Dengue is the most common vector-borne viral disease, with low fatality rate, one death per 1000 patients. Its treatment consists of hydration, rest and symptomatic treatment. Doxycycline interferes with the entry into human cells, by inhibiting the changing E protein configuration, and stopping its replication by acting on the NS2BNS3pro protease of the virus. Therefore, itcould be an alternative, and when the disease has reached the stage of cytokine storm, manifested by severe thrombocytopenia, hemoconcentration and systemic involvement, the use of steroid or immunoglobulin pulses could be indicated. Multicenter placebocontrolled studies are needed to demonstrate the effect of these drugs in secondary indication so that the WHO and CDC can recommend or not their use, so for now we cannot use them.

INTRODUCCIÓN: There is a lack of population studies regarding factors that impact hemoglobin levels in children of a country with varying altitudes of residence.

Background: At sea level, tachypnea (respiratory rate> 24 / min) is a factor commonly associated with community-acquired pneumonia. However, in high altitudes, it must achieve higher rates, thus there is a need to look for other early predictors at these settings. Objective: This study aims to explore the presence of hypoxemia associated to the presence of diseases of the lower airways or not according to pulse oximetry readings. Methods: We used a database of 205071 18 to 65 year old altitude-resident outpatient adults in Cajamarca, Peru (2750 masl) as part of a private health program. Data was collected corresponding to demographic characteristics, vital functions (including peripheral oxygen saturation, SpO2) and individual diagnosis according to ICD-10 classification. The patients were divided into two groups according to the SpO2 level of 90% detected through a portable pulse oximet...

Background: According to the World Health Organization, tuberculosis produces around 1.5 million deaths worldwide each year. In Peru, during the 2011-2015 period, incidence and morbidity rates have decreased from 97.4 to 87.4 and from 109.7 to 99.5 respectively. However, tuberculosis remains as the fifteenth cause of death. The clinical evolution of these patients will depend on many factors, such as adherence to treatment, comorbidities, drug resistance of the pathogen. Therefore, it is the presence and interaction of these factors that help us predict which patients could potentially fail during the treatment. Objective: To determine in patients with pulmonary tuberculosis whether direct smear study at the beginning of treatment is a prognostic factor of the discharge condition. Methods: We performed a secondary analysis of the database of the retrospective cohort study "Evaluation of ...

El presente estudio evaluó los cambios hematológicos en mujeres con exposición crónica a biomasa y gran altura.

ABSTRACT. Rationale: Peru has around 9 million of households. In 30% of them biomass fuel stoves is used to prepare meals. Respiratory diseases as chronic bronchitis, pneumonia, asthma are more frequent in people using traditional biomass stoves. Peruvian government has donated around 1500000 LPG stoves with its balloon and 5 dollars monthly subsidy tobuy LPG. In Peru there were around 450000 improved certified biomass stoves. More time near the pollutant biomass stoves spend women and children than men. Methods We studied men, from 9 rural communities at Ayacucho, Peru, (2750 masl). After signed the inform consent a history and clinical exam was realized. 57.9% (98) were users simultaneously of traditional and improved biomass stoves and 42.1% (71) were users of LPG stoves but simultaneously were using traditional and/or improved biomass stoves, ranging their ages between 19 and 89 year...

Introducción: El desarrollo de enfermedad tuberculosa está condicionado por factores propios del patógeno, genéticos del huésped y ambientales. Objetivo: Determinar la relación que existe entre parentesco y enfermedad tuberculosa en los contactos de pacientes con tuberculosis. Materiales y métodos : Estudio descriptivo. Contactos de los pacientes del PCTBC del HNCH entre 1977-2011. Se les clasificó por el parentesco, y por el % genético compartido en hasta un 100%: hermanos, hasta en hasta un 50%: padres e hijos, hasta un 25% abuelos, nietos, tíos y sobrinos, hasta un 12.5%: primos, bisabuelos y bisnietos y 0% en los que no eran familiares. Para medir la asociación entre parentesco y TB se empleó la prueba de chi cuadrado y para medir la asociación entre el tamaño del PPD y parentesco se empleó la prueba U-Mann Withnney. Se aplicó regresión logística para determinar los...

Introducción: La prevención secundaria de la enfermedad tuberculosa con la administración de quimioprofilaxis (QP) con isoniacida es el tercer elemento de un Programa de Control de la Tuberculosis (PCTB). Objetivos:DeterminarsuefectoprotectorenunestudiooperacionalentreloscontactosdelospacientesdelPCTBdelHospitalNacionalCayetanoHeredia(HNCH). Materialymétodos:Estudiotransversal,queincluyóatodosloscontactosdepacientesconTBquerecibierontratamientoenelPCTBdelHNCHdesde1977hasta2011.SeconsideróqueuncontactohabíatomadoQPsiésteestabaconsignadoenlafichadetratamientodelcasoíndice.Elefectoprotector(EP)delaQPsedeterminóempleandolafórmula(1-OR)x100%.LaasociaciónentrevariablessedeterminómediantelapruebadeChicuadrado,unvalordep<0.05fueconsideradoestadísticamentesignificativo.Resultados:Seincluyóenelestudio12638contactosqueteníanregistradoeldatosobreQP,26.2%(3305)tomaronisoniaciday73.8%(...

Presenta el estudio de los contactos de pacientes del PCTB desde 1977 al 2011.

Introducción La infección tuberculosa se presenta cuando se tiene contacto con un enfermo y el riesgo es mayor entre los que viven con él. El objetivo fue establecer la asociación que existe entre las características demográficas de los contactos de pacientes con tuberculosis (TB) y la infección tuberculosa. Materiales y métodos Estudio descriptivo. Se incluyeron 5242 contactos de pacientes del Programa de Control de TB del Hospital Cayetano Heredia. A 5156 contactos se les aplicó la prueba de tuberculina (PPD) cuando el caso índice (CI) fue diagnosticado, mientras que a 86 dos meses después del diagnóstico del CI. Un contacto tenía infección tuberculosa si su PPD fue positivo (≥ 10 mm) o hubo viraje del mismo (5 mm mayor al control previo). Resultados El PPD fue positivo en 2399. A 349 contactos que tenían PPD negativo se les puso un segundo PPD, siendo 118 los viradore...

Presentamos el caso de un varón de 38 años a quien por presentar dolor torácico se le hizo dieciocho años antes el diagnósticode quiste hidatídico. Se confirmó en la tomografía espiral multicorte (TEM) que tenía una masa heterogénea de contenido líquido, con paredes parcialmente calcificadas localizada en el mediastino anterior. Se la extirpó, siendo el diagnóstico, por la presencia de grupos de células acinares y de conductos con apariencia pancreática, panqueratina y CD68 positivos, de un páncreas ectópico mediastinal. Nunca se ha reportado un caso en el Perú y en la literatura médica éste sería el trigésimo primercaso reportado de páncreas ectópico intratorácico.

Determinar el efecto protector de la vacuna BCG según tipo de TB y características demográficas.

Study Objectives Assess acute changes in nocturnal sleep oxygenation, sleep disordered breathing and symptoms of Acute Mountain Sickness (AMS) in healthy High Altitude (HA) sojourners. Methods Ten subjects born at Sea Level (SL) were enrolled and underwent nocturnal polygraphy for 5 consecutive nights at HA and 2 nights before and after HA (2761 m). Nocturnal oxygen profiles were characterized by the mean Oxyhaemoglobin Saturation (SpO2) during sleep, and sleep apnea severity was represented by the Apnea-Hypopnea Index (AHI). Repeated measures linear regression was used to examine responses in outcome variables (SpO2, logAHI and LLS) between HA and SL. Mean SpO2 on night 1 at HA was used to stratify post-hoc analyses based on mean level of nocturnal desaturation and logAHI. Subjects completed the Lake-Louise Score (LLS) survey every day. Results Compared to SL, mean SpO2 was lower at HA ...