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OBJECTIVE: The objectives of the study are to describe sleep habits, fatigue, and sleepiness in Chiclayo's (Peru) bus drivers and explore their relation with traffic accidents. MATERIAL AND METHODS: This is a descriptive cross-sectional study with a non-probability consecutive sampling. The sample size was 126 drivers. Sleepiness was evaluated using the Epworth Sleepiness Scale and sleep hygiene with validated questionnaires. We used a history of traffic accident or a near-traffic accident as an independent variable and applied chi-squared, t, and Mann-Whitney U tests to evaluate initial associations, which were later tested with a multivariate analysis. RESULTS: The mean age was 47.8 ± 9, 7 years, all were male. Twenty-seven (21%) bus drivers drove 10 or more hours per day; twenty-seven (21%) drove 5 or more hours without stopping; and eleven (9%) slept less than 6 h per day. Ninety-three (74%) drivers had fatigue while driving; thirty-one (25%) sleepiness; thirty-six (29%) had an accident or near accident; and (35%) had nodding while driving. Nodding while driving (PR 2.13, IC 1.26-3.59, p < 0.01) and the number of years as a driver (PR 1.03, IC 1.00-1.05, p = 0.02) were associated with an accident or near accident. CONCLUSION: Fatigue, sleepiness, and a history of accident or near accident were frequent. Having had an accident or near accident was significantly associated with nodding while driving and the number of years as a driver in Chiclayo's bus drivers.
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Condução de Veículo/psicologia , Condução de Veículo/estatística & dados numéricos , Fadiga/epidemiologia , Fadiga/psicologia , Hábitos , Sono , Acidentes de Trânsito/psicologia , Acidentes de Trânsito/estatística & dados numéricos , Estudos Transversais , Humanos , Masculino , Pessoa de Meia-Idade , Peru/epidemiologia , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Nonalcoholic fatty liver disease (NAFLD) is a high prevalent disease associated with the metabolic syndrome. It is unknown whether general practitioners have an appropriate diagnostic and therapeutic approach to this pathology. OBJECTIVE: To determine the level of knowledge on NAFLD of general practitioners of two districts of the province of Chiclayo during 2012. MATERIAL AND METHODS: Cross sectional design; 60 practitioners were selected and interviewed by a non-probabilistic consecutive sampling, using a validated instrument of 13 questions. Data were processed using SPSS v15. RESULTS: Only in 45% of the general practitioners a sufficient knowledge was found. No association was found between the level of knowledge with the university of origin, the number of years of graduated nor the antecedent of previously had diagnosed at least one case of NAFLD. CONCLUSIONS: The level of knowledge in NAFLD in the general practitioners interviewed from Chiclayo was insufficient.
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Competência Clínica , Clínicos Gerais , Hepatopatia Gordurosa não Alcoólica , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Peru , Inquéritos e QuestionáriosRESUMO
Objectives: To describe sociodemographic characteristics and health-related data in persons deprived of liberty (PDL) from South America in the last five years. Methods: Documentary descriptive study. Results: There are 1.5 million PDL in Latin America and the Caribbean; the average overcrowding is 64%; 58% do not sleep in beds, 20% do not have access to clean water and 29% do not receive medical care. In Peru, during 2021, there were 87,245 PDL and 69 penal institutions. The national average overcrowding is 120%, the second-highest in South America. In South America, the prevalence of tuberculosis is 2.0% SD = 0.64 and the median of illegal substances prevalence is 34.6 (IQR = 7.5-41.4). In Peru, the prevalence of tuberculosis has decreased since 2016 (4.3%), 2018(3.5%), and 2021(2.5%). Among the health problems by country, there were more data on substance use: 8/10, and tuberculosis, 7/10 countries. Cardiovascular diseases had the least available data. Regarding COVID-19, during the first wave in Peru, 54% of the total PPL were infected, and by the end of the wave, 446 PDL and 46 members of the prison staff had died. In Colombia, between April and October 2020, there were 16,804 cases (80 in ICU) and 136 deaths. In Brazil, up to March 2021, 340 people had died, and there were over 67,000 infections. Conclusions: Overcrowding is an unresolved problem; tuberculosis and substance use are the most frequent issues. Data are limited in quality, homogeneity and availability. Greater effort is needed from health authorities to improve health management and information systematization. Source: MesH.
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Transtornos Relacionados ao Uso de Substâncias , Tuberculose , Humanos , Saúde Pública , Peru/epidemiologia , Brasil , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Tuberculose/epidemiologiaRESUMO
OBJECTIVE.: To analyze and explore the myths and beliefs about insulin therapy in patients with diabetes mellitus and their family caregivers from a general hospital in northern Peru in 2020. MATERIALS AND METHODS.: This qualitative study used a thematic analysis model, following the interpretative paradigm. Sociodemographic and clinical data were obtained from medical records. Patients with diabetes that used some type of insulin for at least three months prior to the study were interviewed, as well as their family caregivers. Patients participated in a focus group and in-depth interviews; family caregivers participated only in in-depth interviews. RESULTS.: Twelve patients with diabetes (11 with type 2 diabetes mellitus) were included; six in the focus group and six in the in-depth interviews. Seven family caregivers were included. After analysis, we obtained four categories: 1) beliefs related to starting insulin treatment: treatment of choice after failure of other drugs, cures diabetes, regulates sugar, fear of injectables; 2) beliefs related to treatment adherence: decompensation for not using insulin, insulin is necessary to live; 3) beliefs related to alternative therapies and cost: use of alternative therapies, high cost of insulin; and 4) myths related to the use of insulin: generates dependence, dependence for insulin administration, negative effects of insulin. CONCLUSIONS.: The beliefs and myths of patients treated with insulin arise from the beginning of treatment, remain throughout the course of treatment, and are often reinforced by the worldview of family members.
OBJETIVO.: Analizar y explorar los mitos y creencias sobre la insulinoterapia en pacientes con diabetes mellitus y sus familiares cuidadores de un hospital general del norte peruano en el 2020. MATERIALES Y MÉTODOS.: Se realizo un estudio con enfoque cualitativo, paradigma interpretativo y tipo de análisis temático. Se obtuvieron datos sociodemográficos y clínicos de las historias clínicas y se entrevistaron pacientes con diabetes, con uso de algún tipo de insulina por lo menos tres meses antes del estudio, y a sus familiares cuidadores. Los pacientes participaron de un grupo focal y de entrevistas a profundidad; los familiares participaron solo en entrevistas a profundidad. RESULTADOS.: Participaron 12 pacientes con diabetes (11 con diabetes mellitus tipo 2); seis en el grupo focal y seis en las entrevistas a profundidad y siete familiares. Luego del análisis se obtuvieron cuatro categorías: 1) creencias relacionadas al inicio de tratamiento con insulina: tratamiento de elección después del fracaso con otros fármacos, cura la diabetes, regula el azúcar, temor a los inyectables; 2) creencias relacionadas al mantenimiento del tratamiento: descompensación por no usar insulina, la insulina es necesaria para vivir; 3) creencias relacionadas a terapias alternativas y costo: uso de terapias alternativas, costo elevado de la insulina; y 4) mitos relacionados al uso de insulina: genera dependencia, dependencia para la administración de insulina, efectos negativos de la insulina. CONCLUSIONES.: Las creencias y mitos de los pacientes, en tratamiento con insulina, emergen desde el inicio del tratamiento y se mantienen con la evolución de este, siendo en muchas ocasiones reforzados por la cosmovisión de los familiares.
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Diabetes Mellitus Tipo 2 , Insulina , Humanos , Insulina/uso terapêutico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Cuidadores , Peru , HospitaisRESUMO
Backgound: Neurocysticercosis (NCC) is the most common parasitosis of the central nervous system, and a very important cause of epilepsy. AIM: To describe the clinical features of patients with NCC attending a high level hospital from Lambayeque during: 2016-2018. METHODS: The medical records of patients with NCC were reviewed, and their information was collected on a data sheet. RESULTS: 46 stories met the inclusion criteria; 23 patients were male, the median age was 46.5 years (IQR: 26.5-63), the youngest patient was 7 years old, and the longest 85. Thirty patients were from Lambayeque. Epilepsy occurred in 24 patients, intracranial hypertension in 10, psychic syndrome in 2 and focal neurological deficit and visual syndrome in 1; there was one asymptomatic patient and seven had epilepsy and another syndrome. In neuroimaging, cerebral calcifications were the most common lesions; 9 patients had subarachnoid cysts. Serology (western blot) was performed in 20 patients being positive in 11; 38 were definitive NCC and 8 probable. Eighteen patients received only symptomatic treatment, 27 antiparasitic treatment and 6, additionally neurosurgical treatment. Only one patient died. CONCLUSIONS: The symptoms and neuroimaging findings were proteiform and the mortality found was low.
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Epilepsia , Neurocisticercose , Sistema Nervoso Central , Criança , Feminino , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Neurocisticercose/diagnóstico por imagem , Neurocisticercose/epidemiologia , Peru/epidemiologiaRESUMO
Presentamos el caso de un paciente varón de 24 años con hemofilia A de 14 años de evolución. El paciente presentó hemartrosis recurrente en rodilla derecha, luego desarrolló artritis séptica en dicha articulación producida por Serratia marcescens con respuesta satisfactoria al lavado intra-articular con solución salina y 28 días de tratamiento con carbapenémicos. En pacientes con artritis séptica, hemartrosis previa y múltiples ingresos hospitalarios debe sospecharse la presencia de este germen. El tratamiento es quirúrgico y con antibióticos de amplio espectro.
We present the case of a 24-year-old male patient with hemophilia A of 14 years of evolution. The patient presented recurrent hemarthrosis in the right knee, who developed septic arthritis in knee due to Serratia marcescens with a satisfactory response to intra-articular lavage with saline solution and 28 days of treatment whith carbapenems. In patients with septic arthritis, previous hemarthrosis and multiple hospital admissions, the presence of this germ should be suspected. The treatment is surgical and with broad spectrum antibiotics.
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Objetivo. Analizar y explorar los mitos y creencias sobre la insulinoterapia en pacientes con diabetes mellitus y sus familiares cuidadores de un hospital general del norte peruano en el 2020. Materiales y métodos. Se realizo un estudio con enfoque cualitativo, paradigma interpretativo y tipo de análisis temático. Se obtuvieron datos sociodemográficos y clínicos de las historias clínicas y se entrevistaron pacientes con diabetes, con uso de algún tipo de insulina por lo menos tres meses antes del estudio, y a sus familiares cuidadores. Los pacientes participaron de un grupo focal y de entrevistas a profundidad; los familiares participaron solo en entrevistas a profundidad. Resultados. Participaron 12 pacientes con diabetes (11 con diabetes mellitus tipo 2); seis en el grupo focal y seis en las entrevistas a profundidad y siete familiares. Luego del análisis se obtuvieron cuatro categorías: 1) creencias relacionadas al inicio de tratamiento con insulina: tratamiento de elección después del fracaso con otros fármacos, cura la diabetes, regula el azúcar, temor a los inyectables; 2) creencias relacionadas al mantenimiento del tratamiento: descompensación por no usar insulina, la insulina es necesaria para vivir; 3) creencias relacionadas a terapias alternativas y costo: uso de terapias alternativas, costo elevado de la insulina; y 4) mitos relacionados al uso de insulina: genera dependencia, dependencia para la administración de insulina, efectos negativos de la insulina. Conclusiones. Las creencias y mitos de los pacientes, en tratamiento con insulina, emergen desde el inicio del tratamiento y se mantienen con la evolución de este, siendo en muchas ocasiones reforzados por la cosmovisión de los familiares.
Objective. To analyze and explore the myths and beliefs about insulin therapy in patients with diabetes mellitus and their family caregivers from a general hospital in northern Peru in 2020. Materials and methods. This qualitative study used a thematic analysis model, following the interpretative paradigm. Sociodemographic and clinical data were obtained from medical records. Patients with diabetes that used some type of insulin for at least three months prior to the study were interviewed, as well as their family caregivers. Patients participated in a focus group and in-depth interviews; family caregivers participated only in in-depth interviews. Results. Twelve patients with diabetes (11 with type 2 diabetes mellitus) were included; six in the focus group and six in the in-depth interviews. Seven family caregivers were included. After analysis, we obtained four categories: 1) beliefs related to starting insulin treatment: treatment of choice after failure of other drugs, cures diabetes, regulates sugar, fear of injectables; 2) beliefs related to treatment adherence: decompensation for not using insulin, insulin is necessary to live; 3) beliefs related to alternative therapies and cost: use of alternative therapies, high cost of insulin; and 4) myths related to the use of insulin: generates dependence, dependence for insulin administration, negative effects of insulin. Conclusions. The beliefs and myths of patients treated with insulin arise from the beginning of treatment, remain throughout the course of treatment, and are often reinforced by the worldview of family members.
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Humanos , Feminino , Modelo de Crenças de SaúdeRESUMO
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.
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Objetivo: Describir la frecuencia de IAAS y el uso de antibióticos en una UCI COVID del norte peruano. Método: estudio descriptivo trasversal. Se revisaron 85 historias. Hallazgos: mediana de edad= 57 años, RIC (49- 78); 70 % hombres; 74/85 en ventilador, mediana en días= 13 (RIC=7-45). Frecuencia de IAAS: 28,2%: Neumonía asociada a Ventilador 79,1%; 26/85 tuvo al menos un cultivo: 22/26 secreción bronquial: 10/26 Acinetobacter baumani,10/26 Pseudomona Aeruginosa; 8/10 de Acinetobacter y 5/10 de las Pseudomonas fueron multidrogoresistentes; 100% de pacientes recibieron antibióticos; 63 % Carbapenems (36 % Imipenem y 27 % Meropenem) y 22 % cefalosporinas de tercera (14% Ceftazidime y 8% Ceftriaxona); mortalidad: 30,6%. De 19 NAV, 7/19 fueron por Acinetobacter Baummani y 10/19 por Pseudomona Aeruginosa. De los fallecidos, 19% tuvo Acinetobacter baumani y 11% Pseudomona Aeruginosa. Conclusión: gérmenes más frecuentes: Acinetobacter y Pseudomona, todos los pacientes recibieron antibióticos; el más frecuente fue Imipenem.
Objective: To describe the frequency of HAIs and the use of antibiotics in a COVID ICU in northern Peru. The methods cross-sectional descriptive study. 85 stories were reviewed. Findings: median age= 57 years, IQR (49-78); 70% men; 74/85 on a ventilator, median in days= 13 (IQR=7-45). HAI frequency: 28.2%: Ventilator-associated pneumonia 79.1%; 26/85 had at least one culture: 22/26 bronchial secretions: 10/26 Acinetobacter baumani, 10/26 Pseudomonas Aeruginosa; 8/10 of Acinetobacter and 5/10 of Pseudomonas were multidrug resistant; 100% of patients received antibiotics; 63% Carbapenems (36% Imipenem and 27% Meropenem) and 22% third-class cephalosporins (14% Ceftazidime and 8% Ceftriaxone); mortality: 30.6%. Of the 19 VAP, 7/19 were due to Acinetobacter Baummani and 10/19 due to Pseudomonas Aeruginosa. Of the deceased, 19% had Acinetobacter baumani and 11% had Pseudomonas Aeruginosa. Conclusion: the most frequent germs: Acinetobacter and Pseudomona, all patients received antibiotics and the most frequent was imipenem.
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OBJECTIVE: Knowledge about fibromyalgia in general practitioners in the province of Chiclayo, Peru, 2016. MATERIALS AND METHODS: Cross sectional descriptive study. Non-probability sampling, census type. In all, 145 physicians were evaluated through a questionnaire of 14 questions, validated by experts and a pilot. The analysis was performed using STATA v. 13. RESULTS: Accuracy in questions involving diagnosis was 41.1% and in questions about treatment: 65%; 75.1% 'had seen patients with fibromyalgia' previously. The average on locating pain points was 2.2±2.8. Only 2.8% identified 11 or more painful points; 54.5% answered that 'the diagnosis is clinical and exams are for the differential diagnosis'; 46.1% in Ministerio de Salud (MINSA) and 28.3% in Seguro Social de Salud (EsSalud) answered the item about diagnostic criteria (P=.021); 65.7% said that psychotherapy, pregabalin and aerobic exercise were the most effective therapeutic triad, with no differences between MINSA and EsSalud: 61.5% vs. 68.6% (P=.23); 59.3% responded that drugs that had proved to be useful were: Pregabalin, duloxetine and amitriptyline; 66.2% responded that the most effective physical therapy is aerobic exercise. CONCLUSIONS: Knowledge of the diagnosis and treatment of fibromyalgia by general doctors in Chiclayo is poor. There are some differences in knowledge depending on the age and type of institution to which each belongs.
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Fibromialgia , Clínicos Gerais/psicologia , Adulto , Idoso , Atitude do Pessoal de Saúde , Terapia Combinada , Estudos Transversais , Diagnóstico Diferencial , Feminino , Fibromialgia/tratamento farmacológico , Fibromialgia/psicologia , Fibromialgia/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Peru , Modalidades de Fisioterapia , Projetos Piloto , Padrões de Prática Médica , Psicoterapia , Inquéritos e Questionários , Adulto JovemRESUMO
Señor Editor: Durante la pandemia, la práctica clínica se ha visto afectada por muchas razones; ver sufrir al paciente desconcierta, contrastándose lo que la evidencia nos propone, con la realidad. Apesar de que el arsenal terapéutico para COVID-19 es limitado, existen alternativas aplicables. Sin embargo, observamos inercia clínica. Existe impasibilidad ante el sufrimiento; la persona es vista como una estadística. No hacerlo exige, compromiso y olvido de sí mismo
Mr. Editor: During the pandemic, clinical practice has been affected for many reasons; seeing the patient suffer is disconcerting, contrasting what the evidence proposes to us, with reality. Although the therapeutic arsenal for COVID-19 is limited, there are applicable alternatives. However, we observe clinical inertia. There is impassivity in the face of suffering; the person is seen as a statistic. Failure to do so requires commitment and self-forgetfulness.
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Objetivo: Describir características clínicas y aspectos de la mortalidad en pacientes del Hospital Regional Lambayeque,periodo2014-2018; Material y Métodos: Estudio descriptivo retrospectivo con análisis exploratorio. Se incluyeron todos los pacientes fallecidos de diferentes servicios según el registro del Sistema de gestión de la calidad. Resultados: Hubo 1560 fallecidos (4,7%); la mediana de edad: 55 años (RIC=23-100), el grupo etario más frecuente: mayor de 75 años: 25,1%; 50,2% fueron mujeres, 74,1% fueron de Lambayeque y 36,8% de Chiclayo; 32,6% fueron atendidos por medicina interna y 18% por Medicina Intensiva. Los años que contribuyeron con más fallecidos fueron: 2017 (21,2%) y 2014 (20,7%) y la frecuencia de mortalidad fue mayor en el 2014: 6,1% y menor en el 2018: 4,1%. Los diagnósticos de egreso más frecuentes fueron: sepsis/choque séptico: 30,17% e Insuficiencia respiratoria: 10,7%. En 14/1560 (0,9%) aparece "paro cardiaco" como diagnóstico final y en 82/1560 (5,2%) aparece "no diagnóstico". En 14/1560 (0,9%) se consignan sólo signos o diagnósticos que no explican fallecimientos. Sólo en 44,6% del total, se consignó el segundo diagnóstico de egreso. Conclusiones: Predominó el grupo adulto mayor, con sepsis e insuficiencia respiratoria, atendidos por medicina interna y cuidados intensivos; la mortalidad es elevada, pero con disminución en el tiempo. Existen deficiencias en el registro de la información tanto en calidad como en el subreporte.
Objetive: To describe clinical characteristics and aspects of mortality in patients from the Hospital Regional Lambayeque during 2014-2018; Material and Methods: Retrospective and descriptive study with exploratory analysis. All deceased patients from the different services were included according to the Quality Management System registry. Results: There were 1560 deaths (4.7%); the median age was 55 years (IQR = 23-100), the most frequent age group was: over 75 years: 25.1%; 50.2% were women, 74.1% were from Lambayeque and 36.8% from Chiclayo; 32.6% were treated by Internal medicine and 18% by Intensive Medicine. The years that contributed with most deaths were: 2017 (21.2%) and 2014 (20.7%); the frequency of mortality was higher during 2014: 6.1% and lower during 2018: 4.1%. The most frequent discharge diagnoses were: sepsis/septic shock: 30.17% and respiratory failure:10.7%. In 14/1560 (0.9%) "cardiac arrest" appears as the final diagnosis and in 82/1560 (5.2%) the first diagnosis is "non-diagnosis". In 14/1560 (0.9%) only signs or diagnoses that do not explain deaths are reported. Only in 44.6%, the second discharge diagnosis was recorded. Conclusions: The older adult group was the most frequent, with sepsis and respiratory failure, treated by internal medicine and intensive care; Mortality is high, but with decrease through the years. There are deficiencies in the registration of information both in quality and subreport.
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INTRODUCCIÓN: La neurocisticercosis (NCC) es la parasitosis más común del sistema nervioso central, siendo una causa muy importante de epilepsia. OBJETIVO: Describir las características de pacientes con NCC atendidos en un hospital de alta complejidad de Lambayeque durante el período 2016-2018. PACIENTES Y MÉTODOS: Se revisaron las historias clínicas de pacientes con diagnóstico de NCC y se recolectó su información en una ficha de datos. RESULTADOS: 46 historias cumplieron criterios de inclusión; 23 correspondían a varones, la mediana de edad fue 46,5 años (RIC: 26,5-63), el paciente más joven tuvo 7 años, el más longevo 85 años; 30 procedían de la región Lambayeque. Epilepsia se presentó en 24 pacientes, hipertensión endocraneal en 10, síndrome psíquico en dos, déficit neurológico focal en 1, síndrome visual en 1, un paciente fue asintomático. Siete pacientes tuvieron epilepsia y otro síndrome simultáneamente. En las neuroimágenes, las calcificaciones cerebrales fueron las lesiones más comunes; 9 tuvieron quistes sub-aracnoideos. En 20 pacientes se efectuó serología por western blot, siendo positiva en 11; 38 fueron clasificados como NCC definitiva y 8 probable. Recibieron solamente tratamiento sintomático18 pacientes, 27 tratamiento antiparasitario y 6 adicionalmente tratamiento neuroquirúrgico. Falleció un paciente. CONCLUSIONES: La sintomatología y los hallazgos de neuroimágenes fueron proteiformes y la mortalidad fue baja.
BACKGROUND: Neurocysticercosis (NCC) is the most common parasitosis of the central nervous system, and a very important cause of epilepsy. AIM: To describe the clinical features of patients with NCC attending a high level hospital from Lambayeque during: 2016-2018. METHODS: The medical records of patients with NCC were reviewed, and their information was collected on a data sheet. RESULTS: 46 stories met the inclusion criteria; 23 patients were male, the median age was 46.5 years (IQR: 26.5-63), the youngest patient was 7 years old, and the longest 85. Thirty patients were from Lambayeque. Epilepsy occurred in 24 patients, intracranial hypertension in 10, psychic syndrome in 2 and focal neurological deficit and visual syndrome in 1; there was one asymptomatic patient and seven had epilepsy and another syndrome. In neuroimaging, cerebral calcifications were the most common lesions; 9 patients had subarachnoid cysts. Serology (western blot) was performed in 20 patients being positive in 11; 38 were definitive NCC and 8 probable. Eighteen patients received only symptomatic treatment, 27 antiparasitic treatment and 6, additionally neurosurgical treatment. Only one patient died. CONCLUSIONS: The symptoms and neuroimaging findings were proteiform and the mortality found was low.
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Humanos , Masculino , Feminino , Criança , Pessoa de Meia-Idade , Neurocisticercose , Epilepsia , Peru/epidemiologia , Sistema Nervoso Central , Neurocisticercose/epidemiologia , Neurocisticercose/diagnóstico por imagem , HospitaisRESUMO
RESUMEN Fundamento: parvovirus humano B19 es el agente causal de la quinta enfermedad en los niños y de la poliartropatía y la eritroblastopenia aguda en los adultos. Objetivo: determinar los aspectos clínicos, epidemiológicos y analíticos de la infección por parvovirus B19 durante un brote nosocomial. Métodos: se realizó un estudio trasversal descriptivo en los servicios de Medicina y Pediatría en el Hospital Regional de Lambayeque durante los meses de noviembre y diciembre de 2017. Se realizó un estudio de serie de casos en base a las historias clínicas de pacientes y personal de salud, con resultado positivo a la infección por PVB1, mediante la técnica de ELISA. El universo estuvo constituido por 153 pacientes atendidos en los servicios de Medicina y Pediatría en el tiempo mencionado. De los cuales se seleccionó una muestra de 16 casos, cumpliendo los criterios mencionados. Resultados: se identificaron 16 pacientes positivos de los servicios de Medicina y Pediatría, con títulos de IgM contra parvovirus B19 superiores a 17 UI/mL, cuyas edades oscilaron entre los seis meses y 38 años. Entre ellos ocho y 16 pacientes presentaron comorbilidades de las cuales 3/8 correspondieron a enfermedades autoinmunes. Se evidenciaron contactos intrahospitalarios en ambos servicios. Se encontró una mayor morbilidad en el personal de salud femenino de mediana edad. Conclusiones: la infección por parvovirus B19 en el hospital u otro medio sanitario representa un riesgo para el personal de salud.
ABSTRACT Background: human parvovirus B19 is the causative agent of fifth disease in children and of polyarthropathy and acute erythroblastopenia in adults. Objective: to determine the clinical, epidemiological and analytical aspects of parvovirus B19 infection during a nosocomial outbreak. Methods: a descriptive cross-sectional study was carried out in the Medicine and Pediatrics services of the Regional Lambayeque Hospital during the months of November and December 2017. A study of a series of cases was carried out based on the patients and health personnel historical charts, with a positive result to the PVB1 infection, through the ELISA technique. The universe was constituted by 153 patients treated in the Medicine and Pediatrics services. Of which it was selected a sample of 16 cases, based on the criteria. Results: 16 positive patients from the Medicine and Pediatrics departments were identified, with IgM titers against parvovirus B19 greater than 17 IU / mL, whose ages ranged from 6 months to 38 years. Among them 8/16 patients presented comorbidities of which 3/8 corresponded to autoimmune diseases. In-hospital contacts were evident in both services. Greater morbidity was found in middle-aged female health personnel. Conclusions: Parvovirus B19 infection in the hospital or other health environment represents a risk mainly for health personnel.
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Objetivo: Determinar el patrón de clonalidad mediante ERIC-PCR y REP-PCR en aislamientos de Escherichia coli y Klebsiella pneumoniae, productores de betalactamasas de espectro extendido (BLEE), aisladas de pacientes con infección urinaria del Hospital Regional Lambayeque durante julio a noviembre de 2015. Materiales y métodos: Se analizaron 30 aislados clínicos conformados por E. coli y K. pneumoniae procedentes de los servicios de emergencia, medicina, cirugía y pediatría del HRL, La relación clonal, se evaluó mediante ERIC-PCR y REP- PCR. Para las agrupaciones se empleó el algoritmo UPGMA utilizando el software Quantity One-BIORAD, generando los dendrogramas con la unión de los perfiles electroforéticos obtenidos por ambas herramientas de tipificación. Resultados: Del análisis molecular se discriminaron tres patrones clonales predominantes en E. coli y dos en K. pneumoniae. Conclusiones: El estudio revela la diseminación clonal de microorganismos potencialmente patógenos en el servicio de emergencia, donde urge implementar medidas para su prevención y control
Objective: To determine the clonality pattern assessed by ERIC-PCR and REP-PCR in extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae isolates from patients with urinary tract infections at the Hospital Regional Lambayeque (HRL) from July to November 2015. Materials and methods: A total of 30 ESBL-producing E. coli and K. pneumoniae clinical isolates collected from the HRL's emergency, medicine, surgery and pediatrics services were assessed. The clonal relationship was determined using the ERIC-PCR and REP-PCR markers. For clusters, UPGMA algorithm with Bio Rad Quantity One 1-D analysis software was used, thus generating dendrograms through the union of the electrophoretic profiles obtained by both molecular markers. Results: From the molecular analysis, three predominant clonal patterns were found in E. coli and two in K. pneumoniae. Conclusions: The study reveals the clonal dissemination of potentially pathogenic microorganisms in the emergency service, where it is urgent to implement measures for their prevention and control
RESUMO
Objetivos: Evaluar los conocimientos sobre diagnóstico y tratamiento del trastorno depresivo mayor en médicos de atención primaria de la provincia de Chiclayo y determinar su asociación con características sociodemográficas. Material y métodos: Estudio descriptivo transversal con análisis exploratorio de datos. Se realizó un muestreo tipo censal. Se evaluaron a 111 médicos de atención primaria, mediante un instrumento validado, unidimensional, basado en los criterios diagnósticos del DSM-IV para el trastorno depresivo mayor. El análisis univariado y bivariado se realizó con el programa estadístico STATA v. 11.1. Resultados: El nivel de conocimientos fue medio en 18 (16,2%) médicos de atención primaria; y bajo, en 93 (83,8%). Ninguno tuvo un nivel de conocimientos alto. Solo 23 (20,7%) recibieron actualización en salud mental en los últimos 4 años. No se encontró asociación entre el nivel de conocimientos y las variables sociodemográficas. Conclusiones: El nivel de conocimientos en depresión mayor de los médicos de atención primaria de la provincia de Chiclayo fue deficiente. Este hallazgo, sin embargo, no parece estar asociado con las características sociodemográficas de la muestra utilizada.
Objectives: To measure the level of knowledge about the diagnosis and treatment of major depressive disorder among primary care physicians in the province of Chiclayo, and to assess its association with sociodemographic characteristics. Material and Methods: Cross-sectional study with exploratory data analysis. A census-type sampling was performed. One-hundred eleven primary care physicians were evaluated through a unidimensional validated questionnaire, based on DSM-IV diagnostic criteria for major depressive disorder. An univariate and bivariate analysis was performed using STATA statistical software v. 11.1. Results: The knowledge reached a medium level of 18 (16.2%) primary care physicians, and low in 93 (83.8%). None had a high level of knowledge. Only 23 probands (20.7%) had received a mental health update in the last 4 years. No association was found between the level of knowledge and sociodemographic characteristics. Conclusions: The level of knowledge in major depression among primary care physicians from the province of Chiclayo was poor. This finding, however, showed no association with sociodemographic features of the study sample.
Assuntos
Humanos , Atenção Primária à Saúde , Conhecimentos, Atitudes e Prática em Saúde , Médicos de Atenção Primária , Transtorno Depressivo Maior , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/terapia , Demografia , Epidemiologia Descritiva , PeruRESUMO
Determinar la prevalencia de fibromialgia en el distrito de Chiclayo. Material y métodos: Estudio descriptivo, transversal, exploratorio realizado en habitantes entre 18 a 65 años. Se realizó un muestreo aleatorio, por conglomerados, estratificado, multietápico. Se dividió al distrito en 34 zonas según el mapa catastral actualizado al año 2011; se aplicó el cuestionario LFESSQ (cuestionario inglés para el tamizaje epidemiológico de la Fibromialgia), versión en español: Los individuos con dolor corporal difuso en el tamizaje fueron evaluados por el investigador principal mediante los criterios del Colegio Americano de Reumatología de 1990. Resultados: Se entrevistaron 548 habitantes; 504 cumplieron los criterios de inclusión, 333 (66,3%) fueron mujeres. Los antecedentes más frecuentes fueron: diagnóstico previo de depresión 14 (2,5%); hipotiroidismo 11(2%) y ansiedad 8(1,4%). La media de edad fue 39,7 +- 13,6 años; la prevalencia de dolor corporal difuso fue 8,1 % (IC95%: 4,9-9,4%) y la de fibromialgia 2,99%, (IC95%: 1,5-4,4%); la prevalencia en hombres fue 4,1% Y en mujeres 2,4%; no se hallaron diferencias sociodemográficas entre los entrevistados con dolor corporal difuso y los que tuvieron fibromialgia; en los entrevistados con fibromialgia se halló mayor cantidad de puntos dolorosos (p= 0,0001) Y mayor frecuencia de insomnio (p=0,0024); Conclusiones: El dolor corporal difuso y la fibromialgia tienen una prevalencia similar a la reportada en otros estudios. Existen diferencias clínicas entre los pacientes con dolor corporal difuso y los pacientes con fibromialgia...
To determine the prevalence of fibromyalgia in Chiclayo district. Methods: A descriptive, exploratory, cross-sectional study was conducted among habitants from 18 to 65 years. A random, conglomerate and stratified sample was obtained. The district was divided in 34 zones based on a 2011 census. A Spanish version of a questionnaire that looked for symptoms of fibromyalgia was applied, Individuals with diffuse body aches identified through the questionnaire were evaluated by the principal investigator following the criteria of the American College of Rheumatology of 1990. Results: 548 habitants were interviewed; 504 fulfilled the inclusion criteria; 333 (66.3%) were females. The most common underlying medical conditions were depression (14, 2.5%); hypothyroidism (11, 2%) and anxiety (8, 1.4%). Mean age was 39.7 ± 13.6 years; the prevalence of diffuse body aches was 8.1 % (95% CI: 4.9-9.4) and of fibromyalgia was 2.99% (95% CI: 1.5-4.4); the prevalence in males was 4.1% and 2.4% in females; there were no sociodemographic differences between patients with diffuse body aches and fibromyalgia. Among those with fibromyalgia, there was higher number of painful zones (p=O.OOO 1) and higher frequency of insomnia (p=0.0024). Conclusions: Diffuse body aches and fibromyalgia had similar prevalence rates than previously reported in other studies. There are clinical differences between patients with diffuse body aches and fibromyalgia...