Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Objective: To discuss the development and implementation of a service learning experience designed to improve the health status of vulnerable populations in a middle-income country through the implementation of science-based programs designed to address the World Health Organization’s “Ten Threats to Global Health.” Methods: Describes the pragmatic development of a service learning experience designed to provide hands-on experiences to public health and medical students as they develop into professionals in high-middle-and low-income countries. Results: “Exploring Global Social Determinants of Health in the Dominican Republic,” originally designed as an observational experience of social determinants of health, has evolved into an experiential learning experience designed to assist students in the application of their public health knowledge and experience. Conclusion: Public health professionals, including those in training, have a responsibility to implement actions designed to improve the health status of populations around the world. Service learning programs such as “Exploring Global Social Determinants of Health in the Dominican Republic,” provide those hands-on opportunities.

An unplanned health care system is like a paper boat carried by a slowly sinking current. In times of disinformation and excessive distraction, investing in better facts on health technology assessment (HTA) will enable more active actions rather than reactive to the market dynamics. This paper aims to raise some reflections on HTA in terms of political context, health technologies and epidemiological priorities. The perspective of HTA is context dependent, intrinsic to its political and institutional articulation. At the moment, the paradox is to maintain a specialized structure in the face of economic austerity policies that reduce health resources, and a scenario of greater interest in raising public funds by the private sector. Particularly in Brazil, HTA will also have to deal with the gradual shift from a universal health system to a minimum portfolio of services offered by the private sector. The public sector will be requested for very expensive technologies, usually by judicial measures. The precariousness of work relationships will influence HTA workers because they will not have a link and identity with the health system. Thus, there will be more productive and less reflective HTA processes. The context of greater dependence on the private market will allow new problems with medical technologies to emerge, such as the opioid crisis in the United States.

Translocation renal cell carcinoma (t-RCC) is a subtype of renal cell carcinoma (RCC). This case is about an 11-year-old with pain in right iliac fossa for two weeks. Tumor of 2.2 x 1.9 x 2.8 cm was evidenced in the upper pole of the right kidney, by ultrasound. Then, she underwent to a right radical nephrectomy and regional lymph node dissection, after which CRT subtype Xp 11.2 was diagnosed. Subsequently, first-line treatment with pazopanib and concomitant chemotherapy was initiated. This disease is more frequent between 10 and 15 years. Their prognosis is usually better compared to adults. The multidisciplinary management associated with the availability of first-line medications improves progression-free survival.

Viruses that parasitize bacteria, called bacteriophages or phages, are returning to scientific news, evidenced by the creation of the Howard Hughs Medical Institute in the United States (USA), or the CRU-MEDI Institute in the United Kingdom; This change of interest is due to the possibility of using them in antibacterial therapy, against multiresistant bacteria. The knowledge of these viruses begins with the studies of Frederick Twort in the year 1915, demonstrating that "there are viruses that infect bacteria and kill them." But it was Felix d'Herelle, who successfully developed therapeutic protocols for digestive infections in animals and humans. Bacteriophages have been the basic laboratory tool for the development of science in virology and molecular biology.

Case-control studies are analytical observational epidemiological studies generally devoted to evaluate factors associated with infrequent diseases. Its hierarchy within the pyramid of evidence lies in an intermediate place between cross sectional and cohort studies. The measure of association used for these studies is the Odds Ratio. Some variants of this design, such as incident and nested case studies and nested case-control studies (within a cohort) can reduce the risk of selection bias. The basic concepts related to this type of studies are reviewed.

After reading this article with interest published by Hidalgo et al regarding agents related to the surgical site infection (SSI) in elderly between the years 2013 and 2017; we found the consideration of certain relevant determinants related to clinical and surgical aspects. These determinants are useful since they are taken as reference in future research work. Nevertheless, we would like to emphasize the necessity to incorporate some other relevant variables as possible determinants to control such as those related to nutritional status specifically hemoglobin and preoperative albumin levels since in our country this kind of pathologies is common. In different countries, SSI is one of the most deadly and costly complications increasing mortality from 2 to 11 times and the cost to 14.2 million dollars in surgeries4. In Peru, from 15 000 nosocomial infections, 30, 9 % are from an surgical wound5. It is important to know the details of this theme because it contributes to a highly reversible social and economic problem.

Introduction: In chronic obstructive pulmonary disease (COPD), the diaphragm and sternocleidomastoid respiratory muscles (ECOM) work against increased mechanical loads due to limited air flow and changes in chest conformation due to the condition of pulmonary hyperinflation. Objective: To evaluate the histopathological changes present in the lungs and respiratory muscles (diaphragm and ECOM) of the corpses affected by COPD. Materials and methods: This is a blind and descriptive study with analysis of histological images of biopsy. The history of smoking associated with the presence of pulmonary anthracosis, septal thickening and emphysematous bullae included the inclusion criteria of the study. The study was conducted by optical microscopic analysis of histological sheets obtained from 36 corpses with COPD. The histopathological diagnosis was made by a pathologist who did not know the objectives of the study. Results: In the diaphragm, there was the presence of interposed adipose tissue, muscle atrophy, removal of muscle fibers and fibrosis. In ECOM, the elimination of muscle fibers, muscular atrophy, interposed adipose tissue, muscle hypertrophy and thickening of the tendons were also evident. Conclusions: The changes found in the diaphragm and ECOM muscle biopsies of the bodies with COPD were evidenced as a mechanism of compensation and / or dysfunction of the respiratory system due to biomechanical alterations promoted by the disease.

Objective: To determine the prognostic factors of severity in patients with acute pancreatitis (AP) at the Hospital Nacional Sergio E. Bernales during the period June 2016 to June 2018. Methods: Study of cases and controls, being the cases patients with AP moderately severe or severe and controls those of mild AP. The medical records were reviewed to apply the APACHE-II score. Chi- square was used and the ORs were obtained with their respective 95% CI. SPSS 25 program was used. Results: 162 medical records were reviewed. 54 (33.3%) patients developed AP moderately severe or severe and 108 (66.7%) had mild AP. Of the patients with AP moderately severe or severe, 55.6% were men; while in mild AP the female sex was predominant with 91.7%. The majority were of biliary origin (83.3%). There was a predominance of mild AP. AP moderately severe or severe was associated with being over 60 years old (OR: 3.10; 95% CI: 1.26-7.65; p= 0.011), presenting pleural effusion (OR: 7.78 95% CI: 5.745-54.418 ; p <0.001), hematocrit>40% (OR: 4.17; 95% CI: 2.07-8.39; p <0.001) and APACHE score ≥8 (OR: 7.88; 95% CI: 3.77-16.45; p<0.001). Conclusions: The factors associated with the severity of pancreatitis were age, presenting pleural effusion, hematocrit> 40% and APACHE score ≥8.

Surgical Engineering Society conducted a research, the First Review as the pioneers in LATAM, since year 2015, which develops the topic of the latest Medical Robotics technologies created in North América, Europe and Asia, which are imported to apply in the Healthcare System of Peru and Latin America. The robotic systems for surgery, rehabilitation and assistance are presented covering the description of control design and technical specifications. Besides, the patient management using robots is analyzed with diagnosis, prognosis and treatment tools. The process to evaluate the new inventions of robotic devices and bring to the market is introduced where three stages are shown as the following: innovation, regulatory affairs and biomedical application. Moreover, there is a high percentage of population with disability in Latin America, therefore, it is necessary that more biomedical scientists be specialized in robotics to start developing new ideas to improve the patient management. Finally, the new technologies created in Latin America must be affordable, simply and efficient in order to support the healthcare economic situation in the continent and give the best quality standards to improve treatment outcomes on patients.

The human papillomavirus (HPV) has a high prevalence in young women, which is why it is considered a public health problem. As their main form of transmission is sexual relations, it is estimated that around 80% of individuals will have contact with this virus in the course of their lives. According  to  reports  from  the  World  Health  Organization  (WHO),  the  human  papillomavirus  (HPV) associated with cervical cancer, ranks fourth among the most common types of cancer that affect women, with an estimated number of 570,000 deaths in 2018. In addition, WHO includes the HPV vaccine as part of national vaccination programs based on the following considerations: It  constitutes  a  public  health  priority;  the  introduction  of  these  vaccines  is  feasible  from a  programmatic  point  of  view;  sustainable  financing  can  be guaranteed;  It  has  cost-effectiveness  as  a vaccination  strategy;  and  focuses  on  teenage  girls  before  the  start  of  active  sex  life;  taking  into  account the aforementioned, it should be considered that the target population will primarily be made up of girls between the ages of 9 or 10   up to 13 years old.