Impact of the COVID-19 pandemic on the services provided by the Peruvian health system: an analysis of people with chronic diseases.

During the pandemic, many individuals with chronic or infectious diseases other than COVID-19 were unable to receive the care they needed due to the high demand for respiratory care. Our study aims to assess the impact of the COVID-19 pandemic on services provided to people with chronic diseases in Peru from 2016 to 2022. We performed a secondary database analysis of data registered by the comprehensive health insurance (SIS), the intangible solidarity health fund (FISSAL), and private healthcare institutions (EPS), using interrupted time series analysis. Our study identified 21,281,128 individual users who received care. The pooled analysis revealed an average decrease of 1,782,446 in the number of users receiving care in the first month of the pandemic compared with the expected values for that month based on pre-pandemic measurements. In addition, during the pandemic months, there was an average increase of 57,911 in the number of new additional single users who received care per month compared with the previous month. According to the time-series analysis of users receiving care per month based on each chronic disease group, the most significant decreases included people with diabetes without complications and chronic lung disease.

Derrame pleural fetal: drenaje tóraco-amniótico mediante ultrasonido / Fetal pleural effusion: thoraco–amniotic derivation by ultrasound

El concepto de la terapia invasiva fetal guiada por ecografía para corrección de defectos congénitos y adquiridos ha cambiado de lo teórico a lo práctico. Por esta razón, se disminuye la morbi-mortalidad perinatal. Presentamos un caso de diagnóstico prenatal de hidrotórax + hipoplasia pulmonar fetal de una gestante de 33 semanas. La paciente es transferida del Seguro Campesino al Hospital Teodoro Maldonado Carbo. Se realizan exámenes y rastreo ecográfico revelando embarazo de +/- 31 semanas de gestación + derrame pleural fetal izquierdo + polihidramnios. Se realiza con éxito drenaje del hidrotórax, mediante punción transabdominal. Luego de realizar cesárea segmentaria se obtiene producto único vivo, pretérmino, sexo femenino.

The concept of ultrasound-guided invasive fetal therapy for correction of acquired and congenital defects has moved from the theory to a routine application. In this condition, it appears to be effective in reducing both mortality and morbidity. We report the case of prenatal diagnosis of hydrothorax + fetal lung hypoplasia in a 33 weeks pregnant woman, who was admitted at Teodoro Maldonado Carbo Hospital. Ultrasound controls were performed assesing the presence of a +/- 31 pregnancy weeks + left fetal pleural effusion + polyhydramnios. Hydrothorax drainage was successfully realized with transabdominal punction. After segmentary c-section, we obtained a unique, preterm, female product.