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BACKGROUND: Hemodialysis (HD) patients present an increased carotid intima-media thickness (CIMT) and calcified plaques, and studies have demonstrated that CIMT is predictor for cardiovascular death in this patient population; hence, the importance of identifying early non-invasive markers of atherosclerosis. We aim to propose a new three-perspective CIMT measuring method in HD population, and to further investigate the possible use and value of this method to predict outcomes. METHODS: A cross-sectional study was conducted, the CIMT was measured with duplex ultrasound during the perioperative access planning. Software provided maximum CIMT in a 10 mm (mm) width of the common carotid artery. CIMT was measured in Right (R) and Left (L) carotid arteries, both in anterior (a), lateral (l), and posterior (p) view. The sum of these values (Ra+Rl+Rp+La+Ll+Lp) was completed and termed as Sixth Carotid Intimal (SCI) score. We stratified either in low (summation <4) or high (>=4) SCI score groups. Demographics, patency rates, complications, and mortality were collected; chi-square test was used for our analysis. RESULTS: A total of 30 patients (mean age 49 years and 56% females) that underwent access creation in the upper arm from 2010 to 2016 were selected and studied. A low SCI score was found 19 patients and 11 had high SCI, no significant difference was observed in demographics, history cardiovascular disease, and clinical outcomes as early thrombosis, and primary, primary-assisted patency at 12 months. Interestingly, during the follow up period of 36 months a significant higher difference in late thrombosis rates occurred (63.6% vs 26.3%, p = .044) and a higher all-cause mortality (54.4% vs 15.7%, p = .025) in patients with SCI score group above 4. CONCLUSIONS: The SCI score method, might offer a screening tool for traditional cardiovascular risk factors in HD patients. In this study, we demonstrate an increased rate in late thrombosis and mortality in those with high SCI. Further research is necessary to better define the role of CIMT in vascular surgical procedures.

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This study updates knowledge on historical geographic distribution of sand fly species through identifying altitudinal and bioclimatic patterns in leishmaniasis endemic areas in Mexico. We analyze and identify sand fly specimens obtained through national efforts by the Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE, Mexico), collected between 1995 and 2001, 2008-2012, and 2017-2023, and add bibliographic information (427 additional records). After a principal components analysis of WorldClim variables and altitudinal ranges, variables that better explain the distribution of sand fly species were chosen (BIO6, BIO12, and BIO16, explaining 72 % of variation). A total of 1,187 specimens of 22 species were retrieved from eight states, providing 29 new municipalities and 48 new localities, being Lutzomyia cruciata, Micropygomyia chiapanensis, and Psathyromyia shannoni the most common species. We presented new historical records of distribution for sand fly species from Morelos (3), Oaxaca (7) and Tabasco (1). The 82.7 % of sand fly species analyzed were distributed in areas with altitudinal ranges below 420 m. The anthropophilic species Psathyromyia shannoni, and Lutzomyia cruciata showed the greatest variability regarding altitudinal range, and climatic preferences, while several wild species showed abiotic preferences. It is likely that the effect of urbanization and climate change generate new beneficial biotopes for the proliferation of the vector sand fly species. Complementary studies that consider seasonality, vegetation types, and change in land use could provide new information to better understand the spread of vector-borne diseases.

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Objective: To determine, by means of a systematic review and meta-analysis, the clinical effectiveness of pre-treatment with chlorhexidine (CHX) in adhesive dental restorations. Material and Methods: A literature search was conducted until February 2020, in the biomedical databases: Pubmed, Embase, Scielo, Science Direct, Scopus, SIGLE, LILACS, Google Scholar and the Cochrane Central Registry of Clinical Trials. The selection criteria of the studies were defined, which were: randomized and controlled clinical trials, without language and time restrictions, and reporting the clinical effects (retention, marginal discoloration, marginal adaptation, postoperative sensitivity and secondary caries) of pre-CHX treatment in adhesive dental restorations. Study risk of bias was analyzed using the Cochrane Handbook of Systematic Reviews of Interventions. Results:The search strategy resulted in six articles of which five entered a meta-analysis. The studies reported that there was no difference in retention, marginal discoloration, marginal adaptation, postoperative sensitivity, and secondary caries from pre-treatment with CHX in adhesive dental restorations. Conclusion: The reviewed literature suggests that pretreatment with CHX does not influence the clinical effectiveness in adhesive dental restorations.

Resumen: Antecedentes: la pandemia de COVID-19 ha desatado un ataque sin precedentes contra la humanidad en todo el mundo. El escenario en Bangladesh empeora día a día, y todos los aspectos de la sociedad están observando su impacto. Los profesionales de la salud corren un mayor riesgo de contraer la enfermedad mientras atienden a los pacientes. Objetivo: El objetivo de la investigación es explorar el conocimiento, la conciencia y las prácticas de los dentistas registrados con respecto a la epidemiología y transmisión de COVID-19 durante el rápido brote de este virus altamente contagioso en Bangladesh. Material y Métodos: Se realizó una encuesta transversal basada en la web entre los dentistas inscritos con su número de registro único válido del Consejo Médico y Dental de Bangladesh (BMDC). Se distribuyó un cuestionario estructurado entre los dentistas a través de diferentes plataformas de redes sociales. Un total de 184 dentistas participaron en la encuesta entre marzo y abril de 2020. Se realizó tanto análisis descriptivo como análisis de regresión logística multivariable. Resultados: La edad media de los odontólogos fue de 31,75 años, con una desviación estándar de 6,5 años. Aproximadamente el 29,3% de los dentistas habían completado su título de posgrado y el 76% de ellos se dedicaba a la práctica privada en el momento de la recopilación de datos. En comparación con los dentistas con educación universitaria, los dentistas con educación de posgrado tienen tres veces (OR = 3,1, IC del 95%: 1,2 - 7,9 y más de 5 veces (OR = 5,3, IC del 95%: 1,2 - 23,3) más probabilidades de tener) mejores conocimientos y prácticas hacia COVID-19 respectivamente. Los dentistas de 26 a 30 años tienen menos probabilidades de tener buenas prácticas que los dentistas más jóvenes (OR: .1; IC del 95%: .01 - .5). Sin embargo, los dentistas con menos de cinco años de experiencia tienen 10,3 (1,6 - 68,9) veces más probabilidades de tener buenas prácticas en comparación con los dentistas con más experiencia. Conclusión: La mayoría de los dentistas de Bangladesh han demostrado un buen conocimiento, conciencia y práctica con respecto a COVID-19. Recomendamos que las autoridades sanitarias, las organizaciones profesionales y los hospitales coordinen y lleven a cabo una formación avanzada obligatoria sobre enfermedades infecciosas para todos los dentistas en ejercicio del país.

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This report describes the presence of Aedes albopictus Skuse (Diptera: Culicidae) in Yucatan Peninsula and represents the first record of the Asian tiger invasive mosquito in Campeche State, southeastern Mexico. We collected specimens using 11,326 ovitraps put into houses of urban and rural areas, as part of the entomological surveillance by the local Ministry of Health from January 2019 to February 2020. We found Ae. albopictus in five of the 12 municipalities of Campeche (San Francisco de Campeche, Tenabo, Hecelchakán, Calkíni and Escárcega). We record 68 positive ovitraps and 226 Ae. albopictus larvae. This finding increases the number of mosquito species recorded in Campeche, Mexico, and possibly the potential for 22 arbovirus transmission.

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Blood banks in developing countries have limited capability to typify common blood groups creating disparities in the access to blood units for patients with rare blood genotypes. We report the case of a Peruvian woman with metastatic breast cancer with KELnull phenotype (K0), a rare blood group characterized by the lack of expression of all Kell antigens on the red blood cells (RBCs). The molecular studies identified that the patient's RBCs were homozygous for the nonsense c.1546C > T mutation predicted to encode p.Arg516Ter (KEL*02 N.17 allele), which confirmed the K0 phenotype. We conducted a local and international search of compatible blood units. Finally, the Japanese Red Cross donated the blood units for the patient. We present here the first report for a K0 phenotype in Peru and the challenging genetic disparities that many patients have to face to access to blood units in our country.

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In Mexico, Aedes aegypti (L.) (Diptera: Culicidae) is the primary vector of Dengue, Zika, and Chikungunya viruses. Control programs include community participation using personal protection such as household aerosol insecticides. In both, urban or rural areas, the use of aerosol insecticides is a common practice to avoiding mosquito biting. Thus, information on the efficacy of commercial products must be available. This study reports the efficacy of 13 household aerosol insecticides against Ae. aegypti from an endemic dengue area in Mexico. To test each insecticide, six netting cages, containing 10 non-blood fed female mosquitoes each one, were placed in different locations inside a bedroom. Readings at 30 min and 24 h after exposure were recorded. No products showed 100% mortality after 30 min of exposure. Only three products killed the 100% of the individuals 24 h after exposure. Results showed a high mortality variance among insecticides. Location in the room also impacts the insecticide efficacy. Mosquitoes located inside cabinets or with behind an obstacle (preventing an accurate insecticide exposure) showed lower mortalities. Products and spraying methods could and should be improved.

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In Mexico, the use of repellents to prevent insects from landing and biting is a common practice. However, variation in the efficiency of natural and synthetic repellents has been observed. In this study, we evaluated the repellency and protection time of 16 synthetic and 13 natural-based commercial products against Aedes aegypti (L.) from an endemic dengue area (Jojutla, Morelos) in Central Mexico. The "arm exposure" cage test was used to assess the efficacy of the repellents. Tests were conducted by three adult volunteers. Results showed that DEET (N, N-Diethyl-3-methylbenzamide) repellents provided the highest protection and duration times against Ae. aegypti. However, low repellency and short-time protection was observed (when compared with the manufacturers' protection times). Natural-based products did not repel (either landing or biting) mosquitoes for >30 min. These results show that most of the repellent products did not provide satisfactory levels of personal protection against mosquito bites. Frequent reapplication of repellents (synthetic and natural-based) may compensate for their short duration of action. Repellent efficacy data must be integrated into the decision-making process for an optimal response to the local (or specific region) situation.

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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.

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El linfoma folicular primario intestinal es un desorden raro descrito en la última clasificación de linfomas de la WHO. Es una entidad localizada con excelente pronóstico. En el presente artículo, reportamos una mujer peruana de 64 años de edad diagnosticada con linfoma folicular primario intestinal. Ella tuvo dos años con dolor abdominal y vómitos tardíos. Ella desarrolló una obstrucción intestinal y tuvo una resección completa del tumor. Se describe el caso y se realiza una revisión de la literatura de esta entidad.

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.

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Follicular lymphoma (FL) is a prevalent type of non-Hodgkin lymphoma in the United States and Europe. Although, FL typically presents with nodal involvement, extranodal sites are less common, and leukemic phase at diagnosis is rare. There is mounting evidence that leukemic presentation portends a worse prognosis in patients with FL. We describe 7 patients with a pathological diagnosis of FL who presented with a leukemic phase. We compared our cases with 24 additional cases reported in the literature. Based on our results, patients who present with leukemic FL tend to have higher risk disease. Leukemic FL also seems to be associated with a worse prognosis; however, larger studies are needed to confirm our findings. A discrepancy with previously reported cases of FL in leukemic phase raises the possibility of differences attributable to geographic regions.

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We describe the clinical and pathological characteristics of seven patients who were human T-lymphotropic virus type 1 (HTLV-1) carriers and had a pathological diagnosis of de novo diffuse large B-cell lymphoma. Interestingly, three of our cases showed positive expression of Epstein-Barr-virus, (EBV-) encoded RNA within the tumor cells indicating a possible interaction between these two viruses. Furthermore, our three EBV-positive cases presented with similar clinical characteristics such as early clinical stage and low-risk indices. To the best of our knowledge, this is the first case series describing the characteristics of HTLV-1-positive DLBCL patients. The potential relationship between HTLV-1 and EBV should be further explored.

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Objetivo: Determinar si el misoprostol administrado por vía sublingual es más eficaz que administrado vía oral en el tercer período del parto. Diseño: Se realizó un estudio experimental, prospectivo, de corte transversal, comparativo (dos grupos pareados). Lugar: Servicio de Obstetricia del Hospital Regional Docente de Trujillo, durante los meses de junio a diciembre de 1997. Material: La muestra estuvo conformada por 2 grupos de 39 gestantes cada uno, elegidas en forma secuencial, en el que uno de ellos recibió 200 ug de misoprostol vía sublingual (triturado) y el otro vía oral. Los indicadores para evaluar la eficacia del misoprostol fueron el tiempo de alumbramiento, el volumen de sangrado y la intensidad de las contracciones uterinas, así como sus efectos colaterales. Resultados: Para las vías sublingual y oral, en promedio, los tiempos de alumbramiento fueron 5,1 y 10,6 minutos, de sangrado uterino de 170,4 y 266,9 mL y la intensidad de la contracción de 2,87 (+) y 1,28 (+), respectivamente, siendo el valor de p menor 0,001. Los efectos colaterales más frecuentes se presentaron con el misoprostol vía sublingual y fueron fiebre y escalofríos, siendo estos transitorios. Conclusión: El misoprostol administrado por vía sublingual es más eficaz que administrado vía oral en el tercer período del parto, de manera altamente significativa. Disminuye el tiempo de alumbramiento y el volumen de sangrado, así como produce una contracción uterina más intensa.

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Objetivos: Determinar la incidencia de trombocitopenia en gestantes con pre-eclampsia severa y eclampsia y su distribución de acuerdo a edad materna, edad gestacional y paridad. Diseño: Estudio de tipo básico, descriptivo, prospectivo realizado en el Hospital Regional Docente de Trujillo entre el 1º de abril al 1ºde diciembre de 1995. Pacientes: 45 gestantes con diagnóstico de pre-eclampsia severa y/o eclampsia, con edades gestacionales mayor o menor a 28 semanas de amenorrea. Resultados: La incidencia de trombocitopenia encontrada fue del 48,8 por ciento y su distribución de acuerdo a edad materna, edad gestacional y paridad no presentó variaciones estadísticamente significativas. Conclusión: La trombocitopenia se encuentra en casi la mitad de pacientes que presentan H. I. E. Palabras clave: Trombocitopenia, pre-eclampsia, eclampsia.

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OBJETIVO: Revisar casos de abdomen agudo ginecoobstétrico (AAGO) intervenidos quirúrgicamente. DISEÑO: Estudio retrospectivo. LUGAR: Servicios de Emergencia de Obstetricia y de Cirugía del Hospital Nacional Edgardo Rebagliati Martins, IPSS. PACIENTES E INTERVENCIONES: 101 pacientes intervenidas quirúrgicamente de abdomen agudo ginecoobstétrico. RESULTADOS: El AAGO más frecuente en nuestro hospital fue el hemorrágico, principalmente el embarazo ectópico complicado, seguido del AAGO vascular, especialmente debido a quiste de ovario a pedículo torcido; y la mayoría de los AAGO infeccioso inflamatorios fueron realmente anexitis, por lo que no merecieron una laparotomía. Existía patología dependiente del ovario en un tercio de los casos, la mayoria por quiste a pedículo torcido y que terminaron en ooforectomía. Hubo un caso de hidrosalpinx con torsión. La patología asociada a gestación, parto o puerperio ocurrió en la mitad de los casos y consistió en embarazo ectópico roto en la mayoria de los casos, habiendo menos casos de apendicitis aguda, quistes de ovario a pedículo torcido, rotura uterina, perforaciones uterinas, hemorragias postcesárea, pelviperitonitis por aborto séptico, parametritis puerperal, obstrucción intestinal y traumatismo abdominal cerrado. CONCLUSIONES: La mujer en edad reproductiva es susceptible de presentar enfermedades abdominopélvicas que requieren cirugía de emergencia. El diagnóstico de abdomen agudo en la mujer puede complicarse por la presencia de una gestación. El manejo del AAGO requiere experiencia, buen criterio diagnóstico y tratamiento oportuno. La ecografía y la laparotomía implementadas en la sala de emergencia, apoyada por pruebas especiales, como las gonadotrofinas coriónicas subunidad beta y exámenes hematológicos, pueden perfeccionar el diagnóstico preoperatorio.

OBJECTIVE.- Review of cases of acute abdomen in gynecology and obstetries. DESIGN.- Retrospective study. SETTING: Obstetrical and Surgery Emergenty Services of Edgardo Rebagliati Martíns National Hospital, Peruvian Institute of Social Security. PATIENTS AND INTERVTNTIONS.- One hundred one cases of acute abdomen of ginecologic and obstetrical origin (AGOA) who had laparotomy. RESULTS: Most frequent AGOA at our hospital were the hemorrhagic type, mainly due to ruptured ectopic pregnancy, followed by vascular AGOA mainly due to ovarian cyst with torsíon of the pedicle. Most of the inflamatory AGOA were actually adnexitis and should not have required laparotomy. The ovary was involved in one third of the cases, mainly due to torsion of the cyst pedicle,- treatment consisted in oophorectomy. Another case was due to hydrosalpinx with torsion. Pathology associated to pregnancy, labor and pueperium occurred in hal of all cases and included mostly ruptured ectopic pregnancy and some cases of acute appendicitis, ovarian cysts with torsion, uterine rupture, uterine perforation, post cesarean section hemorrhage, peliviperitonitis due to septic abortion, puerperal parametritis, intestinal obstruction, and closed abdominal trauma. CONCLUSIONS: Women in reproductive age are liable to abdomino-pelvic diseases that require emergency surgical intervention. Diagnosis may be complicated by pregnancy. Management requires experience, accurate diagnosis and early and appropiate treatment. Ultrasound and laparoscopy should be done routinely in the emergeney room, and special tests such as beta subunit chorionic gonadotrophins and special hematologic studies should be available at all times.

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Estudiamos un grupo de 20 sujetos que cumplían criterios diagnósticos de fibrositis primaria con el objeto de determinar las características clínicas y psicológicas de este síndrome en nuestro medio. Todos los pacientes fueron incluídos en un protocolo prospectivo que comprendía la elaboración de una historia clínica completa y la determinación del perfil psicológico empleando el test de Minnesota (MMPI) y el Test de Zung (A y D). El perfil psicológico de los sujetos con fibrositis fue comparado con dos grupos controles; uno, constituído por pacientes con artritis reumatoide y otro por sujetos sanos. Los síntomas más frecuentes fueron dolor musculoesquelético (100%), alteraciones del patrón de sueño (95%), fatiga matinal (80%), y sensación de hinchazón de tejidos blandos (70%). Encontramos : puntos dolorosos" y el "signo del salto" en la totalidad de pacientes. Las formas de presentación clínica más frecuentes fueron la Generalizada y la Axial. El perfil psicológico de los sujetos con fibrositis mostró alteraciones más definidas y acentuadas en relación a los grupos controles; hallándose valores en rango patológico para las escalas de MMPI de hipocondría, depresión, desviación psicopática, psicastenia y esquizofrenia

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