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OBJECTIVE: To evaluate the impact of a post-Helping Babies Breathe bundle of interventions on the retention of provider-level knowledge and skills. METHOD: The present prospective pre-post study following a 1-day Helping Babies Breathe training of professional midwives, physicians, and nurses was conducted in Cajamarca Province, Peru between January 1 and July 31, 2017. The interventions to improve retention included structured worksite practice before every shift, weekly in-service simulated scenarios, and monthly supervised peer-to-peer abbreviated refresher trainings. Knowledge and skills were assessed before, immediately after, and 6 months after training using two validated multiple-choice knowledge test and objective structured clinical examinations (OSCEs; OSCE A and OSCE B). Data were analyzed for changes in knowledge and skills over time and to identify predictors of performance. RESULTS: There were 60 learners included. No significant differences were observed between assessments immediately after training and at 6-month follow-up for knowledge scores or time-to-effective-ventilation. Pass rates for OSCE B increased from 83% immediately after training to 95% at follow-up (P=0.007). The only factor associated with a reduced time to effective ventilation at 6-month follow-up was working in a hospital (P<0.001), accounting for years of training and experience. CONCLUSION: Helping Babies Breathe knowledge and skills can be retained and even improved with simple, inexpensive interventions, including supervised on-the-job and peer-to-peer training.

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A 35 years old female with morbid obesity IMC 45 was referred because of a gastrobronchial fistula developed post sleeve gastrectomy initially treated with endoscopic techniques without improvement, reason why a total resection of the gastric remanent with a Roux en Y reconstruction was done as an option with successful result.

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Se presenta el caso de una paciente mujer de 35 años de edad operada por obesidad mórbida con índice de masa corporal (IMC) de 45, que fue referida por presentar fistula gastrobronquial post gastrectomía en manga la que no cicatrizó con medidas endoscópicas requiriendo manejo quirúrgico de resección total del remanente gástrico con reconstrucción en Y de Roux como opción curativa.

A 35 years old female with morbid obesity IMC 45 was referred because of a gastrobronchial fistula developed post sleeve gastrectomy initially treated with endoscopic techniques without improvement, reason why a total resection of the gastric remanent with a Roux en Y reconstruction was done as an option with successful result.

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OBJECTIVE: To know the outcomes of the management of adult patients with appendiceal inflammatory mass at Cayetano Heredia National Hospital. MATERIAL AND METHODS: This is a retrospective and descriptive study, where data collection from medical records of patients with appendiceal inflammatory mass who were managed at Cayetano Heredia National Hospital from 2006 to 2010 was done. RESULTS: 77 patients were included in this study. 41 (53.25%) were male and mean age was 35 years. The incidence of appendiceal inflammatory mass was 2.76%. Mean time of symptoms was 8 days. Conservative treatment succeeded in 88.31% of patients, interval appendicectomy was performed in 11.76%, mean time till interval surgery was 3.5 months. Nine patients (11.69%) did not respond to conservative management and underwent emergency surgery. Mortality was 0%. CONCLUSIONS: In Cayetano Heredia National Hospital, the incidence of appendiceal inflammatory mass is 2.76%. 88.31% of patients respond to conservative treatment, of which interval appendicectomy is performed in 11.76%.

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OBJETIVO: Conocer los resultados del manejo de la masa apendicular inflamatoria en los pacientes adultos que acuden al Hospital Nacional Cayetano Heredia. MATERIAL Y MÉTODOS: El estudio se realizó en forma descriptiva y retrospectiva, tomando los datos de las historias clínicas de los pacientes adultos con diagnóstico de masa apendicular inflamatoria que fueron manejados en el Hospital Cayetano Heredia entre los años 2006 y 2010. RESULTADOS: 77 pacientes fueron incluidos en el estudio. 41 (53,25%) fueron de género masculino y la edad tuvo una media de 35 años. La incidencia de masa apendicular inflamatoria fue de 2,76%. El tiempo de enfermedad tuvo una media de 8 días. Se encontró éxito al tratamiento conservador en el 88,31%, realizando apendicectomía de intervalo en el 11,76% de estos pacientes, el tiempo de intervalo tuvo una media de 3,5 meses. Nueve pacientes (11,69%) no respondieron al manejo conservador inicial y se les realizó cirugía de emergencia. No hubo mortalidad. CONCLUSIONES: En el Hospital Nacional Cayetano Heredia la incidencia de masa apendicular inflamatoria es 2,76%. El manejo conservador tiene éxito en el 88,31% de los pacientes, y al 11,76% de ellos se les realiza apendicectomía de intervalo.

OBJETIVE: To know the outcomes of the management of adult patients with appendiceal inflammatory mass at Cayetano Heredia National Hospital. MATERIAL AND METHODS: This is a retrospective and descriptive study, where data collection from medical records of patients with appendiceal inflammatory mass who were managed at Cayetano Heredia National Hospital from 2006 to 2010 was done. RESULTS: 77 patients were included in this study. 41 (53.25%) were male and mean age was 35 years. The incidence of appendiceal inflammatory mass was 2.76%. Mean time of symptoms was 8 days. Conservative treatment succeeded in 88.31% of patients, interval appendicectomy was performed in 11.76%, mean time till interval surgery was 3.5 months. Nine patients (11.69%) did not respond to conservative management and underwent emergency surgery. Mortality was 0%. CONCLUSIONS: In Cayetano Heredia National Hospital, the incidence of appendiceal inflammatory mass is 2.76%. 88.31% of patients respond to conservative treatment, of which interval appendicectomy is performed in 11.76%.

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We describe the demographic and clinical characteristics of adult patients with tuberculous spondylitis as well as an exploratory analysis that seeked to establish patient characteristics that contributed to the development of this disorder at a reference hospital in Lima. This is a case-series descriptive study where data collection from 33 medical records of patients from 1999 to 2009 was done. Eighteen (55%) were male. Median age was 31 years (IQR 23 to 51 years). Median time of symptoms was 3 months (IQR 1 to 8 months). The most frequent symptom was back pain in 28 (85%). The most frequently affected areas were the thoracic spine involved in 28 (60%) cases and lumbar spine in 13 (28%). Pulmonary tuberculosis was present in fourteen (42%) cases. Twenty four (73%) patients received first line treatment. Treatment duration was 10.5 ± 4.2 months. Clinical and diagnostic characteristics were similar to previous Peruvian case reports and current literature.

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Describimos las características clínicas y demográficas en pacientes adultos con espondilitis tuberculosa así como un análisis exploratorio que buscó establecer características que contribuyeron al desarrollo de esta enfermedad, en un hospital de tercer nivel de Lima. Realizamos un estudio tipo serie de casos y describimos 33 casos recolectados entre 1999-2009. 18 pacientes (55 por ciento) fueron varones, la media de edad fue 31 años (IQ 23 a 51 años) y un tiempo de enfermedad de 3 meses (IQ 1 a 8 meses). El principal síntoma fue lumbalgia en 28 (85 por ciento). Los segmentos más comprometidos fueron el torácico en 28 (60 por ciento) casos y lumbar en 13 (28 por ciento). Tuberculosis pulmonar se encontró en 14 (42 por ciento) casos. Veinticuatro (73 por ciento) recibieron esquema I. La duración de tratamiento fue 10,5 ± 4,2 meses . Las características clínicas, diagnósticas fueron similares a series nacionales previas e internacionales.

We describe the demographic and clinical characteristics of adult patients with tuberculous spondylitis as well as an exploratory analysis that seeked to establish patient characteristics that contributed to the development of this disorder at a reference hospital in Lima. This is a case-series descriptive study where data collection from 33 medical records of patients from 1999 to 2009 was done. Eighteen (55 percent) were male. Median age was 31 years (IQR 23 to 51 years). Median time of symptoms was 3 months (IQR 1 to 8 months). The most frequent symptom was back pain in 28 (85 percent). The most frequently affected areas were the thoracic spine involved in 28 (60 percent) cases and lumbar spine in 13 (28 percent). Pulmonary tuberculosis was present in fourteen (42 percent) cases. Twenty four (73 percent) patients received first line treatment. Treatment duration was 10.5 ± 4.2 months. Clinical and diagnostic characteristics were similar to previous Peruvian case reports and current literature.

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