'Entamoeba histolytica' identified by stool microscopy from children with acute diarrhoea in Peru is not E. histolytica.

Entamoeba histolytica is a rare but feared pathogen owing to its related morbidity and mortality. Physicians in an ambulatory clinic in Cusco noted frequent reports of E. histolytica diagnosed by microscopy. Other non-pathogenic species of Entamoeba have an identical microscopic appearance. To determine whether the organisms were actually E. histolytica, faecal specimens from children aged six months to three years with diarrhoea were tested by a species-specific ELISA for E. histolytica antigen. Although 19/73 patients (26.0%) were presumptively diagnosed with amoebiasis based on microscopy, none were confirmed by ELISA. Most cases diagnosed as E. histolytic by microscopy in Peru are not infected by the pathogenic species and are probably colonised by non-pathogenic amoeba such as Entamoeba dispar.

Mortalidad y factores asociados en pacientes con enfermedad renal crónica en hemodiálisis en un hospital peruano / Mortality and associated factors in chronic kidney disease patients under hemodialysis in a Peruvian hospital

Introducción: La enfermedad renal crónica es un problema de salud en Perú. Objetivo: Determinar la mortalidad y los factores asociados en pacientes con enfermedad renal crónica en hemodiálisis de una población incidente en un hospital peruano. Material y Métodos: Estudio de cohorte retrospectiva, de los pacientes que ingresaron al programa de hemodiálisis crónica del hospital Antonio Lorena (Cusco-Perú), entre 2010-2016. Para el análisis de supervivencia se utilizó el método de Kaplan-Meier, para determinar los factores asociados a mortalidad se realizó la Regresión de Cox, se obtuvo el Hazard Ratio (HR) y sus intervalos de confianza al 95 por ciento (IC 95). Resultados: Se estudiaron 187 pacientes, con una mediana de edad de 57 años (rango intercuartílico: 43-66. El 47 por ciento (89) de los pacientes fallecieron durante el seguimiento. La tasa de mortalidad fue de 24 muertes/100 personas-por año (IC 95 por ciento: 19,6-29,6). La mediana de supervivencia fue de 2,8 años (IC 95 por ciento: 1,9-4,0). La dilatación de la aurícula izquierda en la ecocardiografía (HR: 2,63; IC 95 por ciento: 1,03-6,69; p=0,041), el recuento de leucocitos ≥ 12x103u/mm3 (HR: 6,86; IC 95 por ciento: 2,08-22,66; p=0,002), y la hemoglobina < 7 g/dL (HR: 3,62; IC 95 por ciento: 1,05-12,48; p=0,041) se asociaron a mortalidad. Conclusiones: Se encontró una baja frecuencia de supervivencia la misma que estuvo asociada a factores potencialmente modificable(AU)

Introduction: Chronic kidney disease is a health problem in Perú. Objective: To determine the mortality and the associated factors in chronic kidney disease patients under hemodialysis in an incident population in a Peruvian hospital. Material and Methods: A retrospective cohort study was conducted in patients admitted to the chronic hemodialysis program at Hospital Antonio Lorena (Cusco-Peru), from 2010 to 2016. Kaplan-Meier method was used for the survival analysis to determine the factors associated with mortality, Cox´s Regression was carried out, obtaining Hazard Ratio (HR) and 95 percent confidence intervals (95 percent CI). Results: A total of 187 patients were studied, with a mean age of 57 years (interquartile range: 43-66). The 47 percent (89) of patients died during follow-up. Mortality rate was 24 deaths / 100 people-per year (95 percent CI: 19.6-29.6). The mean survival rate was 2.8 years (95 percent CI: 1.9-4.0). Dilatation of the left atrium in the echocardiography (HR: 2.63; 95 percent CI: 1.03-6.69; p=0.041), a white blood cell count ≥ 12x103u/mm3 (HR: 6.86; 95 percent CI: 2.08-22.66; p=0.002), and hemoglobin <7 g/dL (HR: 3.62; 95 percent CI: 1.05-12.48; p=0.041) were associated with mortality. Conclusions: A low frequency of survival was found, which was associated with potentially modifiable factors(AU)