Revista de la Facultad de Medicina Humana

Heart failure secondary to a snake bite. The intensivist's vision: case report

Andrés Alirio Restrepo Bastidas — 2024-04-09

Background: Ophidic accident is a neglected disease that affects tropical countries. Latin America is the second region after Africa, with the most cases worldwide. Local lesions accompany its clinical course up to systemic affectations such as renal, hematological, and neurological lesions. Cardiac complications are rare, especially in patients who do not have cardiovascular risk factors. There are reports of acute myocardial infarction, but there is little information about heart failure due to Bothrops spp.

Case report: We present the case of a 25-year-old man without cardiovascular risk factors who was admitted to the intensive care unit and developed heart failure with cardiogenic shock and multi-organ failure secondary to a snake bite.

Conclusions: Although the characteristic clinical course of a bothropic ophidian accident and its systemic manifestations are mainly related to coagulation abnormalities, there are cardiovascular complications within its clinical presentation that, although rare, if not detected promptly and not adequately managed, are associated with high morbidity and mortality.

Miliary tuberculosis in an immunocompetent patient: Case report

Renzo Steffano Valle Farfan — 2024-04-10

Milar Tuberculosis (TB) is a presentation with a fatal outcome if it is not diagnosed or treated on time; although certain conditions are required to develop this presentation. In this In this article, the case of a 48-year-old man with no pathological history is studied, who started the disease with a time of six months with an initial diffuse gastrointestinal pain and later one month before admission presented progressive respiratory symptoms; he was admitted for emergencies where bilateral diffuse miliary compromise was evident in the chest computed tomography; upon admission, he was administered oxygen and support measures, an HIV test was obtained which was negative, and positive results were obtained in the sputum smear microscopy. His clinical evolution was stationary until the administration of antituberculosis therapy, observing slight clinical improvement, likewise, low doses of corticosteroids were administered after which a favorable evolution was demonstrated and he was discharged.

Successful intrabdominal preterm pregnancy: A case report

Saida Anyul Abud-Flores — 2024-04-09

Introduction: Ectopic pregnancy is any gestation in which the implantation site of the fertilized egg is located outside the endometrial cavity. Abdominal ectopic pregnancy represents 1.4% of these. Case report: 28-year-old patient with two previous cesarean sections; bilateral tubal obstruction during the last operation. The patient was admitted to the hospital with blood pressure of 180/130 mm Hg that did not respond to medical treatment and not progression to labor so it was decided to interrupt the pregnancy by cesarean section. During surgery, a small uterus with extrauterine pregnancy was observed adhered to the serosa of the cecum, ascending colon, and appendix. A live preterm female product was obtained; the mother had a favorable evolution and no postoperative complications. Conclusion: Ectopic pregnancies are rera. An adequate prenatal control by well trained personnel is essential for an accurate diagnosis. The mother and the newborn did not present any complication. It is very important to have and accurate an opportune diagnosis so trained personnel can offer an adequate management.

Lymph node tuberculosis with genital involvement: Case report

Joel Isaac Atencio Paulino — 2024-04-09

We present the case of a 44-year-old male patient with a family history of lymphoma and hyperthyroidism. He started the disease three months before admission to hospital with pain in the right leg, abdominal pain, weight loss and night sweats. He was diagnosed in his hospitalization with ascites in a cavity of undetermined etiology, and multiple polygastric and fossa lymph nodes right iliac. At 6 months, the symptoms persist and a nodule is added on the penis, left testicular edema and purulent discharge from the right inguinal node, being diagnosed orchiepididymitis. Initially he had negative markers for tuberculosis (TB), however, a lymph node biopsy was performed and the analysis with Xpert MTB/RIF where it resulted positive. The patient improved considerably with anti-TB treatment and antibiotics for purulent discharge.

Toxic megacolon. Case report

Roger Sernaque Mechato — 2024-04-11

Toxic megacolon is a fatal disease, most commonly occurring as a complication of inflammatory bowel disease, infections, and intestinal ischemia. It is characterized by the presence of bloody diarrhea, abdominal distension, signs of systemic toxicity, and segmental colonic dilation is observed in imaging studies. The diagnosis according to Jalan's criteria are: colonic dilation more than 6cm, three of the following: fever, tachycardia, leukocytosis or anemia, and any of the following criteria: hypotension, hypovolemia, electrolyte disorder and altered mental status. This article presents the case of a female patient who was admitted with abdominal pain and chronic diarrhea with an imaging study showing dilation of the entire colonic framework. The corresponding studies were carried out which indicated that she had a toxic megacolon due to colitis. ulcerative, receives medical treatment with favorable evolution, is discharged and readmitted for septic shock, studies are performed and Clostridium difficile infection is identified, antibiotic treatment is started but the evolution is unfavorable, which caused the death of the patient. The present case represents the high mortality of this disease.

Forensic Genetics and Genomics in Peru: Current situation and future challenges

Carlos David Neyra Rivera — 2024-04-10

Forensic Genetics is defined as a field of knowledge that uses both genetic concepts and molecular tools. This is used to resolve cases in which it is desired to identify the identity of people allegedly involved in a criminal act, kinship ties, identification of missing persons, etc. Currently, Forensic Genetics mainly uses molecular markers of the type STRs (short tandem repeats), SNPs (single nucleotide polymorphisms) and insertion/deletion INDELs)(1). In order to use these markers, it generally begins with DNA extraction, a multiplex polymerase chain reaction, capillary electrophoresis and analysis with specialized software to obtain a genetic profile that is unique for each individual.

Anaplastic large cell lymphoma associated to breast implants in Latin America

Gianella Fernanda Ugarte — 2024-04-10

Dear Editor,

After reading the 2023 publication by Manjarres A. et al. in your esteemed journal on cancer and breast implants, I would like to contribute additional data regarding breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) in Latin America. This work highlights the lack of knowledge and evidence in Latin American countries, a crucial aspect given the classification of BIA-ALCL as a new pathological entity by the World Health Organization in 2016 (1).

Early detection of mental health problems in university students

Allyson Dajana Espinoza García — 2024-04-10

Due to community transmission and the increase in cases during the COVID-19 pandemic, preventive measures had to be adopted, including social isolation and quarantine, which have had effects on people's mental health. Thus, the restriction of free movement, the discontinuity of routines, the decrease in social interaction, the lack of traditional learning methods, as well as the new academic, technological and psychological demands have generated an increase in tension, stress and anxiety in young people.

Hyperglycemia as a risk factor for in-hospital mortality in myocardial infarction

Ciro Barrantes-Alarcon — 2024-04-04

Introduction: Myocardial infarction continues with high mortality rates, from 4.6% to 13.1%. There are predictive risk stratification models, such as the Grace Score, which does not include glycemia as a variable. Patients hospitalized for myocardial infarction with hyperglycemia on admission may have higher mortality, in ST elevated and non-elevated infarcts.

Objectives: The objective of this review is to identify and systematize the evidence on hyperglycemia on admission as a biomarker of mortality and heart failure in acute myocardial infarction.

Materials and Methods: The search was carried out in the MEDLINE database including the MeSH terms hyperglycemia and hospital mortality or heart failure in myocardial infarction, selecting 12 articles.

Results: Hospital mortality was calculated in 11 articles, in 9 of them a significant association was found between hyperglycemia and hospital mortality, both in the bivariate and multivariate analysis, and in 2 articles this association was not demonstrated. For in-hospital mortality, the results of 11 articles included in this review were synthesized. The frequency of occurrence of heart failure was determined in 11 articles, finding a higher frequency in 9 of them. For in-hospital mortality, the results of 11 articles included in this review were synthesized and analyzed, in 8 the analysis was performed in non-diabetics, obtaining OR: 4.15, IC 95% (2.853-6.035), in 3 for diabetics obtaining OR 2.365 IC 95% (1.778- 3,146) and in 6 for the total population finding OR 3,314 (2,910-3,774).

Conclusions: Hyperglycemia on admission is associated with increased mortality and frequency of occurrence of heart failure during hospitalization for myocardial infarction, with evidence of moderate quality.

Blockchain technology applied in medicine: a systematic review

Christian Jairo Tinoco Plasencia — 2024-04-09

Objective: Develop an articles review to evaluate the existing evidence on blockchain technology applied in medicine. Methods: The study was of a documentary type, bibliographic design, framed in a systematic review. The harvest of articles was carried out in the Scopus, Web of Sciences, Pro Quest and ScienceDirect databases from January 1, 2018 to July 31, 2023. The descriptors were blockchain, technology and medicine. The PRISMA diagram was prepared considering the inclusion criteria: original articles, with open access; that address the subject and in any language. The search yielded 70 articles, of which 11 formed the sample. Results: The various applications of blockchain technology in medicine were discussed, including its integration with artificial intelligence (AI) for data-centric analysis; regarding the development of traceability systems, however, its greatest applicability is in the registration of medical records of patients, whose application was successful. Despite this, its incipient use in medicine was verified due to the lack of studies in this regard. Conclusions: The application of blockchain technology in medicine is very scarce, despite the potential it has for the registration and safeguarding of medical data, therefore, its study should be deepened.

Non-Fatal strangulation/suffocation in context of gender violence: Medicolegal aspects and implications in clinical practice

Mónica Andrea Núñez Garrido — 2024-04-09

Despite the numerous efforts of the international community to eradicate all forms of violence against women, this problem is far from being resolved. According to the UN, one in three women has suffered physical or sexual violence from an intimate partner, sexual violence outside the couple, or both at least once in their life. Addressing this problem as a social health need of population groups allows an approach to gender violence as a collective health problem.

At the level of physical violence, strangulation/suffocation has been identified as one of the most lethal forms of domestic violence and sexual assault. Victims of domestic violence who have been choked or strangled are 7.5 times more likely to be killed by their partner. A victim of strangulation/suffocation can lose consciousness in seconds or die within minutes, days or weeks after the attack, as well as suffer permanent brain damage or disability or emotional trauma.

Recently, legal changes have been generated in the configuration of this crime, the penalties have increased in United Kingdom, the United States, Australia and New Zealand.

The current non-systematic narrative review of literature sought to explore updated medico-legal aspects of non-fatal strangulation/suffocation in the context of gender violence, and are highlightedrelevant implications for clinical practice.

Transforming medical education in the 21st century: the role of competency-based medical education

Fernando Ramos Zaga — 2024-04-09

Introduction: With the changing landscape of medical education, it is crucial to critically examine existing approaches and frameworks. competency-based medical education (CBME) emerges as a promising paradigm shift, which prioritizes learner-centered, outcome-oriented development of skills, knowledge, and attitudes. Objective: To identify the essential structural and procedural adjustments needed for effective implementation of CBME. It underscores the importance of reorganizing educational institutions, adapting instructional and assessment techniques, and fostering acceptance of CBME in the classroom. Results: To effectively deliver CBME, it is imperative to restructure educational institutions to focus on competency-based curricula and personalized instruction. Also, there is a need to modify teaching and assessment strategies to facilitate continuous assessment and active learning. Conclusions: Adopting CBME principles can enable medical education to produce professionals equipped with the skills necessary to meet the dynamic demands of modern medicine.

Sociodemographic characteristics and bone health in Argentine adults with a plant-based diet

Paula Taboada — 2024-04-14

Objective: To analyze the sociodemographic characteristics and bone health among adult consumers of plant-based diets (PBD). Methods: Individuals aged 18 to 75 were invited to complete a self-administered survey via a digital platform. Results: A total of 1151 participants completed the survey; the majority were women [n=958 (83.2%)], young [age (years): 18-25: 35.8%; 26-35: 39.8%, and 36-45: 17.4%] and single (67.1%). The pattern of PBD consumption was mainly represented by veganism (54.0%), followed by lacto-ovo-vegetarianism (27.7%). The primary reason for their dietary choice was animal welfare (83.5%). Adherence to PBD, based on duration (years), was <1: 12.3%; 1-5: 67.4%; 10-15: 14.8%, and >15: 5.5%.

16% of vegans reported having experienced fractures, and 5.1% reported undergoing bone densitometry. Of these, 88.1% reported normal results, and 11.8% presented osteopenia. No cases of osteoporosis were recorded in the survey. Vitamin B12 was the predominant supplement among PBD consumers (61.4%). Conclusions: PBD consumers constitute a significant minority in our country, predominantly composed of women under 35 years old, with a projected increase in the coming years.

Association between insufficient venous systems and clinical manifestations in chronic venous disease of the lower limbs

Hubert James Mendoza Rojas — 2024-04-14

Introduction: The clinical, etiological, anatomical and pathophysiological classification (CEAP) standardizes the manifestations of lower limb venous disease. Objective: To investigate the association between insufficient venous systems and the clinical classification of CEAP. Methods: A quantitative, cross-sectional, analytical, correlational design was carried out. Non-probability sampling for convenience. Sample size was 136 lower limbs from 71 patients. Chi-square, Monte Carlo and Odd ratio (OR) statistical tests were used with 95% confidence intervals through bivariate logistic regression (p<0.05). Results: 71.8% were female, average age of 66.1. The most frequent insufficient venous system was the superficial one (61.7%). 100% of the dilated great saphenous veins (GSV) had insufficiency. The most frequent CEAP clinical class was C2: 44.9%); 35.1% of C1 (telangiectasia) had an insufficient venous system and 50% of C2 had GSV insufficiency (p=0.227). There was an association between insufficiency of the superficial and deep venous systems and the CEAP clinical classification (p=<0.001). The deep venous system was associated with severe chronic venous disease of the lower limbs OR (6.04) with 95% CI (1.02-35.73) and p=0.047. Conclusions: An association was evident between the insufficiency of the superficial and deep venous systems with the clinical classification of CEAP. One third of lower limbs with C1 (telangiectasias) had an insufficient venous system.

Sociodemographic factors associated with domestic violence in women in Peru, 2021

Luis Fernando Perez Yari — 2024-04-14

Introducción: La violencia intrafamiliar se basa en fenómenos con una relación de subordinación, cuyos comportamientos se relacionan con el daño físico, psicológico y sexual, mediante el uso real o simbólico de la fuerza, con el objetivo de dominar la voluntad, mente y cuerpo de la víctima.

Objetivo: Determinar los factores sociodemográficos asociados a las mujeres víctimas de violencia intrafamiliar en el Perú durante el año 2021.

Material y Métodos: Es estudio observacional, retrospectivo, analítico y transversal, desarrollado mediante las bases secundarias ENDES 2021; se utilizó la información de 21 557 mujeres, la cual fue analizada mediante el software estadístico SPSS versión 27. Se hizo uso de las razones de prevalencia mediante el modelo de regresión de Poisson con varianza robusta.

Resultados: Se determinó una prevalencia del 47.7 % de violencia psicológica. El análisis multivariado identificó que las variables asociadas a violencia psicológica fueron el nivel de educación primaria (RPa: 1.10) y la región Lima Metropolitana (RPa: 1.14), respecto a la violencia sexual, el nivel de riqueza pobre (RPa: 2.35) fue la variable asociada, y en cuanto a la violencia física, la edad de 20 a 29 años (RPa: 1.21), nivel de riqueza pobre (RPa: 1.49) y la región costa (RPa: 0.79).

Conclusiones: Se identificaron como factores asociados a la violencia psicológica el nivel de instrucción y la región natural, el estado civil fue un factor protector ante la violencia sexual, y las variables de edad y nivel de riqueza fueron asociadas a la violencia física.

Analysis of Adverse Drug Reactions caused by antipsychotic drugs in a Mexican health institute

Erick Rojas-Valladares — 2024-04-14

Introduction: Adverse Drug Reactions (ADRs) are unwanted clinical or laboratory manifestations that are related to drug use. ADRs are common and are associated with significant risk of morbidity, mortality and hospital admissions. Antipsychotics have a reduced therapeutic window, and have been related to the manifestation of a variety of ADRs. Objective: To evaluate the pattern of ADRs due to antipsychotic drugs detected in patients treated at the Ramón de la Fuente Muñiz National Institute of Psychiatry between December 2021 and May 2022. Methods: Observational, descriptive, prospective and cross-sectional study of a series of cases. The seriousness, severity, and quality of the information in the notification of the ADRs were defined in accordance with “NOM-220-SSA1-2016, Installation and Operation of Pharmacovigilance”, while causality was determined using the Naranjo algorithm. Results: The incidence of ADRs was 59%, with one or more ADRs detected in 52 of the 88 patients who were receiving antipsychotic treatment during the study period. Forty-five percent of the ADRs had "probable" causality and 55% "possible"; only three ADRs were classified as serious as they prolonged the hospital stay and endangered the patient's life. Conclusions: The ADRs of the gastrointestinal and endocrine systems were the most incidental, with hyperprolactinemia being the most frequent. Olanzapine and clozapine were the medications that caused the most ADRs. It is recommended to promote the culture of notification and follow-up of ADRs caused by antipsychotic drugs.

Factors associated with suicidal ideation in adults from the Lambayeque Region, Peru, during the COVID-19 pandemic

Almir Carlo Sánchez-Neyra — 2024-04-14

Objective: Determine the prevalence and factors associated with suicidal ideation in the adult population of the Lambayeque region, Peru, during the COVID-19 pandemic, 2021. Material and methods: Observational, prospective and cross-analytical study; carried out in a sample of 365 adults. Data were collected through Beck's Suicidal Ideation instrument. and a sociodemographic data collection sheet. Results: The sample was characterized by a median age of 26 years (IQR=23-32) and a slight predominance of the female sex (52.2%). The prevalence of suicidal ideation was 28.3%; and was associated with young age (p=0.047), female sex (p<0.001), widowed marital status (p=0.002) and excessive alcohol consumption (p<0.001), and no religion (p <0.001), to the low income (p=0.032) and to the illness (p<0.001) or presence of relatives who died from COVID-19 (p<0.001). Conclusions: There is a high prevalence of suicidal ideation related to the COVID-19 pandemic, so it is suggested to monitor the mental health of the study population.

Short and prolonged fasting prior to the performance of tracheostomies in intensive therapy: a retrospective study

Lucas Gonzalo Duran — 2024-04-09

Introduction: International guidelines on aid prior to invasive procedures usually generate longer aid than in intensive care (IT) patients. This fact represents a high risk of malnutrition and, consequently, a worse prognosis. The objective of the present investigation was to analyze the degree of association between the fasting time prior to tracheostomy of patients under mechanical ventilatory assistance (MVA) and the appearance of pneumonia.

Methods: Retrospective cohort study that included patients admitted to our IT from 10/01/2018 to 08/31/2022 and with a tracheostomy performed. Two cohorts were defined characterized by fasting ≤3 hours vs. >3 hours. Fisher's exact test and Mann-Whitney test were used for bivariate analysis. A p value <0.05 was shown to be significant.

Results: 141 patients were hospitalized with a tracheostomy, 9 were excluded, leaving 132 patients. The cohort with fasting ≤3 hours was made up of 15 patients and the one with fasting >3 hours was made up of 117, the latter presented an average fast of 2.5 hours (RI 2-3), days of AVM prior to the procedure of 13 days (RI 12-18), while the other cohort presented an average fast of 6 hours (RI 5-8), days of AVM prior to the procedure of 12 days (RI 10-14.5). When analyzing the association between the type of fasting and the appearance of pneumonia, an OR of 0.958 (95% CI: 0.32-2.87) was obtained, p value of 0.743.

Conclusions: No significant differences were found regarding fasting time and the appearance of pneumonia as referred to in the international literature.

Correlation of histopathological results and tomographic findings in patients with liver lesions suspicious for malignancy.

Luis Pablo Valencia Montiel — 2024-04-09

Introduction. Liver cancer is the seventh most common neoplasm worldwide and the second cause of mortality directly associated with cancer. In Mexico it has an incidence of 3.9% in the entire population. Although computed tomography (CT) is the imaging study of choice, the final diagnosis is established with the anatomopathological study of the lesion.

Objective. Correlate the tomographic findings with the histopathological result in patients with liver lesions with suspicion of malignancy, who underwent USG-guided biopsy.

Methods. Descriptive, correlation, retrolective, homodemographic and single-center study. The study period was from September 2021 to February 2022. Patients older than 18 years with liver lesions suspicious of malignancy were selected and underwent Computed Axial Tomography and ultrasound-guided biopsy. Shapiro Wilk tests (for normality) were used and chi-square was used for an analysis of association of categorical variables.

Results. Twenty-four patients were included, who underwent Tomography and lesion biopsy, finding an average size of lesions of 2.39cm. The results of the correlation between the tomographic diagnosis and the definitive histopathological diagnosis did not have statistical significance p=0.069.

Conclusion. No significant correlation was found between the histopathological study and tomographic findings in liver lesions suggestive of malignancy.

Cold chain of the Peruvian National Immunization Program in the context of the COVID-19 pandemic

Alfonso Gutierrez-Aguado — 2024-04-09

Objective: The aim of this study was to identify critical aspects of the Cold Chain in the immunization process in Peru.

Methodology: A descriptive study was conducted, analyzing data from the Ministry of Economy and Finance (MEF) and the Ministry of Health (MINSA) for the years 2020-2021, as well as administrative records from the MINSA's Regional Health Strategies for immunizations in 2020. Technical aspects established in the Health Technical Standard for Cold Chain Management, such as obsolescence, allocation, functionality, and storage capacity were taken into account.

Results: In the year 2020, at the national level, 61.8% of the cold chain equipment showed obsolescence, with some regions exceeding 75%, with Lima’s metropolitan region being the most affected at 88%. Concerning equipment allocation, 9% of the first-level health facilities lacked refrigeration equipment, with Loreto having the highest deficit (46%), followed by Huancavelica with a 21% gap. The overall equipment functionality nationwide was 84%, meaning that 16% of health facilities experienced technical failures, affecting vaccine’s storage capacity and posing risks to their safety and immunogenicity. Significant gaps were identified when considering quarterly or monthly storage for COVID-19 vaccines or other health emergencies.

Conclusions: This study highlights potential risks in the operability and storage capacity of the national immunization program's vaccines in Peru during contingencies such as the COVID-19 pandemic or other health emergencies.

Associated factors with jaundice requiring phototherapy: a case-control study in a hospital in Peru

Maria Claudia Huambo Panduro — 2024-04-09

Objective: To determine the factors associated with jaundice requiring phototherapy. Material and Methods: An observational, analytical, and retrospective case-control study was conducted. Medical records of 212 patients aged 0 to 7 days from the neonatology service at Hospital Carlos Lanfranco La Hoz were reviewed, divided into 106 cases (with phototherapy) and 106 controls (without phototherapy). Results: Preterm neonates showed a significant association with an OR: 5.526; 95% CI (2.038-14.981), P= 0.001; and ABO incompatibility had an OR: 4.373, 95% CI (1.934-9.889), P= 0.001. However, birth weight, Rh incompatibility, neonatal sepsis, maternal urinary tract infection, and maternal anemia were not associated with the need for phototherapy. Conclusions: There is an association between preterm neonates and ABO incompatibility with the requirement for phototherapy.

Associated factors with treatment adherence in children aged 1 to 3 years: a study at the “Señor de los Milagros” Health Center, Huaycan – Ate

Imelda Lourdes Oscanoa Huamán — 2024-04-14

Objetivo: Determinar los factores asociados a la adherencia al tratamiento en niños de 1 a 3 años en el centro de salud “Señor de los Milagros” Huaycán – Ate.

Métodos: Este estudio observacional, retrospectivo y de corte transversal investigó la adherencia al tratamiento antianémico en 169 niños de 1 a 3 años diagnosticados con anemia, seleccionados de un grupo inicial de 300. Utilizando un formulario de recolección de datos, se evaluaron variables que abarcaban aspectos maternos, socioculturales, de tratamiento y del sistema de salud, mediante análisis bivariado y la prueba de Chi-cuadrado de Pearson. Resultados: Los resultados destacaron una baja adherencia al tratamiento, con solo el 4,7% de los niños mostrando alta adherencia y un 15,4% presentando no adherencia. Se observó una mayor adherencia en madres con educación secundaria, amas de casa y en convivencia con su pareja. Factores como la recepción de información comprensible, el trato respetuoso y la proximidad al centro de salud influían positivamente en la adherencia. Conclusión: Existe una asociación significativa entre la adherencia al tratamiento antianémico y los factores maternos, socioculturales y los relacionados con el tratamiento (p<0.05), sugiriendo que mejorar la comunicación, el soporte socioeconómico y la accesibilidad podría potenciar la adherencia terapéutica

Vitamins B1, B6, and B12 and Peripheral Neuropathies: International expert consensus

John Longa López — 2024-04-10

Based on a bibliographic review of the literature, a consensus of international experts has been carried out on the use of vitamins B1, B6, B12, in their deficiencies, and in the peripheral neuropathy that may be associated with them, to optimize the management of these conditions.

Several questions considered important and worthy of being addressed and clarified were raised, retaining nine of them for further discussion to achieve consensus.

Forty one recommendations on the management of these conditions have been proposed, with unanimity of the participants in the consensus. This has been an attempt to clarify controversial points, assisting the clinician's attitude in current medical practice.

Anatomical preparation of the visceral aspect of the human liver to demonstrate the branches of the hepatic portal vein applying the Laskowski filling, dissection and conservation techniques

Emanuel Sebastian Balarezo Rebaza — 2024-04-18

The Human Anatomy course is crucial in the education of medical students, and therefore, the shortage of anatomical specimens poses a challenge in teaching. This study aims to create an anatomical preparation of the visceral surface of the liver, allowing visualization of the branches of the hepatic portal vein using the repletion, dissection, and Laskowski preservation techniques. The preparation successfully revealed the distribution of suprahepatic veins and branches of the portal vein irrigating their respective segments, without encountering anatomical variations. The study successfully produced an anatomical specimen primarily showcasing the branches of the hepatic portal vein. We recommend inspecting

Laura E. Rodríguez Dulanto: The first clinical trial performed by a female physician in Peru.

Oswaldo Salaverry García — 2024-04-04

Laura Gutiérrez Dulanto has been highlighted for her status as the first woman to graduate in Medicine in Peru. Her high intellectual qualities have been noted from various perspectives, as well as her effort and tenacity to overcome the difficulties of pursuing university studies, particularly in scientific disciplines, then reserved exclusively for men. It has been pointed out, however, that due to the limitations imposed on women at the time, she had a diminished professional activity and little scientific production, which has not been reviewed by existing historiography. This article analyzes his scientific production, especially a clinical study developed in a women's hospital in Lima, Peru, showing his ideas about science and medicine and identifying a clear, modern and innovative thought, not exempt from social sensitivity, in addition. to show herself as a keen and thorough observer of clinical-surgical problems.