Despite being a preventable and curable disease, Tuberculosis continues to be a major global health problem. Worldwide, according to the WHO in 2017 were estimated at 10 million new cases of active tuberculosis, equivalent to 133 cases per 100,000 people; and about 1.3 million deaths in non-HIV patients and 300,000 additional deaths in HIV patients due to this cause, mainly in countries with limited resources. On the other hand, what exacerbates the problem is the emergence of resistance to anti-tuberculous drugs, which complicates the possibilities of treatment. Isoniazid is today one of the fundamental first-line drugs for the management of Tuberculosis, being closely related to the rapid negativization of sputum bacilloscopy, attributed to the potent bactericidal effect on rapidly multiplying strains. vital relevance not only in the control of the disease, but also in the control of t...

Despite being a preventable and curable disease, Tuberculosis continues to be a major global health problem. Worldwide, according to the WHO in 2017 were estimated at 10 million new cases of active tuberculosis, equivalent to 133 cases per 100,000 people; and about 1.3 million deaths in non-HIV patients and 300,000 additional deaths in HIV patients due to this cause, mainly in countries with limited resources. On the other hand, what exacerbates the problem is the emergence of resistance to anti-tuberculous drugs, which complicates the possibilities of treatment. Isoniazid is today one of the fundamental first-line drugs for the management of Tuberculosis, being closely related to the rapid negativization of sputum bacilloscopy, attributed to the potent bactericidal effect on rapidly multiplying strains. vital relevance not only in the control of the disease, but also in the control of t...

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Background: Actinomycosis is an unusual chronic bacterial infection, even rarer in people living with HIV. It is not considered an AIDS-defining disease. However, the role in co-presentation or overlap with other opportunistic conditions of advanced HIV is unknown. Case presentation: A 49-year-old Peruvian male presented with a 4-month history of dysphagia, odynophagia, hyporexia and wasting. He underwent an upper digestive endoscopy, in which ulcers with a necrotic center were observed, therefore, the initial diagnostic assumption was esophageal cancer. Subsequent pathology report excluded neoplasms and confirmed the diagnosis of actinomycosis. Serology for human immunodeficiency virus was requested, yielding a positive result. Antimicrobial treatment with amoxicillin and antiretroviral therapy were indicated, with slow clinical improvement. After 4 months, epigastric discomfort present...

Leprosy (Hansen’s disease) is a chronic granulomatous condition caused by Mycobacterium leprae, a microorganism that affects the skin and Schwann’s cells. Making a diagnosis of this condition is difficult in non-endemic areas because of low clinical suspicion. During the 2012-2019 time period, three cases of Hansen’s disease were diagnosed and treated in the ID service of Dos de Mayo Hospital. The average time history of the disease was 4 years. Patients started their condition with the appearance of pruriginous papular lesions affecting specific body regions, progressing to generalized nodular lesions. Paresthesia and tactile, thermal, pain, and vibratory hypoesthesia were found. These manifestations later progressed to anesthesia. Diagnosis was made through bacilloscopy in lymphatic fluid and skin node biopsy. Clinical features for each patient are also described. We emphasize th...

Leprosy (Hansen’s disease) is a chronic granulomatous condition caused by Mycobacterium leprae, a microorganism that affects the skin and Schwann’s cells. Making a diagnosis of this condition is difficult in non-endemic areas because of low clinical suspicion. During the 2012-2019 time period, three cases of Hansen’s disease were diagnosed and treated in the ID service of Dos de Mayo Hospital. The average time history of the disease was 4 years. Patients started their condition with the appearance of pruriginous papular lesions affecting specific body regions, progressing to generalized nodular lesions. Paresthesia and tactile, thermal, pain, and vibratory hypoesthesia were found. These manifestations later progressed to anesthesia. Diagnosis was made through bacilloscopy in lymphatic fluid and skin node biopsy. Clinical features for each patient are also described. We emphasize th...

A 27-year-old Peruvian woman living with human immunodeficiency virus (HIV) in clinical stage B3 and not on antiretroviral therapy presented with a ten-day history of fever, chills, night sweats and a two-day history of skin lesions. On physical examination, several erythematous-purplish lesions were found on the face and legs. Meningococcal infection was suspected and ceftriaxone was started. Blood culture grew nontyphoidal Salmonella enterica. A biopsy of the skin lesions showed leukocytoclastic vasculitis (LCV); therefore, corticosteroids were added. After two weeks of antibiotic and corticosteroid treatment, the lesions had resolved, but they recurred two days after treatment with prednisone was stopped. Corticosteroids and combination antiretroviral therapy were started simultaneously and the lesions resolved without recurrence. HIV infection has been associated with higher rates of...

Objective: To develop a systematic review and meta-analysis to determine the association between hypertriglyceridemic waist (CHTG) and arterial hypertension (HBP) in adults. Materials: The present study is a systematic review (SR) with meta-analysis of analytical cross-sectional observational studies. Search strategies will be used in different databases, which will be Pubmed, SCOPUS, Web of Science, Embase. The qualitative analysis was presented in a table with the characteristics of each study. For quantitative analysis, random-effects meta-analysis was performed due to the heterogeneity of the studies. These variables were compared using Odds Ratios (OR) as a measure of association with their corresponding 95% confidence interval. Results: Five studies were included for statistical analysis. Overall, a statistically significant association was found between both variables (OR: 1.36; 9...

Objetivo: Desarrollar una revisión sistemática y metaanálisis para determinar la asociación entre la cintura hipertrigliceridémica (CHTG) e hipertensión arterial (HTA) en adultos. Métodos: El presente estudio es una revisión sistemática (RS) con metanálisis de estudios observacionales de corte transversal analítico. Se utilizarán estrategias de búsqueda en diferentes bases de datos las cuales serán Pubmed, SCOPUS, Web of Science, Embase. El análisis cualitativo fue presentado en una tabla con las características de cada estudio. Para el análisis cuantitativo, se realizó el metaanálisis de efectos aleatorios debido a la heterogeneidad de los estudios. Dichas variables fueron comparadas usando como medida de asociación Odds Ratios (OR) con su correspondiente intervalo de conanza al 95%. Resultados: Se incluyeron 5 estudios para el análisis estadístico. De manera globa...

Vibrio cholerae serogrupo NO-O1/NO-O139 (VCNO) es causa infrecuente de gastroenteritis. Sin embargo, se le asocia a infección extra-intestinal severa en huéspedes inmunocomprometidos, y entre ellas, la bacteremia en pacientes con cirrosis hepática es digna de mención. A continuación, presentamos el caso de una mujer de 58 años, con el diagnóstico de cirrosis hepática de fondo, que desarrolló progresivamente choque séptico, disfunción orgánica múltiple y desenlace fatal al cuarto día de su admisión. Los resultados obtenidos post mortem, de los hemocultivos previamente tomados, aislaron bacilos gram negativos compatibles con Vibrio cholerae. Posteriormente, se identificó el serogrupo NO-O1/NO-O139, a través de aglutinación en placa y PCR negativo para el gen ctxA. El antibiograma mostró susceptibilidad conservada a ampicilina, cloranfenicol, tetraciclina y ciprofloxacino...

El curso Integración Clínico-Patológica 3 es un curso de especialidad de la carrera de medicina, de carácter teórico, que se dicta a los estudiantes del 8vo ciclo de la carrera de medicina y que contribuye con el desarrollo de la competencia general Uso de la Información para el Pensamiento Crítico (nivel 3) y la competencia específica Práctica clínica (nivel 2). A través del curso los estudiantes integran los mecanismos fisiopatológicos con la patogénesis y manifestaciones clínicas de los problemas de salud que se abordan en relación al sistema vascular y corazón, enfermedades inflamatorias, enfermedades infecciosas, entre otras. La comprensión de esta integración permite a los estudiantes establecer las bases del diagnóstico clínico y las pautas del manejo de los problemas de salud abordados.

El curso Integración Clínico-Patológica 3 es un curso de especialidad de la carrera de medicina, de carácter teórico práctico, que se dicta a los estudiantes del 8vo ciclo de la carrera de medicina y que contribuye con el desarrollo de la competencia general Pensamiento Crítico (nivel 3) y la competencia específica Profesionalismo - aprendizaje autónomo y desarrollo profesional (nivel 3). A través del curso los estudiantes integran los mecanismos fisiopatológicos con la patogénesis y manifestaciones clínicas de los problemas de salud que se abordan en relación al sistema vascular y corazón, enfermedades inflamatorias, enfermedades infecciosas, entre otras. La comprensión de esta integración permite a los estudiantes establecer las bases del diagnóstico clínico y las pautas del manejo de los problemas de salud abordados.

El curso Integración Clínico-Patológica 3 es un curso de especialidad de la carrera de medicina, de carácter teórico práctico, que se dicta a los estudiantes del 8vo ciclo de la carrera de medicina y que contribuye con el desarrollo de la competencia general Pensamiento Crítico (nivel 3) y la competencia específica Profesionalismo - aprendizaje autónomo y desarrollo profesional (nivel 3). A través del curso los estudiantes integran los mecanismos fisiopatológicos con la patogénesis y manifestaciones clínicas de los problemas de salud que se abordan en relación al sistema vascular y corazón, enfermedades inflamatorias, enfermedades infecciosas, entre otras. La comprensión de esta integración permite a los estudiantes establecer las bases del diagnóstico clínico y las pautas del manejo de los problemas de salud abordados. 1

El curso Integración Clínico-Patológica 3 es un curso de especialidad de la carrera de medicina, de carácter teórico, que se dicta a los estudiantes del 8vo ciclo de la carrera de medicina y que contribuye con el desarrollo de la competencia general Uso de la Información para el Pensamiento Crítico (nivel 3) y la competencia específica Práctica clínica (nivel 2). A través del curso los estudiantes integran los mecanismos fisiopatológicos con la patogénesis y manifestaciones clínicas de los problemas de salud que se abordan en relación al sistema vascular y corazón, enfermedades inflamatorias, enfermedades infecciosas, entre otras. La comprensión de esta integración permite a los estudiantes establecer las bases del diagnóstico clínico y las pautas del manejo de los problemas de salud abordados. 1