Multicomponent synthesis and photophysical study of novel α,ß-unsaturated carbonyl depsipeptides and peptoids.

Multicomponent reactions were performed to develop novel α,ß-unsaturated carbonyl depsipeptides and peptoids incorporating various chromophores such as cinnamic, coumarin, and quinolines. Thus, through the Passerini and Ugi multicomponent reactions (P-3CR and U-4CR), we obtained thirteen depsipeptides and peptoids in moderate to high yield following the established protocol and fundamentally varying the electron-rich carboxylic acid as reactants. UV/Vis spectroscopy was utilized to study the photophysical properties of the newly synthesized compounds. Differences between the carbonyl-substituted chromophores cause differences in electron delocalization that can be captured in the spectra. The near UV regions of all the compounds exhibited strong absorption bands. Compounds P2, P5, U2, U5, and U7 displayed absorption bands in the range of 250-350 nm, absorbing radiation in this broad region of the electromagnetic spectrum. A photostability study for U5 showed that its molecular structure does not change after exposure to UV radiation. Fluorescence analysis showed an incipient emission of U5, while U6 showed blue fluorescence under UV radiation. The photophysical properties and electronic structure were also determined by TD-DFT theoretical study.

Comparative Study of the Removal Efficiency of Nalidixic Acid by Poly[(4-vinylbenzyl)trimethylammonium Chloride] and N-Alkylated Chitosan through the Ultrafiltration Technique and Its Approximation through Theoretical Calculations.

Emerging antibiotic contaminants in water is a global problem because bacterial strains resistant to these antibiotics arise, risking human health. This study describes the use of poly[(4-vinylbenzyl) trimethylammonium chloride] and N-alkylated chitosan, two cationic polymers with different natures and structures to remove nalidixic acid. Both contain ammonium salt as a functional group. One of them is a synthetic polymer, and the other is a modified artificial polymer. The removal of the antibiotic was investigated under various experimental conditions (pH, ionic strength, and antibiotic concentration) using the technique of liquid-phase polymer-based retention (LPR). In addition, a stochastic algorithm provided by Fukui's functions is used. It was shown that alkylated N-chitosan presents 65.0% removal at pH 7, while poly[(4-vinylbenzyl)trimethylammonium chloride] removes 75.0% at pH 9. The interaction mechanisms that predominate the removal processes are electrostatic interactions, π-π interactions, and hydrogen bonding. The polymers reached maximum retention capacities of 1605 mg g-1 for poly[(4-vinylbenzyl) trimethylammonium chloride] and 561 mg g-1 of antibiotic per gram for alkylated poly(N-chitosan). In conclusion, the presence of aromatic groups improves the capacity and polymer-antibiotic interactions.

[Acute cardiovascular complications in a Peruvian population of oncology patients]. / Complicaciones cardiovasculares agudas en una población peruana de pacientes oncológicos.

Objective: To know the most frequent acute cardiovascular complications in a Peruvian population of oncologic patients. Materials and methods: Retrospective, descriptive study of oncologic patients treated at Clinica Delgado between January 2014 and December 2019, from which the subgroup with the seven most prevalent cancers at the national level was selected according to information from Globocan 2018. Additionally, we evaluated the epidemiology of patients with cardiovascular complications that conditioned their hospitalization or were detected during this, calculating their cardiovascular risk according to Hermann and SCORE risk scales. Results: Forty-four patients had complications; 27 (61.4%) were hospitalized due to acute cardiovascular causes. The mean age of this subgroup was 69.88 years (SD 12.77), and 22 (81.5%) were older than 60 years. Fourteen (51.9%) were male. According to the Hermann scale, 33.3% had intermediate-risk and 14.9% had a high or very high risk. According to the SCORE scale, 62.97% had an intermediate-risk and 7.40% high risk. The most common acute cardiovascular complications were deep vein thrombosis and ischemic stroke (66.65%). One patient (3.7%) reported previous cardiovascular disease. Four patients (14.8%) had a fatal outcome during hospitalization. The median length of hospitalization was five days. Conclusions: We present the cases of acute cardiovascular complications in a population of oncologic patients and their vascular risk according to Hermann and SCORE scales. The most common complications were deep vein thrombosis (48.14%), stroke (18.51%), and myocardial infarction (14.81%).

Kick-Fukui: A Fukui Function-Guided Method for Molecular Structure Prediction.

Here, we introduce a hybrid method, named Kick-Fukui, to explore the potential energy surface (PES) of clusters and molecules using the Coulombic integral between the Fukui functions in the first screening of the best individuals. In the process, small stable molecules or clusters whose combination has the stoichiometry of the explored species are used as assembly units. First, a small set of candidates has been selected from a large and stochastically generated (Kick) population according to the maximum value of the Coulombic integral between the Fukui functions of both fragments. Subsequently, these few candidates are optimized using a gradient method and density functional theory (DFT) calculations. The performance of the program has been evaluated to explore the PES of various systems, including atomic and molecular clusters. In most cases studied, the global minimum (GM) has been identified with a low computational cost. The strategy does not allow to identify the GM of some silicon clusters; however, it predicts local minima very close in energy to the GM that could be used as the initial population of evolutionary algorithms.

[Epidemiological characteristics of heart transplant recipients in Peru 2010-2020]. / Características epidemiológicas de receptores de trasplante cardiaco en el Perú, 2010-2020.

Objective: To evaluate the epidemiological, clinical, surgical, pathological characteristics and outcomes in the follow-up of heart transplant recipients at the National Cardiovascular Institute during 2010-2020. Material and Methods: A retrospective descriptive study was performed by reviewing the medical records of patients undergoing heart transplantation at a national referral center, describing the clinical, surgical, laboratory, pathology characteristics and survival of patients up to 10 years of follow-up. Results: Eighty-six patients were transplanted in 10 years, the median age was 41 years (RIQ 28-56), being predominantly male (66.3%). The three leading causes of indication for heart transplantation were: dilated cardiomyopathy (48.9%), ischemic heart disease (17.4%), and myocarditis (6.9%). Total ischemia time was 160 minutes (RIQ 129.7-233.5). Survival at one, five, and ten years was 84.8%, 73.6%, and 65.7% respectively. The main cause of death was non-cardiac: infectious (39.1%) and of unknown origin (26%). Conclusions: The main etiology of heart failure in heart transplant recipients in Peru in recent years was nonischemic dilated cardiomyopathy. We observed that the survival rate was similar to that of international registries; however, the rate of mortality due to infectious causes and death of unknown origin is high, which poses a challenge in the management of post-transplant patients.

[Incessant focal atrial tachycardia as a cause of cardiomyopathy. About a case]. / Taquicardia atrial focal incesante como causa de cardiomiopatía. A propósito de un caso.

Focal atrial tachycardia is a rare type of supraventricular tachyarrhythmia, generally present in young people, and is a rare cause of tachycardiomyopathy (10%). We present a clinical case of tachycardiomyopathy in a 30-year-old man, without comorbidities, who was diagnosed with incessant focal atrial tachycardia, refractory to medical therapy, and electrical cardioversion. Successful endocardial ablation was performed, and in outpatient follow-up at 6 months, he showed a recovery of the left ventricular ejection fraction and reduction of the left chambers to normal ranges, with progressive decrease of dyspnea.

[Cardiac Amyloidosis: Experience in a National Reference Cardiovascular Institute]. / Amiloidosis Cardíaca: Experiencia en un Instituto Cardiovascular de Referencia Nacional.

Objectives: To determine the clinical, imaging and laboratory characteristics and one year after diagnosis survival of patients with cardiac amyloidosis in a national reference hospital. Materials and methods: Case series study. We evaluated the clinical characteristics, complementary examinations and survival of patients with cardiac amyloidosis diagnosed, treated and followed up in the Clinical Cardiology service of the National Cardiovascular Institute - INCOR EsSalud in Lima, Peru. Results: We found eight patients with diagnosis of cardiac amyloidosis. The median age was 64.5 years and 75% were male. The etiology of cases was unspecified cardiac amyloidosis (25%), transthyretin cardiac amyloidosis (37.5%), and light chain cardiac amyloidosis (37.5%). Symptomatic heart failure (NYHA II-III) was the most common initial presentation symptom (87.5%). The most frequent extracardiac manifestations were: sensory-motor neuropathy (62.5%), musculoskeletal (37.5%), nephropathy (25%), bilateral carpal tunnel syndrome (25%), monoclonal gammopathies (25%) and refractory pleural effusion (25 %). Survival at one year was 75% and the cause of the 2 deaths was sudden death. Conclusions: In this study of cardiac amyloidosis at a specialized center, the most frequent clinical manifestations were heart failure and sensory-motor neuropathy. Mortality was 25% per year, and in all cases as sudden death.

Exploring the Potential Energy Surface of Trimetallic Deltahedral Zintl Ions: Lowest-Energy [Sn6Ge2Bi]3- and [(Sn6Ge2Bi)2]4- Structures.

The synthesis and structural characterization of the dimer [(Sn6Ge2Bi)2]4- raise the possibility of obtaining a broad variety of analogous compounds with different Sn/Ge/Bi proportions. Several combinations of nine atoms have been detected by electrospray mass spectrometry as potential assembly units. However, [(Sn6Ge2Bi)2]4- remains as the unique experimentally characterized species in this series. This fact has motivated us to explore its potential energy surface, as well as its monomers' [Sn6Ge2Bi]3-/2-, in an effort to gain insight into the factors that might be privileging the experimental viability of this species. Our results show that the lowest-energy [Sn6Ge2Bi]3- structure remains in its oxidized product [Sn6Ge2Bi]2-, which corresponds to that identified in the dimer [(Sn6Ge2Bi)2]4-. Additionally, local minima, very close in energy to the lowest-energy monomer, are chiral mixtures that dimerize into diverse structures with a probable energetic cost, making them noncompetitive isomers. Finally, the global minimum of the dimer [(Sn6Ge2Bi)2]4- presents the most stable monomers as assembly units. These results show the importance of considering the simultaneity of all of these conditions for the viability of these types of compounds.

AUTOMATON: A Program That Combines a Probabilistic Cellular Automata and a Genetic Algorithm for Global Minimum Search of Clusters and Molecules.

A novel program for the search of global minimum structures of atomic clusters and molecules in the gas phase, AUTOMATON, is introduced in this work. This program involves the following: first, the generation of an initial population, using a simplified probabilistic cellular automaton method, which allows easy control of the adequate distribution of atoms in space; second, the fittest individuals are selected to evolve, through genetic operations (mating and mutations), until the best candidate for a global minimum surfaces. In addition, we propose a simple way to build the descendant structures by establishing a ranking of genes to be inherited. Thus, by means of a chemical formula checker procedure, genes are transferred to the offspring, ensuring that they always have the appropriate type and number of atoms. It is worth noting that a fraction of the fittest group is subject to mutation operations. This program also includes algorithms to identify duplicate structures: one based on geometric similarity and another on the similar distribution of atomic charges. The effectiveness of the program was evaluated in a group of 45 molecules, considering organic and organometallic compounds (benzene, cyclopentadienyl anion, and ferrocene), Zintl ion clusters [Sn9- m- nGe mBi n](4- n)- ( n = 1-4 and m = 0-(9- n)), star-shaped clusters (Li7E5+, E = BH, C, Si, Ge) and a variety of boron-based clusters. The global minimum and the lowest-energy isomers reported in the literature were found for all the cases considered in this article. These results successfully prove AUTOMATON's effectiveness on the identification of energetically preferred structures of a wide variety of chemical species.

Heart failure complicating myocardial infarction. A report of the Peruvian Registry of ST-elevation myocardial infarction (PERSTEMI).

OBJECTIVES: The aim of this study is to determine the incidence, associated factors, and 30-day mortality of patients with heart failure (HF) after ST elevation myocardial infarction (STEMI) in Peru. METHODS: Observational, cohort, multicentre study was conducted at the national level on patients enrolled in the Peruvian registry of STEMI, excluding patients with a history of HF. A comparison was made with the epidemiological characteristics, treatment, and 30 day-outcome of patients with (Group 1) and without (Group 2) heart failure after infarction. RESULTS: Of the 388 patients studied, 48.7% had symptoms of HF, or a left ventricular ejection fraction <40% after infarction (Group 1). Age>75 years, anterior wall infarction, and the absence of electrocardiographic signs of reperfusion were the factors related to a higher incidence of HF. The hospital mortality in Group 1 was 20.6%, and the independent factors related to higher mortality were age>75 years, and the absence of electrocardiographic signs of reperfusion. CONCLUSIONS: Heart failure complicates almost 50% of patients with STEMI, and is associated with higher hospital and 30-day mortality. Age greater than 75 years and the absence of negative T waves in the post-reperfusion ECG are independent factors for a higher incidence of HF and 30-day mortality.

Heart failure complicating myocardial infarction. A report of the Peruvian Registry of ST-elevation myocardial infarction (PERSTEMI) / Insuficiencia cardiaca complicando el infarto de miocardio. Un reporte de Peruvian Registry of ST-elevation Myocardial Infarction (PERSTEMI)

Abstract Objectives: The aim of this study is to determine the incidence, associated factors, and 30-day mortality of patients with heart failure (HF) after ST elevation myocardial infarction (STEMI) in Peru. Methods: Observational, cohort, multicentre study was conducted at the national level on patients enrolled in the Peruvian registry of STEMI, excluding patients with a history of HF. A comparison was made with the epidemiological characteristics, treatment, and 30 day-outcome of patients with (Group 1) and without (Group 2) heart failure after infarction. Results: Of the 388 patients studied, 48.7% had symptoms of HF, or a left ventricular ejection fraction <40% after infarction (Group 1). Age > 75 years, anterior wall infarction, and the absence of electrocardiographic signs of reperfusion were the factors related to a higher incidence of HF. The hospital mortality in Group 1 was 20.6%, and the independent factors related to higher mortality were age > 75 years, and the absence of electrocardiographic signs of reperfusion. Conclusions: Heart failure complicates almost 50% of patients with STEMI, and is associated with higher hospital and 30-day mortality. Age greater than 75 years and the absence of negative T waves in the post-reperfusion ECG are independent factors for a higher incidence of HF and 30-day mortality.

Resumen Objetivos: Se desea saber la incidencia, los factores asociados y la mortalidad a 30 días de los pacientes con insuficiencia cardiaca (IC) postinfarto de miocardio con elevación del segmento ST (IMCEST) en Perú. Métodos: Estudio observacional, de cohortes, multicéntrico a nivel nacional, de pacientes enrolados en el registro peruano de IMCEST, excluyendo los pacientes con antecedente de IC. Se compararon las características epidemiológicas, tratamiento y evolución a 30 días de los pacientes con (grupo 1) y sin (grupo 2) IC postinfarto. Resultados: De 388 pacientes se encontró un 48.7% con síntomas de IC o fracción de eyección de ventrículo izquierdo < 40% postinfarto (grupo 1). La edad > 75 años, el infarto de pared anterior y la ausencia de signos electrocardiográficos de reperfusión fueron los factores relacionados a mayor incidencia de IC. La mortalidad intrahospitalaria en el grupo 1 fue del 20.6% y los factores independientes relacionados a mayor mortalidad fueron la edad > 75 años y la ausencia de signos electrocardiográficos de reperfusión. Conclusiones: La IC complica casi al 50% de pacientes con IMCEST y está asociada a mayor mortalidad intrahospitalaria y a 30 días. La edad > 75 años y la ausencia de ondas T negativas en el electrocardiograma posreperfusión son factores independientes de mayor incidencia de IC y de mortalidad a 30 días.

Insights into bonding interactions and excitation energies of 3d-4f mixed lanthanide transition metal macrocyclic complexes.

In this contribution, a computational study of equatorial bound tetranuclear macrocycle (butylene linked) [LnZn(HOMBu)]3+ (Ln = La3+, Ce3+) complexes was carried out. Here, the electronic structure, bonding interaction and excitation energies were studied within the relativistic density functional theory framework. From the electronic structure analysis, the frontier molecular orbitals (FMOs) were strongly localized in the d-orbitals of the Zn centers and the f-orbitals of the lanthanide ions. Besides, the inner MOs were found to exhibit a π-character from the organic part of the macrocyclic chain. EDA-NOCV was used as a tool for evaluating the bonding interaction, taking the trinuclear metallomacrocycle (ZnHOMBu) and the lanthanide center as fragments. This analysis showed that the interaction between these fragments was slightly covalent; with this covalency being the result of a charge transfer from the metallomacrocyclic ring to the lanthanide. This phenomenon was observed in the deformation density channels obtained from the EDA-NOCV study; in which π- and σ-charge transfer was observed. Finally, the TD-DFT study of the excitation energies evidenced three sets of bands: the first set with the highest intensity represented the ligand to metal charge transfer bands; the second set could be attributed to the 3d-4f electronic transitions between the metal centers; and the third set represented the f-f bands found for the open-shell cerium complex. This class of complexes accomplishes the "antenna effect" principle, which states that highly absorptive transition-metal (TM) complexes can be used to enhance the luminescence of poorly emissive systems, and are introduced in this study as self-sensitizer bimetallic d-f systems with potential applications in near infra-red (NIR) technologies.

Aromatic Lateral Substituents Influence the Excitation Energies of Hexaaza Lanthanide Macrocyclic Complexes: A Wave Function Theory and Density Functional Study.

The high interest in lanthanide chemistry, and particularly in their luminescence, has been encouraged by the need of understanding the lanthanide chemical coordination and how the design of new luminescent materials can be affected by this. This work is focused on the understanding of the electronic structure, bonding nature, and optical properties of a set of lanthanide hexaaza macrocyclic complexes, which can lead to potential optical applications. Here we found that the DFT ground state of the open-shell complexes are mainly characterized by the manifold of low lying f states, having small HOMO-LUMO energy gaps. The results obtained from the wave function theory calculations (SO-RASSI) put on evidence the multiconfigurational character of their ground state and it is observed that the large spin-orbit coupling and the weak crystal field produce a strong mix of the ground and the excited states. The electron localization function (ELF) and the energy decomposition analysis (EDA) support the idea of a dative interaction between the macrocyclic ligand and the lanthanide center for all the studied systems; noting that, this interaction has a covalent character, where the d-orbital participation is evidenced from NBO analysis, leaving the f shell completely noninteracting in the chemical bonding. From the optical part we observed in all cases the characteristic intraligand (IL) (π-π*) and ligand to metal charge-transfer (LMCT) bands that are present in the ultraviolet and visible regions, and for the open-shell complexes we found the inherent f-f electronic transitions on the visible and near-infrared region.

Prevalencia y factores asociados con la filariosis por Mansonella ozzardi en 2 comunidades periurbanas de Iquitos, 2009 / Prevalence of filariasis by Mansonella ozzardi and associated factors among 2 suburban communities of Iquitos, 2009

Introducción: Tres casos de infección por Mansonella ozzardi (M. ozzardi) en muestras de malaria que provenían de 2 comunidades periurbanas de Iquitos (Perú) dieron la sospecha de transmisión local. El objetivo del estudio fue determinar la prevalencia y factores asociados con la filariosis por M. ozzardi en estas comunidades. Materiales y métodos: Se realizó un estudio transversal en las comunidades de Laguna Azul y La Unión en Iquitos. A todos los pobladores se les tomó una gota gruesa para la detección de M. ozzardi y se les realizó una encuesta epidemiológica. Se realizó colecta de larvas y mosquitos para identificación de potenciales vectores. Se calcularon los OR ajustados (ORa) usando regresión logística múltiple. Resultados: Se evaluaron a 433 personas; 58% fueron mujeres; la mediana de edad fue de 20 años; 58,2% fueron migrantes, 3,7% pescadores y 12,9% habían viajado por las cuencas del Alto anay. La prevalencia de M. ozzardi fue de 1,4% (6/433) y el más joven de los casos tuvo 31 años; se encontró asociación con ser pescador (ORa: 8,7; IC 95: 1,1-76,0) y con haber realizado viajes por la cuenca del Alto Nanay (ORa: 11,2; IC 95: 1,2-112,5). No se evidenció densidad significativa de vectores simúlidos o culicoides. Conclusión: Las comunidades estudiadas tuvieron una baja prevalencia de M. ozzardi y por la edad de los casos y los factores asociados encontrados se sospecha infección foránea a la zona de estudio, en especial en la cuenca del Alto Nanay.

Introduction: Three cases of M. ozzardi infection from 2 suburban communities in Iquitos, Peru, led to a suspicion of local transmission. The objective of the study was to determine the prevalence of filariasis by M. ozzardi and its associated factors among these communities. Materials and methods: A cross-sectional study was performed, as well as an epidemiological survey and a thick smear blood test. Larvae and mosquitoes were collected. The adjusted OR (aOR) using multiple logistic regression was calculated. Results: A total of 433 participants were enrolled; 58% were women. The prevalence of M. ozzardi was 1.4% and the associated factors included being a fisherman (aOR: 8.7; 95%CI: 1.1-76.0) and being on the Alto Nanay river (aOR: 11.2; 95%CI: 1.2-112.5). No significant evidence of simulidos or culicoides was found. Conclusion: The low prevalence of M. ozzardi found suggests a foreign infection, probably derived from the Alto Nanay river.

Exploring the nature of the excitation energies in [Re6(µ3-Q8)X6](4-) clusters: a relativistic approach.

This contribution is a relativistic theoretical study to characterize systematically the main electronic transitions in a series of hexarhenium chalcogenide [Re6(µ3-Q8)X6](4-) clusters with the aim of understanding: (i) the terminal ligand substitution effect, (ii) the substitution effect of the chalcogenide ion on the [Re6(µ3-Q8)](2+)core, and finally (iii) the significance of the spin-orbit coupling (SOC) effect on the optical selection rules. In all the cases, we found characteristic bands at around 300-550 nm, where the band positions are directly determined by the terminal ligand. However, SCN(-)/NCS(-) presents a different nature of the orbitals involved in the electronic transitions, in comparison with the other studied terminal ligands, located in the near-infrared (NIR) region. All the bands are red-shifted as a consequence of the ligand contribution in the composition of the orbitals involved in the electronic excitations.

Understanding the influence of terminal ligands on the electronic structure and bonding nature in [Re6(µ3-Q8)](2+) clusters.

Since the synthesis of the first molecular cluster [Re6(µ3-Q8)X6](4-), the substitutional lability of the terminal ligands prompted new developments in their chemistry, making these molecular clusters a reasonable point of departure for building new materials. The development of novel inorganic materials of technological interest certainly requires an understanding of the electronic structure, bonding, spectroscopy, photophysical and structural properties of these clusters. Taking into account the potential applications in material sciences and the lack of systematization in the study of these kinds of clusters, the proposal of the present work is to perform a detailed theoretical study of the [Re6(µ3-Q8)X6](4-) (Q = S(2-), Se(2-), Te(2-); X = F(-), Cl(-), Br(-), I(-), CN(-), NC(-), SCN(-), NCS(-), OCN(-), NCO(-)) clusters based on the detailed description of the electronic structure of these complexes and the bonding nature between the [Re6(µ3-Q8)](2+) core and several donor-acceptor peripheral ligands. All this work was developed on the framework of the relativistic density functional theory, in which relativistic effects were incorporated by means of a two-component Hamiltonian with the zeroth-order regular approximation. To describe the relative stability of these complexes, we employed the global descriptors of chemical hardness and softness introduced by Pearson. Moreover, an analysis of bonding energetics was performed by combining a fragment approach to the molecular structure with the decomposition of the total bonding energy according to the Morokuma-Ziegler energy partitioning scheme. After an analysis of these results, we found in all cases an extensive ionic character in the bonding between the core and each peripheral ligand. The interaction between the halide ligand and the core gives about 75% ionic character, whereas the other ligands show a more covalent interaction due to effective synergic mechanisms. We conclude that the most stable clusters are those that present the stronger σ-donor terminal ligands, whereas the cluster stability starts to decrease when the π-acceptor effect will be stronger; this fact is directly related to the terminal ligand lability and the strong electrophilic character of the [Re6(µ3-Q8)](2+) core.

Epidemiologia hospitalaria del Epoc en un Hospital Militar. Lima, Perú / Epidemiology of COPD in Military Hospital

Describir la dinámica epidemiológica de las hospitalizaciones por enfermedad obstructiva crónica (EPOC) en un hospital militar. Material y Métodos: Estudio observacional retrospectivo de las hospitalizaciones por EPOC en un Hospital Militar nivel III-1 de Lima-Perú. El periodo analizado fue desde enero de 1991 a diciembre de 2013. Para el análisis de los datos se utilizó el software de STATA V12.1 y ms Excel 2013. Resultados: Se registraron 1350 egresos con EPOC lo que representa el 1.14% del total de egresos IC95% (0.10% - 1.20%); el 58.15% de los pacientes pertenecían al sexo masculino (p=0.001), el promedio de edad fue de 74 años IC95% (73 - 75 años), (P=0.001), el promedio de estancia hospitalaria fue de 11.3 días IC95% (10.6 - 11.9 días), (P=0.001). En relación al tipo de pacientes según su condición en el hospital, el 31.41% fueron pacientes militares (424/1350) y representaron el 1.32% de todas las hospitalizaciones en esta población. La letalidad por EPOC fue 3.93% IC95% (2.95% - 5.10%) siendo superior a nuestra tasa de mortalidad hospitalaria por todas las causas (2.81%) siendo estadísticamente significativo (p=0.012) odds ratio (OR) 1.4 IC95% (1.05 - 1.87). Conclusión: El perfil epidemiológico de las hospitalizaciones por EPOC en nuestro hospital es la de un paciente del sexo varón con un promedio de edad superior a los 65 años, quién permanecerá en promedio 11 días hospitalizados y donde el 3.93% de los mismo fallecerá en dicha proceso de hospitalización. Observamos también que existe una laguna del conocimiento sobre la Epidemiologia hospitalaria del EPOC en nuestro país; nuestro estudio contribuirá a la generación de este conocimiento...

Objective: To describe the epidemiological dynamics of hospitalizations for chronic obstructive pulmonary disease (COPD) in a military hospital. Material and Methods: Retrospective observational study of hospitalizations for COPD in a level III-1 military Hospital of Lima-Peru. The analyzed period was from January 1991 to December 2013. The data analysis was performed using STATA V12.1 and ms EXCEL 2013. Results: 1350 medical discharged patients with COPD were registered representing 1.14% of all medical discharges IC95% (0.10% - 1.20%); 58.15% of the patients were males (p=0.001), the average age was 74 years IC95% (73 - 75 years old), (P=0.001), the average hospital stay was 11.3 days IC95% (10.6 - 11.9 days), (P=0.001). Regarding the patient type, according to their status in the hospital 31.41% (424/1350) were military servers and represented 1.32% of all hospitalizations in this population. The COPD mortality was 3.93% IC95% (2.95% - 5.10%) which was higher than our hospital mortality rate from all causes (2.81%). This was statistically significant (p=0.012) odds ratio (OR) 1.4 IC95 % (1.05 - 1.87). Conclusion: The epidemiological profile of the COPD patient hospitalization in our hospital is a male patient, with an average age of more than 65 years, with an average length stay of hospitalizated of 11 days, with a 3.93% rate of mortality in the same hospitalization process. We also note that there is a gap of knowledge on hospital epidemiology of COPD in our country; our study will contribute to the generation of this knowledge...

[Genetic variability of Aedes aegypti determined by mitochondrial gene ND4 analysis in eleven endemic areas for dengue in Peru]. / Variabilidad genética del Aedes aegypti determinada mediante el análisis del gen mitocondrial ND4 en once áreas endémicas para dengue en el Perú

In order to establish the genetic variability of Aedes aegypti determined by the analysis of the MT-ND4 gene, in eleven endemic regions for dengue in Peru, 51 samples of Ae. Aegypti were tested. The genetic variability was determined through the amplification and sequencing of a fragment of 336 base-pairs of MT ND4, the analysis of intra-specific phylogeny was conducted with the Network Ver. 4.6.10 program; and the phylogenetic analysis, with the Neighbor Joining distance method. The presence of five haplotypes of Ae. Aegypti grouped in two lineages was identified: the first one includes haplotypes 1, 3 and 5, and the second one comprises haplotypes 2 and 4. The geographic distribution of each of the haplotypes found is also shown. It is concluded that this variability is caused by the active migration of this vector and the human activity-mediated passive migration.

Variabilidad genética del Aedes aegypti determinada mediante el análisis del gen mitocondrial Nd4 en once áreas endémicas para dengue en el Perú / Genetic variability of Aedes Aegypti determined by mitochondrial gene ND4 analysis in eleven endemic areas for dengue in Peru

Con el objetivo de establecer la variabilidad genética de Aedes aegypti determinada por el análisis del gen mitocondrial ND4, se analizaron 51 especímenes de Ae. aegypti en once regiones endémicas para dengue en el Perú. La variabilidad genética se determinó mediante la amplificación y secuenciación de un fragmento de 336 pares de bases del gen mitocondrial ND4. El análisis de filogenia intraespecífica se realizó con el programa Network Ver. 4.6.10; y el análisis filogenético, con el método de distancia Neighbor Joining. Se identificó la presencia de cinco haplotipos de Ae. aegypti agrupados en dos linajes: el primero agrupa a los haplotipos 1, 3 y 5 y el segundo agrupa los haplotipos 2 y 4, se muestra además la distribución geográfica de cada uno de los haplotipos encontrados. Se concluye que esta variabilidad se debe tanto a la migración activa de este vector como a la migración pasiva mediada por la actividad humana.

In order to establish the genetic variability of Aedes aegypti determined by the analysis of the MT-ND4 gene, in eleven endemic regions for dengue in Peru, 51 samples of Ae. Aegypti were tested. The genetic variability was determined through the amplification and sequencing of a fragment of 336 base-pairs of MT ND4, the analysis of intra-specific phylogeny was conducted with the Network Ver. 4.6.10 program; and the phylogenetic analysis, with the Neighbor Joining distance method. The presence of five haplotypes of Ae. Aegypti grouped in two lineages was identified: the first one includes haplotypes 1, 3 and 5, and the second one comprises haplotypes 2 and 4. The geographic distribution of each of the haplotypes found is also shown. It is concluded that this variability is caused by the active migration of this vector and the human activity-mediated passive migration.

Impacto del intervencionismo percutaneo en lesiones complejas en el INCOR - EsSalud (imleco) / Impact of the interventionism percutaneo in complex injuries in the INCOR - EsSalud (imleco)

Objetivos: Evaluar la asociación entre la complejidad de las lesiones y los resultados angiogrßficos, eventos clínicos adversos al mes, a los 6 meses y al a±o. Métodos: Se revisaron retrospectivamente las historias clínicas de 154 pacientes que fueron sometidos a intervencionismo percutßneo coronario en el Instituto Nacional del Corazón- Hospital Guillermo Almenara Irigoyen, entre octubre del 2001 a setiembre del 2002. Se trataron 156 lesiones, de las cuales 91 eran lesiones complejas (definida como la lesión que muestra trombo, calcificación, lesión ostial, bifurcación, aneurisma, oclusión crónica o lesión en puente safeno) y 65 no complejas. Se analizaron variables clínicas, angiogrßficas y resultados de eventos adversos en el seguimiento. Resultados: La edad media de los pacientes fue de 61,7±10,2 a±os, el 83,8 por ciento correspondía al sexo masculino, 63,6 por ciento eran hipertensos y 18,8 por ciento diabéticos. El intervencionismo en lesiones complejas estuvo relacionado con mayor tasa de complicaciones periprocedimiento como fenómeno de no reflujo (71,4 por ciento, p< 0,000), compromiso de brazo colateral (39,6 por ciento, p< 0,000), disección (8,8 por ciento, p< 0,014), embolización distal ( 7,7 por ciento, p<0,02), y eventos adversos al mes de muerte (p< 0,08), muerte/IM (p<0,05), cirugía (p<0,014), muerte/IM/RM( p<0,01), muerte/IM/RM/H (p<0,004), a los 6 meses muerte(p<0,02), muerte/IM (p<0,009), muerte/IM/RM, muerte/IM/RM/H (p< 0,000) y al a±o muerte. Cirugía, muerte/IM, muerte/IM/RM y muerte/IM/RM/H (p<0,01). Conclusiones: Los pacientes con lesiones complejas presentaron una mayor tasa significativa de complicaciones periprocedimiento y eventos adversos (muerte, cirugía, Muerte/infarto, muerte/infarto/revascularización ymuerte/infarto/revascularización/rehospitalización) al mes, a los 6 meses y al a±o.

OBJECTIVES: To evaluate association between coronary lesion complexity and angiographic results, clinical events at first, sixth and twelveth month. METHODS: We retrospectively reviewed clinical charts of 154 patients who underwent coronary percutaneous intervention at the Instituto Nacional del Corazón (INCOR) - National Hospital Guillermo Almenara Irigoyen, between October 2001 and September 2002. 156 lesiones were treated, 91 of them were complex ones (defined as a lesion with thrombus, calcified, ostial lesion, bifurcation, with aneurysm, closed cronically or lesion of a vein graft) and 65 non complex lesions. Clinical, angiographic and clinical events during the foolw up were analyzed. RESULTS: Mean age was 61.7±10.2 years old, 83.8 percent were male, 63.6 per cent had hypertension and 18.8 per cent were diabetic. Intervention in complex lesions was associated with higher rate of periprocedure complications as non reflow phenomenon(71.4 per cent pï0.000), side branch compromise (39.6 per cent pï0.000), dissection (8.8 per cent pï0.014), distal embolisation (7.7 per cent pï0.02) and adverse clinical events at one month of death (pï0.08), death/MI (pï0.05), CABG (pï0.014), death/MI/CABG (pï0.01), death/MI/CABG/hospitalization (pï0.004), at six months death (pï 0.02), death/MI (pï0.009), death/MI/CABG, death/MI,CABG/ hospitalization (pï0.000 ) and death at a year as CABG/death/ MI, death/I/CABG and death/MI,CABG/hospitalization (pï0.01). CONCLUSIONS: Patients with complex lesions showed higher rate of periprocedure complications and adverse cinical events (death, CABG, death/MI, death/MI/CABG and death/MI,CABG/hospitalization) at one, 6 and 12 months.