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The present paper describes a new species of Dermadena (Digenea) parasitizing Pseudobalistes naufragium in Puerto Pizarro, northern Peru, using light and scanning electronic microscopy (SEM). Additionally, molecular analysis was also performed to determine the phylogenetic affinities of Dermadena within the Lepocreadiidae. The new species is differentiated from Dermadena spatiosa, Dermadena stirlingi and Dermadena lactophrysi by presenting a curved and well-developed external seminal vesicle. Also, SEM revealed numerous dome-shaped tegument protuberances forming glandular papillae with transversal wrinkles arranged roughly in concentric rows around the acetabular region, varying in size from large at the middle of the body to small at the margin. In the molecular phylogeny, the new species formed a well-supported clade with sequences of species from the Lepocreadiidae, confirming that it belongs to this family.

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An annotated checklist of the helminth parasites associated with reptiles from Peru is provided, as the result of a compilation of parasitological papers published between 1963 and January 2022 and records of species deposited in national and international collections. The list provides data on hosts, developmental stage, sites of infection, geographical distribution in Peruvian territory, code of material deposited in helminthological collections, references and taxonomic notes. The database includes records of 106 different species of helminth parasites (82 nominal species and 24 taxa identified at the generic level), the majority in the adult stage. These helminth parasites come from 18 of the 25 official Peruvian regions. Nematodes have the highest richness in number of species (79 species), followed by trematodes (17 species) and cestodes (nine species). The acanthocephalans are represented by only one species. The parasites with the highest number of records were Physaloptera retusa Rudolphi, 1819 (11 hosts), Physalopteroides venancioi (Lent, Freitas & Proença, 1946) (nine hosts), Strongyluris oscari Travassos, 1923 (seven hosts), and Parapharyngodon scleratus Travassos, 1923 (five hosts), all of which are nematodes. The 106 taxa of helminth parasites have been reported infecting 55 species of reptiles in Peru, distributed in 34 genera and 14 families. The reptile species harbouring the highest number of helminth parasites are the yellow-footed tortoise Chelonoidis denticulatus (Linnaeus) with 18 species (three trematodes and 15 nematodes), followed by the Peru desert tegu Dicrodon guttulatum Duméril & Bibron (Teiidae) with 11 species (three cestodes and eight nematodes) and the yellow-spotted Amazon River turtle Podocnemis unifilis Troschel (Podocnemididae) with 10 species (five trematodes and five nematodes). Of the 524 species of reptiles reported in Peru, only 55 (>10%) are reported as hosts of helminths representing a small proportion considering the great variety of reptile hosts that inhabit the various tropical and subtropical geographical areas of Peru.

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INTRODUCCIÓN: Los trastornos del equilibrio constituyen un grupo heterogéneo de patologías. Son patologías frecuentes en medicina, representando una carga asistencial significativa en los distintos niveles de atención. En ese sentido, los estudios de frecuencia son una herramienta para entender patrones de enfermedad, como también la evaluación y planificación de una red asistencial. Material y método: Estudio descriptivo transversal sobre pacientes que asistieron al policlínico de otoneurología del Hospital Clínico Herminda Martin con motivo de consulta síntomas vestibulares durante el año 2018. Resultados: 183 pacientes cumplieron con los criterios de inclusión y exclusión, 78% (n=143) del sexo femenino y 22% (n=40) del masculino. Con una edad promedio de 58 años. El diagnóstico otoneurológico más frecuente fue vértigo posicional paroxístico benigno 34,97% (n=64), seguido de migraña vestibular 7,1% (n=13), enfermedad de Ménière 5,46% (n=10) y neuritis vestibular 4,37% (n=8). En 26,78% (n=49) no se logró un diagnóstico definitivo. Los trastornos de origen central representaron un 3,83% (n=7) y aquellos de origen no otoneurológico un 17,49% (n=32). Discusión: Los datos de frecuencia de los distintos trastornos del equilibrio registrados en el policlínico de otoneurología del Hospital Clínico Herminda Martin, son similares a la literatura internacional. Los trastornos vestibulares periféricos son los más frecuentes, de los cuales destaca el vértigo posicional paroxístico benigno representando el 34,97% del total de casos. Dentro de las causas otoneurológicas, la migraña vestibular fue la segunda causa en nuestro medio con un 7,1% del total de casos.

INTRODUCTION: Balance disorders are a heterogeneous group of diseases. They are a frequent medical condition, representing a significant healthcare burden at the different levels of care. Thus, frequency studies are a tool to understand disease patterns, as well as the evaluation and planning of a healthcare network. Material and method: Cross-sectional study of patients who attended the otoneurology out-patient clinic of the Hospital Clinico Herminda Martin with chief complaint of vestibular symptoms during 2018. Results: 183 patients met the inclusion and exclusion criteria, 143 (78%) were female and 40 (22%) male. With an average age of 58 years. The most frequent otoneurological diagnosis was benign paroxysmal positional vertigo 34.97% (n=64), followed by vestibular migraine 7.1% (n=13), Ménière's disease 5.46% (n=10) and vestibular neuritis 4.37% (n=8). In 26.78% (n=49) a definitive diagnosis was not achieved. Disorders of central origin represented 3.83% (n=7) and non-otoneurological origin 17.49% (n=32). Discussion: The frequency data of the balance disorders registered in the otoneurology out-patient clinic are similar to the international literature, peripheral vestibular disorders are the most frequent, of which benign paroxysmal positional vertigo stands out, representing 34.97% of the total cases. Among the otoneurological causes, vestibular migraine was the second cause in our study with 7.1% of the total cases

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La calidad del sueño est  directamente relacionada al buen funcionamiento de los procesos cognitivos, así como al bienestar de los seres humanos. En los estudiantes de Medicina Humana, los procesos de memoria a corto y largo plazo toman especial importancia para el aprendizaje del contenido académico. Objetivo: demostrar la existencia de una relación entre la calidad del sueño y el rendimiento acad‚mico de los alumnos del curso de Fisiología Humana de la Facultad de Medicina Humana de la Universidad de San Martín de Porres (Lima, Perú). Material y Métodos: se trabajó con la población de alumnos (N=384 alumnos), obteniendo 209 encuestas validas; el instrumento aplicado fue el Õndice de Calidad del Sueño de Pittsburg, conjuntamente con preguntas sobre edad y sexo. Resultado: Se encontró un total del 67,5% de malos dormidores y un 32,5% de buenos dormidores. No se halló asociación entre la calidad del sueño y el rendimiento académico (p=0,865), pero sí entre la eficiencia porcentual del sueño y la nota promedio Actitudinal (p=0,039). Conclusiones: no hubo asociación entre calidad de sueño y rendimiento académico. se recomienda integrar nuevas variables para el estudio de la calidad de sueño en estudiantes de Medicina.

Sleep quality is directly related to the good working of the cognitive processes, and also to the wellbeing of human beings. In medical students, long-term and short-term memory processes take special importance for the learning of the academic content. Objective: to demonstrate the existence of a relationship between the sleep quality and the academic performance of the students taking the subject of Human Physiology, in the School of Medicine of the San Martin de Porres University (Lima, Per£). Material and Methods: we worked with the student’s population (N=384 students), obtaining 209 valid polls; and the instrument applied was the Pittsburg Sleep Quality Index, along with age and sex questions. Results: a total of 67,5% of bad and 32,5% of good sleepers was found. Association wasn’t found between sleep quality and academic performance (p=0,865), but it was found between percentage sleep quality and the Attitudinal average mark (p=0,039). Conclusion: association wasn’t found between sleep quality and academic performance. We suggest integrating new variables for the sleep quality study in Medicine students.

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Revisar la experiencia en trauma renal en el Hospital San Juan de Dios, Servicio de Salud Metropolitano Occidente. Se revisan todos los registros de alta con diagnóstico de trauma renal entre los años 1994 y 2000. Se estudian retrospectivamente todos los registros caracterizando pacientes por edad, sexo, tipo trauma, estudio imagenológico y necesidad de cirugía. Durante el período se hospitalizaron 20 pacientes con diagnóstico de trauma renal. Sus edades oscilan entre los 17 y 64 años (mediana 33), 17 (85 por ciento) corresponden a sexo masculino. 4 (20 por ciento) sufren trauma penetrante, todos ellos por arma blanca, 16 (80 por ciento) presentan trauma contuso, principalmente por accidente automovilístico y caída de altura (66 por ciento). Dieciséis pacientes fueron manejados conservadoramente. De los pacientes que fueron a cirugía, en 2 de ellos se realizó nefrectomía por trauma contuso en riñón patológico. Los otros 2 presentaban trauma penetrante y se realizó nefrorrafia. En 3 pacientes del estudio no se realizó TAC. De los 20 pacientes, 9 fueron GI, 8 GII, 1 GIII, 2 GIV. La experiencia de nuestro servicio reproduce lo publicado. El trauma renal es más frecuente en hombres 4:1, el trauma cerrado es responsable del 80 por ciento de los mecanismos, siendo su génesis los accidentes automovilísticos y caídas. Las lesiones penetrantes se asocian a traumas de mayor grado. El manejo conservador es una alternativa en pacientes con trauma renal penetrante bien etapificado.

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Se presenta un estudio de hernioplastía inguinofemoral laparoscópico. En 104 pacientes se realizó 124 hernioplastías. Se comunica la estandarización de la técnica, una clasificación anatómica de acuerdo al tamaño del defecto. En todos se utilizó un parche de malla de polipropileno adicionando trozos planos del mismo material en aquellos casos que tenían una dilatación importante del anillo inguinal profundo o una destrucción completa de la pared posterior. No hubo conversión en la serie. La morbilidad fue leve y transitoria. No ha habido morbilidad a largo plazo o escuelas. El 100 por ciento de la serie se ha seguido. Se comentan siete recurrencias precoces en el primer mes

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An epidemiologic case-control study to ascertain the determinants of low birthweight was carried out in Santiago, Chile, from January to December 1989. The cases were defined as livebirths < 2500 g. The controls were livebirths > or = 2500 g of birthweight. All cases and a random sample (1:1) of controls were selected among 8,254 singleton births occurring at the El Salvador Hospital in the Eastern area of Santiago. These deliveries represented 50% of institutional deliveries in the area. Home deliveries (2%) and private hospital deliveries were not included in the study. Information was obtained from hospital medical records by six trained medical students. Some information could not be obtained from the hospital medical records. Thus the second step in data collection was the tracking of all the selected subjects to their referring neighborhood health centers. For the analysis, the data were divided into 3 case (outcome) categories: 453 subjects were the total case group. From these, 153 were the IUGR case group and 300 were the LBW preterm case group. The general control group consisted of 605 normal birthweight infants. 565 were the IUGR control group and 40 were the preterm control group. A total of 25 risk factors showed a significant crude odds ratio for at least one of the groups. In the multivariate logistic regression analysis eight variables: No. of pregnancies, previous adverse outcomes, previous LBW, pregnancy maternal weight, No. of visits, month of first prenatal care visit, maternal smoking and intrahepatic cholestasis of pregnancy, were significantly associated with LBW after adjustment by confounding. Eight risk factors: IUGR in previous pregnancies, Previous adverse outcome, Maternal smoking, intrahepatic cholestasis, maternal pregnancy weight, maternal height, month first prenatal visit, No. of visit, were significant to IUGR. Only two variables: pregnancy weight, divorced mother, were significantly associated with low birth weight in the preterm group. The most relevant risk factors were included in stepwise logistic regression models carried out for the outcome LBW for the general group, term group and preterm group, in order to adjust by confounding. Adjusted odds ratios were then obtained. Prenatal care related factors and maternal adverse obstetric factors were at higher significance for LBW in the general and IUGR groups. Only nutritional factors were related to LBW in preterm group. Women who delivered a LBW or IUGR infant were more likely to have fewer pregnancies, a history of previous LBW, lower prepregnancy weight and lower gestational weight gain. ICP was associated with an elevated risk of LBW that was independent of gestational age.

PIP: Births occurring in 1989 in the El Salvador Hospital in Santiago's Metropolitan East Health Service were retrospectively studied to determine risk factors for low birth weight and intrauterine growth retardation (IUGR) in the urban Chilean population. 453 of the 605 births at weights between 500 and 2499 g were the cases; complete information was unavailable for the other 152. The 605 controls were the births over 2500 g immediately following low weight births. A total of 8254 singleton live births occurred during 1989. The general prevalence of low birth weight in the study population was 6.8%. The data were classified into three groups according to outcome. 300 were preterm low birth weight cases, 153 were IUGR cases, and 605 were normal birthweight controls. Data were analyzed for the entire group and separately for the preterm and IUGR groups. 25 of the risk factors showed significant crude odds ratios for at least one of the groups. Eight variables were significantly associated with low birth weight in multivariate logistic regression analysis after adjustment for confounding variables. The eight variables were number of pregnancies, previous adverse outcome, previous low birth weight, maternal weight during pregnancy, number of prenatal visits, month of first prenatal visit, smoking, and intrahepatic cholestasis of pregnancy. Eight risk factors were significantly associated with IUGR, but only two, prepregnancy weight and divorced mother, were significantly associated with low birth weight in the preterm group. A stepwise logistic regression was carried out for the entire group, IUGR group, and preterm group, to adjust for confounding variables. Adjusted odds ratios were obtained. In the general and IUGR groups, mothers were likely to have fewer pregnancies, a history of low birth weight, and lower prepregnancy weight and weight gain during pregnancy. Only nutritional factors were related to low birth weight in the preterm group. Intrahepatic cholestasis of pregnancy was associated with increased risk of low birth weight independent of gestational age.

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Desde marzo de 1991 a julio de 1992 se han realizado 700 colecistectomía laparoscópicas consecutivas en nuestro hospital. Nuestra población está constituída en un 66 por ciento por mujeres con un promedio de edad de 47 años. El 95,2 por ciento de los enfermos presentaba una colecistitis crónica, que motivó cirugía electiva. En 27 casos (3,8 por ciento ) el diagóstico preoperatorio fue colecistitis aguda. La técnica francesa se utilizó en el 61 por ciento de los casos y la americana en grupo restante. Se observó un 93 por ciento de éxito en efectuar la colecistectomía laparoscópica (646/700) siendo necesario convertir a colecistectomía abierta en el 7 por ciento por diversas complicaciones o hallazgos intraoperatorios. Se estudió radiológicamente la vía bibliar en el intraoperatorio en el 13 por ciento de los casos, observándose cálculo en el colédoco en el 15 por ciento de este grupo. Las complicaciones intraoperatorias incluyen, ruptura de la vesícula biliar en el 6,5 por ciento , lesiones vasculares (2,5 por ciento ) y de vía bibliar principal en el 0,7 por ciento . Las complicaciones postoperatorias alcanzan un 0,7 por ciento (5 reoperaciones). La estadía postoperatoria promedio fue de 2,3 días para la cirugía laparoscópica y de 6,2 días para los casos que requirieron método clásico

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