Contamination by Antibiotic-Resistant Bacteria on Cell Phones of Vendors in a Peruvian Market.

Background and Objectives. Multiple studies have evaluated the presence of bacterial contamination on cell phones in clinical settings; however, the presence and transmission of antibiotic-resistant bacteria on cell phones in the community have not been adequately elucidated. Material and Methods. A cross-sectional study was carried out to determine the presence of bacteria resistant to antibiotics on the cell phones of vendors in a Peruvian market and the associated factors. A sample of 127 vendors was obtained through stratified probabilistic sampling using a data collection form validated by experts. Cell phone samples were cultured using a standard technique, and antibiotic sensitivity was determined using the Kirby-Bauer technique. Chi-squared and Mann-Whitney U tests were used to determine factors associated with resistance in cell phone cultures. Results. Among the cell phones, 92.1% showed bacterial growth, predominantly Gram-positive bacteria (coagulase-negative staphylococci and Staphylococcus aureus), and 17% of the cultures showed resistance to at least three antibiotics evaluated. Two strains fell into the category of methicillin-resistant S. aureus, and three strains of E. coli had resistance to carbapenems. Conclusions. A short distance between customers and vendors, lack of a cell phone case, and having a cell phone with touchscreen are factors associated with antibiotic-resistant bacteria on cell phones.

Survival and adequate preoperative staging in patients undergoing gastric cancer surgery at a Peruvian Police Hospital.

INTRODUCTION: Gastric cancer is the fifth most common malignant neoplasm and the third leading cause of cancer-related death worldwide. In Peru, its incidence is 15.8 per 100,000 population, and it is associated with high mortality rates, especially in areas with low socioeconomic status. The aim of this study was to compare preoperative, postoperative, and anatomopathological staging results and their relation to disease recurrence and survival. METHODS: We conducted a retrospective cohort study of patients undergoing surgery for gastric cancer with a definitive postoperative anatomopathological diagnosis from 2005 to 2014 at the Hospital Nacional Luis N. Sáenz. Statistical analyses included descriptive and correlation statistics using the κ index, determination of associations between preoperative and postoperative staging and surgical reintervention and recurrence using the χ2  test, as well as Kaplan Meier survival analysis. RESULTS: There was little correlation between preoperative staging and final anatomopathological diagnosis, while there was a good correlation with postoperative staging. A significant association was found between preoperative staging and cancer recurrence. In the survival analysis, survival was lower among patients with underestimated staging. CONCLUSIONS: The survival of patients with gastric cancer can be affected by an overestimation of preoperative staging, therefore improvements in preoperative staging could lengthen the survival of patients undergoing gastric cancer surgery.

Disseminated Cutaneous Leishmaniasis in a Pediatric Patient from Peru.

INTRODUCTION: Leishmaniasis is a disease predominantly prevalent in the tropics, considered as one of the primary neglected diseases, preferably affects individuals of low socioeconomic status. Although this condition is well described in children, disseminated cutaneous leishmaniasis is a rare form of increasing importance and multiple cases observed in the adult population; however, still little described in children. CASE: We present the case of a 12-year-old male, who has multiple ulcerative and nodular lesions distributed throughout the body, of ∼1 year of evolution that did not respond to antimicrobial treatment. After the diagnostic process, positive serological tests were found for leishmaniasis, with improvement in the picture after the use of sodium stibogluconate. DISCUSSION: Disseminated cutaneous leishmaniasis is a clinical form that is described with increasing frequency and should be recognized and treated appropriately, mainly in the pediatric population, avoiding complications and sequelae.

Blastocystis species and Gastrointestinal Symptoms in Peruvian Adults Attended in a Public Hospital.

The objective of this study was to evaluate the role of Blastocystis sp. in gastrointestinal symptoms reported by adult patients in a Peruvian hospital. A case-control 3:1 study was performed at the outpatient clinic. Direct stool examinations were done. One hundred sixty patients were included, 40 cases and 120 controls. Positivity to Blastocystis sp. was associated with dyspepsia (P <0.001), bloating (P <0.001) and abdominal pain (P = 0.03) in patients attending our hospital outpatient clinic.

[Factors associated with the acceptability of the human papillomavirus vaccine, Huanuco, Peru]. / Factores asociados a la aceptabilidad de la vacuna contra el virus del papiloma humano, Huánuco, Perú.

BACKGROUND: Human papillomavirus (HPV) produces the most frequent sexually transmitted viral infection in the world. A strategy to reduce infection rates for this virus is vaccination to young women between 9 and 13 years, so it is imperative to ensure the highest degree of acceptability to the vaccine. AIM: To determine the level of knowledge, attitudes and beliefs associated with the acceptability of the HPV vaccine in the parents of a rural and urban area of ​​the Huanuco. METHODS: Analytical cross-sectional study in 168 parents. The χ2 test was used to assess associations, with 95% confidence, p significant < 0.05. RESULTS: The mean age was 35.08 years, 67% had secondary education and 27.3% of parents did not accept the vaccine. A statistically significant relationship was found between the level of medium-high knowledge (p = 0.017), positive attitudes towards vaccines (p < 0.001), absence of beliefs (p < 0.001), Catholic religion (p = 0.002) and presence of studies in the degree of education (p = 0.016) with the acceptability towards the vaccine. Those parents whose beliefs were evidenced were 6.56 times more likely not to accept the human papillomavirus vaccine. CONCLUSIONS: The factors associated with the acceptability of the human papillomavirus vaccine are the level of knowledge, attitudes, beliefs, religion and the degree of instruction.

Bacterial resistance in cell phone cultures of medical students.

Cell phones are one of the most important and indispensable accessories for professional and social life. Cell phones used by healthcare workers are highly contaminated by microorganisms. The objective of the study was to ascertain the presence of bacterial resistance type Extended-Spectrum Beta-Lactamase [ESBL] and its related factors in cultures isolated from cell phones of medical students. A quantitative, observational, analytical and transversal study was carried out in students of the Faculty of Medicine of the Universidad Nacional Hermilio Valdizán in Huánuco, Peru. The relationship was sought between the frequency of attendance at hospital practices, cell phone disinfection and hand washing after contact with patients with the presence of ESBL-type bacterial resistance. Of the total sample, 95% of students presented positive culture to Gram-negative bacteria, 30% carried out the disinfection of their cell phone and only 5% of the students performed hand-washing in an appropriate manner. In the bivariate analysis, a statistical association was found between cell phone disinfection and the presence of ESBL-type bacterial resistance [p <0.05]. Cell phone disinfection is related to the reduction of ESBL-type resistance, highlighting the need for disinfection of cell phones after performing hospital practices.

[Dengue in a newborn]. / Dengue en un neonato.

Dengue is the disease transmitted by arthropods of major importance in public health; however its presence in the neonatal stage is poorly studied, with few cases described worldwide. We present the case report of a neonate who started illness at 12 days of age, characterized by fever and irritability. He was hospitalized for suspicion of neonatal sepsis; later he presented thrombocytopenia and due the antecedent of his mother with diagnosis of dengue after childbirth, dengue tests were obtained in the neonate, resulting positive, then support treatment and fluid treatment is performed, with subsequent recovery. Dengue in the neonatal stage should always be suspected in areas where the disease is endemic and management guides should be proposed.

Educational level and positive serology for dengue. a knowledge, attitudes and practices study in Huánuco, Peru

Dengue is a worldwide spread arboviral disease. Huánuco region is an endemic area for dengue. Understanding the influence of Knowledge, Attitudes and Practices (KAP) in dengue endemic areas can provide important insight for improving public health policies. The purpose of this study was to understand the KAP about dengue in the marginal urban city of Tingo Maria, district of Rupa-Rupa, a rain forest area in Huánuco region and its association with positive serology for dengue. An analytical, retrospective, cross-sectional study was carried out in which a randomized sample of 112 people were evaluated using a semi structured questionnaire and tested for IgG against dengue virus. Most participants recruited were from marginal urban settlements. The median age was 38 years and 64% were female. A bivariate analysis showed an association between educational level and serological positivity. Over 95% of participants with only primary school education had a positive serological test for dengue. No statistical significances were found between attitudes towards dengue control initiatives (p=0.221), preventive practices against dengue (p=0.773), and the level of knowledge about dengue (p=0.073). Although attitudes, preventive practices and level of knowledge were not related to positive serology in dengue cases, educational level showed an association with serological positivity for dengue.

[Estimation of economic costs for the care of patients with nosocomial pneumonia in a regional peruvian hospital, 2009-2011]. / Estimación de costos económicos en la atención de la neumonía nosocomial en un hospital regional peruano, 2009 al 2011.

OBJECTIVES: To estimate and compare the economic costs for the care of patients with and without nosocomial pneumonia at Hospital II Huánuco EsSalud during 2009-2011, in Peru. MATERIALS AND METHODS: This was a partial economic evaluation of paired cases and controls. A collection sheet was used. DEPENDENT VARIABLE: nosocomial pneumonia. INDEPENDENT VARIABLES: direct health costs, direct non-health costs, indirect costs, occupation, age, comorbidities, sex, origin, and education level. A bivariate analysis was performed. RESULTS: Forty pairs of cases and controls were identified. These patients were hospitalized for >2 weeks and prescribed more than two antibiotics. The associated direct health costs included those for hospitalization, antibiotics, auxiliary examinations, specialized assessments, and other medications. The direct non-health costs and associated indirect costs included those for transportation, food, housing, foregone payroll revenue, foregone professional fee revenue, extra-institutional expenses, and payment to caregivers during hospitalization and by telephone. CONCLUSIONS: The direct health costs for nosocomial pneumonia patients were more than three times and the indirect costs were more than two times higher than those for the controls. Variables with the greatest impact on costs were identified.

Endogamia de comités editoriales en revistas peruanas de la salud / Editorial board inbreeding in peruvian health journals

Introducción: las revistas científicas son el instrumento perfecto para comunicar resultados del proceso de investigación y transmitir el conocimiento. El comité editorial es un equipo de expertos de vital importancia en el funcionamiento de una revista científica. Sin embargo, una frecuente práctica editorial es la publicación de manuscritos en las revistas que editan. Por ello, se buscó determinar cuál es la frecuencia de la endogamia editorial en las revistas peruanas del área de la salud. Métodos: se realizó una revisión de los artículos publicados por miembros del comité editorial de 26 revistas peruanas entre el 2016 y 2019. Se realizó una evaluación de los manuscritos provenientes del comité editorial, así como un análisis de asociación entre el estado de indexación en dos bases de datos regionales; además, cómo esta influye en la frecuencia de endogamia de cada revista. Resultados: durante el periodo evaluado se publicaron 2.885 manuscritos, de los cuales 520 tenían como autores a miembros del comité editorial. El tipo de contribución más frecuente fue el artículo original. La endogamia en los años 2016 al 2018, así como un mayor porcentaje de endogamia por fascículo, fue estadísticamente mayor en las revistas pertenecientes al directorio Latindex. Conclusión: las revistas peruanas del área de la salud tienen frecuencias heterogéneas de endogamia editorial. Las revistas incluidas en el directorio Latindex presentan una mayor frecuencia de esta práctica editorial frente a las revistas que pertenecen a la base de datos SciELO-Perú.

SUMMARY Introduction: Scientific journals are the perfect instrument to communicate results of the research process and transmit knowledge. The editorial board is a team of experts of vital importance in the operation of a scientific journal, however, a frequent editorial practice is the publication of manuscripts in the journals they edit; therefore, we sought to determine the frequency of editorial inbreeding in Peruvian journals in the health area. Methods: A review of the articles published by members of the editorial board of 26 Peruvian journals between 2016 and 2019 was performed, evaluating the manuscripts from the editorial board, as well as analysis of association between the status of indexation in two regional databases and how this influences the frequency of inbreeding in each journal. Results: During the period evaluated, 2885 manuscripts were published, of which 520 had authors of the editorial board as authors. The most frequent type of contribution was the original article. Inbreeding in the years 2016 to 2018, as well as a higher percentage of inbreeding per issue, was statistically higher in the journals belonging to the Latindex directory. Conclusion: Peruvian journals in the health area have heterogeneous frequencies of editorial inbreeding. The journals included in the Latindex directory present higher frequency in editorial inbreeding, compared to journals included in the SciELO-Peru database.

[Factors associated with Ehrlichia canis infection in dogs infested with ticks from Huanuco, Peru]. / Factores asociados a la infección por Ehrlichia canis en perros infestados con garrapatas en la ciudad de Huánuco, Perú.

The aim of the study was to determine the frequency and associated factors of Ehrlichia canis infection in dogs. Blood samples from 150 dogs infested with ticks in 10 veterinary clinics in the city of Huanuco in Peru were collected. The dogs were randomly selected without regard to breed, age or sex. Ehrlichia canis antibodies were detected by chromatographic immunoassay.51.3% of dogs were infected with Ehrlichia canis. In the multivariate analysis, factors associated with the presence of Ehrlichia canis were: poor health of the dog (p = 0.049), a higher average of tick infestation (p = 0.018), and adult dogs (p = 0.038). The frequency of Ehrlichia canis in dogs of this city is high. Control of the brown dog tick (Rhipicephalus sanguineus) vector of Ehrlichia canis is recommended.

Estado nutricional, actividad física y consumo de comida chatarra asociados a colelitiasis en huánuco: estudio de casos y controles / Nutritional status, physical activity and consumption of junk food were associating to colelitiasis in huánuco: a case-control study

Resumen Objetivos: Determinar la asociación entre el consumo de comida chatarra, actividad física y estado nutricional en pacientes con colelitiasis a la ecografía (casos), comparados con controles aparentemente sanos sin colelitiasis a la ecografía, en consulta externa del Hospital EsSalud II Huánuco. Materiales y Método: Estudio de casos y controles. Se incluyeron 107 casos y 107 controles. El consumo de comida "chatarra" se valoró con la encuesta validada por RSEQ (Red deportiva estudiantil de Québec), la frecuencia del consumo (días por semana); la actividad física por el cuestionario IPAQ (Cuestionario Internacional de Actividad Física) y el estado nutricional mediante el índice de masa corporal. En el análisis estadístico se empleó el χ2, U de Mann Whitney y Odds Ratio (p < 0,05). Resultados: La edad y la procedencia no fueron significativos. El consumo de comida "chatarra" estuvo asociado a la colecistitis (OR 10,30; IC 95% 5,48-19,37). La actividad física moderada-vigorosa (≥ 600 MET) promovió el diagnóstico de colecistitis (OR 8,38; IC 95% 4,54-15,48) y el estado nutricional (sobrepeso o mayor), en forma significativa, promovía la colecistitis (OR 11,38; IC 95% 6,01-21,55). Ser femenino estuvo asociado al desarrollo de colecistitis (OR 2,06; IC 95% 1,19-3,55). Conclusión: El consumo de comida "chatarra", la actividad física moderada-vigorosa (≥ 600 MET), el estado nutricional (sobrepeso o mayor) y el género (femenino) fueron asociados al desarrollo de colelitiasis diagnosticados mediante ecografía.

Aim: To determine the association between junk food consumption, physical activity and nutritional status in patients with cholelithiasis on ultrasound (cases), compared with apparently healthy controls without cholelithiasis on ultrasound, in an outpatient EsSalud II Hospital, Huánuco Hospital, 2017. Materials and Method: Case-control study. 107 cases and 107 controls were included. The consumption of junk food was assessed with the survey validated by RSEQ (Québec Student Sports Network), the frequency of consumption (days per week); Physical activity through the IPAQ questionnaire (International Physical Activity Questionnaire) and nutritional status through the Body Mass Index. The chi-square, Mann Whitney U and Odds Ratio (p < 0.05) were used in the statistical analysis. Results: Gender, age and origin were not significant. None or low consumption of "junk" food were associated with cholecystitis (OR 0.097; 95% CI 0.052-0.182). Low physical activity (< 600 MET) did not promote the diagnosis of cholecystitis (OR 0.119; 95% CI 0.064-0.22) and the nutritional status (normal weight), significantly, did not promote cholecystitis (OR 0.09; 95% CI 0.05-0.167). Being male was associated with the non-development of cholecystitis (OR 0.48; 95% CI 0.281-0.838). Conclusión: Low or no consumption of "junk" food, low physical activity (< 600 MET), nutritional status (normal) and gender (male) were associated for the non-development of cholelithiasis diagnosed by ultrasound.

Publicaciones en Scopus y estado de licencia institucional en las escuelas de medicina de Perú / Publications in Scopus and institutional license status of the medical schools of Peru

Introducción: Las universidades son las instituciones llamadas a liderar la investigación para el desarrollo de la sociedad. En Perú existe una proliferación de facultades de medicina y una gran cantidad de alumnos matriculados, sin embargo, la investigación en muchas de ellas dista de lo deseable. Objetivo: Evaluar la producción científica en la base de datos de Scopus de todas las escuelas de medicina de Perú y su comparación con el grado de licenciamiento por la Superintendencia Nacional de Educación Superior Universitaria de Perú. Métodos: Se realizó una revisión en la base de Scopus, de todos los artículos publicados entre los años 2016 y 2019, por integrantes de las escuelas de medicina de Perú. La búsqueda se realizó con la ficha oficial de Scopus, de las 44 universidades que tienen escuelas de medicina. Se revisaron manualmente cada una de las publicaciones encontradas buscando filiaciones de organizaciones estudiantiles. Resultados: Durante el periodo las escuelas de medicina peruanas publicaron 3471 artículos en Scopus, de ellos 3398 artículos correspondían a las facultades con licencia y 73 a las universidades con licencia denegada. Durante el periodo estudiado 6 universidades habían publicado más de 100 artículos, todos del grupo de universidades con licencia institucional. Se encontró que las escuelas de medicina con licenciamiento institucional tienen estadísticamente mayor producción científica que las escuelas no licenciadas (p = 0,02). Conclusión: La producción científica realizada por las escuelas de medicina del Perú es escasa en el grupo de universidades no licenciadas y debe ser incentivada por las instituciones de ciencia del país(AU)

Introduction: Universities are the institutions called to lead research for the development of society. In Peru there is a proliferation of medical schools and a large number of enrolled students, however, research in many of them is far from desirable. The objective of the present study was to evaluate the scientific production in the Scopus database of all medical schools through a bibliometric review and its comparison with the degree of licensure by the National Superintendence of Higher University Education of Peru. Methods: A review of the Scopus database was made, looking for papers published between 2016 and 2019 by members of the Peruvian medical schools. The search was performed with the official Scopus file of the 44 universities that have medical schools and each of the publications found was manually reviewed. Results: During the period, Peruvian medical schools published 3471 papers in Scopus, 3398 were from faculties licensed and 73 were from faculties with denied licenses. During the period 6 universities have published more than 100 papers, all from the group of universities with institutional licenses. Was found that medical schools with institutional have statistical higher scientific production than not licensed schools (p = 0,02). Conclusion: The scientific production carried out by the medical schools of Peru is scarce in the group of non-licensed universities and should be encouraged by the country's science institutions(AU)

Factores asociados a la aceptabilidad de la vacuna contra el virus del papiloma humano, Huánuco, Perú / Factors associated with the acceptability of the human papillomavirus vaccine, Huanuco, Peru

INTRODUCCIÓN: El virus del papiloma humano (VPH) produce la infección viral transmitida por vía sexual más frecuente del mundo. Una estrategia para reducir las tasas de infección por este virus es la vacunación a mujeres jóvenes de entre 9 a 13 años, por lo que es imperioso asegurar el máximo grado de aceptabilidad a la vacuna. Objetivo: Determinar el nivel de conocimiento, las actitudes y creencias asociados a la aceptabilidad de la vacuna contra el VPH en los padres de Huánuco. MATERIAL Y MÉTODOS: Estudio transversal analítico en 168 padres. Las asociaciones se evaluaron con la prueba de χ2 con un 95% de confianza, p significativa < 0,05. RESULTADOS: La media de la edad fue 35,08 años. El 27,3% de padres no aceptaba la vacuna. Se encontró relación estadísticamente significativa entre el nivel de conocimiento medio-alto (p = 0,017), actitudes positivas hacia las vacunas (p < 0,001), ausencia de creencias (p < 0,001), religión católica (p = 0,002) y presencia de estudios en el grado de instrucción (p = 0,016) con la aceptabilidad hacia la vacuna. Aquellos padres en los que se evidenciaba la presencia de creencias tenían 6,56 veces más probabilidades de no aceptar la vacuna. CONCLUSIONES: Los factores asociados a la aceptabilidad de la vacuna contra el VPH son el nivel de conocimiento medio-alto, actitudes positivas hacia las vacunas, ausencia de creencias, religión católica y presencia de estudios en el grado de instrucción.

BACKGROUND: Human papillomavirus (HPV) produces the most frequent sexually transmitted viral infection in the world. A strategy to reduce infection rates for this virus is vaccination to young women between 9 and 13 years, so it is imperative to ensure the highest degree of acceptability to the vaccine. AIM: To determine the level of knowledge, attitudes and beliefs associated with the acceptability of the HPV vaccine in the parents of a rural and urban area of ​​the Huanuco. METHODS: Analytical cross-sectional study in 168 parents. The χ2 test was used to assess associations, with 95% confidence, p significant < 0.05. RESULTS: The mean age was 35.08 years, 67% had secondary education and 27.3% of parents did not accept the vaccine. A statistically significant relationship was found between the level of medium-high knowledge (p = 0.017), positive attitudes towards vaccines (p < 0.001), absence of beliefs (p < 0.001), Catholic religion (p = 0.002) and presence of studies in the degree of education (p = 0.016) with the acceptability towards the vaccine. Those parents whose beliefs were evidenced were 6.56 times more likely not to accept the human papillomavirus vaccine. CONCLUSIONS: The factors associated with the acceptability of the human papillomavirus vaccine are the level of knowledge, attitudes, beliefs, religion and the degree of instruction.

Factores asociados al nivel de empatía hacia el paciente en estudiantes de medicina, Perú, 2018 / Factors associated with the level of empathy towards the patient in medical students, Peru, 2018

RESUMEN Introducción: La empatía es el entendimiento adecuado del paciente, es considerada el eje central de la relación médico-paciente y es un componente vital para la atención en salud de alta calidad. Objetivo: Determinar los niveles de empatía hacia el paciente y su asociación con la funcionalidad familiar, estrés, rendimiento académico y factores sociodemográficos y académicos de los estudiantes de Medicina. Material y Métodos: Estudio observacional, transversal analítico. Se trabajó con todos los estudiantes de medicina (130), matriculados entre 3ro a 6to año, que cumplieron criterios de inclusión y exclusión. Las variables independientes fueron funcionalidad familiar, estrés y rendimiento académico. Se aplicó un cuestionario y la Escala de Empatía Médica de Jefferson versión S. En el análisis, se empleó la prueba de Shapiro-Wilk para evaluar la normalidad, se utilizaron estadísticos no paramétricos. Se consideró significancia estadística p<0,05. Resultados: La media de empatía global fue de 106,08 ± 18,29 puntos. Se encontraron diferencias estadísticamente significativas entre la media de empatía global con el sexo (p=0,03), el año de estudios (p=0,00), y la funcionalidad familiar (p=0,04). Conclusiones: El nivel de funcionamiento familiar está asociado con la empatía. Además, se encontró que las mujeres resultaron más empáticas y el mayor año académico estuvo asociado a una menor empatía hacia el paciente.

ABSTRACT Introduction: Empathy is the adequate understanding towards the patient; it is considered the central axis of the doctor-patient relationship and is a vital component for high-quality health care. Objective: To determine the levels of empathy towards the patient and their association with family functionality, stress, academic performance and sociodemographic and academic factors of medical students. Material and Methods: An observational, descriptive cross-sectional study was conducted. The study population included 130 medical students (between 3rd-year and 6-th year) who fulfilled the inclusion and exclusion criteria. The independent variables were family functionality, stress and academic performance. A questionnaire and the Jefferson Scale of Empathy Version S were applied. For the analysis, the Shapiro-Wilk test was used for testing the assumption of normality, the Student t Test and Anova test were used to establish the relationship between variables. Statistical significance of p <0.05 was considered. Results: The average global empathy was 106.08 ± 18.29 points. Statistically significant differences were found between global empathy and sex (p = 0.03), year of studies (p = 0.00), and family functionality (p = 0.04). Conclusions: The level of family functioning is associated with empathy. Moreover, it was also found that women were more empathic than men and higher academic years were associated with a lower level of empathy towards the patient.

Factores asociados a la depresión en estudiantes de medicina de una universidad peruana / Factors associated with depression in medical students from a peruvian university

Introducción: La depresión es un trastorno del estado de ánimo crónico o recurrente que afecta la habilidad para enfrentarse a la vida cotidiana. Los estudiantes de medicina humana están expuestos a diversos factores propios de los estudiantes y su entorno, que los predisponen a sufrir enfermedades emocionales o psicológicas. Objetivo: Determinar la asociación entre el estrés académico, la calidad de sueño, la funcionalidad, los factores sociodemográficos y la depresión, en los estudiantes de medicina humana de la Universidad Hermilio Valdizán de Huánuco en 2018. Métodos: Se realizó un estudio descriptivo transversal, con muestreo no probabilístico. La muestra estuvo constituida por 179 estudiantes, que cumplieron los criterios de selección. Para la encuesta se usó una ficha de recolección conformada por los datos sociodemográficos edad, sexo, año de estudio, procedencia, trabajo y grupo familiar; el Inventario de depresión de Beck; el Índice de calidad de sueño de Pittsburg; el test de Funcionamiento Familiar (FF-SIL); y el inventario SISCO del estrés académico. Resultados: De los estudiantes, 59 (32,97 por ciento) tuvieron depresión y, entre ellos, 40 (22,35 por ciento) depresión leve. La calidad de sueño (p = 0,001), la funcionalidad familiar (p = 0,001) y el año de estudio (p = 0,003) se asociaron estadísticamente con la depresión. No se halló una relación significativa entre estrés académico y depresión (p = 0,428). Además, pertenecer al sexo femenino presentó un factor de riesgo de 1,03 veces más para tener depresión y la asociación no fue significativa (p = 0,752). Conclusiones: Se observó que presentar una mala calidad de sueño, tener una familia disfuncional y estar en los primeros años de la carrera, influyó en la depresión de los estudiantes; por lo tanto, se requiere crear estrategias de detección y medidas de protección(AU)

Introduction: Depression is a chronic or recurrent mood disorder that affects the ability to cope with everyday life. Students of human medicine are exposed to various factors specific to students and their setting, which predispose them to suffer emotional or psychological conditions. Objective: To determine the association between academic stress, sleep quality, functionality, sociodemographic factors, and depression in students from the first to the fifth academic years of human medicine at Hermilio Valdizán University of Huánuco in 2018. Methods: A descriptive and cross-sectional study was carried out, using non-probability sampling. The sample consisted of 179 students who met the selection criteria. For the survey, a collection form was used, made up of the following sociodemographic data: age, sex, academic year, origin, work, and family group. We also used the Beck Depression Inventory, the Pittsburgh Sleep Quality Index, the Family Functioning Perception Test (FF-SIL), and the SISCO inventory of academic stress. Results: Of the students, 59 (32.97 percent) had depression and, among them, 40 (22.35 percent) mild depression. Sleep quality (p=0.001), family functionality (p=0.001), and academic year of study (p=0.003) were statistically associated with depression. No significant relationship was found between academic stress and depression (p=0.428). In addition, belonging to the female sex represented a risk factor of having 1.03 times more depression, while the association was not significant (p=0.752). Conclusions: We observed that presenting poor sleep quality, having a dysfunctional family, and being in the first academic years of the major influence student depression; therefore, it is required to create detection strategies and protection measures(AU)

Anemia severa en adulto joven con infección por uncinarias / Severe anemia in a young adult with hookworm infection

La uncinariasis, anquilostomiasis o también conocida como anemia tropical, es una parasitosis intestinal de gran importancia mundial. Las uncinarias son parásitos nematodos transmitidas por el contacto de la piel con suelos contaminados. Una de las consecuencias más importantes de la infección masiva por estos parásitos es el sangrado intestinal crónico que conduce a disminución de la hemoglobina, y en casos inusuales, esta anemia puede llegar a ser severa. Con el objetivo de poner en discusión la importancia y morbilidad de esta enfermedad, presentamos el caso de un varón de 23 años, procedente de una zona tropical del Perú, quien ingresa por emergencia con un valor de hemoglobina de 2,3 mg/dL, alteración del nivel de conciencia e historia de rectorragia. Durante el proceso diagnóstico se encuentra en la colonoscopia múltiples parásitos con áreas de sangrado y colitis erosiva, mientras que en el examen parasitológico se observan huevos de Ancylostoma/Necator spp 2+. La sintomatología mejora posterior al tratamiento con albendazol. La uncinariasis debe siempre sospecharse en el proceso diagnóstico de pacientes con anemia crónica tanto en Perú como en zonas tropicales del mundo.(AU)

Uncinariasis or ancylostomiasis, a.k.a. tropical anemia, is an intestinal parasitosis of great importance worldwide. Hookworms are parasitic nematodes transmitted by skin contact with contaminated soils. One of the most important consequences of massive infection by these parasites is chronic intestinal bleeding, which leads to reduced hemoglobin. In unusual cases the resulting anemia may be severe. With the purpose of discussing the importance and morbidity of this disease, a case is presented of a male 23-year-old patient from a tropical area in Peru who was admitted for an emergency hemoglobin value of 2.3 mg/dL, altered mental status and a history of rectal bleeding. During diagnostic examination, colonoscopy revealed multiple parasites with bleeding areas and erosive colitis, whereas parasitological analysis found eggs of Ancylostoma/Necator spp 2+. Symptoms improved after treatment with albendazole. Uncinariasis should always be suspected in the process of diagnosis of patients with chronic anemia both in Peru and in tropical areas worldwide(AU)

Predictores clínicos de tuberculosis multidrogorresistente en pacientes con tuberculosis pulmonar en Huánuco, Perú. 2010-2015 / Predictor Factors For Multidrug-Resistant Tuberculosis Among Patients With Pulmonary Tuberculosis In Huánuco, Peru. 2010-2015

Introducción: En la ciudad de Huánuco se observa un crecimiento progresivo de casos de tuberculosis y cada vez más frecuente la tuberculosis multidrogorresistente, por esta razón fue necesario identificar factores predictores para desarrollar tuberculosis multidrogorresistente. Objetivo: Determinar si la fiebre persistente, el patrón radiográfico cavitario y la baciloscopía positiva al primer mes de tratamiento son predictores de tuberculosis multidrogorresistente en pacientes con tuberculosis Pulmonar en cuatro establecimientos de salud de la ciudad de Huánuco, entre enero 2010 y diciembre 2015. Métodos:Estudio observacional, casos y controles. Se consideraron 37 casos y 111 controles. Los datos se recolectaron de las historias clínicas. Resultados: Los factores predictores encontrados en el análisis bivariado fueron la persistencia de la fiebre a las dos semanas (p=0,001; OR 0,05; IC 0,01-0,5), el patrón radiográfico cavitario (p=0,000; OR 11,6; IC 4,6­26,5), y la positividad de la baciloscopía al primer mes de tratamiento (p=0,00; OR 13,5; IC 4,1-44,6 al 95%). Estas fueron confirmadas con el análisis multivariado (p=0,08; p=0,002; p=0,00 respectivamente). Conclusión: La persistencia de la fiebre a las dos semanas, el patrón radiográfico cavitario y la baciloscopía positiva al primer mes de tratamiento mostraron asociación predictiva en forma independiente para el diagnóstico de tuberculosis multidrogorresistente.

Introduction: In the city of Huánuco and around the world, there is a progressive increase in cases of tuberculosis and multidrug-resistant tuberculosis, for this reason it was necessary to identify predictors to develop multidrug-resistant tuberculosis. Objective: To determine if persistent fever, cavitary radiographic pattern and positive smear microscopy at the first month of treatment, are predictors of multidrug-resistant tuberculosis in patients with pulmonary tuberculosis, in four health facilities in the city of Huánuco, between January 2010 and December 2015. Methods: Case and control study. We considered 37 cases and 111 controls. Data were collected from medical records. Results: The predictive factors found in the bivariate analysis were persistence of fever at 2 weeks (p = 0.001, OR 0.05, CI 0.01-0.5), cavitary radiographic pattern (p = 0.000, OR 11.6, 95%IC 4.6-26.5), and smear microscopy positivity at the first month of treatment (p = 0.00, OR 13.5, 95%CI 4.1-44.6). These were confirmed by multivariate analysis (p = 0.012, p = 0.00, p = 0.00 respectively). Conclusion: The persistence of fever at two weeks, cavitary radiographic pattern and positive smear microscopy at the first month of treatment were predictive factors associated independently for the diagnosis of multidrug-resistant Tuberculosis.