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Un brote infeccioso causado por el virus H3N7 que llega a la ciudad de Los Ángeles, California, procedente de Australia, es el desencadenante para una crisis que incluye actos de corrupción. Al igual que durante la pandemia de SARS CoV-2, Amenaza letal / Pandemic (2007) de Armand Mastroianni, muestra secuencias de falta de decisión política, micro y macro corrupción, así como una falta de responsabilidad social que ocasionan miles de muertes en pocas horas. La corrupción en la respuesta a una emergencia sanitaria es un problema grave que requiere atención urgente ya que puede socavar dramáticamente los esfuerzos de salud pública, exacerbar la desigualdad y erosionar la confianza en las instituciones. En este trabajo se realiza un breve análisis sobre la corrupción durante la epidemia por H3N7 abordando sus efectos sobre las actividades sanitarias, que recrudecen el impacto de la enfermedad y muestran la falta de compromiso social y moral de los ciudadanos. Asimismo, el sistema de salud se ve afectado por las decisiones políticas y los actos de corrupción reduciendo su capacidad de respuesta.

BackgroundOlder adults with tuberculosis (TB) present unusual clinical features and can be challenging to diagnose. Culture after evaluation of sputum smear (AFB) may result in improved diagnosis performance, however it has not yet been evaluated in Peruvian older adults. We aimed to evaluate the diagnostic relation of TB culture after the AFB in patients aged ≥ 65 years derived for the diagnosis of pulmonary (PTB) and extra-pulmonary (EPTB) in Lima, Peru.MethodsA cross-sectional study was developed in Lima, Peru, in order to evaluate the relationship of TB culture after AFB test in older adults (≥ 65 years) during the PTB and EPTB diagnosis. The frequency of contaminated cultures and the discrepancies between the conventional AFB test and Ogawa-Kudoh culture were analyzed.ResultsOf the 10,461 sputum and 2,536 extrapulmonary samples analyzed during 2015–2017, PTB was diagnosed in 282 (2.7%) and EPTB in 88 (3.5%), respectively. The performance of AFB in the diagnosis of PTB had a sensitivity of 78.2% and specificity of 99.8%. The performance of AFB in EPTB had a sensitivity of 45.5% and specificity of 99.9%. Negative AFB with positive culture was more frequent in ≥ 82 years (p = 0.031). We determined a good agreement in the diagnosis of PTB (κ = 0.84) and moderate for EPTB (κ = 0.55).ConclusionOur findings suggest that diagnosis through culture should be performed after the AFB smear evaluation due to the moderate performance of AFB, especially in patients ≥ 82 years old.

Introduction: The COVID-19 pandemic has posed an unprecedented challenge to global public health, leading to a significant increase in scientific production in medical sciences. Objective: To describe the annual variations in publications on COVID-19 in the Revista Cubana de Medicina Militar. Methods: A 4-year bibliometric study (2020-2023) was conducted, including 110 documents on COVID-19. Changes in the timing of publications and the medical specialty addressed were analyzed. Results: Of the total articles, 110 (16.8 %) were on COVID-19, with publications of 16.5 %, 28.3 %, 22.6 %, and 15.4 % in 2020, 2021, 2022, and 2023, respectively. Significant differences were observed in the number of documents between 2020, 2022, and 2023 (p< 0.05). There was a progressive increase in the number of publications over the years, with a particular concentration on mental health (3.8 % in 2020 and 42.5 % in 2023). In 2020, the main topics were therapeutics, education and research, epidemiology, forensic medicine, and obstetrics and gynecology, while in 2023, it was mental health. Conclusions: These findings suggest an evolution in the focus of research during the pandemic years, with a growing emphasis on mental health.

BackgroundMetrology plays a crucial role in small healthcare service businesses to ensure the quality of products and services. While legal metrology in healthcare exists in some regions, it lacks harmonization. In other countries, there is limited presence of metrology in medical and biomedical engineering. We aimed to evaluate the implementation of metrological assurance systems for medical devices in Latin America.MethodsA systematic review was conducted following PRISMA 2020 guidelines and registered with PROSPERO (CRD42022359284). Searches were performed across 13 databases from October 30th to November 3rd, 2022. The search equation was “(((quality assurance) AND (metrology)) AND (medical devices)).” A total of 7,789 documents were identified, of which only 16 met the inclusion criteria.ResultsThe majority of studies (75%) were conducted in Colombia, with a significant portion being undergraduate theses. The primary normative references used in the analyzed studies were ISO 10012 and ISO 17025, with the majority (68.75%) relying on national legislation for their approach. One study in Colombia referenced eight standards, and one in Brazil analyzed user involvement in medical device management. Among the included studies, 56.25% were conducted in healthcare institutions, mainly clinics. Most studies provided implementation guidelines, with ISO 10012 being prominent, alongside ISO 17025, which implicitly addresses ISO 9001 elements. Global bias was low across all studies.ConclusionOur results underscore the importance of metrological assurance in managing medical devices in Latin America. The utilization of international standards and national legislation illustrates the diverse approaches adopted by different institutions. Future research should focus on optimizing metrological practices to enhance quality and safety in healthcare.

BackgroundCOVID-19 has led to significant global mortality, with Peru being among the countries most affected. While pre-existing comorbidities have been linked to most cases, the exact distribution of fatalities within the country remains unclear. We aimed to assess deaths attributed to cardiovascular diseases (CVD) before and during the COVID-19 pandemic across various regions and provinces in Peru.MethodsAn observational georeferencing study was designed. Peru faced four waves of COVID-19 over three years, with variable impacts across its three regions (Coast, Highlands, and Jungle). Deaths related to cardiovascular diseases, such as heart failure (HF), arrhythmia, acute myocardial infarction (AMI), strokes, and acute coronary syndrome, were examined as primary variables. The study period spanned pre-pandemic years (2017–2019) and pandemic years (2020–2021), utilizing death data from the National Death Information System (SINADEF). The georeferencing analysis was conducted using ArcGIS v10.3.ResultsA total of 28,197 deaths were recorded during the study period, with significant increases during the pandemic (2020–2021). Cardiovascular deaths were disproportionately higher during the pandemic, totaling 19,376 compared to 8,821 in the pre-pandemic period (p

Objective: Funeral practices have undergone significant changes during the COVID-19 pandemic. Thus, the death of a family member from this disease has altered the typical course of the bereavement process. Therefore, this study seeks to determine the relationship between the levels of grief, anxiety, and depression in relatives of patients who died from COVID-19 in Peru. Methods: A total of 250 volunteers were obtained, but after applying the inclusion criteria and not being able to contact five of them, the sample consisted of 115 participants over 18 years of age who lost a family member to COVID-19 between 2020 and 2021. They developed the Prolonged Grief Questionnaire-13 and the Zung Anxiety and Depression Questionnaires, in virtual surveys using Google FormTM (Google, CA). Results: Our analysis revealed that all cases of anxiety (18.3%) were present in individuals experiencing prolonged grief (76.5%), while 49.5% (57/115) of participants exhibited symptoms of depression. Furthermore, we identified a significant association between prolonged grief and both anxiety ( p = 0.005) and depression ( p

Introduction and objective: The COVID-19 pandemic has caused mental health problems worldwide. Older people have been particularly affected by the lockdown as their health conditions have changed, although they have been kept in isolation to avoid exposure to contagion. We sought to determine the association between lifestyles and anxiety in older adults during the COVID-19 pandemic. Materials and methods: This study was cross-sectional. We enrolled 150 older adults of both sexes and with a history of chronic diseases from the municipality of El Agustino (Lima, Peru). The 20-item Geriatric Anxiety Scale and the 25-item Lifestyle Questionnaire on eating, physical activity, rest, and sleep were administered in Spanish during July–August 2021. Results: The mean age was 70.8 ± 8.1 years, 54.7% were male, and 75.3% practiced exercise. During the COVID-19 pandemic, 99.3% of the elderly had healthy lifestyles and 40% presented anxiety (mild, moderate, and severe anxiety in 26.7%, 8.7%, and 4.7%, respectively). We found no association between anxiety and lifestyle ( p = 0.189), physical exercise was a predictor of lifestyle ( p 0.05). Conclusions: Our results suggest that there was no link between anxiety symptoms and lifestyle in older adults during the lockdown. It is important to conduct in-depth research on factors associated with anxiety symptoms among older residents in other regions, focusing on population groups with the highest rates of infection and death from COVID-19.

Abstract Background and Aims The incidence of infectious diseases among athletes during international competitions is a concern for public health. In this study, we aim to report six cases of norovirus‐associated gastroenteritis among athletes in Lima 2019 Pan American Games, a multisport event held in Peru. Results During the Lima 2019 event, there were no reported outbreaks or cases of most frequent diseases, however, six cases (0.09%) of norovirus‐associated gastroenteritis were reported. The clinical stage of the cases was self‐limited to 2 days, and the main treatment was fluid replacement. Of the six affected athletes, five came from the United States and one from Chile. Only one karate athlete from the United States, could not continue with the competition due to the illness. Conclusions The incidence of norovirus‐associated gastroenteritis among athletes in Lima 2019 was low, and the clinical course of the illness was self‐limited. We conducted a retrospective analysis of medical records of athletes who presented with gastroenteritis using the Panam Sport In previous sporting events, such as the 2017 World Athletics Championships in London, Injury and Illness Surveillance System. These findings can inform the development of public health strategies for the prevention and control of infectious diseases among athletes during international competitions.

Background: Burnout Syndrome (BS) is a work fatigue phenomenon that leads to physical exhaustion during care work, and there could be an increase in the proportion of nurses affected during the COVID-19 pandemic, especially in those caring for infected patients. We aimed to determine BS in nurses during the COVID-19 pandemic. Methods: An observational study was conducted on 100 nurses over the age of 18 and working in COVID-19 medical units in 2021. The 22-item Maslach Burnout Inventory questionnaire was used to estimate BS, and differences between age groups, gender, work time, and previous infection were estimated. Results: The majority of nurses (mean 30 ± 5.5 years) were women (78%), and the most frequent working time was from 1 to 10 years (58%). A total of 88% of the nurses had moderate BS, affecting more males, aged between 20 and 30 years, and without previous infection. The youngest age group, 20–30 years, presented the highest mean BS with 53.8 (SD 4.18) points (95% CI: 52.79 to 54.8), showing differences with older nurses (p < 0.05). Prediction analysis showed that only age was a significant predictor for the development of SB (p < 0.001). Conclusions: BS negatively impacts young nurses during the care of COVID-19 patients, so strategies should be promoted to ensure a better working environment. Improving the workspace can include self-care strategies, changes in the system and work organization, an improvement of interpersonal relationships, and risk prevention.

BackgroundDiabetic foot is one of the most significant complications in individuals with diabetes and is closely associated with lower limb amputation. The antibiotic susceptibility patterns of these bacterial isolates play a critical role in guiding effective treatment strategies We aimed to determine the most common bacterial agents causing diabetic foot infections in a tertiary-care hospital in Peru.MethodsClinical and microbiological data were collected from 181 patients diagnosed with diabetic foot infections and positive microbiological culture results. All the samples were analyzed with the Vitek 2 compact system and the cut-off points were defined with the CLSI M100 guide. The data were segregated based on mono-microbial or poly-microbial cultures, bacterial types, and antibiotic susceptibility profiles.ResultsA total of 32 bacterial species were identified, predominantly Gram-negative (63%). The most frequent bacterial agents isolated were Staphylococcus aureus (19.9%), Escherichia coli (12.2%), Pseudomonas aeruginosa (8.3%), and Proteus vulgaris (6.6%). These bacteria commonly exhibited resistance to Ampicillin, Ciprofloxacin, Levofloxacin, Trimethoprim-sulfamethoxazole, and Cefuroxime. E. coli showed the highest antibiotic resistance (19 antibiotics), while Gentamicin, Tobramycin, and Levofloxacin demonstrated the highest sensitivity against the most prevalent bacteria. Gram-negative bacteria also exhibited notable antibiotic-susceptibility to Meropenem, Piperacillin/tazobactam, and Amikacin. Regarding the presence of Extended-Spectrum Beta-Lactamase, 54 isolates tested positive, with 35 (64.8%) and 14 (42.4%) of these being S. aureus and E. coli.ConclusionsBacterial agents causing diabetic foot infections pose a constant concern, particularly due to the increasing antibiotic resistance observed. This difficulty in treating the condition contributes to a higher risk of amputation and mortality. Further research on bacterial susceptibility is necessary to determine appropriate dosages for pharmacological treatment and to prevent the overuse of antibiotics.

BackgroundEmpathy in healthcare service refers to the ability of healthcare workers (HCWs) to put themselves in patients’ shoes, which is necessary to ensure a good physician-patient relationship and provide quality care. Various studies have shown that empathy varies depending on the country, the instrument used, the evaluator, and the HCW’s specialty. This systematic review aims to estimate the levels of empathy among HCWs in South American countries between 2000 and 2019.MethodsWe conducted searches in 15 databases (PubMed, Scopus, Web of Science, EMBASE, Scielo, PsycoInfo, ScientDirect, Latindex, and LILIACS), four preprint servers (medRxiv, bioRxiv, SportRxiv, and Preprints), and other search engines such as Dimensions (20), Google Scholar, Yahoo!, and Alicia CONCyTec (c). We followed the PRISMA guidelines, and this study was registered in PROSPERO (CRD42023454007).ResultsOut of 18,532 documents identified from November 10 to 28, 2021, 10 articles were included (n = 2,487 participants, of which 1989 were patients). Among the studies focusing on self-evaluated empathy, four relied on the Jefferson Scale of Empathy for medical professionals (JSE-HP). However, assessments from patients employing Jefferson Scale of Patient’s Perceptions of Physician Empathy (JSPPPE) and Consultation and Relational Empathy (CARE) scale suggested high levels of empathy We found that both professionals and patients perceived that empathic care was provided, often at a medium or regular level. Surgery residents presented lower levels of empathy compared to obstetrics-gynecology and pediatrics physicians.ConclusionEmpathy is crucial in determining the quality of care and patient satisfaction during healthcare services provided by HCWs. Therefore, it is important to support professionals so that the various stressful situations they encounter in their work and daily life do not negatively influence the approach they provide to patients.

Introduction and objective Research attitudes among nursing students are essential to improve the quality of care and promote evidence-based practice. The objective of this study was to determine the attitude towards research of nursing students during their undergraduate internship and explore the demographic and study-related factors that may affect these attitudes. Materials and Methods In this cross-sectional retrospective study, 100 nursing interns who are >18 years old, currently studying and working, and have a prior academic background were included. To assess the attitudes toward research, the 43-item Likert-like Scale of Attitudes Towards Research questionnaire was used, which has been previously validated in the Peruvian population and includes three distinct dimensions: affective, cognitive, and behavioral. Results The mean age was 28.7 ± 5.2 years and 88% were women. Fifty percent had favorable attitudes toward research. The favorable attitude according to the affective, cognitive, and behavioral dimensions was 28%, 11%, and 45%, respectively. Although the youngest age group (20 to 30 years old) had the highest frequency of favorable attitudes (36%), no significant differences were found when compared to other age groups ( p = .082). Conclusions Nursing students presented favorable attitudes toward research during their undergraduate internship, especially among young students. However, more research is needed to understand how these attitudes are shaped and consolidated during the research process and how they can be further improved to promote evidence-based practice in nursing.

En Corea del Sur se han gestado dos hitos con la publicación de Hana Yori Dango durante los 90’s y la emisión de la serie Boys over flowers (2009) a inicios de la primera década del siglo XXI. En Boys over flowers se presenta a Yoo Ji Hoo como miembro de los F4, un grupo de elite coreano, quien sufre de un accidente en su primera infancia donde fallecen sus padres y adquiere autismo luego del trauma. En su orfandad logra “salir” del autismo con la ayuda de Min Seo Hyun, una amiga cercana y de quien se enamora, permitiendo su reincorporación social como un sujeto neurotípico. En vista del progresivo incremento de los casos de niños autistas en todo el mundo, y de las ventajas que promete la medicina moderna sobre su tratamiento y ocasional “curación”, aquí buscamos responder a las siguientes preguntas: i) ¿es posible desarrollar autismo luego de un evento traumático?, y ii) ¿Es posible “salir” del autismo? Realizamos este análisis tomando como eje las cuestiones de vida de Yoo Ji Hoo en Boys over flowers.

Context: Quality assurance in cervical cytology is based on the cyto-histological correlation that is performed in several countries even without standardized protocols. Aims: To evaluate the quality of the Pap smear with the Clinical and Laboratory Standards Institute (CLSI) EP12-A2 guideline in a Peruvian hospital. Settings and Design: This prospective study was carried out at tertiary care national hospital. Methods and Material: The 156 cyto-histological results were collected and coded according to the Bethesda 2014 and FIGO system. The evaluation with the CLSI EP12-A2 guide allowed estimating the performance and quality of the test. Statistical Analysis Used: We performed a descriptive analysis of the cytological and histological data and correlation with the weight Kappa test. From the calculation of the likelihood ratios, the post-test probability was estimated using Bayes' theorem. Results: In cytology, 57 (36.5%) were undetermined abnormalities, 34 (21.8%) low-grade squamous intraepithelial lesion (SIL), and 42 (26.9%) high-grade SIL. Of the total biopsies, 56 (36.9%) were cervical intraepithelial neoplasia (CIN) grade 1, 23 (14.7%) were both CIN grade 2 and 3. We determined sensitivity, specificity, a positive and negative predictive value of 94%, 74.6%, 58%, and 97.1%, respectively. We determined a moderate cyto-histological agreement (κ = 0.57). Atypical squamous cells of undetermined significance (40%), and cannot exclude high-grade squamous intraepithelial lesions (42.1%) that showed higher overdiagnosis results. Conclusions: The quality and performance of the Papanicolaou test show high sensitivity and moderate specificity. The concordance found was moderate and the proportion of underdiagnosis was higher in abnormalities of undetermined significance.

Este artículo presenta un análisis sobre la película “I, Daniel Blake” (2016), filme que nos pone en la posición de una persona con una enfermedad crónica degenerativa, mostrándonos el punto de vista de un paciente y su vivencia fuera de los muros del hospital, dentro de un sistema de salud europeo burocratizado y estandarizado que no cubre las necesidades individuales de los enfermos. Se consideran distintos aspectos de interés en este análisis, útiles para la formación universitaria en medicina humana, como lo son; la amenaza que puede significar que el sistema de salud se enfoque en la eficiencia y eficacia de la gestión por encima del bienestar del paciente y la comprensión de relevancia del contexto individual, familiar y comunitario del mismo, evidenciando que el ejercicio y desarrollo de la medicina integral es indispensable para una apropiada atención a los pacientes.

BackgroundThe COVID-19 pandemic has disrupted human well-being worldwide in unforeseen ways. In early 2020, the spread of the virus left its mark on every affected country, impacting mental health by limiting daily activities and causing fatalities amidst public health strategies to mitigate its impact. The influence of COVID-19 on the quality of life (QoL) may vary between countries, underscoring the need to examine its effects on individuals and families during the mandatory home quarantine. We aimed to assess the QoL of individuals and families during home isolation by COVID-19 lockdown.MethodsA cross-sectional study was conducted from February to May 2020. We included adult partners (≥18 years) of families from Brazil, Colombia, Spain, Japan, Peru, Russia, and Venezuela. Using the 26-item World Health Organization Quality of Life Brief (WHOQOL-BREF) questionnaire we assess the impact of COVID-19 on their partner/family member’s QoL.ResultsThe survey was completed by 466 participants (mean age = 38.59 ± 13.75 years; females = 298) and 76% worked mostly as health professionals from South America (69.2%), Europe (18.4%), and Asia (12.4%). The WHOQOL-BREF mean score from 38.38 ± 11.55 (range = 22.8–43.4). The average quality of life in South America (41.9 ± 1.2) was significantly higher than that of European countries (30.9 ± 11.5) (p = 0.002). The social relations dimension was the only one with values close to 100 (mean = 83.3) in 6/7 evaluated countries, where only Spain had a low score (41 ± 33.12). Women had a slightly lower quality of life than men, but it was not significant (40.2 ± 8.8 vs. 41.5 ± 9.9, p = 0.354), while we found differences in the overall QoL between young and older, and by employment type (p

BackgroundCOVID-19 has been causing mental health problems around the world, with rural and indigenous peoples likely to be the most affected. This systematic review synthesizes and critically analyzes the existing literature on mental disorders in the rural Andean population in Latin America.MethodsA systematic review with narrative synthesis was carried out following the PRISMA guidelines. We searched nine databases (PubMed/MEDLINE, Scopus, EMBASE, ScienceDirect, Web of Science, Cochrane, Scielo, LILACS, and Latindex), five public prepublication servers (SocArXiv, medRxiv, bioRxiv, SportRXiv, and Preprints), ALICIA, and Google Scholar for articles that included the analysis of mental health problems using data collected from the rural Andean population in Latin America. These were eligible for inclusion. Articles that included Non-Latin American populations (including European or African migrants) and studies conducted prior to the COVID-19 pandemic (since the declaration of national lockdown) were excluded.ResultsA total of 23,761 articles were retrieved, 14 of which met the inclusion requirements. Most were cross-sectional (n = 12) and related to anxiety (n = 9), depression (n = 8), and stress (n = 5). The mental health analysis of 5,976 rural dwellers from four countries in Latin America also included gray literature studies (n = 7) that allowed the quantification of mental health problems in adults (n = 7) and adolescents/children (n = 4). Only one study was multinational, and the quality of publications varied. Despite the high frequency of anxiety, depression, and stress symptoms among rural Latin American populations during COVID-19, published research is very limited. This review found preliminary evidence that the frequency of anxiety (45%), depression (27.6%), and stress (33.1%) in the rural population was associated with pandemic restrictions across countries. Measures of other psychiatric problems, such as distress or suicidal ideation, cannot be estimated.ConclusionRegional-wide studies investigating changes in the frequency of symptoms of mental health problems in the context of the COVID-19 pandemic are warranted to inform culturally adapted prevention strategies. This study is limited to a narrative synthesis and may be subject to publication bias.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=320489.

Introduction: In the transition from digital education to face-to-face education, there are changes in the teaching models implemented during COVID-19. Objective: To examine the perception of university students, in terms of satisfaction and acceptance, about virtual classes. Method: A cross-sectional study was made on 11 246 students from 17 university courses at Universidad Norbert Wiener at Lima (Peru). The 11-items UNW Employability Survey 2021 (EE-UNW21) administered through the student platform was used. The data were analyzed in SPSS v. 24.0; work, educational variables and students' perception of remote access to classes and exams were considered. Results: Of the total od students, 72.4% consider returning to classes "very important" (41.0%), with dentistry (48.5%) and human nutrition (46.4%) students being the ones who attributed the greatest importance (p= 0.002). However, the students consider that returning to the classroom is important (72.4%), but also maintaining the benefits of virtuality (77.5%) (p= 0.057). 89.9%, 47.3%, and 71.2% perceived as "very important" the possibility of seeing recorded classes, the ease of accessing the class without having to go to campus, and the fact of being able to take exams that, with notes, readings and other study materials, respectively. Conclusions: There is a perception of acceptance of virtual education during the COVID-19 pandemic and the return of face-to-face classes.

Introduction: Tuberculosis continues to be one of the main causes of morbidity and mortality worldwide. Prevention measures are key to prevent its spread and contagion among health professionals. The objective of the present study was to determine the self-care attitudes about tuberculosis in the nursing staff after a hospital infectious outbreak in Perú. Method: A cross-sectional study was conducted in nursing staff (n= 94; technical staff n= 44, 46.8%). Volunteer nursing staff > 18 years old, of both sexes, and who work in the Emergency Department were included. The 15-item questionnaire from Valle (2017) was used to estimate knowledge and attitudes about self-care in nursing staff in 3 dimensions: prevention, diagnosis and treatment of tuberculosis. Results: The average age of the participants was 44.7±8.8 years, 88.3 % were women, and the average working time was 11.2 ± 7.8 years. Difference was found between the years of service, among technicians (8.55 ± 7.94 years) and nursing professionals (13.48 ± 6.98 years) (p< 0.001). A hundred percent of nurses presented attitudes of acceptance of self-care in all dimensions; 4.5 % and 27.3% of nursing technicians presented attitudes of indifference in the tuberculosis diagnosis and treatment dimension (p= 0.001). Conclusions: There are favorable attitudes in the nursing staff about self-care of tuberculosis after an outbreak in a hospital in Lima, although in nursing technicians we report attitudes of indifference in the diagnosis and treatment of tuberculosis.

Abstract Objective To ensure the health of newborns, it is necessary to perform high-quality diagnostic tests. The TORCH panel is a set of tests that identifies infectious pathogens such as Toxoplasma (Toxo) and Cytomegalovirus (CMV) that are common in low-setting populations. We performed TORCH panel quality planning using six sigma in a reference laboratory at Peru. Results This was a cross-sectional study. TORCH tests include Toxo, Rubella, CMV, and Herpes. We processed all samples by fourth-generation ELISA on the GEMINI XCR200 analyzer (Diatron, Budapest, Hungary). We obtained the imprecision from the annual data of the external quality assessment plan and we used the CLSI EP12-A3 guideline. In a total of 44,788 analyses, the average imprecision was 3.69 ± 1.47%, and CMV had lower imprecision (2.3 and 2.6% for IgM and IgG, respectively). Quality planning of the TORCH panel allowed estimating the sigma value that ranged from 4 to 10 (average 7 ± 2 sigma), where rubella had the highest values (10 for IgM and 8 for IgG) while HSV2 had the lowest values (4 for IgM and 5 for IgG). Our results suggest the optimal performance of half of the markers including Toxoplasma, Rubella, and CMV in the Peruvian population.

Abstract Background and Aims COVID‐19 is a pandemic disease that can lead to altered lung function, systemic inflammatory events, and altered coagulation. During severe stages of the disease, changes in coagulation homeostasis increase, leading to thrombosis, and increased risk of death. In this cross‐sectional study, we aimed to assess coagulation markers by COVID‐19 severity in Peruvian adults. Methods During the second wave of infections, we included 186 adults diagnosed with COVID‐19 (mean age 53.3 ± 16.3 years). Patients were divided into mild, moderate, and severe stages of COVID‐19, and coagulation markers included prothrombin time (PT), activated partial prothrombin time (aPTT), fibrinogen, d‐dimer, and platelet count. Results Of the total, 120 (64.5%) were males and 39 (21%) were in the intensive care unit. We determine 104 (55.9%), 43 (24.7%), and 36 (19.4%) patients in mild, moderate, and severe stages of COVID‐19, respectively. In the severe stage of COVID‐19, patients had an average concentration of PT, aPTT, fibrinogen, d‐dimer, and platelets of 13.2 ± 0.9 s, 28.9 ± 4.3 s, 679.4 ± 185.1 mg/dL, 1.9 ± 3.1 µg/mL, and 272.8 ± 88.9 cel/10 mm,3 respectively. We found no differences in the concentration of each marker according to severity (p

BackgroundQuality of life (QoL) is a multifactorial concept on the perception of the individual’s wellbeing underpinned by environmental, psychological, and physical factors. Several studies have shown changes in QoL in the COVID-19 pandemic and may be due to increases in mortality rates, however, no study has investigated this among Peruvian jungle dwellers. Here, we have sought to estimate the QoL of individuals before and after the increase in cases and deaths from COVID-19.MethodsA questionnaire-based longitudinal study was conducted in 102 inhabitants (mean 40.75 ± 7.49 years). The Spanish version of the WHOQOL-BREF was used in two stages: April and June. The first stage was accomplished before the first confirmed case of COVID-19, and the second stage was when the daily mortality rate was 3.5% with an incidence of 87%.ResultsSixty (54.8%) participants were women, 67 (61.9%) were >31 years, and 38 (34.5%) and 32 (29.1%) participants had primary and secondary education, respectively. In the first and second stage we obtained an overall mean QoL of 46.65 ± 23.2 and 35 ± 27.7 points, respectively. Individuals had significantly lower QoL in the face of increased deaths in physical (p = 0.001), mental (p = 0.028) and environmental (p = 0.001) health domains, with the latter having the greatest impact (51.84 ± 5.81 vs. 16.66 ± 5.55 points).ConclusionQuality of life of Peruvian jungle dwellers is reduced during periods of increased mortality and incidence by COVID-19. Preventive strategies aimed at reducing the impact of COVID-19 on the mental health and global wellbeing of individuals living in the Amazon are recommended to Peruvian authorities.

Contemporary neurosciences continue to separate the act of seeing in the processes of vision and the processes of ocular motor skills, without even proposing a unifying explanation of both aspects of the same reality: as the act of looking. The aim of this article is to explain the act of looking through the series of neurological events that occur and to understand that one looks with consciousness. Visual processes are explained based on the contemporary neuroscientific approach and Informational Sociobiological Theory in Nicolas Poussin's "The Plague of Azoth". While the traditional explanation traditional explanation of neuroscience refers that every stimulus activates a receptor, following a nervous path to the brain, from the Informational Sociobiological Theory, the act of looking is an epiconscious activity, a construction that results from the sum emerging from the five levels of complexity. These integrate this process in the movements that describe the eyes and the action of what is seen simultaneously. "The Plague of Azoth" shows a city plagued by the bubonic plague, with two traits: a divine curse and the presence of breathable miasmas. Poussin not only painted the grounds for a magical (traditional) and scientific explanation, but also for a technological (bacteriological) explanation that would emerge two centuries after his death. In conclusion, the act of looking from the Informational Sociobiological Theory is a process that begins in the neocortex and that integrates information at five levels. This explanation allows us to understand "The Plague of Azoth" as an advanced technological approach.

Fish farms are one of the principal food industries located in peri-urban and rural communities that use available resources to ensure the quality of their products. However, trout can suffer from bacterial infections affecting the sector and being a key component of human health risk. We aimed to identify and characterize Enterobacteriaceae in 46 trout (Oncorhynchus mykiss) in two fish farms in Lima, Peru. Adult trouts older than seven weeks (> 200 grams weight) were included. Cultures were performed in duplicate (n=192 trials) with swabs from the squamous surface and visceral cavity. The isolates were identified with the Vitek® 2 Compact system, and the minimum inhibitory concentrations (MIC) were interpreted with the CLSI VET 03-A guide. At El Molino and El Angelito fish farms, 66 (68.8%) and 57 (59.4%) isolates were obtained. The most frequently isolated species were Escherichia coli (56.8%), Proteus sp. (4.2%) and Klebsiella pneumoniae (2.6%). E. coli was present in all sampling areas, and Aeromonas hydrophila was only present in one open viscera sample at El Angelito fish farm. A. hydrophila showed antibiotic resistance to Ampicillin/Sulbactam (≥32 MIC), Oxytetracycline (>8 MIC), Imipenem (8 MIC), Levofloxacin (>8 MIC), and Ceftazidime (≥64 MIC). Our results suggest the presence of multi-resistant A. hydrophila in O. mykiss. Further studies are needed to understand the developmental context of A. hydrophila, which is crucial to the food industry, aquaculture and public health

Abstract Background and Aims Low‐risk human papillomaviruses (HPV) are important in pregnant women because they are risk factors for Condyloma acuminatum and recurrent respiratory papillomatosis in the newborn. On the other hand, HPV may contribute to the development of preneoplastic lesions such as LSIL in pregnant women. We aimed to assess the frequency of HPV infections in low‐grade squamous intraepithelial lesion (LSIL) in Peruvian pregnant women. Methods A cross‐sectional study was conducted from 2011 to 2015 in 84 primiparous‐ and multiparous pregnant women (mean age: 27 ± 6.3 years). Pregnant women of 18–45 years attending gynecology outpatient department were included for the study. LSIL and HPV (nuclear irregularities, koilocytosis, and cytopathic effect) cellular alterations were reported using the Bethesda System guidelines. Results Sixty‐four percent had cytological HPV infection (koilocytes and/or pathognomonic signs of infection) and more than a half of pregnant women had a previous Pap test. LSIL was more frequent in multiparous (increased by 12%, p = 0.008), in the second and third trimester (60.7%, p = 0.002), and between the ages of 18 and 30 (42 cases (50%), p = 0.110). This proportion was significatively increased in women with ≥2 sexual partners (39.3%), with an early onset of first intercourse, and from the Rímac Municipality (14.3%) (p

The female hormonal profile is of utmost importance for the assessment of the endocrinological functional status and the diagnosis of diseases. The analysis must delimit their normality intervals based on the manufacturer's cut-off points. Due to not all intervals can be evaluated before use, it is imperative to verify the reference intervals to achieve uniformity in the interpretation of results in the female population. We determine the reference intervals of five female sex hormones [Follicle Stimulating hormone (FSH), Estradiol, Luteinizing Hormone (LH), Prolactin, and progesterone] using electrochemiluminescence in the Cobas e411 (Roche). We included female patients >18 years old, between the 3rd and 15th day of the menstrual cycle (follicular phase) and had no previous medical history or recent medication. For reference intervals analysis, we followed the recommendations of the CLSI C28-A3 guideline. The average concentration for FSH, progesterone, LH, prolactin and estradiol were 11.48 ± 21.10 mIU/ml, 8.19 ± 11.90 ng/ml, 10.98 ± 11.55 ng/ml, 25.05 ± 32.74 ng/mL, and 147.08 ± 473.8 pmol/mL, respectively. Eighty per cent of parameters showed a satisfactory transfer for the manufacturer's reference intervals, except for estradiol, which had 85.5% of transferred values. Our results suggest that 4/5 sex hormones were found within the manufacturer's reference intervals and can be quantified in Peruvian women, ensuring the quality of their results. However, it is necessary to determine the estradiol with other reagents and assays since we show errors in the transfer of intervals.

Introducción: El miedo a la COVID-19 se distribuye por todo el mundo y afecta a todas las comunidades, incluidos los estudiantes universitarios. Es necesario tener herramientas para medir este miedo. Objetivo: Validar la traducción al español del cuestionario FCV-19S ( Fear of COVID-19 Scale). Métodos: Estudio transversal basado en cuestionarios online, realizado en universitarios peruanos de pregrado, durante el primer brote de la COVID-19. Se incluyeron estudiantes con idioma español nativo, acceso a internet y se excluyeron sujetos con problemas de compresión del lenguaje. La traducción del cuestionario se realizó bajo un protocolo estandarizado y se aplicó una evaluación observacional para valorar la validez y confiabilidad de FCV-S19 con α de Cronbach, correlación de Pearson y análisis factorial. Resultados: Se encuestaron 208 estudiantes universitarios, con edad promedio de 25,9 ± 5,9 años (IC95 %: 25,1 a 26,7); más de la mitad fueron mujeres (58,7 %) y aproximadamente 57 % vivía con sus padres. El α de Cronbach fue ≥ 0,8 entre los dominios, con buena consistencia interna del cuestionario (α de Cronbach= 0,832). La validez del instrumento entre los 7 ítems y las 5 categorías demostró una correlación adecuada (p< 0,05); el test de Bartlett (p= 0,0001) y el Kaiser-Meyer-Olkin (0,818) definieron por análisis factorial una dimensión que explicó el 52,3 % de la varianza total. Conclusiones: La traducción al español del cuestionario FCV-19S tiene una validez y confiabilidad óptima, es capaz de medir el miedo por la COVID-19 en una muestra de estudiantes universitarios de Perú.

Abstract Introduction Dental care is provided for high-performance athletes at national and international sports events. Elite athletes may seek care for sports-related injuries and pre-existing oral diseases. Previous studies indicate an association between oral health problems and negative performance impacts in elite athletes. Objectives To determine the prevalence of the most common oral pathologies in high-performance athletes during the emergency dental care performed at the Lima 2019 Pan American Games (JPL-19). Methodology All reports of athletes (≥18 years old, of both sexes, from 41 countries) who received emergency dental care at Pan American Villas during the JPL-19 were included. Injuries and types of oral diseases were classified according to the Injury and Disease Surveillance System proposed by the International Olympic Committee. Results Of the 6680 participating athletes, 76 (1.14%) presented as dental emergencies, 90.8% (69/76) of the athletes seen presented pre-existing oral pathological conditions, the most frequent were periodontal diseases (34%, 26/76) and dental caries (29%, 22/76). Among the sports with the most cases, there were 22 (29%) in athletics, 6 (8%) in soccer, and 6 (8%) in taekwondo. The most frequent dental emergencies came from Peru, Puerto Rico, Bahamas, Grenada, and Venezuela. Conclusions Pre-existing oral diseases were more frequent than sports-related accidents. The most prevalent diseases were periodontal disease and dental caries disease. It is necessary to implement new care strategies for athletes, based on prevention, before and during sports competitions.

Existe una remarcada actividad del cine dentro de los procesos de formación médica promoviendo el desarrollo de múltiples habilidades inherentes. En este estudio, presentamos una propuesta de terapéutica fílmica en el contexto complementario de la asistencia médica actual. Revisamos series de antaño, emitidas alrededor de los 70`s, que constan de capítulos cortos (~25 minutos). Series como Candy Candy, Marco, o Heidi, tienen marcadas diferencias de las series contemporáneas, y el potencial de ser instrumentos terapéuticos en sí mismos debido a: i) presentar personajes concretos (un niño o una niña en particular, en un contexto específico), ii) la existencia de un relato argumentativo (que se sigue capítulo a capítulo, lo cual obliga a que el niño o niña recree longitudinalmente una historia), iii) el abordaje de problemas existenciales (la vida de los personajes los obligan a vivir situaciones límite, usualmente ligados a las condiciones históricas de su tiempo); y iv) la vivencia de experiencias de orden moral (que suponen una discusión sobre lo bueno y lo malo). Estos podrían vincular al niño y el padre, ya que cada capítulo representa una actividad de la vida diaria, eximiendo a estos de la transmisión masiva de series sin contenidos educativos (terapéuticos).

Background: Cytological samples are cleared with xylene in two or three baths during a Pap test, however, this solvent has a high degree of toxicity, and being a controlled reagent infers high costs for its purchase and implications for environmental pollution. We estimated the impact of xylene during the Pap test in terms of the number of liters and cost of two baths of xylene, and also estimated the impact with three baths Methods: This cross-sectional study was carried out in four hospitals of EsSalud in Peru in two stages. First, the analysis of the impact due to the use of two baths of xylene was conducted during the period 2015–2019, and second, the estimates were calculated based on the assumption of three baths of xylene for the years 2020–2025. The assumption was based on the recommendations of the 2018 EsSalud cytology guideline. The monthly amount of xylene was ~10 liters per bath/month and the cost per liter was estimated at 8.13 USD (27 soles). Results: For the staining of 594,898 cytology tests, 7,848 liters of xylene were necessary, resulting in a cost of 60,861 USD (202,068 soles) during the period 2015–2019. The estimates showed a maximum assumption of 9,483 liters and 77,110 USD (256,040 soles) for the use of three baths of xylene in the four EsSalud hospitals (p = 0.0025) during the period 2020–2025. Conclusions: We determined that there was a high economic impact of using xylene with two baths from 2015 to 2019 and a dramatic increase in costs with the possible use of three baths of xylene in the Pap test for the following five years.

ABSTRACT Objective Depression is a mental problem that affects the well-being of healthcare workers, impacting the quality of care and even leading to commit suicide. We aim to the levels of depression in frontline healthcare workers during the first severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak in Peru. Methods A prospective cohort study was designed in the coronavirus disease 2019 (COVID-19) Care and Isolation Center – Villa Panamericana in eastern Lima. Care and Isolation Center-Villa Panamericana houses about 150 healthcare workers and COVID-19 patients. The Montgomery-Asberg Depression Rating scale was used for depression assessment. Results A total of 96 participants (30±5.6 years) were analyzed: 15 (15.6%) physicians, 39 (40.6%) nurses, 14 (14.6%) medical technologists, and 28 (29.2%) nurse technicians. Mild, moderate, and severe depression were present in 35 (36.5%), 44 (45.8%), and 9 (9.4%) of the cases, respectively. The physicians and nurses reported more severe levels of depression: 8 (53.3%) physicians and 18 (46.2%) nurses presented moderate depression; and 2 (13.3%) physicians and 3 (7.7%) nurses presented severe depression (p=0.005). This study determined greater symptoms of depression according to years of work (p=0.001). Thirty-two healthcare workers had COVID-19, 4 (12.5%) physicians, 9 (28.1%) nurses, 7 (21.9%) medical technologists, and 12 (37.5%) nurse technicians. Twenty-four (75%) participants showed symptoms of COVID-19 and developed moderate (12 [37.5%]) and severe (3 [9.4%]) symptoms of depression (p=0.041). Conclusion This study clearly demonstrated a high prevalence of depression in the Care and Isolation Center-Villa Panamericana frontline healthcare workers during the COVID-19 pandemic in Peru.

Abstract Doege–Potter syndrome leads to severe and sustained symptomatic hypoglycemia and is associated with the solitary fibrous tumor. It is a rare cause, and its diagnosis requires a clinical suspicion and other markers such as insulin‐like growth factor II. Here, we describe a case of a patient with intrathoracic tumor and hypoglycemia.

Introducción: La infertilidad es una enfermedad multicausal y el componente genético representa uno de sus principales eventos. Si bien la distribución de la infertilidad puede variar entre poblaciones, las parejas de los países con bajos y medianos ingresos pueden verse más afectadas por la infertilidad, con una proporción de alteraciones citogenéticas aún no esclarecidas. Objetivo: Evaluar la frecuencia de alteraciones citogenéticas y su correlación con el número de abortos en pacientes peruanas con diagnóstico de infertilidad. Método: Se realizó un estudio de corte transversal en 400 pacientes de 18 a 60 años, de ambos sexos, con diagnóstico de infertilidad. Se registraron las características clínicas disponibles durante el examen genético y el análisis citogenético convencional fue con bandeo GTG en muestras de sangre periférica. El análisis de correlación se realizó con la prueba de Spearman. Resultados: Del total, 389 pacientes cumplieron los criterios de inclusión, y de estos, 169 (43,44%) tuvieron reportes de abortos (promedio: 2,25, rango: 1-7). Hallamos una correlación significativa ente el número de abortos y las alteraciones citogenéticas (p < 0,000). Reportamos 25/289 (6,43%) alteraciones cromosómicas, de las que 11/25 (44%) fueron heterocromatinas constitutivas y 6/25 (24%) fueron translocaciones reciprocas. Las alteraciones citogenéticas más frecuentes fueron 16qh+ y 9qh+ (ambas con un 16%), y afectaron a 17 (68%) varones. Conclusiones: Existe una moderada frecuencia de alteraciones citogenéticas en pacientes peruanos con diagnóstico de infertilidad, y las alteraciones más frecuentes fueron heterocromatina constitutivas. Además, evidenciamos una correlación significativa ente el número de abortos y las alteraciones citogenéticas.

We propose the answer to a question that until today is very questionable, is there life after death? In this document we will give an answer from the perspective of the Sociobiological Informational Theory. For this we need exact moments of the movie Coco (2017), in which this theory can be applied, thanks to the cinema. It should be noted first that in the film there are two aspects of the same side. A life as social information and a life as a conscious-psy- chic system, then the key moment that serves as an example to explain this phenomenon is when the character «Chicharrón» disappears from the world of the dead when no one in the real world remembers. However, when the old «Coco» remembers her deceased father «Hector», he manages to revive informationally. At the same time, we also indicate and congratulate the upright graphic quality in the details that characterize the animation. In short, we are going to say that, indeed, yes, there is life (informationally speaking) after death. And this because when we appear in the world we begin to live as social information, then we are born, and our life as social information grows in increasing complexity.

Background: The COVID-19 pandemic has generated a remarkable change in the behaviour of Healthcare workers (HCWs) around the world. However, there is a lack of evidence on substance use among HCWs in Latin America. Therefore, this study aimed to determine the current frequency of substance use among Latin American among HCWs. Methods: We searched 8 databases (PubMed, Scopus, ScientDirect, Web of Science, Cochrane, Scielo, LILACS and Latindex), 4 public prepublication servers (SocArXiv, medRxiv, bioRxiv and Preprints) and Google scholar from 1/9/2019 to 11/1/2021. We determined the frequency of each study based on original studies, scientific letters, and clinical trials in English, Spanish and Portuguese. Results: A total of 17 175 study articles were identified from electronic databases and preprints, and 2 cross-sectional studies conducted in 2020 were included in the qualitative analysis. Both studies included HCWs but did not perform a differential analysis. The first was developed by the Pan-American Health Organization and included interviewees from 35 countries, while the second was conducted with 1145 Brazilian participants. Both studies showed increases in substance use during the pandemic, with alcohol being the most commonly used substance (30%), but PAHO’s study reported a 13.8% increase in self-reported heavy-episodic drinking, with differences among genders (males, 15.4%), age groups (highest increase in the 40-49 age group, 16.5%) and area of residence (urban with 14%). The second study showed that 21 32% of participants reported initiating psychoactive substance use, 29.3% added some substance to their initial use and 4% of them had to replace the substance, mainly due to difficulty of access. Other substances of abuse that showed significant increases were tobacco (0.5%) and marijuana (0.3%). Conclusion: Overall, despite the analysis of the 2 studies, the results provided are not a conclusive description of the frequency of substance use by HCWs in Latin America during the COVID-19 pandemic. Further research is required to understand the impact of the pandemic on drug abuse in the region. Protocol Registration: The protocol has been registered on 30 November 2021 on the International Prospective Register of Systematic Reviews (PROSPERO) with ID: CRD420212919700.

Abstract COVID‐19 patients are prone to coinfections during their hospitalization. These coinfections are challenging as they involve longer hospital stays, high costs, and higher risk of mortality. Here, we present a case of a patient with multi‐infection by resistant parasites, fungi, and bacteria during his hospitalization in a hospital in Lima, Peru.

La pandemia ocasionada por el virus de la COVID-19 determinó que se tomaran medidas sanitarias que afectaron el normal desarrollo, no solo de las actividades laborales sino también de las académicas. La prohibición de la presencialidad en las universidades, específicamente en las facultades de odontología donde la actividad clínica en los últimos tres años de estudio es fundamental para el desarrollo de las competencias procedimentales y actitudinales quedaron totalmente suspendidas. El presente artículo tiene como objetivo revisar el uso de los simuladores pospandemia, como una tecnología que permita, gracias a sus alcances, suplir la presencia de los pacientes. Para ello se realizó una búsqueda de artículos científicos en las siguientes bases de datos: Google académico, MEDLINE/PubMed, SciELO, Scopus y LILACS, durante los años 2020-2021; los artículos recolectados estuvieron relacionados con la importancia del uso de simuladores en el desarrollo de las competencias requeridas. De acuerdo con los resultados obtenidos se pudo determinar que el uso de esta tecnología permitió básicamente desarrollar habilidades, destreza y confianza en los estudiantes sin tener que poner en riesgo la salud e integridad física del paciente, con la posibilidad de evaluar y repetir los procedimientos realizados indeterminadamente.

Background: COVID-19 has shaken countries at all levels, putting public health at risk. Global efforts have allocated funding for the development of research for the development of vaccines, digital tools, epidemiologic, social, and economic studies. Although these efforts have been developed worldwide, not all countries have prioritized the same topics and may have a different impact on solving problems and containing the spread of COVID-19. Methods: A descriptive study was conducted with secondary data of "Special Projects COVID-19” in order to analyze the prioritization of proposals and projects to Peruvian needs in the face of pandemic. Two calls were made by the Peruvian research council (CONCyTec); the first with five areas and the second with seven. The global amounts financed by each call were 342,857 USD (1,200,000 soles) and 700,000 USD (1,750,000 soles), respectively. Results: A total of 1,101 research projects were presented, 600 (54.5%) in the first call. In this call, 176 (29.3%) projects were from technological development and innovation and 29 were winners (with a global budget of 1,711,907.25 USD /6,077,270.75 soles). In the second call, 120 (23.9%) projects were from the area of Social and economic research and 21 were winners (global budget of 1,284,002.25 USD/558,208.55 soles) (p=0.043). The largest proportion of winning projects in both calls was 12 (41.4%) in Technological developments and innovation, then five (17.2%) each in telehealth and mobile health, and epidemiological and social studies. Across both calls, 214 (55.8%) and 160 (51.9%) projects were of private organizations and universities, respectively. Conclusions: This research shows ~2% of rapid response "Special Projects COVID-19” were financed by the CONCyTec call with over a million dollars of funds. Although the main topics were technological innovation, detection systems, and vaccines, these priorities have not had a global impact on the epidemiological development of the pandemic in Peru.

Lophomonas infection is an emerging parasitic disease causing respiratory infections. After China, Peru is the second country with the highest number of cases. In the bright-field microscopy evaluation of fresh samples, most of them are incorrectly estimated. Therefore, correct identification using cytological stains is to be supplemented. We report a case of a 29-year-old male with typical clinical symptoms of pneumonia, marked eosinophilia, and noninfiltrative pattern in chest X-ray, who had bronchopulmonary lophomoniasis.

The use of exponential technologies is changing how people live and interact; this has been called the “Fourth Industrial Revolution”. Within these technologies, 3D printing is playing a leading role, especially in health. In this context, this literature review aims to present the state of the art of 3D printing, its digital workflow and applications in medicine, and the advantages of its use in public health. Consequently, it describes the benefits for the patient and the medical team from a diagnostic stage, a brief history of its development, what is the digital flow when working with a 3D printer, what experiences of its use in medicine, and finally, how this technology used in medicine and public health can be part of the Digital Transformation in Peru.

The objective of the present study is to make a comparison between various free and open-source software used for medical image processing, such as 3D Slicer (version 4.11), ITK-Snap (version 3.8), and Invesalius (version 3.1) in its application for the calculation of solitary fibrous tumor volumes. Knowing the size, shape, and volume of mesothelioma is decisive for clinical decision-making by health personnel when performing surgery; the currently used standard procedure is manual segmentation through magnetic resonance imaging (MRI). This process tends to take a long time to complete. On the other hand, automatic segmentation software is much faster and more user-friendly, so looking for software that gives us greater accuracy when doing this task is very important. This work obtained magnetic resonance imaging (MRI) of a mesothelioma patient, and the images were segmented in the 3 different programs to evaluate the concordance between the software later.

Introduction: In light of the threat posed by the COVID-19 pandemic, most countries have implemented several containment and prevention measures to slow down the rapid spread of the disease. Objectives: To compare the COVID-19 pandemic containment strategies implemented in Peru [World Health Organization (WHO) - confinement and social distancing] and the United Kingdom [herd immunity (HI)] in terms of morbidity and mortality, and to simulate the implementation of HI in Peru during the initial stage of the pandemic. Materials and methods: Exploratory study with a simulation model based on official data obtained from both countries at the beginning of the pandemic. Mortality, case fatality, and infection rates documented within the first 55 days after the first COVID-19 case report in the United Kingdom and the start of the WHO-recommended containment and prevention strategy implementation in Peru were evaluated. Additionally, the impact of applying HI, according to WHO guidelines, as the initial strategy in Peru was simulated. The Paired-samples t-test was used to determine the differences between the two strategies at both stages of the study. Results: During the follow-up period, 15 034 and 33 931 COVID-19 cases were reported in the United Kingdom and Peru, respectively. The case fatality rate was higher in the United Kingdom (7.82% vs. 2.74%), while the cumulative mortality rate was higher in Peru (2.89 vs. 1.74×100 000 inhabitants p= 0.0001). Regarding the simulation, a minimum critical population of 60% (>19 million positive cases) was established for Peru to achieve HI, with 1 223 473.1 deaths and a hospitalization rate of 44 770×100 000 patients. Conclusions: During the follow-up period (55 days), the United Kingdom’s strategy resulted in a higher case fatality rate, while the Peruvian strategy in over twice as many COVID-19 cases. The HI simulation strategy in Peru showed a sharp increase in all unfavorable indicators of the pandemic.

Introduction: Estimating and monitoring changes in liver function tests is necessary to prevent the occurrence of chronic liver disease in HIV patients undergoing highly active antiretroviral therapy (HAART). Objective: To determine the variation liver profile test levels in HIV patients undergoing HAART. Materials and methods: Retrospective longitudinal study conducted in 100 HIV patients treated at the Hospital Nacional Hipólito Unanue, Lima, Peru, between 2015 and 2017. Patients in all stages of clinical infection under HAART and with liver function panel results for alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and total protein (TP) were included. Three follow-up liver function tests (every 3 months) were performed while undergoing HAART and participants were categorized as having normal or elevated levels for all liver markers. Differences between the samples analyzed were determined using the paired-samples T test, with a 95% confidence interval and a significance level of p

Background: In the midst of the coronavirus disease 2019 (COVID-19) pandemic, there are many ways to communicate hygiene measures, such as memes and stickers that are widely used on social networks. We carried out a systematic review in order to determine the impact of stickers and memes as tools to face the COVID-19 pandemic, following the PRISMA guide. Methods: The search was carried out in scientific databases (MEDLINE / PubMed, ScientiDirect, Scielo, LILACS, and Latindex), and in public pre-publication servers (bioRxiv, SocArXiv, medRxiv and Preprints). The publications were identified using the terms (((meme) OR (sticker)) AND ((COVID-19) OR (SARS-COV-2)) AND (WhatsApp)) and the corresponding translations for Spanish and Portuguese. Results: In the initial search, 8434 studies were obtained, 7749 in Preprints, 446 in SocArXiv, 145 in ScientDirect, 82 in medRxiv, and 12 in PubMed. No studies were found in LILACS, Latindex, Scielo, or bioRxiv. Of the 51 studies included as eligible, all were eliminated for not meeting the study inclusion criteria. The majority (40 studies) were eliminated as studies were publications related to the social aspects related to COVID-19, but did not develop an analysis of stickers or memes. Conclusions: No studies were identified that met the inclusion criteria related to the role of stickers and memes as tools to face the COVID-19 pandemic. More studies are needed to estimate its role as a means of communication in health.