Los exámenes de ayuda diagnóstica y los conflictos de interés en nuestros hospitales: ¿Corrupción enmascarada?

Introducción: En los hospitales públicos, las dificultades surgidas por el déficit de recursos logísticos en el laboratorio clínico, dificultan aún más una atención de calidad. La carencia de una gestión por procesos y los conflictos de interés surgidos por la proliferación de laboratorios no certificados ni acreditados, hacen necesaria una nueva visión sobre este tema. La Medicina del Laboratorio Basado en la Evidencia, es una herramienta de la cual clínicos, tecnólogos y biólogos pueden beneficiarse. Por otro lado, es necesario que, a partir del estado, se consensuen los esfuerzos realizados por los distintos actores de este problema: UNAGESP, IETSI, SIS, INACAL, SUSALUD, Defensoría del Pueblo, Contraloría General de la República, Colegios profesionales y Empresa privada para mejorar la gestión del laboratorio clínico.

Background: In public hospitals, the difficulties arising from the lack of logistical resources in the clinical laboratory make quality care even more difficult. The lack of management by processes and the conflicts of interest arising from the proliferation of laboratories that are not certified or accredited make a new vision on this subject necessary. Evidence-Based Laboratory Medicine is a tool from which clinicians, technologists and biologists can benefit. On the other hand, it is necessary that, from the state, the efforts made by the UNAGESP, IETSI, SIS, INACAL, SUSALUD, the Ombudsman's Office, the Comptroller General's Office of the Republic, professional associations and private companies to improve the management of the clinical laboratory be agreed upon.

Detección de Patotipos de Cepas de Escherichia coli Causantes de Diarrea Infantil de Establecimientos de Salud de la Región Lambayeque-Perú, 2018 / Detection of Patotypes of Escherichia coli Strains Causing Childhood Diarrhea in Health Establishments of the Lambayeque-Peru Region, 2018

Objetivo: Identificar patotipos de genes de virulencia de Escherichia coli de muestras diarreicas de niños menores de cinco años de la Región Lambayeque, en el periodo abril­setiembre 2018. El estudio: Estudio descriptivo y transversal. Se analizaron 75 cepas de E. coli de muestras diarreogénicas usando PCR Multiplex en tiempo real y primers para genes de patotipos de E. coli: daaD, aggR, eaeA, stx, ipaH y st. Hallazgos: Se detectó 34,66 % (26/75) de genes de virulencia del total de cepas aisladas. El patotipo de E. coli Enterotoxigénica presentó mayor frecuencia, 18,67% (14/75) del total de cepas aisladas. También se detectó que el patotipo E. coli Enterotoxigénica se presentó en 53,86% (14/26) del total de cepas positivas. También en un 11,54% de cepas positivas (3/26) presentaron más de un patotipo. Conclusión: La epidemiologia molecular ayudará a un mejor diagnóstico adecuado y oportuno de las diarreas infantiles en esta población vulnerable.

Objetive. To identify pathotypes of virulence genes of Escherichia coli from diarrheal samples of children under five years of age in the Lambayeque Region, in the period April-September 2018. The study: Descriptive and cross-sectional study. 75 E. coli strains from diarrheogenic samples were analyzed using realtime Multiplex PCR and primers for E. coli pathotype genes: daaD, aggR, eaeA, stx, ipaH and st. Findings: 34.66% (26/75) of virulence genes were detected from the total isolates. The enterotoxigenic E. coli pathotype presented the highest frequency, 18.67% (14/75) of the total isolates. It was also detected that the enterotoxigenic E. coli pathotype appeared in 53.86% (14/26) of the total positive strains. Also, in 11.54% of positive strains (3/26) they presented more than one pathotype. Conclusion: Molecular epidemiology will help a better, adequate and timely diagnosis of childhood diarrhea in this vulnerable population

Dignidad y Dignidad Póstuma: Respeto al Paciente y al Fallecido / Dignity and Posthumous Dignity: Respect for the Patient and the Deceased

Objetivo. La pandemia del COVID-19 ha causado revuelo en los diferentes sistemas sanitarios, económicos y socioculturales de todo el mundo, esto debido a sus características tan suigéneris que la comparan con otras grandes pandemias. El Perú no es ajeno a estas circunstancias que desestabilizan y alteran la tranquilidad y nos confrontan con diferentes dilemas éticos. La dignidad de la persona intrínseca a su condición humana, y que constituye la base de la ética, durante los tiempos de crisis como el que se viene atravesando se vuelve más vulnerable, viéndose esto claramente reflejado en el trato que se les da a los pacientes, olvidando que son personas dignas de respeto en todo momento y que este respeto trasciende a todos los datos y exámenes que le pertenecen, incluyendo a su cuerpo inerte en el caso de fallecimiento.

Objetive. The COVID-19 pandemic has caused a stir in the different system: health, economic and sociocultural around the world, this due to its characteristics so unique that they compare it to other great pandemics. Peru is no stranger to these circumstances that destabilize and alter tranquility and confront us with different ethical dilemmas. The dignity of the person intrinsic to his human condition, and which constitutes the basis of ethics, during times of crisis such as the one he is going through becomes more vulnerable, this being clearly reflected in the treatment given to patients , forgetting that they are people worthy of respect at all times and that this respect transcends all the data and examinations that belong to them, including their inert body in the event of death.

Seroprevalence of toxoplasmosis in pregnant women and its associated factors among hospital and community populations in Lambayeque, Peru.

INTRODUCTION: Toxoplasmosis is a zoonosis caused by Toxoplasma gondii. This study investigated the prevalence and factors associated with toxoplasmosis among pregnant women. METHODS: We followed an analytical observational study. From July 2016 to June 2017, 218 pregnant women were selected. The infection was detected through serological dosage of anti-T.gondii Immunoglobulin(Ig) M and IgG antibodies. RESULTS: The seroprevalence was 35.8%; the factors associated with infection were consumption of non-drinking water, residence in an urban area, and threatened abortion during the current pregnancy. CONCLUSIONS: The seroprevalence of toxoplasmosis among pregnant women is high. The risk factors are dependent on environmental determinants.

Seroprevalence of toxoplasmosis in pregnant women and its associated factors among hospital and community populations in Lambayeque, Peru

Abstract INTRODUCTION Toxoplasmosis is a zoonosis caused by Toxoplasma gondii. This study investigated the prevalence and factors associated with toxoplasmosis among pregnant women. METHODS We followed an analytical observational study. From July 2016 to June 2017, 218 pregnant women were selected. The infection was detected through serological dosage of anti-T.gondii Immunoglobulin(Ig) M and IgG antibodies. RESULTS The seroprevalence was 35.8%; the factors associated with infection were consumption of non-drinking water, residence in an urban area, and threatened abortion during the current pregnancy. CONCLUSIONS The seroprevalence of toxoplasmosis among pregnant women is high. The risk factors are dependent on environmental determinants.

Genes de virulencia de Escherichia coli detectados en muestras diarreicas de niños de la Región Lambayeque - Perú / Escherichia coli virulence genes detected in diarrheal samples of children from the Lambayeque region - Peru

Objetivo: Detectar genes asociados a factores de virulencia de Escherichia coli aisladas de muestras diarreicas de niños menores de cinco años con el empleo de PCR Multiplex. Materiales y métodos: Se realizó un trabajo descriptivo, transversal, de una sola cohorte de muestras diarreicas de niños menores de cinco años colectadas desde enero 2014 a marzo 2015. Se usaron primers específicos para genes de los seis patotipos causantes de diarreas infantiles: gen daaD (Escherichia coli difusamente adherente - DAEC), gen aggR (Escherichia coli enteroagregativa - EAEC), gen eaeA(Escherichia coli enteropatógena - EPEC), gen stx (Escherichia coli productora de toxina Shiga - STEC), gen ipaH (Escherichia coli enteroinvasiva - EIEC)y gen st (Escherichia coli enterotoxigénica - ETEC). Resultados: Se aislaron 106 cepas de Escherichia coli en las que se encontraron genes de virulencia analizados en el 37,74 % (40/106) de las mismas. El grupo etario más afectado con la presencia de estos genes fue el comprendido entre 1-2 años (48,6 %). Conclusiones: El gen daaD del patotipo DAEC presentó la mayor distribución en un 16,98 %; así mismo la detección de los genes de virulencia específicos podría ayudar a tratar de manera adecuada y oportuna un episodio de diarrea aguda infantil

Objective: This study aimed to detect, by multiplex PCR, genes associated with virulence factors of Escherichia coli de isolated from diarrheal samples of children under 5 years of age. Materials and methods: A descriptive, cross-sectional, single-cohort study, in which diarrheal samples from children under five years of age collected from January 2014 to March 2015 were analyzed. Specific primers for detecting the genes of the six pathotypes that cause childhood diarrhea were used: daaD gene (diffusely adherent Escherichia coli - DAEC), aggR gene (Enteroaggregative Escherichia coli - EAEC), eaeA gene (enteropathogenic Escherichia coli - EPEC), stx gene (Shiga toxin-producing Escherichia coli - STEC), ipaH gene (Enteroinvasive Escherichia coli - EIEC) and st gene (Enterotoxigenic Escherichia coli - ETEC). Results: Virulence genes were found in 37.74 % ( 40/106) of the 106 Escherichia coli isolated strains. The 1-to 2-year-old age group was the most affected with these genes (48.6 %). Conclusions: The daaD gene of the DAEC pathotype showed the greatest distribution (16.98 %). The detection of specific virulence genes could help to treat an episode of acute childhood diarrhea in an appropriate and timely manner