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Stevens-Johnson syndrome is an infrequent condition affecting the skin and mucous membranes, it involves cutaneous detachment with high mortality without adequate treatment. We present the case of a 40-year-old male with a history of epilepsy treated with valproic acid and lamotrigine, previously diagnosed with dengue. Evaluation showed erythematous blisters on skin and mucosa with bleeding and desquamation, covering 10% of the body surface. The patient progressed favorably with the medical care received. Stevens-Johnson syndrome should be studied in association with arboviral diseases.
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Dengue , Síndrome de Stevens-Johnson , Masculino , Humanos , Adulto , Síndrome de Stevens-Johnson/complicações , Síndrome de Stevens-Johnson/diagnóstico , Peru , Anticonvulsivantes , Ácido Valproico/uso terapêutico , Dengue/complicações , Dengue/diagnósticoRESUMO
Introduction: Surgical site infections (SSIs) can increase mortality and morbidity in patients after surgery. Antibiotic prophylaxis is an effective measure to prevent SSIs, but inappropriate prescription is frequent. The objective of the study was to determine compliance with the clinical practice guideline for antibiotic prophylaxis in the general surgery and gynecology and obstetrics wards in the city of Huánuco, Peru. Methods: An analytical cross-sectional study was carried out on all surgical interventions in the general surgery and gynecology and obstetrics services during the year 2019. Compliance was determined based on the chosen antibiotic, dose, time of administration, and duration of prophylaxis. Related factors considered were age, presence of co-morbidities, surgery performed, duration of surgery, types of procedure, anesthesia, as well as years as a surgeon and anesthesiologist. Results: A total of 557 medical records of patients with a median age of 33 years undergoing surgery were collected,. Antibiotic prophylaxis was correctly followed in all aspects in 14.6% of cases in the general surgery service and only in 5.6% of cases in the gynecology and obstetrics service. The correct duration of prophylaxis was 11.6% and 19.7% in general surgery and gynecology and obstetrics, respectively. Conclusion: Low compliance with institutional clinical practice guidelines for antibiotic prophylaxis was identified in both services. However, surgical interventions in the general surgery service presented better compliance with antibiotic prophylaxis compared to gynecology and obstetrics procedures.
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Introduction: Bovine brucellosis is a significant public health problem in countries with economic and zoonotic implications. Although relevant, there are no previous systematic reviews about bovine brucellosis in Latin America. Methods: We performed a systematic literature review in five data-bases to assess the seroprevalence of Brucella in cattle. A meta-analysis with a random-effects model was performed to calculate the pooled prevalence and 95% confidence intervals (95%CI). In addition, measures of heterogeneity (Cochran's Q statistic and I2 test) were reported. Results: The literature search yielded 3,403 articles, of which 65 studies were fully valid for analysis. The pooled seroprevalence for Brucella in bovine (n â= â46,883,177) was 4.0% (95%CI: 3.0%-5.0%; p â< â0.001), and Venezuela was the country with the highest prevalence (16.0%). By regions, the highest seroprevalence is in Central America and the Caribbean islands (8.0%,95%CI: 3.0%-15.0%; p â< â0.001, I2 â= â99.85). Conclusions: Some countries reported still relevant seroprevalences of bovine brucellosis, especially at the Central America and Caribbean islands. Multiple factors may influence the survival and spread of pathogens in the environment; farms located in regions bordering forest areas, in areas of difficult access to the veterinary service; extensive beef herds raised at pastures with different age and productive groups inter-mingled, and minimal concerns regarding hygiene practices and disease prevention measures. Bovine brucellosis has not been eliminated and needs to be considered with new tools for prevention and control, especially being a zoonosis.
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INTRODUCTION: Surgical site infections (SSI) can be as high in gynecology and obstetrics surgeries compared to other areas. Antimicrobial prophylaxis is an effective tool in the prevention of SSIs; however, it is often not adequately administered, so this study aimed to understand the compliance and factors associated with the use of the clinical practice guidelines for antibiotic prophylaxis in gynecological surgeries in two hospitals in the city of Huanuco, Peru. METHODS: An analytical cross-sectional study of all gynecologic surgeries performed during 2019 was performed. Compliance was determined based on the antibiotic chosen, dose, administration time, redosing, and prophylaxis duration. Age, hospital of origin, presence of comorbidities, surgery performed, as well as its duration, types of surgery, and anesthesia were considered as related factors. RESULTS: We collected 529 medical records of patients undergoing gynecological surgery with a median age of 33 years. The prophylactic antibiotic was correctly indicated in 55.5% of cases, and the dose was correct in 31.2%. Total compliance with the five variables evaluated was only 3.9%. Cefazolin was the most commonly used antibiotic. CONCLUSION: Low compliance with the institutional clinical practice guidelines for antibiotic prophylaxis was identified, showing that antimicrobial prophylaxis in the hospitals studied was inadequate.
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Background and Objectives. Multiple studies have evaluated the presence of bacterial contamination on cell phones in clinical settings; however, the presence and transmission of antibiotic-resistant bacteria on cell phones in the community have not been adequately elucidated. Material and Methods. A cross-sectional study was carried out to determine the presence of bacteria resistant to antibiotics on the cell phones of vendors in a Peruvian market and the associated factors. A sample of 127 vendors was obtained through stratified probabilistic sampling using a data collection form validated by experts. Cell phone samples were cultured using a standard technique, and antibiotic sensitivity was determined using the Kirby-Bauer technique. Chi-squared and Mann-Whitney U tests were used to determine factors associated with resistance in cell phone cultures. Results. Among the cell phones, 92.1% showed bacterial growth, predominantly Gram-positive bacteria (coagulase-negative staphylococci and Staphylococcus aureus), and 17% of the cultures showed resistance to at least three antibiotics evaluated. Two strains fell into the category of methicillin-resistant S. aureus, and three strains of E. coli had resistance to carbapenems. Conclusions. A short distance between customers and vendors, lack of a cell phone case, and having a cell phone with touchscreen are factors associated with antibiotic-resistant bacteria on cell phones.
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Telefone Celular , Staphylococcus aureus Resistente à Meticilina , Humanos , Antibacterianos/farmacologia , Estudos Transversais , Escherichia coli , Peru , BactériasRESUMO
Introduction: Multidrug-resistant tuberculosis is a significant public health problem for which drugs are used with many adverse effects. Among the devastating consequences of these diseases, there is a wide variation in the incidence of ototoxicity and hearing loss in patients with multidrug-resistant and extremely resistant tuberculosis. Cochlear implants may be indicated in patients with unilateral/severe bilateral hearing loss with no benefit from conventional hearing aids, but their use in patients with tuberculosis is rare. Case report: We present the first case of a right unilateral cochlear implant performed on a 34-year-old Peruvian patient who presented profound sensorineural hearing loss of cochlear origin. Conclusion: Cochlear implant surgery is an essential milestone in the treatment of patients with auditory sequelae of tuberculosis treatment. Close monitoring of possible complications of tuberculosis treatment should be strengthened in countries with a high incidence of multidrug-resistant and extremely resistant tuberculosis.
Introducción: La tuberculosis multidrogorresistente es un importante problema de salud pública para el que se utilizan fármacos con múltiples efectos adversos. Entre las devastadoras consecuencias de estas enfermedades, existe una amplia variación en la incidencia de ototoxicidad y pérdida auditiva en pacientes con tuberculosis multirresistente y extremadamente resistente. Los implantes cocleares pueden estar indicados en pacientes con pérdida auditiva unilateral/bilateral severa sin beneficio de los audífonos convencionales, pero su uso en pacientes con tuberculosis es raro. Reporte de un caso: Presentamos el primer caso de implante coclear unilateral derecho realizado a un paciente peruano de 34 años que presentaba hipoacusia neurosensorial profunda de origen coclear. Conclusión: La cirugía de implante coclear es un hito fundamental en el tratamiento de los pacientes con secuelas auditivas del tratamiento de la tuberculosis. Se debe fortalecer la vigilancia estrecha de las posibles complicaciones del tratamiento de la tuberculosis en los países con una alta incidencia de tuberculosis multirresistente y extremadamente resistente.
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Surtos de Doenças , Farmacorresistência Bacteriana Múltipla , Infecções por Klebsiella , Antibacterianos/uso terapêutico , COVID-19 , Hospitais , Humanos , Infecções por Klebsiella/tratamento farmacológico , Infecções por Klebsiella/epidemiologia , Klebsiella pneumoniae , Testes de Sensibilidade Microbiana , Pandemias , Peru/epidemiologia , SARS-CoV-2 , beta-LactamasesRESUMO
Introducción: las revistas científicas son el instrumento perfecto para comunicar resultados del proceso de investigación y transmitir el conocimiento. El comité editorial es un equipo de expertos de vital importancia en el funcionamiento de una revista científica. Sin embargo, una frecuente práctica editorial es la publicación de manuscritos en las revistas que editan. Por ello, se buscó determinar cuál es la frecuencia de la endogamia editorial en las revistas peruanas del área de la salud. Métodos: se realizó una revisión de los artículos publicados por miembros del comité editorial de 26 revistas peruanas entre el 2016 y 2019. Se realizó una evaluación de los manuscritos provenientes del comité editorial, así como un análisis de asociación entre el estado de indexación en dos bases de datos regionales; además, cómo esta influye en la frecuencia de endogamia de cada revista. Resultados: durante el periodo evaluado se publicaron 2.885 manuscritos, de los cuales 520 tenían como autores a miembros del comité editorial. El tipo de contribución más frecuente fue el artículo original. La endogamia en los años 2016 al 2018, así como un mayor porcentaje de endogamia por fascículo, fue estadísticamente mayor en las revistas pertenecientes al directorio Latindex. Conclusión: las revistas peruanas del área de la salud tienen frecuencias heterogéneas de endogamia editorial. Las revistas incluidas en el directorio Latindex presentan una mayor frecuencia de esta práctica editorial frente a las revistas que pertenecen a la base de datos SciELO-Perú.
SUMMARY Introduction: Scientific journals are the perfect instrument to communicate results of the research process and transmit knowledge. The editorial board is a team of experts of vital importance in the operation of a scientific journal, however, a frequent editorial practice is the publication of manuscripts in the journals they edit; therefore, we sought to determine the frequency of editorial inbreeding in Peruvian journals in the health area. Methods: A review of the articles published by members of the editorial board of 26 Peruvian journals between 2016 and 2019 was performed, evaluating the manuscripts from the editorial board, as well as analysis of association between the status of indexation in two regional databases and how this influences the frequency of inbreeding in each journal. Results: During the period evaluated, 2885 manuscripts were published, of which 520 had authors of the editorial board as authors. The most frequent type of contribution was the original article. Inbreeding in the years 2016 to 2018, as well as a higher percentage of inbreeding per issue, was statistically higher in the journals belonging to the Latindex directory. Conclusion: Peruvian journals in the health area have heterogeneous frequencies of editorial inbreeding. The journals included in the Latindex directory present higher frequency in editorial inbreeding, compared to journals included in the SciELO-Peru database.
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HumanosRESUMO
Visceral leishmaniasis is a neglected zoonotic disease that affects animals and humans in different tropical and subtropical regions and even beyond, with variable prevalence among infected hosts. To date, there have been no systematic reviews on human visceral leishmaniasis prevalence in Latin America. We therefore performed a systematic literature review with meta-analysis, using six databases to assess prevalence of visceral leishmaniasis in human patients in Latin American countries. Observational studies were included but analyzed separately. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95%CI). In all, 10,435 articles were retrieved for the time frame (1950-2019). After initial screening, 120 articles were selected for full-text assessment, 97 being finally included for qualitative and quantitative analyses. Overall, VL pooled prevalence was estimated at 38.8% (95% CI 33.8-43.8%), derived from 97 studies, including 44,986 individuals. Many aspects of the transmission dynamics of Leishmania and the exact burden of this parasitosis on public health remain largely unknown. Although the elimination of zoonotic VL in the Americas appears an unrealistic goal, additional efforts need to be put in place to achieve better diagnosis, treatment, and prevention of VL.