Revista Científica Internacional de Ciencias de la Salud, cumple con las normas editoriales y estándares de calidad requeridos por los servicios de indización nacionales, regionales e internacionales, por lo tanto, los artículos publicados son arbitrados por un comité de pares. Una política de acceso abierto.
RICSA is an open access journal distributed under the terms and conditions of Creative Commons Attribution 4.0 International license
Response to the Letter Regarding the Article "Cat Scratch Disease: A Case Report in a Child"
Agradecemos el interés mostrado por los autores de la carta al editor respecto a nuestro artículo "Enfermedad por arañazo de gato: reporte de caso en un niño" y valoramos las observaciones realizadas, las cuales enriquecen la discusión científica y permiten precisar algunos aspectos clínicos y metodológicos del caso reportado. En relación con la observación sobre la afirmación de una "alta incidencia de síndromes febriles prolongados", coincidimos en que un reporte de caso no permite estimar medidas epidemiológicas poblacionales. Nuestro propósito fue señalar que, en la práctica clínica de nuestra región, los síndromes febriles prolongados constituyen un motivo de consulta relativamente frecuente y forman parte del diagnóstico diferencial cotidiano, especialmente en áreas donde coexisten diversas enfermedades infecciosas tropicales. En ese sentido, reconocemos que una redacción más precisa habría sido referirse a la frecuente presentación clínica de estos síndromes, evitando interpretaciones de carácter epidemiológico.
Copyright (c) 2026 Mauro Pablo Meza Olivera, Mai Ling Guevara Terán, Fiorela Alexandra Echeverre Alemán https://creativecommons.org/licenses/by/4.0
Digital Literacy as a Key Determinant of Social Inclusion and Sustainable Development in the Age of Artificial Intelligence
Digital transformation has profoundly changed educational, occupational, social, and institutional processes, creating new demands for competencies required to operate effectively in increasingly complex technological environments. In this context, digital literacy has emerged as a fundamental competency for accessing, understanding, evaluating, creating, and communicating information through digital technologies in a safe, critical, and responsible manner. This article analyzes the conceptual evolution of digital literacy, its main dimensions, its relationship with artificial intelligence, and the challenges associated with the use of digital technologies. Furthermore, it examines its contribution to social inclusion, reduction of digital divides, employability, and sustainable development. The paper highlights that the effective use of technology depends not only on access to digital tools but also on individuals’ ability to critically interpret information, exercise sound judgment, and make evidence-based decisions. Digital literacy is therefore a strategic component for strengthening digital citizenship and promoting inclusive digital transformation.
Digital literacy; digital competencies; artificial intelligence; social inclusion; digital transformation. (Source: DeCS-BIREME).
Copyright (c) 2026 Stephany Karola Ariansen-Moncada https://creativecommons.org/licenses/by/4.0
Factors Associated with Self-Medication among Medical Interns in a Public Hospital in Peru
Introduction: The World Health Organization defines self-medication as the use of medications without a medical prescription. In Peru, approximately 50% of individuals consume pharmaceutical products inappropriately. Additionally, it has been reported that up to 98.1% of university students in health sciences engage in self-medication. Objective: To determine the factors associated with self-medication among medical interns at Hospital Belén de Trujillo during 2021. Materials and Methods: A non-experimental, analytical, cross-sectional study was conducted. The sample size was calculated using the formula for a known finite population, resulting in a sample of 80 medical interns. Results: Chi-square analysis revealed no statistically significant association between economic factors (family income) and self-medication (p = 0.424). However, a significant association was found between the sociocultural factor (access to medical care) and self-medication (p = 0.0346). Likewise, a significant relationship was identified between the personal factor (perceived effect after self-medication) and the use of medications without prescription (p = 0.024). Conclusion: There is a significant association between personal and sociocultural factors and self-medication, whereas no association was found with economic factors.
Self Medication; Medical Students; Sociocultural Factors; Economic Factors; Drug Utilization. (Source: DeCS-BIREME)
Copyright (c) 2026 Mayra carolina Vásquez Carrión, Cristian Díaz-Vélez https://creativecommons.org/licenses/by/4.0
A One Health approach: multidisciplinary work from desk to field
La salud humana, la sanidad animal y la integridad de los ecosistemas conforman un continuo indivisible. El Panel de Alto Nivel de Expertos en Una Salud (OHHLEP) definió en 2022 el enfoque One Health como un abordaje integrado y unificador que busca equilibrar y optimizar de manera sostenible la salud de las personas, los animales y los ecosistemas, reconociendo su estrecha interdependencia (1). Esta definición incorpora de forma explícita la sostenibilidad y la equidad como principios rectores, y desplaza el énfasis desde la respuesta reactiva hacia la anticipación y la prevención en la fuente. En la práctica, ello exige que la evidencia científica descienda del escritorio al campo, y que las observaciones del campo retroalimenten la investigación. Pocas enfermedades ilustran esta necesidad con tanta claridad como la leptospirosis. La leptospirosis es una de las principales zoonosis desatendidas a escala global: se estima que ocasiona alrededor de 1,03 millones de casos y 58 900 muertes cada año, con la mayor carga concentrada en regiones tropicales empobrecidas y allí donde la vigilancia es deficiente (2). En el Perú, la transmisión se intensifica durante las lluvias, las inundaciones y los eventos de El Fenómeno del Niño, y se concentra en la Amazonía y la costa norte, incluida la región Tumbes. La vigilancia regional documentó que la leptospirosis representó el 2,2 % de los síndromes febriles agudos notificados en Tumbes durante 2024, con un incremento de casos a partir del mes de mayo (3). En 2026, en el contexto del Fenómeno El Niño Costero, el Ministerio de Salud emitió una alerta epidemiológica nacional ante el incremento del riesgo de leptospirosis, con Tumbes entre las regiones declaradas en emergencia (4). Estos datos, lejos de ser una cifra menor, advierten sobre una enfermedad cuyo diagnóstico se confunde con frecuencia con el dengue y otras causas de fiebre, y que demanda una vigilancia integrada y oportuna.
Copyright (c) 2026 Luz M. Moyano, Eshly Yacila Preciado, Percy Vílchez-Barreto, Kattia Pozada-Limo, Ricardo Gamboa Morán, Guillermo Salvatierra Rodríguez, Winnie. M. Contreras Marmolejo https://creativecommons.org/licenses/by/4.0
Adherencia a la Guía de Práctica Clínica de la OPS 2016 sobre Dengue en un hospital del norte de Perú, 2022-2023.
Objective: Effective dengue management enhances the chances of survival. The level of adherence to the suggestions in northern Peru is uncertain. The primary aim of the study was to assess adherence to the 2016 PAHO guideline on dengue in a hospital located in northern Peru during the period from 2022 to 2023. Methodology: The study performed a cross-sectional design and exploratory analysis, reviewing 140 medical records. Fifty-four percent were from 2023; 66.43% were from women; 38,57% came from a first level healthcare center; 77.14 % had diagnosis of dengue with warning signs and 20.71% had severe dengue; 18.44% died. Results: We found at least one error in the classification of severity and/or treatment in non-hospital healthcare facilities (95 %), triage (90.23%), and uviclin/observation (58.93%). Errors in classification and inadequate hydration in the first level healthcare centers, triage, and uviclin/observation were: 40.68%/60.0%, 31.0.6%/76.6%, and 15.32%/44.14 %, respectively. Persistent errors were inadequate hydration in triage (76.69%) and urinary flow in the center (81.67 %). In a bivariate analysis, mortality was associated with age 18 years or older (p = 0.047), having a case from 2023 (p = 0.008), and having severe dengue (p<0.001). In the multivariate analysis, only severe dengue (PR: 28.13, 95% CI :9.32-84.86 p<0.001), and age 18 years or older (PR:2.97, 95%CI:1.19-7.43 p: 0.020), were associated with mortality. Conclusions: We found a high frequency of misclassification and management errors in these three scenarios, but they were not associated with higher mortality.
Dengue, Adherence, Clinical Practice Guidelines, Mortality. (Source: MeSH-NLM)
Copyright (c) 2026 Franco E. León Jiménez, Nataly BF Mendoza-Farro, Adriana Montoya Reategui, Joel Emmanuel Inga Chero, Karim M.V. Dioses Diaz, Moisés Barranzuela Herrera, Sophia Cavalcanti Ramírez, LUZ MARIA Moyano Vidal https://creativecommons.org/licenses/by/4.0
Parasitological Microphotography: Visualization of Enterobius vermicularis
The case of a 7-year-old male pediatric patient is presented, who comes to the laboratory accompanied by his mother due to intense itching in the perianal region, predominantly at night, irritability, sleep disturbances, and occasional episodes of mild abdominal pain. As epidemiological background, the mother reports active school attendance, considered a factor associated with the transmission of enterobiasis. For the parasitological study, the Graham method or transparent adhesive tape test (patch) was performed in the morning, before the patient's personal hygiene. The obtained sample was placed on a microscope slide and observed directly under an optical microscope without additional staining.
parasitology, microphotography, enterobius
Copyright (c) 2026 Angel Anderson Suyon Castillo https://creativecommons.org/licenses/by/4.0
Apgar Score at Birth as a Predictor of Neonatal Death in a Regional Hospital in Northern Peru, 2018–2023
Objective: To determine the predictive value of one and five-minute Apgar scores as factors associated with neonatal death (ND) at the JAMO Regional Hospital, Tumbes. Materials and methods: Quantitative, analytical, and cross-sectional study. The sample included 114 records of deceased neonates (2018-2023). Generalized Linear Models (GLM) were used to calculate prevalence ratios (PR) with 95% CI. Results: An Apgar score ≤3 at five minutes predicted a higher risk of early neonatal death (END) with a Positive Predictive Value (PPV) of 70.0%. Perinatal asphyxia (p<0.001) and eutocic delivery (p=0.036) were significantly associated with severe neonatal depression. Multivariate analysis confirmed that severe depression increases the probability of asphyxia as the underlying cause of death by 2.96 times. Conclusions: The five-minute Apgar score is a robust predictor of early ND, validated as a marker of resuscitation failure. Asphyxia remains a key determinant of fatal outcomes.
Apgar score, positive predictive value, neonatal mortality, perinatal asphyxia.
Copyright (c) 2026 Mauro Pablo Meza Olivera, Heidy Lisbeth Villavicencio Boyer, Percy Mc-Quen Vílchez Barreto https://creativecommons.org/licenses/by/4.0
Comment on the article: “Cat scratch disease: a case report in a child”
Hemos leí do con intere s el artí culo “Enfermedad por aran azo de gato: reporte de caso en un nin o”, publicado en la revista RICSA, en el cual se describe el abordaje clí nico y diagno stico de un caso pedia trico en el departamento de Tumbes. Consideramos que el reporte constituye un aporte relevante al evidenciar las limitaciones diagno sticas en contextos regionales. No obstante, quisie ramos realizar algunas precisiones. En primer lugar, la afirmacio n sobre una “alta incidencia de sí ndromes febriles prolongados en la regio n Tumbes” excede el alcance metodolo gico de un reporte de caso, ya que este disen o no permite estimar medidas epidemiolo gicas poblacionales como incidencia o prevalencia (1).
Copyright (c) 2026 Rubén Alfaro, Liliana Solis https://creativecommons.org/licenses/by/4.0
Factors Associated with Nonalcoholic Fatty Liver Disease in Patients Receiving Antiretroviral Therapy for HIV at a Hospital in Trujillo, Peru, 2023
Objective: analyze the risk factors associated with non-alcoholic fatty liver disease (NAFLD) in HIV patients during 2023. Material and Method: analytical, observational, cross-sectional, retrospective. The sample consisted of 141 patients diagnosed with HIV, treated at a hospital in Trujillo, among whom 42 cases of fatty liver disease were found. Factors such as obesity, DM II, disease treatment duration, coinfection with HBV and HCV, as well as a trend in gender, were observed. A chi-square test was performed, yielding a p-value of less than 0.005. A multivariate logistic regression analysis was used to adjust PR, using the SPSS program. Results: Highlighting a prevalence of 29.79%. It was identified that age, gender (higher risk in men), the duration of antiretroviral treatment, and coinfections with HBV and HCV (X2 = 297.4) (p-value = 0.001) (X2 = 249.6) (p-value = 0.001) have a significant relationship with the presence of NAFLD. Additionally, type II diabetes mellitus and obesity are key factors, suggesting the importance of an integrated management approach to reduce the impact of NAFLD in this population. Conclusions: They indicate that obesity and type II diabetes mellitus increase the risk of NAFLD in patients with HIV, while coinfection with HBV and, especially, with HCV also contributes to the development of this condition.
Type 2 Diabetes Mellitus (DM II); Obesity; HCV; HBV; HIV; Hepatic Steatosis; Gender. (Source: DeCS-BIREME)
Copyright (c) 2026 Cristian Díaz Vélez, Yersin Silva Silva https://creativecommons.org/licenses/by/4.0
The 2026 healthcare landscape, navigating theconvergence of tectonic forces: A SICs Strategic Outlook
Declaración de autoría: El autor declara haber participado en la concepción, redacción y revisión crítica del contenido intelectual de este artículo, así como en la aprobación final de la versión que se presenta. El contenido y las opiniones expresadas son responsabilidad exclusiva del autor y no necesariamente reflejan la postura oficial de todas las organizaciones mencionadas, salvo donde se especifica la metodología de Seniors International Consulting (SICs). Declaración de conflicto de interés: El autor declara que me desempeña el cargo de Organizational Transformation Manager en Seniors International Consulting (SICs), organización que provee servicios de consultoría y gestión de riesgos mencionados en este texto. No obstante, manifiesta que no existen intereses económicos, comerciales o personales que hayan influido de manera indebida en la objetividad o integridad de la información presentada en este análisis. Financiamiento: El autor declara que no recibió financiamiento externo específico de agencias de subvenciones, organismos gubernamentales o entidades comerciales. El desarrollo del presente análisis se realizó como parte de las actividades de investigación y divulgación estratégica de Seniors International Consulting (SICs) para el año 2026.
Copyright (c) 2026 Víctor Piriz Correa https://creativecommons.org/licenses/by/4.0
Etoricoxib-Induced Fixed Drug Eruption with Cutaneous and Mucosal Involvement: A Case Report
Introduction: Fixed drug eruption (FDE) is a delayed hypersensitivity reaction characterized by erythematous- violaceous plaques recurring at identical anatomical sites upon re-exposure to the causative drug, with persistent residual hyperpigmentation. Etoricoxib, a widely used COX-2 inhibitor, is an increasingly recognized trigger. Case Report: A 49-year-old woman developed hyperpigmented plaques on the arms and oral mucosa eight hours after a single dose of etoricoxib 120 mg for acute low back pain. A clinically identical episode had occurred two years earlier at the same sites, initially misdiagnosed as herpetic infection. Diagnosis was established by temporal chronology, exact anatomical recurrence, and a Naranjo score of 10 (definite causal relationship). Management comprised drug discontinuation, oral antihistamine, and topical corticosteroid, with favorable outpatient evolution. Conclusion: This case illustrates etoricoxib-induced FDE with cutaneous and mucosal involvement and exact site recurrence. Early recognition, definitive discontinuation, and pharmacovigilance reporting are clinical imperatives to prevent recurrence and ensure safe alternatives.
Fixed drug eruption; Etoricoxib; Cyclooxygenase-2 Inhibitors; Drug Hypersensitivity; Pharmacovigilance. (Source: MeSH-NLM
Copyright (c) 2026 LUZ MARIA Moyano Vidal, Lucia Margarita Bolivar Herrada, Martha Patricia Diaz Guevara https://creativecommons.org/licenses/by/4.0
Epidemiological and Sociodemographic Characteristics of Dengue Cases in an Endemic Region of Northern Peru, 2024
Objective: To describe the epidemiological behavior of dengue in the Tumbes region during 2024 according to demographic, social, and geographic variables. Materials and methods: An observational, descriptive, and retrospective study based on epidemiological surveillance and laboratory records from the Regional Health Directorate of Tumbes. Confirmed cases by NS1 antigen, IgM, or RT-PCR tests were included. Descriptive statistical analysis was performed using frequencies and percentages for categorical variables, and median with interquartile range for numerical variables with non-normal distribution. Results: A total of 2,594 dengue cases were confirmed. The median age was 22 years (IQR: 12–38). The most affected age groups were 30–59 years (29.6%) and 0–11 years (24.4%). The highest concentration of cases occurred in the province of Tumbes (92.1%). Diagnostic confirmation was mainly performed through NS1 antigen detection (77.5%), followed by IgM (23.8%) and RT-PCR (1.4%). Transmission showed a predominantly urban pattern and marked seasonality, with a higher number of cases during months with higher temperature and precipitation. Conclusion: Dengue in Tumbes during 2024 mainly affected young populations, was concentrated in urban areas, and showed marked seasonality associated with climatic conditions favorable for transmission. These findings may help strengthen epidemiological surveillance and guide strategies focused on vector control and prevention in the region.
Dengue, Epidemiological Surveillance, Sociodemographic Factors, Vector-Borne Diseases, Peru. (Source: MeSH-NLM)
Copyright (c) 2026 Víctor Guzmán, Liliana Solís, Edith Solís, Rubén Alfaro https://creativecommons.org/licenses/by/4.0
Predisposing factors associated with dengue, chikungunya and leptospirosis in patients with febrile syndrome in the department of Tumbes, Peru
Objective: Tó evaluate the assóciatión between demógraphic and seasónal factórs and the óccurrence óf dengue, chikungunya, and leptóspirósis amóng patients with febrile syndróme in Tumbes during 2024. Materials and Methods: A retróspective analysis was cónducted using 13,148 recórds fróm the epidemiólógical surveillance system, cónsidering variables such as age, sex, and mónth óf nótificatión. Results: Dengue was the móst frequent etiólógy (15.5%), fóllówed by leptóspirósis (2.2%) and chikungunya (1.3%). Significant assóciatións were fóund between disease óccurrence and age gróup, as well as sex. Regarding seasónality, dengue shówed higher incidence between March and May, peaking in April, whereas leptóspirósis increased fróm May ónward and predóminated tóward the end óf the year. Conclusions: The findings demónstrate distinct patterns that reinfórce the impórtance óf a syndrómic appróach and timely diagnósis tó impróve the surveillance and cóntról óf these diseases.
Dengue; Chikungunya Virus; Leptóspirósis; Fever; Epidemiólógy. (Source: DeCS-BIREME)
Copyright (c) 2026 Mg. Víctor Guzmán, Liliana Solís, Edith Solís, Rubén Alfaro https://creativecommons.org/licenses/by/4.0
Cat scratch disease: case report in a child
Introduction: Bartonella Henselae is a gram-negative bacterium that lives in cats that come into direct contact with feces and bites from infected fleas. Case report: A 5-year-old boy presented with prolonged fever and painful lymphadenopathy on the right side of his face. The diagnosis was confirmed by indirect immunofluorescence testing for IgM and IgG antibodies against Bartonella Henselae. Discussion: The clinical presentation was consistent with a case of cat scratch disease, exhibiting its typical clinical manifestations. The patient's recovery was long, favorable, and without sequelae, as described in the literature. Conclusion: This case highlights the high incidence of prolonged febrile illnesses in the Tumbes Region and the lack of laboratory methods for their timely diagnosis.
Bartonella Henselae; Lymphadenopath; Cat scratch; Tumbes. (Fuente: DeCS-BIREME)
Copyright (c) 2026 MAURO MEZA OLIVERA, Mai Ling Guevara Terán, Fiorela Alexandra Echeverre Alemán https://creativecommons.org/licenses/by/4.0
Maternal Complementary Feeding Practices Associated with Anemia in Children Aged 6–24 Months
Objective: To determine if there is an association between maternal practices on complementary feeding and anemia in children 6-24 months of age. Material and methods: An analytical, cross-sectional study was carried out in which 185 children from 6 to 24 months of age were included, using selection criteria that were divided into the presence or absence of childhood anemia, based on chi-square and the prevalence ratio statistician. Results: It was obtained that the frequency of child malnutrition, acute diarrheal disease and maternal anemia were significantly higher in the group of patients with child anemia (p<0.05), inadequate maternal practices on complementary feeding are associated with anemia in children aged 6- 24 months of age with a PR of 3.83 being significant with the value of p<0.05, within the multivariate analysis the variables inadequate eating practices, infant malnutrition, acute diarrheal disease and maternal anemia were identified as factors associated with infant anemia. Conclusion: there is an association between inadequate maternal practices on complementary feeding and anemia in children 6-24 months of age.
Association, maternal practices on complementary feeding, childhood anemia. (Source DeCS-BIREME)
Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0
Adherence as a Critical Survival Variable in Dengue: Evidence from the Peruvian Experience
El dengue persiste como una de las principales causas de morbilidad y mortalidad evitable en América Latina. Aunque los avances diagnósticos han mejorado la detección temprana de casos, la letalidad continúa asociada a un elemento directamente asociado a la ejecución clínica que adopta protocolos establecidos basados en evidencias. La distancia entre lo normado y lo realizado en la práctica clínica constituye un terreno poco explorado y, sin embargo, decisivo en la evolución de los pacientes con dengue. La experiencia en el Perú, durante el 2023, el país alcanzó 444 fallecidos por dengue, con una tasa de letalidad de 0.17 %, claramente por encima del estándar internacional. La presencia de normativas técnicas actualizadas no se tradujo en resultados clínicos óptimos, revelando un problema estructural: no existía un mecanismo nacional que verificara la adherencia a los pasos críticos del manejo clínico del dengue. Sin indicadores, la calidad de la atención dependía de decisiones individuales, variables entre establecimientos y regiones, lo que favoreció errores diagnósticos, retrasos terapéuticos y fallas en la clasificación de riesgo.(1) La literatura científica ha señalado este vacío desde hace más de una década, demostraron que la supervivencia en dengue no depende de la disponibilidad de medicamentos específicos, sino de la exactitud con que se interpretan los signos clínicos y se ejecutan las intervenciones indicadas en los protocolos(2). Revisiones recientes confirman que el pronóstico no se liga exclusivamente al acceso hospitalario, sino a la consistencia del proceso clínico, particularmente en el primer nivel de atención, donde se toman las decisiones iniciales que condicionan el curso de la enfermedad(3,4).
Copyright (c) 2026 Moisés Apolaya Segura https://creativecommons.org/licenses/by/4.0
Role of the Na⁺/K⁺ ATPase Pump in Ionic Regulation and Cellular Homeostasis
Na⁺/K⁺-ATPase is an essential transmembrane protein responsible for maintaining cellular homeostasis through the regulation of sodium and potassium electrochemical gradients. This review aimed to analyze recent scientific evidence regarding the role of Na⁺/K⁺-ATPase in ionic regulation and cellular homeostasis, focusing on its molecular structure, active transport mechanism, physiological regulation, and involvement in pathological processes. A narrative review of the literature was conducted using recent publications in cellular physiology, molecular biology, and diseases associated with Na⁺/K⁺-ATPase dysfunction. Current evidence demonstrates that Na⁺/K⁺-ATPase not only maintains membrane potential, cell volume, and secondary active transport but also participates in intracellular signaling pathways, metabolic regulation, and tissue-specific adaptive responses. Its activity is finely regulated by the interaction of the α and β catalytic subunits with FXYD regulatory proteins, which modulate pump function according to cellular requirements. Impaired Na⁺/K⁺-ATPase activity resulting from hypoxia, acidosis, or energy depletion disrupts ionic balance, promotes cellular edema, and contributes to dysfunction of major organs, including the brain, heart, and kidneys. Overall, Na⁺/K⁺-ATPase represents a fundamental regulator of cellular physiology and a promising therapeutic target for cardiovascular, neurological, and renal disorders associated with impaired ionic homeostasis.
odium-Potassium-Exchanging ATPase; Homeostasis; Active Transport; Ion Channels; Cell Physiology. (Source: MeSH-NLM)
Copyright (c) 2026 Mesias Mendieta Valeria Rubi, Miranda Rojas José Daniel, Montoya Abanto Julio César https://creativecommons.org/licenses/by/4.0
Altered body mass index and gestational complications: a case-control study in primary healthcare
Introduction: Alterations in body mass index during pregnancy represent a significant risk factor for maternal complications. Material and methods: Through a 1:1 matched case-control design, we evaluated the association between altered BMI and gestational complications in one hundred pregnant women at the San Isidro I-3 Health Center in Tambogrande, Piura, between 2020 and 2021. Cases included pregnant women with BMI outside the normal range (less than 18 or greater than 29 kg/m²), while controls had normal BMI, matched by age. Results: Women with altered BMI had six times higher odds of developing complications (OR=5.95; 95%CI: 2.2216.67; p=0.0001). Notably, pregnancy-induced hypertension showed a particularly strong association (OR=16.71; 95%CI: 2.36-713.74; p=0.0006). When stratified by obesity type, women with class II obesity presented 5.62 times higher risk of gestational hypertension and 4.38 times higher risk of preeclampsia compared to those with normal weight. Conclusion: These findings underscore the importance of early nutritional monitoring in prenatal care at the primary care level as a fundamental preventive strategy.
Obesity, maternal; Pregnancy complications; Primary health care (Source: DeCS-BIREME)
Copyright (c) 2026 Jenny Valle, Dayanna Dioses-fernández, Noelia Morocho-Alburqueque, LUZ MARIA Moyano Vidal https://creativecommons.org/licenses/by/4.0
Epilepsy and inhibitory neurotransmission: the role of gaba in neuronal balance and brain excitability
Diábetic neuropáthic páin ánd epilepsy sháre á common páthophysiologicál básis involving áltered neuronál excitábility driven by ion chánnel dysfunction ánd impáired neurotránsmission. In epilepsy, γ-áminobutyric ácid (GABA) pláys á centrál role ás the primáry inhibitory neurotránsmitter, máintáining the excitátion–inhibition bálánce through GABA_A ánd GABA_B receptors. During epileptogenesis, álterátions in GABA synthesis, releáse, reuptáke, ánd receptor function occur, álongside disruptions in intrácellulár chloride homeostásis reguláted by KCC2 ánd NKCC1. These chánges máy shift GABAergic signáling from inhibitory to depolárizing, promoting neuronál hyperexcitábility. Additionálly, dysfunction of GABAergic interneurons ánd gliál cells contributes to ábnormál neuronál synchronizátion ánd seizure propágátion. Together, these mechánisms fácilitáte the onset ánd máintenánce of epileptic áctivity. A deeper understánding of these processes highlights potentiál therápeutic tárgets, including modulátion of GABAergic receptors ánd ion tránsporters, párticulárly in drug- resistánt epilepsy.
Epilepsy; Gámmá-Aminobutyric Acid; Neurotránsmission; Neuronál Excitábility; Ion Chánnels. (Source: DeCS-BIREME)
Copyright (c) 2026 Caroline Alexandra Blas De La Cruz, Sthefany M. Berrocal Inocente, Rosario M. Angulo Inocente, Ximena A. Angeles Pumayalla, Washington Alfonso Trujillo-Ulloa https://creativecommons.org/licenses/by/4.0
Physiology of the hypothalamic-pituitary-ovarian axis in the regulation of the menstrual cycle in perimenopausal women
This review describes the physiology of the hypothalamic–pituitary–ovarian (HPO) axis, its neuroendocrine regulation, and its role in menstrual cycle variability during the perimenopausal transition. A narrative review was conducted focusing on pulsatile GnRH secretion, pituitary responses of FSH and LH, ovarian steroidogenesis, and age-related ovarian changes. Perimenopause is characterized by progressive disruption of negative feedback mechanisms, with decreased inhibin B and anti-Müllerian hormone levels, marked estradiol fluctuations, and irregular elevations of FSH, leading to anovulatory cycles and menstrual irregularity. Hormonal variability also affects the central nervous system, modulating neurotransmitters, thermoregulation, and cerebral metabolism. Understanding these mechanisms helps explain neuroendocrine symptoms and supports clinical strategies based on hormonal education, individualized management, and metabolic monitoring.
Copyright (c) 2026 Brisayda Mabet Torrealva Lázaro, Jheremy J. Teodoro Maza, Ariana V. Silva Carranza, Nayely X. Soto Aguilar, Oscar Lenin López Amaya https://creativecommons.org/licenses/by/4.0
Alterations in the physiological mechanisms of synapsis in alzheimer's
Alzheimer's disease (AD) is the leading cause of dementia and is characterized by early synaptic dysfunction that precedes neurodegeneration and cognitive decline. This review aimed to analyze the available scientific evidence on alterations in the physiological mechanisms of synapses involved in AD progression, focusing on changes in synaptic proteins, structural synaptic remodeling, oxidative stress, and glial activation. A narrative review of the literature was conducted using studies published in indexed biomedical journals, emphasizing recent evidence on synaptic physiology, biomarkers, and molecular mechanisms of AD. Current evidence indicates that synaptic proteins, including SNAP-25, PSD-95, neurogranin, β-synuclein, and NPTX2, are sensitive biomarkers of synaptic dysfunction. In addition, synaptic density loss, dendritic spine degeneration, and alterations in glutamatergic and GABAergic neurotransmission are early events strongly associated with cognitive impairment. Oxidative stress, mitochondrial dysfunction, and persistent activation of microglia and astrocytes further promote neuroinflammation and complement-mediated elimination of functional synapses. Collectively, these mechanisms play a central role in AD pathophysiology and represent promising biomarkers and therapeutic targets for early diagnosis and interventions aimed at preserving synaptic integrity.
Alzheimer Disease; Synapses; Neurodegenerative Diseases; Neuroinflammatory Processes; Biomarkers. (Source: MeSH-NLM)
Copyright (c) 2026 Piero Felix Raul Castro Sanchez, Pedro Valentin Ferre Pantigoso, Tatiana Alexandra Flores Cotrina, Jose Carlos Carrera Huaman, Oscar Lenin W López Amaya https://creativecommons.org/licenses/by/4.0
Physiology of vitamin d and bone metabolism: implications for osteoporosis and rickets
Vitamin D is important for the endocrine regulation of mineral metabolism and bone integrity. Its synthesis in the skin from ultraviolet B radiation, together with its conversion in the liver and kidneys, allows the formation of 1,25-dihydroxyvitamin D, which regulates intestinal absorption of calcium and phosphorus, modulates the release of parathyroid hormone (PTH), and participates in bone remodeling. Vitamin D metabolism is influenced by factors such as FGF23 and Klotho, which interact to maintain mineral homeostasis in the body. Vitamin D deficiencies manifest clinically as rickets in children and osteomalacia in adults, while in adulthood it can lead to osteoporosis, characterized by bone loss and increased risk of fractures. Currently, vitamin D deficiency remains a major public health problem, affecting millions of people worldwide, including a significant percentage of the population in Peru. This review addresses the physiological mechanisms involved in bone metabolism and the clinical implications for diagnosis and treatment. It concludes that, despite advances in understanding the physiology of vitamin D, there are important áreas that require further research to comprehensively address the treatment and prevention of these bone diseases.
Vitamin D; Bone and Bones; Osteoporosis; Rickets; Vitamin D Deficiency; Public Health (Fuente: DeCS-BIREME)
Copyright (c) 2026 Victor D. Martinez Ulloa, Alexis G. Saavedra Pascual, Angélica D. Luna Albarrán, Lilian M. Miñano Vega https://creativecommons.org/licenses/by/4.0
Factors associated with BLEE antimicrobial resistance in urinary tract infections in childrenunder 5 years of age treated at a hospital in Trujillo 2024.
This study focused on identifying the factors associated with urinary tract infection in pediatric patients. Objective: To determine the factors associated with BLEE-type antimicrobial resistance in urinary tract infections in children under five years of age treated at a hospital in Trujillo – 2024. Material and methods: A retrospective, analytical, observational case-control study was conducted. The sample comprised 110 pediatric patients treated at a hospital in Trujillo, of whom 55 were cases (UTI with positive urine culture for E. coli) and 55 were controls (UTI with negative urine culture for E. coli). The Chi-square test was performed to measure how closely the variables were associated and to calculate the odds ratio (OR). Multivariate logistic regression analysis was used to adjust the OR, using the SPSS program. Data were collected over a period of four months using a results collection form. Results: Female sex was 66.7%; UTI recurrence was 68.5% with an OR= 8.35, and previous hospitalization in the last 3 months was 66.7% with an OR= 8.26, which were risk factors for antimicrobial resistance in UTIs. Conclusion: Factors associated with BLEE-type antimicrobial resistance in UTI in children under five years of age are female sex, previous hospitalization in the last three months, and recurrence of UTI.
urinary tract infection, risk factors, pediatrics. (Source: DeCS-BIREME)
Copyright (c) 2026 arosales https://creativecommons.org/licenses/by/4.0
INTRALOBAR PULMONARY SEQUESTRATION AS A CAUSE OF RECURRENT PNEUMONIAS IN AN ADULT WOMAN: A CASE REPORT
Introduction: Intralobar pulmonary sequestration (IPS) is an uncommon congenital malformation in adults, characterized by non-functioning lung tissue supplied by an aberrant systemic artery. Its clinical and radiologic presentation may mimic recurrent pneumonias or pulmonary neoplasms, leading to diagnostic delays. Case of report: We report the case of a 49-year-old woman with a history of asthma and insulin resistance, who had recurrent right lower lobe pneumonias since 2018. In December 2023, during the most severe episode, initial chest CT suggested a possible pulmonary neoplasm; however, a second radiologic interpretation identified a basal pseudomass with an aberrant systemic artery consistent with pulmonary sequestration. Further imaging at referral centers confirmed anomalous arterial supply from the thoracic aorta. In May 2024, a right lower lobectomy was performed via thoracotomy, revealing an intraparenchymal aberrant artery. Pathology confirmed complicated IPS with fibrosis, bronchiectasis, and chronic inflammation. Conclusion: IPS should be considered in adults presenting with recurrent pneumonias and basal lung lesions. Clinical–radiologic correlation, particularly the identification of an aberrant systemic artery, is essential for establishing the correct diagnosis and guiding definitive treatment.
Pulmonary sequestration; Pneumonia, Recurrent; Case Reports. (Source: DeCS-BIREME)
Copyright (c) 2026 Dra. Luz María Moyano Vidal, Dr. Ricardo Taipe-Mallqui, Mr. Roly Gonzaga-Vilchez, Dra. Narcisa Reto Otero, Dra. Raquel Herrer Ticse https://creativecommons.org/licenses/by/4.0
Peripheral Ion Channel Dysfunction as a Physiological Mechanism of Diabetic Neuropathic Pain
Diábetic neuropáthic páin is á common ánd disábling complicátion of diábetes mellitus. Ráther thán á simple distál áxonál polyneuropáthy, it cán be conceptuálized ás án ácquired peripherál chánnelopáthy. Chronic hyperglycemiá, dyslipidemiá, oxidátive stress, ádvánced glycátion end products, ánd microángiopáthy creáte á metábolic ánd inflámmátory microenvironment thát dámáges peripherál nerves, Schwánn cells, ánd the vásá nervorum, promoting demyelinátion, chronic ischemiá, ánd persistent neuroinflámmátion. In this context, nociceptive neurons in the dorsál root gángliá undergo ion chánnel reprográmming, chárácterized by overexpression of sodium chánnels (Náv1.7, Náv1.8), T-type cálcium chánnels (Cáv3.2), tránsient receptor potentiál chánnels (TRPV1, TRPA1), ánd purinergic receptors (P2X3), álong with reduced stábilizing potássium currents. The result is á chronicálly hyperexcitáble nociceptor with á lowered áctivátion threshold, ectopic dischárges, ánd repetitive firing, clinicálly mánifesting ás állodyniá, hyperálgesiá, ánd spontáneous páin. This model expláins why current treátments often provide only pártiál relief, ás they moduláte nociceptive tránsmission without correcting the primáry ion chánnel dysfunction. Therefore, future mánágement should focus on tárgeted ion chánnel therápies ánd the development of biomárkers to enáble pátient strátificátion ánd personálized treátment strátegies.
Diábetic Neuropáthies; Neurálgiá; Ion Chánnels; Dorsál Root Gángliá; Hyperglycemiá. (Source: DeCS-BIREME)
Copyright (c) 2026 Rafael Beltrán Osorio, Tamara Fernanda Garibay Culcos, Marcela María Gonzales Tarazona, Jesús Eduardo Guaylupo Montenegro, Fredy Jampol Guevara Alvarado, Braian Anthony Haro Villanueva https://creativecommons.org/licenses/by/4.0
“Numerical inconsistencies in 'albumin' and 'bulky disease' in patients ≥80 years with diffuse large B-cell lymphoma”
El artículo “Impacto de la albúmina en la sobrevida de los pacientes ancianos con linfoma difuso de células B grandes (LDCBG)” de Beltrán BE et al. (1) constituye una valiosa contribución para la oncología hematológica peruana. Los autores evidencian que la hipoalbuminemia se asocia significativamente con menor sobrevida global, hallazgo congruente con estudios internacionales que identifican la albúmina sérica como un marcador pronóstico independiente del estado inflamatorio y nutricional en neoplasias hematológicas (2,3).
Copyright (c) 2025 Marco Antonio Miñano Quiroz https://creativecommons.org/licenses/by/4.0
Collaborative Research Networks to Transform Public Health in Latin America
La investigación científica es el motor del desarrollo y la herramienta más poderosa para enfrentar los desafíos en salud pública. Sin embargo, en América Latina, la fragmentación institucional, las brechas de financiamiento y la escasa interoperabilidad de los sistemas de información han limitado la capacidad de generar conocimiento aplicable a las políticas sanitarias. En este contexto, las redes de investigación colaborativa emergen como una estrategia esencial para fortalecer la evidencia científica y su traducción en decisiones públicas efectivas.
Copyright (c) 2025 Cristian Díaz-Vélez https://creativecommons.org/licenses/by/4.0
Hospital Risk Factors for Neonatal Mortality: A New Strategy
Objective: To identify the main hospital risk factors associated with neonatal mortality in a regional hospital in northern Peru. Material and Methods: A retrospective descriptive study analyzed 619 hospitalized newborns and 78 deaths in the Neonatal Intensive Care Unit of JAMO Regional Hospital II-2, Tumbes, from 2019 to 2021. Birth weight, hospitalization time, and basic cause of death were evaluated. Results: The highest mortality occurred in newborns weighing < 1250g, mainly between the 3rd and 7th day of hospitalization. Neonatal sepsis was the leading cause of death (47.8 % in < 1000 g and 71.4 % in 1000–1249 g). Conclusions: The critical neonatal mortality weight identified was 1250 g. Strengthening hospital biosecurity and implementing perinatal regionalization networks are essential strategies to reduce neonatal mortalit.
Neonatal mortality, prematurity, hospital sepsis, intensive care, perinatal regio- nalization. Source: DeCS-BIREME
Copyright (c) 2025 MAURO MEZA OLIVERA, TEODORO EDUARDO PEREDO CAVASSA https://creativecommons.org/licenses/by/4.0
Strategies to Enhance Healthcare Workers’ Quality of Work Life
Work life quality among healthcare personnel is a critical determinant of both profesional well-being and the effectiveness of health services. This review aimed to analyze strategies reported in the literature between 2020 and 2025 that address the improvement of healthcare workers’ quality of work life. A structured search was conducted in PubMed, Scopus, Web of Science, and Scielo, including original and review articles in Spanish and English. Findings revealed that the most effective interventions fall into five main dimensions: economic and contractual conditions, organizational climate, motivation and recognition, psychosocial support, and professional development. In high-income countries, flexible work policies, work-life balance, and participatory leadership have shown significant impact. In contrast, Latin American settings face persistent challenges such as job instability, excessive workload, and limited resources. In Peru, successful initiatives have been related to resilience programs, self-care practices, and continuous training. It is concluded that improving the quality of work life requires integrated and context-specific strategies. Incorporating this approach into health management is essential to enhance work force retention, reduce burnout, and ultimately improve patient care outcome
Quality of Work Life; Health Personnel; Occupational Stress. Source: DeCS_BI- REME
Copyright (c) 2025 JOSE MIGUEL SILVA RODRIGUEZ, GINO FRANKLIN GARAVITO CRIOLLO, ZULLY DUBERLY VALENCIA CRUZ, ANDY JIMM VALENCIA CRUZ https://creativecommons.org/licenses/by/4.0
Lessons Learned and Resilience Strategies in Post-Pandemic Maternal and Neonatal Care
Objective: To describe key lessons learned and resilience strategies implemented in maternal health care services during the COVID-19 pandemic, emphasizing the responses of health systems and frontline personnel. Material and Methods: A narrative review of scientific literature and institutional documents published between 2020 and 2024 was conducted. Reports from WHO, the Peruvian Ministry of Health (MINSA), and regional articles on continuity of maternal services in crisis contexts were analyzed. Information was organized into thematic categories: continuity of care, management adaptations, workforce resilience, and institutional learning. Results: The pandemic initially caused a decline in prenatal checkups and access to obstetric services, revealing weaknesses in the health network. However, resilience strategies were identified, including the implementation of telemonitoring, prioritization of high-risk pregnancies, coordination across levels of care, and leadership by health professionals. At the institutional level, capacities were strengthened in epidemiological surveillance, risk communication, and mental health support for health personnel, promoting intersectoral and community collaboration. Conclusions: The pandemic experience reaffirmed the need to strengthen maternal health care within a resilient health system framework—person-centered, evidence-based, and community-oriented. Lessons learned should inform sustainable policies that ensure the continuity and quality of maternal and child health services in future public health emergencies.
COVID-19; resilience; maternal health; health services; public policy.
Copyright (c) 2025 Mg. Cecilia I. Silva, Mg. Elva M. Ramírez, Mg. Judith M. García, Mg. Hiesica E. Abad https://creativecommons.org/licenses/by/4.0