Estudio de la mortalidad en pacientes con infección por el virus de la inmunodeficiencia humana en el Hospital Nacional 2 de Mayo 2001 - 2004

El presente estudio investigó las principales causas de mortalidad por VIH/SIDA en el Hospital Nacional Dos de Mayo (HNDM) durante los años 2001 al 2004, igualmente estableció el perfil demográfico y epidemiológico de los pacientes fallecidos, su estado inmunológico, su estadio al diagnostico y la frecuencia de las enfermedades oportunistas y su relación con la sobrevida. Para obtener los datos se seleccionó la historia clínica de pacientes con ELISA para VIH reactivo, así como los pacientes fallecidos en el HNDM entre enero del 2001 a Junio 2004. Se encontró que el 77.6 por ciento de los pacientes fueron masculinos, los grupos etareos más afectados fueron de 25 a 34 años; solo el 48.5 por ciento no tuvo antecedente de infección de transmisión sexual (ITS), el resto presento sífilis diagnosticada por serologia o ulcera genital. La tendencia sexual predominante fue heterosexual con 56.8 por ciento, seguido por la bisexual con 25.3 por ciento. En cuanto al antecedente de farmacodependencia solo estuvo presente en 18.3 por ciento, mientras que la principal vía de transmisión fue la sexual con 86.7 por ciento. El motivo para el diagnostico más frecuente fue "cuadro clínico" 70.3 por ciento y el estadio señalado en ese momento fue SIDA en el 60.6 por ciento de los casos, siendo las enfermedades indicadoras más frecuentes fueron la caquexia por ciento y TBC pulmonar 27.9 por ciento. El uso de antirretrovirales estuvo restringido al 16 por ciento de los pacientes. Entre Las enfermedades más frecuentemente observadas están la diarrea crónica 68.8 por ciento, TBC pulmonar 66.2 por ciento y candidiasis oral 37.0 por ciento. La sobrevida en pacientes diagnosticados como infección VIH fue 63.6 por ciento hasta 48 meses, mientras que en estadio SIDA fue de 58.9 por ciento solo 12 meses. Las causas de muerte más frecuente fueron TBC pulmonar, meningitis TBC y criptococosis. Se concluye que aunque el perfil demográfico y epidemiológico se mantiene, la tuberculosis en todas sus formas ha incrementado su relación con el VIH.Trabajo académic

"Fire burns matter: A case-control study of severe accidental burns in pediatric patients"

"Objective: We aimed to identify factors associated with severe accidental burns in patients ≤12 years old. Materials and methods: We conducted a matched case-control study, in which we retrospectively reviewed the medical records of children treated in a single institution from 2014-2016. We classified the cases (patients with severe burns) and controls (patients with non-severe burns) according to the criteria of the American Burn Association. We used multivariate conditional logistic regression analysis to identify the relationship between the etiology of burns and their severity. Results: We reviewed 180 cases and 90 controls. The most common etiology of burns was boiling water in both cases (65.6%) and controls (83.3%). Most burns occurred inside the home (84.1%) and in the afternoon (37.4%). Multivariate analysis identified that severe burns were mainly due to exposure to fire (odds ratio [OR]: 3.22, 95% confidence interval [CI]: 1.53-6.81). Similarly, these patients were more likely to live in a rural area (OR: 2.96, 95% CI: 1.17-6.19). Conclusions: In pediatric patients ≤12 years of age severe accidental burns are more likely to be caused by fire compared to boiling water. Public health interventions should focus on populations located in rural areas.

Tuberculosis pericárdica con efusión hemorrágica

Se presenta el caso de un paciente varón de 19 años con tres semanas de enfermedad, fiebre, diaforesis, tos, pérdida de peso, disnea progresiva. Llegó al servicio de Emergencia con síntomas de insuficiencia cardiaca. Los estudios demostraron derrame pericárdico moderado. Se realizó una ventana pericárdica donde se evidenció liquido pericárdico hemorrágico. El estudio histológico del pericardio y de un ganglio mediastínico reveló uninfiltrado crónico granulomatoso y caseificante, sugerente de tuberculosis pericárdica. Respondió favorablemente al tratamiento antituberculoso más prednisona

"HIV therapy adherence and outcomes in Peruvian military personnel over a 30-year period"

"Objectives: We aimed to describe the sociodemographic, clinical, and therapeutic characteristics of Peruvian military personnel diagnosed with HIV. Furthermore, we determined the frequency of highly active antiretroviral therapy (HAART) adherence, the complications and mortality. Methods: We retrospectively reviewed the medical records of patients diagnosed with HIV, confirmed by Western blot at a single institution from 1989-2020. Descriptive analyses were performed for all the variables using mean and standard deviation (SD) in the case of quantitative variables, and frequency and percentage for qualitative variables. Results:Ofthe 161 patients included, 95.7% were males and the mean age was 39.59 years (SD= 16.45 years). Most had college or higher education (67.7%) and were on active duty at diagnosis (77%). 35.4% had AIDS at diagnosis; 28.6% opportunistic infections; and 8.1% tuberculosis. The median follow-up was five years. 94.4% of the patients received HAART as the principal treatment; of these, 88.8% was adherent to treatment, and death was reported in 6.8%. There were no factors associated with adherence. Conclusions: Although the sociodemographic characteristics of Peruvian military personnel are similar to those of other countries, our findings suggest that Peruvian military personnel present higher adherence to HAART compared to previous studies in other military populations from South American countries. Further studies are recommended to assess specific factors attributed to these successful outcomes in the military personnelthat can be applied in other hospitals.

Slow Inactivation in Shaker K Channels Is Delayed by Intracellular Tetraethylammonium

After removal of the fast N-type inactivation gate, voltage-sensitive Shaker (Shaker IR) K channels are still able to inactivate, albeit slowly, upon sustained depolarization. The classical mechanism proposed for the slow inactivation observed in cell-free membrane patches—the so called C inactivation—is a constriction of the external mouth of the channel pore that prevents K+ ion conduction. This constriction is antagonized by the external application of the pore blocker tetraethylammonium (TEA). In contrast to C inactivation, here we show that, when recorded in whole Xenopus oocytes, slow inactivation kinetics in Shaker IR K channels is poorly dependent on external TEA but severely delayed by internal TEA. Based on the antagonism with internally or externally added TEA, we used a two-pulse protocol to show that half of the channels inactivate by way of a gate sensitive to internal TEA. Such gate had a recovery time course in the tens of milliseconds range when the interpulse voltage was −90 mV, whereas C-inactivated channels took several seconds to recover. Internal TEA also reduced gating charge conversion associated to slow inactivation, suggesting that the closing of the internal TEA-sensitive inactivation gate could be associated with a significant amount of charge exchange of this type. We interpreted our data assuming that binding of internal TEA antagonized with U-type inactivation (Klemic, K.G., G.E. Kirsch, and S.W. Jones. 2001. Biophys. J. 81:814–826). Our results are consistent with a direct steric interference of internal TEA with an internally located slow inactivation gate as a “foot in the door” mechanism, implying a significant functional overlap between the gate of the internal TEA-sensitive slow inactivation and the primary activation gate. But, because U-type inactivation is reduced by channel opening, trapping the channel in the open conformation by TEA would also yield to an allosteric delay of slow inactivation. These results provide a framework to explain why constitutively C-inactivated channels exhibit gating charge conversion, and why mutations at the internal exit of the pore, such as those associated to episodic ataxia type I in hKv1.1, cause severe changes in inactivation kinetics

Instalación y configuración de Zentyal como base para la configuración de servicios en una organización

A través del desarrollo de este trabajo se presenta la instalación, configuración y debida parametrización de algunos de los servicios de Zentyal Server 6.2, como opción de uso en la utilización de Windows Server. Los servicios descritos en este documento son DHCP Server, DNS Server, Controlador de Dominio, Proxy no Transparente, Cortafuegos, File Server, Print Server y VPN. Estas instalaciones y configuración se realizaron mediante la utilización de máquinas virtuales mediante el programa VirtualBox, donde se obtuvo el conocimiento para la implementación y puesta en marcha de estos servicios.Through the development of this work, the installation, configuration and proper parameterization of some of the Zentyal Server 6.2 services are presented, as an option for using Windows Server. The services described in this document are DHCP Server, DNS Server, Domain Controller, Non-Transparent Proxy, Firewall, File Server, Print Server, and VPN. These installations and configuration were carried out through the use of virtual machines through the VirtualBox program, where the knowledge for the implementation and start-up of these services was obtained

Implementación de Zentyal 6.2 como administradores de servicios de tecnologías de la información en ambientes empresariales.

A través del desarrollo de este trabajo se presenta la instalación, configuración y debida parametrización de algunos de los servicios de Zentyal Server 6.2, como opción de uso en la utilización de Windows Server. Los servicios descritos en este documento son DHCP Server, DNS Server, Controlador de Dominio, Proxy no Transparente, Cortafuegos, File Server, Print Server y VPN. Estas instalaciones y configuración se realizaron mediante la utilización de máquinas virtuales mediante el programa VirtualBox, donde se obtuvo el conocimiento para la implementación y puesta en marcha de estos servicios.The purpose of this project is to explain the implementation of a Zentyal-based system that manages technological services in a business environment

"HIV therapy adherence and outcomes in Peruvian military personnel over a 30-year period"

"Objectives: We aimed to describe the sociodemographic, clinical, and therapeutic characteristics of Peruvian military personnel diagnosed with HIV. Furthermore, we determined the frequency of highly active antiretroviral therapy (HAART) adherence, the complications and mortality. Methods: We retrospectively reviewed the medical records of patients diagnosed with HIV, confirmed by Western blot at a single institution from 1989-2020. Descriptive analyses were performed for all the variables using mean and standard deviation (SD) in the case of quantitative variables, and frequency and percentage for qualitative variables. Results:Ofthe 161 patients included, 95.7% were males and the mean age was 39.59 years (SD= 16.45 years). Most had college or higher education (67.7%) and were on active duty at diagnosis (77%). 35.4% had AIDS at diagnosis; 28.6% opportunistic infections; and 8.1% tuberculosis. The median follow-up was five years. 94.4% of the patients received HAART as the principal treatment; of these, 88.8% was adherent to treatment, and death was reported in 6.8%. There were no factors associated with adherence. Conclusions: Although the sociodemographic characteristics of Peruvian military personnel are similar to those of other countries, our findings suggest that Peruvian military personnel present higher adherence to HAART compared to previous studies in other military populations from South American countries. Further studies are recommended to assess specific factors attributed to these successful outcomes in the military personnelthat can be applied in other hospitals

Easy Appark

La Formulación y Evaluación de Proyectos es el procedimiento general para recopilar, crear y sistematizar la información que permita identificar ideas de negocios y medir cuantitativamente los costos y beneficios de un eventual emprendimiento. Además, es una materia interdisciplinaria, ya que durante la elaboración de un estudio de este tipo intervienen disciplinas como estadística, investigación de mercados, investigación de operaciones, ingeniería de proyectos, contabilidad general, distribución de la planta, finanzas, ingeniería económica y otras. Como parte del curso Desarrollo de Negocios 2, este trabajo de investigación nació del curso predecesor, Desarrollo de Negocios 1, el cual incluirá la tecnología y el negocio inmobiliario como piezas fundamentales. Además, presentará la siguiente estructura: descripción general de la idea de negocio, presentación del equipo de trabajo, análisis externo, análisis interno, investigación de mercado, plan de marketing, plan de operaciones, estructura organizacional, plan económico – financiero, conclusiones y recomendacionesThe Formulation and Evaluation of Projects is the general procedure to collect, create and systematize the information that allows identifying business ideas and quantitatively measuring the costs and benefits of an eventual business. In addition, it is an interdisciplinary subject, because includes disciplines such as stadistics, market research, operations research, project engineering, general accounting, plant distribution, finance, economic engineering and others intervene during the preparation of a study of this type. As part of the Business Development 2 course, this research work was born from the predecessor course, Business Development 1, which will include technology and the real estate business as fundamental pieces. In addition, it will present the following structure: general description of the business idea, presentation of the work team, external analysis, internal analysis, market research, marketing plan, operations plan, organizational structure, economic-financial plan, conclusions and recommendations.Trabajo de investigació

Human Rabies and Rabies in Vampire and Nonvampire Bat Species, Southeastern Peru, 2007

After a human rabies outbreak in southeastern Peru, we collected bats to estimate the prevalence of rabies in various species. Among 165 bats from 6 genera and 10 species, 10.3% were antibody positive; antibody prevalence was similar in vampire and nonvampire bats. Thus, nonvampire bats may also be a source for human rabies in Peru