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) Sun, 23 May 2021 00:00:00 -0500 OJS 60 Advances in the development and use of SARS-CoV-2 vaccines Claudio F. Lanata de las Casas, Lucie Ecker Ledesma, Ana I. Gil Merino Copyright (c) 2021 ACTA MEDICA PERUANA Fri, 07 May 2021 00:00:00 -0500 Intraventricular hemorrhage in premature infants under 28 weeks in general hospital of Lima, 2013 - 2017 <p><strong>Objective</strong>: To determine the incidence and clinical characteristics of intraventricular hemorrhage in premature infants younger than 28 weeks, born in a general hospital. <strong>Material and methods:</strong> This is an observational, retrospective cohort study, which included premature infants under 28 weeks gestational, who survived the first day of life and who had a brain ultrasound, born in the Cayetano Heredia Hospital from 2013 to 2017. Neonates with brain malformations and those with incomplete perinatal data were excluded. <strong>Results</strong>: During the study period, 21 722 newborns were born, of whom 84 were under 28 weeks of age, 72 children from 24 to 27</p> <p>gestational weeks were included. The male / female ratio was 1.6. The HIV frequency was 58.3% (42/72). 52.4% (22/42) were found in the early form and 47.6% (20/42) in the late form. The severe degrees corresponded to 64% (27/42). Post hemorrhagic hydrocephalus occurred in 26% (11/42) and venous hemorrhagic infarction 21.4% (9/42). 51 patients died, with a fatality rate of 76.1% (32/42). <strong>Conclusions</strong>: HIV was very frequent, severe and lethal in premature babies &lt;28 weeks, half of the cases occurred in the first three days and the rest during the first two weeks of life. Associated factors were lower birth weight, labor, and pneumothorax<strong><em>.</em></strong></p> <p>KEY WORDS: Prematurity, intraventricular hemorrhage, neonate.</p> Elizabeth Ruth Espiritu Rojas Copyright (c) 2021 ACTA MEDICA PERUANA Thu, 29 Apr 2021 00:00:00 -0500 Characteristics and associated factors with mistreatment perception in medical interns in Peru <p><strong>Introduction</strong>: The medical internship is an entirely hospital stage where the mistreatment can adversely affect students' performance. The study's objective was to determine the characteristics and factors associated with the perception of abuse in medical interns in Peru. <strong>Materials and methods:</strong> Multicenter, cross-sectional and analytical study. We surveyed medical interns from eighteen Peruvian hospitals. Sociodemographic characteristics included a scale that mediates the perception of psychological, physical, and sexual mistreatment in the study. The researchers used generalized linear models and prevalence ratios at 95% confidence intervals. <strong>Results</strong>: 418 medical interns participated, 52.9% were women. The psychological, physical, and sexual mistreatment perceived was 91.9%, 55.5%, and 34%, respectively. A relationship was found in medical interns who perceived psychological maltreatment and performed rotated in surgery (RPa: 1.09; 95% CI: 1.00-1.20) came from a private university (RPa: 1.08; 95% CI: 1.02-1, 15) and being in a hospital of the Ministry of Health (RPa: 1.08; 95% CI: 1.01-1.16). Regarding physical abuse, they came from a private university (RPa: 0.77; 95% CI: 0.64-0.92) and were in a Ministry of Health hospital (RPa: 0.72; 95% CI: 0.55-0,94). The factors associated with sexual abuse were being a woman (RPa: 1.52; 95% CI: 1.15-2.01) and rotating in medicine (RPa: 1.52; 95% CI: 1.04-2.23). <strong>Conclusions</strong>: The abuse perceived by the inmates is high, being the psychological abuse the most frequent. The physical and psychological abuse was associated with the services' rotation, coming from a private university and interning in the Ministry of Health hospitals. Sexual abuse had associated with being a woman and rotation in the medical service.</p> Jennifer Steffany Vilchez Cornejo, Ronald D Viera-Morón, Ruth C Taminche-Canayo, Carlos Andrés Carrasco-Farfán, Luccio Romani, Cynthia R. Mendoza-Flores, Gabriel Larico-Calla, Sandra Paola Álvarez-Soto, Magaly Lizana-Medrano, Eliseo Flores-Naquiche, Juan J. Saenz, Hugo Arroyo-Hernández Copyright (c) 2021 ACTA MEDICA PERUANA Thu, 29 Apr 2021 00:00:00 -0500 Factors associated with abnormal findings on digital chest radiographs in asymptomatic workers in Lima, Peru <p><strong>Introduction: </strong>Posteroanterior Chest X-Ray (CXR) is usually performed as a routine exam for workers’ health surveillance, but their benefits are discussed and controversial. Our investigation described the associated factors with abnormal digital CXR in workers without respiratory symptoms. <strong>Materials and methods: </strong>An analytical cross-sectional observational study was performed, including 24 069 digital CXR obtained from workers without respiratory symptoms who performed their workers’ health surveillance at an accredited occupational health center in Lima, Perú, from 2016 to 2019. <strong>Results: </strong>Of the 24069 asymptomatic workers, 1166 (4.84%, 95% CI [4.58-5.12]) had abnormal radiography. The main findings were found in the lung parenchyma and of these, sequential images of tuberculosis were the most frequent. It was observed that workers older than 50 years (RP(a) = 6.34), those with low weight (RP(a) = 2.71) and those with a history of pulmonary pathology (RP(a) = 6.19) were more likely to have abnormalities on pulmonary radiography. <strong>Conclusions: </strong>Due to the low frequency of abnormal digital Chest X-Ray (CXR), it is not useful as an early detection of respiratory pathology in the population studied, however it should be considered in those over 50 years with a history of respiratory disease and/or low weight. It is important to carry out more studies that confirm our results.</p> Jorge Luis Maguiña Quispe, Maria Verona, Raúl Gomero-Cuadra, José Véliz Copyright (c) 2021 ACTA MEDICA PERUANA Sun, 23 May 2021 00:10:43 -0500 Knowledge on diabetes mellitus type 2 and adherence to treatment in patients from the hospital Reátegui, Piura, Peru <p><strong>Objective:</strong> To determine the association between knowledge about Diabetes Mellitus and adherence to treatment in patients of the Jorge Reátegui Piura Hospital 2019.</p> <p><strong>Methods:</strong> Study carried out in 236 patients from the Jorge Reátegui - Piura Hospital, who attended the endocrinology office during 2019. Adherence and level of knowledge were evaluated through questionnaires: Morisky Green-8 test (high, medium or low adherence) and Test Diabetes Knowledge Questionnaire 24 (adequate and inadequate). Multinomial logistic regression was applied between the variables, in SPSS v.25.</p> <p><strong>Results:</strong> Inadequate knowledge predominated (68.2%); over the adequate (31.8%). Adherence was low (38.6%); medium (31.4%) and high (30.0%). An association was found between knowledge and adherence to treatment (p = 0.001). Also, between educational level (p = 0.002) and origin (p = 0.037). If the patient does not present studies, it is associated with low adherence OR 6,244 [CI (2,113 -18,449), p = 0.001], or mean OR 3,724 [CI (1,207 -11,492), p = 0.022]. In addition, if the patient presents primary, it is associated with low adherence OR 5,591 [CI (1,766 -17,703), p = 0.003]. Likewise, if the patient comes from a rural area OR 5,923 [IC (1,596 -21,979), p = 0.008], or marginal urban OR 4,431 [IC (1,274 -15,411), p = 0.019] associated with low adherence. An association was found between inadequate knowledge and low adherence OR 3,451 [CI (1,748 -6,814), p = 0.000], or mean OR 2,625 [CI (1,313 -5,247), p = 0.006].</p> <p><strong>Conclusion:</strong> There is an association between knowledge about diabetes and adherence; inadequate knowledge predisposes to a higher risk of low or medium adherence. Likewise, certain sociodemographic factors such as the degree of education and the origin.</p> Bruno Alesander Farías Vílchez Copyright (c) 2021 ACTA MEDICA PERUANA Thu, 29 Apr 2021 00:00:00 -0500 Clinical and epidemiological characteristics in older adults with a diagnosis of hip fracture in a hospital in Lima, Peru. <p>OBJECTIVES: To determine the clinical and epidemiological characteristics in older adults with hip fracture in a hospital in Lima, Peru. METHOD: Case series type study carried out in the trauma department of the PNP Central Hospital “Luis N. Saenz” during the period 2015-2018. Medical records of patients diagnosed with hip fracture were reviewed. RESULTS: A total of medical records were included. A predominance was found in the female sex (54.3%) and in patients over 80 years old (45%). Most of these events occurred at home (81.4%). Intertrochanteric fractures were the most frequent (60%), especially on the right side (51.4%), osteosynthesis was the most used therapeutic option (62.1%). Pain (92%) and functional impotence (91.4%) were the characteristic clinical presentation of hip fractures, and arterial hypertension was the most common associated pathology (52.2%). CONCLUSIONS: Hip fracture primarily affects people over 80 years of age, especially women with high comorbidity. The highest percentage occurs as a result of falls produced at home, with pain on the affected side being the main manifestation. The most common type of fracture is intertrochanteric and the most used treatment is osteosynthesis.</p> ericson gutierrez Copyright (c) 2021 ACTA MEDICA PERUANA Thu, 29 Apr 2021 00:00:00 -0500 Epidemiology of mental disorders in Hernando Moncaleano-Perdomo University Hospital (2017-2018) <p><strong>I</strong><strong>ntroduction</strong>: Mental health is defined as a state of well-being in which the individual is aware of their own abilities, can face daily life activities, can work productively and can contribute to their community; but at the same time mental health is more than the absence of mental disorders, it is an integral part of health; So much so that there is no health without mental health. In Colombia, the Ministry of Health and Social Protection (MSPS), the five-year public health plan 2012-2021 (PDSP); Within the framework of Law 1751 of 2015, the Statutory Health Law, secondary to inequities in health services, the MSPS under Law 1751 builds the Comprehensive Health Care Policy (PAIS) and the comprehensive medical care model (MIAS) as the alternative for solving problems and for this, adopts strategies such as PHC with a family and community approach, comprehensive risk management and attention and a differential approach. <strong>Methods:</strong> Observational descriptive cross-sectional study with retrospective temporality of patients with mental disorders in a period between 2017 and 2018 in the municipality of Neiva Huila, at the Hernando Moncaleano Perdomo University Hospital (HUHMP). <strong>Results:</strong> depression was the most prevalent pathology with 24.16%, followed by schizophrenia with 14.62%. The average age was 36 years, the highest frequency was in the male gender with 55.32%, with a male-female ratio of 1.23. The service attended by the largest psychiatric population was through outpatient consultation with a percentage of 62.94%. <strong>Conclusions:</strong> Mental and behavioral disorders are a growing problem in mental health at a global, national and regional level, combined with the consumption of psychoactive substances since a dual pathology increases the risk of suffering from psychiatric pathologies. This internal characterization has allowed us to understand that the scandalous projections of Goldberg and Huxley are a reality, that are traced in the Department of Huila, and that our Mental Unit becomes a grain of sand in the desert.</p> Diego Julian Alvis Peña Copyright (c) 2021 ACTA MEDICA PERUANA Thu, 29 Apr 2021 00:00:00 -0500 Effect of SARS-COV-2 on kidney tissue: a narrative review <p>We describe evidence on SARS-CoV-2 effect on the kidney. We carried a narrative review of articles published in SCOPUS and PUBMED until September 2020. The results were divided into six topics: evidence of direct effect of virus on the kidney, mechanisms of cellular invasion, mechanisms of kidney injury, and potential therapeutic implications.&nbsp; SARS-Cov-2 gains access to proximal tubule cells and podocytes via ACE-2 receptors. Viral invasion and replication may induce kidney damage through a direct cytopathic effect and immune-mediated damage. Due to ACE-2 cellular expression, Renin–Angiotensin–Aldosterone System Inhibitors have been proposed as potential treatment for COVID-19. However, current evidence does not support its therapeutic use.</p> Percy Herrera Añazco Copyright (c) 2021 ACTA MEDICA PERUANA Sun, 23 May 2021 00:12:31 -0500 Transradial approach for diagnostic cerebral angiography: first experience in a social security hospital <p>Transradial approach for cerebral diagnostic angiography is gaining territory in the neuroendovascular field for diagnostic and therapeutic procedures. Less complication rates, less hospital stay and patient comfort are some features of this approach. Nevertheless, the transition from the classic femoral approach to the radial approach is difficult to achieve in institutions with established protocols. We present our initial experience using the transradial approach for cerebral diagnostic angiography performed successfully achieving catheterization of the supra-aortic vessels.</p> Giancarlo Saal-Zapata, John Vargas-Urbina, Walter Durand-Castro, Rodolfo Rodríguez-Varela Copyright (c) 2021 ACTA MEDICA PERUANA Thu, 29 Apr 2021 00:00:00 -0500 Clinical practice guideline for the management of patients with acute lymphoblastic leukemia in Peruvian Social Security (EsSalud) <p><strong>Introduction:</strong> This article summarizes the clinical practice guidelines (CPG) for the management of patients with ALL in the Social Security of Peru (EsSalud). <strong>Objective:</strong> To provide clinical evidence-based recommendations for the evaluation and management of patients with ALL in EsSalud. <strong>Methods: </strong>A CPG for the diagnosis and management of patients with ALL in EsSalud was developed. To this end, a guideline development group (local GDG) was established, including medical specialists and methodologists. The local GDG formulated 8 clinical questions to be answered by this CPG. Systematic searches of systematic reviews and -when it was considered pertinent- primary studies were conducted in PubMed and CENTRAL during 2019. The evidence to answer each of the posed clinical questions was selected. The quality of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic work meetings, the local GDG used the GRADE methodology to review the evidence and formulate the recommendations, points of good clinical practice, and flowcharts of evaluation and management. Lastly, the CPG was approved with Resolution N° 23-DGPCFyT–IETSI-ESSALUD-2019. <strong>Results: </strong>This CPG addressed 8 clinical questions, divided into four topics: diagnosis, general measures, pharmacological management, and surgical management of ALL. Based on these questions, 5 recommendations (3 strong recommendations and 2 weak recommendations), 20 points of good clinical practice, and 3 flowcharts were formulated. <strong>Conclusion: </strong>This article summarizes the methodology and evidence-based conclusions from the CPG for the diagnosis and management of ALL in EsSalud.</p> Wendy C. Nieto Gutiérrez, Raul Timana-Ruiz, Sergio Goicochea-Lugo, Alvaro Taype-Rondan Copyright (c) 2021 ACTA MEDICA PERUANA Thu, 29 Apr 2021 00:00:00 -0500 Retraction statement <p>Luego de un análisis detallado, el director de la revista Acta Médica Peruana ha decidido retirar el artículo “Historia del cólera en el Perú en 1991”, presentado por Ciro Maguiña Vargas, Carlos Seas Ramos, Edén Galán Rodas y Jimmy Jesús Santana Canchanya; publicado en el año 2010; Volumen 27, Número 3; páginas 212 a 217 de la revista Acta Médica Peruana[1], por motivos que el documento contiene varios párrafos extraídos literalmente del capítulo 5 del libro “El regreso de las epidemias: salud y sociedad en el Perú del siglo XX” de autoría de Marcos Cueto; publicado por el Instituto de Estudios Peruanos en el año 1997 y reimpresión en el 2000. (ISBN 9972-51-011-5 &amp; ISSN 1019-4533)[2]. Estos párrafos no aparecen referenciados en la bibliografía del artículo. Los autores han reconocido esta falta, aceptando nuestra decisión que sigue lineamientos del COPE (Comité sobre ética en publicaciones)[3], la Guía de Buenas Prácticas para el Fortalecimiento de la Ética en la Publicación Científica de Scielo[4] y el Consejo de Editores de Ciencia[5]; entre otros .</p> Editor Revista Acta Médica Peruana Copyright (c) 2021 ACTA MEDICA PERUANA Thu, 29 Apr 2021 00:00:00 -0500 COVID-19: An urgent need for an adequate interpretation of laboratory diagnostic tests Fredy Canchihuamán, Ernesto Gozzer Copyright (c) 2021 ACTA MEDICA PERUANA Thu, 29 Apr 2021 00:00:00 -0500