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1
artículo
Publicado 2024
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Tuberculosis (TB) remains a significant global health burden, with substance abuse being a common comorbidity. Cocaine-derived drugs, particularly crack and cocaine hydrochloride, have been associated with poor TB treatment outcomes. Objective: This systematic review aimed to synthesize the evidence on the relationship between crack or cocaine hydrochloride use and TB treatment outcomes. Materials and methods: A comprehensive search was conducted across multiple databases (PubMed, Ovid, EBSCOhost, Lilacs, and Google Scholar) using structured search terms. Eligible studies were included in a meta-analysis performed using STATA 16. Results: Five studies were included in the analysis. Overall, crack or cocaine use was associated with a higher risk of loss to follow-up or non-completion of TB treatment (OR = 2.73; 95% CI: 1.33-5.61). In the subgroup of individuals with active TB, this associ...
2
artículo
Publicado 2016
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Background: Human immunodeficiency virus (HIV)-associated tuberculosis deaths have decreased worldwide over the past decade. We sought to evaluate the effect of HIV status on tuberculosis mortality among patients undergoing treatment for tuberculosis in Lima, Peru, a low HIV prevalence setting. Methods: We conducted a prospective cohort study of patients treated for tuberculosis between 2005 and 2008 in two adjacent health regions in Lima, Peru (Lima Ciudad and Lima Este). We constructed a multivariate Cox proportional hazards model to evaluate the effect of HIV status on mortality during tuberculosis treatment. Results: Of 1701 participants treated for tuberculosis, 136 (8.0 %) died during tuberculosis treatment. HIV-positive patients constituted 11.0 % of the cohort and contributed to 34.6 % of all deaths. HIV-positive patients were significantly more likely to die (25.1 vs. 5.9 %, P <...
3
artículo
Publicado 2015
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OBJECTIVES: To establish the influence of tuberculosis on gestation, birth and newborn. To determine the reactivation factors and the course of tuberculosis during gestation. To estimate the influence of nutritional factor of tuberculous pregnant women on adverse perinatal outcome. DESIGN: Descriptive retrospective study of cases and controls, revising the clinical histories of patients attended at the Gynecologic Obstetrics service of Edgardo Rebagliati Martins Hospital during the years 1990-1995. MATERIAL: Group cases, were 31 pregnants with diagnosis of tuberculosis and the control group 31 pregnants without diagnosis of tuberculosis. RESULTS: Ninety percent of tuberculosis reactivated during gestation. A great percentage of patients with tuberculosis had history of tuberculosis (p < 0,048). In these patients specific treatment for tuberculosis prior to gestation was irregular and/or ...
4
artículo
Publicado 2015
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OBJECTIVES: To establish the influence of tuberculosis on gestation, birth and newborn. To determine the reactivation factors and the course of tuberculosis during gestation. To estimate the influence of nutritional factor of tuberculous pregnant women on adverse perinatal outcome. DESIGN: Descriptive retrospective study of cases and controls, revising the clinical histories of patients attended at the Gynecologic Obstetrics service of Edgardo Rebagliati Martins Hospital during the years 1990-1995. MATERIAL: Group cases, were 31 pregnants with diagnosis of tuberculosis and the control group 31 pregnants without diagnosis of tuberculosis. RESULTS: Ninety percent of tuberculosis reactivated during gestation. A great percentage of patients with tuberculosis had history of tuberculosis (p < 0,048). In these patients specific treatment for tuberculosis prior to gestation was irregular and/...
5
tesis de grado
Publicado 2025
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Contexto: Durante la pandemia de COVID-19 en el CENEX del CMI San José, se investigaron los factores asociados a la condición de egreso en pacientes con tuberculosis entre 2020 y 2022. Métodos: Estudio observacional retrospectivo con 163 pacientes. Se analizaron variables sociodemográficas, bacteriológicas y clínicas. Se utilizó muestreo no probabilístico. Resultados: La mayoría fueron hombres (62.58%) con tuberculosis pulmonar (85.89%) y en esquema de primera línea (85.89%). Se observó éxito de tratamiento en el 92.02%. El consumo de tabaco (p = 0.028) es un factor de riesgo para el no éxito de tratamiento. Discusión: El consumo de tabaco se identificó como factor un factor de riesgo asociado con resultados no exitosos en el tratamiento de la tuberculosis. Estos hallazgos resaltan la necesidad de abordar el tabaquismo en estrategias de gestión de la tuberculosis. Conclus...
6
artículo
Publicado 2023
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The case of a 20-year-old male patient is presented, with an illness of one week characterized by asthenia, hyporexia, nausea, vomiting, neck stiffness, intermittent headache of intensity 9/10, fever quantified at 38.5. °C, scant dry cough, weight loss and left hemiparesis without loss of consciousness. Serological tests, including HIV, were negative. The spinal fluid showed pleocytosis with a predominance of mononuclear cells, hyperproteinorrachia and hypoglycorrhachia, with a positive GeneXpert MTB/RIF test for M. tuberculosis resistant to rifampicin, in addition to a positive sputum smear for the same germ. The images showed a miliary pattern and vascular compromise (bilateral hypodensities at the level of the basal ganglia and internal capsule). He was treated as multidrug-resistant systemic tuberculosis with a favorable outcome.
7
artículo
Publicado 2024
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Milar Tuberculosis (TB) is a presentation with a fatal outcome if it is not diagnosed or treated on time; although certain conditions are required to develop this presentation. In this In this article, the case of a 48-year-old man with no pathological history is studied, who started the disease with a time of six months with an initial diffuse gastrointestinal pain and later one month before admission presented progressive respiratory symptoms; he was admitted for emergencies where bilateral diffuse miliary compromise was evident in the chest computed tomography; upon admission, he was administered oxygen and support measures, an HIV test was obtained which was negative, and positive results were obtained in the sputum smear microscopy. His clinical evolution was stationary until the administration of antituberculosis therapy, observing slight clinical improvement, likewise, low doses o...
8
tesis doctoral
Depresión y alcoholismo en pacientes recibiendo tratamiento con esquema 1 para tuberculosis pulmonar
Publicado 2024
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La tuberculosis (TB) es la principal causa de muerte atribuible a un agente infeccioso. La falla y pérdida en el seguimiento en su tratamiento constituyen los principales factores de riesgo para el desarrollo de cepas multidrogo (MDR) y extremadamente resistente (XDR). Los trastornos depresivos y de uso de sustancias se han visto también fuertemente asociados a pérdida en el seguimiento durante el tratamiento de TB, sin embargo, las características en el cambio del puntaje de depresión durante una parte del tratamiento podrían permitir la identificación de otros grupos con mayor riesgo para resultados negativos. Por otro lado, dado que algunos de los síntomas que se utilizan regularmente en escalas para la detección de síntomas depresivos coinciden o se parecen a aquellos propios de un cuadro de TB, podrían tener menor utilidad en este grupo. Basados en esto, proponemos las si...
9
artículo
Publicado 2006
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Background: Studies on tuberculosis (TB) risk in patients with rheumatoid arthritis (RA) non-users of biological therapy show contradictory results. Objetives: To determine RA as independent risk factor for TB. Design: Non concurrent cohort study. Setting: Guillermo Almenara Asistential Net, Lima-Peru, a teaching hospital. Participants: Biological therapy non-users RA patients. Interventions: RA patients fulfilled the ARA 1987 diagnosis criteria and were biological therapy non-users. Control group was paired by age and sex to RA patients. Patients in control groups had non immunological disorders. Clinical information was completed by interviews. RA patients follow-up was started at the time of diagnosis and ended at the time of interview and/or TB diagnosis. Density incidence (DI) was found for each cohort and TB relative risk (RR) was calculated. To evaluate time length to TB evolution...
10
artículo
Publicado 2021
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A 60-year-old woman born in Tarma and living in Lima, with a history of biomass exposure, contact with a patient with tuberculosis, arterial hypertension, heart arrhythmia and mother with ovarian cancer, visited the medical center with progressive dysphagia, 15-kilogram weight loss and evening fever for seven months. A previous endoscopy revealed an esophageal tumor. A CT scan showed middle and distal third esophageal wall thickening, and 10x10 mm mediastinal adenopathies. The rest of the thoracic and abdominal organs were normal. The last endoscopy revealed an ulcerated lesion in the esophagus. The pathological evaluation showed a large chronic granulomatous inflammation with giant cells and necrosis. Ziehl–Neelsen stain was negative for Koch bacillus and revealed no malignant lesion. A Mycobacterium tuberculosis-positive polymerase chain reaction (PCR) was observed. An adenopathy bio...
11
artículo
Therapeutic effects of copaiba oil as an adjunct to the treatment of pulmonary tuberculosis, the experimental group copaiba oil more drug treatment and drug treatment control group was administered; quantitative application, longitudinal, prospective and experimental techniques used: questionnaire, interview and record observation guide. Were analyzed using SPSS, and statistical calculation was square CHI for possible correlations between the different variables and the mean difference before and after the program. Condence interval of 95 % was used. <0.05 were signicant. The outcome of treatment is the best kind to help reduce normal secretion and 4(11%) of patients with mild malnutrition and 1(3%) moderate malnutrition. The post test control group we observed 27 (76%) mild malnutrition treatment based copaiba oil capsules to the experimental group, 32 ( 89%) patients have pres...
12
artículo
Background: Tuberculosis (TB) is sanitary and national research priority. Scientific production on TB in Peru has not been studied. Objectives: To analyze publications on tuberculosis (TB) done in Peru in the period 1981-2010. Design: Bibliometric study on tuberculosis in Peru. Setting: Universidad Nacional Mayor de San Marcos and Instituto Nacional de Salud, Lima, Peru. Analysis unit: Original articles including reports and series of cases completely developed in Peru or multicentre studies with participation of Peruvian settings. Interventions: Bibliographic search was performed in journals with indization in Medline, SciELO and LILACS 1981-2010. Year of publication, authors, time for realization, language, study area, publication type, study design, study field, population studied, type of research as defined by WHO, institutions participating, financing, and impact factor were regist...
13
artículo
A case of congenital tuberculosis with fatal outcome is presented. Tuberculosis lesions of the mother's genital tract by endometrial biopsy and hysterosalpingography were shown. The preterm newborn had thirty sixth weeks of pregnancy and weighed 2760 g. After an evolution that included hyperbilirrubinemia, hydrocele, equinus varus, abdominal rectus diastasis, pyodermitis and omphalitis, the infant developed respiratory failure with cyanosis on day 27. Diagnosis was milliary tuberculosis and sepsis with fatal outcome. This case meets Cantwell's proposal for diagnostic criteria for congenital tuberculosis, as tuberculosis was documented in the newborn and in the mother's genital tract, confirmed by anatomopathological examination. Postnatal transmission was excluded by isolation of the newborn from the mother and the presence of lesions from the very first weeks of life.
14
artículo
Publicado 2012
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detection and immediate installation of appropriate therapy. Given the low sensitivity of sputum smear and culture of bacillus tuberculosis, other tools should be explored in the differential diagnosis of tuberculous meningitis such as adenosine deaminase (ADA) isoenzymes. Objectives: To determine ADA isoenzymes activity in cerebrospinal fluid (CSF) of patients with tuberculous meningitis. Design: Descriptive study, with non-probability sampling. Institution: Biochemistry and Nutrition Research Center, Universidad Nacional Mayor de San Marcos, Lima, Peru. Biological materials: Samples of CSF from patients with clinical symptoms of tuberculous meningitis. Interventions: Samples of CSF with ADA activity above 9 U / L were stored at -40°C until vertical electrophoresis was run. Mann - Whitney statistical analysis was used with 0.1 significance level to compare meningeal tuberculosis ADA va...
15
artículo
Publicado 2008
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Objective: To predict by using bioinformatic tools Mycobacterium tuberculosis (MT) metabolic pathways under hypoxic conditions. Design: Biology analysis. Setting: Instituto de Química Biológica, Microbiología y Biotecnología Marco Antonio Garrido Malo Biological, Microbiologic and Biotechnologic Chemistry Institute, Faculty of Pharmacy and Biochemistry, UNMSM. Biologic material: Mycobacterium tuberculosis genes. Methods: The study began with the selection of 355 genes of MT H37Rv whose expression has been shown by other studies is induced by hypoxic conditions and 359 genes whose expression was repressed. Up and down expressed genes were comparatively analyzed, localizing genes of each group within the MT genome and predicting some physicochemical properties (isoelectric point and hydrophobic moment) for their protein products. In order to assign a metabolic or regulatory pathway to ...
16
tesis de grado
Publicado 2025
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La neumonía y la tuberculosis (TB) son las enfermedades respiratorias más prevalentes en niños de uno a cinco años en Perú. Un diagnóstico rápido y eficaz es esencial para hospitales, clínicas e instituciones de salud, ya que mejora los resultados del paciente y optimiza la eficiencia operativa. El deep learning (DL) aplicado al análisis de imágenes médicas ha demostrado ser valioso para el diagnóstico, ayudando a los médicos a incrementar la exactitud y reducir el error humano. Este estudio desarrolló un modelo basado en la arquitectura ResNet para detectar neumonía y TB en radiografías de tórax pediátricas, utilizando una base de datos de 5856 imágenes del Centro Médico de Mujeres y Niños de Guangzhou (4100 de entrenamiento, 878 de validación y 878 de prueba) y del Instituto Nacional de Alergias y Enfermedades Infecciosas (988 de entrenamiento, 211 de validación ...
17
artículo
Publicado 2014
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Introduction: Lima and Callao are high risk areas for tuberculosis active transmission in Peru. Multidrug-resistant tuberculosis represents 5.54% of the new cases of pulmonary tuberculosis (primary MDR-TB) in Lima and Callao. Involved risk factors have not been studied in patients from Callao. Objectives: To determine risk factors for primary MDR-TB in patients attending health care facilities in Callao during 2009-2010. Design: Case-control study. Setting: Health care facilities from Callao. Participants: Twenty nine primary MDR-TB patients and 37 drug-sensitive TB patients were studied through assessment of the Tuberculosis Control Program Registries and healthcare facilities’ clinical records. Interventions: Information was obtained from secondary sources. Odds-ratios were calculated by bivariate analysis. Logistic regression models were used to calculate multivariate odd-ratios. Ma...
18
artículo
Publicado 2010
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Objective: To determine the validity of both adenosine diaminase (ADA) test and differential cell count for pleural tuberculosis diagnosis. Design: Retrospective study for diagnosis precision. Setting: Huacho Hospital, Ministerio de Salud, Huacho, Peru. Material: Medical records of patients with ADA test in pleural fluid. Interventions: Medical records study of patients with ADA test in pleural effusion performed from January 2005 through December 2007. ADA test values and differential cell counts were analyzed by ROC curve. Sensitivity (Se), specificity (Sp), predictive values (VPP and VPN) and likehood ratios (LRP and LRN) were found for each variable. Main outcome measures: ADA test cut-off point for pleural tuberculosis diagnosis. Results: Tuberculosis was responsible for most cases of pleural effusion; 47,5 UI/L was the cut-off point by ROC curve, with Se and Sp 73% and 90%, respect...
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20
artículo
Publicado 2016
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Objetivo: Identificar los factores asociados al abandono del tratamiento antituberculoso en un centro de salud de atención primaria del distrito de Chorrillos, Lima, Perú. Materiales y métodos: Estudio de casos y controles retrospectivo no pareado. Se definió como caso a los pacientes que abandonaron el tratamiento por un periodo de 30 días consecutivos o más y como controles a los pacientes que terminaron el tratamiento antituberculoso. Se evaluó el puntaje de riesgo de abandono que se realiza en el centro de salud (≥22), así como variables demográficas. Se calculó el odds ratio (OR) e intervalos de confianza al 95% (IC95%) usando regresión logística. Resultados: Se incluyó 34 controles y 102 casos. En el análisis multivariado se encontró que quienes cursaron menos de seis años de educación (OR: 22,2; IC95%: 1,9-256,1) así como quienes tenían un puntaje ≥ a 22 pun...
