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) Mon, 09 May 2022 01:16:39 -0500 OJS 60 Dos años de Pandemia, una batalla que aún no termina Roger V Araujo-Castillo Copyright (c) 2022 ACTA MEDICA PERUANA Mon, 09 May 2022 00:38:01 -0500 Elimination and prevention of iodine deficiency in pregnant women from Peru <p>Iodine is an essential element for synthesizing thyroid hormones, it is also essential for cell metabolism and tissue development, especially in the brain. Iodine requirements are higher during pregnancy and lactation. Iodine deficiency (ID) is a widespread condition all over the world; it is frequent in Peruvian highlands and rainforest. ID causes damage in all life periods, and vulnerability for this is greater during pregnancy and infancy. Universal salt iodination (USI) for human use is the most cost-effective and sustainable strategy for controlling ID. Peru has achieved the sustained elimination of iodine deficiency disorders (IDD) since 1994. <strong>Objective.</strong> To determine the effectiveness of the national program for controlling IDDs and the USI strategy for complying with the increased iodine requirement and to assure optimal iodine nutrition in pregnant women from the Peruvian highlands, a region with severe natural iodine deficiency. <strong>Material and Methods</strong>. The study included 489 pregnant women from the highlands, who were selected from those attending prenatal assessment in healthcare centers. Iodinated salty consumption was verified in each subject and a casual urine sample was collected for measuring iodine and creatinine concentration. <strong>Results.</strong> According to the admission survey, 99.6% of household use iodinated salt. The overall mean of iodine urine concentration (IUC) was 209 μg/L, which is well within the adequate range for pregnant women, and it shows a normal iodine nutrition status. The creatinine urinary concentration was normal. <strong>Conclusion.</strong> These results confirm<br>the efficiency and success of the national program for the sustained elimination of IDDs, assuring normal iodine nutritional supply during pregnancy; and, therefore, preventing the risk for brain damage in newborns every year in the highlands.</p> Eduardo Pretell Zárate, Ana María Higa, Michael B. Zimmermann, Jorge Collantes, Juan Condori, Ethel M. Meza, Ernesto Molina, Pablo Salinas, Rubén Villacaqui, Wilfredo Villamonte, Luis Cordero Copyright (c) 2022 ACTA MEDICA PERUANA Mon, 09 May 2022 00:38:39 -0500 Vision problems in people over 50 years old in Peru: A population-based study <p><strong>Objective</strong>: To evaluate the history of cataract and vision problems in people over 50 years of age in Peru. <strong>Methods</strong>: Secondary database analysis of the Demographic and Family Health Survey (ENDES) 2016. We included 7970 adults over 50 years of age. We evaluated the indicators of interest at the national and regional level. Likewise, we analyzed factors related to these events using a multivariate Poisson model. <strong>Results</strong>: 13.6% (95% CI: 12.8-14.3%) had a history of cataract, 20.4% (95%CI: 19.5-21.3%) had long-distance vision problems. (LDVP) and 29.4% (95%CI: 28.4-30.4%) of short-distance vision problems (SDVP). In the multivariate model, we observed that people with a history of high blood pressure, a history of diabetes, and older age groups were significantly more likely to report a history of cataracts and vision problems. We also observed that people with a better economic status had a lower frequency of LDVP and SDVP. <strong>Conclusion</strong>: The history of cataract and vision problems in the studied population vary according to sociodemographic and geographic characteristics. The identification of factors related to these events of interest allows us to propose better interventions to control these problems.</p> Deivy Cruzado-Sanchez, Christopher Ichiro-Peralta, Karla Loayza-Torres, Walter Andree-Tellez, Jorge Osada Copyright (c) 2022 ACTA MEDICA PERUANA Mon, 09 May 2022 00:39:08 -0500 Predictors of in-hospital mortality and poor functional outcomes in patients who underwent surgical evacuation of intracerebral hemorrhage <p><strong>Objective</strong>: To determine predictors of in-hospital mortality and poor functional prognosis in patients undergoing surgery for intracerebral hemorrhage.</p> <p><strong>Materials and Methods</strong>: Clinical records, operative reports, and cerebral CT scans of patients with intracerebral hemorrhage from March 2018 to March 2020 were analyzed. Univariate and multivariate logistic regression analyses were performed for determining independent predictors of in-hospital mortality and poor functional prognosis at discharge.</p> <p><strong>Results</strong>: In-hospital mortality was 33.7% (n= 31 patients). Independent predictors for mortality were female sex (OR= 3.01, p= 0.031) and Glasgow score &lt;8 on admission (OR= 3.19, p= 0.031). A poor functional prognosis after the intervention was found in 77 patients (83.7%). Independent risk factors for a poor functional prognosis were score &gt;3 in the modified Rankin scale (OR= 15.5; p= 0.01), and preoperative motor deficit (OR= 8.95; p= 0.042).</p> <p><strong>Conclusions</strong>: In patients with intracerebral hemorrhage who were surgically treated, high morbidity and mortality rates were found. Female sex and clinical factors, such as consciousness condition and functional status on admission were independent predictors for in-hospital mortality and poor functional prognosis.</p> Giancarlo Saal-Zapata, John Vargas-Urbina, Gianfranco Reyes-Narro, Aarón Rodríguez-Calienes, Rodolfo Rodríguez-Varela Copyright (c) 2022 ACTA MEDICA PERUANA Mon, 09 May 2022 00:39:45 -0500 Presence of by Escherichia coli in Pucusana Beach, Lima and its potential effect on public health <p><strong>Objective</strong>: To determine the values of the bacteria and fecal indicator Escherichia coli (EC) for seawater of safe and recreational use of the Pucusana beach, Lima. <strong>Materials and Methods</strong>: The campaigns of samplings were carried out once a week in the summer of 2019 and were processed in the microbiology laboratory of the Faculty of Biological Sciences (FCB) of the Ricardo Palma University using colimetry and the method of the most probable number (NMP). <strong>Results</strong>: The presence of EC was verified in all the analyzed samples, with average values higher than 1000 MPN/100 ml. in all collected samples. <strong>Conclusions</strong>: The lack of environmental health and its relevance in public health is demonstrated. The risk factors are produced mainly by the production and discharge of wastewater. residuals carried by the collectors to the sea and although an important proportion of these waters are processed at the PTAR Pucusana Wastewater Treatment Plant. Domestic and municipal discharges that discharge into the Pacific were identified, a problem that must have good management and environmental control because it deteriorates the environment and the seas.</p> Cinthia Milagros Huayanay Quevedo, Veronica Aldoradin Basilio, Alcides Guerra Santa Cruz Copyright (c) 2022 ACTA MEDICA PERUANA Mon, 09 May 2022 00:48:31 -0500 Relationship between type of cleft palate and Eustachian tube function in children, Peru 2020 <p><strong>Introduction and objectives</strong>: The objective of this study is to determine if the type of cleft lip and palate is associated with a higher risk of alteration of the Eustachian tube. <strong>Materials and methods</strong>: A descriptive case series study was carried out with an inferential analysis of children operated on for cleft lip and palate at the San Bartolomé hospital during the years 2018 and 2019. <strong>Results</strong>: 48 patients with tympanometry were evaluated, 62.5% male (n = 30) and 37.5% female (n = 18), the mean age was 1.3 years. The type of cleft lip and palate was determined using the Veau classification, the most frequent type found was Veau type III: 62.5% (n = 30), the least frequent type was Veau I with 4.2% (n = 2). The evaluation of the function of the Eustachian tube was performed with tympanometry, defining the type B curve as pathological. In the study<br>group, there was an overall prevalence of type B curves of 66.7% (n = 32), while type A and C curves were 33.3% (n = 16). The probability that the Veau IV crack type has an association with type B curves more frequently than the other types, using the Binomial test, was significant. (p = 0.000038 &lt;0.05). <strong>Conclusions</strong>: The type of cleft palate that is most associated with impaired middle ear function, expressed by type B tympanometry curves, is type IV cleft according to Veau's classification, this relationship is statistically significant.</p> Sara Isabel Antayhua Ortiz Copyright (c) 2022 ACTA MEDICA PERUANA Mon, 09 May 2022 00:49:28 -0500 Clinical and epidemiological characteristics of hypertrophic pyloric stenosis in a hospital in Lima, Perú. <p><strong>Objective</strong>: To determine clinical and epidemiological characteristics of hypertrophic pyloric stenosis in a hospital in Lima, Peru. <strong>Materials and Methods</strong>: A descriptive and retrospective study encompassing years 2013 to 2019 was performed in the Pediatric Surgery Service of San Bartolome Teaching Mother and Child Hospital. Data from clinical records of patients diagnosed with hypertrophic pyloric stenosis was collected. <strong>Results</strong>: Records from fifty-nine patients were obtained, 79% were male, 68.4% were first born, and their mean age was 31.3 ± 13.6 days. All patients (100 %) had vomit, 44.1% had abnormal abdominal movement, and only 35.6% had palpable pyloric olive. The average surgical correction time was 51.39 minutes, and the average hospital stay was 6.35 days, major complications occurred in 13.6% of all children, and the mortality rate was 3.4%. <strong>Conclusions</strong>: Early initiation of oral intake is important, as well as post-surgical management<br>in these patients, in order to reduce their in-hospital stay and the development of post-surgical ventilatory complications.</p> Carlos Guillermo Torres Guinand, Armando Reque García Copyright (c) 2022 ACTA MEDICA PERUANA Mon, 09 May 2022 00:50:28 -0500 Current situation of the prevention of type 2 diabetes mellitus <p>Most of aspects of Diabetes Mellitus type 2 (DM2) subject to be prevented are reviewed, to low down the morbi-mortality of this disease under the current circumstances. In a descriptive, transversal study, the aspects and methods to prevent both the development of the disease as well as its chronic manifestations, acute complications and related morbidities are described. It is concluded that effective measures and methods to diminish the prevalence and morbi-mortality of type 2 diabetes mellitus are available under the current circumstances.</p> Fausto Aníbal Garmendia Lorena Copyright (c) 2022 ACTA MEDICA PERUANA Mon, 09 May 2022 00:54:37 -0500 Latest advances in neoadjuvant therapy for bladder cancer <p>Cisplatin-based neoadjuvant therapy has shown clear benefits in clinical stage II or IIIA muscle invasive bladder cancer (MIBC), achieving an impact in progression-free survival and overall survival. This updated review focuses on neoadjuvant therapy for MIBC, including the current recommendations from international and/or local practice guidelines, as well as studies of new therapeutic agents (immunotherapy, targeted therapy), on top of research on potential biomarkers that may predict response to immunotherapy.</p> Patricia Rioja, Guillermo Valencia, Zaida Morante, Roberto Paz, Heberth Vallejos, Hugo Fuentes, Silvia Neciosup Copyright (c) 2022 ACTA MEDICA PERUANA Mon, 09 May 2022 00:56:16 -0500 Risk factors associated with hypoglycemia in newborns <p>A review paper was written aiming to determine risk factors related with hypoglycemia in newborns. Objectives were to determine clinical evidence for neonatal hypoglycemia-related risk factors and to determine the pathophysiological support upon risk factors implicated in the occurrence of hypoglycemia in newborns. Searches were performed in Medline-Pubmed, SCOPU, and HINARI, looking for papers published up to November 2021. We obtained 108 papers. It was concluded that although universal screening for hypoglycemia in asymptomatic low-risk newborns could be unnecessary, there is evidence that hypoglycemia may cause abnormalities in neurological development. Maternal risk factors for neonatal hypoglycemia include gestational diabetes, preeclampsia, and gestational obesity. Risk factors in newborns include sepsis, low birth weight and prematurity.</p> Willam Ynguil Amaya, Berardo Caciano Leiva, Hugo Vega Díaz, Bravo Avilés Copyright (c) 2022 ACTA MEDICA PERUANA Mon, 09 May 2022 00:56:49 -0500 El Actinomyces and Kartagener syndrome: Case report and literature review <p>Kartagener syndrome, which is part of the subgroup of the primary ciliary dyskinesias, predisposes to recurrent respiratory tract infections due to Haemophilus influenzae, Staphylococcus aureus and Streptococcus pneumoniae. The case of a patient with a diagnosis of Kartagener syndrome in whom colonization by Pseudomonas fluorescens and pneumonia complicated with empyema by Actinomyces spp is a rare association in the literature, which is described below.</p> Carlos Mauricio Martinez Montalvo Copyright (c) 2022 ACTA MEDICA PERUANA Mon, 09 May 2022 00:58:38 -0500 Raoultella planticola pneumonia in a patient with critical COVID-19 <p>Raoultella planticola is a bacterium that has been recently described in the literature as an emerging pathogen that causes urinary, abdominal, and lung infections. We present the case of a 63-year-old overweight and with dyslipidemia that was hospitalized because of a SARS-CoV-2 infection. He developed R. planticola and E. aerogenes superinfections. He was treated with cefepime for seven days, and he recovered uneventfully.</p> Carlos Mauricio Martínez Montalvo, Daniel Valery Rojas Kozhakin, María Alejandra Villamil Forero, Mateo Rodríguez Giraldo, José Gabriel Montenegro Vargas, Natalia Cabal Copyright (c) 2022 ACTA MEDICA PERUANA Mon, 09 May 2022 00:59:43 -0500 Transthoracic extrapleural discectomy without fusion for dorsal disc herniation resection giant calcified: case report and review of literature <p><strong>Introduction</strong>: Calcified thoracic disc herniation are rare and their approach represents a surgical challenge when they are large and symptomatic. Extrapleural Transthoracic discectomy can be considered a safe approach to resection of the calcified disc fragment and spinal cord descompression. <strong>Clinical case</strong>: 53-year-old man with middle dorsalgia radiating to the inframammary region and progressive difficulty walking, proximal paraparesis moderate, sensory level T8 and urinary retention. The images demonstrated a large T6-7 disc herniation calcified causing severe spinal cord compression. The patient underwent T6-7 extrapleural transthoracic discectomy plus T6 partial corpectomy without fusion. The patient tolerated the procedure well without complications and postoperative imaging demonstrated descompression of spinal cord. At followup,<br>irradiated dorsalgia, paraparesis, sensitive level and urinary retention improved.</p> Annel Murga Villanueva, Alfonso Basurco-Carpio, Eduardo Laos-Plasier Copyright (c) 2022 ACTA MEDICA PERUANA Mon, 09 May 2022 01:01:03 -0500 Oil spill and health effects Cinthya Vasquez-Velásquez, Carol Ordóñez-Aquino, Gustavo F. Gonzales Copyright (c) 2022 ACTA MEDICA PERUANA Mon, 09 May 2022 01:14:40 -0500