Cardiovascular disease in human immunodeficiency virus-infection as a cause of hospitalization: a case-series in a General Hospital in Peru

Background Cardiovascular disease in the context of human immunodeficiency virus infection has become a major clinical concern in recent years. In the current report we assess hospitalizations due to cardiovascular disease in human immunodeficiency virus patients in a Social Security reference hospital in Peru. Methods A retrospective study was carried out between January 1996 and December 2012 in a General Hospital in Lima, Peru. Results We included 26 patients hospitalized due to cardiovascular disease. Mean age was 46.3 years (SD 12.5), predominantly male (57.7%). Ten patients (38.4%) were in Acquired Immunodeficiency Syndrome stages. Seventeen (65.4%) received high-active-antiretroviral therapy. Eleven (42.3%) had cardiac involvement and 15 (57.7%) had non-cardiac vascular involvement. The most frequent causes of cardiac involvement were pericardial effusion and myocardial infarction. On the other hand, deep vein thrombosis and stroke were the most frequent for non-cardiac vascular involvement. Conclusions Cardiovascular disease is an important cause of hospitalization in Peruvian human immunodeficiency virus patients, with differences between immunosuppression stages. Further studies analyzing associated factors are warranted.
Authors: Valenzuela Rodríguez, Germán; Mezones Holguin, Edward; Mendo Urbina, Fernando; Rodríguez Morales, Alfonso J.
Source:  The Brazilian Journal of Infectious Diseases

URL: http://hdl.handle.net/10757/550453

A Shocking Cystory

A39-year-old woman from the south highland of Peru presented with abdominal distention, 10-kg weight gain, and intense stabbing pain in right upper quadrant of the abdomen. On physical examination, she had abdominal dullness and distention. She had a history of a liver cyst diagnosed by ultrasound 14 years ago. Three years ago a second ultrasound showed 3 cysts inside the first one. She did not receive any treatment before this hospitalization. The patient used to raise dogs and livestock (sheep and cattle) in her rural house when she was a child. The current ultrasound showed large cysts in liver and spleen that were confirmed by an abdominal computed tomography (CT) scan that revealed that both cysts contained hundreds of smaller cysts inside. Laboratory results showed a positive enzyme-linked immunosorbent assay (immunoglobulin G) for hydatid cyst. Laparotomy was performed, and the liver cyst was removed as well as the entire spleen.
Authors: Cayo Quiñe, Alexandra; Bustamante Voysest, Rossi; Martínez Vargas, Valeria
Source: Clinical Gastroenterology and Hepatology (Clin Gastroenterol Hepatol)
URL: http://hdl.handle.net/10757/528064

¿Schwannoma gástrico de crecimientorápido o tumor del estromagastrointestinal?: presentación de casoclínico y revisión de la literatura

Sr. Director:
Los schwannomas, también conocidos como neurinomas, neurilemomas o fibroblastomas perineurales, se originan a partir de las células de Schwann del tejido nervioso periférico1,2. Pertenecen a la familia de tumores mesenquimatosos, son solitarios, de crecimiento lento, típicamente encapsulados y habitualmente bien diferenciados2,3. Pueden originarse del plexo de Auerbach (en la capa muscular) o del plexo de Meissner (en la submucosa), siendo el último el de menor frecuencia2. Su tamano˜ es variable (0,5-11 cm de diámetro). La localización más frecuente corresponde a las regiones cefálica y cervical1---3; raramente se originan en el tracto gastrointestinal, pero de presentarse ahí, el segmento más afectado es el estómago2.
Autores: Pinedo Pichilingue, Aranza; Quijano Ono, Javier
Fuente: Gastroenterología y Hepatología (Gastroenterol Hepatol)
URL: http://hdl.handle.net/10757/527969

Primary non-polipoid intestinal folicular lymphoma: case report and review of the literature

The primary intestinal follicular lymphoma is a rare disease described in the last classification of lymphomas from WHO. It is a localized disease with excellent prognosis. We describe in this article ,a 64 year-old Peruvian female with abdominal pain and delayed vomiting for the last two years, has undergone a partial intestinal resection due to bowel obstruction. There was a well-circumscribed annular tumor. A diagnosis of non-polypoid primary intestinal follicular lymphoma was made. We report the case and review the literature in this article.
Authors: Beltran, Brady; Carlos Alva, José; Morales, Domingo; Portanova, Michel
Source: Revista de Gastroenterología del Perú (Rev Gastroenterol Peru)

URL: http://hdl.handle.net/10757/348591

¿Existe la equidad injusta? por la eliminación del requisito obligatorio del SERUMS

Sr. Editor.
Hemos leído la respuesta de Mujica et al. a nuestro manuscrito sobre el requisito obligatorio del servicio social en salud (SERUMS) (1). Ellos basan su comentario sobre uno de los aspectos introductorios del artículo (la búsqueda de evidencias sobre el efecto de la intervención) y no sobre el fondo de nuestra propuesta, ya que mencionan que la “inefectividad de un programa social no lo hace necesariamente inconstitucional (i.e., falacia non sequitur)”. Este comentario nos llama la atención porque en ninguna parte del manuscrito hemos afirmado que la inconstitucionalidad se deba a la falta de evidencias de efectividad del programa, sino al requisito obligatorio del SERUMS para que los recursos humanos en salud (RHUS) puedan ingresar a programas de segunda especialización, ocupar cargos en entidades púbicas, recibir becas u otra ayuda equivalente para estudios o perfeccionamiento (2). Nosotros basamos nuestro análisis de inconstitucionalidad en que este requisito obligatorio afecta tanto el derecho al trabajo y el derecho a la educación, y que por ser aplicado solo para los RHUS, es discriminatorio.
Autores: Mayta Tristán, Percy; Poterico, Julio A.; Galán Rodas, Edén; Raa Ortiz, Daniel
Fuente: Revista Peruana de Medicina Experimental y Salud Pública (Rev Peru Med Exp Salud Publica)
URL: http://hdl.handle.net/10757/348586