Neuroendocrine Carcinoma of the Gallbladder.

Neuroendocrine carcinoma of the gallbladder (NECGB) is a rare, aggressive tumor with a poor prognosis. There are two main categories, well-differentiated NECGB and poorly differentiated NECGB, the latter with a worse prognosis. The clinical presentation is non-specific, but the occurrence is more frequent in women with cholelithiasis.

[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.

Case Report: Unusual Cause of Chest Pain: A Multi-Image Assessment of a Cardiac Mass.

Myxomas represent the most common benign primary cardiac tumor, they usually grow out of the interatrial septum into the left atrium with a pedunculated base. Intracardiac masses can be found incidentally on imaging studies, but symptomatology may arise secondary to the mass effect, embolization, and valvular function impairment. We present the case of a 75-year-old woman who arrived at the emergency department with atrial fibrillation and NSTEMI segment elevation myocardial infarction (NSTEMI) secondary to a highly vascularized neoplasm visible by coronary angiography and angiotomography.

Community-based accompaniment for adolescents transitioning to adult HIV care in urban Peru: a pilot study.

We piloted a community-based intervention to improve outcomes among adolescents living with HIV who were transitioning to adult-oriented care in Lima, Peru. We assessed feasibility and potential effectiveness, including within-person changes in self-reported adherence, psychosocial metrics (NIH Toolbox), and transition readiness ("Am I on TRAC" questionnaire, "Got Transition" checklist). From October 2019 to January 2020, we enrolled 30 adolescents (15-21 years).

Evaluation of the humoral response induced by BBIBP-CorV vaccine by determining neutralizing antibodies in peruvian healthcare personnel.

Objective.: To determine the titer of antibodies against the receptor binding domain (RBD) of the spike protein (S) in health personnel between the 4th and 12th week after receiving the BBIBP-CorV vaccine (Sinopharm).

Materials And Methods.

Mortality and associated risk factors in patients hospitalized due to COVID-19 in a Peruvian reference hospital.

Objectives: To determine the risk factors for in-hospital mortality in patients with COVID-19 from a Peruvian national hospital.

Methods: Retrospective cohort study of medical records of patients with COVID-19 hospitalized at Hospital Nacional Hipólito Unanue (HNHU) during the months of April to August 2020. The dependent variable was in-hospital mortality.

Methylene blue for the treatment of refractory septic shock secondary to listeriosis in a paediatric patient.

Current therapies frequently used for refractory septic shock include hydrocortisone, vasopressin, extracorporeal membrane oxygenation (ECMO) support, inodilators, levosimendan and methylene blue. The evidence for these treatments is very limited. We present a case of a 5-year-old patient with refractory septic shock, secondary to meningitis.

Latin American registry of renal involvement in COVID-19 disease. The relevance of assessing proteinuria throughout the clinical course.

The Latin American Society of Nephrology and Hypertension conducted a prospective cohort, multinational registry of Latin American patients with kidney impairment associated to COVID-19 infection with the objective to describe the characteristics of acute kidney disease under these circumstances. The study was carried out through open invitation in order to describe the characteristics of the disease in the region. Eight-hundred and seventy patients from 12 countries were included.

Fatal Sinus of Valsalva Aneurysm and Dissection into the Left Ventricle With Extension to the Interventricular Septum: A Challenging Diagnosis.

• SVA is a rare condition caused by weakness of elastic lamina. • The right coronary sinus is involved in 67% to 85% of the reported cases. • Clinical features are varied and nonspecific, demanding a high index of suspicion.

[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.

Underutilization and Quality Gaps in Blood Culture Processing in Public Hospitals of Peru.

Correct processing of blood cultures may impact individual patient management, antibiotic stewardship, and scaling up of antimicrobial resistance surveillance. To assess the quality of blood culture processing, we conducted four assessments at 16 public hospitals across different regions of Peru. We assessed the following standardized quality indicators: 1) positivity and contamination rates, 2) compliance with recommended number of bottles/sets and volume of blood sampled, 3) blood culture utilization, and 4) possible barriers for compliance with recommendations.

Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials.

Background: Convalescent plasma has been widely used to treat COVID-19 and is under investigation in numerous randomized clinical trials, but results are publicly available only for a small number of trials. The objective of this study was to assess the benefits of convalescent plasma treatment compared to placebo or no treatment and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, https://doi.org/10.

FAST tuberculosis transmission control strategy speeds the start of tuberculosis treatment at a general hospital in Lima, Peru.

Objective: To evaluate the effect of the FAST (Find cases Actively, Separate safely, Treat effectively) strategy on time to tuberculosis diagnosis and treatment for patients at a general hospital in a tuberculosis-endemic setting.

Design: Prospective cohort study with historical controls.

Participants: Patients diagnosed with pulmonary tuberculosis during hospitalization at Hospital Nacional Hipolito Unanue in Lima, Peru.

Acute Stanford type A aortic dissection associated with aortic coarctation repaired by Tirone E. David & debranching techniques with combined axillar and femoral perfusion: a case report.

We present the case of a 38-year-old male with a diagnosis of Stanford A aortic dissection and associated coarctation of the thoracic aorta. Acute dissection associated with coarctation of the aorta is a rare problem and difficult to manage surgically. Establishing a cardiopulmonary bypass (CPB) with adequate flows is the main objective of the procedure; optimal cannulation ensures the protection of cerebral and visceral organs.

Factors associated with mortality in hospitalized elders in an internal medicine department.

The aim of this prospective cohort study was to determine the factors associated with mortality in elders admitted to an Internal Medicine Department of a public hospital in Lima. During 2019, 360 patients over 60 years of age were consecutively evaluated by applying the Comprehensive Geriatric Assessment tools and reviewing their medical records. During hospitalization, 45 (12.

Sleep Quality and Perinatal Depression in Pregnant Women Treated in a Primary Care Centre in Lima, Peru.

Objective: The aim is to evaluate the association between sleep quality and perinatal depression in pregnant women between the 12th week of gestation and the 36th week of gestation in a maternity and child centre in Lima.

Methods: Analytical cross-sectional study in pregnant women cared for in a primary care centre between August and December 2019. The data were collected through a self-administered survey.

Detection of Viral and Bacterial Respiratory Pathogens Identified by Molecular Methods in COVID-19 Hospitalized Patients and Its Impact on Mortality and Unfavorable Outcomes.

Purpose: The purpose of this study is to evaluate the frequency of viral and bacterial respiratory pathogens detected by molecular methods in sputum samples of patients hospitalized for COVID-19 and to evaluate its impact on mortality and unfavorable outcomes (in-hospital death or mechanical ventilation).

Patients And Methods: The prospective cohort included patients with diagnosis of COVID-19 hospitalized at Hospital Nacional Hipólito Unanue. Sociodemographic and clinical data were collected from clinical records.

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.

Entrenamiento vascular intensivo para el cirujano no vascular.

IntroducciÓn: En la mayoría de los servicios de emergencia del Perú no se cuenta con un cirujano vascular, teniendo que resolver los problemas vasculares el cirujano general. Es necesario que los cirujanos generales estén entrenados en el manejo vascular, sobre todo de aquellas condiciones que pueden comprometer la vida.

Objetivo: Compartir los resultados del primer curso de cirugía vascular para el cirujano no vascular y el nivel de satisfacción de los alumnos participantes.

Randomized clinical trial to evaluate safety and efficacy of convalescent plasma use among hospitalized patients with COVID-19 (PERUCONPLASMA): a structured summary of a study protocol for a randomized controlled trial.

Objectives: The general objective of this study is to test the hypothesis that administration of convalescent plasma from donors with previous diagnosis of severe COVID-19 pneumonia is safe and associated with a decrease in all-cause in-hospital mortality among hospitalized patients with COVID-19 at 30 days in comparison with standard treatment alone. The secondary objectives are as follows: (1) to assess the efficacy of convalescent plasma to reduce the length of hospitalization, (2) to assess the efficacy of convalescent plasma to reduce the length of ICU stay, and (3) to assess the efficacy of convalescent plasma on reducing the requirement of invasive mechanical ventilation or ICU stay.

Trial Design: PERUCONPLASMA is a IIb phase open label, randomized, superiority clinical trial with 1:1 allocation taking place in real life routine clinical practice at public hospitals in Lima, Peru.