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PubMedDate not supplied

[Epidemiological profile of epilepsy in a hospital population in Lima, Peru].

INTRODUCTION: Epilepsy is a chronic disorder with important personal and collective consequences. Its epidemiology has received widespread attention in numerous studies concerning the general population, but not in hospitals, where the population differs in the way it must be handled and followed up. AIMS: The main purpose of this study was to determine the characteristics of patients with a discharge diagnosis of epilepsy and the prevalence of the different types of epilepsy according to age groups. PATIENTS AND METHODS: We conducted a descriptive, retrospective study based on the discharge registry of 121 patients with a discharge diagnosis of epilepsy who were attended in the Neurology Unit at the Hospital Nacional Guillermo Almenara between January 2000 and December 2001. The variables obtained were age, sex, age of onset of seizures and the kind of seizures. The mean, standard deviation and variance analysis were employed, according to the type of variable used. RESULTS: The patients were between 3 and 90 years old (mean: 40.79 years), the male/female ratio was 65/56 (1.16:1). Age at onset of the seizures varied from 1 90 years (mean: 36.6). Predominance of partial seizures (52.07%), followed by generalised clonic tonic seizures (47.11%). Of the partial seizures, 33.33% were simple partial, 14.29% were complex partial and 52.38% were secondarily generalised; no significant differences were found according to age groups. CONCLUSIONS: The epidemiological profile of hospitalised patients diagnosed as suffering from epilepsy is similar to that observed in the population outside the hospital, and there are no variations from one age bracket to another. There is a need for further complementary studies to help in the development of a correct classification.

Adolescent↗
PubMed2004

Diagnostic and clinical implications of response to tuberculin in two ethnically distinct populations from Peru and Cambodia.

BACKGROUND: Proper interpretation of the tuberculin skin test (TST) requires knowledge about prior vaccination with BCG and the results of epidemiological studies with the test. DESIGN: A TST survey was performed in patients with pulmonary tuberculosis (PTB) in two ethnically distinct populations from Cambodia and the Peruvian Andes. We examined interferon-gamma (IFN-gamma) production in whole blood cultures stimulated by ESAT-6, a Mycobacterium tuberculosis specific antigen in tuberculin-positive BCG-vaccinated Peruvians with no history of PTB. RESULTS: Of the 81 Peruvian PTB patients tested, none had a skin response to tuberculin that was <10 mm, whereas 98 of 364 Cambodian PTB patients (37%) did. Furthermore, TST skin reaction sizes were significantly larger in Peruvian (21.69+/-5.46 mm) than Cambodian patients (11.42+/-7.74 mm; P < 0.0001). IFN-gamma production in response to ESAT-6 correlated with a TST reaction size >15 mm indicating previous infection with M. tuberculosis (kappa coefficient of agreement 0.66; 95%CI 0.29-1). CONCLUSION: Ethnicity is an important factor in the interpretation of TST results in both BCG-vaccinated and non-vaccinated individuals. A negative TST appears to be a useful indicator to rule out tuberculosis infection in Peruvians of Quechua origin.

Adult↗
PubMed2004

Peru.

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Adolescent↗
PubMedDate not supplied

[Gastric Cancer in Early Stage: study of 371 lesions in 340 patients in the E. Rebagliati National, Lima-Peru].

The first concrete description of the Gastric Cancer in Early Stage is attributed to the German, M. Versé in 1903, in his book Die Histogenese der Schleimhautcarcinome, but the first to use the term, was the French, Bayle in 1833, calling it First Stage Gastric Cancer. From 1963 to 2002, 5118 gastric cancers were histologically diagnosed, in our hospital from which 2337 (46%) were resected in 340 of the resected specimens, 371 early gastric cancers (EGC) (15.87%) were found. DISTRIBUTION: For every five periods, the number and proportion of early cancers increases, from 10 (6.8%) in the first five years to 78 (21.0%) in the last one. AGE: The average is: 64 years old for men and 58 for women with a global average of 61 years old. The youngest case was in a woman of 23 years old. The oldest case in men was 93 years old, and in women, 81 years old. SEX: 235 males and 105 females, with a ratio of 2,2:1. MACROSCOPY: elevated type: Type l 70 (18.9%) Ila 66 (17.8%) Ila+Ilc 26 (7.0%) lla+l 1 (0.3%) I+lla 0 (0.0) IIa+III 1 (0.3%) IIa+IIb 1 (0.3%). Global average of the elevated type: 44.6%. SUPERFICIAL TYPE: llb 17 (4.6%), DEPRESSED TYPE: llb+llc 10 (2.7%), llc 127 (34.2%), llc+l 0 (0.0%) llc+lll 43 (11.6%) lll 3 (0.8%) lll+llc 5 (1.3%) llc+lla 1 (0.3%) lla+llb 0 (0.0%). The global average of the depressed type is: 50.9%. LOCATION: Antrum 171 (46.1%) body 138 (37.3%) bottom 46 (12.3%) antrum-body 12 (3%) and body-bottom 3 (1%). SIZE: Maximum 90 mm, minimum 1.5 mm, average 24.9 mm; 25 (8%) diminute (microcarcinomas), 58 (21%) small. HISTOLOGY: Differentiated 219 (64%) undifferentiated 121 (36%). Degree of differentiation in men 74% and in women 26%. Degree of differentiation in diminutes 92%, in small 79% and in large 69%. DEPTH: 204(55%) in mucous, 167(45%) in mucous/submucous. In differentiated 182 (63%) in mucous, 108 (37%) in mucous/submucous. GANGLION METASTASIS: In the 187 located in mucous, 13 (3.8%) were positive, in the 153 located in mucous/submucous 30 (8.8%) were positive. Global percentage of positive ganglions: 12.3%. SYNCHRONIC LESIONS: General in synchronic lesions in 54.6% in other types of cancer 12.7%. INTESTINAL METAPLASIA: Present in 65%, of which 50% of them were uncompleted. SYMPTOMS AND SIGNS: Dyspepsia 82.2%, hyperoxia 32.9%, loss of weight 23.3%, non-characteristic pain 23.3%, ulcer pain 20.5%, melena 8.2%, anemia 7.7%, diarrhea and/or constipation 7.4%, vomiting 2.2%, hematemesis 1.9%. BLOOD TYPE: O (63.2%) A (24.7%) B (11.3%) AB (0.6%). GASTRIC SECRETION: This was determined in 70 patients: In 55 with ulcer, none showed achlorhydria 0%, 20 (36%) hypochlorhydria, 20 (36%) normochlorhydria and 15 (28%) hyperacidity. In 16 in an elevated form 13 (87.5%) with achlorhydria, 1 (6.5%) with hypochlorhydria, 1 (6.5%) with normal acidity. Average in ulcerated cases DAB 3.04 +/- 1.25 mEqh and DAM 12.31 +/- 8.00. In elevated cases: DAB 0.89 +/- 0.32 and DAM 2.20 +/- 0.95 mEqh.

Adult↗
PubMed2005

Taeniasis and cysticercosis in housemaids working in affluent neighborhoods in Lima, Peru.

Taenia solium taeniasis/cysticercosis is endemic in most developing countries, where it is an important cause of epileptic seizures and other neurologic symptoms. In industrialized countries, cysticercosis results from travel or immigration of tapeworm carriers from endemic areas. In both endemic and nonendemic countries, housemaids commonly immigrate from cysticercosis-endemic areas and can transmit the infection if they carry the adult tapeworm. Between July 2001 and July 2002, 1,178 housemaids (961 of them work in the top five most affluent districts of Lima, a metropolis of 8 million inhabitants considered nonendemic for cysticercosis) were evaluated for serum antibodies to Taenia solium and stool microscopy for taeniasis and cysticercosis. The serosurvey revealed a prevalence of cysticercosis-specific antibodies of 14.6% (95% CI: 12.6-16.6%), and stool microscopy detected 12 T. solium tapeworm carriers, for a prevalence of taeniasis of 1.2% (95% CI: 0.6-1.8%). A nonrandom sample of 26 seropositive housemaids was examined by brain CT and 50% of them had brain lesions compatible with neurocysticercosis, mainly calcifications. From the families who used a tapeworm-carrier housemaid, cysticercosis antibodies were detected in 6 (23%) of 26 persons who agreed to participate. One seropositive member of the employer families was symptomatic for seizures and had brain calcifications. The prevalence of tapeworm infections in this housemaid group is similar to levels in endemic areas, constituting a source of neurocysticercosis infection.

Adolescent↗