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 It covers current issues, with original and unpublished articles, related to the various specialties of the biomedical and Public Health area.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> en-US <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> (Dr. Jhony A. De La Cruz Vargas PhD, MCR, MD) (Grecia Flores Flores) Fri, 27 Mar 2020 00:00:00 +0000 OJS 60 Protecting health personnel in the Covid-19 pandemic <p>La Epidemia y Pandemia del COVID-19 constituyen una urgencia de salud publica sin precedentes, llego a Latinoamérica, primero a Brasil, luego a Ecuador, los primeros casos en Perú fueron registrado a partir del 06 de marzo de 2020. &nbsp;La respuesta acertada del Gobierno del Perú decretó estado de emergencia nacional y aislamiento social obligatorio, inicialmente por 14 días, con el objetivo de reducir la exposición y trasmisión del Coronavirus. Asignó fondos económicos para 3 millones de familias pobres en el Perú, durante el aislamiento social.&nbsp;</p> <p>Las repercusiones de COVID-19 son enormes, a nivel social, económico, cultural, educativo y por supuesto en el sistema de salud del país y su personal. Universidades cerradas, fronteras cerradas, restaurantes cerrados, comercios cerrados. Las Administradoras de Fondos de Pensiones (AFP) anunciaron verse afectadas rápidamente, trasladando importantes perdidas a los usuarios. Todo esto es impredecible y solo es la punta del iceberg.</p> Jhony A. De La Cruz-Vargas ##submission.copyrightStatement## Sun, 22 Mar 2020 02:33:46 +0000 Adult Lymphoma / Leukemia T: Prevalent entity in South America <p>El Linfoma/Leucemia T del adulto es una entidad linfoproliferativa T agresiva asociado al retrovirus, HTLV-1.</p> <p>La infección por HTLV-1 es endémica en Japón, Caribe, África, Sudamérica y en el Medio Este. En Sudamérica, tenemos a Perú, Brasil, Colombia y Chile.<br>El Perú es endémico para este virus. La prevalencia del retrovirus en Europa y USA es menor del 1% pero en Perú se estima alrededor del 3% de la población adulta sana es portadora del retrovirus.<br>De Chile, existen varios reportes de ATLL desde el año 1992 por la Dra. Cabrera y col.</p> Brady E. Beltran, Jorge Castillo ##submission.copyrightStatement## Wed, 25 Mar 2020 02:03:10 +0000 Risk factors for infertility in women in a Peruvian Hospital <p><strong>Introduction:</strong> Infertility is defined as the failure to achieve pregnancy after 12 months of unprotected sex, according to the World Health Organization (WHO). Between 60 to 80 million couples annually suffer from this problem. In Peru there are no updated reports that allow to know these figures and there are few studies that allow to know the causes of this condition</p> <p><strong>Objective:</strong> To determine the risk factors associated with infertility in female patients treated in outpatient offices in the Gynecology Service of the Vitarte Hospital, period January 2015 to April 2019.</p> <p><strong>Methods:</strong> An observational, analytical, retrospective case-control study was conducted, considering a sample of 82 cases and 82 controls. Clinical, demographic and habits of harmful consumption factors were considered and, to measure the association, the crude and adjusted odds ratios were used, for which the statistical package SPSS was used. <strong>Results:</strong> Based on the adjusted OR, dyspareunia was identified (OR: 4.16, 95% CI 1.56-11.14), dysmenorrhea, (OR: 4.22, 95% CI 1.79-9.93), pelvic inflammatory disease (OR: 5.59, 95% CI 2.11-14.84), and alcohol consumption (OR: 2.87, 95% CI 1.10-7.49), as statistically significant risk factors for the development of infertility.</p> <p><strong>Conclusion:</strong> The factors associated with infertility in the gynecology service of the Vitarte Hospital during the period from January 2015 to April 2019 are dyspareunia, dysmenorrhea, the history of pelvic inflammatory disease and alcohol consumption.</p> <p>&nbsp;</p> <p><strong>Keywords:</strong> Infertility, Pelvic Inflammatory Disease, ectopic pregnancy (Source: DeCS BIREME).</p> Sheyla Briggith Villanueva Ccoyllo, Luis Roldan-Arbieto ##submission.copyrightStatement## Wed, 25 Mar 2020 00:26:18 +0000 Predictor factors for multidrug-resistant tuberculosis among patients with pulmonary tuberculosis in Huánuco, Peru. 2010-2015 <p><strong>Introduction</strong>: In the city of Huánuco and around the world, there is a progressive increase in cases of Tuberculosis and multidrug-resistant Tuberculosis, for this reason it was necessary to identify predictors to develop multidrug-resistant Tuberculosis.</p> <p><strong>Objective</strong>: To determine if persistent fever, cavitary radiographic pattern and positive smear microscopy at the first month of treatment, are predictors of multidrug-resistant Tuberculosis in patients with Pulmonary Tuberculosis, in four health facilities in the city of Huánuco, between January 2010 and December 2015.</p> <p><strong>Methods</strong>: case and control study. We considered 37 cases and 111 controls. Data were collected from medical records.</p> <p><strong>Results</strong>: The predictive factors found in the bivariate analysis were persistence of fever at 2 weeks (p = 0.001, OR 0.05, CI 0.01-0.5), cavitary radiographic pattern (p = 0.000, OR 11.6, 95%IC 4.6-26.5), and smear microscopy positivity at the first month of treatment (p = 0.00, OR 13.5, 95%CI 4.1-44.6). These were confirmed by multivariate analysis (p = 0.012, p = 0.00, p = 0.00 respectively).</p> <p><strong>Conclusions</strong>: The persistence of fever at two weeks, cavitary radiographic pattern and positive smear microscopy at the first month of treatment were predictive factors associated independently for the diagnosis of multidrug-resistant Tuberculosis.</p> Kovy Arteaga-Livias, Anghella Valdivia-Gómez, Noelia Zavala-Lazo, Bernardo Dámaso-Mata, Vicky Panduro-Correa, Edinho Segama-Fabian ##submission.copyrightStatement## Wed, 25 Mar 2020 00:27:33 +0000 Contraceptive Attitudes among Hmong Young Adults in Rural California <p>Introduction: While different contraceptive attitudes have been reported among different ethnic groups in<br>the US, little if any research has been conducted to understand the reproductive health needs and attitudes<br>among Hmong young adults. To our knowledge, this is the first study to investigate the relationship among<br>contraceptive perception of this community. Objective: The purpose of this research was to identify attitudes<br>that influence Hmong college students’ contraceptive practices. Methods: A campus-wide online survey was<br>used as part of the data collection at a midsize institution in Central California. The questionnaire was a 32-items<br>scale instrument called Contraceptive Attitude Scale (CAS), developed by Dr. Black. Results: Three hundred<br>and forty-four students successfully completed the 32-items scale instrument CAS, which measured general<br>contraceptive attitudes among Hmong young adults in rural California. The data reveals a high prevalence of<br>unmarried (85%) Hmong college students reporting being sexually active (67%), with 62% having at least one<br>sexual partner over the past 12 months; however, only 36% reported to use condom compared to 58% who<br>did not use condoms during the last time of sexual intercourse. Conclusion: The findings indicated statistically<br>significant differences between groups on the characteristics of sexual partners, contraceptive methods, marital<br>status, birthplace, primary language spoken at home, years spent in college and years lived in the United States.<br>The findings greatly contribute to the understanding of factors that influence contraceptive choices among the<br>Hmong college population. More importantly, the information is crucial in designing programs to promote<br>contraceptive knowledge and practices that are specific to the Hmong.</p> Chia Thao, Miguel A. Perez, Tou Thao, Kau Vue ##submission.copyrightStatement## Wed, 25 Mar 2020 02:12:40 +0000 Comparative study of biopsies of phrenic nerves of cadavers with and without chronic obstructive pulmonary disease <p><strong>Introduction: </strong>Functional changes resulting from the evolution of chronic obstructive pulmonary disease (COPD) are progressive and irreversible, causing increased diaphragm work due to pulmonary hyperinflation and airway obstruction. Phrenic nerves have promoted innervation of the diaphragm and may have been compromised in COPD condition. <strong>Objective:</strong> To compare the morphology of the phrenic nerves of the cadavers with COPD and without COPD by optical microscopy. <strong>Materials and methods:</strong> An exploratory descriptive studio conducted on the Death Verification Service in Alagoas. Pulmonary and phrenic nerve biopsies will be bilaterally taken from the cadavers after a necropsy with the diagnosis of COPD. Tissue samples were fixed and processed by conventional histology for hematoxylin-eosin (HE) histological slides. Biopsies are divided into experimental groups, one composed by patients with COPD and the other with patients without COPD (control - CTR). This classification was realized after the histological analysis, when typical halls of COPD were found. Histological slides were analyzed by optical microscopy by a pathologist, who was able to assess the study. <strong>Results:</strong> According to the inclusion and exclusion criteria of the study, if it includes 38 cadavers in the initial evaluation, of which 31 are included in the COPD group and 7 in the CTR group. In the analysis of the phrenic nerves, 8 cadavers, 25.8%, of the COPD group had histopathological changes: perineural edema (75%, n=6), nervous atrophy (12.5%, n=1) and perineural eosinophilic infiltrate (12.5%, n=1). The CTR group does not present histopathological alterations of the phrenic nerves. <strong>Conclusions:</strong> Given the hallmarks of the biopsies performed on the phrenic nerves of the corpses with COPD, we can infer that there is a tendency for nerve alteration, with perineural edema, to be the major modification found.</p> Tales Lyra de Oliveira, Fernanda Mayara Santos-Santana, Byron Martins-Lucena, Tácio Nertan Cartaxo de Souza, Lysien Ivania-Zambrano, Ana Rose de Carvalho-Araujo, Ana Lúcia de Gusmão-Freire ##submission.copyrightStatement## Wed, 25 Mar 2020 00:28:45 +0000 Saturation and overcrowding of the emergency service of an urban hospital <p>Over-demand and overcrowding is a problem in the emergency department of our environment.</p> <p>Objective: to determine the characteristics of the demand for medical care at the emergency department of a tertiary social security hospital.</p> <p>Methodology: observational study at Rebagliati hospital, first quarter 2019. Sociodemographic, time and emergency indicators of the institutional statistical system, descriptive statistical statistics with IBM SPSS 24.00 were evaluated.</p> <p>Results: 51294 patient care between 14 and 102 years (median 60), 56.7% female sex, 18% recorded more than one visit in the quarter. Monday was the day of greatest demand and the schedule between 8 and 13 hours. Priority attention 3 and 4 corresponded to 60.8 and 20.8% of the total. The topics of medicine, relief and surgery performed 41, 22 and 20% of attentions respectively. In the shock trauma unit, 3% of attentions were performed. 13% attention was admitted to observation rooms. The most frequent diagnoses were respiratory failure, infections and strokes. 88% of admissions were made in common rooms with a stay between 4.4 and 7.0 days. 0.8% of those treated died, 0.7% performed surgery and 0.1% transferred to another hospital.</p> <p>Conclusion: the demand to the emergency department is mainly due to medical problems (priority 3 and 4), predominantly elderly and female patients. 13% of attention were admitted, with long stay, low mortality, very few transfers, high return rate and low supply of hospital beds.</p> Waldo Taype-Huamaní, Lino Castro-Coronado, Delcio Miranda-Soler, Jose Amado ##submission.copyrightStatement## Wed, 25 Mar 2020 00:32:10 +0000 Risk Perception of Skin Cancer at a High-Altitude Hospital <p>Objective: To determine the level of risk perception of skin cancer in a population from Cusco.</p> <p>Materials and methods: It is an observational descriptive cross-sectional study and was aplied in a skin cancer screening campaign in Cusco. The applied questionnaire was designed and validated by Morales-Sánchez M and Cols, and it measures the risk perception of skin cancer. The reported Cronbach's alpha value is 0.824.</p> <p>Results: The majority of patients were female (64.7%), average age was 44.9 years (SD: 14.2) and the 51.0% had higher education level. The median hours of sun exposure was 4 (95% CI: 1-6), the most frequent origin was from Cusco (77.6%) and most of the population have normal risk perception of skin cancer (65.8%).</p> <p>Conclusion: The risk perception of skin cancer was normal in the majority of the population.</p> <p>Keywords: Skin Neoplasms, Perception, Health Behavior, Attitude</p> Nuria Leticia Huanca Huirse, Joel Sack Roque Roque, Verónica Nélida Lurel Vargas, Alan Wenceslao Quispe Sancho ##submission.copyrightStatement## Wed, 25 Mar 2020 00:33:07 +0000 Tobacco: A problem that affects young universities at the national and international levels <p><strong>Introduction: </strong>The consumption of tobacco is very harmful to people’s health. According to WHO, smoking is the cause of death of 8 million people a year. <strong>Objetive: </strong>The purpose of the research was to determine the factors associated with the consumption of tobacco in university students in Metropolitan Lima.<strong> Methods: </strong>The sample consisted of 447 students from Lima universities, the survey was applied: Fagerstrom test. Subsequently the data was analyzed using tables of: distribution, frequency, contingency. <strong>&nbsp;Results: </strong>It was evidenced through the X<sup>2</sup> statistical test that there is a significant association between the variables sex and smoking habit, OR = 1.93, IC 95%[1.29-6,519]. It was also observed that having smoking parents is significantly associated with the habit of smoking by the children, with a value p =0,000 of X<sup>2</sup> and the OR 3.31, IC 95%[2,145 - 5,116].<strong> Conclusion: </strong>The variables sex and parental background have a significant association with tobacco consumption, emphasizing that our family environment deserves to be safe, healthy and free of tobacco smoke</p> Lucy E. Correa-López, Andrea M. Morales Romero, Jesús E. Olivera Ruiz, Carmen L. Segura Márquez, Lucy Cedillo Ramirez ##submission.copyrightStatement## Wed, 25 Mar 2020 00:34:33 +0000 Prevalence and factors associated with depressive symptomatology in older adults of the “Micaela Bastidas” health center, Lima-Peru <p><strong>Objective</strong>: To evaluate the factors associated with depression in older adults in a marginal urban area of ​​Peru. <strong>Material and methods</strong>: &nbsp;It is a cross-sectional analytical study in adults over 60 years of age in a marginal urban area of ​​Lima. The dependent variable was evaluated using the geriatric depression scale of 15 items, the presence of depression with a score ≥ 6 was considered. The factors associated with depression were calculated using raw and adjusted prevalence ratios with 95% confidence intervals (95% CI) using poisson regressions with robust variance. <strong>Results</strong>: Of the 142 older adults with an average age and standard deviation was 70.4 ± 8.14.&nbsp;The prevalence of the presence of depression was 55.6% (women 39.6% and men 53.4%). The lack of schooling (RPa: 1.40, 95% CI: 1.04 - 1.88) and not working (RPa: 1.50, 95% CI: 1.09 - 2.05) were risk factors that increased the presence of depression. <strong>Conclusion</strong>: The prevalence of depression in older adults in a marginal urban area of ​​Peru was high. Older adults who did not complete their schooling and did not work were more likely to develop depression.</p> Christian Ponce, Luigui Viteri-Condori, Pablo Ramos-Martínez, Wendy Nieto-Gutiérrez, Jesus Cueva-Velazco ##submission.copyrightStatement## Wed, 25 Mar 2020 00:36:51 +0000 University characteristics associated with the award of places for midwives in the peruvian rural service <p><strong>Objective:</strong> To determine the university characteristics associated with the allocation of place for obstetricians in the Rural and Urban Marginal Service in Health (SERUMS), 2019. <strong>Material and Methods:</strong>&nbsp; secondary base analysis obtained from the Peruvian Ministry of Health, where 506 obstetrics licenses were selected who submitted the National Obstetrics Exam (ENAOBS) and who&nbsp;have applied to SERUMS in the 2019-2 call. The characteristics of the&nbsp;universities where the obstetricians come from, the score obtained in the&nbsp;national and university exam and if it is suitable for SERUMS were evaluated.&nbsp;For the bivariate analysis it will be used in the Students&nbsp; T, ANOVA and&nbsp;Pearsons Correlation tests, while to adjust the model a logistic regression was&nbsp;performed, a 95% confidence level. <strong>Results:</strong> The obstetrics&nbsp; graduate visited&nbsp;mostly from a private university (66.01%), from the Lima region (41.7%) and&nbsp;applied for the paid modality (99.41%). It was found that 49.61% [95%CI: 45.23-53.98] were suitable for SERUMS. The average university qualification was 13.87 ± 1.35 and that of the ENAOBS was 10.93 ± 2.02, which had a&nbsp;significant correlation (p&lt;0.001) that had a greater slope in graduates of public&nbsp;university (R=0.56). Belonging to a public university (OR=2.62) and studying&nbsp;in Lima (OR=1.49) were significantly associated (p&lt;0.01) to be able to&nbsp;perform SERUMS in obstetrics. Conclusions: Being a graduate in obstetrics&nbsp;from a public university and studying in Lima gives you a better chance of being&nbsp;able to award a place in the SERUMS.</p> Elizabeth Llanos-Najarro, Dulce Villafuerte-Cooban, Victor Hugo Moquillaza-Alcántara ##submission.copyrightStatement## Wed, 25 Mar 2020 00:37:30 +0000 Patient complaints in the adult emergency department of a tertiary referral hospital <p>Introduction: The critical condition of the patient who presents to an emergency department creates a need to provide timely, safe and warm care. Failing to meet these expectations causes patient dissatisfaction, reflected by complaints, which are mostly justified and lead to opportunities for improvement and corrective measures. Objective: To analyze complaints presented by patients and their relatives at the Adult Emergency Department of the Edgardo Rebagliati Martins National Hospital. Methods: Nonexperimental, descriptive, cross-sectional study. Our sample was comprised of 109 complaints between May and November 2019. We used a data collection sheet based on the information in the complaints book for health care services. Results: We identified 187 reasons for complaints. Our results show that direct relatives filed 47.7%; 43% involved Internal Medicine consultations. In the dimension “inadequate treatment by healthcare workers,” 13.9% of patients complained about impolite and rude treatment. In the dimension “delay in care”, 12.8% were discontent due to the lack of timely care. In the dimension “user disagreement with care or treatment received,” 10.2% were dissatisfied with the care they were provided. 60.6% of complaints were satisfactorily resolved within the period specified by current regulations. Conclusion: Most complaints were related to the direct care of the patient.</p> Isabel J. Alamo-Palomino, Juan P. Matzumura-Kasano, Hugo F. Gutiérrez-Crespo ##submission.copyrightStatement## Wed, 25 Mar 2020 02:24:33 +0000 Factors associated with the performance of self-care activities in diabetic patients in three Ucayali hospitals <p><strong>OBJECTIVES:</strong> To determine the levels and assessment of self-care in diabetic patients in three hospitals in Ucayali during 2017. <strong>MATERIALS AND METHODS:</strong> Analytical cross-sectional study, conducted in three hospitals in Ucayali during 2017 with a sample size of 572 participants through a stratified random sampling. A self-administered survey was applied that evaluated the general characteristics, the Diabetes Knowledge Questionnaire 24 (DQK-24), the patient's attitude by the Diabetes Attitude Scale (DAS-3) and Summary of Diabetes Self Care Activities Measure (SDSCA) which mediates self-care practices. <strong>RESULTS:</strong> From 572 patients, 50.8% being women, with the median age of 47 years (RIQ: 35-56). Hypertension (22.4%) was the most frequent comorbidity. Also, having an adequate knowledge about their disease (RPa: 2.47; 95% CI: 13.5-4.50), strict control (RPa: 1.34; 95% CI: 1.09-1.65) predispose adherence in their diet. The need for some special training (RPa: 1.23; 95% CI: 1.03-1.47), the perception of the severity in their illness (RPa: 1.25; 95% CI: 1.02-1.55) and have autonomy (RPa: 1.35; 95% CI : 1.12-1.64) predisposed to taste your blood sugar. <strong>CONCLUSIONS:</strong> More than half of the patients performed inadequate self-care activities, knowledge about their disease and strict control influence the patient's diet, as well as special training, perceive the severity of their disease and be autonomous drives the realization of taste blood sugar.</p> Jennifer Vilchez-Cornejo, Luccio Romani, Silvia Reategui, Elice Gomez-Rojas, Claudia Silva ##submission.copyrightStatement## Wed, 25 Mar 2020 00:38:33 +0000 Knowledge and habits of solar exposure in street traders of a market in Chiclayo, Peru <p><strong>Background:</strong> people who work outdoors are exposed to long periods of ultraviolet radiation; such is the case of street vendors. Objectives: determine the knowledge and habits of solar exposition in itinerant traders around a Chiclayo market. Materials and methods: A questionnaire were applied to 291 itinerant merchants located around the Mercado Modelo of Chiclayo, who evaluated sun exposure habits, photo protection measures, a history of sunburn and skin cancer, as well as knowledge of ultraviolet radiation and sources of information. <strong>Results:</strong> the following results were found: the age ranges were 18-25 (42.3%), 36-54 (38.1%), 55 -78 (19.6%). At the level of education, 13.1% have completed primary school, 32.6% have full secondary and 8.2% complete. At the time of the study, 71.9% had been working as street traders for more than 3 years. The phototype of the participants were phototype I (0.3%), phototype II (4.5%), phototype III (24.7%), phototype IV (48.8%), phototype V (19.6%), phototype VI (2.15). A 90 ± 3.5 %% recognizes that causes skin cancer, 53.6% recognizes that a feature of skin aging by radiation are spots and warts, 56% responded that solar radiation causes cataracts, a 52,92 % replied that white-skinned people are more sensitive to the sun's rays. 59.5% of traders indicated that they go to work from Monday to Sunday, 39.4% work 5-6 days a week, and 4.1% work 4 or less days a week. A 48.5% of them declared to expose themselves more than 6 hours to the solar rays, 24.7% are exposed of 3 - 6 hours a day, while 8.6% registered the shortest time of solar exposure (0 - 2 hours). 75.3% did not use sunscreen, 24.7% of merchants used sunscreen at the time of being surveyed as a measure of photo protection; of them, 63.9% said that a family member recommended their use, 94.4% use it 1-2 times a day, 38.9% only apply it when they go to work, 52.8% use it on their face , neck, ears and hands, and half of them (50.0%) get it from a catalog. <strong>Conclusions:</strong> the knowledge and habits of solar exposition in itinerant traders were equal or inferior to that described in other studies. It was found that the knowledge is from regular to adequate and poor habits.</p> Sherly Raquel Sempértegui-Ruiz, Carol Jennifer del Milagro Nuñez-Campos, Maxi Andrea Bustios-Ahumada, Andrés Eduardo Arenas-Piscoya, Cynthia Lizeth Estela-Moreto, Winston Maldonado-Gómez, Sebastian Iglesias-Osores, Alain Monsalve-Mera ##submission.copyrightStatement## Wed, 25 Mar 2020 00:39:21 +0000 Gastroesophageal reflux disease as a factor associated with bronchial asthma in the pediatric population <p>Objective: To determine the relationship between gastroesophageal reflux disease and bronchial asthma in the pediatric population of the National Children's Hospital Breña headquarters between the years 2017-2018. Methods: An analytical observational study of cases and controls was not matched, with a ratio of 1 case to 2 controls, with a total of 45 cases and 90 controls, a simple random probability sampling was performed, with a retrospective collection for the variables bronchial asthma, GERD, GERDinduced esophagitis, prematurity, interrupted breastfeeding, sex and age. A bivariate and multiple logistic regression model was performed to obtain the Odds Ratio for the strength of association. Results: A statistically significant difference was found for GERD (p = 0.002), being 33.33% and 11.11% for cases and controls, as well as for interrupted lactation (p = 0.013); by multiple logistic regression analysis the variables GERD (OR 4.27, p = 0.003, CI 1.64-10.92) and interrupted breastfeeding (OR 2.74, P = 0.011, CI 1.26-5.97 ) presented a relationship for bronchial asthma. Conclusion: A relationship was found between GERD and bronchial asthma which can be extrapolated to the pediatric population of the city of Lima, this is the first article published in this regard at the national level, prospective studies are recommended to determine causality.</p> Rafael Ricra, Juan Carlos Roque, Joseph Alburqueque-Melgarejo, Pedro Ricra, Claudia Saldaña ##submission.copyrightStatement## Wed, 25 Mar 2020 02:39:53 +0000 Exclusive Breastfeeding and associated factors in mothers who attend Health Establishments of Lima, Peru <p><strong>Objetivos</strong>: Determinar factores asociados a la práctica de la lactancia materna exclusiva, en tres espacios de tiempo: antes, durante y después del parto en madres que acuden a tres establecimientos de salud&nbsp; que pertenecen a la Dirección de Salud de Lima Centro. <strong>Métodos: </strong>Estudio descriptivo, transversal correlacional realizado en una muestra de 140 mujeres madres de niños entre 6 y 12 meses. El instrumento fue una cuestionario validado por juez experto y prueba piloto; los factores se clasificaron de acuerdo al momento en que ocurren: durante la gestación (antes del parto), en el proceso del parto y en el puerperio (periodo después del parto), la técnica fue la entrevista personal. <strong>Resultados: </strong>El&nbsp; análisis estadístico de los datos muestra que en la primera fase (antes del parto) de todos los factores que se consideraron durante a entrevista, el número de controles prenatales a las que la madre asistió tuvo asociación estadísticamente significativa (p:0,0120) entre los factores que se estudiaron para el periodo durante el parto, &nbsp;se encontró asociación significativa para el parto vaginal (p:0,0476); en la última fase posparto se observó &nbsp;asociación negativa con el uso de fórmulas lácteas en el periodo pos parto (p:0,0001). <strong>Conclusiones. </strong>La asistencia a un número mínimo de&nbsp; controles prenatales durante la gestación y el parto&nbsp; por vía vaginal favorecen la práctica&nbsp; de la lactancia materna por lo cual hay que promover estos dos factores, al mismo tiempo evitar el uso innecesario de fórmulas lácteas.</p> <p>&nbsp;</p> Carmen Villarreal Verde, Maritza Dorila Placencia Medina, Violeta Alicia Nolberto Sifuentes ##submission.copyrightStatement## Thu, 26 Mar 2020 21:50:18 +0000 Leukemia / Lymphoma T of the adult HTLV1, a challenge for the clinic <p>Adult T-cell leukemia/lymphoma (ATL) is an aggressive disease of mature activated T cell caused by human T-cell lymphotropic virus type 1 (HTLV-1). ATL carries a bad prognosis due to intrinsic chemoresistance and severe immunosuppression. The aggressive ATL forms, acute and lymphoma, are treated with chemotherapy associated with antiretroviral agents (AZT/IFN) the acute form. However, they have failed to achieve an impact on survival, that ranges from 8-10 months, respectively. Patients with chronic and smoldering ATL forms, have a better prognosis, but long term survival is poor as well, when these patients are managed with a watchfulwaiting policy or with chemotherapy. Apparently, AZT/IFN seams to benefit these patients. Meanwhile, prevention of dissemination of HTLV-1, is a must in public health policies, performing screening in blood banks and a screening to pregnant women to reduce/avoid vertical transmission of the virus.</p> María Elena Cabrera, Camila Peña ##submission.copyrightStatement## Wed, 25 Mar 2020 02:45:25 +0000 Human space medicine: Physiological performance and countermeasures to improve the astronaut's health <p>This Review Article is presented based on current scientific evidence on space medicine focused on human physiology and its countermeasures. Therefore, a non-systematic bibliographic search of scientific articles and research books in English-Spanish of the last 7 years was carried out, detailing their application in humans, murine models and in vitro experiments. The conditions of the space environment such as microgravity and radiation that produce considerable physiological changes in the cardiovascular system (redistribution of fluids, cardiovascular remodeling, arrhythmias) were taken into account; nervous (sensorimotor, neurosensory, neurovestibular); respiratory (volume and capacity changes); renal (lithiasis); musculoskeletal (muscular atrophy, osteoporosis); hematological (anemia); immunological (immune dysregulation) and digestive (intestinal microbiota disorder). In addition, there are biological, molecular and genetic processes still to be explored, in order to know and mitigate the uncertain mechanisms triggered in extreme and dangerous environments. Therefore, it is a priority to develop and implement countermeasures to reduce the harmful effects on health, with the aim of guaranteeing the astronaut's adaptation, safety and performance during future space flights.</p> Milton V. Rivera, José Cornejo, Karen Huallpayunca, Aurora B. Diaz, Zhamanda N. Ortiz-Benique, Andrés D. Reina, Gustavo Jamanca Lino, Victor Ticllacuri ##submission.copyrightStatement## Wed, 25 Mar 2020 02:50:09 +0000 Fox - Fordyce Disease, a Case Report <p>Fox-Fordyce disease is a non-infectious, infrequent inflammatory dermatosis of apocrine glands, isolated by a pruritic papular rash that usually begins frequently at puberty, and which may involve vulva, armpit and perianal region. It affects women more frequently, approximately in a 9 to 1 ratio, compared to men. In the presentation of the case of a female patient, 53 years old, in consultation of Gynecology-Obstetrics, of the General Maria Auxiliadora Hospital, for presenting for 5 months, papular eruption in vulvar area, associated with intermittent pruritus. A biopsy of the lesion was requested, and it was sent to the Pathological Anatomy Service, receiving a fragment of dark brown tissue, 0.3 x 0.2 x 0.1cm, which was automatically processed, obtaining a histological sheet, in which evidence dilated apocrine glands, which show a thick secretion made up of mucin, in its light. The patient met the histopathological criteria for the diagnosis of Fox - Fordyce disease. Consider the case presentation because of the infrequent nature of this disease</p> Katherine Luisa Contreras Gala ##submission.copyrightStatement## Wed, 25 Mar 2020 00:45:40 +0000 Case report: Exposed midfoot fracture due to traffic accident in HIV/AIDS patient <p>Currently there is a high incidence of traffic accidents in the world, many of them cause severe disability in people. These limb injuries cause high morbidity even reaching an amputation. This is aggravated in HIV/AIDS patients, especially in treatment and evolution. A clinical case of a patient with severe midfoot injury that ends in amputation is presented and a surgical management review of the trauma patient with HIV/AIDS is made.</p> Freddy J. Fernández-Villacorta, Luis Sebastián-Castillo, Shakira Serrano- Díaz, Jorge Tandaypan-Agreda, Cristhian Solórzano-Rojas, Jorge Tantachuco- Ruiz, Patrick Tolentino-Gonzalez, Tony Chávez-Uceda, Esmeralda Torres-Soto ##submission.copyrightStatement## Tue, 31 Mar 2020 20:50:51 +0000 Ulnar nerve injury after radial extracorporeal shock wave therapy identified with high–resolution ultrasonography: Case Report. <p>A 49-year old woman was evaluated for developing bilateral acute medial elbow pain, numbness, and tingling sensation in the fourth and fifth fingers after receiving radial extracorporeal shock wave therapy (rESWT) for bilateral medial epicondylitis. Neurologic examination revealed the presence of Tinel’s sign, paresthesia and impaired two-point discrimination testing over the ulnar side of the fourth and fifth fingers bilaterally. High-resolution ultrasonography demonstrated findings of nerve injury, such as hypoechogenicity and increased diameter of both ulnar nerves.&nbsp; After conservative treatment, the patient improved her condition demonstrating an apparently acute compressive nerve injury as a result of the therapy. ESWT is used as a promising alternative for the treatment of various musculoskeletal disorders; however, there is limited evidence regarding its side effects, in particular peripheral mononeuropathy. To the authors’ knowledge, this is the first report demonstrating structural damage of a nerve after rESWT with the use of high-resolution ultrasonography.</p> Paul German Terán, Diana Maritza Martínez, Tania Marcela Platero, Sebastián Guillermo Ramos, Sussan Llocclla ##submission.copyrightStatement## Wed, 25 Mar 2020 00:48:15 +0000 COVID 19: Without distinction of race, sex or socioeconomic position; No one is safe. <p>I have read with great pleasure and gratitude the article Protecting Health Personnel in the COVID- 19 Pandemic By Jhony De La Cruz, publish March, 21, 2020 in this prestigious journal.</p> <p>In response to this very informative article on the COVID-19 pandemic, I would like to express my sadness and share my experience of what we are living first hand here in the epicenter of the United States, New York city but first let me begin by giving you an idea of the timeline that has taken place to get us where we are today. As we all know, there was a whistleblower doctor in Wuhan, China, his name was Li Wenliang, he was an ophthalmologist. On December 31 st 2019,&nbsp; China confirmed the existence of the new virus initially called 2019-nCoV now referred to as SARS-CoV2, but Dr. Li Wenliang said he had observed many of his colleagues get very ill, fall sick, and observed 4 die from the virus in the 2 months prior to that.</p> D. Tello-Majluf ##submission.copyrightStatement## Tue, 31 Mar 2020 20:39:34 +0000 Anemia in future medical generations <pre id="tw-target-text" class="tw-data-text tw-text-large tw-ta" dir="ltr" data-placeholder="Traducción"><span lang="en" tabindex="0">Anemia has become a silent companion throughout academic life in medical students, which is the reason for the following document comments and verifies the prevalence in which it is found and the negative effects it would be causing.</span></pre> Leyla Elena Rodas ##submission.copyrightStatement## Wed, 25 Mar 2020 00:49:04 +0000 Fetal programmig, intrauterine toxic stress and consequences on the product <p>Dos décadas atrás Baker dio el concepto de Programación Fetal (PF), donde asociaba el ambiente prenatal y el desarrollo del feto. En consecuencia, la PF representaría “la inducción de las respuestas fetales debido al entorno uterino” que condicionará cambios funcionales y estructurales en el propio feto, con repercusión a corto y largo plazo. En consecuencia, si el ambiente prenatal es adverso en el desarrollo, tendremos posiblemente patologías en la vida extra uterina.</p> <p>Las evidencias señalan, que procesos implicados en el desarrollo de diversas funciones de los sistemas orgánicos complejos, se iniciarían mucho antes del nacimiento y conformarían problemáticas de salud a futuro.</p> Carmen Miluska Silva López, Iván Hernández P. ##submission.copyrightStatement## Wed, 25 Mar 2020 02:54:56 +0000 Are infections induced by NSAI? <p>Los antiinflamatorios no esteroideos (AINE) constituye una familia farmacológica que comparten efectos antipiréticos, analgésicos y lógicamente anti inflamatorios a través de su capacidad para inhibir la producción de prostaglandina. El término no esteroideo refiere a sus efectos similares a los corticoides, pero sin las consecuencias secundarias que son característicos de los esteroides. Los fármacos que están incluidos son variados, siendo los más tradicionales el Ibuprofeno, AAS, ketoprofeno, ketorolaco, Naproxeno, entre otros</p> Miguel Ángel Poma, Julio Gutarra-Mendez ##submission.copyrightStatement## Wed, 25 Mar 2020 00:50:11 +0000 Early detection: Pap testing is always the best option? <p>This paper presents the detection ways for cervical cancer but mainly, the rol that plays the Liquid-Based Citology test in the early detection and also some aspects related to this.&nbsp;</p> Franshesca Leonor Sedano Chiroque ##submission.copyrightStatement## Wed, 25 Mar 2020 00:51:35 +0000 Research and mental health in the medical profession <p><span class="tlid-translation translation" lang="en"><span class="" title="">Research allows to acquire certain behaviors or aptitudes such as social skills, resilience, perseverance, etc.</span> <span class="" title="">Furthermore, it reduces the risk of dissatisfaction with professional and / or academic achievements in medical students.</span> <span class="" title="">For these reasons, research can have a positive impact on the mental health of those who practice it.</span> <span class="" title="">It is proposed that research is a relevant variable to be evaluated as a protective factor for the appearance of some mental health problems in Peruvian doctors and medical students.</span></span></p> Cristhian Alexander Rojas Miliano ##submission.copyrightStatement## Wed, 25 Mar 2020 01:20:28 +0000