18 research outputs found
Valoración de diferentes propuestas de diagnóstico de anemia ferropénica en gestantes de Cusco, 2020
El propósito de estudio del presente trabajo fue evaluar la capacidad diagnóstica de diferentes propuestas de diagnóstico para identificar anemia ferropénica en mujeres gestantes de Cusco. Métodos utilizados para el análisis secundario con base de un estudio observacional de corte transversal, y analítico. Se determinó parámetros laboratoriales de muestras sanguíneas mediante el hemograma automatizado para obtener valores de hemoglobina e índices eritrocitarios. Se usó kits de ELISA para determinar valores de los biomarcadores del estado de hierro. El análisis descriptivo y bivariado fue realizado con el programa Stata, y la capacidad diagnostica evaluada mediante modelos crudos y ajustados en términos de curvas ROC con el programa R v3.6.1. Resultados: La prevalencia de anemia fue diferente según cinco propuestas diagnosticas usando hemoglobina sin corregir fue 2%, corregida por el método OMS fue 13,2%, por Dirren 17,1%, por Dallman 2,9% y Bartolo 11,7%, durante la gestación la hemoglobina tiene un descenso más marcado en el segundo trimestre que correlaciona con la hemodilución fisiológica; la estrategia propuesta por Dallman y la de hemoglobina sin corregir además de los índices eritrocitarios tuvieron valores altos de Área Bajo la Curva en los modelos crudos y ajustados. Se encontró cifras considerables de eritrocitosis en gestantes mediante la estrategia de hemoglobina sin corregir. Conclusiones: La estrategia de corrección de Dallman y de hemoglobina sin corregir además de los índices eritrocitarios tuvieron buen rendimiento diagnóstico respecto a otras estrategias.Financiada por la UNSAA
La implicancia del reordenamiento genético en el diagnóstico y la epidemiología del virus Oropuche en el Perú
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Embarazo ectópico cervical. A propósito de dos casos
Background. Cervical ectopic pregnancy is the implantation of the embryo in the lining of the endocervical canal lining. It represents less than 1% of all ectopic pregnancies. Case description: We report two patients who come to the emergency room for transvaginal bleeding. The diagnosis of cervical ectopic pregnancy was made by transvaginal ultrasound (7- and 8-weeks' gestation). Treatment was started with methotrexate (28-year-old patient) and methotrexate-folinic acid (35-year-old patient). Due to the increase in human chorionic gonadotropin hormone, it was decided to perform an abdominal hysterectomy (28-year-old patient) and McDonald-type cervical curettage-cerclage (35-year-old patient). There were no complications after surgery in both patients. Conclusions: The treatment of cervical ectopic pregnancy is controversial. The most appropriate therapy should be chosen to preserve fertility and avoid complications such as bleeding.Antecedentes. El embarazo ectópico cervical es la implantación del embrión en la zona de revestimiento del canal endocervical. Representa menos del 1% de todos los embarazos ectópicos. Reporte de Caso: Reportamos dos pacientes que acuden a consulta de emergencia por sangrado transvaginal. El diagnóstico de embarazo ectópico cervical fue realizado por ecografía transvaginal (7 y 8 semanas de gestación). Se inició tratamiento con metotrexato (paciente de 28 años) y metotrexato-ácido folínico (paciente de 35 años). Debido al aumento de la hormona gonadotropina coriónica humana se decidió realizar una histerectomía abdominal (paciente de 28 años) y curetaje-cerclaje cervical tipo McDonald (paciente de 35 años). No hubo complicaciones posteriores a la cirugía en ambas pacientes. Conclusiones: El tratamiento del embarazo ectópico cervical es controversial. Se debe elegir la terapia más apropiada para preservar la fertilidad y evitar complicaciones como la hemorragia
Mortality attributable to diabetes mellitus as recorded by the Ministry of Health of Peru, 2005-2014
Objective. To estimate the mortality attributable to diabetes mellitus (DM) as recorded by Peru’s Ministry of Health and its association with the human development index (HDI). Methods. This was an ecological study based on a secondary analysis of death records belonging to the Ministry of Health for the period from 2005 to 2014. A death was considered attributable to DM if the underlying cause of death given in the death record was DM. Mortality attributable to DM has been presented descriptively and in terms of geospatial analyses, and Spearman’s rho was used to test for an association between the difference in the mortality attributable to DM (between 2005-2006 and 2013-2014) and the HDI in Peru’s various departments.Revisado por pare
National trends of hepatocellular carcinoma mortality registered by the ministry of health in Peru, from 2005 to 2016
Background. Hepatocellular carcinoma results in most cases from underlying chronic liver disease. The most common causes are the Hepatitis B virus and the Hepatitis C virus in-fections, the alcoholism and the aflatoxin. Mortality statistics of liver cell carcinoma in Peru is limited. Objectives. Update statistics on hepatocellular carcinoma mortality in Peru between the years 2005 and 2016. Methods. Observation-al, descriptive studyand secondary analysis of the Ministry of Health database. Records with the basic cause of death ICD 10: C22, the liver cell carcinoma were reviewed. Mortality was calculated according to the age, the sex and the department in which death was recorded; Also, standardized mortality by age was calculated. Results. 2,170 people were registered as deceased due to hepatocellular carcinoma. The 50.1% were male and the 67.5% older than 60 years. The standardized mortality rate in Peru decreased from 1.1 to 0.7 per 100,000 population from 2005 to 2016. The raw cup of mortality per 100,000 population shows that when comparing the first period (2005-2010) with the second (2011-2016), the tendency in Peru has decreased. The only region that presented a decrease in mortality was the Mountains (% change =-40.1). Conclusions. Standardized mortality by age had a slight decrease from 2005 to 2016; however, this difference does not show considerable variations. Mortality from this neoplasm seems to remain high and stable since the period from 1995 to 2000
Tendencia nacional de la mortalidad por hepatocarcinoma registrada en el ministerio de salud del Perú del 2005 al 2016
Background. Hepatocellular carcinoma results in most cases from underlying chronic liver disease. The most common causes are the Hepatitis B virus and the Hepatitis C virus in-fections, the alcoholism and the aflatoxin. Mortality statistics of liver cell carcinoma in Peru is limited. Objectives. Update statistics on hepatocellular carcinoma mortality in Peru between the years 2005 and 2016. Methods. Observation-al, descriptive studyand secondary analysis of the Ministry of Health database. Records with the basic cause of death ICD 10: C22, the liver cell carcinoma were reviewed. Mortality was calculated according to the age, the sex and the department in which death was recorded; Also, standardized mortality by age was calculated. Results. 2,170 people were registered as deceased due to hepatocellular carcinoma. The 50.1% were male and the 67.5% older than 60 years. The standardized mortality rate in Peru decreased from 1.1 to 0.7 per 100,000 population from 2005 to 2016. The raw cup of mortality per 100,000 population shows that when comparing the first period (2005-2010) with the second (2011-2016), the tendency in Peru has decreased. The only region that presented a decrease in mortality was the Mountains (% change =-40.1). Conclusions. Standardized mortality by age had a slight decrease from 2005 to 2016; however, this difference does not show considerable variations. Mortality from this neoplasm seems to remain high and stable since the period from 1995 to 2000.Revisión por pare
Aplasia medular asociado con virus linfotrópico humano de células T tipo 1 (HTLV-1): Reporte de un caso
Background: Medullary aplasia is a disease characterized by pancytopenia with hypocellular bone marrow. Most of these are acquired and can be idiopathic or secondary to bone marrow damage produced by physical, chemical or infectious agents. HTLV-1 is an intracellular retrovirus that is transmitted by prolonged breastfeeding, sexual intercourse, and blood transfusions. Case description: We report the case of a 28-year-old woman who presented petechiae, gingivorrhagia, and generalized paleness. In the laboratory examination, severe pancytopenia was found, HTLV-1 positive, and in the bone marrow aspirate, marked hypocellularity. She received antibiotics, antifungals, antivirals, and immunosuppressive agents with a steady course. Conclusions: HTLV-1 infection is common in Peru; however, its association with medullary aplasia is poorly described. Hematopoietic stem-cell transplantation is an alternative treatment in case of failure to respond to immunosuppressive therapy.Antecedentes: La aplasia medular es una enfermedad caracterizada por pancitopenia con médula ósea hipocelular. La mayor parte de estas son adquiridas pudiendo ser idiopáticas o secundarias al daño de la médula ósea producido por agentes físicos, químicos o infecciosos. El HTLV-1 es un retrovirus intracelular que se transmite por la lactancia materna prolongada, las relaciones sexuales y las transfusiones sanguíneas. Descripción del caso: Reportamos el caso de una mujer de 28 años que presentó petequias, gingivorragia y palidez generalizada. En sus exámenes se encontró pancitopenia severa, HTLV-1 positivo y en el aspirado de médula ósea, hipocelularidad marcada. Se administró antibióticos, antifúngicos, antivirales y agentes inmunosupresores con una evolución estacionaria. Conclusiones: La infección por HTLV-1 es frecuente en Perú; sin embargo, su asociación con aplasia medular es poco descrita. El trasplante de células madre hematopoyéticas es una alternativa de tratamiento en caso de no responder a la terapia inmunosupresora
National trends in age-standardized mortality attributable to hypertension in Peru
Abstract Introduction: Hypertension (HTN) is a public health problem. The prevalence and mortality rates are significantly higher in middle and low-income countries, such as Peru. This study aimed to determine the trend of mortality attributable to HTN for the 2005-2016 period in Peru. Methods: We conducted a secondary analysis based on death certificates provided by the Ministry of Health. We applied linear regression models to test the HTN mortality rate trend. Results: The age-standardized HTN mortality per 100,000 inhabitants decreased from 14.43 for the 2005 to 2010 period to 11.12 for the 2011 to 2016 period. The coast was the natural region with the highest decrease in mortality rate. Moreover, Tumbes, Callao, and Lambayeque were regions with the highest decline in mortality rate. Conclusion: The age-standardized mortality attributable to HTN decreased in Peru, with variations in both natural and political regions of the country.</div
¿Movimientos involuntarios asociado a corrección por déficit de vitamina B12?: A propósito de un caso
Background: Vitamin B12 deficiency is a nutritional problem that can present with neurological and hematological manifestations. There are limited reports on the appearance of involuntary movements when initiating cyanocobalamin treatment. Case report: A 5-month-old infant presented vomiting, paleness, and difficulty holding his head. Among the examinations, pancytopenia and vitamin B12 deficiency were found in the patient and the mother. Treatment with folic acid and cyanocobalamin was administered; However, on the fourth day of treatment, she presented choreiform movements for which clonazepam was administered. The tomography and the electroencephalogram were normal. At follow-up, the platelet and leukocyte count improved and the movements gradually remitted. Conclusion: Little is reported about the occurrence of involuntary movements when vitamin B12 deficiency is corrected. Follow-up evaluation is important to avoid unnecessary overmedication.Antecedentes: La deficiencia de vitamina B12 es un problema nutricional que puede cursar con manifestaciones neurológicas y hematológicas. Existen limitados reportes sobre la aparición de movimientos involuntarios al iniciar tratamiento con cianocobalamina. Descripción del caso: Lactante de 5 meses presentó vómitos, palidez y dificultad para sostener la cabeza. Dentro de los exámenes se encontró pancitopenia y déficit de vitamina B12 en el paciente y la madre. Se administró tratamiento con ácido fólico y cianocobalamina; sin embargo, al cuarto día de tratamiento presentó movimientos coreiformes por lo que se administró clonazepam. La tomografía y el electroencefalograma fueron normales. Al seguimiento el recuento de plaquetas y leucocitos mejoraron y los movimientos remitieron gradualmente. Conclusiones: La aparición de movimientos involuntarios cuando se realiza la corrección por déficit de vitamina B12 es poco reportado. La evaluación al seguimiento es importante para evitar la sobremedicación innecesaria
