[Proposal for initial management of uncomplicated ST elevation myocardial infarction in centers without percutaneous coronary intervention capacity in Peru].

ST-segment elevation myocardial infarction (STEMI) is a clinical entity whose adequate treatment will depend on its prompt recognition, accurate diagnosis, and management in reperfusion networks. The first contact with these patients is generally done in centers without reperfusion capacity, attended by non-cardiologist doctors, and in centers far from hospitals with greater resolution capacity, something that is well known in our country. This manuscript proposes a strategy for the diagnosis and treatment of STEMI in centers without percutaneous coronary intervention capacity of the public health system in Peru, emphasizing not losing sight of electrocardiographic patterns compatible with coronary artery occlusion, adequate fibrinolysis and management of its complications, the treatment of infarction in special populations and highlighting the importance of the pharmacoinvasive strategy as the main form of reperfusion treatment in our country.

[Cholecystectomy as a risk factor for duodenogastric reflux].

Unlabelled: Bile reflux or duodenogastric reflux (DGR), refers to the retrograde flow of duodenal contents (mainly bile) into the stomach; capable of producing chemical damage to the mucosa, and triggering mutations towards the development of intestinal metaplasia, dysplasia and even gastric cancer.

Objective: This study aimed to estimate the prevalence of primary bile reflux in cholecystectomized patients and to identify whether cholecystectomy is a risk factor for development of DGR.

Materials And Methods: An analytical cross-sectional and observational study was conducted, in which all patients who underwent upper digestive endoscopy from February to June 2023 in a private endoscopic center in Lima, Peru, were included.

[Atypical presentation of ruptured aneurysmal right sinus of Valsalva with severe aortic insufficiency].

Aneurysm of the Sinus of Valsalva (ASV) is a rare abnormality and affects less than 0.1% of the general population. We describe the case of a 37-year-old woman with a clinical picture characterized by dyspnea, palpitations, and syncope of 6 years of evolution.

[Right intraatrial lipoma. A case report].

We present the case of a 56-year-old male patient with a history of atrial flutter for six months; he was admitted to the hospital for presenting a mass of 8 cm in maximum diameter in the right atrium, which prolapsed through the tricuspid valve into the right ventricle. Emergency surgery was scheduled, performing exeresis of the tumor and tricuspid annuloplasty. The Pathological anatomy determined that the removed mass corresponded to a cardiac lipoma.

Giant cardiac hydatid cyst causing sustained ventricular tachycardia. Successful surgical treatment.

Cardiac involvement of hydatid disease is rare. In Peru, a country with a high prevalence of this infectious disease, few cases of cardiac hydatid disease have been reported. We present the case of a man with a cardiac hydatid cyst of more than 10 cm in diameter that debuted with malignant arrhythmia and successfully treated with surgery.

[Subcapsular hepatic hematoma after endoscopic retrograde cholangiopancreatography: a case report and review of the literature].

Endoscopic retrograde cholangiopancreatography (ERCP) is currently considered a diagnostic and therapeutic procedure in obstructive lesions of the biliary tract, especially choledocholithiasis and stenosis, as well as in pancreatic diseases in general. However, it is known the development of certain complications such as acute pancreatitis, acute cholangitis, cholecystitis among others of lower incidence within which the hepatic subcapsular hematoma takes relevance due to its high mortality. We present the case of a 52-year-old male patient who three hours after undergoing ERCP develops abdominal pain of sudden onset with significant reduction of hematocrit, and imaging study shows a hepatic subcapsular hematoma.

[Response to the COVID-19 Pandemic in Chile, Colombia, and Peru from a children's rights perspectiveResposta à pandemia de COVID-19 no Chile, Colômbia e Peru com foco nos direitos da criança].

Objective: Describe the strategies established by Chile, Colombia, and Peru during the first year of the COVID-19 pandemic and compare them from a children's rights perspective.

Methods: A qualitative study with comparative analysis of public policies was conducted around seven cat-egories constructed by the Latin American Chapter of the International Society for Social Pediatrics and Child Health, based on the Convention on the Rights of the Child. Country documents were selected based on convenience sampling and were analyzed in deliberative dialogues.

[Association between the type of major duodenal papilla and difficult biliary cannulation in a private tertiary center].

Introduction: Difficult cannulation in cases of endoscopic retrograde cholangiopancreatography (ERCP) could be associated with several factors, including: type of major papilla, however, there are limited data regarding this possible association.

Objectives: To determine the association between the type of papilla and difficult biliary cannulation.

Materials And Methods: A retrospective cross-sectional analytical study was conducted in patients over 18 years old who underwent ERCP on papilla naive, from July 2019 to April 2021, in a private institution.

Alteration in liver function tests among patients hospitalized for COVID-19: a multicentric study in Peru.

Introduction: COVID-19 affects the liver, causing alteration in liver biochemistry tests such as aspartate transferase (AST), alanine transferase (ALT), alkaline phosphatase (ALP), total bilirubin and albumin.

Objective: To determine the prevalence of alteration in liver functions tests and associated factors for severity among Peruvian COVID-19 patients.

Materials And Methods: A descriptive, retrospective and cross-sectional study was performed in 4 public hospitals in Peru.

Referral Process for Surgical Management of Tuberculosis in Lima: A Qualitative Study.

Background: Lung resection surgery can be a complementary therapy for managing tuberculosis (TB) complications, but access is lacking in high-burden areas. The referral process for surgical evaluation is not well described. This study aimed to elucidate the TB surgery referral process in Peru.

[Surveillance, prevention, and control of influenza virus in Peru].

The importance of surveilling the circulation of the influenza virus and timely vaccination of different populations in Peru was analyzed in three sessions by a group of clinical experts from different specialties. The Peruvian national influenza surveillance system has many selected establishments that have become currently ineffective in terms of a timely report. Most of the samples come from Lima.

[Barriers to effective care in the referral hospitals of Peru's Ministry of Health: serving patients in the 21st century with 20th century resources].

The reference hospitals of the Peruvian Ministry of Health serve patients with complex pathologies. Quality care involves not only good treatment, warmth and humanism in care, but also material resources and real capacity to solve problems. Unfortunately, the reality of the hospitals of the Peruvian Ministry of Health is far from the recommended quality standards, with notable deficiencies in their problem-solving capacity due to the lack of diagnostic aid methods, lack of equipment, and flaws in the acquisition of medications and supplies.

[Neoendocrine carcinoma of the esophagus: report of a case].

Neuroendocrine carcinoma of esophagus represents less than 2% of cases of cancer of the esophagus. This presentation is extremely unusual, as this type of carcinoma typically presents with greater frequency in bronchopulmonary regions. The symptoms are usually associated with esophageal obstruction and include odynophagia, dysphagia and weight loss and are not usually associated with Carcinoid syndrome.

[Sensitivity to Fosfomycin in Extended-spectrum Betalactamase-producing Escherichia coli].

Urinary infections are caused mainly by Escherichia coli (E. coli); indiscriminate use of antibiotics has caused an increase in infections due to extended-spectrum beta-lactamase (ESBL)-producing strains. Aiming to determine the sensitivity to fosfomycin, a study was conducted in ESBL-producing E.

Congenital Atrophic Plaque: Fibroblastic Connective Tissue Nevus.

Fibroblastic connective tissue nevus (FCTN) is a rare, benign, dermal mesenchymal hamartoma that affects children. We report a 15-year-old boy with a congenital FCTN and describe the clinical, dermatoscopic, and histopathologic features.

[Knowledge translation: the basics for public health professionals].

Knowledge translation (KT) in Public Health involves the use of scientific evidence by decision makers when generating health policies directed to accelerate the benefits resulting from research and innovation in health system and ultimately people´s health. In this paper we review the definitions and conceptual frameworks related to systematization of KT processes. The different approaches to KT share the concept that KT is composed by two main elements: a product (information) developed through scientific method with a friendly format for the target public and an action devoted to support or promote a health related practice using the aforementioned product.

[Abdominal Tuberculosis in children and adolescents. A diagnostic challenge].

Objective: To present our experience with abdominal tuberculosis in children and adolescents treated in our hospital from 2003 - 2014.

Material And Methods: It is a retrospective study. We have collected clinical records of inpatients <20 years old who were admitted at Hipolito Unanue Hospital from January 2003 to July 2014, with diagnosis of abdominal tuberculosis.

[Related factors to re-bleeding and mortality in cirrhotic patients with acute variceal bleeding at Hipolito Unanue Hospital, Lima, Peru].

Objectives: To determine related factors to 5 days re-bleeding and 6 week-mortality of an episode of variceal bleeding in cirrhotic patients.

Material And Methods: Observational, descriptive, co relational, retrospective study. In this study were included the cirrhotic patients who entered to Hipolito Unanue Hospital, Lima, Peru, between January 2006 and February 2012 with suspicion of variceal bleeding.