Revista Peruana de Medicina de Experimental y Salud Publica最新文献

Objectives.: Monkeypox (Mpox) is a zoonotic disease, endemic in some areas of Africa. But since May 2022, multiple cases of Mpox have been reported in non-endemic countries. We present the case of a patient with a history of HIV, as well as rash in several areas of the body, mostly in the gluteal region, associated with cervical lymphadenopathy and infectious proctitis. Diagnosis was confirmed by real-time polymerase chain reaction (RT-PCR) of skin lesion samples. Treponema pallidum and Neisseria gonorrhoeae infection was confirmed by serology and rectal discharge culture, respectively. The patient received antibiotics specific for gonorrhea and syphilis and his condition improved due to symptomatic and immunomodulatory therapy.

Objectives.: Motivation for the study. During the COVID-19 pandemic, spatial analysis methodologies were used to identify the territorial determinants of its distribution and social inequalities in access to medical care. Main findings. We found a concentration of cases in a specific location of the municipality, which remained constant throughout the study period, with sporadic outbreaks in other areas. Implications. It is necessary to pay attention to possible endemic foci of viral diseases in urban settings and to take measures to eliminate them as well as to prevent their spread within and outside the area.

Objectives.: Motivation for the study. The impact of the COVID-19 pandemic on the risk of death in cancer patients on chemotherapy and immunotherapy is controversial. Published studies mainly compared patients on anti-cancer therapy to those off treatment or COVID-19 positive cancer patients to COVID-19 negative ones. Few studies were conducted in developing countries. Main findings. Mortality didn't increase in unvaccinated outpatients on active intravenous oncology treatment during the COVID-19 pandemic. Implications. This is the first propensity score-matched cohort study evaluating the impact of the COVID-19 pandemic on the population of unvaccinated oncology patients receiving intravenous anticancer therapy. . To compare all-cause mortality of unvaccinated oncology patients who received chemotherapy or immunotherapy during the pandemic with those treated before the pandemic.

Materials and methods.: We conducted a cohort study in four tertiary hospitals in Argentina. Outpatients with a solid neoplasm of any stage under-going cytotoxic or intravenous immunotherapy were eligible. The pandemic cohort was enrolled during the initial phase of the outbreak and compared with a pre-pandemic cohort using propensity score matching (PSM). Subjects were matched for age, sex, health insurance, risk factors for severe COVID-19 complications, performance status, cancer type and treatment, line of treatment, and body mass index. All-cause mortality was estimated for both cohorts after 6 months of follow-up.

Results.: A total of 169 patients were recruited between April and August 2020 for the pandemic cohort and 377 for the pre-pandemic cohort in the same months of 2019; 168 patients were matched. After PSM, all-cause mortality was 17.9% in the pandemic cohort and 18.5% in the pre-pandemic cohort; the Relative Risk was 0.97 (95 % confidence interval: 0.61-1.52; p=0.888). In the pandemic cohort, 30/168 patients died, but none from COVID-19.

Conclusions.: Our findings show that the mortality rate of unvaccinated ambulatory patients on active intravenous oncology treatment during the COVID-19 pandemic did not increase.

Objectives.: Motivation for the study. To understand the characteristics and distribution of the main parasitic zoonoses in Peru and to generate data for decision making in surveillance, prevention and control. Main findings. These parasitic zoonoses are distributed in areas of extreme poverty in the central and southern highlands of Peru. Fascioliasis seropositivity was found to be higher than for echinococcosis and cysticercosis. In addition, sociodemographic characteristics and lifestyle habits influence the transmission of these zoonoses. Implications. An active search for these zoonoses should be carried out in other risk areas with similar epidemiological characteristics to determine the prevalence of each of these zoonoses and implement multisectoral prevention and control programs. . To determine seropositivity to anti-IgG antibodies against Echinococcus granulosus, Fasciola hepatica and Taenia solium cysticercus infection and to describe the characteristics of the infected patients in 13 regions of the Peruvian highlands between 2016 and 2019.

Materials and methods.: Cross-sectional, observational study, in which we analyzed 7811 epidemiological records of laboratory-based surveillance of parasitic zoonoses from 2016 to 2019. Diagnosis was established by detecting IgG type anti-E. granulosus, F. hepatica and T. solium cysticercus antibodies using native antigens by enzyme-linked immunosorbent assay (ELISA) and Immunoblot. We evaluated the difference in the frequency of the cases according to identified characteristics using Pearson's chi-square test and Fisher's exact test.

Results.: Seropositivity was 7.9% for fascioliasis, 4.9% for cystic echinococcosis, and 2.3% for T. solium cysticercus. These rates were higher in Cerro de Pasco for cystic echinococcosis (24.5%), in Ayacucho for T. solium cysticercus (4.5%) and in Puno for fascioliasis (40.6%). Regarding the sociodemographic characteristics, we found a statistically significant difference in the frequency of cases for all zoonoses according to age group, occupation, and region of residence. We also found a difference with the consumption of vegetables in emollients, and between clinical-epidemiological characteristics and having a family history of parasitic zoonoses.

Conclusions.: From the 7811 samples, we found that these parasitic zoonoses are distributed in 13 regions of the Peruvian highlands, and represent a major health problem, with frequencies that change according to different characteristics.

Objectives.: Acquired hemophilia A is a rare bleeding disorder worldwide, characterized by the presence of inhibitory autoantibodies directed against a coagulation factor, most often factor VIII. There are several possible causes, and it can occur during the postpartum period. We present the case of a 34-year-old female patient with back pain, hematuria and a right gluteal hematoma, with no previous history of bleeding. She was transferred to the emergency department due to the extension of the hemorrhagic manifestations. Diagnosis was confirmed with the coagulation profile, mixing test and the assessment of factor VIII inhibitor tier. The case highlights the importance of considering this condition in a postpartum patient with persistent postoperative bleeding, extensive hematoma and no history of previous bleeding.

Objectives.: Motivation for the study. There are few reports on the clinical experience of the population infected with the omicron variant of COVID-19 in Latin America, particularly in pediatric population. Main findings. There was a rapid increase in the number of hospitalizations compared to previous waves, mainly due to respiratory conditions; most patients progressed favorably. Antibiotics and corticosteroids were the most used drugs. Implications. Studying the characteristics of children hospitalized during the third wave of COVID-19 in Peru may increase the knowledge of how the omicron variant affects this population group, which will allow comparisons with possible new waves or diseases.