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1
artículo
Publicado 2022
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Diabetes mellitus is a public health problem that causes early and late complications. Continuous glucose monitoring (CGM) has become the main technological tool for real-time glycemic control and has the potential to prevent complications. However, its use has not spread in low- and middle-income countries. We present the experience in the management of a patient with type 1 diabetes with hypoglycemia unawareness in whom the use of real-time CGM achieved both: less hypoglycemic episodes and optimization of insulin regimen. The benefit of real-time CGM in addition to the use of analog insulins and diabetes education resulted in better metabolic control. CGM is a useful tool to consider in patients with hypoglycemia unawareness and to minimize the risk of complications in the future.
2
artículo
Following almost three decades of political instability, economic uncertainty, and activist diplomacy, President Alberto Fujimori in the early 1990s returned a degree of economic and political stability to Peru. To restore the international standing of Peru, he also reoriented Peruvian foreign policy, modifying its direction, content, and tone. In the new millennium, successive Peruvian governments, from Alejandro Toledo to Ollanta Humala, have built on the initiatives introduced by Fujimori with a focus on traditional concerns, including sovereignty, territorial integrity, economic independence, regionalism, and continental solidarity. Notable for both continuity and coherence, Peruvian foreign policy after 2000 also evidenced a degree of pragmatism when an increasingly complex world called for new solutions to old problems.
3
artículo
Publicado 1997
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It is usual to think that between the historical processes of Peru and Mexico there are more similarities than differences. And, indeed, there are reasons to suppose that this is true: both were the cradle of the most developed cultures in the American continent until before the arrival of the Spaniards; later, the two became the most powerful viceroyalties of the Crown; they also followed a similar pattern in their dependent relationship with the international economy; In both territories there is a rich and diverse cultural heritage that, according to some discourses, will merge into a thriving miscegenation. And we could continue with the enumeration.
4
artículo
Publicado 2025
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The management of ST-segment elevation acute myocardial infarction after reperfusion involves critical decisions for patients with multivessel disease (MVD), acute heart failure, and left ventricular (LV) thrombus. Complete revascularization of non-culprit lesions ≥70% is recommended during the initial intervention or within the first 19 days, particularly in stable patients. Coronary artery bypass grafting is indicated for high-risk anatomies or complex lesions following a successful coronary intervention, where a hybrid strategy combines percutaneous intervention with surgery, with timing adjusted based on whether a stent was implanted. Post-infarction heart failure is common (28-31%) and requires urgent treatment. Continuous monitoring and prompt intervention can reduce complications. In cases of shock or mechanical complications, an intra-aortic balloon pump and inotropic support m...
5
artículo
This article provides an overview of the work produced by Vallejo in the first part of his stay in Paris. It seeks to show how, although there are natural continuities between what he produced in Peru and what he wrote in Europe, the period 1923-1929 represents a process of decantations and discoveries of great significance for the poet’s later work (written in the context of his adherence to Marxism and in a particularly tense political context). In the years of my interest, Vallejo writes from the aesthetics of the vital (which supposes an ethic) and from his position-taking in the three imbricated literary fields in which he participates: the French, the Peruvian and the Spanish American writer in Paris.
6
artículo
Publicado 2023
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The post-pandemic represents, in many aspects, a period in which a closer relationship with the use of electronic devices is evident; However, the digital divide continues to exist for some sectors of society; The objective was to make known, through specific indicators, the magnitude of the digital divide in an educational community in the "new normal"; The methodology was mixed, through the implementation of structured surveys (quantitative) and their analysis in conjunction with the group of teachers (qualitative); The results indicate an increase in devices and connectivity lines, lack of continuity in the use of digital applications in the transition to face-to-face modality and new behaviors against the use of devices, such as the increase in the consumption of content from social networks and in some cases, a routine that implies too much time in front of screens, With which it ca...
7
artículo
Publicado 2024
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This paper, drawing from what occurred before and after the pandemic, is a substantiation endeavour aimed at determining the grounds that authorize the imposition, by law, of the corporate duty to continue paying wages, despite not receiving -or even expecting- work in return. To this end, first, it shows that the law in force already provides a powerful legal reason to justify legislative interventions in this sense: the constitutionalized social dimension of wages. Subsequently, in order to support the constitutional principle in question, it argues that there are sufficient moral reasons to implement distributive mechanisms of business income that even cover cases in which it is factually impossible to offer work in exchange. Finally, appealing to the notion of “special positive duty”, it asserts that the aforementioned constitutional provision is the materialization in the labour...
8
artículo
Publicado 2017
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Objective: To determine the variables of the comprehensive geriatric assessment (CGA), predictors of mortality six months after discharge of inpatients from the Acute Geriatric Unit (AGU) of the Hospital Nacional Guillermo Almenara Irigoyen. Materials and methods: An observational, prospective, longitudinal study was conducted in the Acute Geriatric Unit of the Hospital Nacional Guillermo Almenara Irigoyen (HNGAI) from July 2015 to January 2016. Variables (general characteristics [age, gender, hospital stay] and comprehensive geriatric assessment [comorbidity, functional assessment, emotional assessment, cognitive assessment and social-family assessment]) were collected from the Geriatric Unit medical records and a mortality-related telephone follow-up was performed six months after discharge. Results: The study population consisted of 110 patients (57.3% were male, age: 77.47 ± 8.92 ye...
9
artículo
Publicado 2018
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La leishmaniasis de las mucosas (ML) se asocia con la destrucción progresiva de tejido y la formación de granulomas, a menudo después de un período de latencia considerable desde una infección cutánea inicial. Presentamos un caso de epistaxis recurrente de 3 años de duración y obstrucción nasofaríngea en una mujer con leishmaniasis cutánea tratada casi 30 años antes y sin más exposición a Leishmania. La tomografía computarizada reveló perforación del tabique nasal y la histopatología demostró inflamación crónica. La microscopía fue negativa para amastigotes, pero las pruebas moleculares de la biopsia de la mucosa nasal detectaron Leishmania (Viannia) braziliensis. La paciente se sometió a 28 días de tratamiento con estibogluconato de sodio intravenoso y sus síntomas mejoraron significativamente. Dieciséis meses después del tratamiento, continúa teniendo epista...
10
artículo
Publicado 2025
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The study aimed to assess the efficacy of high-intensity interval-training (HIIT) compared to moderate-intensity continuous training (MICT) for 12 weeks on a treadmill on maximal aerobic potency, aerobic resistance, respiratory and heart rate at rest, left ventricle structure and function in dogs. The study design was a blinded controlled clinical trial. Thirty untrained dogs between 12 and 84 months were randomly distributed in the groups: HIIT (n=11), MICT (n=9); and control (n=10). Dogs with cardiovascular, neuromuscular, orthopaedic conditions, body condition score over 7, or any abnormalities that impaired exercise performance were excluded. Before and after the programme, dogs performed an incremental exercise test to determine the maximal velocity (Vmax) and velocity at lactate threshold (VLT). Respiratory and heart rates and left ventricular chambers and systolic function at rest...
11
artículo
Publicado 2025
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El 2 de junio de 1924, Carlos Monge Medrano presentó ante la Academia Nacional de Medicina del Perú el primer caso clínico de mal de montaña crónico (MMC), y luego publicado en 1925. Describió una eritrocitosis severa inicialmente confundida con Enfermedad de Vaquez, pero que se diferenciaba por su reversibilidad al descender de altitud. En 1929, en París, el profesor Roger confirmó que se trataba de una entidad distinta y propuso el nombre “enfermedad de Monge” en honor a su descubridor. A cien años de esa descripción, el MMC continúa afectando a poblaciones de gran altitud, con síntomas de hipoxia crónica y policitemia. Aunque en los Andes no se ha confirmado la introgresión del gen EPAS1 como en los tibetanos, estudios recientes señalan mecanismos adaptativos genéticos, epigenéticos y hormonales. El legado de Monge Medrano sigue vigente y resulta clave para compre...
12
tesis de maestría
Publicado 2020
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Gold extraction via small scale mining in the Amazon rainforest of Peru has become one of the greatest threats to deforestation and land degradation in the Amazon, especially in the Madre de Dios region which is one of the last biggest remnants of continuous tropical rainforest in the world. Restoration of these degraded ecosystems have become a priority in the last decade but without concrete actions, however, few research has been conducted in response to these restoration activities nor natural regeneration. The significance of this research was to 1) To Analyze how gold mining affects forest structure, species richness and diversity in the Amazon Rainforest of Madre de Dios, Peru. 2) To assess variation on diversity levels in secondary successional forest compared to that found in primary forest 3) to identify variations in the gold extraction methods reported in the region and how i...
13
artículo
Publicado 2023
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This research focuses on knowing the actions deployed by the Peruvian legation in France and England after the fall of Lima in the hands of the Chilean army and in the midst of a deep political anarchy that influenced the setting of the objectives of the foreign policy of the parallel governments that Peru had between 1881 and 1883, specifically in obtaining funds and weapons for the regimes of the presidents Francisco García Calderón, Nicolás de Piérola, Lizardo Montero and Miguel Iglesias. Despite the deep political division, the Peruvian legation continued with the execution of the orders of Lima and Arequipa as part of foreign policy, although with increasing autonomy towards the end of the war. In this sense, unpublished information from various historical sources will be analyzed, including the archives of the Ministry of Foreign Affairs of Peru, the National Library of Peru,...
14
artículo
Publicado 2024
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Objective: To evaluate the efficacy of scheduled second-look endoscopy in patients with acute peptic ulcer bleeding (PUB). Materials and methods: We systematically search in four databases for randomized controlled trials (RCTs) that evaluated the usefulness of scheduled second-look endoscopy vs. single endoscopy in patients with PUB. Our primary outcome was rebleeding. Secondary outcomes were surgery, mortality, and the number of units of blood transfused (NUBT). All meta-analyses were performed using a random-effects model. Pooled risk ratio (RR) and mean difference (MD), with their 95% confidence intervals (CIs) were calculated for categorical and continuous outcomes, respectively. The risk of bias was assessed using the Cochrane RoB 2.0 tool, and the quality of evidence (QoE) was rated with the GRADE approach. Results: Eight full-text RCTs and two RCT abstracts were included (n=1513)...
15
tesis de grado
Publicado 2023
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Una empresa en el sector de las telecomunicaciones que se dedica a la venta de servicios móviles, cable e internet a través de todos sus canales, de igual manera, terceriza su servicio postventa de atención para el cliente empresa ha realizado una serie de buenas prácticas para mejorar la satisfacción del cliente durante veintidós meses, logrando así alcanzar un resultado histórico en el nivel de satisfacción. En el sector en el que nos encontramos, la competencia es altamente competitiva, lo que significa que es crucial prestar atención a este aspecto. También es importante tener en cuenta las recomendaciones de los clientes y su percepción del servicio. Estos factores son determinantes, ya que, dependiendo de los resultados obtenidos, podemos optar por seguir haciendo lo mismo para mantener la satisfacción del cliente, o bien realizar cambios para adaptarnos a las nuevas e...
16
artículo
Publicado 2019
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Introduction. Prostate cancer is the most common in men and is the second cause of death. Exercise-based rehabilitation is effective and safe in mitigating cancer effects. Objective. To determine the hemodynamic changes and quality of life in prostate cancer after a high intensity training (HIIT) or continuous to moderate intensity (MICT). Methods. A randomized clinical trial with 249 patients with stage II prostate cancer divided into 3 groups (MICT, HIIT and control group) who were applied EORTC QLQ C-30 questionnaire for quality of life, echocardiogram, stress test, vital signs and FACT-Fatigue Scale. The training program lasted 36 sessions of 70 minutes, 3 times a week. Results. When comparing the post-training results of the hemodynamic variables, we managed to determine changes in the ejection fraction (GE1: 49.0 ± 5.6 vs 52.0 ± 5.4, GE2: 45.0&n...
17
artículo
Publicado 2010
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Se describe la variación temporal en agentes virales en pacientes con enfermedades similares a la influenza antes y después de la aparición de la pandemia de influenza A (H1N1) (Ph1h1) en Perú, entre el 04 de enero y el 13 de julio de 2009. En los centros de salud, se obtuvo un hisopo orofaríngeo para el aislamiento viral. Desde la semana epidemiológica 1 a 18, en el Centro de Investigación Médica Naval de los Estados Unidos destacado en Lima. Las muestras se inocularon en cuatro líneas de células para el aislamiento del virus. Además, desde la semana 19 hasta la 28, las muestras fueron analizadas mediante reacción en cadena de polimerasa en tiempo real. La distribución viral en Perú había cambiado a la introducción del virus pH1N1 en comparación a los meses previos. El virus pH1N1 predomina sobre otros virus de influenza A.
18
artículo
Publicado 2019
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The research applied the concepts and strategies of the new model of strategic management using the Balanced Scorecard, integrated with other approaches on a broader and more comprehensive management scheme to influence the performance of the company Kaniman SRL in the city of Pucallpa, Peru, 2012 period; for this purpose the quantitative research methodology with quasiexperimental design was used, representing the research process in time or time series and technical analysis: univariate inferential; for assessing the performance of the company seventeen indicators as a measure of business performance, was used in the four dimensions of the Balanced Scorecard, which are: financial perspective, customer perspective, internal perspective and learning and growth perspective. establishing that the implementation of the proposed management model, positive influence on improving the performan...
19
artículo
Publicado 2025
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This research was conducted in a farinaceous products company that was facing a problem of low productivity due to frequent downtime, leading to underutilization of their capacity. The lean manufacturing methodology was used to address this issue, specifically value stream mapping (VSM) and single-minute exchange of die (SMED) tools. These tools were applied in stages, including a diagnostic pretest (current map), followed by design, implementation, and a posttest (final map). The results were evaluated after the completion of the process, and it was found that the application of SMED led to a significant reduction in downtime. The product changeover time was decreased from 82 minutes to 42 minutes, reducing plant downtime or waste by 40 minutes and improving lean manufacturing indicators.
20
tesis de grado
Publicado 2023
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This research takes as an example a microenterprise in the automotive sector with problems directly related to its warehouses. Tauro Servs has more than 20 years in the market providing preventive and corrective maintenance services for light, heavy and linear vehicles. The evaluated stores to study contain various products that are used in each service or sold to customers, these products are from different brands such as Toyota, Nissan, Hyundai, Mitsubishi, Mercedes, Land Rover and others. The most notorious problem of the company was the lack of order and cleanliness in the warehouses, which generated delays in the time of service and loss of customers for not having a certain product at the requested time. The objective of the thesis is to develop a proposal for improvement that allows the optimization of the warehouses of the company in the automotive sector. The tools used are the ...
