 21 1 10.25176/RFMH.v21i1.3401 Hospital security. A vision of multidimensional security <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> Augusto Flavio Figueroa Uribe Julia Hernández Ramírez ##submission.copyrightStatement## 2020-12-28 2020-12-28 21 1 10.25176/RFMH.v21i1.3490 Cross-sectional studies <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> Aleksandar Cvetković Vega Jorge L. Maguiña Alonso Soto Jaime Lama-Valdivia Lucy E. Correa López ##submission.copyrightStatement## 2020-12-16 2020-12-16 21 1 10.25176/RFMH.v21i1.3069 Risk factors associated with Barrett's esophagus in hospitalized patients <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> Gerard Martín Gómez ##submission.copyrightStatement## 2020-12-16 2020-12-16 21 1 10.25176/RFMH.v21i1.3119 Skin manifestations in young military personnel diagnosed with Covid 19 - Peru <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.</p> <p>&nbsp;</p> <p>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</p> <p>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.</p> <p>We can conclude that skin manifestations are similar to skin involvement that occurs during common viral infections.</p> Richard Jeremy Febres Ramos Stephany Keila Vilchez Bravo ##submission.copyrightStatement## 2020-12-17 2020-12-17 21 1 10.25176/RFMH.v21i1.3310 IgA (Henoch Schönlein Purpura) Vasculitis in a Pediatric Patient with COVID-19 and Strongyloidiasis <p><strong>ABSTRACT</strong></p> <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> Mayron David Nakandakari Gomez Hamilton Marín Macedo Raúl Seminario Vilca ##submission.copyrightStatement## 2020-12-17 2020-12-17 21 1 10.25176/RFMH.v21i1.3265 Granulomatous Neutrophilic Cystic Mastitis, Case Report <p>La mastitis granulomatosa neutrofílica quística (MGQN) es una entidad recientemente caracterizada, con detalles histopatológicos específicos que la diferencian de otros tipos de mastitis crónicas idiopáticas. La presencia de bacilos grampositivos dentro de espacios de apariencia quística rodeados de neutrófilos, en un contexto de inflamación granulomatosa supurativa, definen esta entidad. La importancia de su reconocimiento en el reporte diagnóstico recae en su asociación a la infección por especies de corinebacterias, de esa manera se puede direccionar el tratamiento con antibióticos, más allá del tratamiento antiinflamatorio que suele administrarse en mastitis idiopáticas.&nbsp;</p> <p>Se describe el caso de una paciente de sexo femenino, de 35 años de edad, sin antecedentes relacionados, con dolor mamario intermitente, asociado a la presencia de múltiples nodulaciones palpables, duras, en ambas mamas, con resultados de múltiples biopsias particulares previas que describieron mastitis crónica granulomatosa con reacción de tipo tuberculoso, por lo cual recibió tratamiento antituberculoso. Pese a ello, las tumoraciones cedieron sólo parcialmente<strong>. </strong>Se revisó las láminas histológicas en la institución y se estableció el diagnóstico de MGNQ.</p> <p>Se consideró importante la presentación de este caso debido a su escaso reconocimiento entre patólogos, pese a presentar características ya definidas en estudios previos.</p> Katherine Luisa Contreras Gala María del Carmen Kapsoli ##submission.copyrightStatement## 2020-12-17 2020-12-17 21 1 10.25176/RFMH.v21i1.3239 Congenital malformation of the pulmonary airway (MCVAP), Case Report <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> José Luis Medina Valdivia ##submission.copyrightStatement## 2020-12-28 2020-12-28 21 1 10.25176/RFMH.v21i1.3488 Compartment syndrome due to liquid extravasation in a pediatric patient. Case report and bibliographic review <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> Juan Sebastián Rueda Mojica Jose Alfredo Neira Garza Arturo García Galicia Álvaro José Montiel Jarquín ##submission.copyrightStatement## 2021-01-06 2021-01-06 21 1 10.25176/RFMH.v21i1.3594 Clinical spectrum of systemic lupus erythematosus in children. Case report. <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&nbsp; this article, we report the case of a ten year old female&nbsp; 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> Giuliana Reyes-Florián Martín Seminario-Aliaga Sandra Mendoza-Cernaqué Consuelo Luna-Muñoz ##submission.copyrightStatement## 2021-01-14 2021-01-14 21 1 10.25176/RFMH.v21i1.3607 Preventive measures against SARS-CoV-2 in the community: What does the evidence say? <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> Jhonattan Jesús Villena Prado ##submission.copyrightStatement## 2020-12-16 2020-12-16 21 1 10.25176/RFMH.v21i1.3181 Clinical presentations associated with SARS-CoV-2 in a Covid pediatric intensive care unit of a national hospital in Lima <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> Edgar Coila Paricahua Ricardo Rodriguez Portilla Liliana Cieza Yamunaqué Pedro Baique Sánchez Claudia Guerra Ríos ##submission.copyrightStatement## 2021-01-06 2021-01-06 21 1 10.25176/RFMH.v21i1.3595 Vanity galleries, Pay Drivers and predatory journals: Profitting on discredit David Fabian Ramirez ##submission.copyrightStatement## 2020-12-17 2020-12-17 21 1 10.25176/RFMH.v21i1.3417 Communicating medical reports to family members in times of COVID-19 Waldo Augusto Taype Huamani Lucila Amelia De La Cruz Rojas ##submission.copyrightStatement## 2020-12-16 2020-12-16 21 1 10.25176/RFMH.v21i1.3262 Economic impact on the quality of health services in the framework of the COVID-19 pandemic in Peru Alfonso Gutierrez-Aguado Mitsy Pinares-Bonnett Walter Salazar-Panta José Guerrero-Cruz ##submission.copyrightStatement## 2020-12-16 2020-12-16 21 1 10.25176/RFMH.v21i1.3244 Covid-19 and tuberculosis: the encounter between new threats and old diseases <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> Carolina Marley Suárez Benites Carmen Miluska Silva Lopez ##submission.copyrightStatement## 2021-01-06 2021-01-06 21 1 10.25176/RFMH.v21i1.3596 Penile Synovial Sarcoma: Clinical and Radiological findings <p>Varón de 22 años, se presentó con una tumoración de consistencia dura, de 8 cm, dependiente de base del pene de 6 meses de evolución, cuya biopsia fue compatible con sarcoma sinovial (Figura 1). La resonancia magnética (RM) mostró una tumoración que compromete la base del pene, pilar izquierdo y parcialmente el pilar derecho, se extiende hacia los 2/3 distales, sin descartar infiltración uretral (Figura 1).</p> Jossué Espinoza-Figueroa Ana Karla Uribe Rivera Jorge Luna-abanto ##submission.copyrightStatement## 2020-12-17 2020-12-17 21 1 10.25176/RFMH.v21i1.3090