https://amp.cmp.org.pe/index.php/AMP/issue/feedACTA MEDICA PERUANA2024-03-19T02:08:35-05:00Acta Medica Peruanaactamedicaperuana@cmp.org.peOpen Journal SystemsActa Médica Peruana es la revista científica oficial del Colegio Médico del Perú; tiene como finalidad difundir el conocimiento médico a la comunidad médica y científica a nivel nacional e internacional.https://amp.cmp.org.pe/index.php/AMP/article/view/2757Implications derived from the regulation of the General Law for the Protection of People with Diabetes Mellitus (DM)2024-02-19T02:02:32-05:00Arturo E. Villena Pachecoavillena1708@gmail.com2023-11-17T15:27:08-05:00Copyright (c) 2023 ACTA MEDICA PERUANAhttps://amp.cmp.org.pe/index.php/AMP/article/view/2618Finnish risk score for detection of dysglycemia in adults in the Family Medicine Unit2024-01-25T01:57:41-05:00Gabriela García-Moralesgabygarcia_morales@hotmail.comMiriam Casarrubias-Martínezgabygarcia_morales@hotmail.comVíctor F Herrera-Reyesgabygarcia_morales@hotmail.comYuliana García-Jiménezgabygarcia_morales@hotmail.comJosue Rosaliano-Salinasgabygarcia_morales@hotmail.com<p><strong>Objective:</strong> to establish the discriminative capacity of the Finnish risk score for dysglycemia in users of a family medicine unit located in the suburbs of the State of Guerrero, Mexico. <strong>Material and methods:</strong> We conducted a cross-sectional study from March to December 2021 in a Family Medicine Unit. With prior informed consent, we applied the Finnish risk score for the detection of dysglycemia to 200 people between the ages of 20 and 60, we obtained somatometric measurements and fasting plasma glucose figures. We estimated sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratio, and calculated the area under the curve (AUC) to estimate the discriminative ability of the risk score, where the reference test was fasting glucose. We performed bivariate analysis to identify factors associated with dysglycemia, obtaining Odds Ratio (OR) and 95% confidence intervals (95%CI). <strong>Result:</strong> The occurrence of dysglycemia was 26.5% (53/200). The AUC of the ROC curve of the Finnish score for dysglycemia was 0.65 (95%CI 0.57-0.74). The factors associated with diabetes were ≥40 years (OR 2.1; 95%CI 1.1-3.9), body mass index ≥25 Kg/m2 (OR 2.8; 95%CI 1.2-6.7) and suffering from arterial hypertension (OR 2.2; 95%CI 1.1 -4.4). <strong>Conclusions:</strong> The FINDRISC was shown by AUC to be a poor tool for detecting people at risk of suffering from dysglycemia, in a population attached to a suburban medical unit</p>2023-10-30T14:19:29-05:00Copyright (c) 2023 ACTA MEDICA PERUANAhttps://amp.cmp.org.pe/index.php/AMP/article/view/2695Spirometric reference equation in men from 2 regions of northern Peru located between 0 and 100 meters above the sea level: Cross-sectional study2024-03-02T02:05:35-05:00Miguel Angel Pretell Cabreramiguel.pretell.c@upch.peJonh Astete Cornejomiguel.pretell.c@upch.pe<p><strong>Objective:</strong> Determine the spirometry reference values and formulate an equation to predict spirometric values in the economically active population (EAP) in regions with an altitude of 0-100 m.a.s.l. <strong>Materials and Methods:</strong> Study participants were selected considering the study selection criteria. Information was collected on the variables considered in the study: Forced Vital Capacity (FVC) and Forced Expiratory Volume in the first second (FEV1), sociodemographic data and anthropometric measurements. The sample was divided into 2 groups to be able to formulate the reference equation and to assess its reliability in a validation subgroup using intraclass correlation tests, Student's t-test for paired samples, and Bland-Altman plots. <strong>Results:</strong> 1052 male participants were selected. The normal ranges for FVC and FEV1 calculated were FVC 3.48 – 5.47 and FEV1 2.83 – 4.41. Using multiple linear regression, the following formulas were obtained: FVC = 2.206 – 0.131 (Geographic Altitude) – 0.014 (Age) + 0.045 (Height) and FEV1 = 1.589 – 0.08 (Geographic Altitude) – 0.015 (Age) + 0.033 (Height). In the reliability analyses, a statistically significant difference was found in the means between the values predicted by the equation and the real values, although the Bland-Altman plots did not show a significant bias and the intraclass correlation coefficients (FVC- ICC: 0.69; FEV1-ICC: 0.70) were within an adequate range. <strong>Conclusions:</strong> The developed FVC and FEV1 equations allow adequate prediction of spirometric values in male PEA of the regions included in the study.</p>2023-12-02T13:29:56-05:00Copyright (c) 2023 ACTA MEDICA PERUANAhttps://amp.cmp.org.pe/index.php/AMP/article/view/2651Factors related to anatomical and functional success of rhegmatogenous retinal detachment surgery at the Regional Institute of Ophthalmology "Javier Servat Univazo" (2010 – 2019), Trujillo, Peru2024-03-19T02:08:28-05:00Marita Lucía Quezada-Osoriaradrianzen@unitru.edu.pePatricia Chirinos-Saldañaradrianzen@unitru.edu.peRosa Adrianzénradrianzen@unitru.edu.pe<p><strong>Objective</strong>: To determine the factors related to the anatomical and functional success of surgery for rhegmatogenous retinal detachment (RRA) in patients of the Regional Institute of Ophthalmology "Javier Servat Univazo". <strong>Materials and methods</strong>: retrospective observational cohort study of 204 patients with RRD submitted to different surgical techniques between January 2010-December 2019, with at least 6 months of follow-up. The variables studied were: anatomical success (primary retinal reapplication) and functional success (improvement in visual acuity [VA]); looking for an association between these variables and demographics, clinics and waiting times<strong>. Results:</strong> The mean age was 50 + 16.5 (9-85) years. Anatomical success was achieved in 165 (80.9%) patients and functional in 110 (52.9%). There was a shorter surgical waiting time in patients who achieved anatomical success (20.0 +/- 22.6 days [1-120]) vs (29.8 +/- 40.1 days [1-210]) (p=0.04) and in those who had functional success (13.3+/- 15.1 [1-100]) vs (31.9 +/- 33.7 [1-210]) (p=0.000<sup>2</sup>); and shorter sick time and shorter total time in those who had functional success (29.7 +/-56.5 days [1-365] vs (61.9 +/- 110.6 days [1-730]) (p = 0.008) and (43.1 +/-68.1 [5-465]) vs 93.8 +/- 118.3 [3-766]) respectively (p = 0.0002). <strong>Conclusions:</strong> The shorter surgical waiting time was associated with RRD surgery's anatomical and functional success. The shortest time of illness and the shortest total time were associated with functional success. We recommend implementing measures to shorten waiting times and establish early and timely surgical therapy in these patients.</p>2023-12-12T15:41:03-05:00Copyright (c) 2023 ACTA MEDICA PERUANAhttps://amp.cmp.org.pe/index.php/AMP/article/view/2707Relationship of reticulocyte hemoglobin equivalent (Ret- He) to the different categories according to hemoglobin concentration in blood donor applicants.2024-03-11T02:07:40-05:00Aro Aropedro.aro.g@upch.peRodrigo Paredesrodrigoparedesdlf@gmail.comRubelio Cornejorubecornejo@gmail.comKatherine Laverianokatherine.laveriano.s@upch.peRuth Rengiforuth.rengifo.i@upch.peChristian Lezamachristian.lezama.m@upch.peLesly Talaveraltala2@uis.edu<p><strong>Objective:</strong> to determine the relationship between Ret-He with different categories according to hemoglobin concentration in candidates for blood donation. <strong>Methods:</strong> A cross-sectional study was carried out based on the review of 227 medical records of candidates to donate blood during the month of December 2021 in the Blood Bank and Hemotherapy Service of the Cayetano Heredia Hospital. They were categorized into 3 groups according to hemoglobin levels: Group 1: ≥12.5 g/ dl (females) - ≥13.5 g/dl (males). Group 2: 12 g/dl ≥ females <12.5 g/dl and 13 g/dl ≥ males<13.5 g/dl. Group 3: <12 g/dl (females) - <13 g/dl (males). Hematocrit, hemoglobin, VCM, HCM, CHCM and Ret-He data were collected. For the bivariate analysis, analysis of variance (ANOVA) was used and a significance level of 5% was considered. <strong>Results:</strong> The median Ret-He was higher in group 1 than in group 2 (33.5 vs. 32.5; p=0.002) and in group 3 (33.5 vs. 27.8; p<0.001). A statistically significant relationship was found between the groups studied and Ret-He (p<0.001), in addition to a moderate-strong positive correlation between Ret-He and erythrocyte indices. <strong>Conclusions:</strong> An association was found between groups based on hemoglobin categories and Ret-He in blood donation candidates.</p>2023-12-04T00:53:34-05:00Copyright (c) 2023 ACTA MEDICA PERUANAhttps://amp.cmp.org.pe/index.php/AMP/article/view/2712Medical devices in times of pandemic: Efficacy of a high-flow artisanal system in the management of patients hospitalized by COVID-19.2024-03-12T02:07:38-05:00Agueda Muñoz del Carpio Toiaamunozde@ucsm.edu.peAldo López Ticonaalopez@gmail.comJorge Osadajorge.osada@gmail.com<p><strong>Objective</strong>: To evaluate the efficacy of the Wayrachi continuous positive airway pressure (CPAP) non-invasive respiratory support device compared to the commercial high-flow cannula (CAF) for the treatment of patients with SARS-CoV-2. <strong>Methods</strong>: Study carried out at the Honorio Delgado Espinoza Hospital in Arequipa (Hospital COVID-MINSA Arequipa). The medical records of patients with SARS-CoV-2, of moderate or severe severity, who required non-invasive respiratory assistance, hospitalized in the internal medicine service during the 2nd wave of COVID in Peru, were evaluated. A survival analysis was performed considering days to death comparing Wayrachi with CAF. The effect of variables on death was explored using Cox regression. <strong>Results</strong>: 114 patients treated with Wayrachi (56.44%) and 88 with CAF (43.5%) were evaluated, observing a frequency of death of 34.2% and 34.1%, respectively. When comparing the frequency of death, or its survival, in both managements, no significant difference was observed (p=0.986 and p=0.928), this was maintained in the multivariate model. <strong>Conclusion</strong>: The Wayrachi CPAP had similar results to those presented by the commercial CAF equipment, which indicates it as an effective option for the management of COVID patients who require non-invasive respiratory support.</p>2023-12-04T21:58:51-05:00Copyright (c) 2023 ACTA MEDICA PERUANAhttps://amp.cmp.org.pe/index.php/AMP/article/view/2569Revised trauma score as a predictor of in-hospital mortality in polytrauma patients treated at the Hospital Belén in Trujillo, Peru2024-03-19T02:08:25-05:00Christian Macedo Pinedocmacedo1997@gmail.comMiguel Ángel Villena Ruizmvillenar@upao.edu.pe<p><strong>Objective:</strong> To determine whether the revised trauma score is a predictor of in-hospital mortality in polytrauma patients treated at Hospital Belén de Trujillo. <strong>Material and methods:</strong> An observational, analytical, retrospective, cross-sectional study of diagnostic tests was conducted, identifying patients who were admitted for polytrauma and were hospitalized in the Department of General Surgery during the period from January 2017 to December 2021; mortality was assessed in a sample of 100 patients. <strong>Results:</strong> Mean age was 47.18 ± 20.40 vs 41.13 ± 18.37 in those who died and survived; 55% and 63.33% of the deceased and survivors were male in the study groups. Coagulopathy, metabolic acidosis and SIRS were associated with mortality. A proportion of 72.50% and 3.33% STR < 6 was observed in polytrauma patients who died and survived (p = 0.001); sensitivity: 73% CI 95% [59% - 86%], specificity: 97% CI 95% [92% - 100%], positive predictive value: 94% CI 95% [85% - 100%] and negative predictive value: 84% CI 95% [75% - 93%]. The area under the curve was 96.50% in predicting mortality by RTS in polytrauma patients. <strong>Conclusion:</strong> The revised trauma score is a good predictor of mortality in polytrauma patients.</p>2023-12-12T16:00:25-05:00Copyright (c) 2023 ACTA MEDICA PERUANAhttps://amp.cmp.org.pe/index.php/AMP/article/view/2652Validation of an instrument to measure satisfaction of kidney patients treated by telemedicine during the COVID-19 pandemic2024-02-11T02:00:44-05:00Katya Laos-Choyklaosc@unmsm.edu.peVioleta Alicia Nolberto Sifuentesklaosc@unmsm.edu.peRosario M. Allcca-Soveroklaosc@unmsm.edu.peAlicia Fernández-Giustiklaosc@unmsm.edu.pe<p><strong>Objective:</strong> To evaluate the validity and reliability of an instrument that measures the satisfaction of nutritional services in renal patients. <strong>Material and Methods:</strong> The study had 7 phases within which an instrument was developed that measures the satisfaction of the patients of the Renal Health Unit, attended in nutrition workshops by telemedicine, which was applied to 31 patients. <strong>Results:</strong> The global content validity had a Lawshe index equal to 0.95. The construct validity of the satisfaction questionnaire through exploratory factor analysis found 2 factors that correspond to 87.5% of the total. The reliability of the questionnaire had a Cronbach's Alpha of 0.9. <strong>Conclusions:</strong> The questionnaire that measures the satisfaction of renal patients attended by telemedicine had high content, construct, and reliability validity.</p>2023-11-06T17:49:52-05:00Copyright (c) 2023 ACTA MEDICA PERUANAhttps://amp.cmp.org.pe/index.php/AMP/article/view/2731Diabetic Neuropathy: A narrative review of pathophysiology, diagnosis, and treatment2024-03-01T02:05:20-05:00Gilberto A. Jiménez-Castillogilbertojc@hotmail.comLuis E. Martínez-Bravoluisenrique.martinez@udem.eduAntonio Anaya-Escamillaanayamed@gmail.com<p>Diabetic neuropathy occurs in up to 60% of diabetic patients. Diabetic peripheral neuropathy is the most common cause of neuropathy in the world. The pathophysiology of diabetic neuropathy involves peripheral nerve damage due to the accumulation of toxic products derived from hyperglycemia. The central nervous system is subsequently involved through sensitization, decreased function of the inhibitory system, and increased excitability of the facilitative system. The most common symptoms manifest symmetrically, affecting small and large sensory fibers, although atypical forms of presentation have been found. Confirmatory diagnostic tests are reserved for diagnostic doubt, atypical symptoms, or research. The consensus regarding treatment is the prescription of gabapentinoids, tricyclic antidepressants, and serotonin and norepinephrine reuptake inhibitors. These three families are considered the first line.</p>2023-11-29T19:04:00-05:00Copyright (c) 2023 ACTA MEDICA PERUANAhttps://amp.cmp.org.pe/index.php/AMP/article/view/2562Ectopic pregnancy in cesarean scar: case report2024-02-11T02:00:40-05:00Manuel Fernandez-Navarromg.fernandezn21@gmail.comMia Pinillos-Peraltapinillos.mia92@gmail.comVanessa Mires-Montoromiresvanessa@gmail.comCesar Urbina-Gordillocurbina0812@gmail.com<p>Extrauterine gestation is called ectopic pregnancy, this is an obstetric emergency of the first trimester, which is having an increasing incidence. One of the locations in which these pregnancies can be generated is the scar from a previous cesarean section, which is a challenge for the treating gynecologist due to its diagnostic difficulty and therapeutic options. We report the case of a 37-year-old patient who was admitted to the emergency service with 6 weeks of amenorrhea, and with a history of 2 cesarean sections. She underwent a uterine curettage that was complicated and ended in a hysterectomy. Ectopic pregnancy in cesarean section scar is rare, however, it is important to consider this diagnostic option in pregnant women with bleeding in the first trimester with a history of cesarean section to be able to look for ultrasound signs in the evaluation.</p>2023-11-09T15:01:13-05:00Copyright (c) 2023 ACTA MEDICA PERUANAhttps://amp.cmp.org.pe/index.php/AMP/article/view/2583Primary gastric lymphoma to T cells, not associated with HTLV1, with initial presentation of pathological fracture. Case report2024-03-19T02:08:21-05:00Marisa Estelita Riveros Anglasmarisaoskr14@gmail.comRocío Del Castillo Glennychio_lili_dcg@hotmail.comGustavo Cerrillogcerrillos@unmsm.edu.pe<p>Adult T-cell lymphoma (ATLL) is an aggressive neoplasm of T-lymphocytes, usually associated with human T-lymphotropic virus type 1 (HTLV-1). Variegated clinical presentation. Primary gastric lymphomas most frequently have type B non-Hodgkin lymphoma (NH) as an etiology, and a minimal percentage is due to T lymphocytes. Literature on primary gastric lymphomas due to HTLV1 Negative T cells that metastasize to bone is scarce. The case of a 41-year-old adult who was admitted for a pathological fracture is presented. At 15 days he presented diarrhea, abdominal distension. An upper endoscopy finds: "Ulcerated gastric lesions, neoproliferative appearance." Biopsy reported: Non-Hodgkin lymphoma to T lymphocyte. HTLV1: negative. He had 3 sessions of chemotherapy with CHOEP scheme. There was a favorable response, at first. Unfortunately DID NOT RETURN. He returned 2 months later in poor general condition. He presented complications, multi-organ failure, resulting in his death.</p>2023-12-12T16:13:44-05:00Copyright (c) 2023 ACTA MEDICA PERUANAhttps://amp.cmp.org.pe/index.php/AMP/article/view/2711Health: Dignity, Rights and Ethics2024-03-19T02:08:31-05:00Luis Ricardo Robles-Guerrerolroblesguerrero@gmail.com<p>Health and care for sick people involve not only aspects of medical diagnosis and treatment; on the contrary, it contains a set of aspects that are intrinsically linked (or should be) even though they are apparently not easily visible. The health of the people involves the perspectives of respect for the dignity of the people, the exercise of their rights, and the ethical performance of the protagonists (those who attend and those attended), which should not be left aside in the real moment. that happens every health care.</p>2023-12-06T17:39:29-05:00Copyright (c) 2023 ACTA MEDICA PERUANAhttps://amp.cmp.org.pe/index.php/AMP/article/view/2673Research as a tool for professional medical training2024-03-02T02:05:38-05:00Fausto Garmendia Lorenagarmendiafausto@gmail.com<p>The training of a medical professional is a truly endless ongoing process. It is based on the axes of ethics, work in the community and research. It includes the stages of general studies, undergraduate and postgraduate, the latter in turn is composed of Continuing Medical Education, Second Specialization, Master's and Doctorate. It is necessary for the doctor to constantly update his knowledge, in order to meet the care needs that patients require, he must also be aware of the creation or discovery of new knowledge and the transmission of the same for adequate training of greater human resources in health, improvement of professional practice, health research and medical education.</p>2023-11-30T00:00:00-05:00Copyright (c) 2023 ACTA MEDICA PERUANAhttps://amp.cmp.org.pe/index.php/AMP/article/view/2648Foreign scientific contributions in the study of Carrion's Disease2024-01-07T01:52:33-05:00Ricardo Iván Álvarez-Carrascoralvarezcarrasco@yahoo.com<p>The current state of knowledge of Carrión's Disease, a pathology that exists mainly in some areas of the Peruvian highlands, is due, to a large extent, to the investigations of doctors of that nationality, however, doctors, other scientists, travelers, publications and technological advances from other countries have also provided contributions on this nosological entity, some transcendent and others counterproductive. The purpose of this article is to acknowledge such contributions in the context of the evolution of scientific and historical knowledge of this disease.</p>2023-10-22T13:21:42-05:00Copyright (c) 2023 ACTA MEDICA PERUANAhttps://amp.cmp.org.pe/index.php/AMP/article/view/2596Theodor Kocher (1841-1917) and his outstanding contributions to surgery2024-02-12T02:00:37-05:00Rafael Romero-Reveronrafa1636@yahoo.es<p>Theodor Kocher (1841-1917), an exceptional Swiss surgeon who described a technique for the safe removal of enlarged thyroid unraveled the true function of this endocrine gland but also made significant contributions to many other fields of surgery. Kocher was the first surgeon awarded the Nobel prize in Physiology and Medicine in 1909 for his work on the physiology, pathology, and surgery of the thyroid gland. He was professor and clinical director at Insel Hospital during 45 years. Kocher created the prominent Surgeon's School in Bern. He was the first president of the International Society of Surgery in 1903 and the founding president of the Swiss Society of Surgery in 1913.</p>2023-11-14T15:23:23-05:00Copyright (c) 2023 ACTA MEDICA PERUANAhttps://amp.cmp.org.pe/index.php/AMP/article/view/2471Feasibility of freeze-dried pig skin grafting in the surgical treatment of burns in the context of a Peruvian health service2024-02-24T02:03:39-05:00Ana Paula Nikole Quijandria Granadosana.quijandria@urp.edu.pe2023-11-24T17:01:31-05:00Copyright (c) 2023 ACTA MEDICA PERUANAhttps://amp.cmp.org.pe/index.php/AMP/article/view/2689Climate change and aedes aegypti: strategies against the vector2024-03-19T02:08:18-05:00Carol Ordoñez-Aquinocarol.ordonez@upch.peChristian Requenacrequenap@gmail.comGustavo F. Gonzalesgustavo.gonzales@upch.pe<p>Non applicable</p>2023-12-12T17:02:57-05:00Copyright (c) 2023 ACTA MEDICA PERUANAhttps://amp.cmp.org.pe/index.php/AMP/article/view/2730Hip fracture and Anemia in the elderly: Transfuse or not?2024-03-19T02:08:35-05:00Juan Rodrigo Tuesta-Noledoc.jrtn@gmail.com2023-12-06T13:07:49-05:00Copyright (c) 2023 ACTA MEDICA PERUANA