RESUMO

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.

RESUMO

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.

RESUMO

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.

Assuntos

RESUMO

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.

Assuntos

Assuntos

RESUMO

Dengue is a worldwide spread arboviral disease. Huánuco region is an endemic area for dengue. Understanding the influence of Knowledge, Attitudes and Practices (KAP) in dengue endemic areas can provide important insight for improving public health policies. The purpose of this study was to understand the KAP about dengue in the marginal urban city of Tingo Maria, district of Rupa-Rupa, a rain forest area in Huánuco region and its association with positive serology for dengue. An analytical, retrospective, cross-sectional study was carried out in which a randomized sample of 112 people were evaluated using a semi structured questionnaire and tested for IgG against dengue virus. Most participants recruited were from marginal urban settlements. The median age was 38 years and 64% were female. A bivariate analysis showed an association between educational level and serological positivity. Over 95% of participants with only primary school education had a positive serological test for dengue. No statistical significances were found between attitudes towards dengue control initiatives (p=0.221), preventive practices against dengue (p=0.773), and the level of knowledge about dengue (p=0.073). Although attitudes, preventive practices and level of knowledge were not related to positive serology in dengue cases, educational level showed an association with serological positivity for dengue.

Assuntos

RESUMO

Cáncer pain is defined as an unpleasant sensory and emotional experience. 90% of patients with terminal cáncer present pain. An alternative for the management of pain located in the thorax is erector spinae plane (ESP) block guided by real-time ultra- sound. However, its use in the management of oncological chest pain is not very common, with few reports in this regard, with most of these reports always performed by anesthesiologists. We describe our first experience performing a real-time guided ESP block using ultrasound performed by a trained pulmonologist in a 64 years-old male with lung adenocarcinoma stage IVa with sternum metastases and multiple left costal arches associated with left pleural effusion due to pleural metastases. We found ESP block to be safe for the patient as well as effective in reducing pain measured by Visual Analogic Score and was able to reduce the use of systemic analgesics.

El dolor es una experiencia sensorial y emocional desagradable. El 90% de los pacientes con cáncer terminal presentan dolor y una alternativa para el tratamiento del dolor localizado en el tórax es el bloqueo del plano del erector espinal de la columna (BPEE) guiado por ultrasonido en tiempo real. Sin embargo, su uso en el tratamiento del dolor oncológico no es común y hay pocos informes al respecto, la mayoría realizados por anestesiólogos. Describimos nuestra primera experiencia realizando un BPEE guiado en tiempo real con ultrasonido y realizado por un neumólogo en un varón de 64 años con adenocarcinoma de pulmón en estadio IVa, con metástasis en el esternón y múltiples arcos costales izquierdos y derrame pleural izquierdo debido a metástasis pleural. Descubrimos que el bloqueo BPEE fue seguro y efectivo para reducir el dolor medido por la puntuación de Escala Visual Analógica y fue capaz de reducir el uso de analgésicos sistémicos.

Assuntos

RESUMO

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.

Assuntos

RESUMO

The goal of this review was to systematize the evidence on pulmonary ultrasound (PU) use in diagnosis, monitorization or hospital discharge criteria for patients with coronavirus disease 2019 (COVID-19). Evidence on the use of PU for diagnosis and monitorization of or as hospital discharge criteria for COVID-19 patients confirmed to have COVID-19 by reverse transcription polymerase chain reaction (RT-PCR) between December 1, 2019 and July 5, 2020 was compared with evidence obtained with thoracic radiography (TR), chest computed tomography (CT) and RT-PCR. The type of study, motives for use of PU, population, type of transducer and protocol, results of PU and quantitative or qualitative correlation with TR and/or chest CT and/or RT-PCR were evaluated. A total of 28 articles comprising 418 patients were involved. The average age was 50 y (standard deviation: 25.1 y), and there were 395 adults and 23 children. One hundred forty-three were women, 13 of whom were pregnant. The most frequent result was diffuse, coalescent and confluent B-lines. The plural line was irregular, interrupted or thickened. The presence of subpleural consolidation was noduliform, lobar or multilobar. There was good qualitative correlation between TR and chest CT and a quantitative correlation with chest CT of r = 0.65 (p < 0.001). Forty-four patients were evaluated only with PU. PU is a useful tool for diagnosis and monitorization and as criteria for hospital discharge for patients with COVID-19.

Assuntos