ACTA MEDICA PERUANA 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. en-US (Acta Medica Peruana) (Asistencia Tecnica - AMP) Sat, 02 Oct 2021 17:02:39 -0500 OJS 60 Presentación <p>Presentación</p> César Palomino Colina Copyright (c) 2017 ACTA MEDICA PERUANA Sat, 29 Mar 2014 00:00:00 -0500 La Orden médica en tiempo de la reforma <p>La Orden médica en tiempo de la reforma</p> Christian R. Miranda-Orrillo Copyright (c) 2017 ACTA MEDICA PERUANA Sat, 29 Mar 2014 00:00:00 -0500 Albuminuria diagnosis in patients over 55 years of a care network <p>Objective. To determine the diagnosis of albuminuria (microalbuminuria, macroalbuminuria) in patients over 55 years of Rebagliati Care Network (RCN) using the albumin/creatinine ratio (A/CR). Materials and methods. We performed a cross-sectional, descriptive during 2012, in adults over 55 years of RAR, of both sexes, who have conducted tests on urine albumin and creatinine. We used the ratio A/CR for the assessment of albuminuria (microalbuminuria, macroalbuminuria). Results. The study involved 3943 patients. The median age was 70 ± 8,96 years and 57,10 % (N = 2250) were women. The 23 % (N = 918) of patients had albuminuria, 17,92 % N = 706) microalbuminuria and 5,38 % (N = 212) macroalbuminuria. The Hospital III Suárez Angamos had the highest percentage of patients with albuminuria. When evaluating the strength of Kappa between urinary albumin method versus the ratio A/CR observe a substantial concordance (k = 0,789) between these diagnostic methods. Conclusions. The 23,30 % of patients over 55 years of RCN, presented albuminuria. A total of 212 (5,68 %) patients had macroalbuminuria. A therapeutic intervention for these patients with microalbuminuria or macroalbuminuria, effectively decrease the increase of chronic kidney disease in the RCN.</p> Luis Edgardo Figueroa-Montes, Mariza Yolanda Ramos-García Copyright (c) 2020 ACTA MEDICA PERUANA Sat, 29 Mar 2014 00:00:00 -0500 Factors related to perinatal mortality in public hospital in Huanuco <p>Objective. To determine the preconceptional, pregnancy, delivery and product risk factors related to perinatal mortality in the Hermilio Valdizan Hospital of Huanuco during 2007-2008 period. Materials and methods. A case series; retrospective and analytical design. The target population was all born in the hospital, registered in the clinical history, Perinatal Information System and CLAP. The perinatal mortality was response variable. The exposure variables were divided into preconceptional, pregnancy, delivery and product factors. Exclusion criteria were incomplete information in clinical history, Perinatal Computer System or CLAP. Bivariate analysis was performed with chi2, Fisher and Mann-Whitney U-test. Multivariate analysis was by multiple logistic regressions. Results. The perinatal mortality rate was 16,5 [IC95 % (12,3; 21,7)] per 1 000 live births (LB). Educational attainment (illiterate) [OR 2,89 (IC95 % 1,28; 6,54) p = 0,011], type of delivery (cesarean) [OR 0,48 (IC95 % 0,24; 0,96) p = 0,038], birth weight (&lt; 2500 g) [OR 3,05 (IC95 % 1,19; 7,83) p = 0,020], gestational age (&lt; 37 weeks) [OR 3,19 (IC95 % (1,26; 8,08) p = 0,014], Apgar (&lt; 8 score) [OR 13,74 (IC95 % 5,21; 36,25) p = 0,000] and diagnosis of hyaline membrane [OR 21,01 (IC95 % 5,21; 84,68) p = 0,000] were independently associated with perinatal mortality. Conclusions. Educational attainment (illiterate), birth weight (&lt; 2500 g), gestational age (&lt; 37 weeks), Apgar (&lt; 8 score) and diagnosis of hyaline membrane were independently related factors with perinatal mortality. Cesarean delivery was a protective factor.</p> Bernardo C. Dámaso-Mata, Carlo Carbajal-Álvarez, César Loza-Munarriz, Omar Raraz-Vidal, Jarvis Raraz-Vidal Copyright (c) 2020 ACTA MEDICA PERUANA Sat, 29 Mar 2014 00:00:00 -0500 Using dry autolytic method in managing pressure ulcers in elderly patients <p>Back ground. The pressure sore is a common disease and affects mainly elderly people and patients with neurological sequels. In the domiciliary medical attention of the elderly patient made by Padomi from Essalud, the pressure sores are one of the most common pathologies. Objective. This study aimed to evaluate the effectiveness of dry autolytic method in the treatment of pressure ulcers. Methods. This is a prospective randomized simple-blind clinical trial study. The sample is composed by elderly patients with diagnostic of pressure sore, attended by Padomi from Essalud between 2008 to 2012. Both treatments have been evaluated based in the time of healing of the lesions. Results. Two groups of 50 patients with 123 and 112 pressure sores respectively have been treated by an interdisciplinary team from Padomi of Essalud between 2008 to 2012. This study have found statistical significant differences in favor of the dry autolytic method in the lesions located at the trochanter level (p = 0,04). Conclusions. The results obtained with the two methods vary according with the anatomical localization of the lesions. The use of the autolytic method have been demonstrated be more efficient (less time of healing) than conventional method in the treatment of pressure sores located in the trochanter level.</p> Percy Rossell-Perry, María Aguirre-Flores-Rosas, Janett Jiménez-Villafán Copyright (c) 2020 ACTA MEDICA PERUANA Sat, 29 Mar 2014 00:00:00 -0500 The new Bartonella ancashi to cause the Peruvian wart: Does Koch’s postulates? <p>Although most of the bacteria that cause disease in humans adapt to the Koch’s postulates. Koch’s postulates as the first model had to Bacillus anthracis, the bacterium that was first shown to be the cause of an infectious disease, whose life cycle was discovered by Koch. Oroya fever and Peruvian wart on one disease. Peruvian wart is an infection with a characteristic clinical pattern, caused by Bartonella bacilliformis. Recent published studies awarded as the cause of a new Peruvian wart bartonella, the Candidatus Bartonella ancashi. Analyzing research, the proposed causality of B. ancashi is based only on observational evidence: the association of the new bartonella in one patient with a clinical pattern similar to the wart Peruvian and the origin of the patient from an endemic area. With the new B. ancashi has not been investigated whether or not it meets all of Koch’s postulates, still lack experimental reproduction of Peruvian wart animals to contend with more proven that causes the Peruvian wart. Observational evidence does not necessarily determine causality. An association between a specific infection and a particular infectious agent does not means that the agent cause disease. Science needs to base its conclusions on the best available evidence and reasoning.</p> David Salinas-Flores Copyright (c) 2020 ACTA MEDICA PERUANA Sat, 29 Mar 2014 00:00:00 -0500 Mandibular reconstruction with polyetheretherketone computer designed implant <p>A 22 years old male was referred to emergency for a gunshot trauma that involves the inferior third of the face with extension to the both submandibular and submental regions. The patient presented at the inferior half of the mandible, bodies and symphysis, a comminuted mandible fracture and two displaced fractures at the upper half of the mandible; though no teeth were missing. He underwent at emergency an open reduction and osteosynthesis with wires. A polyetheretherketone (PEEK) computer designed implant was placed to replace the lost bone tissue and restore the facial aesthetics. The PEEK implant is actually a new, simple and versatile method for complex mandibular reconstructions.</p> Juan Francisco Oré-Acevedo, Katerin Castillo-Chávez, Walter Huaranga-Bustamante Copyright (c) 2020 ACTA MEDICA PERUANA Sat, 29 Mar 2014 00:00:00 -0500 The vindication of Daniel A. Carrion’s real portrait <p>After thorough research, a group of Medical Doctors discovered that, for the last 50 years, some members of the Peruvian Medical Professional College (PMPC) have been misleading the scientific community and the public opinion’s understanding of Daniel A. Carrion’s (DAC) historic figure. In effect, these members of the PMC have made public a fake portrait of the Peruvian Medical Doctor. In that way, DAC’s legacy has been distorted in several medical articles, in the press and in the media to the extent that false images were used in the process and replaced DAC’s real portrait with a fake image in all the PMPC offices nationwide. Since April of 2011, the researchers went through a thorough literature review, which included DAC’s book published in 1886, and several publications made by prominent Medical Doctors from the XIX, XX and XXI centuries. Those publications are reliable sources to understand DAC’s life, work and sacrifice. To fully understand DAC’s life, work and sacrifice, the researchers reviewed medical articles and press articles from the XIX century to the present. In that way, three books have been published to fully prove DAC’s real portrait. The document has several illustrations and photos that portrait DAC and his family. The evidence demonstrates which is DAC’s real portrait. Accordingly, the document will show the fallacies and mistakes made by the PMPC members who tried to impose DAC’s fake portrait. That information will be included in order to reflect these PMPC members’ effort to impose a false and deceptive portrait.</p> Bertilo Malpartida-Tello Copyright (c) 2020 ACTA MEDICA PERUANA Sat, 29 Mar 2014 00:00:00 -0500 Workers in health, the forgotten actors by reform’s <p>The health reform has gained a new momentum in Peru, because via legislative decrees, wants to implement a series of changes which have been called improperly "health care reform", because it does not alter fundamentally the structure and functioning of our exclusionary and segmented system. In this context, it becomes relegated to postpone key actors<br>of the reforms, namely: workers health. The evidence of this are persistence of: the lack of government in the field of human resources, centralist and inequitable distribution, the precariousness of employment, rising occupational health problems, high migration, the deregulation of training and professional practice in the Peru. It is urgent to meet the challenges set for the Decade of human resources in health 2006-2015.</p> Víctor Carrasco-Cortez Copyright (c) 2020 ACTA MEDICA PERUANA Sat, 29 Mar 2014 00:00:00 -0500 In memory of Dr. Jorge Campos Rey de Castro (1921-2014) <p>Recientemente falleció el doctor Jorge Campos Rey de Castro (Arequipa, 3 de enero de 1921 - Lima, 3 de marzo de 2014) eminente figura de la medicina nacional en la segunda mitad del siglo XX. Su trayectoria ha dejado una huella indeleble en diversos campos de su vida profesional, sobre todo en el de su especialidad, la Histopatología; y, en el de la educación universitaria, particularmente de la medicina.</p> Julio Castro-Gómez Copyright (c) 2020 ACTA MEDICA PERUANA Sat, 29 Mar 2014 00:00:00 -0500 Basosquamous carcinoma <p>El estudio histopatológico de la muestra tomada por biopsia en sacabocado informa carcinoma basocelular ulcerado infiltrante. Fue evaluada por oncología y cirugía. Se realizó exéresis de la lesión, con resección amplia. El informe histopatológico de la pieza operatoria fue carcinoma basoescamoso (CBE) infiltrante multicéntrico con bordes quirúrgicos libres de neoplasia.</p> Soky Del Castillo-Cabrera, Emma Escalante-Jibaja Copyright (c) 2020 ACTA MEDICA PERUANA Sat, 29 Mar 2014 00:00:00 -0500 Intoxicación accidental por mercurio elemental <p>El reporte de caso ‘Intoxicación accidental por mercurio elemental’ me ha dejado una serie de dudas y quisiera aclarar algunos aspectos.</p> Melinda M. Valdivia-Infantas Copyright (c) 2020 ACTA MEDICA PERUANA Sat, 29 Mar 2014 00:00:00 -0500