Objective: To describe and analyze the factors associated with prolonged work absenteeism due to medical reasons among agribusiness workers. Materials and methods: A secondary source research was conducted in a population of 3,150 agribusiness workers in Peru. A sample of 9,443 cases of work absenteeism was taken during the years 2012 and 2013. Long-term work absenteeism was defined as ≥ 10 days. Analyzed factors were: age, sex, job tenure, type of activity, work schedule, job stability, type of contingency, and affected body system according to the diagnosis. A descriptive and multivariate statistical analysis was applied by binary logistic regression. Results: The factors explaining prolonged work absenteeism were occupational accidents (OR: 13.9, CI: 11.2- 17.2), atypical schedule (OR: 3.14, CI: 1.58-6.25), shorter job tenure (OR: 0.95, CI: 0.95-0.96), moderate-intense work activity...

A thematic review on MELAS in Latin America between 1990 and 2021 was conducted through a systematic literature search on LILACs, Scielo, PubMed/Medline and Scopus databases. Nineteen case reports/series out of 966 publications were selected and included 51 patients, 42 of them with genetic diagnosis reported in eight Latin American countries. The m.3243A> G variant was the most frequently reported, the mean age at onset being 12 ± 9.7 years, with a mild female predominance. The most frequent neurological features were stroke-like episodes and seizures. Neuroimaging tests highlighted ischemic stroke-like lesions as well as calcified lesions in the basal ganglia.

Objective: To determine if the Tomographic Severity Score (TSS) of patients with COVID- 19 pneumonia at admission, as well as some laboratory tests or clinical features predict ICU admission in this group of patients. Material and methods: Case-control study, which included patients with a clinical diagnosis of SARS-CoV2 virus infection, performed by reverse transcriptase polymerase chain reaction (RT-PCR), reactive serological test (IgM / IgG) and/or Computed Tomography of the chest (CTT) without contrast. Two radiologists (blind evaluators) described the tomographic findings. The data were taken from electronic medical records (EHR). The most important variables for the prediction of ICU admission were analyzed: TSS, age, BMI, obesity, ferritin, D-Dimer, O2 saturation, PO2, lymphopenia, C-reactive protein, and presence of comorbidities: Diabetes Mellitus, HTN. The prediction of admissi...

Objective: To determine if the Tomographic Severity Score (TSS) of patients with COVID- 19 pneumonia at admission, as well as some laboratory tests or clinical features predict ICU admission in this group of patients. Material and methods: Case-control study, which included patients with a clinical diagnosis of SARS-CoV2 virus infection, performed by reverse transcriptase polymerase chain reaction (RT-PCR), reactive serological test (IgM / IgG) and/or Computed Tomography of the chest (CTT) without contrast. Two radiologists (blind evaluators) described the tomographic findings. The data were taken from electronic medical records (EHR). The most important variables for the prediction of ICU admission were analyzed: TSS, age, BMI, obesity, ferritin, D-Dimer, O2 saturation, PO2, lymphopenia, C-reactive protein, and presence of comorbidities: Diabetes Mellitus, HTN. The prediction of admissi...

Objetivo: Analizar los factores asociados a la alteración de la glicemia basal en el primer control posterior a una hospitalización en pacientes con DM2. Materiales y métodos: Se realizó un estudio observacional, retrospectivo, de casos y controles, en proporción 1:1. Se analizaron 100 registros médicos de pacientes con DM2, de ambos sexos, mayores de 18 años, con un control médico dentro de los 3 primeros meses posteriores a la hospitalización. Los casos definidos mediante glicemia basal elevada (> 130 mg/dL) y los controles definidos como glicemia normal (≤ 130 mg/dL). Se calculó medias y porcentajes, se usó la prueba Chi2 y regresión logística binaria. Resultados: Niveles elevados de glicemia al ingreso (OR: 2.7, p< 0.05), niveles elevados de glicemia al alta (OR: 3.7, p< 0.005), HbA1c ≥ 9 % durante la hospitalización (OR: 2.9, p< 0.05), niveles elevados de triglicé...

Objective: To analyze the factors associated with the alteration of baseline glycemia in the first post-hospitalization checkup in patients with type 2 diabetes mellitus (T2DM). Materials and methods: A retrospective observational case-control study was performed in a 1:1 ratio. One hundred (100) medical records of patients of both genders and over 18 years of age with T2DM who had a medical checkup within the first 3 months after hospitalization were analyzed. Cases were defined as those with high baseline glycemia (> 130 mg/dL) and controls were defined as those who had normal glycemic levels (≤ 130 mg/dL). Mean and percentages were estimated using the chi-square test and binary logistic regression. Results: Elevated glycemic levels at admission (OR: 2.7, p <0.05), elevated glycemic levels at discharge (OR: 3.7, p <0.005), HbA1c ≥ 9 % during hospitalization (OR: 2.9, p <...

La Ataxia-Telangiectasia (AT) es una rara enfermedad de herencia autosómica recesiva y de afección multisistémica, caracterizada por ataxia progresiva, inmunodeficiencia variable con infecciones recurrentes, riesgo incrementado de neoplasias con o sin telangiectasias óculo-cutáneas. La AT es causada por variantes patogénicas bialélicas en el gen ATM. Su diagnóstico se basa en la sospecha de un cuadro clínico compatible, niveles elevados de alfafetoproteína, atrofia cerebelosa y estudios genéticos. No existe tratamiento curativo de AT y su manejo se basa en medidas de soporte y prevención de complicaciones y asesoramiento genético. En esta revisión, actualizamos la epidemiología, manifestaciones clínicas, diagnóstico y tratamiento de AT incluyendo una búsqueda de casos publicados en el Perú.

La Ataxia de Friedreich (AF) es una enfermedad neurodegenerativa autosómica recesiva con compromiso multisistémico. En esta revisión, se actualizan aspectos epidemiológicos, fisiopatológicos y clínico-terapéuticos y se conduce una búsqueda sistemática de casos de AF reportados en Latinoamérica. La prevalencia de AF en poblaciones caucásicas es estimada entre 2 y 5 casos por 100 000 habitantes. En Latinoamérica se han publicado 35 estudios que reúnen 1481 casos en 6 países. Causada por la expansión anormal de repeticiones GAA en el gen FXN, la etiopatogenia está asociada a una reducción en los niveles de la proteína frataxina (que altera el metabolismo energético) y el acúmulo de hierro mitocondrial. El fenotipo clásico de AF suele comenzar antes de los 25 años, aunque hay otros de inicio tardío y retención de reflejos. La sintomatolog...

Hasta un tercio de individuos diagnosticados de epilepsia continúan teniendo crisis a pesar del tratamiento antiepiléptico apropiado. Estos pacientes pueden ser referidos para evaluación pre-quirúrgica y la cirugía es considerada un tratamiento efectivo para epilepsia relacionada a localización refractaria. Los factores que predicen un mejor resultado de la cirugía son contradictorios, y las recomendaciones incluyen evaluación detallada del rendimiento cognitivo antes y después de la cirugía; sin embargo no se considera la evaluación de la reserva cognitiva (RC). La incorporación de un instrumento que valore la RC de los pacientes permitiría incrementar la fuerza predictiva de la evaluación neuropsicológica respecto al pronóstico post-quirúrgico y aportaría a la investigación de los factores neuroprotectores en aquellos pacientes con un perfil de rendimiento cognitivo ...

Dopa-responsive dystonia (DRD) encompasses a heterogenous group of primary dystonias, caused by enzymatic deficiencies across the amines pathway and, by definition, show as their main characteristic a favorable and sustained response to levodopa. There are up to 6 genes associated with DRD, including pathogenic variants of the GCH1 gene as the most frequently involved. The typical presentation of DRD is characterized by start in childhood, lower limb-onset dystonia with daytime fluctuation, mild parkinsonism, and a sustained response to low doses of levodopa. A systematic literature search on DRD reported cases in Latin America is presented.