ACTA MEDICA PERUANA
https://amp.cmp.org.pe/index.php/AMP
Acta 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.Colegio Médico del Perúen-USACTA MEDICA PERUANA1018-8800Implications derived from the regulation of the General Law for the Protection of People with Diabetes Mellitus (DM)
https://amp.cmp.org.pe/index.php/AMP/article/view/2757
Arturo E. Villena Pacheco
Copyright (c) 2023 ACTA MEDICA PERUANA
2023-11-172023-11-1740310.35663/amp.2023.403.2757Finnish risk score for detection of dysglycemia in adults in the Family Medicine Unit
https://amp.cmp.org.pe/index.php/AMP/article/view/2618
<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>Gabriela García-MoralesMiriam Casarrubias-MartínezVíctor F Herrera-ReyesYuliana García-JiménezJosue Rosaliano-Salinas
Copyright (c) 2023 ACTA MEDICA PERUANA
2023-10-302023-10-3040310.35663/amp.2023.403.2618Spirometric reference equation in men from 2 regions of northern Peru located between 0 and 100 meters above the sea level: Cross-sectional study
https://amp.cmp.org.pe/index.php/AMP/article/view/2695
<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>Miguel Angel Pretell CabreraJonh Astete Cornejo
Copyright (c) 2023 ACTA MEDICA PERUANA
2023-12-022023-12-0240310.35663/amp.2023.403.2695Factors related to anatomical and functional success of rhegmatogenous retinal detachment surgery at the Regional Institute of Ophthalmology "Javier Servat Univazo" (2010 – 2019), Trujillo, Peru
https://amp.cmp.org.pe/index.php/AMP/article/view/2651
<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>Marita Lucía Quezada-OsoriaPatricia Chirinos-SaldañaRosa Adrianzén
Copyright (c) 2023 ACTA MEDICA PERUANA
2023-12-122023-12-1240310.35663/amp.2023.403.2651Relationship of reticulocyte hemoglobin equivalent (Ret- He) to the different categories according to hemoglobin concentration in blood donor applicants.
https://amp.cmp.org.pe/index.php/AMP/article/view/2707
<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>Aro AroRodrigo ParedesRubelio CornejoKatherine LaverianoRuth RengifoChristian LezamaLesly Talavera
Copyright (c) 2023 ACTA MEDICA PERUANA
2023-12-042023-12-0440310.35663/amp.2023.403.2707Medical devices in times of pandemic: Efficacy of a high-flow artisanal system in the management of patients hospitalized by COVID-19.
https://amp.cmp.org.pe/index.php/AMP/article/view/2712
<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>Agueda Muñoz del Carpio ToiaAldo López TiconaJorge Osada
Copyright (c) 2023 ACTA MEDICA PERUANA
2023-12-042023-12-0440310.35663/amp.2023.403.2712Revised trauma score as a predictor of in-hospital mortality in polytrauma patients treated at the Hospital Belén in Trujillo, Peru
https://amp.cmp.org.pe/index.php/AMP/article/view/2569
<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>Christian Macedo PinedoMiguel Ángel Villena Ruiz
Copyright (c) 2023 ACTA MEDICA PERUANA
2023-12-122023-12-1240310.35663/amp.2023.403.2569Validation of an instrument to measure satisfaction of kidney patients treated by telemedicine during the COVID-19 pandemic
https://amp.cmp.org.pe/index.php/AMP/article/view/2652
<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>Katya Laos-ChoyVioleta Alicia Nolberto SifuentesRosario M. Allcca-SoveroAlicia Fernández-Giusti
Copyright (c) 2023 ACTA MEDICA PERUANA
2023-11-062023-11-0640310.35663/amp.2023.403.2652Diabetic Neuropathy: A narrative review of pathophysiology, diagnosis, and treatment
https://amp.cmp.org.pe/index.php/AMP/article/view/2731
<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>Gilberto A. Jiménez-CastilloLuis E. Martínez-BravoAntonio Anaya-Escamilla
Copyright (c) 2023 ACTA MEDICA PERUANA
2023-11-292023-11-2940310.35663/amp.2023.403.2731Ectopic pregnancy in cesarean scar: case report
https://amp.cmp.org.pe/index.php/AMP/article/view/2562
<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>Manuel Fernandez-NavarroMia Pinillos-PeraltaVanessa Mires-MontoroCesar Urbina-Gordillo
Copyright (c) 2023 ACTA MEDICA PERUANA
2023-11-092023-11-0940310.35663/amp.2023.403.2562Primary gastric lymphoma to T cells, not associated with HTLV1, with initial presentation of pathological fracture. Case report
https://amp.cmp.org.pe/index.php/AMP/article/view/2583
<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>Marisa Estelita Riveros AnglasRocío Del Castillo GlennyGustavo Cerrillo
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2023-12-122023-12-1240310.35663/amp.2023.403.2583Health: Dignity, Rights and Ethics
https://amp.cmp.org.pe/index.php/AMP/article/view/2711
<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>Luis Ricardo Robles-Guerrero
Copyright (c) 2023 ACTA MEDICA PERUANA
2023-12-062023-12-0640310.35663/amp.2023.403.2711Research as a tool for professional medical training
https://amp.cmp.org.pe/index.php/AMP/article/view/2673
<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>Fausto Garmendia Lorena
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2023-11-302023-11-3040310.35663/amp.2023.403.2673Foreign scientific contributions in the study of Carrion's Disease
https://amp.cmp.org.pe/index.php/AMP/article/view/2648
<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>Ricardo Iván Álvarez-Carrasco
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2023-10-222023-10-2240310.35663/amp.2023.403.2648Theodor Kocher (1841-1917) and his outstanding contributions to surgery
https://amp.cmp.org.pe/index.php/AMP/article/view/2596
<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>Rafael Romero-Reveron
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2023-11-142023-11-1440310.35663/amp.2023.403.2596Feasibility of freeze-dried pig skin grafting in the surgical treatment of burns in the context of a Peruvian health service
https://amp.cmp.org.pe/index.php/AMP/article/view/2471
Ana Paula Nikole Quijandria Granados
Copyright (c) 2023 ACTA MEDICA PERUANA
2023-11-242023-11-2440310.35663/amp.2023.403.2471Climate change and aedes aegypti: strategies against the vector
https://amp.cmp.org.pe/index.php/AMP/article/view/2689
<p>Non applicable</p>Carol Ordoñez-AquinoChristian RequenaGustavo F. Gonzales
Copyright (c) 2023 ACTA MEDICA PERUANA
2023-12-122023-12-1240310.35663/amp.2023.403.2689Hip fracture and Anemia in the elderly: Transfuse or not?
https://amp.cmp.org.pe/index.php/AMP/article/view/2730
Juan Rodrigo Tuesta-Nole
Copyright (c) 2023 ACTA MEDICA PERUANA
2023-12-062023-12-0640310.35663/amp.2023.403.2730