The definition of Primary Health Care is reviewed, as whole-of-society approach to health that aims at ensuring the highest possible level of health and well-being and their equitable distribution by focusing on people's needs and as early as possible along the continuum from health promotion and disease prevention to treatment, rehabilitation and palliative care, and as close as feasible to people's everyday environment. Some distortions of the term are described and explained,such as Primary care, Selective Primary health care and Basic Healthcare. Finally, some proposals are postulated to implement it in health facilities in urban areas, including an application case.

Objective: To characterize the publications on Health Systems produced in Peru between 2000-2020. Study: A bibliometric study of the scientific publications on health systems in Peru was carried out in journals indexed in the PubMed and SciELO databases. Narrative reviews, original articles with cross-sectional, and retrospective or prospective designs, were included. Collaboration networks of authors and institutions were described. Findings: 136 bibliographic units were identified. The institutions with the highest production were Universidad Peruana Cayetano Heredia (24.52%), the Ministry of Health (14.19%) and the Universidad Peruana de Ciencias Aplicadas (7.74%). The most studied component was the provision of services (50%), with descriptive designs. 65.44% were published between 2015-2020 and 35.29% in the Revista Peruana de Medicina Experimental y Salud Pública. 51.47% of the ar...

A 38-year-old woman with an initial diagnosis of urinary tract infection (UTI) was treated for five days with ciprofloxacin. On the third day of treatment, she presented fever, eyelid edema and rash over 50% of the body associated with pruritus. On admission, ceftriaxone was started considering a complicated UTI. On the eighth day, eosinophilia was evidenced and DRESS syndrome was diagnosed, being treated with chlorphenamine and ranitidine, achieving progressive remission of the initial symptoms.

En el mundo, el estándar diagnóstico para la infección por el SARS-CoV-2 son las pruebas de detección de ácido nucleico viral [1]. Sin embargo,el Perú ha basado su estrategia diagnóstica en adquirir pruebas serológicas (PS) de anticuerpos [2], a pesar de su utilidad solo para evaluar la respuesta inmunológica a la infección [3]. Así, según el flujograma de manejo del Ministerio de Salud (MINSA) el diagnóstico de infección por SARS-CoV-2 se confirma según el resultado de la IgM e IgG en la PS.

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Objectives: To determine the validity and reliability of the instrument "Computer Vision Syndrome Questionnaire (CVS-Q)" in the measurement of the Computer Visual Syndrome in health personnel in Lima. Methods: A quantitative, observational, descriptive, cross-sectional and questionnaire study was carried out in 82 health workers. Content validity was evaluated by expert judgment with the Aiken V statistical method; construct validity, through factor analysis; discriminant validity, through the receiver operating characteristic curve (ROC) curve contrasted with the CSSV17 questionnaire; internal consistency reliability, with Cronbach's alpha; reliability test - re-test (7 days apart); with Spearman's Rho and Interclass Correlation Coefficient (ICC) with 95% CI. The SPSS software version 20.0 for Windows with a trial license was used for its processing. Results: The V of Aiken obtained a v...

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Paciente mujer de 27 años con antecedente quirúrgico de nefrectomía radical derecha por angiomiolipoma, ingresa por emergencia refiriendo dos días de tos no productiva; minutos antes de su ingreso presenta dolor torácico brusco y disnea al reposo. La radiografía de tórax demuestra neumotórax espontáneo y se procede a colocación de tubo de drenaje torácico. La tomografía espiral multicorte de tórax sin contraste muestra múltiples quistes pulmonares difusosbilaterales y en los exámenes de laboratorio se destaca la elevación del Factor de Crecimiento Vascular Endotelial D en 573.0. Es referida a un centro hospitalario de tercer nivel para biopsia pulmonar, donde se confirma mediante anatomía patológica el diagnóstico de linfangioleiomiomatosis. Este caso resalta la importancia de considerar linfangioleiomiomatosis en el diagnóstico diferencial de neumotórax espontáneo ...

  Background. Patients with systemic lupus erythematosus (SLE) are at high risk of cardiac compromise with high mortality. The subclinical diagnosis may improve their survival. Longitudinal myocardial deformation (strain) has been found to be useful in evaluating cardiac function in these patients. Objectives. Our aims were to evaluate myocardial function by analyzing the two-dimensional (2D) global longitudinal strain, to compare the longitudinal strain in SLE patients with controls, and to determine the correlation with SLE activity index. Material and Methods. 44 patients with SLE (50.0 ± 13 years) and 50 controls (49 ± 12 years) matched by age and sex, underwent transthoracic echocardiogram. Longitudinal strain was assessed using the speckle tracking method and SLE activity was estimated using the Systemic Lupus Erythematous Disease Activity Index (SLEDAI). A score of 4 or mor...

Antecedentes. Los pacientes con lupus eritematoso sistémico (LES) tienen alto riesgo de compromiso cardíaco con elevada mortalidad, por lo que el diagnóstico subclínico podría mejorar su sobrevida. Se ha observado que el strain (deformación) miocárdico longitudinal (SGL) puede ser de utilidad para la evaluación de la función cardíaca en estos pacientes. Objetivos. Evaluar la función miocárdica mediante el análisis del strain longitudinal bidimensional (2D), comparar el strain longitudinal entre pacientes con LES y controles, y determinar la correlación con el índice de actividad del LES. Material y métodos. Se estudiaron a 44 pacientes con LES (50 ±13 años) y 50 controles (49 ±12 años) pareados por edad y sexo, a quienes se les realizó un ecocardiograma transtorácico bidimensional. Se valoró el strain longitudinal mediante el método de speckle tracking, y la activ...

  Background. Patients with systemic lupus erythematosus (SLE) are at high risk of cardiac compromise with high mortality. The subclinical diagnosis may improve their survival. Longitudinal myocardial deformation (strain) has been found to be useful in evaluating cardiac function in these patients. Objectives. Our aims were to evaluate myocardial function by analyzing the two-dimensional (2D) global longitudinal strain, to compare the longitudinal strain in SLE patients with controls, and to determine the correlation with SLE activity index. Material and Methods. 44 patients with SLE (50.0 ± 13 years) and 50 controls (49 ± 12 years) matched by age and sex, underwent transthoracic echocardiogram. Longitudinal strain was assessed using the speckle tracking method and SLE activity was estimated using the Systemic Lupus Erythematous Disease Activity Index (SLEDAI). A score of 4 or mor...

Objective: To analyze the clinical and angiographic characteristics of patients with coronary ectasia found on coronary angiography. Materials and methods: Descriptive study of patients admitted to the cardiac catheterization laboratory of the Hospital Guillermo Almenara with coronary ectasia, during the years 2012 to 2020. The frequency of coronary ectasia, clinical, angiographic and coronary flow characteristics were determined. Results: 7504 catheterizations were reviewed, and 91 patients were found to have coronary ectasia (1.21%). Of these patients, 71 cases were male (78%), and the mean age was 67.74 ± 9.9 years. The 38.5% of cases were obese or overweight; 39.6% were hypertensive; 11% diabetic; 13.2% smoked; 3.3% had chronic kidney disease and 3.3% had polyglobulia. Sixty-one percent of cases had a diagnosis of acute coronary syndrome, and 24% of cases had high-risk stable angina...

Objetivo: Analizar las características clínicas y angiográficas de pacientes con hallazgo de ectasia coronaria en la coronariografía. Materiales y métodos: Estudio descripitivo de pacientes admitidos a laboratorio de hemodinámica del Hospital Guillermo Almenara con hallazgo de ectasia coronaria, durante el periódo comprendido entre 2012 y 2020. Se determinó la frecuencia de ectasia coronaria, características clínicas, angiográficas y de flujo coronario. Resultados: se revisaron 7504 cateterismos y se halló 91 pacientes con ectasia coronaria (1,21%). De estos, 71 casos fueron varones (78%), y la edad media de 67,74 ± 9,9 años. El 38,5% de casos tuvieron obesidad o sobrepeso; 39,6 % fueron hipertensos; 11% diabéticos; 13,2% fumaban; 3,3% padecían enfermedad renal crónica y un 3,3% poliglobulia. El 61% de casos tuvieron diagnóstico de síndrome coronario ...

Objective: To analyze the clinical and angiographic characteristics of patients with coronary ectasia found on coronary angiography. Materials and methods: Descriptive study of patients admitted to the cardiac catheterization laboratory of the Hospital Guillermo Almenara with coronary ectasia, during the years 2012 to 2020. The frequency of coronary ectasia, clinical, angiographic and coronary flow characteristics were determined. Results: 7504 catheterizations were reviewed, and 91 patients were found to have coronary ectasia (1.21%). Of these patients, 71 cases were male (78%), and the mean age was 67.74 ± 9.9 years. The 38.5% of cases were obese or overweight; 39.6% were hypertensive; 11% diabetic; 13.2% smoked; 3.3% had chronic kidney disease and 3.3% had polyglobulia. Sixty-one percent of cases had a diagnosis of acute coronary syndrome, and 24% of cases had high-risk stable angina...

Objectives. During acute infection by the SARS-CoV-2 virus, myocardial involvement has been demonstrated; it is unknown if cardiovascular sequelae in patients recovered from this infection and if these are associated with global morbidity and mortality. The objective of this study was to compare myocardial deformation in patients recovered from mild SARS-CoV-2 virus infection with healthy controls. Materials and methods. This was a cross-sectional observational study that included 33 subjects recovered from mild SARS-CoV-2 infection, who were diagnosed in the previous three to six months, and 31 healthy volunteers, both groups free of cardiovascular risk factors. The study of myocardial deformation was performed using echocardiography with the speckle tracking modality. Clinical and anthropometric variables were compared. Results. The 2D global longitudinal strain of the left ventricle w...

Objetivos. Durante la infección aguda por el virus SARS-CoV-2 se ha demostrado una afectación miocárdica, se desconoce si existen secuelas cardiovasculares en pacientes recuperados de esta infección y si estas se asocian a un incremento en la morbilidad y mortalidad global. El objetivo de este estudio fue comparar la deformación miocárdica en pacientes recuperados de infección leve por SARS-CoV-2 con controles sanos. Materiales y métodos. Estudio observacional transversal que incluyó 33 sujetos recuperados de infección leve por SARS-CoV-2, quienes fueron diagnosticados en los tres a seis meses previos, y 31 voluntarios sanos, ambos grupos libres de factores de riesgo cardiovascular. El estudio de deformación miocárdica se realizó mediante ecocardiografía con modalidad speckle tracking. Se compararon variables clínicas y antropométricas. Resultados. El strain longitudinal ...

Objectives: To determine structural or functional echocardiographic findings in patients recovered from SARS-CoV-2 infection. Materials and methods: Cross-sectional observational study, which included worker patients of a national COVID hospital, who were studied between 3 to 6 months after the diagnosis of SARS-CoV-2 infection. The echocardiographic examination was carried out systematically and included conventional modalities. Results: 65 cases with CoV-2 infection were included, the average age was 37.7 years, obesity was the most frequent comorbidity (13.8%) and the mild clinical presentation was the one with the highest prevalence (84.6%). The mean diastolic diameter and left ventricular eyection fraction were 42mm and 57%, respectively. Likewise, the mean basal diameter of the right ventricle was 31mm, the shortening fraction was 44%, and the probability of pulmonary hypertension ...

Objetivos: Determinar hallazgos estructurales o funcionales ecocardiográficos en pacientes recuperados de infección SARS-CoV-2. Materiales y métodos: Estudio observacional transversal, que incluyó pacientes trabajadores de un hospital nacional COVID, estudiados entre 3 a 6 meses luego del diagnostico de infección SARS-CoV-2. La exploración ecocardiográfica se desarrolló de forma sistemática e incluyó las modalidades convencionales. Resultados: Se incluyeron 65 casos con infección-CoV-2, la edad promedio fue 37.7 años, la obesidad resultó la comorbilidad mas frecuente (13.8%) y la presentación clínica leve fue la de mayor prevalencia (84.6%). Las medias del diámetro diastólico y la fracción de eyección ventrículo izquierdo fueron 42mm y 57% respectivamente. Así mismo la media del diámetro basal del ventrículo derecho fue de 31mm, de la fracción de acortamiento 44% ...

Objetivos: Determinar hallazgos estructurales o funcionales ecocardiográficos en pacientes recuperados de infección SARS-CoV-2. Materiales y métodos: Estudio observacional transversal, que incluyó pacientes trabajadores de un hospital nacional COVID, estudiados entre 3 a 6 meses luego del diagnostico de infección   SARS-CoV-2. La exploración ecocardiográfica se desarrolló de forma sistemática e incluyó las modalidades convencionales. Resultados: Se incluyeron 65 casos con infección-CoV-2, la edad promedio fue 37.7 años, la obesidad resultó la comorbilidad mas frecuente (13.8%) y la presentación clínica leve fue la de mayor prevalencia (84.6%).  Las medias del diámetro diastólico y la fracción de eyección ventrículo izquierdo fueron 42mm y 57% respectivamente. Así mismo la media del diámetro basal del ventrículo derecho fue de 31mm, de la fracción de...

Objectives. During acute infection by the SARS-CoV-2 virus, myocardial involvement has been demonstrated; it is unknown if cardiovascular sequelae in patients recovered from this infection and if these are associated with global morbidity and mortality. The objective of this study was to compare myocardial deformation in patients recovered from mild SARS-CoV-2 virus infection with healthy controls. Materials and methods. This was a cross-sectional observational study that included 33 subjects recovered from mild SARS-CoV-2 infection, who were diagnosed in the previous three to six months, and 31 healthy volunteers, both groups free of cardiovascular risk factors. The study of myocardial deformation was performed using echocardiography with the speckle tracking modality. Clinical and anthropometric variables were compared. Results. The 2D global longitudinal strain of the left ventricle w...