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El Instituto Nacional de Salud, ha llevado a cabo por primera vez el proceso de identificación de Prioridades Nacionales de Investigación en Salud Bucal a cargo de la Subdirección de Investigación y Laboratorios de Enfermedades No Transmisibles del Centro Nacional de Salud Pública con la asesoría técnica de la Dirección de Investigación e Innovación en Salud y en coordinación con la Dirección Ejecutiva de Salud Bucal de la Dirección General de Intervenciones Estratégicas en Salud Pública del Ministerio de Salud mediante metodología participativa de tres actores claves: investigadores/especialistas, expertos y decisores. El objetivo de este artículo es describir el proceso seguido para la identificación de estas prioridades, el cual comprendió cinco fases: i) identificación de objetivos estratégicos del MINSA, ii) identificación de necesidades de investigación en salud bucal, iii) revisión por expertos y valoración de las necesidades según criterios, iv) priorización (valoración de la lista de prioridades según calificación) y v) presentación de las prioridades. Como resultado se obtuvieron las 12 prioridades que posteriormente fueron aprobadas por Resolución Ministerial N.° 262-2022/MINSA, con un periodo de vigencia 2022–2026. Además, se brindaron recomendaciones para futuros procesos.

Objective. To determine the genetic structure of drug-resistant strains of Mycobacterium tuberculosis that circulated throughout Peru during the years 2011-2015, by using haplotypes obtained from a line probe assay. Materials and methods. A total of 6589 samples that were admitted to the Instituto Nacional de Salud for routine diagnosis using the GenoType® MTBDRplus v2 assay were analyzed during the study period. Resistant haplotypes were created by concatenating 21 polymorphic sites of the evaluated genes using the line probe assay; and the association analysis was carried out with phenotypes obtained by the 7H10 agar ratio method. Results. The most frequent mutations were: rpoB S531L (55.4%) and rpoB D516V (18.5%) for rifampicin resistance, and katG S315T (59.5%) and inhA c-15t (25.7%) for isoniazid resistance. We obtained 13 representative haplotypes (87.8% of analyzed samples), 6 corresponded to the multidrug-resistant genotype, 4 to the isoniazid mono-resistant genotype and 3 to the rifampicin mono-resistant genotype. Eighteen regions and the province of Callao showed high haplotype diversity; four showed moderate diversity and two showed low diversity. Conclusions. Most regions showed high haplotype diversity; in addition, most drug-resistant strains of Mycobacterium tuberculosis were concentrated in the cities of Lima and Callao. Likewise, drugresistant Mycobacterium tuberculosis strains circulating in Peru mainly contain the genetic markers with the highest prevalence worldwide, which are associated with resistance to rifampicin and isoniazid.

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an anti-neuronal antibody-mediated inflammatory brain disease whose early diagnosis and treatment significantly improves the disease prognosis. We report four cases with definitive diagnosis of anti-NMDAR encephalitis hospitalized at Instituto Nacional de Ciencias Neurológicas, Lima-Perú. All patients had seizures, being refractory status epilepticus observed in three cases (75%). Psychiatric disorders, dyskinesia and dysautonomic signs were evidenced in all patients, and two of them required mechanical ventilation. Electroencephalographic abnormalities were reported in all patients; as well as abnormal cytological findings in cerebrospinal fluid in two (50%), and brain lesions in magnetic resonance imaging in one (25%). All patients were treated immunosuppressive medication with methylprednisolone, and two of them (50%) required plasma exchange given the poor response to corticoids. At 12 months of follow-up after discharge, three patients (75%) did not report seizures and one of them did not achieve functional independence. Anti-NMDAR encephalitis mainly affects young people and we have to take it into account in our differential diagnoses given that its omission can lead to death or severe disability of our patients. Early diagnosis and treatment is essential for a positive prognosis. [ABSTRACT FROM AUTHOR]