Peritoneal dialysis (PD) is a cost-effective therapy, little used worldwide. Urgent start PD is defined as the start of therapy in incident patients, immediately after or before two weeks after having placed a catheter for chronic PD in patients with chronic renal failure with indication of urgency dialysis, compared with the conventional start after two weeks. The objective was to review the current information on urgent start PD. A search was performed in PubMed, The Cochrane Library and SciELO. A total of 12 articles published up to October 31, 2021, were included. A low incidence of patients admitted to PD was found, even more so in urgent start PD. No significant differences were found that justify waiting to use the implanted catheter, thus avoiding hemodialysis in dialysis urgency. A meta-analysis with 16 studies (2953 patients) concluded that urgent start PD compared with convent...

Acute renal injury due to collapsing glomerulonephritis is associated with high morbidity and mortality, requiring chronic dialysis, COVID-19 is one of its causes. A 17-year-old male patient presented with a four-month history of edema, foamy urine and reduction in the urine flow; anasarca was observed at physical examination. Laboratory values showed creatinine 4,2 mg/dl; albumin 1,9 gr/dl; cholesterol and triglycerides were high; proteinuria 6,7 gr/24h: leucocyturia and hematuria with negative urine culture. Serologies for HIV, syphilis and hepatitis were negative. Studies for systemic lupus were negative. An antigenic test for SARS-CoV-2 was positive as well as an IgG. Renal Biopsy showed Focal and Segmental Glomerulosclerosis, Collapsing variant. He received corticosteroids and cyclosporine. Creatinine improved; proteinuria remained >3 gr/24 hours.

Los estudios de supervivencia en hemodiálisis (HD) y diálisis peritoneal (DP) muestran diferencias y variabilidad de resultados. Objetivo: Determinar la supervivencia a mediano plazo de pacientes en HD y DP en un hospital del MINSA Callao, e identificar los factores que influyen. Métodos. Cohorte retrospectiva de pacientes > 18 años, incidentes con >3 meses en HD o DP (2012-2021). Variable principal supervivencia en meses, variable independiente tipo de terapia. Para comparar se utilizó chi2, y U de Mann Whitney. Se calculó Hazard Ratio (HR) según tipo de diálisis y covariables, regresión multivariada de Cox para evaluar riesgo de fallecer con HR ajustado (IC 95%). Se realizó estimaciones de Kaplan-Meier, curvas de supervivencia hasta 3 años, y Long Rank (p <0,05). Resultados. Hubo 901 pacientes, 749 HD (86,1%) y 152 DP (13,9%); más hombres en HD, más diabéticos e hipertens...

The clinical presentation of focal and segmental glomerulosclerosis (FSGS) includes edema, an abnormal urine examination, and variably decreased kidney function. A twenty three year-old female patient, with a non-remarkable medical history developed during the last 18 months lower extremity, facial, and chest wall edema, and decreased urinary output that improved with the use of diuretics, but after two months she had a recurrence of her symptoms. Physical examination revealed the presence of eyelid and leg edema. Relevant laboratory tests showed normal creatinine values, creatinine clearance 61 mL/min, normal urinalysis, normal proteinuria; ANA, anti-DNA, hepatitis and HIV tests were reported as negative. C3 was also normal, as well as kidney ultrasonography. A kidney percutaneous biopsy was performed, which showed 8/20 affected glomeruli, and focal and segmental glomerulosclerosis.

The clinical presentation of focal and segmental glomerulosclerosis (FSGS) includes edema, an abnormal urine examination, and variably decreased kidney function. A twenty three year-old female patient, with a non-remarkable medical history developed during the last 18 months lower extremity, facial, and chest wall edema, and decreased urinary output that improved with the use of diuretics, but after two months she had a recurrence of her symptoms. Physical examination revealed the presence of eyelid and leg edema. Relevant laboratory tests showed normal creatinine values, creatinine clearance 61 mL/min, normal urinalysis, normal proteinuria; ANA, anti-DNA, hepatitis and HIV tests were reported as negative. C3 was also normal, as well as kidney ultrasonography. A kidney percutaneous biopsy was performed, which showed 8/20 affected glomeruli, and focal and segmental glomerulosclerosis.

 Objective: To determine if the eradication rate of Helicobacter pylori with first line triple therapy for 14 days is better than with 10 days. Material and methods: Retrospective cohort study. It was reviewed medical records of the patients with dyspepsia and upper digestive endoscopy with a positive H. pylori biopsy, who received triple therapy with amoxicillin, clarithromycin and omeprazole for 10 or 14 days. Eradication was defined by the 13C-UBT breath test, 4 to 6 weeks after treatment. Results: It was evaluated 381 patients, 207 received treatment for 10 days and 174 for 14 days. The average age was 49 ± 13.9(15 to 82) years. The female sex was predominating (69,8%). The eradication rate of H. pylori in the 10-day and 14-day treatment group was 79, 7% and 82, 2% respectively (risk ratio, 1.03; 95% confidence interval, 0.94-1.14; p=0,541). Adverse events were reported in 75,1...

 Objective: To determine if the eradication rate of Helicobacter pylori with first line triple therapy for 14 days is better than with 10 days. Material and methods: Retrospective cohort study. It was reviewed medical records of the patients with dyspepsia and upper digestive endoscopy with a positive H. pylori biopsy, who received triple therapy with amoxicillin, clarithromycin and omeprazole for 10 or 14 days. Eradication was defined by the 13C-UBT breath test, 4 to 6 weeks after treatment. Results: It was evaluated 381 patients, 207 received treatment for 10 days and 174 for 14 days. The average age was 49 ± 13.9(15 to 82) years. The female sex was predominating (69,8%). The eradication rate of H. pylori in the 10-day and 14-day treatment group was 79, 7% and 82, 2% respectively (risk ratio, 1.03; 95% confidence interval, 0.94-1.14; p=0,541). Adverse events were reported in 75,1...

Curso de la especialidad de la carrera de medicina, de carácter práctico del ciclo 11, en el que los estudiantes realizan discusiones con tutores y/o se incorporan al equipo de salud asistencial o de administración o de investigación según la elección del estudiante, para desarrollar actividades en el área clínica o de gestión o de investigación o de salud pública. El curso del electivo de externado 1, busca desarrollar la competencia específica de profesionalismo (nivel 3). El electivo de externado 1 le permitirá al estudiante generar aprendizajes que contribuyan a su desarrollo de los principales problemas médicos o quirúrgicos o de investigación o de salud pública que le servirá en su vida profesional.