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
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
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
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
“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
Differences in Postpartum Depression Among Adolescent, Young, and Advanced Maternal Age Mothers in Two Health Centers in Trujillo, 2024
Introduction: Postpartum depression is a mental health complication that significantly affects maternal and infant well-being, with variations potentially linked to maternal age and socioeconomic conditions. Objective: To compare the prevalence, severity, and associated factors of postpartum depression among adolescent, young adult, and older postpartum women in two health centers in Trujillo during 2024. Materials and Methods: A quantitative, descriptive, cross-sectional study was conducted by reviewing 141 medical records of postpartum women. The prevalence and severity of postpartum depression were assessed using the Edinburgh Postnatal Depression Scale (EPDS), and associated sociodemographic and clinical variables were analyzed. Results: Of the participants, 7.8% were adolescents, 76.6% were young adults, and 15.6% were older adults. No significant differences in the prevalence of postpartum depression were found among age groups; however, being a single mother was significantly associated with a higher risk of postpartum depression (RR = 1.5; p = 0.05) according to Poisson regression analysis, while economic problems and other variables did not show a significant association. Conclusion: Postpartum depression similarly affects women across different age groups; however, social factors such as single motherhood increase the risk. It is recommended to implement emotional and social support strategies at all levels of care to prevent and manage postpartum depression effectively.
Postpartum depression, postpartum women, adolescence, maternal age, mental health, socioeconomic factors.
Copyright (c) 2025 Fernández Cárdenas Thanery Neidy, Díaz-Vélez Cristian https://creativecommons.org/licenses/by/4.0
Challenges in Research for Undergraduate Students: “We Are in Community, Not Alone.”
La investigación es el pilar fundamental en la formación de los estudiantes de las Escuelas de Medicina Humana y su integración en la curricula tiene como objetivo fortalecer el pensamiento crítico, la toma de decisiones basada en evidencia y el desarrollo de conocimiento orientado a resolver problemas sanitarios locales. Sin embargo, los estudiantes enfrentan numerosas barreras que dificultan la sostenibilidad y efectividad de esta integración. Estudios en Pakistán y Jordania en estudiantes de medicina identificaron barreras comunes en investigación, tales como: la falta de conocimiento metodológico (90 %), la ausencia de mentores capacitados (~86 %), la sobrecarga académica (> 88 %), una mentoría limitada (85,7 %) y los limitados recursos financieros y acceso a bases de datos. (1–3) Los problemas institucionales de Perú, como la escasa financiación, los limitados recursos de investigación, la inadecuada gestión y supervisión estatal y las inadecuadas políticas institucionales, se traducen en una escasa producción científica y una limitada visibilidad internacional. (4,5). Las barreras identificadas en nuestro país son similares a las descritas en medio oriente y estas limitaciones impactan negativamente en la productividad científica. (6,7) Aprovechando el desarrollo de la XIII Jornada científica y de investigación de la Universidad Nacional de Tumbes, realizada los días 19-20 de junio; se llevó a cabo una mesa redonda organizada por la Sociedad Científica de Estudiantes de Medicina Humana, bajo el liderazgo de la estudiante Annia Valeria Silva Calderón. Durante esta actividad, se formularon seis preguntas clave a cinco docentes investigadores procedentes de diversas universidades públicas y privadas del país. La discusión giró en torno a los Retos que enfrentan los estudiantes de pregrado para insertarse en la investigación, temática que da título a esta editorial.
Copyright (c) 2025 Guillermo Salvatierra, Coralith Garcia APAC , José Oswaldo Cabanillas Angulo , Maria Edith Solis-Castro , Luz M. Moyano Vidal https://creativecommons.org/licenses/by/4.0
TRANSPORT OF FLUIDS AND ELECTROLYTES IN THE INTESTINE: PHYSIOLOGICAL BASIS AND ASSOCIATED DISEASES
To describe the physiological mechanisms of intestinal fluid and electrolyte transport, their regulation, and implications in digestive diseases. A narrative review of recent physiological and biomedical literature was conducted, focusing on major intestinal transporters and channels (SGLT1, NHE3, DRA, ENaC, CFTR) and their neuroendocrine regulation. Intestinal transport depends on the interplay between active and passive mechanisms regulated by neurohormonal signals. Dysregulation causes disorders such as secretory diarrhea, Crohn’s disease, and short bowel syndrome. In secretory diarrhea, enterotoxins activate CFTR, increasing Cl- and water secretion; in Crohn’s disease, inflammation impairs absorption and barrier integrity; and in short bowel syndrome, resection induces compensatory functional and structural adaptations. Understanding intestinal transport physiology clarifies the pathophysiology of major gastrointestinal diseases and guides effective therapeutic strategies such as oral rehydration, early enteral nutrition, and hormonal modulators.
Intestinal transport; electrolytes; secretory diarrea; Crohn’s disease; short bowel syndrome. Source: DeCS-BIREME
Copyright (c) 2025 Jose Manuel Javier Alcantara, Cesar Hoyos Cabrera, Luis Iraita Cabero, Jesus Medina Mendoza, Pedro Medina Panta https://creativecommons.org/licenses/by/4.0
Role of the Renin–Angiotensin–Aldosterone System in Arterial Hypertension
The role of the renin-angiotensin-aldosterone system (RAAS) in the pathophysiology of hypertension (HTN), its link to cardiovascular damage, and advances in diagnosis and treatment are analyzed. The RAAS is involved in sustained vasoconstriction, inflammation, oxidative stress, and cardiovascular remodeling. Its chronic activation promotes the progression of HTN. Technologies such as Lab-on-a-Chip, POCT, and liquid biopsies, together with genetic biomarkers, have improved early diagnosis and therapeutic personalization. Although RAAS inhibitors remain key, new therapies targeting alternative pathways are being explored. Current knowledge allows for a more precise and personalized approach to the management of HTN.
Hypertension; Renin–Angiotensin System; Biomarkers; Molecular Diagnostic Techniques (Source: DecCS-BIREME)
Caroline Andrea Grissell Zavaleta Olortegui
Copyright (c) 2026 Zavaleta O. Caroline, Zavaleta Aguirre B., Vivar A. Tatiana, Aramel S. Acosta, Ramirez L. Jorge, Beltrán O. Rafael https://creativecommons.org/licenses/by/4.0
Hemodynamic Alterations in Patients with End-Stage Chronic Kidney Disease UndergoingHemodialysis
End-stage chronic kidney disease causes significant alterations in the cardiovascular system, particularly in patients undergoing hemodialysis. Although this procedure is essential for removing toxins and regulating body fluid volume, it induces important hemodynamic changes that affect blood pressure and cardiac output. The most common complication is intradialytic hypotension, which may occur in multiple sessions and lead to dizziness, hypoperfusion of vital organs, and progressive clinical deterioration. This review aimed to describe the main hemodynamic changes associated with hemodialysis, explain the underlying pathophysiological mechanisms, and analyze the factors that compromise stability during treatment. It also examined interventions that may improve patient tolerance, including gradual adjustment of dry weight, the use of cooler dialysate solutions, nutritional assessment, and—in selected cases—techniques such as hemodiafiltration. Individualizing therapy according to each patient’s condition can reduce risks and optimize quality of life.
End-Stage Renal Disease; Hemodialysis; Hypotension; Hemodynamics; Cardiovascular Diseases
Copyright (c) 2026 José Antonio Rosas Alegre https://creativecommons.org/licenses/by/4.0
Interpretation of the ECG as a diagnostic tool in cardiac electrophysiology
Cardiovascular diseases remain the leading cause of death globally, with cardiac electrical conduction disorders such as arrhythmias playing a key role in this burden. This review article presents an integrative approach to cardiac electrophysiology, from the physiological processes of the generation and propagation of the cardiac electrical signal, through the interpretation of ECG components and the evaluation of the cardiac vector. It includes diagnostic protocols using intracardiac recordings and explores emerging technologies such as artificial intelligence applied to ECG signal analysis, as well as the use of wearable multi-lead monitoring systems. These advances offer new insights for arrhythmia detection, risk segmentation, and therapeutic strategies. The article highlights the importance of promoting electrophysiological research and strengthening medical education with applied methodologies, aiming to enhance clinical training and cardiovascular care quality.
Electrocardiography; Electrophysiology; Arrhythmias, Cardiac; Atrial Fibrillation; Artificial Intelligence; Education, Medical. Source: DeCS-BIREME
Copyright (c) 2025 Dennis Gerardo Mendoza Palma, Gustavo Adolfo Ortega Contreras, Mariesther Sarai Ortiz Valencia, Jeanpierre Agustín Paredes Bautista, Alessandro Humberto Pascacio Armas https://creativecommons.org/licenses/by/4.0
Digestive physiology and intestinal microbiota: functional integration, neuroendocrine regulationand clinical relevance
The digestive system plays a fundamental role in transforming food into nutrients usable by the body. This process involves a series of well-coordinated physiological mechanisms, ranging from mechanical and chemical digestion to the intestinal ab- sorption of macronutrients. Throughout the gastrointestinal tract, distinct regions and specialized structures progressively break down carbohydrates, lipids, and proteins, enabling their subsequent transport into systemic circulation. In this context, the gut microbiota emerges as a key component, not only in fermenting non-digestible com- pounds but also in producing bioactive metabolites, modulating immune responses, and preserving the integrity of the intestinal barrier. The interaction between the mi- crobiota, intestinal epithelium, and enteric nervous system forms a functional axis that can be disrupted by various factors, leading to digestive dysfunctions with systemic implications. This review summarizes the main anatomical and physiological aspects of the digestive system, the mechanisms of intestinal absorption, and the key role of the microbiota, offering a useful conceptual basis for understanding functional altera- tions and proposing new therapeutic strategies.
Digestive physiology; intestinal absorption; gut microbiota; gastrointestinal system; gut-brain axis. (Source: DeCS-BIREME)
Copyright (c) 2026 Allison P. Correa, Hellen S. Ramos, Ayrton M. Caruajulca, Paolo F. Monzón, Daniel M. Falla, Rafael B. Osorio https://creativecommons.org/licenses/by/4.0
Inflammatory Mechanisms in Action: Unraveling Their Central Role in Atherosclerosis
Atherosclerosis is a chronic inflammatory disease of the arterial wall, characterized by the accumulation of lipid plaques that reduce blood flow. Its pathogenesis begins with endotelial dysfunction, triggered by hemodynamic stress, oxidized LDL (oxLDL) and risk factors (hypertension, smoking), which increases vascular permeability and facilitates lipid infiltration in the intima. Subsequently, innate immunity is activated: monocytes attach to the endothelium by adhesion molecules (VCAM-1/ICAM-1), migrate to the subendothelial space and differentiate into macrophages. These, when phagocytosing oxLDL through receptors (CD36, LOX-1), are transformed into foam cells, releasing pro-inflammatory cytokines (IL-1β, TNF-α, IL-6) and activating the NLRP3 inflammasome in response to cholesterol crystals or oxidative stress. This complex amplifies inflammation by processing IL-1β, perpetuating cell recruitment and plaque progression. The adaptive immune response involves T lymphocytes (Th1, Th17) and B cells, which exacerbate inflammation, while mediators such as chemokines (MCP-1) facilitate leukocyte migration. Plaque instability arises from collagen degradation (via metalloproteinases), necrotic core expansion, and defective angiogenesis, increasing the risk of ruptura and acute events (infarction, stroke). Currently, therapies seek to modulate these mechanisms through anti-inflammatory drugs (anti-IL-1β, colchicine), NLRP3 inflammasome inhibitors and microRNA regulation (miR-33) or epigenetics. This approach is crucial, given that cardiovascular complications associated with atherosclerosis are the leading cause of global death, with 1.9 million deaths annually in Latin America.
Atherosclerosis, Atherosclerotic Plaque, LDL Lipoproteins, Inflammation. Source: DeCS-BIREME
Copyright (c) 2025 Isaac Julio Diego Chinchayan Valois, Benjamín Adrián Barrenechea Varas, Sandra Mariana Crisologo Acosta, Nathaly Alexandra Castro Manrique, Ivett Medalit Cadenillas Bernal https://creativecommons.org/licenses/by/4.0
Knowledge of the preventive triad against rabies and associated factors in the Peruvian population: a cross-sectional study based on ENAPRES 2024
Introduction: Rabies remains a significant public health threat in Peru, with the canine variant predominating in urban transmission contexts. This viral disease, almost invariably fatal once symptoms appear, can be prevented through immediate wound washing with soap and water, identification of the biting animal, and timely medical care. Objective: To assess the level of knowledge about the preventive triad and its associated factors using data from the 2024 Encuesta Nacional de Programas Presupuestales (ENAPRES). Materials and Methods: The sample included 98,700 participants. Descriptive, bivariate, and logistic regression analyses were performed, accounting for the complex survey design. Results: Only 3.56% of respondents correctly identified all three components of the preventive triad. The highest levels of knowledge were observed in Arequipa, while Apurímac, Ancash, Huancavelica, and Loreto reported the lowest. In the adjusted model, higher knowledge was observed among individuals aged 45–49 years (aOR = 3.41; 95% CI: 2.85–4.07) and residents of the highlands (aOR = 1.12; 95% CI: 1.04–1.21), while it was lower in the jungle region (aOR = 0.76; 95% CI: 0.69–0.84) and in rural areas (aOR = 0.35; 95% CI: 0.32–0.38). Conclusions: These findings reveal a critical gap in basic knowledge about rabies prevention, underscoring the urgent need to strengthen health education, particularly among young and rural populations, as part of a comprehensive strategy to reduce exposure and improve responses to animal bites
Human rabies, preventive triad, knowledge, Peru. Source: DeCS-BIREME
Copyright (c) 2025 Guillermo Salvatierra, Marcelo Cardenas, Cirene Santana, Chiara Badell, Diego Montañez, Alex Yauyo, Alejandra Castro https://creativecommons.org/licenses/by/4.0
Neurophysiological and muscular mechanisms in gastrointestinal motility: implications for irritable bowel syndrome
Objective: To analyze the neurophysiological and muscular mechanisms involved in the regulation of gastrointestinal motility and their relationship with the pathophysiology of irritable bowel syndrome (IBS). Material and Methods: A narrative review was conducted through a systematic search in PubMed, Scopus, Web of Science, SciELO, Redalyc, and Google Scholar databases. Thirty-five articles published between 2015 and 2025 were identified, of which 18 met the inclusion criteria (Spanish or English language, full-text availability, and direct relation to IBS). Data were organized using standardized collection forms and analyzed narratively and descriptively. Results: The findings indicate that dysfunction of the gut–brain axis is the main pathophysiological determinant of IBS, affecting gastrointestinal motility and visceral sensitivity. Alterations in interstitial cells of Cajal and smooth muscle modify contractile patterns, while serotonin dysregulation and intestinal dysbiosis exacerbate visceral hypersensitivity. Neuroimmune–microbial interactions and glial activation contribute to the chronicity and persistence of symptoms. Conclusions: IBS is a multifactorial disorder resulting from the interplay of neurophysiological, muscular, immunological, and microbial dysfunctions. Understanding these mechanisms is essential to develop integrated therapies that modulate the gut–brain axis and restore intestinal homeostasis, thereby improving clinical management and patients’ quality of life.
Irritable bowel syndrome, gastrointestinal motility, gut–brain axis, interstitial cells of Cajal, serotonin. Source: DeCS-BIREME
Copyright (c) 2025 Teresa HURTADO LLAURI https://creativecommons.org/licenses/by/4.0
Helicobacter pylori as a Risk Factor for Gastric Cancer: A Systematic Review
Introduction: Helicobacter pylori infection is a major modifiable risk factor for gastric cancer, involved in the progression from chronic gastritis to preneoplastic lesions and carcinoma. Materials and methods: A narrative review with partial systematization was conducted. Literature searches were performed in PubMed, Scopus, SciELO, and Google Scholar using MeSH and DeCS terms related to H. pylori, gastric cancer, carcinogenesis, and eradication. A total of 137 studies were identified; 107 full-text articles were screened, and 31 were included based on predefined PICO criteria. Study selection was organized through Rayyan®. Results: Evidence indicates that H. pylori infection significantly increases gastric cancer risk, with estimates exceeding a 2.5-fold increase. Virulent strains such as cagA+ confer an even higher risk. Mechanisms implicated include chronic inflammation, atrophy, intestinal metaplasia, epigenetic alterations, and activation of oncogenic pathways. Early eradication reduces progression to preneoplastic stages and is considered a cost-effective preventive strategy. Endoscopy and emerging biomarkers provide valuable tools for surveillance of high-risk individuals. Conclusion: H. pylori plays a central role in gastric carcinogenesis. Targeted eradication and risk-based surveillance strategies are essential to reduce the burden of gastric cancer, particularly in high-incidence regions. Further longitudinal studies are required to optimize prevention and follow-up protocols.
Helicobacter pylori, Stomach Neoplasms, Carcinogenesis, Primary Prevention, Endoscopy, Digestive (Source: DeCS-BIREME)
Copyright (c) 2026 Heidy L. Villavicencio Boyer https://creativecommons.org/licenses/by/4.0
Factors associated with the indication of episiotomy in pregnant women attended at Hospital II-1
Objective: To determine the factors associated with the indication for episiotomy in pregnant women attended at the Hospital de Apoyo II-2 Sullana during 2023. Materials and Methods: A quantitative, analytical, cross-sectional study was conducted. The simple consisted of 274 pregnant women selected through simple random sampling. A data collection form based on medical records was used to analyze sociodemographic, obstetric, and neonatal variables. Statistical analysis included prevalence ratios and the Chi-square test, with a 5% significance level. Results: The frequency of episiotomy was 51.8%. A significant association was found with age under 20 years (PR=1.41; 95% CI: 1.14–1.75), nulliparity (PR=1.83; 95% CI: 1.43–2.35), second stage of labor lasting more than 60 minutes (PR=1.49; 95% CI: 1.17–1.89), and fetal weight over 3500 g (PR=1.56; 95% CI: 1.25–1.96). Conclusion: Episiotomy remains a common practice. It is significantly associated with maternal factors (age, parity), labor factors (duration of the second stage), and neonatal factors (fetal weight), highlighting the need to reinforce adherence to evidence-based practices and woman-centered care.
Episiotomy; vaginal delivery; risk factors; labor; maternal health.
Copyright (c) 2025 Mayra Fiestas Pulido, Fiestas Pulido Mayra Yesenia , Diaz Vélez Cristian https://creativecommons.org/licenses/by/4.0
Multicenter Study on Neurophobia in Health Sciences Students from Spanish-Speaking Universities
Introduction. There is scarce scientific evidence from non-capital Spanish-speaking health sciences students on neurophobia, the definition of fear of facing the neurological clinic. Objective: Our study aimed to a) assess the prevalence of neurophobia; and b) identify associated factors among health sciences students from Spanish-speaking public and private universities. Material and Method: We conducted a cross-sectional, analytical, and multicenter study on medical and physical therapy students who completed the neurology course at Peruvian, Colombian, and Mexican universities. We used "snowball" sampling and sent a virtual survey to undergraduate students via social networks (WhatsApp). Results: Our research demonstrate that 23.28% of students had neurophobia (95% CI: [19.0528.13]), had been "exposed to neurological patients" (OR 3.9, 95% CI: [2.71–5.62]) p<0.001), “came from a Colombia/Mexico university” (OR 1.53) (27.57% vs. 18%, CI [1.01-2.32], p=0.043), were all linked to a positive Schon test, while "had been performed more than 4 neurological medical histories" (RPa = 0.38; p<0.001) and coming from "a private university" (RPa = 0.61; p = 0.013) were protective factors. Conclusions: The high prevalence of neurophobia was similar to previous studies in other regions; it is necessary to perform mixed studies to understand the causes of this phenomenon, in addition to encouraging and promoting neurology as an attractive specialty.
Medical education, Neurophobia, Neurology. (Source: DeCS-BIREME)
Copyright (c) 2025 Luz M. Moyano , María José Villalta-Cunya, Fiorela Luna-Céspedes1, Noelia Morocho-Alburqueque, Thalía Tocto-Tornero, María E. Mendez, Alexa Reyes-Camac, Dayanna Dioses-Fernandez, Heydi L. Villavicencio Boyer, Percy Vilchez-Barreto, José Jaime Móvil Amaya, Vyanis V. Bolívar-Cañas , Narcisa reto Otero https://creativecommons.org/licenses/by/4.0
The Role of Physical Exercise and Physiotherapy in the Comprehensive Management of Chronic Diseases: Barriers, Evidence, and Proposals for Clinical Integration
Estimado Editor. Se ha documentado ampliamente que el ejercicio físico no solo reduce el riesgo de enfermedades cardiovasculares y cerebrovasculares, sino que también contribuye significativamente al abordaje de trastornos psicológicos y conductuales (1). De hecho, la actividad física puede superar en eficacia a ciertas intervenciones farmacológicas convencionales (2). Cuando se prescribe e implementa de forma adecuada, el ejercicio físico constituye una herramienta de gran impacto en la prevención y el manejo de enfermedades crónicas no transmisibles (3). No obstante, su integración en la práctica clínica aún enfrenta barreras importantes. Entre ellas destacan el desconocimiento de los profesionales médicos sobre los alcances de la fisioterapia, la escasa articulación interdisciplinaria, la sobrecarga laboral de los fisioterapeutas y la limitada formación en prescripción de ejercicio terapéutico (4). Tanto fisiatras como fisioterapeutas intervienen en el tratamiento de pacientes con patologías similares. Los fisiatras, médicos especialistas, integran el ejercicio terapéutico con farmacoterapia y procedimientos intervencionistas, enfocándose en el alivio del dolor, la mejora funcional y la calidad de vida del paciente (5). Por su parte, los fisioterapeutas son profesionales de salud que evalúan, planifican y ejecutan intervenciones destinadas a restaurar y optimizar el movimiento humano en los ámbitos de la promoción, prevención, tratamiento, habilitación y rehabilitación (6,7). Su participación es clave en la atención del paciente crítico (8), y todo modelo de atención a enfermedades crónicas o vinculadas al envejecimiento requiere su presencia como parte esencial del equipo multidisciplinario (9).
Copyright (c) 2025 Mesías Alberto Sánchez Vélez https://creativecommons.org/licenses/by/4.0
One Health Approach as an Integrated Strategy for the Control of Vector-Borne Diseases
Metaxenic diseases are those transmitted by vectors, such as insects or arthropods, which act as intermediaries between a host and a pathogen (1). Their transmission chain involves three essential elements: a host (generally an infected person), a vector that transmits the disease, and a biological agent, which can be a virus, bacteria, or parasite (2). Among the metaxenic diseases, malaria (transmitted by mosquitoes of the genus Anopheles) and dengue fever, considered the most prevalent viral infection transmitted by mosquitoes of the genus Aedes, stand out. Other viral diseases included are chikungunya, Zika, yellow fever, West Nile fever, Japanese encephalitis, tick-borne encephalitis, and Oropouche fever, the latter transmitted by Culicoides paraensis (3).
Copyright (c) 2025 Mauro Meza Olivera https://creativecommons.org/licenses/by/4.0
Microfotografía: Piojos y liendres, retratos de un huésped no deseado
Se presenta el caso de una paciente femenina de 8 años de edad, que acude al laboratorio con prurito intenso en la región occipital del cuero cabelludo, irritabilidad nocturna y presencia de excoriaciones secundarias al rascado. A la inspección clínica se observa infestación activa por Pediculus humanus capitis, con múltiples liendres adheridas a la base del tallo piloso. La muestra fue obtenida mediante peinado fino con peine metálico especializado, recolectando cabellos con liendres y ejemplares del parásito. Las muestras fueron colocadas en el equipo y observadas sin tratamiento adicional. Las imágenes fueron obtenidas utilizando un estereoscopio de luz reflejada a 40x de aumento, lo que permitió la observación detallada de las estructuras externas del parásito sin necesidad de cortes histológicos ni tinciones. En las imágenes se observa claramente la morfología externa de Pediculus humanus capitis, destacando el cuerpo segmentado, las patas prensiles adaptadas al anclaje en el cabello. También se visualizan liendres ovaladas, firmemente adheridas al tallo piloso por una sustancia cementante, en diferentes etapas de desarrollo.
Copyright (c) 2025 Angel Anderson Suyon Castillo https://creativecommons.org/licenses/by/4.0
Case report of Bifid Uvula in the northern coast of Peru
Introduction: The incomplete fusion of the palatal processes during pregnancy results in bifid uvula, often identified incidentally. Children predominantly observe it, and it may be associated with otologic discomfort, aneurysms, or certain genetic syndromes, requiring a thorough clinical evaluation. Its reported prevalence varies widely, ranging from 0.18% to 10.3%. The potential systemic associations further emphasize the importance of comprehensive assessment. Case Report: A 5-year-old mestizo girl with a history of recurrent throat discomfort was diagnosed with acute pharyngitis and tonsillar hypertrophy. Oral examination revealed a bifid uvula, with no additional oral anomalies. The diagnosis of isolated, non-syndromic bifid uvula was confirmed by both a gastroenterologist and an otolaryngologist. The only clinical manifestation was mild nasal speech without functional impairment, and thus, no treatment was deemed necessary. Conclusions: This case illustrates a benign anatomical variant with no clinical consequences, highlighting the importance of individualized management.
Uvula; Congenital abnormalities; Pharyngitis; Language; Child (Source: DeCS-BI- REME)
Copyright (c) 2025 Roly P. Gonzaga, Edgardo J. Carrillo, Luz M. Moyano https://creativecommons.org/licenses/by/4.0
Quality standards in university education and the public policy process in medical training, an exploratory observational study
With the aim of determining the relationship between knowledge of quality standards in higher education and the public policy process in medical training, an exploratory descriptive study was conducted to assess the level of knowledge about quality standards and the public policy process for medical training. A total of 36 participants were surveyed, including authorities and officials from the National University of Tumbes and authorities and officials from the Regional Government of Tumbes. As a result, no significant relationship was found between knowledge of quality standards and the public policy process in medical training. In conclusion, although the results regarding knowledge of the basic quality conditions reflect significant success in the training and dissemination of information about quality standards, deficiencies were identified in the components of the public policy process for medical training in the Tumbes region.
Knowledge; Undergraduate Medical Education; Public Policy. (Source: DeCS BIREME)
Copyright (c) 2025 Angel Anderson Suyon Castillo, Maria Edith Solis-Castro, Luz M. Moyano-Vidal https://creativecommons.org/licenses/by/4.0
Nutritional Status and Academic Performance of Second-Grade Primary School Students at Peru Canada Educational Institution, 20244
Introduction: Nutritional status directly influences students’ academic performance, impacting their physical and mental development. According to WHO, around 828 million people suffered from malnutrition in 2021, showing an increase compared to previous years. Globally, 99% of countries implement school feeding programs to improve academic performance. Studies such as Narayana (2021) in India confirm the relationship between good nutritional status and school performance. In Peru, challenges persist, including chronic malnutrition in Huancavelica (33%) and increasing adolescent overweight rates, affecting development and learning. Objective: To determine the relationship between nutritional status and academic performance among second-grade primary school students at I.E. 3080 Peru Canada in 2024. Material and Methods: A quantitative, descriptive, correlational, non-experimental study was conducted with 60 second-grade students. A registration form was used to assess nutritional status and academic performance using non-probabilistic sampling. Correlational analysis was performed using SPSS® v.25. Results: A significant relationship was found between nutritional status and academic performance (p=0.031). Students with poorer nutritional status had lower academic performance. Conclusion: Second-grade students at I.E. Peru Canada show a significant relationship between nutritional status and academic performance, highlighting the importance of nutrition in learning.
Academic performance, nutritional status, students. (Source: DeCS-BIREME)
Copyright (c) 2025 Steven Stiwar Tandazo Nilupú, Balgélica Antazara Cervantes Rujel , Leslie Bequed Lloclla Sorroza https://creativecommons.org/licenses/by/4.0