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1013941
artículo
Publicado 2025
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Introduction: The COVID-19 pandemic resulted in high global mortality rates, particularly among patients with comorbidities such as Chronic Kidney Disease (CKD) undergoing dialysis. Material and methods: This study included data from 310 CKD patients on dialysis in a Peruvian hospital during the first and second waves of the pandemic. It assessed in-hospital mortality and its associated factors, and evaluated the effectiveness of the International Severe Acute Respiratory and Emerging Infections Consortium (ISARIC4C) score as a predictive indicator of patient deterioration. Additionally, one-year post-discharge mortality and the main causes of death were analyzed. Results: In-hospital mortality among dialysis patients with COVID-19 was 48.71%. Admission to the ICU and male sex were associated with an increased risk of death. The ISARIC4C score appeared to be a valid predictor of clinical...
1013942
artículo
Publicado 2025
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Objective: To determine the coverage and factors associated with non-vaccination against hepatitis B in newborns in Peru. Materials and methods: Multiple cross-sectional, the population consisted of children under five years of age. The source of information was a combination of vaccination cards and mother's report. Results: In the 2023 demographic survey, the vaccination rate was 91.9%. The characteristics associated with non-vaccination in the generalized linear models (p value ˂ 0.05) were: i) home births and births in private clinics, ii) cesarean births, iii) not having received the BCG vaccine, and iv) not belonging to the mountain region. Conclusion: The percentage of children vaccinated in the 2023 demographic survey exceeded 90.0%. The factors that were shown to be associated with non-vaccination were place of delivery (home, private clinic), cesarean delivery, not having re...
1013943
artículo
Publicado 2025
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Introduction: Malaria is one of the most important parasitic diseases in humans, and children are the vulnerable group with the highest risk of complications and death. Objective: To analyze the magnitude of the incidence of malaria in children and its relationship with some demographic and socioeconomic characteristics. Materials and methods: Cross-sectional, descriptive, ecological study, analyzing secondary sources; district and national analysis units, study period 2010-2023. Results: In Peru, in the period 2010-2023, 219,126 cases of malaria in children were reported, representing 41.64% of the national total and an average annual incidence rate (AAR) of 12.07 cases/1000 children. The TIAM in <5 years was 12.40 cases/1000, the highest TIAM between 2010-2019 and the lowest between 2020-2021, Loreto reported 89.62% of cases with the highest TIAM (49.19 cases/1000) in this group. P....
1013944
1013945
artículo
Publicado 2025
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Objectives: To describe the prevalence of obesity according to BMI in the adult population between 25 and 59 years of age, post-COVID-19 pandemic, and to specify the waist circumference cut-off point for obesity diagnosis. Material and methods: Descriptive cross-sectional study, sample 384 people, probabilistic sampling in six districts of the Lambayeque Region. With the approval of the USMP ethics committee and informed consent was applied to the participants. Results: The frequency of obesity was 28.4% (27.1% males and 29.5% females), 50.2% overweight with a statistical difference according to sex. Obesity is higher in Ilimo district 50.01%. The ROC curve was used to identify waist circumference cut-off points: 97.50 cm in males, 89.6% sensitivity and 80.0% specificity and 92.50 cm in females, 88.5% sensitivity and 70.5% specificity. Conclusions: One in four adults is obese and the cut...
1013946
artículo
Publicado 2025
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Introduction: Access to contraceptive methods in Venezuelan immigrant women residing in Peru presents limitations due to multiple factors that directly impact their ability to obtain and use them. Objective: To describe the prevalence and explore the factors associated with the use of contraceptive methods among Venezuelan immigrant women in Peru during 2022. Methods: Cross-sectional analytical study of secondary data from the second Survey of the Venezuelan Population Residing in Peru (ENPOVE). The generalized linear Poisson model with log-link function was used and crude prevalence ratios (PRc) and adjusted prevalence ratios (PRa) were calculated with their respective 95% confidence intervals (95% CI). Results: The prevalence of access to contraceptive methods was 50%. Access to contraceptive methods was higher in those Venezuelan immigrant women who were young (PRa: 3.12; 95 % CI: 1.7...
1013947
artículo
Publicado 2025
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Antimicrobial resistance is one of the greatest threats to public health, and hospital wastewater effluents are an important source of transmission for resistant pathogens. The objective of this study was to determine the presence of multidrug-resistant bacteria producing extended-spectrum beta-lactamases, AmpC, and carbapenemases in hospital effluents from three regions of Peru. Bacteria were collected and characterized from nine hospitals using chromogenic media and an automated microbiology system. Conventional PCR was also used to identify resistance genes for beta-lactamases, such as blaCTX-M, blaTEM, blaSHV, blaAmpC, and carbapenemases like KPC, NDM, and IMP. Fifty-five isolates were identified from various healthcare centers, with extended-spectrum beta-lactamase genes, such as blaTEM, found. In level II2 hospitals, the KPC resistance gene was found, particularly in the Regional H...
1013948
artículo
Publicado 2025
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Introduction: Intraventricular hemorrhage (IVH) affects the subependymal germinal matrix, and usually presents between 3 and 4 days of life. Fifty percent of cases occur on the first day and are diagnosed by cranial ultrasound. Affected neonates may develop neurodevelopmental alterations and even die. Objective: To identify the factors associated with intraventricular hemorrhage in very low birth weight newborns in a Peruvian hospital. Material and Methods: Analytical, case-control study. Information was obtained from virtual medical records and analyzed by descriptive and analytical statistics (chi-square or Fisher's exact test, crude and adjusted OR); a sample calculation and goodness-of-fit test were previously performed. Results: 204 neonates were included (55 cases and 149 controls). The most frequent HIV grades were I and II. In logistic regression, the significantly associated fac...
1013949
artículo
Publicado 2025
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A 22-year-old male patient who went to the emergency room at Hospital III-1 José Cayetano Heredia in Piura due to acute respiratory symptoms, was hospitalized with Acute Respiratory Failure associated with a moderate Asthma Attack, Community Acquired Pneumonia and Systemic Lupus Erythematosus as a history. Throughout the hospital course, a complex interaction between asthma and the pulmonary manifestations of SLE is evident. For this reason, lupus pneumonitis was proposed as a diagnosis, with a good response to antibiotic treatment and pulse corticosteroids.
1013950
artículo
Publicado 2025
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Objective: To evaluate associated factors with health-related quality of life in older adults’ beneficiaries of the “Pensión 65” program in Angaraes, Huancavelica. Materials and methods: A cross-sectional study. 160 people over 65 years-old were surveyed using the SF-36 questionnaire to measure health-related quality of life through eight dimensions (physical function, physical role, corporal pain, emotional role, general health, vitality, social function and mental health) and two components (physical health-SF and mental health-SM). Additionally, data about demographic and social characteristics was collected. The relationship with health-related quality of life was evaluated through multivariable models (multiple linear regression). Results: A statistically significant relationship was found between the SM component scores and primary or secondary educational level (β: -3.080 ...
1013951
artículo
Publicado 2025
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INTRODUCTION: Vulvar lichen sclerosus is a chronic inflammatory skin disease with a clear predilection for the anogenital region that is commonly underdiagnosed; It is the most common vulvar dermatosis associated with pruritus. OBJECTIVE: To report a clinical case of a patient with vulvar lichen sclerosus. CLINICAL CASE: 51-year-old quechua-speaking patient treated for vulvar itching of two years' duration. On clinical examination, a wrinkled hypopigmented plaque was found covering the vulva, the perineal body, the perianal area and the labia minora were adhered, defining a 5mm excoriative lesion in the vulvar fork. The diagnosis was clinical and confirmed with histopathology. Local corticosteroids were administered and the patient progressed with substantial improvement. CONCLUSION: The diagnosis of vulvar lichen sclerosus is usually clinical when the clinical features are typical; hist...
1013952
artículo
Publicado 2025
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Aim: To evaluate the risk factors for poor functional prognosis in patients hospitalized for spontaneous intracerebral hemorrhage. Methods: A retrospective cohort study was carried out where 73 patients with a diagnosis of intracerebral hemorrhage were included in a reference hospital in Peru from 2020 to 2022. The clinical history was used, which included demographic, clinical, laboratory and imaging data. Associations between qualitative variables and the incidence of poor functional outcome and mortality were established using Pearson's chi-square test, crude relative risks (RRc) with 95% confidence intervals were used, and a Poisson linear model with a function was applied. log link and robust variances. Results: 66.7% experienced poor functional outcome, the associated factors were: previous cerebrovascular disease, Glasgow Coma Scale on admission from 3 to 8, leukocyte level, early...
1013953
artículo
Publicado 2025
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Introduction: the presence or absence of ST elevation determines the prognostic and therapeutic approach to acute coronary syndrome. Objective: to predict, using neural networks, the presence or absence of ST-elevation according to symptoms and signs of acute coronary syndrome. Material and methods: analytical and cross-sectional study based on a database of 106 patients admitted for acute coronary syndrome in a Peruvian hospital. A series of symptoms and signs were analyzed prior to performing the electrocardiogram. Multilayer perceptron-type neural networks were used, from which the classification table of correct forecasts, the predictive capacity of the model, as well as the normalized importance of the predictor variables were evaluated. Results: The neural network had overall percentages of correct predictions in training and testing of 93.40% and 93.30%, respectively. The area und...
1013954
artículo
Publicado 2025
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The aim of this special article is to describe the role of artificial intelligence in the identification of pediatric pneumonia applied to chest X-rays, summarizing and analyzing the most relevant evidence and recent advancements. We also discuss its implications for improving diagnosis in areas with a shortage of specialists. Artificial intelligence offers great potential for enhancing the categorization of pediatric pneumonia in chest X-rays, especially in resource-limited regions. However, its success depends on the quality of the data, physicians' trust in the results, and the implementation of appropriate ethical and safety frameworks. While further research and the development of effective integration strategies are needed, artificial intelligence could play a crucial role in the global fight against childhood pneumonia.
1013955
artículo
Publicado 2025
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Electrocardiographic findings in ST-segment elevation acute myocardial infarction do not always evolve in a typical manner, with concomitant changes such as early repolarization that can cause diagnostic confusion. We present the case of a patient with typical chest pain and an atypical electrocardiogram, in which the presence of early repolarization in the inferior leads caused subtle changes in the precordial leads to be overlooked, leading to an error in the initial diagnosis but not in the treatment.
1013956
artículo
Publicado 2025
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Introduction: The evaluation of the homeostatic model gives results close to the gold standard (hyperinsulinemic-euglycemic clamp). Objective: To develop an equation to determine the homeostatic model of insulin resistance. Material and methods: Analytical and cross-sectional study of secondary databases of 2004 Venezuelan adults and another of 4363 Mexicans. The variables were: homeostatic model of insulin resistance (HOMA-2), basal insulin, basal glucose. Multiple linear regression, scatter plot, and student t test were used. Results: The regression equation was -0.694+(0.138*basal insulin)+(0.009*basal glucose), where HOMA2-IR increases 0.138 for each U/mL of insulin and increases 0.009 for each mg/dL of basal glucose. The R2 value was 0.983 (Venezuelan database), indicating that 98% of the change in HOMA2-IR can be explained by the model based on basal insulin and glucose. The equati...
1013957
artículo
Publicado 2025
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Background: Euglycemic diabetic ketoacidosis (EDKA) accounts for up to 7% of cases of diabetic ketoacidosis (DKA) and is characterized by blood glucose levels below 200 mg/dL. It has been associated with the use of sodium-glucose cotransporter-2 inhibitors (SGLT-2i). Case report: We present the case of a 34-year-old male with obesity and type 2 diabetes who, four days prior to admission, began treatment with empagliflozin/metformin 12.5/1000 mg twice daily due to hyperglycemia exceeding 350 mg/dL. He presented to the emergency department with symptoms consistent with DKA and a blood glucose level of 180 mg/dL. The patient was managed with fluid resuscitation and insulin therapy, resulting in significant clinical improvement. Discussion: The typical blood glucose level in EDKA is 184.5 mg/dL, often with false-negative urine ketone results, which can delay diagnosis. Management include...
1013958
1013959
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1013960
artículo
Publicado 2024
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La Revista del Cuerpo Médico del Hospital Nacional Almanzor Aguinaga Asenjo (RCMHNAAA) se encuentra indizada en dos prestigiosas bases de datos, como son Web of Science y Scopus, las cuales evalúan la calidad e impacto de las publicaciones científicas a través de un sistema de cuartiles. Este 2024, la RCMHNAAA ha obtenido un logro más en su trayectoria al posicionarse en el tercer cuartil (Q3), tanto en el Journal Citation Indicator de Web of Science como en el CiteScore de Scopus. La inclusión de la revista en el cuartil Q3 es de gran importancia, ya que facilita la difusión de investigaciones nacionales, promueve la visibilidad de la producción científica local y contribuye al avance de la ciencia en el ámbito regional. El reto es aprovechar esta visibilidad para seguir mejorando los estándares de calidad, fomentar la colaboración y potenciar la influencia de la producción...
