En el Perú, el programa actual de inmunización para COVID-19 comprende las vacunas BBIBP-CorV, BNT162B2 y ChAdOx1 nCoV-19. Si bien el esquema de inmunización es de dos dosis, algunos países han incluido recientemente una dosis de refuerzo a su esquema. Métodos: Se realizó una búsqueda de evidencia científica sobre la eficacia y seguridad de la vacunación de refuerzo con la vacuna BNT162b2 en población con esquema de vacunación completa para COVID-19 en Perú. Evidencia incluida: Se consideraron cuatro documentos de recomendación basados en evidencia, un estudio observacional y tres ensayos clínicos fase III en curso. Conclusión: A la fecha, no existe evidencia suficiente sobre la eficacia de agregar una dosis de refuerzo al esquema de inmunización para COVID-19. La evidencia disponible no permite justificar el uso de una dosis de refuerzo con la vacuna BNT162B2 en poblaci�...

Background: In Peru, the current immunization schedule for COVID-19 includes BBIBP-CorV, BNT162B2 and ChAdOx1 nCoV-19 vaccines. Although the full immunization schedule is two doses, some countries have recently included a booster dose to their schedule. Methods: We conducted a search for scientific evidence on the efficacy and safety of booster vaccination with BNT162b2 vaccine in a population with a complete vaccination schedule for COVID-19 in Peru. Evidence: Four evidence-based recommendation documents, one observational study and three ongoing phase III clinical trials were included for analysis. Conclusion: To date, there is insufficient evidence on the efficacy of adding a booster dose to the immunization schedule for COVID-19. The available evidence does not justify the use of a booster dose of BNT162B2 vaccine in a population that has previously received two doses of the aforemen...

Introducción: La cirrosis hepática representa en Perú el 9,1 % de las causas de mortalidad. Existe poca evidencia sobre la influencia de variables epidemiológicas y clínicas en la mortalidad de pacientes con cirrosis hepática en Latinoamérica, en especial en países en vías de desarrollo, como Perú. Objetivo: Identificar los factores asociados a la mortalidad en pacientes cirróticos. Métodos: Estudio trasversal en pacientes cirróticos atendidos en el Hospital “Cayetano Heredia”, de Piura, Perú, en el año 2017. La variable dependiente fue la mortalidad hospitalaria y las variables independientes fueron las características epidemiológicas, clínicas y de laboratorio. Se utilizó la prueba exacta de Fisher y la prueba de t para estimar los factores asociados a la mortalidad. Resultados: De 52 pacientes, la frecuencia de mortalidad debido a cirrosis fue de 35,4 %. Tener a...

Background: Limitations have been reported to comply with good methodological practices in the development of health technology assessments (HTA). Therefore, the objective of the present study was to describe the methodological characteristics of the HTAs carried out in Peru, between 2019-2021. Methods: Descriptive study. We are looking for Peruvian institutions that prepare HTAs whose reports are accessible to the public. We collected the total number of HTAs produced by these institutions per year, and we collected the characteristics of the HTAs produced during the 2019-2021 period. Results: Three Peruvian institutions developed at least three public HTAs between 2019-2021: The Institute for the Evaluation of Technologies in Health and Research (IETSI) (n=142), the Unit for the Analysis and Generation of Evidence in Public Health (UNAGESP) (n=60), and the National Institute of Neoplas...

Previous studies have described multiple nutritional deficiencies after bariatric surgery (BS). However, few studies have evaluated these deficiencies prior to BS, specifically in Latin America. This study aimed to determine the factors associated with nutritional deficiency biomarkers in candidates for BS in Peru. We included adults of both sexes, aged 18 to 59 years, admitted to a Peruvian clinic with a body mass index (BMI) ≥ 30 kg/m2; they were candidates for BS from 2017 to 2020. We considered the serum levels of hemoglobin and albumin (in tertiles) as the nutritional deficiency biomarkers. In order to assess the associated factors, we calculated crude (cPR) and adjusted prevalence ratios (aPR) with their respective 95% confidence intervals (95%CI). We analyzed 255 patients: 63.1% were males, with a mean age of 37.1 ± 10.3 years and mean hemoglobin and albumin values of 14.0 ± 1...

Introducción: Estudios recientes han identificado reducción de eficacia de terapia triple para la erradicación del H. pylori. En Perú, no existe suficiente evidencia sobre la eficacia de este tipo de terapia. El objetivo fue identificar la asociación entre tipo de terapia y erradicación de H. pylori. Materiales y métodos: Estudio retrospectivo analítico en un hospital privado de Piura, Perú 2017. Se recolectó información de historias clínicas de pacientes con biopsia positiva para H. pylori. Se evaluó la asociación entre tipo de terapia recibida (triple estándar, MOCA y BOTF) y la erradicación de infección por H. pylori. También, se exploró la presencia de comorbilidad, diagnóstico endoscópico antes y después de la terapia recibida,presencia de metaplasia y displasia. Se utilizó la prueba exacta de Fisher y un nivel de significancia al 5 %. Resultados: De 80 pacien...

El presente artículo resume la guía de práctica clínica (GPC) para el tamizaje y el manejo del episodio depresivo leve en el primer nivel de atención en el Seguro Social del Perú (EsSalud). Para el desarrollo de esta GPC, se conformó un grupo elaborador de la guía (GEG) que incluyó especialistas clínicos y metodólogos, el cual formuló 06 preguntas clínicas. Para responder cada pregunta se realizó búsquedas sistemáticas en PubMed y en repositorios de GPC, y se seleccionó la evidencia pertinente. La certeza de la evidencia fue evaluada usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones periódicas, el GEG usó la metodología GRADE para revisar la evidencia y emitir las recomendaciones. Se emitieron siete recomendaciones (tres fuertes y cuatro condicionales), 28 puntos de buena práctica clínica, y dos flujogram...

This paper summarizes the clinical practice guide (CPG) for the screening and management of mild depressive episode at the first level of care in the Social Security of Peru (EsSalud). A guideline development group (GDG) was established for develop this CPG, which included clinical and methodology specialists, who formulated 06 clinical questions. Systematic searches were conducted in Pubmed and GPC repositories to answer each question, and relevant evidence was selected. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic work meetings, the GDG used the GRADE methodology for reviewing the evidence and for developing recommendations. At the end, this CPG formulated 07 recommendations (03 strong and 04 conditional), 28 points of good clinical practice, and 02 flow charts were formulated.

We aimed to identify the factors associated with mortality in patients with COVID-19 from the hospitalization service of the Cayetano Heredia Hospital, Piura, Peru, from May to June 2020. A prospective study was conducted in hospitalized patients with a confirmed diagnosis of COVID-19 through serological and/or molecular reactive testing. The dependent variable was death due to COVID-19, and the independent variables were the epidemiological, clinical and laboratory characteristics of the patient. The chi-square test and the non-parametric Mann–Whitney U test were used, with a significance level of 5%. Of 301 patients with COVID-19, the majority of them were male (66.1%), and the mean age was 58.63 years. Of the patients analyzed, 41.3% of them died, 40.2% of them were obese and 59.8% of them had hepatic steatosis. The three most frequent signs/symptoms were dyspnea (90.03%), fatigue (...

We aimed to identify the factors associated with mortality in patients with COVID-19 from the hospitalization service of the Cayetano Heredia Hospital, Piura, Peru, from May to June 2020. A prospective study was conducted in hospitalized patients with a confirmed diagnosis of COVID-19 through serological and/or molecular reactive testing. The dependent variable was death due to COVID-19, and the independent variables were the epidemiological, clinical and laboratory characteristics of the patient. The chi-square test and the non-parametric Mann–Whitney U test were used, with a significance level of 5%. Of 301 patients with COVID-19, the majority of them were male (66.1%), and the mean age was 58.63 years. Of the patients analyzed, 41.3% of them died, 40.2% of them were obese and 59.8% of them had hepatic steatosis. The three most frequent signs/symptoms were dyspnea (90.03%), fatigue (...

This paper summarizes the clinical practice guide (CPG) for the screening and management of mild depressive episode at the first level of care in the Social Security of Peru (EsSalud). A guideline development group (GDG) was established for develop this CPG, which included clinical and methodology specialists, who formulated 06 clinical questions. Systematic searches were conducted in Pubmed and GPC repositories to answer each question, and relevant evidence was selected. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic work meetings, the GDG used the GRADE methodology for reviewing the evidence and for developing recommendations. At the end, this CPG formulated 07 recommendations (03 strong and 04 conditional), 28 points of good clinical practice, and 02 flow charts were formulated.