Introduction. Tuberculosis is a public health problem in our country. Affected patients are slow to access health services, among other factors due to the stigma and social discrimination that this disease has in the population. In addition, stigma has an impact on the social and family relationship of affected patients. The objective of the present study was to quantify the stigma in students of the faculty of medicine of a public university. Methods. An observational, descriptive and transversal study was carried out. A previously validated questionnaire was applied to students of the first three years of medical school, in order to quantify the stigma of tuberculosis. Results. The questionnaire was applied to 505 students of the medical school. 39% of the student population showed a moderate and great stigma in front of the people affected by tuberculosis; likewise, 38% showed a sligh...

Introduction: The constitutional province of Callao is one of the most affected by the epidemic of tuberculosis nationwide. Likewise, it should be considered that the first level health care services are usually the gateway for these patients to the health system. Objectives: To describe the characteristics of the offer of health services in tuberculosis units from first level of care in the Constitutional Province of Callao. Methods: A descriptive study was carried out in 45 tuberculosis units from primary care health services, which investigated the characteristics of infrastructure, human resources and data entry to the information system. Results: 45 primary care health services have “Differentiated units of TB care”; which have 19 doctors, 35 nurses, 3 nutritionists, 10 psychologists, 9 social workers and 50 nursing technicians. 96% of professi...

Analiza los determinantes sociales de la salud que influyen en el inicio temprano del tratamiento, el egreso con “éxito” y el termino en el tiempo estipulado en las personas afectadas por tuberculosis. Se realizo un estudio cuantitativo, descriptivo y transversal, en 1 593 personas afectadas por tuberculosis que ingresaron a tratamiento de enero a diciembre del año 2017. Las variables de estudio se operacionalizaron en factores individuales de las 1025 personas tratadas por tuberculosis sensible y en los factores contextuales de los 45 servicio de salud de Callao y se realizó un análisis de regresión logística multinivel. Encuentra que los determinantes sociales individuales influyen en el inicio temprano en 85.4%, en el egreso con “éxito” en 92.7% y el término del tratamiento en el tiempo estipulado en 88.7%, mientras que el 14.6%, 7.3% y 13% de esta variabilidad en cada...

Objetive: This integrative review with a descriptive approach aimed to describe the available scientific information on the methods of antifungal identification and susceptibility used to characterize Candida isolates from blood cultures in patients diagnosed with COVID-19. Methods: A systematic search of primary publications was conducted in databases including MEDLINE/PubMed and the Cochrane Library. Specific inclusion and exclusion criteria were established to select studies conducted between 2020 and 2023. Case reports and series, as well as retrospective and prospective analytical studies, were included to describe molecular methods for the identification of Candida species, antifungal susceptibility testing, and the assessment of clonality and resistance genes. Our review process was based on the Whittemore and Knafl model. Results: A total of 446 studies were identified, of which ...

through hormonal therapy. The aim of this review is to evaluate the effects of anti-androgen therapy on sexual offenders with paraphilic disorders. We searched for systematic reviews and clinical practice guidelines on anti-androgen therapy. Two systematic reviews and a clinical practice guide were selected whose evidence corresponds to case reports and observational studies. Primary outcome, sexual relapse, has only been evaluated in two comparative studies with medroxyprogesterone. Small number of participants and high percentage of dropouts do not allow conclusions to be drawn as to efficacy. Frequent adverse effects were reported. Available evidence is scant and of low quality on the efficacy of hormonal therapy with antiandrogens steroids and GnRH analogs in patients with paraphilic disorders.

This article shares the experience of the technology transfer (TT) developed by the Peruvian National Institute of Health (INS) towards the multidisciplinary clinical groups of different IPRESS and managers of the Ministry of Health (MINSA), inside the framework of the development of guidelines for Clinical Practice-Informed in Evidence (GPC-IE). It presents the evolutionary context of the CPG together with the role assumed by the INS, in their development of current regulations and in their implementation. It expresses the inherent situation to operationalization of the process that were not initially contemplated in the guideline and the contributions made to afford it; as the variability of the prioritization strategies of topics to be developed, the additional characteristics of the development group (GE) and methodology group (GM), the relevance of the management group, the pedagogi...

This article presents interventions to prevent mortality and injuries from traffic accidents (TA), from the scientific evidence and perspective of the actors involved. For this purpose, a systematic search was carried out, a policy summary was organized with the participation of key actors to finally carry out a deliberative dialogue with technical representatives of the various institutions related to the approach of the proposed problem. Describe evidence-based interventions related to education, integral infrastructure, pre-hospital assistance, regulations and control that were deliberate and contextualized to our local environment. The multi-sector technical representatives contributed considerations for its implementation, the potential benefits or damages, the use of resources, necessary adaptations, possible barriers and facilitators for its approach. It presents the channeling ro...

Introduction. On March 5 2020, the first case of COVID-19 was reported and on March 16, order of quarantine was issued which resulted in interruption of academic activities. Objective. Determine the seroprevalence and risk factors associated to SARS-CoV-2 infection in undergraduate students of the school of medicine in a public university. Methods. Descriptive cross-sectional study by means of a serology survey to a representative sample of the population of undergraduate students of a health sciences school using a rapid test to detect antibodies IgG, IGM or both in a total blood sample by digital punction. Results. On August 2021, 24,92% (IC95% 18,2-33,0) of students of health sciences tested positive for antibodies anti SARS-CoV-2, 21,2% for IgG, 2,3% for IGM and 0,8% for both; 75,08% (IC95% 66,9-82,0) tested negative antibodies. Conclusions. The seroprevalence in students was not dif...

Introducción. El objetivo primordial de los programas nacionales es la supresión de la replicación viral hasta niveles indetectables y el sostenimiento de esta respuesta virológica a lo largo del tiempo. El objetivo del estudio fue analizar la duración de la supresión viral en pacientes adultos con VIH que iniciaron tratamiento antiretroviral en el Perú durante el periodo 2004-2006 con seguimiento hasta el 2012 mediante análisis de sobrevida acumulada. Métodos. Se realizó un estudio observacional retrospectivo realizado en base a la cohorte histórica de pacientes que accedieron al programa nacional de tratamiento antirretroviral durante el periodo 2004 al 2006 en el Perú y que tuvo seguimiento hasta el 31 de diciembre del 2012. Resultados. Del total de 6289 pacientes, 5142(81,7%) iniciaron algún esquema de tratamiento y 4530(72%) alcanzaron supresión viral, la cual se sostu...

Introduction. Depression is a mental disorder that in its most severe form can end in suicide. Objective. This Evidence-based Clinical Practice Guideline (EB-CPG) provides recommendations for the pharmacological and psychotherapeutic treatment of depression in adults. Methods. An adapted EB-CPG was elaborated through a systematic, rigorous and transparent process with a team of methodologists and psychiatrists experts in clinical management of the disease. The guide has seven clinical questions and 10 recommendations, the search and preselection of CPGs was carried out responding to the scope and objectives, which were evaluated through the “Appraisal of Guidelines for Research and Evaluation II” (AGREE-II), and the guide with the best methodological quality was selected for methodological adaptation. A systematic search for evidence to answer the clinical questions was made in multi...

Objective: Adapt the microneutralization test (MNT) to detect neutralizing antibodies against dengue serotype 2 virus (DENV-2) in the Vero-76 cell line.  Materials and methods. Different cellular concentrations (0.6 x 105 cell / mL, 0.9 x 105 cell / mL, 1.2 x 105 cell / mL) and percentages of fetal bovine serum (FBS) at 2%, 3% and 4%, passages number of virus stock and incubation days were evaluated. The viral seed was confirmed by RT-qPCR. DENV-2 was propagated by carrying out 5 successive passages in the Vero-76 cell line, then the virus was titrated in microplates and 2 methods were evaluated: complete monolayer and cell suspension, and the optimal coloring day was determined.  Obtained the results, it was evaluated by the MNT for DENV-2: 5 sera negative to DENV-2 and YFV, 5 sera negative to DENV-2 and seropositive to YFV and 5 seropositive sera to DENV-2 confirmed by plaque...

Objetivo: Estandarizar la prueba de microneutralización (MNT) para detección de anticuerpos neutralizantes contra el virus dengue serotipo 2 (DENV-2) en la línea celular Vero-76.  Materiales y métodos: Se evaluaron diferentes concentraciones celulares (0,6 x105 cel/mL, 0,9 x105 cel/mL, 1,2 x105 cel/mL), porcentajes de 2%, 3% y 4% de suero bovino fetal (SBF), número de pasajes del stock de virus y los días de incubación. La semilla viral se confirmó por RT-qPCR. El DENV-2 se propagó realizando 5 pasajes en células Vero-76, seguidamente se tituló el virus en placas de 96 pozos y se evaluaron 2 métodos de infección celular: monocapa y células en suspensión, además se determinó el día óptimo de coloración de las células. Obtenidos los resultados, se procesaron mediante MNT para DENV-2 las siguientes muestras: 5 sueros negativos a DENV-2 y YFV, 5 sueros negativos a D...

The COVID-19 pandemics required the countries to take decisions rapidly. Consequently, the National Institute of Health (INS) developed a series of documents of scientific evidence synthesis according to the Ministry of Health’s requirements. Based on these reports, the INS developed recommendations to update normative documents related to COVID-19’s management. This article describes the construction of a new methodology applied by the INS to synthesize scientific evidence during the COVID-19 pandemic. Moreover, it emphasizes the efforts and strategies used to guarantee the methodological quality and the implementation of the GRADE approach. Finally, it provides a short reflection on the limitations and challenges of using evidence to design national public policies in the future.

The COVID-19 pandemics required the countries to take decisions rapidly. Consequently, the National Institute of Health (INS) developed a series of documents of scientific evidence synthesis according to the Ministry of Health’s requirements. Based on these reports, the INS developed recommendations to update normative documents related to COVID-19’s management. This article describes the construction of anew methodology applied by the INS to synthesize scientific evidence during the COVID-19 pandemic. Moreover, it emphasizes the efforts and strategies used to guarantee the methodological quality and the implementation of the GRADE approach. Finally, it provides a short reflection on the limitations and challenges of using evidence to design national public policies in the future.

Introduction: Schizophrenia is a psychotic disorder characterized by substantive alteration of mental functioning and effects on the social functionality of affected individuals. Objective: Provide recommendations based on the best available evidence for early approach, pharmacological and psychosocial treatment. Methods: An Evidence-based Clinical Practice Guide (GPC-BE) was developed, adapted through a systematic, rigorous, transparent process, by a working group composed of methodologists and psychiatrists who are experts in the management of schizophrenia. The guide includes four clinical questions and recommendations, we searched for guides that respond to the prioritized topic, guides were pre-selected and evaluated using the “Appraisal of Guidelines for Research and Evaluation II” (AGREE-II) instrument, the one with the best methodological quality...

Introduction. Neonatal sepsis is a set of clinical signs and symptoms caused by a systemic infection, associated with maternal, neonatal or hospital risk factors. Objective. Provide informed recommendations for the best available evidence for the prevention, diagnosis and treatment of neonatal sepsis. Methods an Evidence-based Clinical Practice Guide (CPG) was developed through an adaptation process, in charge of a team of methodologists and neonatologists who are experts in the clinical management of neonatal sepsis. The search and pre-selection of CPGs that respond to the scope and objectives set were carried out, using the AGREE-II instrument, the methodological quality of the guides was evaluated and their adaptation decided. To identify the evidence that answers the questions in the guideline, a systematic search was carried out in multiple databases: M...

Introduction. In Peru, hypertensive disorders of pregnancy are the second cause of maternal mortality. Objective. This evidence-based clinical practice guideline (EB-CPG) provides recommendations for the prevention and treatment of pre-eclampsia and eclampsia. Methods. An adapted EB-CPG was elaborated through a systematic, rigorous and transparent process with a group consisting of methodologists and health professionals who are experts in the management of the disease. The guide has sixteen clinical questions and sixteen recommendations. The search and pre-selection of EB-CPGs were performed, which were evaluated through the “Appraisal of Guidelines for Research and Evaluation II” tool (AGREE-II), for its adaptation. The systematic search for evidence to answer the 16 clinical questions were made in multiple databases: MEDLINE / PubMed, EMBASE / Ovid, C...