Introduction: Despite the efficacy of treatment for osteoporosis, about 50% of the patients tend to discontinue. Objectives: To assess the frequency of poor adherence to treatment of osteoporosis and its associated characteristics. Design: A descriptive, cross-sectional study. Location: Department of Rheumatology, National Hospital Alberto Sabogal, Callao, Peru. Participants: Patients diagnosed with postmenopausal osteoporosis. Interventions: In February and March 2013 a questionnaire of 32 questions to postmenopausal women with osteoporosis was applied. The Morisky-Green (MG) was used to measure adherence to treatment. Main outcome measures: Percentage and characteristics associated with nonadherence. Results: 81 patients were surveyed; the mean age was 67.1 years (± 8.2); the percentage of non-adherence to treatment was 80.2%. Associated features were number of additional medications,...

Background: Resistance by extended-spectrum beta-lactamase (ESBL) is the most common antimicrobial resistance and of public health importance. Objectives: To describe ESBL producing bacteria characteristics in a national reference hospital. Design: Cross sectional, descriptive study. Setting: Hospital Nacional Daniel Alcides Carrión, Callao, Peru. Materials: Records of secretion cultures done in the hospital Laboratory of Microbiology during 2012. Methods: Patient data (age, sex and service from which the sample was received) and sample data (date of collection, sample type, microorganism found, sensitivity and detailed classification as ESBLproducing bacteria) were analyzed. Main outcome measures: Characteristics of infections by ESBL-producing bacterias. Results: Study included 3 149 samples, 70.9% (2 235) from female patients; 29.4% were cultures positive for ESBL-producing bacteria....

Background: Acute appendicitis is the most common cause of acute surgical abdomen. Despite its frequency, little is known on its epidemiology in Peru. Objectives: To determine the relation between incidence of appendicitis and environmental temperature. Design: Multiple group study. Setting: San Fernando Faculty of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru. Material: Records from the Ministry of Health and data from the National Institute of Statistics and Informatics, Lima, Peru. Methods: An ecological study of multiple groups was performed from appendicitis records. Results were analyzed with Pearson coefficient and Poisson regression. Main outcome measures: Incidence of appendicitis and annual average temperature by department and incidence rate ratios (IRR). Results: A positive correlation between temperature and rate of incidence of appendicitis (r = 0.46; p = 0...

Subcutaneous emphysema of noninfectious cause occurs rarely. We present this case due to the importance of discerning it from one with an infectious etiology. Our patient came to the hospital with increased volume in the left hand after suffering a cut on the fifth finger of that hand with a metal bar. Blood tests were within normal ranges. Signs of subcutaneous emphysema were noted in the hand X-ray. Empirical antibiotic therapy was initiated with improvement at 36 hours. This case is of interest to consider non-infectious causes in the differential diagnosis of hand emphysema.

Estudio descriptivo, transversal y observacional para evaluar la frecuencia de la baja adherencia al tratamiento de la osteoporosis y sus características asociadas. Se realizó en el Servicio de Reumatología del Hospital Nacional Alberto Sabogal, en Callao, Perú, en febrero y marzo 2013, con 81 pacientes posmenopáusicas con diagnóstico de osteoporosis. Se aplicó un cuestionario de 32 preguntas y se usó la prueba de Morisky-Green (MG) para medir la adherencia al tratamiento. Se encontró que el porcentaje de no adherencia al tratamiento fue 80,2%. Las características asociadas fueron número de medicamentos adicionales, número de comorbilidades, diabetes y la falta de búsqueda de información sobre la enfermedad.

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We report the immediate reconstruction with personalized implants in the craniofacial region in a 22-year-old female patient with a craniofacial tumor of 12x15 cm in the left zygomatic orbital frontal region that corresponded to an ossifying fibroma. The reconstruction was performed with a custom-made implant based on tomographic images. The polyetheretherketone (PEEK) implant was selected to replace bone loss and restore facial anatomy. There was no need for transsurgical adjustment of the implant, no rejection, infection or implant exposure in the postoperative period. Although autologous bone is preferred for implants, it is often limited in the morbidity of the donor site, the difficulty of giving shape mainly to the borders and the limitation of the area to be donated; therefore the PEEK implants are currently an option in terms of biocompatibility resistance, duration, thermal cond...

Objective: To identify the "opportunity gap" with the BABIES method using perinatal mortality rates. Materials and methods: A descriptive cross-sectional study was performed with the Perinatal and Neonatal Epidemiological Surveillance Database. Perinatal mortality rates by districts and by areas of possible intervention were determined according to the BABIES method. Results: The district of Independencia had the lowest mortality rate, with 6.1 and 5.9 per 100 live births in the years 2014 and 2015, respectively. The priority area of intervention in the district of Comas was "maternal health" and in Carabayllo, "care during pregnancy". Conclusions: The BABIES method allows us to identify the "opportunity gap" which can guide us to perform interventions at the local level.

Objetivo: El objetivo del presente estudio fue determinar la prevalencia de seropositividad para HBsAg, Anti-HBcAg y Anti-HVC del Banco de Sangre del Hospital Nacional Daniel Alcides Carrión (HNDAC) durante el periodo 2010 al 2012. Materiales y métodos: Estudio transversal retrospectivo. Se incluyó a los potenciales donadores. Se recolectaron las características tales como edad, sexo y conductas de riesgo. Se realizó el análisis descriptivo con el programa STATA 14. Resultados: Se incluyó 13 887 potenciales donantes del HNDAC entre enero 2010 y diciembre 2012. Se identificaron 897 potenciales donantes positivos. La prevalencia de HBsAg fue 0,55%; Anti-HBcAg, 5,15%; y Anti-HVC, 1,25%. De ellos se encontró edad promedio de 37,4 años para los pacientes infectados por virus de hepatitis B y de 36,9 para los pacientes infectados por virus de hepatitis C, 31,2% fueron mujeres de...

Pulmonary alveolar microlithiasis a rare disease whose main characteristic accumulation of calcium salts within the air cell, this due to the presence of a genetic mutation autosomal recessive. This entity is within the group of diffuse lung diseases and primary diagnosis is a challenge for health professionals. There is no treatment to date, has raised the use of bisphosphonate, steroids and bronchoalveolar lavage without reaching conclusive results. It is preferred to perform the transplant before the development of right ventricular failure for best results. The definitive diagnosis is histopathological. In Peru it has been poorly described this disease as the only report found no definitive histopathological diagnosis. We report a case diagnosed in the Department of Thoracic and Cardiovascular Surgery Hipolito Unanue National Hospital in Lima, Peru.

Introduction: Studies have reported high prevalence of parasitic disease in students from the jungle although none has associated itwith poverty and nutritional factors. Objectives: To determine the relationship between poverty and nutritional factors with the presenceof intestinal parasites in students from a Huanuco village. Design: Cross-sectional study. Setting: Venenillo hamlet, Huanuco, Peru.Participants: Students from the only school in Venenillo. Interventions: Parasitological examination by Lugol’s iodine direct examinationand Lumbreras' fast sedimentation technique was performed in 42 students. Level of poverty was determined by the unsatisfied basicneeds index and degree of malnutrition by the Waterlow index. Statistical analysis was performed using Goodman and Kruskal’sgamma coefficient. Main outcome measures: Intestinal parasitosis association with poverty and nutritiona...