Factors associated with normal or abnormal Papanicolaou smear among HIV-infected women at a national hospital in Lima, Peru, 2012-2015.

HIV-infected women are at a risk of developing abnormal lesions of the uterine cervix. The objective of this study was to determine factors associated with normal or abnormal Papanicolaou (Pap) smear among HIV-infected women. A case-control study was conducted; case and control were defined as HIV-infected women ≥18 years with an abnormal and normal Pap smear, respectively. A logistic regression analysis was performed, and the Odds Ratio (OR) was calculated with its 95% Confidence Interval (CI). We included 368 patients, and the mean age was 36.83 years (SD ± 9.81), similar between cases and controls. Regarding cases, 30.50% (n = 43) had an alcohol consumption (AC), 75.18% (n = 106) were on antiretroviral therapy (ART) and 37.74% (n = 40) were in virologic failure (VF). About controls, 18.02% (n = 41) had AC, 85.02% (n = 193) were on ART, and 23.12% (n = 40) were in VF. In multivariate analysis, AC [OR: 1.77 (1.06-2.95)], VF [OR: 2.41 (1.55-3.74)], and ART [OR: 0.07 (0.02-0.23)] were significant factors. The risk factors associated with an abnormal Pap smear were AC and VF. ART was a protective factor. Therefore, besides scheduled Pap smear, human papillomavirus screening/immunization, VF, and ART should be strictly reinforced, and AC should be mitigated.

Actualización en clínica y terapia de mordedura de serpiente (ofidismo) / Update on snake bites

Resumen Esta revisión sobre mordedura de serpiente (ofidismo), buscar actualizar la epidemiologia clínica y terapia de la patología frecuente en la selva y costa peruana. Entre las serpientes venenosas destaca el accidente producido por el género Bothrops, en el Perú la especie B. atrox (Jergón de la selva) es el causante en más del 90% de los casos.

Summary This review on snake bites, seek to update the clinical epidemiology and therapy of frequent pathology in the Peruvian jungle and coast. Among the venomous snakes, the accident caused by the genus Bothrops stands out, in Peru the species B. atrox (jungle jar) is the cause in more than 90% of cases.

Infecciones intrahospitalarias asociadas a dispositivos invasivos en unidades de cuidados intensivos de un hospital nacional de Lima, Perú / Nosocomial infections associated to invasive devices in the intensive care units of a national hospital of Lima, Peru

Con el objetivo de describir la incidencia de infecciones intrahospitalarias asociadas a dispositivos invasivos en unidades de cuidados intensivos (UCI) del Hospital Nacional Cayetano Heredia se realizó un estudio observacional retrospectivo utilizando datos de la Oficina de Epidemiología y Salud Ambiental durante los años 2010 al 2012. Se notificó un total de 222 infecciones intrahospitalarias, la UCI de Medicina tuvo la incidencia por 1000 días de uso del dispositivo más alta para neumonía asociada a ventilador mecánico (28,6); infección del torrente sanguíneo asociado a catéter venoso central (11,9), e infección del tracto urinario asociado a catéter (8,1). Los principales agentes infecciosos aislados fueron Pseudomona sp. (32,3%) en la UCI de emergencia, Staphylococcus coagulasa negativo (36%) en la UCI de medicina y Candida sp (69,2%) en la UCI de cirugía. Las tasas de infecciones asociadas a dispositivos invasivos se reportaron altas semejantes a otros hospitales nacionales con limitados recursos e infraestructura.

In order to describe the incidence of nosocomial infections associated to invasive devices in intensive care units (UCI) of the National Hospital Cayetano Heredia, a retrospective observational study was conducted using the data from the Office of Epidemiology and Environmental Health from 2010 to 2012. A total number of 222 nosocomial infections were reported; the general medicine UCI reported the highest incidence of pneumonia cases associated to a mechanical ventilator in 1000 days of use of the device (28.6); infection of the blood stream associated to central venous catheter (11.9), and infection of the urinary tract associated to a catheter (8,1). The main infectious agents isolated were Pseudomona sp. (32.3%) in the emergency UCI, negative Staphylococcus coagulasa (36%) in the general medicine UCI and Candida sp (69.2%) in the Surgery UCI. The rates of infections associated to invasive devices were high as in other national hospitals with limited resources and infrastructure.