INTRODUCTION. Fecal leukocytes are widely used to identify invasive diarrhea and to make then the decision of prescribing or not antibiotics. This test has been hardly assessed in small hospitals of developing countries with efficient laboratory processes. We aimed to assess the diagnostic performance of different thresholds of fecal leukocytes in children under-five with acute diarrhea. MATERIAL AND METHODS. Retrospective study of clinical and laboratory records in the Pediatric Emergency Hospital, Lima, Peru. All cases with a stool culture and fecal leukocytes independently and systematically performed were studied. Sensitivity, specificity, predictive values, likelihood ratios (LR), and receiver operating characteristics (ROC) curves were calculated. RESULTS. Out of 1,804 stool samples assessed, 901 (49,9%) were positive for one or more bacterial entheropathogens. Sensitivity (Sn), sp...

   

Niña de dos años con fiebre y síntomas catarrales que presenta convulsiones focales de hemicuerpo derecho, las cuales persisten adicionándose signos de hipertensión endocraneana. Se identifica Influenza AH1N1 mediante reacción de cadena de polimerasa en hisopado nasofaríngeo. Paciente evoluciona favorablemente con medidas de soporte. No recibió Oseltamivir.

CONTEXT: The seeds from Lupinus mutabilis Sweet, also called “chocho”, are an important part of the diet in several countries in South America. Prior to consumption, processing is required to remove toxic alkaloids. These alkaloids are known to have pharmacological properties as antiarrhythmics, antimuscarinics and hypoglycemics. CASE REPORT: We report a case in which a one-year-old male initially presented with altered mental status and respiratory distress and subsequently developed symptoms of anticholinergic toxicity, after ingesting a large amount of chocho seeds. CONCLUSION: In spite of going through a difficult clinical condition, the subject evolved favorably through receiving supportive treatment. The seeds from Lupinus mutabilis provide nutritional benefits when consumed, but people need to know their risks when these seeds are consumed without proper preparation.

En los últimos años la práctica y la enseñanza médica han incorporado en forma progresiva y creciente el concepto de medicina basada en la evidencia (MBE). La misma se define como la utilización de la mejor evidencia proveniente de la investigación clínica para la toma de decisiones en el manejo del paciente individual. Esta propuesta de cambio en la manera de practicar y enseñar la medicina clínica es, en parte, consecuencia del vertiginoso avance de la investigación científica, particularmente en las últimas décadas, aunque el costo creciente involucrado en la atención de los pacientes ha jugado también un rol importante en su desarrollo y consolidación. La MBE implica la integración de la preparación y experiencia del médico con la mejor evidencia clínica externa accesible, proveniente de la investigación sistemática, proporcionando una visión más crítica en ...

Listeria meningoencephalitis is a rare condition, occurring mainly in immunocompromised patients. We present two cases of Listeria monocytogenes meningoencephalitis in immunocompetent children, with successful treatment with betalactam/aminoglycoside combination. Unpasteurized cheese was postulated as the source of infection.

Objective: The objective of this study is to establish the association between caring for older adults with neurological disorders and suffering from caregiver burden at the Naval Geriatric Center of Peru, from November 2019 to January 2021. Methodology: Analytical, observational, cross-sectional study carried out at the Geriatric Center of the Naval Medical Center. A total of 290 older adult's caregivers who went to medical consultation were surveyed. Caregiver burden was measured with the Zarit burden scale. Results: A prevalence of caregiver burden of 52.76% was found. The patients that suffered some neurological alteration were 62.76%. When adjusting for sociodemographic variables, being the patient's spouse increased the probability of suffering from caregiver burden by 2.23 times. When adjusting for the variables related to care, caring for a patient with neurological disorder and ...

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.

Background: Diabetic retinopathy (DR) is a primarily asymptomatic microvascular complication. Even though it is preventable, it is the first cause of irreversible blindness among working-age adults. Due to recent meta-analysis results, dyslipidemia is an inconclusive risk factor; therefore, the importance of accomplishing our study in the Peruvian population. Objective: Evaluate the relationship between dyslipidemia and DR in type II diabetic patients of the Ophthalmology area from the Edgardo Rebagliati Martins National Hospital in Lima-Peru, from 2018 to 2020. Methods: Case-control study, 219 cases and 219 controls were included. Diabetic patients will be classified based on the presence or absence of DR lesions on the ocular fundus determined by the specialist. Lipids parameters (triglyceride, LDL, HDL, total cholesterol) and other variables were recollected and analyzed in STATA 14. ...

Background: Diabetic retinopathy (DR) is a primarily asymptomatic microvascular complication. Even though it is preventable, it is the first cause of irreversible blindness among working-age adults. Due to recent meta-analysis results, dyslipidemia is an inconclusive risk factor; therefore, the importance of accomplishing our study in the Peruvian population. Objective: Evaluate the relationship between dyslipidemia and DR in type II diabetic patients of the Ophthalmology area from the Edgardo Rebagliati Martins National Hospital in Lima-Peru, from 2018 to 2020. Methods:  Case-control study, 219 cases and 219 controls were included. Diabetic patients will be classified based on the presence or absence of DR lesions on the ocular fundus determined by the specialist. Lipids parameters (triglyceride, LDL, HDL, total cholesterol) and other variables were recollected and analyzed in STATA 14...

Cartas al editor

Objective: To determine the risk factors for extubation failure in the intensive care unit. Methods: The present case-control study was conducted in an intensive care unit. Failed extubations were used as cases, while successful extubations were used as controls. Extubation failure was defined as reintubation being required within the first 48 hours of extubation. Results: Out of a total of 956 patients who were admitted to the intensive care unit, 826 were subjected to mechanical ventilation (86%). There were 30 failed extubations and 120 successful extubations. The proportion of failed extubations was 5.32%. The risk factors found for failed extubations were a prolonged length of mechanical ventilation of greater than 7 days (OR = 3.84, 95%CI = 1.01 - 14.56, p = 0.04), time in the intensive care unit (OR = 1.04, 95%CI = 1.00 - 1.09, p = 0.03) and the use of sedatives for longer than 5 ...

Suicide is a public health problem. Suicide by hanging is seen in all ages, starting around the age of 10-12. "Hanging injuries" is the term used to refer to people who survive after hanging. We present the case of a pediatric patient who survived mechanical asphyxia by hanging. A 12-year-old female patient who recently attempted suicide by hanging herself was admitted to the nearest hospital presenting "near-hanging injuries." She received ventilatory support and sedation-analgesia in the Pediatric Intensive Care Unit (PICU), treating cerebral edema with mannitol. Upon discharge, she presented neurological and structural sequelae. Although suicide is one of the most common causes of death in the pediatric population, near-hanging injuries are rare in this setting. Patients with these injuries should be treated aggressively and early to avoid possible complications. In this case, the fam...

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.

Escolar de once años con cuadro inicial de monoartritis de rodilla derecha por traumatismo local, fi ebre, trastorno del sensorio y disnea. Es hospitalizado y recibe tratamiento antibiótico empírico. El hemocultivo resulta positivo para Streptococcus pyogenes, por lo que se decide corregir la cobertura antibiótica. Sin embargo, el estado general del paciente empieza a decaer e ingresa a la unidad de cuidados intensivos. A pesar del tratamiento instaurado, el sujeto desarrolla shock séptico y posteriormente falla multiorgánica, requiriendo soporte hemodinámico y ventilatorio. Los síntomas se agravan y fallece a las 38 horas de su admisión hospitalaria.

We report a patient with Von Hippel-Lindau disease who presented with an intradural extramedullary hemangioblastoma as a primary manifestation.

Objective: To analyze the variation in attendance and diagnoses after the national vaccination campaign against COVID-19 in the pediatric emergency department. The study: Analytical retrospective cross-sectional study. Pediatric emergency department visits were compared between epidemiological weeks 1 and 52 of the years 2020 and 2021, analyzing sociodemographic characteristics, condition and diagnosis. Chi-square was used for bivariate analysis. Findings: A 77.8% increase was found in the number of attentions during the year 2021 compared to 2020. There was a 4% increase in infectious diseases and a 9.2% increase in respiratory diseases. In addition, a decrease of 8.7% was observed in gastrointestinal diseases. Conclusion: The results indicate that after the start of the national vaccination campaign, there was a significant increase in the number of patients compared to 2020, mainly fo...

Objective: To assess the association between fluid overload (FO) and other risk factors in the mortality of patients admitted to the Pediatric Intensive Care Unit (PICU). Patients and Method: A historical cohort study was conducted. Pediatric patients older than one month and younger than 18 years who were hospitalized in the PICU for more than 48 hours during 2016 were included. Demographic and clinical data were recorded. FO was calculated as [Sum of daily (fluid in − fluid out)/weight at ICU admission] × 100. Poisson regression analysis was performed to determine factors associated with mortality. Results: 171 patients were included. The median age was 31 months (RIQ 8; 84). Mortality was 8.18%. FO in the surviving population was 7% and 11.5% in the deceased patients (p < 0.05). The adjusted analysis identified FO as a major risk factor for mortality with a Relative Risk 1.32 (1.24...