Factores asociados a la anemia en niños menores de cinco años de un distrito de Huaraz, Ancash / Factors associated to anemia in children below five years of age in a district of Huaraz, Ancash

Objetivos: Identificar los factores asociados a la anemia en niños menores de cinco años de edad del distrito de La Libertad, Huaraz, Ancash. Material y métodos: Estudio de tipo cuantitativo, observacional, serie de casos comparativa, retrospectiva. Cuya población de estudio fueron los niños menores de cinco años de edad del distrito de La Libertad, Huaraz, 2019. El muestreo fue de tipo probabilístico. Se recolectaron datos de la historia clínica en torno a los factores intrínsecos y extrínsecos para anemia. Se realizó un análisis exploratorio para determinar los factores asociados. Se analizó la información en hojas de cálculo del software Microsoft Excel 2013® y en el programa estadístico IBM SPSS Statistics 22. Resultados: Predominó el nivel de anemia moderado con 30%. Tanto el sexo masculino (OR=3,66; IC 95%: 1,65-8,08) y la edad mayor de 1 año (OR=13,99; IC 95%: 3,07-63,77) fueron factores intrínsecos asociados a la mayor frecuencia de anemia (p<0,05). Respecto a los factores extrínsecos, el pertenecer a un caserío diferente a Cajamarquilla (OR=3,63; IC 95%: 1,44-9,16) y el no contar con servicios básicos completos (OR=2,72; IC 95%: 1,24-5,97) se asociaron también a un incrementado número de casos (p<0,05). Conclusiones: Los factores asociados a una mayor frecuencia de casos de anemia fueron el sexo masculino, la edad mayor de 1 año, el pertenecer a un caserío diferente a Cajamarquilla y el no contar con servicios básicos completos.

SUMMARY Objectives: To identify associated factors to anemia in children under five years of age in La Libertad District, Huaraz, Ancash. Methods: It is a quantitative, observational, comparative case series, retrospective study. The population was children under five years of age in La Libertad District, Huaraz, 2019. The sampling was Probabilistic. Medical history data were collected around intrinsic and extrinsic factors for anemia. An exploratory analysis was performed to determine the associated factors. The information was analyzed in Microsoft Excel 2013 software spreadsheets® and in IBM SPSS Statistics 22 program. Results: The level of moderate anemia prevailed with 30%. Both males (OR=3.66; CI 95%: 1.65-8.08) and age older than 1 year (OR=13.99; 95% CI: 3.07-63.77) were intrinsic factors associated with the higher frequency of anemia (p<0.05). Regarding the extrinsic factors, belonging to a hamlet different to Cajamarquilla (OR=3.63; CI 95%: 1.44-9.16) and not having complete basic services (OR=2.72; CI 95%: 1.24-5.97) were also associated with a higher number of cases (p<0.05). Conclusions: The factors associated with a higher frequency of anemia cases were male sex, age over 1 year, belonging to a hamlet different to Cajamarquilla and not having complete basic services.

Vasculitis por IGA (púrpura de henoch schönlein) en un paciente pediátrico con COVID-19 y estrongiloidiasis. Reporte de caso

La vasculitis es una enfermedad rara en los niños, siendo la Vasculitis por IgA su presentación más frecuente. Una condición aún poco investigada, es la probable asociación de los procesos tipo vasculitis por IgA con la infección por SARS-CoV-2. Se presenta el caso de una paciente de cuatro años que cursó con lesiones purpúricas palpables a predominio de miembros inferiores, dolor abdominal agudo, y episodios de hemorragia digestiva alta. Inicialmente catalogado como un posible dengue grave y leptospirosis, pero que clínica y laboratorialmente se asoció a un cuadro de vasculitis por IgA. Fue SARS-CoV-2 IgM e IgG: Reactivo. Y tuvo coproparasitológico en el que se identificó al Strongyloides stercoralis. La sintomatología remitió tras la administración de corticoterapia y la evolución fue favorable. Como conclusión, se expuso un caso infrecuente en la población pediátrica, probablemente asociado a los efectos y daños aún desconocidos de la COVID-19 en la actual pandemia.

Vasculitis is a rare disease in children, with IgA Vasculitis being its most common presentation. One condition that is not yet under-researched is the likely association of IgA vasculitis-like processes with SARS-CoV-2 infection. It is presented the case of a four-year-old patient who healed with palpable purplish lesions to lower limb predominance, acute abdominal pain, and episodes of high digestive hemorrhage. Initially listed as a possible severe dengue and leptospirosis, but clinically and laboratorially associated with IgA vasculitis. It was SARS-CoV-2 IgM and IgG: Reactive. And in parasitological study was identified Strongyloides stercoralis. Symptomatology subsided after administration of corticotherapy and the evolution was favorable. In conclusion, it was presented a rare case in the pediatric population, probably associated with the still unknown effects and damage of COVID-19 in the current pandemic.

Apreciación estudiantil de la investigación médica en pregrado. Estudio multicéntrico en 19 universidades / Student appreciation of medical research in undergraduate. Multicenter study in 19 universities

Objetivo: Conocer la apreciación estudiantil sobre la labor de las universidades peruanas en la investigación científico médica de pregrado en estudiantes de facultades de medicina del Perú, 2016-2017. Métodos:El estudio fue de tipo multicéntrico, observacional, descriptivo, transversal. Se contó con la participación de 400 estudiantes de medicina pertenecientes a 19 facultades de medicina reconocidas oficialmente por la Asociación Peruana de Facultades de Medicina (ASPEFAM). El muestreo aplicado fue no probabilístico. Se utilizó una encuesta validada por un estudio anterior, autoaplicativa, anónima, voluntaria, y que fue sometida a una prueba piloto. La recolección fue virtual y el análisis realizado fue de tipo descriptivo. Resultados: De la población encuestada, solo el 7,8% refirió que su facultad de medicina sí apoyaba a la investigación. Alrededor del 56% refirió no sentirse suficientemente capacitado por su universidad para lograr la publicación científica en revistas biomédicas. Y en su gran mayoría hicieron apreciar que en sus universidades no se fomentan los semilleros en investigación, no cuentan con pasantías científicas y no existe apoyo para que los estudiantes ejecuten o realicen sus tesis. Conclusión: La apreciación de los estudiantes entorno al trabajo que vienen haciendo las universidades y/o facultades de medicina en la investigación científico médica de pregrado, fue catalogada como "deficiente" por la mayoría de los encuestados.

Objective: To know the appreciation of the student on the work of the Peruvian scientific research universities medical undergraduate students of faculties of medicine of the Peru, 2016-2017. Methods: It is a multicentric, observational, descriptive and transversal study. It featured the participation of 400 medical students belonging to 19 faculties of medicine officially recognized by the Peruvian Association of faculties of Medicine (ASPEFAM). Applied sampling was not probabilistic. A validated by a study earlier, auto-applicative, anonymous, voluntary survey was used, and which underwent a pilot test. The collection was virtual and the analysis was descriptive. Results: Only 7,8% concerned that its faculty of medicine Yes supported research. Around 56% concerned do not feel sufficiently trained by their University to achieve the scientific publication in biomedical journals. And most they did appreciate that their universities do not encourage the seed research, do not have scientific internships and there is support for students to execute or carry out their thesis. Conclusions: The perceptions of the students about the work of universities in undergraduate scientific medical research, it was classified as "deficient" by the majority of the surveyed.

Paciente con botriomicosis pulmonar primaria confundida con actinomicosis: una mortal e infrecuente enfermedad infecciosa / A patient with primary pulmonary botryomycosis mistaken with actinomycosis: a lethal and uncommon infectious disease

La botriomicosis es una mortal e infrecuente infección bacteriana granulomatosa supurativa. Presentamos el caso de una paciente de 52 años que reingresó por cuadro respiratorio complicado dos meses anteriores, con síntomas caracterizados por tos, disnea, alza térmica, inapetencia y pérdida de peso. En la tomografía pulmonar se observó fibrosis, infiltrado alveolar bilateral, cavidades y bronquiectasias bilaterales. La citología de aspirado bronquial mostró gránulos azurófilos haciendo sospechar de actinomicosis, por lo que se le dio tratamiento con penicilina, sin mejoría. En el segundo cultivo de aspirado bronquial el patólogo describió a dos grupos de colonias bacterianas gramnegativas de Escherichia coli, las cuales simularon gránulos azurófilos, planteándose como diagnóstico definitivo botriomicosis pulmonar por E. coli BLEE, no obstante, la paciente ya había fallecido. Como conclusión, se reporta una patología infecciosa de muy baja prevalencia, pero frecuentemente confundida con la Actinomicosis, cuyo diagnóstico temprano es extremadamente importante para reducir su alta mortalidad.

Botryomycosis is a lethal and uncommon granulomatous and suppurative bacterial infection. We present the case of a 52-year old female patient who was readmitted because of a respiratory disease that became complicated. She had had cough, dyspnea, fever, loss of appetite, and weight loss. A pulmonary CT scan showed fibrosis, bilateral alveolar infiltrate, cavities, and bilateral bronchiectasis. Bronchial aspirate cytology showed azurophilic granules, leading to suspect a diagnoses of actinomycosis, so penicillin was started, but no improvement was observed. In the second culture of bronchial aspirate two groups of Gram-negative bacteria colonies resembling Escherichia coli were observed, but also images resembling azurophilic granules were found, so the definitive diagnosis proposed was pulmonary botryomycosis caused by BLEE E. coli; nonetheless, the patient had just passed away. As a conclusion, an infectious disease with a very low prevalence is reported, where an early diagnosis is extremely important in order to reduce its high lethality rate.

Enteroparasitosis en niños de una comunidad rural de Lima-Perú / Enteric parasites in children of a rural community in Lima, Peru

Determinar la frecuencia de enteroparasitosis en niños de 1 a 10 años de una comunidad rural del departamento de Lima-Perú. Material y métodos: Estudio observacional, descriptivo y transversal. La población de estudio fueron los niños de 1 a 10 años. Se usó el examen coproparasitológico microscópico directo y el método de Graham. Se analizaron los datos mediante el programa Microsoft Excel 2010. Resultados: Se estudiaron 36 (100%)niños, 22 (61,1%) resultaron ser mono parasitados y 10 (27,8%) multiparasitados. El parásito intestinal más observadofue el Blastocystis hominis en el 33,3% de los casos. Conclusiones: Se identificó a una población que en su granmayoría presentaron carencias sanitarias y que vivían en condiciones rurales, y que tuvieron una alta frecuencia de enteroparasitosis tanto con el examen coproparasitológico microscópico directo como con el método de Graham.

Objective: To determine the prevalence of enteric parasites in 1-10 year children of a rural community in Lima, Peru. Methods: A cross-sectional study was conducted involving children from 1-10 years of age. Direct microscopic examination and Graham test were performed. Data were analyzed using Microsoft Excel 2010. Results: 36 children were studied; 22 (61.1%) were mono infected and 10 (27.8%) were poli-infected. The most common parasite identified was Blastocystis hominis in 33.3% of cases. Conclusions: We identified a population with a high prevalence of enteric parasitic infections that lived in a rural area with poor sanitary conditions.

Síndrome de burnout en estudiantes de medicina pertenecientes a sociedades científicas peruanas: un estudio multicéntrico / Burnout syndrome in medical students belonging to Peruvian scientific societies: A multicenter study

Identificar la frecuencia de síndrome de burnout (SBO) en los estudiantes de Medicina pertenecientes a sociedades científicas peruanas en el 2015. Material y Métodos: Estudio observacional, descriptivo y transversal. La población estudiada fueron todos los estudiantes de medicina humana pertenecientes a 9 sociedades científicas de diferentes departamentos del Perú y afiliadas a la Sociedad Científica Médica Estudiantil Peruana (SOCIMEP). La recolección de datos fue a través de un cuestionario para datos biográficos y el Maslach Burnout Inventory. Resultados: Se encuestó a 158 estudiantes de medicina humana pertenecientes a 9 sociedades científicas peruanas. El 24,1 % tuvo un nivel severo de agotamiento emocional, el 45,6% un nivel severo de despersonalización, el 25,3% un nivel bajo de realización personal y 57,6% tuvieron SBO. El 60,8% de los estudiantes se encontraba realizando algún trabajo de investigación y el 49,4% ocupaba algún cargo en su sociedad científica. Conclusiones: Se identificó una importante frecuencia de SBO en los estudiantes de Medicina pertenecientes a las sociedades científicas estudiadas...

To identify the frequency of burnout syndrome (BOS) in medical students belonging to Peruvian scientific societies (2015). Material and Methods: It is an observational, descriptive and transversal study. The study population was all students of human medicine belonging to 9 scientific societies involving different departments of Peru and affiliated to the Sociedad Científica Médica Estudiantil Peruana (SOCIMEP). The data collection was through a biographical data questionnaire and the Maslach Burnout Inventory. Results: We surveyed 158 students of Human Medicine belonging to 9 Peruvian scientific societies. The 24.1% had a severe emotional exhaustion level, 45.6% a severe level of depersonalization, 25.3% reported low level of personal accomplishment, and 57.6% had BOS. The 60.8% of students were doing some research and 49.4% occupied a position in the scientific society. Conclusions: An important frequency of BOS was identified in the medical students belonging to scientific societies of the study...

Carcinomatosis peritoneal secundaria a adenocarcinoma de células en anillo de sello del colon: a proposito de un caso / Periotoneal carcinomatosis secondary to signet ring cell colon carcinoma: a case-report

La carcinomatosis peritoneal (CP) secundaria a adenocarcinoma de colon es una metástasis al peritoneo poco frecuente e indicativa de mal pronóstico. Se reporta el caso de un varón de 26 años con diagnóstico de tuberculosis (TBC) enteroperitoneal y con tratamiento esquema sensible para TBC extrapulmonar. Tenía un tiempo de enfermedad de un mes caracterizado por dolor abdominal, náuseas, vómitos y constipación. Fue catalogado como "abdomen congelado" y se le realizó laparotomía exploratoria encontrándose nódulos blanquecinos en peritoneo como "granos de mijo". Fue hospitalizado con diagnóstico sindrómico de obstrucción intestinal y con diagnóstico probables de TBC miliar peritoneal vs linfoma no Hodgkin enteroperitoneal. El estudio anátomo-patológico de la biopsia peritoneal y colónica fue carcinomatosis peritoneal secundaria a adenocarcinoma de células en anillo de sello de colon...

Peritoneal carcinomatosis (PC) secondary to colonic adenocarcinoma is an infrequent condition usually associated with poor prognosis. We report the case of 26-year old male patient diagnosed of entero-peritoneal tuberculosis treated with a standard regimen for drug-sensitive tuberculosis. The patient had one month of illness characterized by abdominal pain, nausea, vomiting and constipation. A diagnosis of "frozen abdomen" was made and a laparotomy was performed finding white nodules mimicking "milliary seeds". The patient was admitted with a presumed diagnosis of tuberculosis or non-Hodgkin lymphoma. The biopsy revealed PC secondary to signet ring cell colon carcinoma...

Stability and compatibility of topotecan hydrochloride with selected drugs.

The physical and chemical compatibility of topotecan 56 microg/mL (as the hydrochloride) with 18 other drugs during simulated Y-site injection was studied. A vial of topotecan hydrochloride was reconstituted under aseptic conditions with sterile water for injection to yield a solution containing 1 mg of topotecan base per milliliter and further mixed with 0.9% sodium chloride injection or 5% dextrose injection. Equal volumes of topotecan solution and each secondary drug, also prepared in 0.9% sodium chloride injection or 5% dextrose injection, were mixed in sterile vials. All mixtures were stored at 20-23 degrees C under normal fluorescent light. Samples were taken initially and at four hours for analysis by high-performance liquid chromatography, visual inspection, and pH measurement. With a few exceptions, the drug combinations exhibited no visible change in color or clarity initially or after four hours, and the concentration of topotecan hydrochloride and of the secondary drugs was 95% or more of the initial concentration. The concentration of topotecan hydrochloride dropped to 88.7% of the initial concentration after four hours when the drug was mixed with ticarcillin disodium and with clavulanate potassium in 5% dextrose injection. An intense yellow color and a slight haze developed immediately after topotecan hydrochloride was mixed with dexamethasone sodium phosphate or with fluorouracil in 0.9% sodium chloride injection. The topotecan-mitomycin combination in both diluents became pale purple immediately and turned dark pink-lavender within four hours, after which analysis showed 15-20% degradation of mitomycin. During simulated Y-site injection, topotecan hydrochloride was physically and chemically compatible with 15 of 18 drug products.

Stability and compatibility of granisetron hydrochloride in i.v. solutions and oral liquids and during simulated Y-site injection with selected drugs.

The stability and compatibility of granisetron hydrochloride in common i.v. fluids and oral liquids and during simulated Y-site injection with selected drugs were studied. One milliliter of solution containing granisetron 1 mg (as the hydrochloride salt) was added to 50 mL of 5% dextrose injection, 5% dextrose and 0.9% sodium chloride injection, 5% dextrose and 0.45% sodium chloride injection, or 0.9% sodium chloride injection in polyvinyl chloride (PVC) bags and to 5 mL of 5% dextrose injection, 0.9% sodium chloride injection, or bacteriostatic water for injection in polypropylene syringes and stored at room temperature (20 degrees C) for 24 hours. One milliliter of the granisetron hydrochloride injection was added to 50 mL of apple juice, orange juice, cola, or an electrolyte replacement solution and stored for 60 minutes at room temperature. Twenty-nine drugs were mixed with the granisetron hydrochloride injection in 0.9% sodium chloride injection in volumes simulating Y-site injection and stored at room temperature. Finally, dexamethasone sodium phosphate injection 0.5 mL and 1 mL of the granisetron hydrochloride injection were added to 50 mL of 0.9% sodium chloride injection in a PVC bag and stored for 60 minutes. Drug concentrations were determined by high-performance liquid chromatography, and color, clarity, and pH were evaluated. Granisetron hydrochloride was stable in and compatible with all the i.v. solutions and oral liquids. Neither granisetron nor any of the drugs it was tested with during simulated Y-site injection showed any physical changes except for a slight Tyndall effect in the granisetron hydrochloride-doxorubicin hydrochloride combination; all the drugs retained at least 96% of initial concentrations. Granisetron and dexamethasone sodium phosphate were stable and compatible in the admixture. Granisetron 1 mg (as the hydrochloride salt) was stable for 24 hours in four i.v. infusion fluids in PVC bags and in 5% dextrose injection, 0.9% sodium chloride injection, and bacteriostatic water for injection in polypropylene syringes; for 1 hour in four oral liquids; for 4 hours in the presence of each of 29 drugs during simulated Y-site injection; and for 1 hour when mixed with dexamethasone sodium phosphate in 0.9% sodium chloride injection in a PVC bag.

Cimetidine hydrochloride compatibility. III: Room temperature stability in drug admixtures.

The stability of cimetidine hydrochloride mixed in intravenous solutions individually with 37 additives was investigated. Recommended doses of cimetidine hydrochloride injection and the other additives were diluted aseptically in varying concentrations in compatible intravenous solutions. The admixtures were stored at room temperature for 24 hours. Initial and 24-hour samples were evaluated visually on the basis of color, clarity, and pH. Cimetidine content was determined with a high-pressure liquid chromatographic procedure. The following drugs formed a precipitate with some dilutions of cimetidine hydrochloride injection in i.v. solutions: amphotericin B, cefamandole nafate, cefazolin sodium, and cephalothin sodium. The combination of cimetidine hydrochloride (300 mg) and cephalothin sodium (100 mg) resulted in a cimetidine concentration that was 77% of theory. Cimetidine hydrochloride injection was visually and chemically stable in the other admixtures examined. The results of this investigation suggest that incompatibility may be expected when cimetidine hydrochloride is combined with some antibiotics, and cimetidine incompatibilities may be concentration dependent.

Cimetidine hydrochloride compatibility. II: room temperature stability in intravenous infusion fluids.

The visual compatibility and chemical stability of cimetidine hydrochloride diluted in 19 intravenous infusion fluids were investigated. Cimetidine hydrochloride injection was added aseptically to large-volume parenteral solutions at concentrations of 120 and 500 mg/100 ml. Cimetidine concentration was analyzed by high-pressure liquid chromatography initially and after storage periods of 24, 48, 72, and 168 hours at room temperature. Cimetidine hydrochloride in each of the dilutions remained visually compatible for one week, exhibiting no changes in color, clarity, or odor; pH values remained constant. The addition of cimetidine to Normosol-R pH 7.4 resulted in solutions having pH values of 6.3 and 6.0 at 120 and 500 mg/100 ml, respectively. Cimetidine remained chemically stable in each of the intravenous fluids studied. Cimetidine hydrochloride is visually and chemically stable for at least one week when added to the intravenous fluids studied at concentrations of 120 and 500 mg/100 ml and stored at ambient room temperature.

Cimetidine hydrochloride compatibility. I: Chemical aspects and room temperature stability in intravenous infusion fluids.

The visual and chemical stabilities of cimetidine hydrochloride in solution with frequently prescribed large-volume parenteral fluids were studied. Cimetidine hydrochloride was added aseptically to each of 22 intravenous fluid products in glass or polyvinyl chloride containers to final concentrations of 120 and 500 mg/100 ml. The solutions were stored at approximately 25 degrees C. At 0, 24, 48, 72, and 168 hours (1 week) after mixing, the solutions were examined for color, odor, and clarity; pH values were measured; and the cimetidine contents were determined by high-pressure liquid chromatography. The solutions showed no changes in odor, color, or clarity. The pH values remained relatively invariant, except for slight increases in the 5% dextrose and in the Aminosyn 3.5% M solutions (120 mg/100 ml) and the 10% Travert Injection (500 mg/100 ml). Cimetidine content remained steady in all solutions. Cimetidine hydrochloride is visually and chemically stable for at least one week at ambient temperatures when combined with commonly used intravenous fluids in concentrations of 120 and 500 mg/100 of solution.