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 It covers current issues, with original and unpublished articles, related to the various specialties of the biomedical and Public Health area.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 López Trujillo) Mon, 15 Mar 2021 00:00:00 +0000 OJS 60 Phase III clinical trials: No ethics no paradigm <p>The phase III clinical trial is the paradigm of experimental health research and is the boundary between standard medicine and research medicine, so much so that two or more positive clinical trials support evidence-based medicine in routine clinical practice. The therapeutic, diagnostic and preventive advances of modern medicine rest to a large extent on the proper, ethical development and with the necessary scientific rigor established at the international and national levels.</p> Jhony A. De La Cruz-Vargas ##submission.copyrightStatement## Wed, 10 Mar 2021 00:00:00 +0000 Have we learned anything from the 10th most devastating pandemics over the past 3000 years? <p>When I received the invitation to write an editorial about the Romanian perspective on the SARS CoV 2 pandemics, I instantly knew that George Santayana’s quote: “Those who forget the past are condemned to repeat it” would be most apt to describe the Pan-European approach against this global epidemiological crisis.</p> Cristian Dragos Stefanescu ##submission.copyrightStatement## Tue, 09 Mar 2021 14:59:52 +0000 Ethics of human research in Peru. Yet another pending task. <p>We are currently cruising through a second wave of cases during the pandemics of COVID-19 in Peru. Anonymous heroes leave their houses every day and keep offering their work to support their families and communities. After almost a year of the beginning of this Public Health Crisis, much more is being demanded from health and allied professionals. Important efforts leading to improvements on infrastructure and technical guidance for medical innovations have been forced to move forward and be implemented in unprecedented timelines, but their visibility is hindered by another pending task in the Peruvian Health System related to the Ethics of Human Research.</p> Fanny L. Casado ##submission.copyrightStatement## Fri, 05 Mar 2021 04:42:25 +0000 Variants in COVID: Research Opportunity. <p><em><strong>In times of social distancing we need to be more united than ever.</strong></em><br>We are currently living an unprecedented reality, which will inevitably lead us to change our way of behaving as social beings, that is, to change our way of living.</p> Félix Llanos-Tejada, Renzo Villanueva-Villegas ##submission.copyrightStatement## Fri, 05 Mar 2021 04:33:36 +0000 Characterization of the V4 and T1 polymorphism of the ADAM33 gene and its association with the development of asthma <p><strong>Objective</strong>: To determine the association between the presence of V4 polymorphisms of the ADAM33 gene and asthma disease and to describe the frequency of T1 polymorphism in patients from a hospital in the Lambayeque region. <strong>Materials and methods:</strong> Design of cases and controls. Location: Hospital Almanzor Aguinaga Asenjo - EsSalud, level of complexity III-1. Population: patients between 5-17 years old attended by an outpatient clinic. The cases were patients diagnosed according to the Global Initiative for Asthma (GINA) 2016 guidelines. Controls were patients without a diagnosis of any chronic lung disease or a family history of asthma. <strong>Results:</strong> In most cases, both cases and controls did not present the V4 polymorphism, I feel positive only in 46% of cases and 31% of controls. When the association between the V4 polymorphism and the presence of asthma was evaluated, the OR was 1.93 (95% CI: 0.62 - 6.00), with a non-significant value (p = 0.196) for the Xi test --Pearson square. However, the T1 polymorphism was present in 87% of cases; and the proportion of Tumbesinos with the mutation was much lower than that of other regions. <strong>Conclusions:</strong> No association was found between the V4 polymorphism and the presence of asthma in patients from a Lambayeque hospital. The T1 polymorphism occurs quite frequently in asthmatic patients at Hospital Almanzor Aguinaga Asenjo - ESSalud.</p> Clarisa Carolina Arrascue Vega, Rossana Menendez Nuñez, Walter Gutierrez Celestino-Segura, Luis Miguel Serquén López, Alain Eduard Monsalve Mera ##submission.copyrightStatement## Mon, 08 Feb 2021 22:44:26 +0000 Platelet / spleen ratio for the diagnosis of esophageal varices and the risk of bleeding in patients with liver failure <p><strong>Introduction:</strong>&nbsp;Upper gastrointestinal bleeding of variceal origin has a high mortality. The platelet count/spleen major diameter ratio may be a useful noninvasive parameter to predict esophageal variceal bleeding in cirrhotic patients.&nbsp;<strong>Objective:</strong> to determine the sensitivity and specificity of the platelet count/spleen diameter ratio for the diagnosis of esophageal varices with risk of bleeding in patients with hepatic insufficiency.&nbsp;<strong>Material and Methods:</strong> Process study, performed in a Second Level Medical Facility, in patients with liver failure who underwent ultrasound, blood cytometry, liver function tests and endoscopy. Sensitivity and specificity of the platelet/spleen ratio were assessed in patients with esophageal variceal and bleeding risk.&nbsp;<strong>Results:</strong> There were 70 patients: 28 women, 42 men; main cause of liver failure in men was ethylism in 31 patients and hepatitis C virus in 20 women.&nbsp;The spleen-platelet ratio has a sensitivity of 90%, specificity 83%, false positives 16%, false negatives 9%, positive predictive value 94%, negative predictive value 75%, prevalence of 74% and diagnostic accuracy of 88% to diagnose esophageal varices with risk of bleeding.&nbsp;<strong>Conclusion:</strong> Platelet/spleen ratio is a useful, non-invasive study to diagnose esophageal varices with bleeding risk, in hospitals where endoscopy is not available.</p> Álvaro José Montiel Jarquín, Arturo Garcia Galicia, Andrés Gámez Herrera, Emma Ixchel González Bravo, Ricardo Adolfo Parker Bosquez, José Alfredo Leon Zamudio, José Álvaro Parra Salazar, María del Socorro Romero Figueroa ##submission.copyrightStatement## Wed, 17 Feb 2021 17:21:43 +0000 Employees’ perception of management skills in the Los Olivos Municipal Hospital <p><strong>Objective: </strong>Analyze management skills from employees’ perception in the Los Olivos Municipal Hospital in 2019.&nbsp;<strong>Methods: </strong>Quantitative, correlational, cross-sectional study. A simple random sample of 52 participants was applied. We used a questionnaire to assess perceptions regarding management skills, consisting of 27 questions and 4 dimensions, with a Cronbach’s alpha reliability value of 0.97. We used Pearson’s chi-squared test to analyze correlation between management skills variable and sociodemographic variables.&nbsp;<strong>Results:</strong> Management skills were considered adequate in analytic and interpersonal dimensions by 69% of participants, while emotional and motivational skills and values were considered regular by 69% and 58%, respectively. 55.8% of participants perceived their bosses’ management skills as adequate, 44.2% perceived them as regular, and none as inadequate. The only sociodemographic variable that was associated with management skills was service time.&nbsp;<strong>Conclusion:</strong> 55.8% of the health personnel in the Los Olivos Municipal Hospital perceived management skills as adequate.</p> Irma Emperatriz Arrascue Lino, Luis Enrique Podestá Gavilano, Juan Pedro Matzumura Kazano, Hugo Florencio Gutiérrez Crespo, Raúl Alberto Ruiz Arias ##submission.copyrightStatement## Tue, 23 Feb 2021 19:36:55 +0000 Application of Panoramic T2 Sequence for Magnetic Resonance Imaging of Lumbosacral spine <p><strong>Introduction:</strong> The evaluation of the total spine by magnetic resonance imaging in a T2-weighted single sequence using Software Composing previous planning, called panoramic, would be beneficial in the study of lumbosacral spine for the additional information that could be obtained. <strong>Objective:</strong> To analyze the application of T2 panoramic sequence for magnetic resonance imaging of the lumbosacral segment. <strong>Methods:</strong> Retrospective and cross-sectional study executed with 186 cases selected by stratified probability sampling, between 18 and 60 years old, using a form consisted of a general sheet and an analytical sheet obtained from the request for radiological study and the examination itself. <strong>Results:</strong> Of the total, 80.1% were in the adult stage of life, and 53.8% were female, and 52.7% had the suspicion of herniated disc as a specific diagnostic presumption. Degenerative pathologies were mainly presented, with 93%, having herniated discs as the most frequent with 57%, which included extruded, protruded and migrated hernias with 40.6%, 37.9% and 21.5 % respectively. Likewise, it was verified with hypothesis test that this acquisition allows to localize 50% more findings in contrast to the usual examination, defining that this sequence should be applied because it localizes findings in a greater number in comparison to the lumbosacral selective examination. <strong>Conclusions:</strong> In general, it was defined that the application of this panoramic T2 sequence is more usefulness for a better evaluation, because it achieves greater findings, resulting as main pathologies in lumbosacral, cervical and dorsal segments those of a degenerative type, standing out the herniated discs.</p> Alexander Humberto Román Meza, Raúl Ruiz Arias ##submission.copyrightStatement## Mon, 08 Feb 2021 22:48:29 +0000 Perception of knowledge and attitudes towards COVID-19 in a group of citizens in the urban area of Huánuco <p><strong>Objective.</strong> To identify relationship between knowledge and type of attitudes towards COVID-19 in the citizens of the urban area of Huánuco.&nbsp;<strong>Methods.</strong> Observational, descriptive and cross-sectional study, with a quantitative approach. It was carried out in the city of Huánuco, 2020. Sample comprised 168 citizens. A previously validated knowledge questionnaire and an attitudes scale towards COVID-19 were applied. Pearson's χ² test and Spearman's correlation coefficient (rho) were applied.&nbsp;<strong>Results.</strong> When analyzing the type of knowledge regarding COVID-19, 62.5% (105) of the sample was located in the category “unknown”. Analyzing the type of attitudes perceived by citizens towards COVID-19, 36.9% (62) had positive attitudes, while 63.1% (106) presented negative attitudes. Contrasting the relationship of knowledge and the type of attitudes towards COVID-19, statistical significance was found between both variables (p &lt;0.005). The level of education presented a significant relationship with knowledge about COVID-19 (r = 0.314; p &lt;0.000).&nbsp;<strong>Conclusion.</strong> There is a direct relationship between the knowledge and the type of attitudes towards COVID-19 in the citizens of the urban area of Huánuco. In other words, there is ignorance about COVID-19. The vast majority show negative attitudes.</p> Mely Ruiz Aquino, Anibal Diaz Lazo, Milward Ubillús, Alejandrina Kibutz Aguí Ortiz, Violeta Rojas Bravo ##submission.copyrightStatement## Mon, 08 Feb 2021 22:53:22 +0000 Most frequent pediatric diseases in an international airport in Mexico <p>The frequency in which people travel internationally increases the potential for transmission of infectious diseases. The main causes of disease in children and adolescents vary according to the age group. Prevention is the most important action to take in public health, as it cannot be carried out if the diseases are not detected in a timely manner. The purpose of this study was to identify the most frequent pediatric diseases in the Emergency Medical Service of an international airport in Mexico. The study was observational, descriptive, retrospective and cross-sectional. It is concluded that diseases of digestive (presumed infectious gastroenteritis) and respiratory origin (pharyngitis) were the most frequent. This information can be used not only as a basis for decisions regarding public health, but also for the selection of equipment and supplies to be used in the medical service of an airport (pre-hospital care), in addition to the type of training required by the medical personnel.</p> Augusto Flavio Figueroa Uribe, Inti Ernesto Bocanegra Cedillon, Julia Hernández Ramírez, Maribel Mújica Hernández, Viridiana Cruz Laureano ##submission.copyrightStatement## Wed, 17 Feb 2021 17:20:38 +0000 Fragility syndrome in older adults in a rural community in the Peruvian Andes <p><strong>Objectives:</strong> To determine the prevalence and factors associated with Frailty Syndrome (SF) in older adults residing in the district of Chaglla-Huánuco, located at 3000 meters above sea level. <strong>Methods:</strong> Analytical cross-sectional study of adults over 60 years of age living in a rural community in the Peruvian Andes. For the evaluation of the dependent variable, a modified version of Fried's criteria was used. The factors associated with SF were calculated using crude and adjusted prevalence ratios with 95% confidence intervals (95%CI), using a multiple Poisson regression model with robust variance. A p value &lt;0.05 was considered significant.&nbsp;<strong>Results:</strong> 233 older adults were studied (median: 74, interquartile range: 70-79 years), 50.6% women. The prevalence of FS was 72.1%. The presence of depression (PR=1.77; 95%CI: 1.43-2.18, p &lt;0.001) and female gender (PR=1.46; 95%CI: 1.16-1.81, p=0.001), were associated factors that increased the prevalence of FS.&nbsp;<strong>Conclusions:</strong> The prevalence of FS among older adults residing in a rural Andean community was high. The factors associated with this diagnosis were the presence of depression and female sex. More studies are required on this topic in rural populations in high altitudes.</p> Jaime Lama-Valdivia, Erick Acosta-Illatopa, Franko García-Solórzano ##submission.copyrightStatement## Mon, 08 Feb 2021 00:00:00 +0000 Quality of work-life and work performance in physicians at the Mexican Institute of Social Security, in the state of Chiapas <p><strong>Introduction:</strong> Maintaining a quality of working life brings as a benefit a greater productivity.&nbsp;<strong>Objective</strong>: To know if the quality of work life is a significant predictor of the level of self-perceived work performance by the doctors who work at the Mexican Institute of Social Security of Well-being, in the state of Chiapas. <strong>Material and methods</strong>: The study had a quantitative, cross-sectional and predictive approach. The population consisted of 445 doctors. The type of sampling was non-probabilistic for convenience, since the doctors who work in the Mexican Institute of Social Security (IMMSS) Bienestar, in the state of Chiapas, were selected. The sample consisted of 169 physicians who represent 37.97% of the population. A simple linear regression analysis was carried out by the method of successive steps. <strong>Results</strong>: It was found that the variable level of working life described 64.9% of the variance of the dependent variable level of job performance. Similarly, it was determined that there is a positive and significant linear influence between the variables. The quality of work life variable was found to be a significant predictor of work performance in a very important way (β = .806). <strong>Conclusions</strong>: It was found that the quality of work life influences the work performance of the doctors who work in the Mexican Institute of Social Security of Well-being, in the state of Chiapas in a very important way. To the extent that the surveyed doctors improve their quality of work life, it will influence their work performance.</p> Brenda Esther López-Martínez, Jason Miguel Aragón-Castillo, Manuel Muñoz-Palomeque, Saúl Madrid-Tovilla, Iván Tornell-Castillo ##submission.copyrightStatement## Tue, 23 Feb 2021 19:31:13 +0000 Regional distribution of COVID-19 mortality in Peru <p><strong>Objectives:</strong>&nbsp;Compare the death rate from COVID-19 at the national level by regions and departments from March to September 2020.&nbsp;<strong>Methods:</strong>&nbsp;Quantitative, observational, cross-sectional, ecological and retrospective study. The data was extracted from the National Death System (SINADEF) in Microsoft Excel 2016 and imported into Stata. The variables were described as frequencies and percentages. Mortality was obtained by dividing the total deaths over the total population according to the last census. An adjusted exploratory analysis was performed using robust regression methods to evaluate the association between mortality by department and regions adjusted for age and sex of the deceased. P &lt;0.05 was considered significant.&nbsp;<strong>Results:</strong>&nbsp;32535 deaths were reported, 69.84% were male and the median was 67. The mortality rate in the Costa region 145 deaths were calculated (n = 24,276), followed by Sierra with 51 (n = 4434) and Selva with 63 (n = 2545). There were significant differences in mortality according to the region, in the comparison of the coast with the Sierra region a beta coefficient of -96.28 was found (p &lt;0.001 IC -123.76 -68.77), while in the comparison with the Selva it was determined a coefficient of -50.38 (p 0.01 95% CI -91.47 -9.29). No significant association was found between the mortality rate and the average age or sex of the deceased by department.&nbsp;<strong>Conclusion:</strong>&nbsp;The death rate from COVID-19 at the national level was 101 per 100 000 inhabitants. The mortality rate found was higher on the Costa region than in the Sierra and Selva, regardless of the proportion of men, women or age.</p> Maria Gracia Flores López, Alonso Soto Tarazona, Jhony A. De La Cruz-Vargas ##submission.copyrightStatement## Wed, 24 Feb 2021 17:21:57 +0000 Work conditions and personal protective equipment against COVID-19 in health personnel, Lima-Peru <p><strong>Objective: </strong>To determine the association between working conditions and access to personal protective equipment (PPE) in health personnel in the city of Lima-Perú.&nbsp;<strong>Methods: </strong>Descriptive, cross-sectional and analytical study. The sample was of 323 respondents virtually in the city of Lima, who met the selection criteria, captured between 07/09/2020 to 08/09/2020. The data collection instrument was validated by expert judgment with a score&gt; 80% (content validity). An analysis was carried out with the generalized linear model of the poisson family, log link function, robust models with fit. A statistically significant value of p &lt;0.05 was considered.&nbsp;<strong>Results: </strong>52% of health personnels (HP) worked more than 12 hours and only 55% received one PPE per work day. 50.9% of the HCP almost never received a mask. In the multivariate analysis, the SP with ages &lt;26 years (p=0.00) and from 26 to 55 years (p=0.00) received an incomplete PPE. HP who did not have an employment relationship with the institution (p=0.006) and those who worked in areas with little contact with COVID-19 patients (p=0.022) received a mask on few occasions.&nbsp;<strong>Conclusion: </strong>Health personnels under 56 years of age rarely received PPE. When they work without an employment relationship and belonged to areas with little contact with COVID-19 patients, they sometimes received a mask.</p> Jarvis Giusseppe Raraz Vidal, Henry Lowell Allpas Gomez, Flor Karina Torres Salome, Wenner Manuel Cabrera Patiño, Rafael Paolo Ramos Gómez, Lilian Maria Alcántara Leyva, Flor Karina Aldea Chihuantito, Viviana Colona Risco, Omar Baldomero Raraz Vidal ##submission.copyrightStatement## Mon, 08 Feb 2021 23:03:02 +0000 Anxiety, depression, somatization and experiential avoidance indicators in peruvian university students in quarantine by COVID-19 <p><strong>Introduction:</strong> The COVID-19 quarantine has greatly affected university students in Peru, generating a series of physical, psychological and behavioral effects. <strong>Objective</strong>: To determine the factors associated with anxiety, depression, somatization and experiential avoidance in peruvian university students quarantined by COVID-19. <strong>Methods:</strong> A cross-sectional observational study was carried out. The sample was made up of 1264 university students from various departments of Peru, anxiety, depression, somatization and experiential avoidance were taken as dependent variables, which were evaluated with the questionnaire "The Inventory of unadjusted psychosocial behavior, in the presence of COVID-19 in the Peruvian population” and the AAQ II, for the statistical analysis the chi square was used <strong>Results:</strong> More than half of the university students in Peru present between 3 and 6 of the 6 anxiety indicators, and this same number of depression indicators is presented by 45% of the sample. 30% of the sample has between 3 and 6 indicators of somatization and 40.3% of the sample is located in the middle upwards on the experiential avoidance scale. <strong>Conclusions:</strong> There are differences in the levels of anxiety, somatization and experiential avoidance between men and women, it was also found that older students had lower levels of anxiety, depression and experiential avoidance, but not in somatization.</p> Héctor Hugo Sánchez Carlessi, Luis Alberto Yarlequé Chocas, Leda Javier Alva, Edith Rocío Nuñez LLacuachaqui, Carlos Arenas Iparraguirre, Maria Luisa Matalinares Calvet, Eduardo Gutiérrez Santayana, Irma Egoavil Medina, Jorge Solis Quispe, Ceyda Fernandez Figueroa ##submission.copyrightStatement## Fri, 26 Feb 2021 00:00:00 +0000 Prenatal factors associated with breach of the basic vaccination scheme in under 5 years of age <p><strong>Objective:</strong> To determine the prenatal risk factors associated with the failure to comply with the basic vaccination scheme in children under 5 years of age, based on the Demographic and Family Health Survey (ENDES) of 2018. <strong>Materials and Methods:</strong> It is an observational, retrospective, analytical and transversal study. We study the sample of the National Demographic and Health Survey (ENDES) for 2018 that includes 18 104 children between 1 and 5 years with health card seen in the interview, finding the results in the INEI surveys. The files containing the vaccination scheme questionnaires are selected and the data processed with SPSS version 25. The statistical processing is analytical and descriptive, bivariate and multivariate with the help of STATA v16 and Excel 2016. <strong>Results:</strong> There was a final sample of 18,104 children between 1 to 5 years old in 2018. The multivariate analysis found the association of non-compliance with the vaccination schedule with the mother&amp;#39;s age (p value = &amp;lt;0.01, PR = 1.20, CI = 1.13 - 1.28), the number of controls inadequate (p value = &amp;lt;0.01, PR = 1.28, CI = 1.23 - 1.33) and the pregnant woman did not receive the tetanus vaccine during pregnancy (p= &amp;lt;0.01, RP= 1.16, CI= 1.12 - 1.20). No such association was found with the place of residence, wealth index and natural region. <strong>Conclusions:</strong> The prenatal risk factors associated with the failure to comply with the basic vaccination scheme in children under 5 years of age were maternal age, the number of inadequate prenatal check-ups and the pregnant woman who had not received the tetanus vaccine.</p> Trinidad L. Isidro-Ríos, Alfonso Gutiérrez-Aguado ##submission.copyrightStatement## Fri, 12 Feb 2021 18:52:06 +0000 Occupational disease and absenteeism in the workers in one Hospital in Lima -Perú <p><strong>Introduction:</strong>&nbsp;Absenteeism from work in public or private institutions is classified as one of the main labor problems.&nbsp;<strong>Objective:</strong>&nbsp;To determine the association between occupational disease and work absenteeism at the Hospital Policial Augusto Belisario Leguía, in the years 2017-2018. Methodology: A descriptive, cross-sectional, and qualitative-quantitative retrospective study in a convenience sample of 79 medical breaks with a diagnosis of occupational diseases of police health personnel. Collecting data was used.&nbsp;<strong>Results:</strong>&nbsp;The highest work absenteeism occurred in female patients, married, over 50 years of age, technical nursing profession and with a work seniority of more than 20 years. A global absenteeism rate of 7.56% (2017) and 6.39% (2018) was obtained, a severity index of 25.12 days (2017) and 26.43 days (2018).&nbsp;<strong>Conclusions:</strong>&nbsp;Occupational diseases caused by physical agents develop greater absenteeism due to musculoskeletal injuries more frequently.</p> Catherine Amparo Suárez Egoávil ##submission.copyrightStatement## Fri, 12 Feb 2021 18:54:41 +0000 Hand hygiene habit and pathogens found in medical students <p>The objective was to know the hand hygiene habits of medical students; as well as the bacterial population resident in the palm of the hands. An observational, descriptive cross-sectional study was carried out. Likewise, a hand hygiene behavior survey was carried out on 100 students, and a microbiological culture of the palmar surface was carried out on 33 other students. Regarding hygiene habits, 74% showed an appropriate attitude. The hygiene attitude was appropriate in 41.3% and 46% in relation to the prevention of contagion. The following pathogenic microorganisms were isolated: S.aureus with 20 cases (60.6%), P. aeruginosa, Enterobacter and S.viridans, one in each case. Therefore, workshops or dissemination campaigns should be organized to raise awareness and modulate hand hygiene habits in students.</p> Nicanor Domínguez Navarrete, Sara Palomino Berríos, Carolina Cucho Espinoza, Kelly Alarcón Oré, Jossian Valencia Pillaca ##submission.copyrightStatement## Mon, 08 Feb 2021 23:07:34 +0000 Teacher's educational capacity and achievement of competences during its clinical practices in the nursing internal of the Emergency Hospital Grau Essalud, 2019. <p><strong>Objective: </strong>To identify the relationship between the teaching capacity of the teacher tutor and the achievement of competencies of the Nursing intern during their clinical practices at the Grau Emergency Hospital in 2019. <strong>Methods</strong>. Study with a quantitative approach, relational level and non-experimental design. Through non-probabilistic convenience sampling, a sample of 50 nursing interns from the Grau EsSalud emergency hospital was used. <strong>Results.</strong> Most were between 20 and 27 years old (56%), and female (98%). The teaching capacity of the teacher achieved a regular (62%) and good (34%) level, and the achievement of the nursing interns' competencies was at a level achieved in 46%. There was a considerable direct relationship between the teaching capacity of the teacher and the achievement of competencies of the nursing intern during their clinical practices, (rho=0.793; p=0.000), as well as a direct and considerable relationship between the achievement of competencies of the nursing intern and the didactic capacity of the teacher in its communication dimensions (rho=0.785; p=0.000), and didactics (rho=0.806; p=0.000). <strong>Conclusion.</strong> There is a considerable direct relationship between the teaching capacity of the teacher and the achievement of competencies during their clinical practices in the Nursing internship of the Hospital de Emergencias Grau EsSalud, 2019.</p> Diana Alicia García Caldas ##submission.copyrightStatement## Tue, 23 Feb 2021 19:22:13 +0000 Neurological damage in SARS-CoV-2 infections <p>The current Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic has severely impacted the economy and health care system in more than 180 countries around the world in an unprecedented event, which since its inception has resulted in countless case reports focusing on the potentially fatal systemic and respiratory manifestations of the disease. However, the full extent of possible neurological manifestations caused by this new virus is not yet known. Understanding the interaction of SARS-CoV-2 with the nervous system is essential to assessing likely short- and long-term pathologic consequences. This review seeks to gather and discuss evidence on the occurrence of neurological manifestations and/or nervous system involvement in SARS- CoV-2 infected patients.</p> Jorge Arturo Vega-Fernández, Danny Omar Suclupe-Campos, Franklin Rómulo Aguilar-Gamboa ##submission.copyrightStatement## Tue, 23 Feb 2021 19:21:16 +0000 Management of genetic diseases: Present and future <p>Today, the number of genetic diseases is around 10000 conditions, affecting to 6%-8% of all populations. This review shows us how the discovery of genetic variants in our genome, this facilitated to know with precision about the mechanisms physiopathological, and hence to recognize those target points susceptible to modifications, through therapeutical strategies different with palliative proposals, increase life expectancy, or improve qualities of life. These therapies are diverse, using drugs for polygenic diseases, nutritional therapy, special formulas, enzyme replacement therapies, hematopoietic stem cell transplant, substrate reduction, oligonucleotides, and gene therapy. These genetic diseases are heterogeneous clinically with a very low frequency; nevertheless, open to the possibility of research in new strategies for more genetic disease, that today, furthermore, are orphans.</p> <p>&nbsp;</p> Hugo Hernán Abarca Barriga, Milana Trubnykova, María del Carmen Castro Mujica ##submission.copyrightStatement## Tue, 23 Feb 2021 19:37:44 +0000 Molecular basis of COVID-19 pathogenesis and in silico studies of potential pharmacological treatment <p>COVID-19 is a disease caused by SARS-CoV-2, a virus that represents a serious threat to global health. The objective of the article is to deepen into the structure of the structural and non-structural proteins of SARS-CoV-2 and their role during the infection of its target cells; also to propose molecules from <em>in silico</em> studies that inhibit proteins of the viral cycle for potential pharmacological treatments. The SARS-CoV-2 genome has ORFs that encode sixteen non-structural proteins (Nsp1-16), four structural proteins (Spike, Envelope, Membrane, and Nucleocapsid), and nine accessory proteins; that fulfill various functions in the entry of the virus and its viral cycle. <em>In silico</em> studies of drugs such as disulfiram and viomycin, and molecules found in plants as <em>Azadirachta indica</em>, the tea plant, and <em>Andrographis paniculata</em> have shown inhibitory effects on the SARS-CoV-2 viral cycle.</p> Eduardo Rubén Lam Cabanillas, Anthony Omar León Risco, Kevyn Bryce León Risco, Gaby Lisbeth Llamo Hoyos, Rosa María López Zavaleta, Estefanía del Rocío Luzuriaga Tirado, Alex Michael Mendoza Blas, Juan Jorge Huamán Saavedra ##submission.copyrightStatement## Mon, 08 Feb 2021 23:09:17 +0000 Characteristics of the mentor in surgery and its contribution in the education of the future <p>Mentoring in surgery is the art of guiding a future surgeon toward specific academic and professional goals that are likely to determine career success. This mentoring requires a solid mentor-resident relationship and a mentor with certain characteristics such as: research productivity, understanding of pedagogy and the application of educational technology. The mentor in surgery is in charge of properly channeling the resident's various clinical-surgical experiences to achieve meaningful learning; likewise, experience and motivation are the main characteristics of a good mentor. The availability of the mentor is essential to foster a solid mentor-resident relationship, in order to achieve the academic and professional success of the future specialist; using not only theoretical-practical methods, but also the use of educational technology that will allow the maximum development of the mentee</p> Alberto Córdova-Aguilar, Lucy Perla Gulliana Cedillo Ramírez ##submission.copyrightStatement## Mon, 08 Feb 2021 23:08:24 +0000 Dengue with signs of alarm and Leptospirosis in a pediatric patient with COVID-19 <p>Dengue and Leptospirosis are endemic metaxenic diseases that affect tropical and subtropical areas, mostly in underdeveloped countries.&nbsp;In addition to this, the COVID-19 pandemic is causing a great deal of damage to both the population and the health level.&nbsp;This is the case of a 13-year-old patient who had fever, gingival and intermenstrual bleeding, abdominal pain and shortness of breath.&nbsp;She&nbsp;had SARS-CoV-2 IgM and IgG positive rapid test, and positive serology NS1 for Dengue and IgM for Leptospira.&nbsp;In addition, non-contrast pulmonary tomography showed areas of consolidated and frosted glass at the base level, as well as cysturitis.&nbsp;Diagnoses of COVID-19 pneumonia, Dengue with warning signs and Leptospirosis were had.&nbsp;Therapeutics were based on&nbsp;fluid therapy according to diuresis and blood pressure, symptomatic, oxygen support, constant monitoring and antibiotic therapy with Ceftriaxone, having a favorable evolution.</p> Mayron David Nakandakari Gomez, Hamilton Marín-Macedo, Raúl Seminario-Vilca ##submission.copyrightStatement## Mon, 08 Feb 2021 23:11:38 +0000 Spontaneous pneumomediastinum in patients with COVID-19. Case report. <p><strong>Introduction:</strong>&nbsp;Pneumomediastinum is an infrequent and rare pathology. The typical radiological manifestations in patients with SARS-CoV-2 pneumonia consist of the presence of bilateral pulmonary opacities, of peripheral distribution. In a recent series of patients with COVID-19, it indicates that 1% of patients can develop spontaneous pneumomediastinum as a complication, it is generally benign and it is not yet clear that this may be an indicator of worsening.&nbsp;<strong>Clinical Case:</strong>&nbsp;This is a 43-year-old male patient who presented a 15-day illness characterized by pharyngeal pain, fever, chest pain and respiratory distress, receiving multiple antiviral and antibiotic treatment schemes without response, for which he attended to Rebagliati Hospital where he was found respiratory failure, hypoxemia and sepsis. His tomography was compatible with ground glass infiltrate, areas of bilateral lung consolidation, and pneumomediastinum. It did not require surgical treatment and it evolved favorably to pneumonia with a decrease in inflammatory markers and remission of pneumomediastinum in tomographic control.&nbsp;<strong>Conclusion:</strong>&nbsp;This report highlights that in COVID-19 infection the pulmonary complications to take into account are bilateral pneumonia, bacterial coinfection, sepsis and spontaneous pneumomediastinum.</p> Pedro Paolo Sotelo-Jiménez, Enrique Moyano Navarro, Félix Tipacti Rodríguez, Carlos Milla Bravo ##submission.copyrightStatement## Thu, 18 Feb 2021 22:37:33 +0000 Patellar tendon rupture after radial pressure wave therapy – also known as radial shock wave therapy – for patellar tendinopathy: Report of two Cases <p>Patellar tendinopathy is characterized by anterior knee pain located at the lower pole of the patella at the junction of the patellar tendon. This is often a disabling condition that limits patients' quality of life, affects their ability to participate in sports, and even hinders their normal daily activities. Extracorporeal shock wave therapy (ESWT) has been recognized as a promising and safe alternative for the treatment of various musculoskeletal disorders – including chronic patellar tendinopathy. However, there is limited evidence regarding its side effects, in particular ESWT-associated tendon injuries. To the authors' knowledge, this is the first report demonstrating clinical and radiological evidence of two patients without known risk factors for partial patellar tendon tears that developed this condition after the application of radial pressure wave therapy - also known as radial shock wave therapy - for patellar tendinopathy. ESWT must be applied by properly trained professionals so that specific requirements needed to guarantee an appropriate application technique, minimize possible adverse effects, and improve patient safety could be met.</p> Walter Insuasti Abarca, Sussan Llocclla Delgado, Paul Terán Vela, Tania Platero Portillo, Diana Martínez Asnalema, Lilian Abarca García ##submission.copyrightStatement## Thu, 18 Feb 2021 22:39:46 +0000 Telemedicine: A viable option in times of COVID-19? <p>We have read with great interest the article “A new coronavirus, a new disease: COVID-19” by Pareja, et. al. where we observe that the repercussions bringing with pandemic, evidence the limited experience we have. Telemedicine (TM) has become a technological tool to provide medical care and a tool with great potential in settings where the infrastructure is intact and doctors are available for care. In this way, exposure is minimized, taking into account that number of infections occurred in hospitals was gargantuan.</p> Dayana Ticona Tiña ##submission.copyrightStatement## Mon, 08 Feb 2021 23:14:40 +0000 Impact of COVID-19 on sexual and reproductive health <p>Peru is going through a pandemic originated by coronavirus disease (COVID-19) and we continue to maintain mandatory social isolation as a preventive measure to reduce infections.Due to this event, many health establishments had to suspend care, also affecting Sexual and Reproductive Health (SRH) services, especially external consultation services. Due to this event, many health establishments had to suspend their attention , also affecting Sexual and Reproductive Health (SRH) services, especially external consultation services. Limited access to those services would increase the rate of unwanted pregnancies, abortions, sexually transmitted infections (STIs), complications during pregnancy, intimate partner violence, and maternal and infant mortality</p> Lalescka Araceli Soria Gonzales ##submission.copyrightStatement## Mon, 08 Feb 2021 23:15:51 +0000 Transcendence of computer vision syndrome due to prolonged exposure to electronic devices <p>Eye health, without a doubt, has been gaining more relevance in recent years due to the promotion of healthy habits in search of caring for our eyes, but the question also arises as to whether we are increasingly exposed to electronic devices with screens, these, can be detrimental to our visual well-being since, due to confinement, the use of these as a work and study tool has increased exponentially.</p> Klisman Lennon Custodio Sanchez ##submission.copyrightStatement## Mon, 08 Feb 2021 23:15:21 +0000 Lifestyle Medicine and Sleep Quality in Medical Students <p>Maintaining a good sleep quality is a basic human need, because the poor sleep is associated with negative effects such as exhaustion, uncontrolled emotions, the inability to concentrate, the inability to remember or think clearly, poor university and work performance, psychological and academic stress, anxiety, depression and difficulty in resolving problems; also long-term effects such as cardiovascular diseases, diabetes mellitus type II, obesity, cancer, among others.</p> Fiorella Rosemary Allende-Rayme, Jeremi Harold Acuña-Vila, Juan Carlos Ezequiel Roque, Lucy E. Correa-López ##submission.copyrightStatement## Tue, 23 Feb 2021 19:20:16 +0000 COVID-19 an oportunnity or a disaster for undergraduate medical education? <p>This letter expresses a novel opinion on the prospects for undergraduate medical education during the COVID-19 pandemic. It reviews traditional medical education and the benefits and harms of new educational models, such as telemedicine.</p> Rodrigo Fernando Flores Quiroga ##submission.copyrightStatement## Mon, 08 Feb 2021 23:16:17 +0000