Ivermectin has emerged as a therapeutic option for various parasitic diseases, including strongyloidiasis, scabies, lice infestations, gnathostomiasis, and myiasis. This study comprehensively reviews the evidence-based indications for ivermectin in treating parasitic diseases, considering the unique context and challenges in Peru. Fourteen studies were selected from a systematic search of scientific evidence on ivermectin in PubMed, from 2010 to July 2022. The optimal dosage of ivermectin for treating onchocerciasis, strongyloidiasis, and enterobiasis ranges from 150 to 200 μg/kg, while lymphatic filariasis requires a higher dose of 400 μg/kg (Brown et al., 2000). However, increased dosages have been associated with a higher incidence of ocular adverse events. Scientific evidence shows that ivermectin can be safely and effectively administered to children weighing less than 15 kg. S...

La anquilostomiasis es una de las principales geohelmintiasis, causada por Ancylostoma duodenale (A. duodenale) o por Necator americanus, que afecta principalmente la mucosa de las primeras porciones del intestino delgado (duodeno y yeyuno), inicialmente produce pequeñas hemorragias, las cuales pueden durar años, dando lugar al agotamiento de depósitos de hierro teniendo como consecuencia la anemia. En el peor de los casos, anemia ferropénica, constituyendo un gran problema de salud pública, siempre que haya contaminación fecal del medio ambiente.

Infestations caused by fly larvae (Myiasis) have been observed in patients with risk factors and in tropical zones. The aim of our study was to describe the clinical and epidemiological aspects and the risk factors associated with the occurrence of obligatory myiasis, as well as the therapeutic approach to patients. We identified the cases of myiasis diagnosed in two referral hospitals in northern Peru from January 2012 to December 2015 and included patients in whom larval development and a compatible clinical profile were observed. Epidemiological, clinical, analytical, diagnostic, therapeutic, and follow-up data were collected from clinical files. Nine clinical cases were compatible with a diagnosis of myiasis; of these, two were pediatric patients, one was a middle-aged adult, and six were elderly patients. Four of the nine patients were male. The identified species were Dermatobia ho...

Presentamos un estudio epidemiológico realizado en el Hospital Regional Lambayeque para discutir el aislamiento microbiológico obtenido de 541 muestras en líquido cefalorraquídeo (LCR) procesadas en el laboratorio de microbiología de 2014 a 2016, de las cuales 32 (5.9%) fueron detectadas como cultivos positivos, cumpliendo con los criterios de inclusión para este estudio. De ellos, 10 (31.25 %) correspondieron a Cryptococcus sp, todos procedentes de pacientes VIH+ y los 22 (68.75 %) restantes correspondieron a agentes bacterianos, donde los Staphylococcus coagulasa negativas y Pseudomonas aeruginosa fueron los más frecuentes entre los Gram positivos y Gram negativos (cuadro I). Como dato adicional, todos los aislamientos de enterobacterias presentaron resistencia a cefalosporinas de tercera generación

Presentamos un estudio epidemiológico realizado en el Hospital Regional Lambayeque para discutir el aislamiento microbiológico obtenido de 541 muestras en líquido cefalorraquídeo (LCR) procesadas en el laboratorio de microbiología de 2014 a 2016, de las cuales 32 (5.9%) fueron detectadas como cultivos positivos, cumpliendo con los criterios de inclusión para este estudio. De ellos, 10 (31.25 %) correspondieron a Cryptococcus sp, todos procedentes de pacientes VIH+ y los 22 (68.75 %) restantes correspondieron a agentes bacterianos, donde los Staphylococcus coagulasa negativas y Pseudomonas aeruginosa fueron los más frecuentes entre los Gram positivos y Gram negativos (cuadro I). Como dato adicional, todos los aislamientos de enterobacterias presentaron resistencia a cefalosporinas de tercera generación

Background: Hypokalemic periodic paralysis (HypoKPP) is characterized by transient episodes of flaccid muscle weakness. We describe the case of a teenaged boy with HypoKPP and hyperthyroidism due to Hashimoto's thyroiditis with initial manifestation of renal tubular acidosis. This combination is rare and little described previously in men. Case presentation: A 17-year-old boy was admitted after three days of muscular weakness and paresthesia in the lower limbs with an ascending evolution, leading to prostration. Decreased strength was found in the lower limbs without a defined sensory level, reduced patellar and ankle reflexes. Positive antithyroid antibodies were found. He received hydration treatment, IV potassium and levothyroxine, with which there was a clinical improvement. Other examinations led to the diagnosis of type 1 renal tubular acidosis. Conclusion: HypoKPP is a rare disord...

Background: Hypokalemic periodic paralysis (HypoKPP) is characterized by transient episodes of flaccid muscle weakness. We describe the case of a teenaged boy with HypoKPP and hyperthyroidism due to Hashimoto's thyroiditis with initial manifestation of renal tubular acidosis. This combination is rare and little described previously in men. Case presentation: A 17-year-old boy was admitted after three days of muscular weakness and paresthesia in the lower limbs with an ascending evolution, leading to prostration. Decreased strength was found in the lower limbs without a defined sensory level, reduced patellar and ankle reflexes. Positive antithyroid antibodies were found. He received hydration treatment, IV potassium and levothyroxine, with which there was a clinical improvement. Other examinations led to the diagnosis of type 1 renal tubular acidosis. Conclusion: HypoKPP is a rare disord...

ABSTRACT: Introduction: The Kristeller maneuver consists in making fundal pressure during the second stage of labor. Objective: To determine the prevalence, characteristics of the application of Kristeller maneuver and the physical and ethical consequences in puerperal women of a highly complex hospital in Lima, Peru. Methods: A cross-sectional and prospective descriptive study was carried out in 250 puerperal women of vaginal delivery, with single gestation at term, assisted at Hipólito Unanue National Hospital, from August to December 2016. This research used the Stop Kristeller questionnaire - prepared by the Spanish Association “El parto es nuestro”. A questionnaire validated by experts was applied to the puerperal women during their stay. A descriptive analysis was made and the results in frequencies and percentages are shown. Results: It was showed that 116 of them (46.4 %) un...

principales causas de mortalidad a nivel mundial y la actual pandemia por la COVID-19 ha producido un gran impacto en la atención de estos pacientes. El objetivo es describir las características de los pacientes con evento cerebro vascular en pacientes hospitalizados con COVID-19 en un hospital peruano de referencia. El estudio. Estudio retrospectivo, se incluyó a pacientes mayores de 18 años hospitalizados con el diagnostico de COVID-19 y evento cerebro vascular. Hallazgos. Se incluyeron 26 pacientes con ECV y COVID-19, la edad promedio fue 69.8 años y la mediana del tiempo de admisión fue 24 horas. La mortalidad fue elevada (42.3%) y estuvo asociada a la edad y al compromiso respiratorio por COVID-19. La mayoría de sobrevivientes obtuvieron un pobre resultado funcional. Conclusión. Es necesaria la mejora en los procesos de atención para así realizar un diagnóstico precoz y u...

Introducción: Los eventos cerebro vasculares son una de las principales causas de mortalidad a nivel mundial y la actual pandemia por la COVID-19 ha producido un gran impacto en la atención de estos pacientes. El objetivo es describir las características de los pacientes con evento cerebro vascular en pacientes hospitalizados con COVID-19 en un hospital peruano de referencia. El Estudio. Estudio retrospectivo, se incluyó a pacientes mayores de 18 años hospitalizados con el diagnostico de COVID-19 y evento cerebro vascular. Hallazgos. Se incluyeron 26 pacientes con ECV y COVID-19, la edad promedio fue 69.8 años y la mediana del tiempo de admisión fue 24 horas. La mortalidad fue elevada (42.3%) y estuvo asociada a la edad y al compromiso respiratorio por COVID-19. La mayoría de sobrevivientes obtuvieron un pobre resultado funcional. Conclusión. Es necesaria la mejora en los proces...

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Background: Stroke is one of the leading causes of mortality worldwide and the current COVID-19 pandemic has a great impact on the care of these patients. Aim: To describe the characteristics of patients with a cerebrovascular event in patients hospitalized with COVID-19 in the medical center with the highest hospital capacity in Peru. Material and Methods. We conducted a retrospective study and included patients older than 18 years hospitalized with the diagnosis of COVID-19 and stroke. Results. A total of 26 adults were included, the mean age was 69.8 years and the median time of admission was 24 hours. Mortality was high (42.3%) and was associated with age and respiratory compromise by COVID-19. The majority of survivors had a poor functional outcome. Conclusion. It is concluded that improvement in care processes is necessary in order to make an early diagnosis and timely treatment.

"La bartonelosis (también llamada enfermedad de Carrión o verruga peruana) es una enfermedad reemergente tropical causada por Bartonella bacilliformis. Actualmente, se expande a nuevas áreas y regiones del Perú, debido a la mayor distribución del vector Lutzomia verracarum. Esto sugiere la necesidad urgente de estrategias de control que incluyan, entre otros aspectos, el diagnóstico de laboratorio sensible y pertinente. Sin embargo, las pruebas sensibles para la detección de esta enfermedad (RPC, inmunoblot, etc.) son costosas y complejas de implementar en laboratorios de baja y mediana complejidad; o exigen demasiado tiempo para su ejecución (hemocultivo). Es por ello que la microscopía de sangre coloreada con tinción de Giemsa es una alternativa diagnóstica muy utilizada en países endémicos con escasos recursos. El objetivo de esta comunicación es analizar la utilidad del...

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Objective: To describe the clinical and demographic characteristics of patients with acute cerebral infarction treated at a national reference hospital in Peru and determine the risk factors for inhospital complications. Methods: We conducted a retrospective cohort study including 192 patients with acute ischemic stroke in a national reference hospital in Peru from January to September 2021. Clinical, demographic and paraclinical information was recorded from medical records. We estimated risk ratios and 95% confidence intervals using regression models with Poisson family and robust variance for the bivariate and multivariate model, adjusting for age, sex and risk factors for stroke. Results: At least one in-hospital complication occurred in 32.3% of the patients. The most frequent complications were infectious in 22.4%, followed by 17.7% of neurological complications, with other complic...

Objective: To describe the clinical and demographic characteristics of patients with acute cerebral infarction treated at a national reference hospital in Peru and determine the risk factors for inhospital complications. Methods: We conducted a retrospective cohort study including 192 patients with acute ischemic stroke in a national reference hospital in Peru from January to September 2021. Clinical, demographic and paraclinical information was recorded from medical records. We estimated risk ratios and 95% confidence intervals using regression models with Poisson family and robust variance for the bivariate and multivariate model, adjusting for age, sex and risk factors for stroke. Results: At least one in-hospital complication occurred in 32.3% of the patients. The most frequent complications were infectious in 22.4%, followed by 17.7% of neurological complications, with other complic...

Objective: To describe the clinical and demographic characteristics of patients with acute cerebral infarction treated at a national reference hospital in Peru and determine the risk factors for inhospital complications. Methods: We conducted a retrospective cohort study including 192 patients with acute ischemic stroke in a national reference hospital in Peru from January to September 2021. Clinical, demographic and paraclinical information was recorded from medical records. We estimated risk ratios and 95% confidence intervals using regression models with Poisson family and robust variance for the bivariate and multivariate model, adjusting for age, sex and risk factors for stroke. Results: At least one in-hospital complication occurred in 32.3% of the patients. The most frequent complications were infectious in 22.4%, followed by 17.7% of neurological complications, with other complic...

Objetivo: Describir las características de los ensayos clínicos activos (EC) desarrollados en la Seguridad Social de Salud del Perú. Material y métodos: Estudio observacional y descriptivo de los EC activos entre el 24 mayo al 8 julio del 2021, inscritos en el Registro Peruano de Ensayos Clínicos durante el periodo 2007-2020. Se analizó la distribución de las diferentes variables tales como N° de EC, fase, redes de EsSalud, regiones en el Perú, patrocinador, fuentes de financiamiento, especialidad, número de centros de investigación (CI) de EsSalud por EC, CIEI que aprobó los ECs por CI, y el cálculo de frecuencias relativas y absolutas. Resultados: Se identificaron 97 EC, ejecutados 144 veces en 23 diferentes CI pertenecientes a EsSalud. El 94,9% de los EC activos fue patrocinado por la industria farmacéutica y el 36% pertenecen a la especialidad de oncología. El 80,42% s...

Objetive: To describe the characteristics of active clinical trials (CTs) developed in the Social Health Security of Peru. Material and methods: Observational and descriptive study of active CTs between May 24 to July 8, 2021, registered in the Peruvian Registry of Clinical Trials during the period 2007-2020. The distribution of the different variable was analyzed, such as the number of CTs, phase, EsSalud networks, sponsor, funding sources, specialty, number of EsSalud research centers per CT, CIEI that approved CT by research center, and the calculation of relative and absolute frequencies. Results: 97 active CTs were identified, executed 144 times in 23 different research centers that belong to EsSalud. 94.9% of the active CTs were sponsored by pharmaceutical industries and 36% belong to the specialty of oncology. 80.42% are phase III and 70.8% were approved by an EsSalud CIEI. Conclu...