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 It covers current issues, with original and unpublished articles, related to the various specialties of the biomedical and Public Health area.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> HEALTH RESEARCH INTERNSHIPS <div style="text-align: justify; text-justify: inter-word;">The Faculty of Human Medicine and the Research Institute in Biomedical Sciences of the University Ricardo Palma, has been participating as Headquarters of the Student Mobility Program of the Peruvian Network of Student Teaching Mobility in REPEMIDE Medicine, constituted by the Peruvian Association of Faculties of Medicine ASPEFAM. We were pilot center in 2017-2018, receiving medical students from various universities of the country, with the "Health Research Internship", and in the 2018-2019 call we received 4 medical students selected from Peruvian universities.</div> <p>DOI:<a href=""><strong>10.25176/RFMH.v19.n2.2081</strong></a></p> Jhony Alberto De La Cruz Vargas María del Socorro Alatrista Gutiérrez Vda. de Bambarén ##submission.copyrightStatement## 2019-04-11 2019-04-11 19 2 4 4 DOCTOR HONORIS CAUSA GRANTED BY THE RICARDO PALMA UNIVERSITY TO DR. ALFREDO QUIÑONES HINOJOSA <div style="text-align: justify; text-justify: inter-word;">The Doctor Honoris Causa, is the highest honorary title granted by the Ricardo Palma University, to eminent persons. They are conferred with zeal by our house of studies to very outstanding personalities of the national and international scope, who with their work and personal trajectory honor to the culture, the science and the humanity.<br>I want to thank the Rector of the University for receiving the order, to make a brief sketch of Dr. Alfredo Quiñones Hinojosa.</div> <p><strong>DOI:</strong><a href=""><strong>10.25176/RFMH.v19.n2.2003</strong></a></p> Jhony Alberto De La Cruz Vargas ##submission.copyrightStatement## 2019-04-11 2019-04-11 19 2 4 4 COMPARATIVE STUDY OF BIOCHEMICAL HEALTH MARKERS, IN TWO GROUPS OF UNIVERSITY PROFESSORS OF THE SAME AGE GROUP, 2017 <div style="text-align: justify; text-justify: inter-word;"><strong>Objective:</strong> Compare the values of the blood biomakers: uric acid, creatinine, glucose, cholesterol and triglycerides, in two groups of university professors apparently healthy. <strong>Methods:</strong> The first group, formed by 58 professors aged 60 to 64, and the second formed by 35 professors aged 75 to 81, in order to evaluate if there is a significant statistic difference in both groups. <strong>Results:</strong> The values of uric acid in group I were between 2,50 mg/dL. and 8,20&nbsp;mg/dL; in groups II were between 2,50 mg/dL and 8,63 mg/dL, showing a significant difference (p=0.035). The&nbsp;values of creatinine in group I were between 0,64 mg/dL and 1,56 mg/dL; and in group II were between 0,80 mg/dL and 1,61 mg/dL., showing a significant difference (p=0.004). The values of glucose in group I were between 63 mg/dL and 188 mg/dL; and in group II were between 60 mg/dL y 297 mg/dL, not showing significant difference (p=0.671). The values of cholesterol in group I were between 125 mg/dL and 265 mg/dL; and in group II were between 107 mg/dL and 244 mg/dL; not showing significant difference (p=0.053). The values of triglycerides in group I were between 58 mg/dL and 507 mg/dL; and in group II were between 68 mg/dL and 314 mg/dL; not showing significant difference (p=0.104).<strong> Conclusion:</strong> There is a significant difference in the biomarkers of uric acid and creatinine between the age groups; however, there was not found significant difference in the biomarkers of glucose, cholesterol and triglycerides between the age groups.</div> <p>DOI:<a href=""><strong>10.25176/RFMH.v19.n2.2063</strong></a></p> Nicanor Domínguez Navarrete Cecilia Rojas Guerrero Carola Chambers Medina ##submission.copyrightStatement## 2019-04-11 2019-04-11 19 2 7 7 LIFESTYLE FACTORS PREDISPOSING TO CERVICAL DYSPLASIA IN WOMEN ATTENDED IN THE HOSPITAL MARÍA AUXILIADORA, 2013-2017 <div style="text-align: justify; text-justify: inter-word;"><strong>Introduction:</strong> The cervical clearance is the precursor lesion of cancer of the cervix, in which alterations of the cervical cells are observed.<strong> Objective:</strong> To identify the predisposing factors for the cervical dispute in the patients treated at the María Auxiliadora Hospital during 2013 to 2017.<strong> Methods:</strong> Design study, cases, controls, analytical and observational. 216 clinical records of patients will be analyzed, divided into 72 cases and 144 controls.<strong> Results:</strong> In the bivariate analysis, significant results in early menarche (OR = 2.071, p = 0.024), the early sexual intercourse (OR = 2.213, p = 0.017), having multiple sexual partners (OR = 3.036; = 0.001) and multiparity (OR = 2.316, p = 0.005). In the multivariate analysis, the independent variables were multiple sexual partners (OR = 2.626, p = 0.003) and multiparity (OR = 2.759, p = 0.045). Conclusion: It is concluded that women with multiple sexual partners and with multiparity are at higher risk to develop cervical dysplasia.</div> <p>DOI:<a href=""><strong>10.25176/RFMH.v19.n2.2065</strong></a></p> Rocío Gallegos Toribio Milagros Fuentes Vargas Magdiel José Manuel Gonzales Menéndez ##submission.copyrightStatement## 2019-04-11 2019-04-11 19 2 9 9 LYMPHOCYTE / MONOCYTE INDEX AS PRONOSTIC FACTOR IN DIFFUSE LARGE B CELL LYMPHOMA, EDGARDO REBAGLIATI MARTINS HOSPITAL 2010-2017 <div style="text-align: justify; text-justify: inter-word;"><strong>Introduction:</strong> The lymphocyte / monocyte index (ILM) has been described as an inflamatory prognostic parameter in many hematological diseases and solid tumors. The aim of the present study was to evaluate the prognostic value of the lymphocyte / monocyte index in the survival of patients with diffuse large B-cell lymphoma (LCGBD). <strong>Methods:</strong> The present is an analytical, longitudinal and non-experimental study. Patients diagnosed with diffuse large B-cell lymphoma of the Edgardo Rebagliati Martins hospital from 2010 to 2017 were selected. <strong>Results:</strong> 121 patients were included, 57% female, 66.1% older than 60 years. Regarding the Performance Status Zubrod, 66.5% corresponded to the degree of best forecast 0 and 1; 59.5% presented associated B symptoms. Nearly 60% were stages I and II and 57% presented extranodal involvement. We show that the ILM is significant for overall survival in the regression analysis of bivariate cox, not reaching significance in the multivariate. <strong>Conclusion:</strong> ILM is a potential simple and accessible prognostic biomarker for our population with diffuse large B-cell lymphoma.</div> <p>DOI:<a href=""><strong>10.25176/RFMH.v19.n2.2068</strong></a></p> Brady Beltrán Willy Ramos Muñoz Jhony Alberto De La Cruz Vargas ##submission.copyrightStatement## 2019-04-11 2019-04-11 19 2 8 8 MATERNAL FACTORS ASSOCIATED WITH FETAL MACROSOMIA IN A PUBLIC HOSPITAL OF LIMA - PERU, JANUARY TO OCTOBER 2018 <div style="text-align: justify; text-justify: inter-word;"><strong>Objective:</strong> To determine the maternal factors associated to fetal macrosomia in a Public Hospital of Lima - Peru, from January to October of 2018.<strong> Methods:</strong> Analytical, observational, retrospective study, of type cases and controls. A data collection form was used and for the statistical analysis the SPSS v25.0 program was used. <strong>Results:</strong> Of the 401 newborns, it was found that the weight gain during pregnancy 27.2% the mothers studied had an inadequate weight gain (OR=6.96, 95% CI4.22-11.48, p=0.00), regarding the prepregnancy weight category, and parity was 73 (73.7%). Also, maternal age was less than 35 years in 278 (92.1%), being statistically significant (p=0.004).<strong> Conclusion:</strong> It is concluded that there is a relationship of maternal factors such as inadequate weight gain during pregnancy, maternal pre-gestational weight, parity, maternal age associated with fetal macrosomia.</div> <p>DOI:<a href=""><strong>10.25176/RFMH.v19.n2.2066</strong></a></p> Dania Bazalar Salas María Loo Valverde ##submission.copyrightStatement## 2019-04-11 2019-04-11 19 2 4 4 CLINICAL EPIDEMIOLOGICAL INDICATORS ASSOCIATED WITH PRESSURE ULCERS IN A HOSPITAL OF LIMA <div style="text-align: justify; text-justify: inter-word;"><strong>Objective:</strong> To determine the clinical epidemiological indicators associated with pressure ulcers (UPP) in patients of the Medicine Service of the Hipólito Unanue National Hospital during the years 2016-2017. <strong>Methods:</strong> Observational, analytical and retrospective study, based on the review of medical records. A non-probabilistic sample was obtained for convenience, calculating the odds ratio (OR), applying the 95% confidence interval and using the chi square test, with a value of p &lt;0.05 as statistically significant. <strong>Results:</strong> For the sample, 93 patients were obtained who fulfilled the study criteria; 50.5% were male, with an average age of 68 years (+21 years), with 74.19% of the total population being older adults. The most frequent locations of UPP were at the sacral level (77%) and heel (12.9%); likewise, the most frequent stages were: II (32.3%), IV (31.2%) and III (26.9%). The presence of severe UPP was associated to: being older (OR: 3.12, 95% CI: 1.2-8.2), hypoalbuminemia (OR: 6.23, 95% CI: 1.8-21.1), anemia (OR: 4.31, 95% CI: 1.2- 14.9) and lymphopenia (OR: 3.68, 95% CI: 1.5-9). <strong>Conclusion:</strong> Elderly patients with hypoalbuminemia, anemia or lymphopenia are at greater risk of developing severe pressure ulcers, which significantly interfere with their quality of life.</div> <p>DOI:<a href=""><strong>10.25176/RFMH.v19.n2.2067</strong></a></p> Jessica Chacón Mejía Alex Del Carpio Alosilla ##submission.copyrightStatement## 2019-04-11 2019-04-11 19 2 9 9 CHILDHOOD OVERWEIGHT AND OBESITY IN THE REGIONAL HOSPITAL OF MOQUEGUA <div style="text-align: justify; text-justify: inter-word;"><strong>Objective:</strong> To establish the prevalence, epidemiology and clinical, biochemical characteristics and images of overweight and obesity in children from 5 to 10 years of age attended in outpatient pediatrics of the Moquegua Regional Hospital between the months of August to December 2017. <strong>Methods:</strong> A descriptive, observational, cross-sectional study was carried out; a database was created in the SPSS version 23 program, descriptive statistics were used to determine if there were significant differences between the variables Chi square was used.<strong> Results:</strong> Of a total of 170 children from 5 to 10 years of age attended in the outpatient clinic of pediatrics of the Moquegua Regional Hospital, 88 children (51.8%) were found with overweight and obesity according to the WHO 2007 Diagnostic criteria; 36 children (21.2%) with overweight and 52 children (30.6%) with obesity. <strong>Conclusion:</strong> The present study shows an increase in the prevalence of overweight and obesity in children from 5 to 10 years old, with epidemiological, clinical, biochemical, ultrasound and radiographic images very important to develop non communicable diseases such as diabetes, hypertension, dyslipidemias, cancer, metabolic syndrome, among others, causing an inadequate quality of life, resulting in a public health problem and therefore an increase in morbidity and mortality in our Moquegua Region.</div> <p>DOI:<a href=""><strong>10.25176/RFMH.v19.n2.2069</strong></a></p> José Medina Valdivia ##submission.copyrightStatement## 2019-04-11 2019-04-11 19 2 11 11 RISK FACTORS ASSOCIATED TO DIABETIC FOOT AT LUIS N. SAENZ PNP HOSPITAL, YEAR 2017 <div style="text-align: justify; text-justify: inter-word;"><strong>Introduction:</strong> Diabetic foot is one of the most serious and frequent complications of diabetes mellitus, for this reason it is important to know the risk factors that trigger it.<strong> Objective:</strong> To determine the risk factors associated with diabetic foot in the PNP Luis N. Sáenz Hospital, 2017. <strong>Methods:</strong> Observational, retrospective, analytical, case and control study of 165 patients (55 cases and 110 controls) treated in the endocrinology service in 2017. Modifiable and non-modifiable risk factors associated with the development of diabetic foot were studied; the information of the clinical histories was collected through a data collection form, which was analyzed by means of the SPSS program version 25.0 using the statistical models of Chi square and the odds ratios with a level of significance less than 0.05% and a range of 95% confidence. <strong>Results:</strong> The risk factors associated with diabetic foot are disease time (p: 0.000, OR: 12.77, CI: 4.12 - 39.60); poorly controlled glycosylated hemoglobin (p: 0.029, OR: 4.55, CI: 1.17 - 17.68); Onychomycosis (p: 0.014, OR: 7.10, CI: 1.48 - 34.07); antecedent of smoking (p: 0.031, OR: 2.66, CI: 1.09 - 6.34) and chronic kidney disease (p: 0.047, OR: 3.023, CI: 1.01 - 9.0). <strong>Conclusion:</strong> We conclude that there is a statistically significant association between time of illness, poorly controlled glycosylated hemoglobin, onychomycosis, chronic kidney disease, history of smoking and developing diabetic foot.</div> <p>DOI:<a href=""><strong>10.25176/RFMH.v19.n2.2070</strong></a></p> Yajaira Arribasplata Espinoza Consuelo Luna Muñoz ##submission.copyrightStatement## 2019-04-11 2019-04-11 19 2 7 7 TIME OF DISEASE AND PREMEDICATION AS A RISK FOR PERFORATED APPENDICITIS IN VENTANILLA HOSPITAL, 2017 <div style="text-align: justify; text-justify: inter-word;"><strong>Objective:</strong> To determine the time of illness and pre-medication as risk factors for perforated appendicitis<br>in the Hospital of Ventanilla during the period of January - September 2017. <strong>Methods:</strong> An analytical study<br>of type and control was carried out. The population consisted of 234 patients with their clinical histories,<br>the group cases constituted by 78 patients with postoperative diagnosis of perforated appendicitis and the<br>control group constituted by 156 patients with postoperative diagnosis with non-perforated appendicitis.<br><strong>Results:</strong> It was found that 61.5% of the patients with a disease time longer than 72 hours had perforated<br>appendicitis (OR = 5.33, 95% CI (2.96, 9.61), p &lt;0.001). 69.2% of patients with an out-of-hospital disease time<br>longer than 24 hours presented perforated appendicitis (OR = 5.72, 95% CI: (3.16 - 10.37), p &lt;0.001). 56.4%<br>of patients with intrahospital disease time greater than 12 hours had perforated appendicitis (OR = 2.24 95%<br>CI (1.29, 3.91) p &lt;0.003). In relation to premedication, 15.4% of patients who took previous medications had<br>perforated appendicitis (OR = 2.97, 95% CI (1.19, 7.39) p = 0.017). <strong>Conclusion:</strong> It is concluded that the time<br>of illness and the premedication that in the majority of the unprescribed are risk factors for the presence of<br>perforated appendicitis.</div> <p>DOI:<a href=""><strong>10.25176/RFMH.v19.n2.2071</strong></a></p> Luis Augusto Cruz Díaz César Colquehuanca Hañari Alejandro Machado Núñez ##submission.copyrightStatement## 2019-04-11 2019-04-11 19 2 5 5 MATERNO-FETAL CLINICAL EPIDEMIOLOGICAL AND INDICATORS OF UTERINE ATONY IN PUERARPAS POST PRIMARY CESÁREA IN A PRIVATE CLINIC OF AUGUST 2017 - AUGUST 2018 <div style="text-align: justify; text-justify: inter-word;"><strong>Objective:</strong> To determine the association between maternal - fetal clinical - epidemiological indicators and the presence of uterine atony in post - caesarean primary puerperae at the Good Hope clinic during the period of August 2017 - August 2018.<strong> Methods:</strong> An observational, analytical, retrospective and quantitative study, type of cases and controls was carried out. The dependent variable was uterine atony, and the independent variables were maternal age, multiple gestation, polyhydramnios, pregnancy, parity, maternal anemia, concomitant diseases, fetal weight, fetal presentation and indication of cesarean section. The population consisted of 106 cases and 212 controls (ratio 2: 1). For the inferential statistics, the bivariate analysis was used to find the Odds Ratio, 95% confidence intervals. The values p &lt;0.05 were considered statistically significant. <strong>Results:</strong> Of the 318 patients in the study, the mean age was 30.87 ± 0.298 years. Associated variables to uterine atony in the bivariate analysis were age over 30 years, multiple gestation, polyhydramnios, low birth weight and macrosomia. In multivariate analysis were polyhydramnios (ORa: 5,973, 95% CI: 2,443-14,603) and macrosomia (ORa: 6.280, 95% CI: 2.307-17.095). <strong>Conclusion:</strong> It is concluded that, association of uterine atony with polyhydramnios indicators and fetal macrosomia was found.</div> <p>DOI:<a href=""><strong>10.25176/RFMH.v19.n2.2072</strong></a></p> María Ponce de León Galarza ##submission.copyrightStatement## 2019-04-11 2019-04-11 19 2 7 7 CHALLENGES FOR THE CONSUMPTION OF FRUITS AND VEGETABLES <div style="text-align: justify; text-justify: inter-word;"><strong>Objective:</strong> Identify the challenges to face in order to improve the low consumption of fruits and vegetables in Colombia. <strong>Methods:</strong> Documentary, descriptive and exploratory research carried out in 2016 and 2017, based on the search, selection and revision of bibliographic references to analyze and reflect on the indicators of consumption and production of fruit and vegetable consumption and to identify the challenges to reach WHO recommendations based on scientific evidence. <strong>Results:</strong> the nutritional contribution of fruits and vegetables and their benefits for human health is reaffirmed, followed by production and consumption indicators as a topic of public health interest; the rules and guidelines of public policy that promote the consumption of healthy eating as a lifestyle are reviewed and the main challenges that sectors such as the food industry, gastronomy, government, public social and sectorial policies in health, education, agriculture, social promotion, communication, as well as the academy; to define effective strategies to increase the consumption indicators of fruits and vegetables and to achieve the goals of a minimum percapita consumption of 5 servings or 400 g per day proposed by the World Health Organization (WHO). <strong>Conclusion:</strong> Several countries, have been providing technical guidelines to encourage the consumption of fruits and vegetables; however, it is advisable to carry out periodic monitoring of the indicators, perform outcome and impact evaluations and research aimed at identifying the causes of low consumption and designing effective strategies appropriate to the context of the populations.</div> <p>DOI:<a href=""><strong>10.25176/RFMH.v19.n2.2077</strong></a></p> Mylene Rodriguez Leyton ##submission.copyrightStatement## 2019-04-11 2019-04-11 19 2 8 8 ADDICTIONOLOGY A MEDICAL SPECIALTY AND SUB-SPECIALTY OF PSYCHIATRY <div style="text-align: justify; text-justify: inter-word;">Addictionology as a component of the health sciences is rapidly becoming recognized as a medical discipline, specifically as a subspecialty of psychiatry. The problem of addictions is a subject that extends and worsens in postmodern society, due to its multidimensionality and multifactoriality. The health conditions of the countries have improved in terms of reducing mortality and the incidence of some communicable diseases. However, there is a greater incidence of chronic noncommunicable diseases related to lifestyles, as well as the emergence of health problems derived from violence, drug consumption, social, recreational addictions and digital addiction (connectivity). Family factors, including rejection by parents and family conflicts, due to substance abuse and mental health problems, are among the strongest and most consistent predictors of adolescent behavior problems. Therefore, in the Holistic Family Centered Model, Nizama proposes integral human development through multidimensional organization as an axis of life that comprises eleven dimensions of human life: body, genetic potential, personality, human essence, cognition, imagination, lifestyles, assets, image, futurity and posterity. In conclusion, addictionology is the medical specialty indicated for the successful and hopeful management of this volitional disease in all age groups, with committed and sustainable family adherence.</div> <p>DOI:<a href=""><strong>10.25176/RFMH.v19.n2.2078</strong></a></p> Martín Nizama Valladolid Fernando Luna Carlos Cachay ##submission.copyrightStatement## 2019-04-11 2019-04-11 19 2 11 11 THE GLOBAL BURDEN OF DIABETES: PREVALENCE, PREVENTION AND RECOMMENDATIONS <div style="text-align: justify; text-justify: inter-word;">The global burden of diabetes, a major cause of death, morbidity, and health care expenditures, now represents one of the greatest threats to global health and development. The main behavioral and biological determinants of diabetes are diets of processed sugars and fats, low physical activity levels, and overweight and obesity (Birn, Pillay, &amp; Holtz, 2017). As one of the four major non-communicable diseases (NCDs), Diabetes Mellitus (DM) has attracted a great deal of attention from global health authorities. In fact, the World Health Organization has developed a strategy to address increasing rates of DM including prevention, management, access to essential medicines, and surveillance. A comprehensive approach integrating health care policy, health promotion, and health education is necessary for the prevention and subsequent treatment of diabetes around the world.</div> <p>DOI:<a href=""><strong>10.25176/RFMH.v19.n2.2079</strong></a></p> Miguel Pérez Jenette Smith ##submission.copyrightStatement## 2019-04-11 2019-04-11 19 2 5 5 FACTORS ASSOCIATED WITH KNOWLEDGE ON THE PREVENTION OF GASTRIC CANCER IN PATIENTS AT A HOSPITAL OF LIMA - PERU, 2017 <div style="text-align: justify; text-justify: inter-word;"><strong>Objective:</strong> To determine the factors associated with knowledge on the prevention of gastric cancer in patients attended at the external office of the Vitarte Hospital in September - November 2017. <strong>Methods:</strong> Cross-sectional, analytical and observational study. The sample consisted of 321 patients who met the selection criteria. The knowledge level test on gastric cancer prevention and the Graffar test was applied. The statistical software IBM SPSS version 23 was used to analyze the data.<strong> Results:</strong> 62% of the surveyed population obtained a medium level of knowledge. In addition, the association of the level of knowledge, work situation, access to the internet and the socioeconomic stratum was statistically significant (p = 0.019, p = 0.018, p = 0.001). <strong>Conclusion:</strong> It is concluded that the level of low and medium knowledge about gastric cancer prevention was significantly associated with having no occupation, not having access to the internet and belonging to a socioeconomic level IV and V.</div> <p>DOI:<a href=""><strong>10.25176/RFMH.v19.n2.2064</strong></a></p> Mariela Berrospi Zavala Sussan Llocclla Delgado Lucy Elena Correa López ##submission.copyrightStatement## 2019-04-11 2019-04-11 19 2 6 6 HEPATIC MUCINOUS CYSTADENOMA <div style="text-align: justify; text-justify: inter-word;">Hepatic cystadenoma is a very rare neoplasm, with less than 250 cases reported in the world literature, which occurs more frequently in women. Due to the difficulty of differentiating the simple cyst and the hydatid cyst with the hepatic cystadenoma; as well as its recurrence and possibility of dysplasia or carcinoma, if it is not treated by complete resection, we present the case of a woman of 56 years old with history of simple hepatic cyst treated on 2 occasions with simple hepatic cyst unroofing and that they relapsed, so it was a hepatic cystadenoma.</div> <p>DOI:<a href=""><strong>10.25176/RFMH.v19.n2.2075</strong></a></p> Héctor Juárez Granda Consuelo Cornejo Carrasco Wilder Ramos Castillo ##submission.copyrightStatement## 2019-04-11 2019-04-11 19 2 5 5 RECOGNITION OF MYOCARDIAL RUPTURE IN EMERGENCY: CASE REPORT <div style="text-align: justify; text-justify: inter-word;">A 86-year old female patient with hypertension was admitted to emergency due to chest pain, dyspnea, hypotension and bradycardia with confusional symptoms. The electrocardiogram and the laboratory are compatible with acute non-Q myocardial infarction, with a left ventricular ejection fraction of 20% in the ultrasound, with pericardial effusion and hyperechoic mass compatible with a clot. The diagnosis was a low cardiac output due to an evolutive non-Q myocardial infarction with myocardial rupture. The patient required endotracheal intubation and mechanical ventilation, evolved with cardiac arrest and was resuscitated without success. The diagnosis and timely management of cardiac rupture is discussed as a mechanical complication of acute myocardial infarction.</div> <p>DOI:<a href=""><strong>10.25176/RFMH.v19.n2.2076</strong></a></p> Jessica Calcino Cuela Fanny Ramírez Calderón Rolando Vásquez Alva ##submission.copyrightStatement## 2019-04-11 2019-04-11 19 2 5 5 PNEUMONIA AND HEART FAILURE, BEYOND A BIDIRECTIONAL SENSE <div style="text-align: justify; text-justify: inter-word;">Community-acquired pneumonia (NAC) continues to be an issue in vogue, being defined as a acute inflammatory disorder of the lung parenchyma in patients who have acquired the infection in the community and have not been hospitalized during the last 3 weeks.</div> <p>DOI:<a href=""><strong>10.25176/RFMH.v19.n2.2073</strong></a></p> Paola Oruro Cari ##submission.copyrightStatement## 2019-04-11 2019-04-11 19 2 3 3 CHOLECYSTECTOMY WITH DIAGNOSIS OF GALLBLADDER CANCER <div style="text-align: justify; text-justify: inter-word;">Gallbladder cancer is one of the most common pathologies of the digestive tract, it is more frequent in women than in men predominantly in the 6th and 7th decade of life; in white populations This is a type of neoplasia that ranks fifth worldwide.</div> <p>DOI:<a href=""><strong>10.25176/RFMH.v19.n2.2074</strong></a></p> Kelly Regina Huacachi Trejo José Luis Castañeda Campos ##submission.copyrightStatement## 2019-04-11 2019-04-11 19 2 4 4