Con mucho interés hemos leído el artículo especial recientemente publicado en la revista que usted dirige (1) en el cual los autores sugieren el uso de hidroxicloroquina (HC) o cloroquina (CQ) para el tratamiento de casos leves de Covid-19 en la comunidad. Hemos revisado las 39 referencias que citan los autores sin poder encontrar alguna que se refiera al tratamiento de casos leves de Covid-19. La tabla 1 muestra las referencias citadas que son estudios clínicos con HC o CQ en casos moderados/severos de Covid-19. En la carta de Gao (2) se menciona que 100 pacientes de varios ensayos clínicos vienen recibiendo CQ con éxito; sin embargo, esa información preliminar no puede ser corroborada. En la serie de casos de Gautret (3) el 90% de pacientes tratados con HQ presentaron un aclaramiento viral al final del estudio. Hay un reporte de Chen ...

Despite being a preventable and curable disease, Tuberculosis continues to be a major global health problem. Worldwide, according to the WHO in 2017 were estimated at 10 million new cases of active tuberculosis, equivalent to 133 cases per 100,000 people; and about 1.3 million deaths in non-HIV patients and 300,000 additional deaths in HIV patients due to this cause, mainly in countries with limited resources. On the other hand, what exacerbates the problem is the emergence of resistance to anti-tuberculous drugs, which complicates the possibilities of treatment. Isoniazid is today one of the fundamental first-line drugs for the management of Tuberculosis, being closely related to the rapid negativization of sputum bacilloscopy, attributed to the potent bactericidal effect on rapidly multiplying strains. vital relevance not only in the control of the disease, but also in the control of t...

The Cystic fibrosis (CF) is an autosomal and recessive genetic disease. It affects much more frequently the population of Caucasian origin, where their incidence ranges from 1 in 3,000 in Caucasians to 1 in 8,000 in newly Hispanic live births. By 2018, 30,775 patients with cystic fibrosis, of them less than 10% of patients worldwide had more 40 years and none had been diagnosed after 40 years of age. We present below the case of a 52-year-old Peruvian adult with CF. This would be one of the patients with the latest diagnosis worldwide and the longest patient in Peru and one of the longest in Latin America.

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SARS-CoV-2 infection is the most important emerging disease of this century. Since its inception to the present, it has caused almost a million deaths worldwide, becoming a real threat to public health. For this reason, new reviews and scientific studies in this regard are extremely important. In the same way, it is known that the main disease caused by this virus is confined to the respiratory system. However, there are still unknown aspects of the disease and within them are extrapulmonary complications. This review attempts to summarize all that is known at the time regarding the disease and its neurological, hematological, cardiological, kidney and liver complications.

CF is an autosomal recessive disease, requiring mutations to be present in both alleles in the CF transmembrane conductance regulatory gene (CFTR). The c.3274T> C (p.Tyr1092His) mutation is not registered in the “CFTR2 project” database, but it is registered in The Human Gene Mutation Database. Neither are the two DNAAF4 c.1177C> T (p.Leu393Phe) and DNAAF5 c.1195G> A (p.Glu399Lys) mutations found in the "CFTR Project”, and their clinical consequences are currently uncertain. Here, we report the case of a Peruvian woman presenting this mutation, bronchiectasis and loss of lung function and provide a review of the literature.

La isoniazida (INH), desde su descubrimiento en la década de 1950, se constituyó en uno de los medicamentos fundamentales en el tratamiento de la tuberculosis (TB). La actividad bactericida de la INH está dada por la inhibición de la biosíntesis del ácido micólico. La INH es activada por la catalasa peroxidasa sintetizada por el gen KatG y logra su efecto uniéndose al gen InhA del Mycobacterium tuberculosis. A partir de su primer uso, como monoterapia en 1952, se informó rápidamente del desarrollo de resistencia a INH (R-INH). Esta ocurre principalmente por una mutación en dos genes (el katG y/o el inhA). La mutación en el katG confiere R-INH de “alto nivel”; es decir, que la INH se hace ineficaz incluso a altas dosis (HAD) de 15-20 mg/kg/día, aunque se asocia a una sensibilidad de la bacteria a la etionamida (ETO). La mutación del gen inhA, por su parte, causa una resi...

El asma se define como una enfermedad inflamatoria crónica de las vías respiratorias, donde participan distintas células y mediadores de la inflamación, condicionada en parte por factores genéticos, qué cursa con hiper respuesta bronquial y una obstrucción variable al flujo aéreo ,total o parcialmente reversible, ya sea por la acción médicamentosa o espontánea.

Introducción: La tuberculosis multidrogorresistente es un importante problema de salud pública para el que se utilizan fármacos con múltiples efectos adversos. Entre las devastadoras consecuencias de estas enfermedades, existe una amplia variación en la incidencia de ototoxicidad y pérdida auditiva en pacientes con tuberculosis multirresistente y extremadamente resistente. Los implantes cocleares pueden estar indicados en pacientes con pérdida auditiva unilateral/bilateral severa sin beneficio de los audífonos convencionales, pero su uso en pacientes con tuberculosis es raro. Reporte de un caso: Presentamos el primer caso de implante coclear unilateral derecho realizado a un paciente peruano de 34 años que presentaba hipoacusia neurosensorial profunda de origen coclear. Conclusión: La cirugía de implante coclear es un hito fundamental en el tratamiento de los pacientes con sec...

Introducción: Desde el inicio de la pandemia por el COVID-19 se han utilizado distintos fármacos y medicamentos para la prevención y tratamiento de la infección por COVID-19. Asimismo, se han desarrollado diversas investigaciones que evalúan la eficacia y seguridad de estas intervenciones, muchas de las cuales han demostrado generar más daño que beneficio para el paciente, por tal motivo es necesario estandarizar el manejo del paciente adulto con COVID-19 en nuestro contexto. Objetivo: Proveer recomendaciones clínicas basadas en evidencia para el manejo del adulto con COVID-19. Métodos: Se conformó un grupo elaborador de la guía (GEG) que incluyó médicos especialistas y metodólogos. El Para su elaboración se GEG decidió realizar una adaptación rápida de la Guía para el cuidado de pacientes adultos críticos con COVID-19 en las Américas de la Organización Panamericana...

La tuberculosis sensible es la enfermedad producida por una bacteria miembro del complejo mycobacterium tuberculosis y que no muestra resistencia a los medicamentos involucra sintomatología radiología aislamiento de bacterias genotipificación y prueba de sensibilidad para recibir el mejor tratamiento adecuado para cada paciente.

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Introduction: Multidrug-resistant tuberculosis is a significant public health problem for which drugs are used with many adverse effects. Among the devastating consequences of these diseases, there is a wide variation in the incidence of ototoxicity and hearing loss in patients with multidrug-resistant and extremely resistant tuberculosis. Cochlear implants may be indicated in patients with unilateral/severe bilateral hearing loss with no benefit from conventional hearing aids, but their use in patients with tuberculosis is rare. Case report: We present the first case of a right unilateral cochlear implant performed on a 34-year-old Peruvian patient who presented profound sensorineural hearing loss of cochlear origin. Conclusion: Cochlear implant surgery is an essential milestone in the treatment of patients with auditory sequelae of tuberculosis treatment. Close monitoring of possible c...

Introduction: Since the beginning of the COVID-19 pandemic, different drugs and medications have been used for the prevention and treatment of COVID-19 infection. Likewise, various investigations have been carried out to evaluate the efficacy and safety of these interventions, many of which have been shown to generate more harm than benefit for the patient, for this reason it is necessary to standardize the management of adult patients with COVID-19 in our context. Objective: To provide evidence-based clinical recommendations for the management of adults with COVID-19. Methods: A guideline development group (GEG) was formed that included medical specialists and methodologists. For its elaboration, GEG decided to carry out a rapid adaptation of the Guide for the care of critical adult patients with COVID-19 in the Americas of the Pan American Health Organization (PAHO) as well as to carry...

Despite being a preventable and curable disease, Tuberculosis continues to be a major global health problem. Worldwide, according to the WHO in 2017 were estimated at 10 million new cases of active tuberculosis, equivalent to 133 cases per 100,000 people; and about 1.3 million deaths in non-HIV patients and 300,000 additional deaths in HIV patients due to this cause, mainly in countries with limited resources. On the other hand, what exacerbates the problem is the emergence of resistance to anti-tuberculous drugs, which complicates the possibilities of treatment. Isoniazid is today one of the fundamental first-line drugs for the management of Tuberculosis, being closely related to the rapid negativization of sputum bacilloscopy, attributed to the potent bactericidal effect on rapidly multiplying strains. vital relevance not only in the control of the disease, but also in the control of t...

The Cystic fibrosis (CF) is an autosomal and recessive genetic disease. It affects much more frequently the population of Caucasian origin, where their incidence ranges from 1 in 3,000 in Caucasians to 1 in 8,000 in newly Hispanic live births. By 2018, 30,775 patients with cystic fibrosis, of them less than 10% of patients worldwide had more 40 years and none had been diagnosed after 40 years of age. We present below the case of a 52-year-old Peruvian adult with CF. This would be one of the patients with the latest diagnosis worldwide and the longest patient in Peru and one of the longest in Latin America.

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