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INTRODUCTION: Although 80% of symptomatic individuals with COVID-19 develop mild forms, it is the severe (15%) and critical (5%) forms that have the greatest impact in the hospital setting. Recognizing markers that can predict severe forms is essential, especially in high-altitude populations. METHODS: We conducted a prospective cohort study at 3200 masl (meters above sea level) in a city in Peru to determine if MPV (mean platelet volume) level is a predictor of COVID-19 severity. Patients with mild/moderate disease were enrolled and followed for 21 days or until the development of severe disease (primary outcome). A bivariate analysis was used to identify variables associated with severe disease. A ROC analysis determined the best MPV (mean platelet count) cut-off to predict COVID-19 severity, and then, a multiple regression analysis was performed. RESULTS: 64 patients were enrolled. The median age was 48.5 years (IQT 39-64.5) and the proportion of women was 51.6%, the most frequent symptoms were chest pain (73%), fever (71%), and dyspnea (67%). The median time to develop a severe form from the onset of symptoms was 11 days (IQT 10.5-13). The most common radiographic phase on CT scan (computed tomography) was progressive (60.38%). We observed that an MPV of more than 10.15 fL in the first week of disease predicted severity regardless of age and sex at high altitudes. CONCLUSIONS: MPV in the first week of the disease may predict severity in patients diagnosed with COVID-19 at high altitudes; however, we need prospective studies with a larger population and at a different altitude, levels to confirm these findings.
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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.
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Objetivo: Describir las características epidemiológicas, clínicas e inmunoserológicas de los pacientes en Tratamiento Antirretroviral de Gran Alcance (TARGA), de la Red Asistencial de EsSalud de Ica, en el año 2012. Materiales y métodos: Se realizó un estudio observacional, transversal y descriptivo con los pacientes VIH(+) mayores de 18 años que recibieron TARGA en el Hospital III Augusto Hernández Mendoza, se recabó la información aplicando una entrevista personal y revisión de historias clínicas en consultorio externo. La muestra fue de 69 pacientes. Se realizó un análisis univariado utilizando el programa SPSS. Resultados: La relación hombre/mujer fue de 2/1, predominó el grupo de heterosexuales, el 74,60% inició tratamiento en estadío SIDA con una media de CD4 de 96,15 cél/mL, el tiempo promedio de inicio de TARGA es de 6.5 meses a partir del diagnóstico, se encontró una frecuencia de 75,36% de efectos adversos al TARGA y una asociación significativa de estos al consumo de efavirenz (p=0,001); 53,62% de cambió de esquema y 63,77% lo interrumpió. La frecuencia de sífilis y VIH fue de 7,25%. Conclusiones: Existe un alto porcentaje de pacientes que inicia TARGA en estadío SIDA, el principal motivo de cambio de esquema fueron las reacciones adversas a medicamentos, siendo las náuseas y vómitos las más frecuentes. El uso de efavirenz se ha asociado a un aumento de efectos adversos. Es frecuente la presentación de ITS en pacientes con VIH. (AU)
Objective: to describe the epidemiological, clinical and immunoserological of patients on highly active antiretroviral therapy (HAART), the EsSalud Care Network of lea, in 2012. Materials and Methods: An observational, transversal and descriptive study with HIV (+) patients over 18 years who received HAART at Hospital III Augusto Hernandez Mendoza, information was collected using a personal interview and review of medical records in office external. The sample consisted of 69 patients. Univariate analysis was performed using 5P55. Results: The male / female ratio was 2/1, the predominant group of heterosexuals, 74.60% in stage AIDS treatment started with an average of 96.15 CD4 cells/mL, the median time to onset of HAART is of 6.5 months from diagnosis, there was a 75.36% rate of adverse effects to HAART and a significant association of these consumption efavirenz (p = 0.001), 53.62% of schema change and 63.77 % interrupted. The frequency of syphilis and HIV was 7.25%. Conclusions: A high percentage of patients who started HAART in AIDS stage, the main reason for schema change were adverse drug reactions, nausea and vomiting being the most common. The use of efavirenz has been associated with an increased side effects. Often the presentation of STIs in HIV patients. (AU)
