Señor editor: El cáncer de mama es la neoplasia más frecuente entre las mujeres, con un estimado de 1.67 millones de nuevos casos diagnosticados en 2012 (25% de todos los cánceres). Entre 1990 y 2013, las tasas de incidencia estandarizada por edad por cada 100 000 mujeres han incrementado en 17% a nivel mundial, siendo más afectados los países en desarrollo, donde cerca de la mitad de los casos corresponden a una enfermedad avanzada debido al diagnóstico tardío y al pobre acceso al tratamiento. En Perú, el cáncer de mama ocupa la segunda causa de muerte por cáncer en mujeres, detrás del cervicouterino, y su supervivencia se estima en alrededor de 60 a 70% a los cinco años del diagnóstico...

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Introducción La motivación en los estudiantes de medicina está asociada positivamente con las estrategias de aprendizaje. Sin embargo, la evidencia de una relación directa entre la motivación y el rendimiento es vaga. El objetivo de este estudio es determinar si la motivación que empujó a los estudiantes a elegir la carrera médica está asociada con su rendimiento académico durante sus años universitarios. Métodos El estudio se realizó en 4.290 estudiantes de medicina de 10 países de América Latina. La "Escala de atribución de la motivación de logro general" se utilizó para evaluar su desempeño general. La prueba "Escala de motivación médica" se usó para medir motivadores sociales, altruistas, económicos y de prestigio. Para los análisis estadísticos, se describieron las frecuencias y los porcentajes, y se utilizaron modelos lineales generalizados para establecer ...

“Background The incidence of kidney cancer has been increasing worldwide, with variable patterns in mortality due to improved diagnostic techniques and increased survival. The mortality rates, geographical distribution and trends of kidney cancer in South America remain poorly explored. This study aims to illustrate mortality by kidney cancer in Peru. Methods A secondary data analysis of the Deceased Registry of the Peruvian Ministry of Health database, from 2008 to 2019 was conducted. Data for kidney cancer deaths were collected from health facilities distributed throughout the country. We estimated age-standardized mortality rates (ASMR) per 100,000 persons and provided an overview of trends from 2008 to 2019. A cluster map shows the relationships among 3 regions. Results A total of 4221 deaths by kidney cancer were reported in Peru between 2008 and 2019. ASMR for Peruvian men ranged...

Background The incidence of kidney cancer has been increasing worldwide, with variable patterns in mortality due to improved diagnostic techniques and increased survival. The mortality rates, geographical distribution and trends of kidney cancer in South America remain poorly explored. This study aims to illustrate mortality by kidney cancer in Peru. Methods A secondary data analysis of the Deceased Registry of the Peruvian Ministry of Health database, from 2008 to 2019 was conducted. Data for kidney cancer deaths were collected from health facilities distributed throughout the country. We estimated age-standardized mortality rates (ASMR) per 100,000 persons and provided an overview of trends from 2008 to 2019. A cluster map shows the relationships among 3 regions. Results A total of 4221 deaths by kidney cancer were reported in Peru between 2008 and 2019. ASMR for Peruvian men ranged fr...

Background: Liver cancer is one of the leading causes of cancer-related death in Peru, and some reports have indicated an increase in mortality rates among the largest cities. To our knowledge, no study has been carried out at a national level or by geographic area in recent years. Thus, our objective was to examine overall, regional and sexspecific liver cancer mortality rates in Peru between 2003-2017. Methods: We retrieved data on liver cancer deaths between 2003 and 2017 from the mortality database of the Peruvian Ministry of Health. Age-standardized mortality rates (ASMR) were estimated per 100,000 person-years using the world standard SEGI population. We analyzed mortality trends using Joinpoint regression Program Version 4.7.0. To examine the spatial distribution of the mortality rates, we used GeoDa software. Results: Between 2003 and 2017, 31,473 deaths from liver cancer were re...

Background Stroke is a leading cause of death and disability globally, with significant public health implications. In Latin America, while mortality rates have declined, the number of stroke cases has increased due to prevalent risk factors like high blood pressure and obesity. Unlike Europe, recent trends in stroke mortality in this region remain underreported. Objective This study evaluates stroke mortality rates in Latin America Latin American and Caribbean (LAC) countries from 1997 to 2020 and predictions to 2035. Methods This ecological observational study utilized mortality data from the World Health Organization database. Trends were analyzed using Joinpoint regression to evaluate the annual percent change (APC) by sex and country. Predicted mortality rates through 2035 were calculated using the Nordpred package in R. Changes in stroke mortality were assessed by disentangling the...

Background Childhood obesity is emerging as a major public health problem worldwide. To date, most studies of obesity and overweight in Peru are focused on adults, with few of them involving children, a population at a critical stage of development. The trend in overweight and obesity prevalence in Peruvian children under the age of five has not yet been determined. Thus, the objective of the present study is to evaluate the prevalence rates of overweight and obesity between 2010 and 2015 in children under the age of five, stratified by geographical areas in Peru. Methods Data were obtained from the Nutritional Status Information System of Peru. The total number of children evaluated was 14,155,914. For the Geographic Information Systems (GIS), the program Geo Da 1.8® was used to ascertain the spatial distribution of prevalence rates and was mapped for children under five. To assess the...

Background: In 2022, breast cancer was one of the most commonly diagnosed neoplasms and the leading cause of cancer death among women worldwide. In Peru, reports on mortality due to this neoplasm are scarce, especially after implementing strategies to reduce its impact. This study aimed to estimate mortality rates for breast cancer in Peru and its geographic regions from 2013 to 2022 and to project its evolution to 2027. Methods: An observational ecological study of multiple time series was conducted. Data were obtained from the Ministry of Health’s death database via SINADEF. Mortality rates per 100,000 women were calculated using the direct method and Segi’s world standard population. Mortality trends were analyzed using the Annual Percent Change (APC) calculated with Joinpoint regression software. Predictions for 2027 were also made using the Nordpred package in R Studio. Results:...

Background In 2022, cervical cancer was the second most common neoplasia among women in Peru, with 4809 cases and 2545 deaths reported. Infection with human papillomavirus (HPV) is a key factor in the development of this disease. Vaccination is the primary strategy for HPV prevention. Although HPV vaccination coverage has improved, evaluating acceptance profiles is crucial for effectively monitoring public immunization policies. We aimed to determine the associated factors with parental acceptance of the HPV vaccine in girls from Peru. Methods An observational, analytical, and cross-sectional study was conducted with a sample of 204 parents of girls and adolescents aged 9 to 19 years in Metropolitan Lima. The dependent variable was acceptance of the HPV vaccine, while the independent variables included demographic data, level of knowledge about HPV, and socioeconomic and cultural factors...

“Objective: We aimed to identify factors associated with severe accidental burns in patients ≤12 years old. Materials and methods: We conducted a matched case-control study, in which we retrospectively reviewed the medical records of children treated in a single institution from 2014-2016. We classified the cases (patients with severe burns) and controls (patients with non-severe burns) according to the criteria of the American Burn Association. We used multivariate conditional logistic regression analysis to identify the relationship between the etiology of burns and their severity. Results: We reviewed 180 cases and 90 controls. The most common etiology of burns was boiling water in both cases (65.6%) and controls (83.3%). Most burns occurred inside the home (84.1%) and in the afternoon (37.4%). Multivariate analysis identified that severe burns were mainly due to exposure to fire ...

“Objective: We aimed to identify factors associated with severe accidental burns in patients ≤12 years old. Materials and methods: We conducted a matched case-control study, in which we retrospectively reviewed the medical records of children treated in a single institution from 2014-2016. We classified the cases (patients with severe burns) and controls (patients with non-severe burns) according to the criteria of the American Burn Association. We used multivariate conditional logistic regression analysis to identify the relationship between the etiology of burns and their severity. Results: We reviewed 180 cases and 90 controls. The most common etiology of burns was boiling water in both cases (65.6%) and controls (83.3%). Most burns occurred inside the home (84.1%) and in the afternoon (37.4%). Multivariate analysis identified that severe burns were mainly due to exposure to fire ...

Objetivos. Evaluar la asociación entre tener una especialidad médica y el ingreso económico mensual en médicos peruanos, y comparar los ingresos económicos entre áreas con mayor y menor densidad de médicos en Perú. Materiales y métodos. Se analizaron los datos de la Encuesta Nacional de Satisfacción de Usuarios de Salud realizada en Perú el año 2015. Esta encuesta con nivel de inferencia nacional fue realizada a médicos que laboran en establecimientos de salud de Perú. Se evaluó el ingreso económico considerando todas las actividades remuneradas del médico. Se calcularon las razones de prevalencia crudas y ajustadas (RP y RPa) y sus intervalos de confianza al 95% (IC95%) mediante regresiones de Poisson con varianza robusta, tomando en cuenta el muestreo complejo de la encuesta. Resultados. De 2219 médicos encuestados, se analizaron 2154 (97,0%) observaciones. La frecuen...

Background Maternal mortality remains a significant public health issue in low- and middle-income countries (LMICs), with high incidence rates in Latin America and the Caribbean (LAC). While maternal mortality decreased by nearly 45% between 1990 and 2015, regional inequalities persist. This study assesses maternal mortality trends in LAC women from 1997 to 2019, providing key insights to address this issue. Methods An ecological observational time-series study was conducted using data from the WHO Mortality Database for 18 countries in Latin America and the Caribbean between 1997 and 2019, focusing on women aged 15–49 years. Age-standardized maternal mortality rates (ASMR) per 100,000 person-years were estimated using the direct method, based on the SEGI world standard population. The MMR, defined as maternal deaths per 100,000 live births, was calculated using data from the Pan Ameri...

“Objectives: We aimed to describe the sociodemographic, clinical, and therapeutic characteristics of Peruvian military personnel diagnosed with HIV. Furthermore, we determined the frequency of highly active antiretroviral therapy (HAART) adherence, the complications and mortality. Methods: We retrospectively reviewed the medical records of patients diagnosed with HIV, confirmed by Western blot at a single institution from 1989-2020. Descriptive analyses were performed for all the variables using mean and standard deviation (SD) in the case of quantitative variables, and frequency and percentage for qualitative variables. Results:Ofthe 161 patients included, 95.7% were males and the mean age was 39.59 years (SD= 16.45 years). Most had college or higher education (67.7%) and were on active duty at diagnosis (77%). 35.4% had AIDS at diagnosis; 28.6% opportunistic infections; and 8.1% tube...

Background: Breast cancer is among the leading cause of cancer-related mortality among Latin American and Caribbean (LAC) women, but a comprehensive and updated analysis of mortality trends is lacking. The objective of this study was to determine the breast cancer mortality rates between 1997 and 2017 for LAC countries and predict mortality until 2030. Methods: We retrieved breast cancer deaths across 17 LAC countries from the World Health Organization mortality database. Age-standardized mortality rates per 100,000 women-years were estimated. Mortality trends were evaluated with Joinpoint regression analyses by country and age group (all ages, < 50 years, and ≥ 50 years). By 2030, we predict number of deaths, mortality rates, changes in population structure and size, and the risk of death from breast cancer. Results: Argentina, Uruguay, and Venezuela reported the highest mortality...

Background Diarrhea remains a major cause of preventable mortality in Latin American and Caribbean (LAC) countries, particularly among children and vulnerable populations. However, there are no studies showing the changes that have occurred in recent years in developing countries. Our objective was to determine the evolution of diarrhea mortality rates in LAC countries between 2000 and 2019. Methods An ecological observational time series study was conducted using only countries with complete population-based data in the World Health Organization mortality database between 2000 and 2019 with diarrhea mortality. Analyses were performed using Joinpoint Regression software to calculate mortality trends and annual percentage change by sex and by country. A mortality rates analysis of the last 5 years of the study period was performed to assess the countries with the highest rates. Results Be...

“Objectives: We aimed to describe the sociodemographic, clinical, and therapeutic characteristics of Peruvian military personnel diagnosed with HIV. Furthermore, we determined the frequency of highly active antiretroviral therapy (HAART) adherence, the complications and mortality. Methods: We retrospectively reviewed the medical records of patients diagnosed with HIV, confirmed by Western blot at a single institution from 1989-2020. Descriptive analyses were performed for all the variables using mean and standard deviation (SD) in the case of quantitative variables, and frequency and percentage for qualitative variables. Results:Ofthe 161 patients included, 95.7% were males and the mean age was 39.59 years (SD= 16.45 years). Most had college or higher education (67.7%) and were on active duty at diagnosis (77%). 35.4% had AIDS at diagnosis; 28.6% opportunistic infections; and 8.1% tube...

Background Gastrointestinal bleeding (GIB) is a common cause of emergency medical admissions and represents a significant public health issue due to its high morbidity and mortality. In Peru, information on mortality rates from GIB disaggregated by region and sex is limited. Therefore, this study aimed to analyze GIB mortality in the country between 2003 and 2022 using official data from the Peruvian Ministry of Health (MINSA). Methods An observational, ecological, and descriptive time-series study was conducted using MINSA mortality records for gastrointestinal bleeding from 2003 to 2022. Mortality rates were analyzed by sex and geographical region. Trends were assessed using Poisson regression models in Joinpoint software, identifying significant changes over time. Results Comparing the first (2003–2007) and last (2018–2022) five-year periods, a shift in the geographic burden was o...