Considerando la importancia que tiene el Seguro Integral de Salud (SIS) en el Aseguramiento Público del Perú, y su estrecha relación con los Hospitales Nacionales e Institutos Especializados del Ministerio de Salud, se buscó determinar la influencia de las estrategias implementadas por el SIS para mejorar las Transferencias Financieras (Pago) a los Establecimientos de Salud ubicados en Lima-Perú, así como la Ejecución (Gasto) por parte de estos entre los años 2009 y 2017. De una población de 22 Establecimientos de Salud del más alto nivel resolutivo que actualmente hay en Lima, se seleccionaron 16 para el análisis, los cuales estuvieron financiados por el SIS a lo largo de este periodo de estudio. Se realizó un estudio descriptivo y retrospectivo, basado en información secundaria obtenida de los registros Institucionales de la Página Web Oficial del SIS. Los resultados most...

Objetivo: Analizar la prevalencia y componentes del Síndrome Metabólico (SM) premórbido en trabajadores asegurados al seguro social de salud en una zona de altitud moderada (Chachapoyas, Perú). Materiales y métodos: Se realizó un estudio transversal con datos de diverso tipo de trabajadores pertenecientes a un programa de EsSalud enfocado a diagnosticar SM premórbido, obesidad y sobrepeso en trabajadores en sus centros laborales durante el periodo octubre 2017 a agosto 2018. Se trabajó con datos previamente registrados por el programa mencionado. El SM se diagnosticó según los criterios de la guía “Harmonizing the Metabolic Syndrome”. Resultados: Se incluyeron un total de 1021 sujetos. La prevalencia global de SM premórbido fue de 32,8 % (312/952). En hombres, la prevalencia fue de 35,4 % (160/452) y en mujeres de 30,4 % (152/500), no existiendo diferencias estadísticame...

Objective: To analyze the prevalence and components of pre-morbid Metabolic Syndrome (MS) in workers insured by social health in a moderate altitude area (Chachapoyas, Peru). Materials and methods: A cross-sectional study was conducted with data from various types of workers belonging to a program focused on diagnosing pre-morbid MS, obesity and overweight in workers in their workplaces during the period from October 2017 to August 2018. Data previously recorded by the program were used. MS was diagnosed according to the criteria of the guide "Harmonizing the Metabolic Syndrome". Results: A total of 1021 subjects were included. The overall prevalence of pre-morbid MS was 32.8% (312/952). In men, the prevalence was 35.4% (160/452) and in women 30.4% (152/500), with no statistically significant differences between sexes (p = 0.101). The frequency of the components of MS in the total popula...

Objective: To analyze the prevalence and components of pre-morbid Metabolic Syndrome (MS) in workers insured by social health in a moderate altitude area (Chachapoyas, Peru). Materials and methods: A cross-sectional study was conducted with data from various types of workers belonging to a program focused on diagnosing pre-morbid MS, obesity and overweight in workers in their workplaces during the period from October 2017 to August 2018. Data previously recorded by the program were used. MS was diagnosed according to the criteria of the guide "Harmonizing the Metabolic Syndrome". Results: A total of 1021 subjects were included. The overall prevalence of pre-morbid MS was 32.8% (312/952). In men, the prevalence was 35.4% (160/452) and in women 30.4% (152/500), with no statistically significant differences between sexes (p = 0.101). The frequency of the components of MS in the total popula...

Introducción:Es fundamental identificar las características epidemiológicas y clínicas de los pacientes infectados con COVID-19, asociadas a una progresión de la enfermedad que conlleva al ingreso a UCI. El objetivo fue revisar sistemáticamente los modelos o scores de predicción de ingreso a la unidad de cuidados intensivos(UCI)disponibles a la fecha para pacientes con COVID-19.Métodos:El estudio es una revisión sistemática. Se hicieronbúsquedas en PubMed, Scopus, Web of Science, Ovid-Medline, y Embasehasta el 13 de Julio del 2022. Se incluyeron estudios que hayan desarrollado y validado un modelo o sistema de puntuación para predecir el ingreso a la UCI en pacientes con COVID-19.El desenlace primario fue el ingreso a la UCI.La evaluación del riesgo de sesgo se realizó utilizando la herramienta PROBASTque se basa en cuatro dominios: participantes, predictores, desenlace y a...

Background: It is essential to identify the epidemiological and clinical characteristics of patients infected with COVID-19 associated with disease progression leading to ICU admission. The objective was to systematically review the models or scores for predicting admission to the intensive care unit (ICU) available to date for patients with COVID-19. Methods: The study is a systematic review. PubMed, Scopus, Web of Science, Ovid-Medline, and Embase were searched until July 13, 2022. We included studies that have developed and validated a model or scoring system to predict ICU admission in patients with COVID-19. The primary outcome was ICU admission. Risk of bias assessment was performed using the PROBAST tool which is based on four domains: participants, predictors, outcome and analysis. Results: Two studies were included for data extraction and critical appraisal. Predictive models of...

El embarazo después del trasplante de hígado tuvo un resultado favorable en la mayoría de los casos estudiados, pero aún existen riesgos graves para la madre y el feto. Su evaluación y seguimiento debe involucrar a un equipo multidisciplinario.

Introduction: This article summarizes the clinical practice guide (CPG) for the diagnosis and management of cholelithiasis, acute cholecystitis and choledocholithiasis in the Peruvian Social Security (EsSalud). Objective: To provide clinical recommendations based on evidence for the management of patients with cholelithiasis, acute cholecystitis and choledocholithiasis in EsSalud. Methods: a guideline task force (GTF) was formed with internists, general surgeons, gastroenterologists, and methodologists. The group proposed 10 clinical questions to be answered in this Clinical practice guideline (CPG). Systematic searches of preview reviews were performed and when it was necessary, primary studies from PubMed and CENTRAL during 2017 were reviewed. The evidence was selected aiming to answer each proposed question. Certainty of evidence was evaluated using Grading of Recommendations Assessme...

Liver transplantation is the major treatment for end-stage liver disease. Postoperative care is a great challenge to reduce morbidity and mortality in patients. In this sense, management in the liver ICU allows hemodynamic management, coagulation monitoring, renal support, electrolyte disturbances, respiratory support and early weaning from mechanical ventilation and evaluation of the liver graft. Objective: The present study shows the results of the management of liver transplant patients in 20 years of experience in a transplant center in a low- to middle-income country. Materials and methods: The medical records of 273 adult patients in the ICU in the immediate postoperative liver transplant were reviewed, from March 20, 2000 to November 30, 2020, including the effect of the pandemic caused by COVID-19. Liver-kidney, retransplanted, SPLIT, and domino transplant patients wer...