Objetivo: Determinar la asociación entre las variantes CYP2C9*2 y CYP2C9*3 y la hipertensión arterial esencial en una muestra peruana de pacientes hipertensos y controles normotensos residentes en Lima-Perú. Metodología: Se trabajó con 90 casos hipertensos y 267 controles. La genotipificación se realizó utilizando el método de la reacción en cadena de la polimerasa en tiempo real. Para analizar la asociación entre los polimorfismos y el riesgo de hipertensión arterial, se realizó un análisis de regresión logística multivariado ajustado para edad e índice de masa corporal. Resultados: La frecuencia alélica del CYP2C9*2 fue de 3.1% y del CYP2C9*3 de 3.5%. La frecuencia del genotipo mutado del CYP2C9*2 (CT + TT) fue significativamente mayor en hipertensos comparados con normotensos (11.1% vs. 4.1%, p=0.01). La asociación de las variantes *2 y *3 con hipertensión fue no si...

A 40-year-old man, with a history of migraine, experienced a left occipital headache, tinnitus and photopsias. He was treated with analgesics at the emergency room with partial relief during 3 consecutive visits during the week prior to admission. At admission, general physical exam was normal as was the neurological examination. A lumbar puncture (LP) was performed, showing no blood cells but 100 mononuclear cells with normal protein and glucose levels. Cerebrospinal fluid (CSF) microbiological and virologic tests and brain imaging studies were not contributory. The pain was controlled after a trigeminal nerve block. Five days after admission and with the status migrainosus resolved, a second LP was performed which was reported as normal with resolution of the pleocytosis. Recognition of transitory CSF pleocytosis in the context of an acute migraine episode could serve to avoid unnecess...

Creutzfeldt-Jakob disease (CJD) is the commonest human prion disease with a reported annual incidence rate of one per million worldwide. CJD has a bad prognosis, and the mean length of survival is 4-6 months. Only 11 cases have been reported in the literature from Perú. Thus, we report a case of a 66-year-old male patient with the diagnosis of probable sporadic CJD in whom the survival duration was of 25 months. We identify that the time from disease onset to myoclonus and to reach the akinetic mutism state, the absence of early imaging findings, the delayed cortical and basal ganglia involvement and the supportive therapies implemented were factors that could contribute for the long survival in this patient. 

Objective: To determine predictors of in-hospital mortality and poor functional prognosis in patients undergoing surgery for intracerebral hemorrhage. Materials and Methods: Clinical records, operative reports, and cerebral CT scans of patients with intracerebral hemorrhage from March 2018 to March 2020 were analyzed. Univariate and multivariate logistic regression analyses were performed for determining independent predictors of in-hospital mortality and poor functional prognosis at discharge. Results: In-hospital mortality was 33.7% (n= 31 patients). Independent predictors for mortality were female sex (OR= 3.01, p= 0.031) and Glasgow score <8 on admission (OR= 3.19, p= 0.031). A poor functional prognosis after the intervention was found in 77 patients (83.7%). Independent risk factors for a poor functional prognosis were score >3 in the modified Rankin scale (OR= 15.5; p= 0.01),...

Objective: To determine predictors of in-hospital mortality and poor functional prognosis in patients undergoing surgery for intracerebral hemorrhage. Materials and Methods: Clinical records, operative reports, and cerebral CT scans of patients with intracerebral hemorrhage from March 2018 to March 2020 were analyzed. Univariate and multivariate logistic regression analyses were performed for determining independent predictors of in-hospital mortality and poor functional prognosis at discharge. Results: In-hospital mortality was 33.7% (n= 31 patients). Independent predictors for mortality were female sex (OR= 3.01, p= 0.031) and Glasgow score <8 on admission (OR= 3.19, p= 0.031). A poor functional prognosis after the intervention was found in 77 patients (83.7%). Independent risk factors for a poor functional prognosis were score >3 in the modified Rankin scale (OR= 15.5; p= 0.01),...

ABSTRACT Introduction To evaluate the diagnostic accuracy of three brief cognitive screening (BCS) tools, Peruvian version of Addenbrooke's Cognitive Examination (ACE-Pe), of INECO Frontal Screening (IFS-Pe) and of the Mini-Mental State Examination (MMSE-Pe), for the diagnosis of vascular cognitive impairment (VCI) and its non-dementia stages (VCI-ND) and vascular dementia (VD) in patients with cerebral stroke in Lima—Peru. Materials and methods A cohort analysis to evaluate the diagnostic accuracy of three BCS for VCI. Results Two hundred and four patients were evaluated: 61% Non-VCI, 30% VCI-ND and 9% VD. To discriminate patients with VCI from controls, the area under the curve (AUC) of ACE-Pe, IFS-Pe and MMs-Pe were 0.99 (95% confidence interval [CI] 0.98–0.99), 0.99 (95%CI 0.98–0.99) and 0.87 (95%CI 0.82–0.92), respectively. Of the three BCS, the IFS-Pe presented a larger AUC...

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