Oligosymptomatic diphtheria infection in adults: two contacts of the Peruvian index case after 20 years without disease report.

In Peru, diphtheria infection was eradicated in the last two decades. However, recently, diphtheria pharyngeal infection was confirmed and reported in a 5-year-old boy (index case). We report two more cases of this outbreak (in the index case parents) with confirmed diphtheria infection and tox gene identified by molecular assay, who were in close contact with the index case and never presented any symptoms. Both parents had a congestive pharynx with erythematous plaques at the back of it. In adults, diphtheria infection can be oligosymptomatic or mimic viral pharyngitis, which could lead to misdiagnosis and, furthermore, an increased risk of transmission in regions with lower immunization rates.

Diagnóstico de carcinoma urotelial durante estudio de bacteremia por Streptococcus gordonii / Diagnosis of uroepithelial carcinoma during bacteremia by Streptococcus gordonii

Resumen La bacteremia por Streptococcus gordonii es infrecuente. Su aislamiento en hemocultivo traduce alta significancia clínica y debe dirigir el abordaje diagnóstico hacia la búsqueda de entidades subyacentes como neoplasias hematológicas, cardiopatías valvulares, neumonía, alteraciones estructurales de cabeza y cuello, inmunosupresión, y otras condiciones asociadas. No se han identificado reportes en pacientes con neoplasia de vías urinarias como posible condicionante de bacteremia por este agente. Se describe el caso de un paciente que, durante el estudio de bacteremia por este microorganismo, fue diagnosticado de carcinoma urotelial de alto grado.

Abstract Streptococcus gordonii bacteremia is rare. Its isolation in blood culture translates into high clinical significance and the diagnostic approach should be directed towards the search for underlying entities such as hematologic malignancies, valvular heart disease, pneumonia, structural changes of the head and neck, immunosuppression and other related conditions. No reports have been identified in patients with urinary tract neoplasia as a possible condition of bacteremia by this agent. The case of a patient who was diagnosed with high-grade urothelial carcinoma during the study of bacteremia by this microorganism is described.

Lateral amyotrophic sclerosis-like onset after combined antiretroviral treatment initiation.

Motor neuron disease (MND) have an incidence of 2 in 100 000 persons, resulting in the death of 1 in every 500 people affected. The most common disease in MND spectrum is amyotrophic lateral sclerosis (ALS). We describe the case of an ALS-like syndrome in a HIV patient. This case report presents a 38 years old male from Peru with HIV who after 2 months of combined antiretroviral treatment (cART) initiation was admitted to the hospital for spastic paraplegia. On his first admission, rapid plasma reagent (RPR) was positive and he was treated for neurosyphilis and discharged. Nevertheless, one month after, he was admitted for the second time because paraplegia persisted. Laboratory tests, electromyography and imaging were performed, and ALS was diagnosed. Normally, HIV treated patient with ALS tend to have a better prognosis, however this was not the case. In this case report, we discuss possible association between ALS and immune reconstitution inflammatory syndrome in HIV patients.

Hospital-acquired SARS-CoV-2 pneumonia in a person living with HIV.

We report the case of a 38 year-old man living with well-controlled HIV on antiretroviral therapy who developed cerebellar symptoms and was admitted to hospital for management of an intraventricular cryptococcoma. During his hospital stay he contracted SARS CoV-2 infection within the hospital setting with a fatal outcome.

Acute toxoplasmosis complicated with myopericarditis and possible encephalitis in an immunocompetent patient.

We document a case of a 34-year-old man with no medical previous history, presenting with lymphoproliferative syndrome associated to Toxoplasma gondii infection complicated with myopericarditis and possible encephalitis, whose diagnosis was made with lymph node biopsy, cardiac imaging, serology compatible with acute toxoplasmosis and clinical response after treatment.

Factors associated with consumption of fruits and vegetables among Community Kitchens customers in Lima, Peru.

Community Kitchens (CKs) are one of the main food providers to low-income families in Peru and may encourage healthier diets. We aimed to determine the prevalence of fruit and vegetable consumption and associated sociodemographic and behavioral factors among CKs customers. A cross-sectional study enrolling customers of 48 CKs in two areas of Lima, Peru, was performed. The self-reported amount of fruits and vegetables consumed (< 5 vs. ≥ 5 servings/day) was the outcome. The exposures were grouped in sociodemographic variables (i.e. age, gender, education level, etc.), and self-reported intention to change eating- and exercise-related habits in the last four weeks just prior to the interview. Prevalence ratios (PR) were estimated using Poisson regression. Data from 422 subjects were analyzed, 328 females (77.9%), mean age 43.7 (± 14.5) years. Only 36 (8.5%; 95% CI 5.9%-11.2%) customers reported consuming ≥ 5 servings of fruits and vegetables daily. This pattern was 4-fold more likely among those with higher levels of education (≥ 12 vs. < 7 years), and 64% less common for migrants relative to non-migrants. In terms of intentions to change habits, those who reported having tried to reduce sugar consumption or to eat more fruits were up to 90% more likely to meet the ≥ 5 servings/day target. A substantial gap in the consumption of ≥ 5 servings of fruits and vegetables/day was found among CKs customers that does not appear to be dependent on familial income. The profiles reported in this study can inform appropriate strategies to increase healthier eating in this population.

Gender Associated with the Intention to Choose a Medical Specialty in Medical Students: A Cross-Sectional Study in 11 Countries in Latin America.

INTRODUCTION: The selection of a medical specialty has been associated with multiple factors, such as personal preferences, academic exposure, motivational factors and sociodemographic factors, such as gender. The number of women in the medical field has increased in recent years. In Latin America, we have not found any studies that explore this relationship. OBJECTIVE: To determine whether there is an association between gender and the intention to choose a medical specialty in medical students from 11 countries in Latin America. METHODS: Secondary analysis of the Collaborative Working Group for the Research of Human Resources for Health (Red-LIRHUS) data; a multi-country project of students in their first year and fifth year of study, from 63 medical schools in 11 Latin American countries. All students who referred intention to choose a certain medical specialty were considered as participants. RESULTS: Of the 11073 surveyed students, 9235 indicated the name of a specific specialty. The specialties chosen most often in the fifth year were General Surgery (13.0%), Pediatrics (11.0%), Internal Medicine (10.3%) and Obstetrics/Gynecology (9.0%). For women, the top choices were Pediatrics (15.8%), Obstetrics/Gynecology (11.0%), Cardiology (8.7%), General Surgery (8.6%), and Oncology (6.4%). In the adjusted analysis, the female gender was associated with the choice of Obstetrics/Gynecology (RP: 2.75; IC95%: 2.24-3.39); Pediatric Surgery (RP: 2.19; IC95%: 1.19-4.00), Dermatology (RP: 1.91; IC95%:1.24-2.93), Pediatrics (RP: 1.83; IC95%: 1.56-2.17), and Oncology (RP: 1.37; IC95%: 1.10-1.71). CONCLUSIONS: There is an association between the female gender and the intention to choose Obstetrics/Gynecology, Pediatrics, Pediatric Surgery, Dermatology, and Oncology. We recommend conducting studies that consider other factors that can influence the choice of a medical specialty.

[Overlap of irritable bowel syndrome and functional dyspepsia based on Rome III criteria in medical students from a private university in Lima, Peru]. / Superposición del síndrome de intestino irritable y dispepsia funcional basados en criterios ROMA III en estudiantes de medicina de una universidad privada de Lima, Perú.

AIMS: To determine the prevalence of irritable bowel syndrome and functional dyspepsia in medical students from a private university in Lima, Peru. Furthermore, to determine the associated factors with these diseases. MATERIAL AND METHODS: Observational descriptive and retrospective cross sectional study. Medical students from a private university in Lima were surveyed using a Rome III questionnaire for functional disorders and the STEPwise auto survey for defining the variables of alcohol and tobacco. For data analysis the Stata 11.0 program was used. RESULTS: Of the 608 students, 543 answered the questionnaire. The prevalence of Irritable Bowel Syndrome was 12.4%, 16.9% of dyspepsia, and of both diseases simultaneously, a prevalence of 7.1% was found. Alcohol consumption in the total population was 89.4% and 29.0% of tobacco. Association between both disorders was found (OR 10.47, 95% CI 5.08 to 21.55; p < 0.001), dyspepsia was associated with sex (OR: 0.16, 95% CI 0.07 to 0.36 p < 0.001), with alcohol consumption (OR: 5.22, 95% CI 23.99 1,13- p = 0.034) and with irritable bowel syndrome (OR: 9.88, 95% CI 4.78 to 20.46 p <0.001). Both conditions together were associated with sex (OR: 0.20, 95% CI from 0.06 to 0.60 p = 0.004) and daily consumption of tobacco (OR: 3.23, 95% CI 1.17 to 8.89 p = 0.023). CONCLUSION: A prevalence of 12.4% of Irritable Bowel Syndrome and 16.9% of dyspepsia was determined. An overlap of 7.1% of these diseases was reported.

Superposición del síndrome de intestino irritable y dispepsia funcional basados en criterios ROMA III en estudiantes de medicina de una universidad privada de Lima, Perú / Overlap of irritable bowel syndrome and functional dyspepsia based on Rome III criteria in medical students from a private university in Lima, Peru

Determinar la prevalencia de síndrome de intestino irritable y dispepsia funcional en estudiantes de medicina de una universidad privada en Lima, Perú. Asimismo, determinar los factores asociados a estas patologías. Material y métodos: Estudio de corte transversal observacional, descriptivo, retrospectivo. Se encuestó estudiantes de medicina de una universidad privada en Lima usando un cuestionario auto aplicado para trastornos funcionales Roma III y el cuestionario auto aplicado STEPwise para la definición de variables de consumo de alcohol y tabaco. Para el análisis de datos se usó el programa Stata 11.0. Resultados: De los 608 estudiantes, 543 respondieron el cuestionario. Se encontró una prevalencia de Síndrome de Intestino Irritable del 12,4%, de dispepsia del 16,9% y de ambas patologías simultáneamente, una prevalencia de 7,1%. El consumo de alcohol en la población total fue del 89,4% y de 29,0% de tabaco. Se encontró asociación entre ambas alteraciones (OR: 10,47, IC95% 5,08-21,55; p<0,001), dispepsia se asoció con sexo (OR: 0,16, IC95% 0,07-0,36 p<0,001), con consumo de alcohol (OR: 5,22, IC95% 1,13- 23,99 p=0,034) y con síndrome de intestino irritable (OR: 9,88, IC95% 4,78-20,46 p<0,001). Ambos trastornos en conjunto se asociaron con sexo (OR: 0,20, IC95% 0,06-0,60 p=0,004) y consumo diario de tabaco (OR: 3,23, IC95% 1,17-8,89 p=0,023). Conclusión: Se determinó una prevalencia de 12,4% de Síndrome de Intestino Irritable y 16,9% de dispepsia. Se reportó una superposición de estas patologías en 7,1%...

To determine the prevalence of irritable bowel syndrome and functional dyspepsia in medical students from a private university in Lima, Peru. Furthermore, to determine the associated factors with these diseases. Material and methods: Observational descriptive and retrospective cross sectional study. Medical students from a private university in Lima were surveyed using a Rome III questionnaire for functional disorders and the STEPwise auto survey for defining the variables of alcohol and tobacco. For data analysis the Stata 11.0 program was used. Results: Of the 608 students, 543 answered the questionnaire. The prevalence of Irritable Bowel Syndrome was 12.4%, 16.9% of dyspepsia, and of both diseases simultaneously, a prevalence of 7.1% was found. Alcohol consumption in the total population was 89.4% and 29.0% of tobacco. Association between both disorders was found (OR 10.47, 95% CI 5.08 to 21.55; p <0.001), dyspepsia was associated with sex (OR: 0.16, 95% CI 0.07 to 0.36 p <0.001), with alcohol consumption (OR: 5.22, 95% CI 23.99 1,13- p = 0.034) and with irritable bowel syndrome (OR: 9.88, 95% CI 4.78 to 20.46 p <0.001). Both conditions together were associated with sex (OR: 0.20, 95% CI from 0.06 to 0.60 p = 0.004) and daily consumption of tobacco (OR: 3.23, 95% CI 1.17 to 8.89 p = 0.023). Conclusion: A prevalence of 12.4% of Irritable Bowel Syndrome and 16.9% of dyspepsia was determined. An overlap of 7.1% of these diseases was reported...