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

Abstract   Microbiological mapping is a tool and base for good antibiotic management. It guides the empirical treatments in the hospital services as well as in the updating of care protocols. Objective: To determine the situation of the microbiological mapping of urine cultures in referential hospital. Methods: A cross-sectional descriptive study of urine cultures of the different hospital services from the first semester of 2013 to 2015 was carried out. The situation was defined as the determination of the microbiological profile and the most frequent pathogens isolated. The percentage of resistance by extended-spectrum beta-lactamase (ESBL) for 3 consecutive years was determined. The data were collected and added to a database coded in double back up. Results: The most frequently isolated pathogens were E. coli (56.60%), K. pneumoniae (10.12%) and P. mirabilis (4.22%). The frequency of E. coli ESBL (+) in the years 2013, 2014, 2015 was 37.49%; 47.02% and 50.10% respectively. The sensitivity of E. coli was for ertapenem, meropenem and imipenem (99% -100%), tigecillin (99%) and the percentage of resistance of E. coli to Ciprofloxacin: 67%, 72% and 82% respectively. Conclusion: The most frequently isolated agent was E. coli. The frequency of E. coli ESBL (+) has increased by 33% (2013) to 50% by 2015, with an increase in resistance to ciprofloxacin. However, there is a therapeutic alternative (cefotaxime / clavulanic acid) whose sensitivity is greater than 90%. Key words: Microbiological analysis; Escherichia coli; Antibiotic therapy. (source: MeSH NLM) DOI: https://doi.org/10.25176/RFMH.v18.n1.1268

Abstract   Objective: To determine the association between prenatal controls and morbidity and mortality in the newborn at the Sergio Bernales hospital, January-May 2016. Methods: Quantitative, observational, analyticrelational, retrospective study. The population was formed by 2350 newborns. The sex, gestational age, weight, morbidity and mortality variables of newborns recorded in the registry of births of the neonatology service were studied, a data collection form was used. Results: We proceeded to use the Chi-square statistic to find the association between the variables, obtaining a p = 0.000 (value less than 0.05), which indicated that such an association exists. In relation to the morbidity and mortality of newborns with less than 6 prenatal controls, an OR = 52,305 (95% CI: 40,786 -67,077) and OR = 8,175 (95% CI: 6,269 -10,661) were obtained, being statistically significant. Conclusion: There is a significant association between the prenatal controls and the morbidity and mortality of the newborn. Key words: Prenatal control; Morbidity; Mortality; Newborns; Birth weight. (source: MeSH NLM) DOI: https://doi.org/10.25176/RFMH.v18.n1.1267

Abstract The World Health Organization defined mental health as a state of well-being in which the individual is aware of his own abilities, and is able to make a valuable contribution to his community1. On the contrary, the prevalence of mental disorders in the world is worrisome, to cite some figures, depression is a frequent mental disorder and one of the main causes of disability that affects more than 300 million people around the world; bipolar disorder affects around 60 million people worldwide; Approximately 21 million people suffer from schizophrenia; and about 47.5 million show clinical signs of dementia. It is expected that the prevalence of these diseases will increase due to the scarcity of psychiatry.In Peru, the situation in the area of mental health is similar; every year 20% of the adult population suffers from some type of mental disorder; and only 1 in 10 people who require treatment have access to health services. To guarantee the mental health care of more Peruvians, the Health Reform has incorporated specialized care in the Primary Healthcare Level. However, there are currently approximately 700 Peruvian psychiatrists, an amount with which it is impossible to cover care in the more than 7,000 health facilities in the country.In view of this global problem, it is urgent to find out about the factors that contribute to more medical students consider the choice of psychiatry as a medical specialty. Different studies worldwide and nationally suggest that the selection of the medical specialty is influenced mainly by personality and this is not alien to the choice of psychiatry as a specialty to study. In addition, among medical students there are significant differences in their vocational preferences according to sex; According to this, women are the ones who mostly choose psychiatry⁷. On the other hand, the experience in the course during the academic years of the medical career, provide a more realistic view of psychiatry, which contributes to more medical students are interested in pursuing the specialty later. DOI: https://doi.org/10.25176/RFMH.v18.n1.1275

Abstract The leiomyosarcomas of the inferior vena cava are tumors so rare that it is estimated below 200 welldocumented and published patients. Its incidence is higher in women and frequently appear between 50- 60 years. They originate in the muscle cells of the middle layer of the venous wall, present an extraluminal growth, being more rare to find exclusively intraluminal growth and have, in general, a slow progression and a poor prognosis. The symptoms are nonspecific causing the diagnosis to be made late; This generates great comorbidity despite its slow growth. The diagnosis is made through imaging and guided biopsy, but the exact origin of the tumor is usually discovered during the surgical procedure and especially after the definitive histological study. Surgical treatment is the only one that has described changes in survival. We report the case of a 71-year-old woman with a diagnosis of leiomyosarcoma of the inferior vena cava treated with surgery and postoperative radiotherapy with tumor-free survival at 5 years. Key words: Leiomyosarcoma; Vein cava. (source: MeSH NLM) DOI: https://doi.org/10.25176/RFMH.v18.n1.1273

Abstract Hemophagocytic lymphohistiocytosis (HLH), is rare, is caused by a dysfunction of cellular immunity by an alteration of NK cells (primary) or by an excessive proliferation of activated (secondary) macrophages. It is characterized by fever, hepatosplenomegaly, cytopenia, hemophagocytosis, hypertriglyceridemia and / or hypofibrinogenemia. In conclusion, in the presence of fever, hepatosplenomegaly and cytopenia, the diagnosis of hemophagocytic lymphohistiocytosis (HLH) should be considered. Key words: Fever; Hepatosplenomegaly; Cytopenia. (source: MeSH NLM) DOI: https://doi.org/10.25176/RFMH.v18.n1.1274

Abstract Nephrotic syndrome in children is a very frequent pathology in our environment. The initial approach, usually, is performed by the pediatrician or general practitioner, until it is evaluated by the pediatric nephrologist and / or nephrologist of adults with training in pediatrics; so in this review some guidelines are outlined to standardize their initial study, edema control and treatment until their evaluation by the specialty, through an adequate reference and counter-referral system, guaranteeing the adherence of the child and his family, is special in those who live in remote places with reduced access to health systems on an ongoing basis. Key words: Nephrotic syndrome; Child; Role of the pediatrician; Role of the nephrologist. (source: MeSH NLM) DOI: https://doi.org/10.25176/RFMH.v18.n1.1270

Abstract Kerion Celsi is a rare complication of Tinea Capitis caused by an hyperreaction to a Type 4 Hypersensibility against the fungus. We are presenting a case from a peruvian 9 year old boy with a 20 days illness in which it is described a painful, pruriginous alopecia plate covered by myeleric crust and suppuratives abscesses with boggy mass at the right parietal region. The clinical diagnosys was made, and later confirmed by the agent cultive in which was trichopyton tonsurans. A treatment with Terbinafine for 4 weeks, prednisone 7 days and clindamicine for 10 days was started, with a favorable evolution. Key words: Kerion Celsi; Complication; Tinea capitis; Trichophyton tonsurans. (source: MeSH NLM) DOI: https://doi.org/10.25176/RFMH.v18.n1.1272

Abstract Gastric cancer (CG) is one of the most common neoplasms in Peru. Recently the molecular subtypes have been typified in CG. A molecular subtype is associated with the Epstein Barr virus. This entity presents with a frequency of 10%, in a non-cardiac region, in male patients and with the diffuse histological subtype. The prognosis is better compared to the other types of CG. It presents its own molecular alterations that in the future could be susceptible to target therapies or immunotherapy. DOI: https://doi.org/10.25176/RFMH.v18.n1.1269

Abstract   Objective: To evaluate the factors associated with hyperglycemic crisis in patients with Type 2 Diabetes Mellitus in the emergency service of internal medicine of Vitarte Hospital in 2016. Methods: Observational, analytical, retrospective type, case and control type. The sample consisted of 119 patients with Type 2 Diabetes Mellitus of which 63 developed hyperosmolar hyperglycemic state that entered the Internal Medicine Emergency Service of Hospital Vitarte in 2016. Results: Of the 119 patients, 52.9% (63) presented hyperglycemic crisis. 52.3% (33) were women, while 47.6% (30) were men. 38.6% (46) of the diabetic patients presented infections. 63% (75) of patients had the disease less than 10 years, or did not know they had it. Of these, 54% (41) developed hyperosmolar hyperglycemic state, while 22 patients who lived with diabetes mellitus for more than 10 years developed hyperglycemic state. Those who received treatment were 68.9% (82), of whom 53.6% (44) developed hyperosmolar hyperglycemic state. Conclusion: There is an association between infections and HHS with an OR of 9.12 (CI: 3.6-22.4). No statistically significant difference was found between the time of illness and the hyperglycemic crisis with an OR of 0.82 (CI: 0.3-1.7), as well as the treatment with an OR of 7.7 (CI: 0, 5-2.3). The oral treatment was also not associated with the development of hyperosmolar hyperglycemic state, obtaining an OR of 0.4 (CI: 0.17-1.1). Within the comorbidities, the vascular disease was the only one associated with HHS with an OR of 2, 55 (IC: 11-5,5). Key words: Hyperglycemic crisis; Hyperosmolar hyperglycemic state; Infections; Time of illness; Mental state; Comorbidities; Abdominal pain. (source: MeSH NLM) DOI: https://doi.org/10.25176/RFMH.v18.n1.1265

Abstract   Diabetes is a chronic disease that occurs when the pancreas does not produce enough insulin or when the body does not use efficiently the insulin it produces. According to the ENDES 2013, it has found a prevalence of overweight of 33.8% and obesity of 18.3%. Objective: Determine the results of the risk test for diabetes mellitus type 2 of the American Diabetes Society in the care and administrative personnel of a particular clinic. Methods: Observational, cross-sectional, analytical study that evaluates the probability of workers suffering from diabetes mellitus. The population of the study will be made up of workers, both clinical and administrative staff of the institution. Results: 34% of the population had normal BMI, 49% were overweight and 18.3% were obese. 15% of the studied population is at risk of developing diabetes mellitus type 2 according to the risk test for diabetes mellitus type 2 of the American Diabetes Society. The factors significantly associated with the risk of developing diabetes were older than 40 years OR: 10,14 IC95% 4,29, 23,98, p: 0.000; male sex OR: 2,35 % 1,06-5,21, p: 0.03; family history of diabetes OR: 6,330 IC95% 2,76-14,51, p: 0.000; BMI greater than 25 OR: 19,706 IC95% 2,62-147,96, p: 0.000 and physical activity OR: 28,95 IC95% 3,86-217,18; as well as the diagnosis of arterial hypertension OR: 13.500 IC95% 4.87-37.38. Conclusion: The risk found to develop diabetes was 15%, being higher in the administrative group than in the healthcare group. The factors associated with the risk of developing diabetes are directly linked to lifestyle medicine. Key words: Diabetes Mellitus; Risk Factors; Massive Screening. (source: MeSH NLM) DOI: https://doi.org/10.25176/RFMH.v18.n1.1264