Objetivo: Describir las características demográficas, clínicas, laboratoriales y de tratamiento de pacientes hospitalizados por la COVID-19 y determinar los factores de riesgo de mortalidad hospitalaria. Materiales y métodos: Estudio de cohorte retrospectivo de pacientes adultos hospitalizados por la COVID-19. Se extrajeron datos demográficos, clínicos, laboratoriales y de tratamiento de las historias clínicas de pacientes que ingresaron al Hospital III Daniel Alcides Carrión de Tacna. Para el análisis de supervivencia se empleó el modelo de riesgos proporcionales de Cox y se calcularon los cocientes de riesgo instantáneos (HR) crudos y ajustados con sus respectivos intervalos de confianza al 95% (IC 95%). Resultados: Se evaluó a 351 pacientes, el 74,1% eran hombres; las comorbilidades más comunes fueron obesidad (31,6%), hipertensión (27,1%) y diabetes mellitus (24,5%). La mediana de tiempo de hospitalización fue 8 días (RIC: 4-15). El 32,9% falleció durante el seguimiento. El análisis multivariado mostró un aumento del riesgo de morir asociado a la edad ≥65 años, HR = 3,55 (IC 95%: 1,70-7,40); al incremento de lactato deshidrogenasa 720 U/L, HR = 2,08 (IC 95%: 1,34-3,22); y a la saturación de oxígeno por debajo del 90%, principalmente cuando fue menor al 80%, HR = 4,07 (IC 95%: 2,10-7,88). Además, el uso de colchicina en el tratamiento tuvo un efecto protector, HR = 0,46 (IC 95%: 0,23-0,91). Conclusiones: Los factores de riesgo de muerte por la COVID-19 incluyeron ser mayor de 65 años, tener saturación de oxígeno menor de 90% y elevación del lactato deshidrogenasa 720 U/L; el tratamiento con colchicina podría mejorar el pronóstico de los pacientes.

Objective. We aimed to describe the main demographic, clinical, laboratory and therapeutic characteristics and to identify whether they are associated with mortality in tracheostomized patients. Material and methods. Retrospective cohort study in adult patients diagnosed with COVID-19, admitted to ICU (Intensive Care Unit) and requiring tracheostomy. Demographic, clinical, laboratory and treatment data were obtained from the medical records of patients admitted to Hospital III Daniel Alcides Carrión in Tacna. The Cox proportional hazards model was used for survival analysis and hazard ratios (HR) with their 95% confidence intervals (95%CI) were calculated. Results. We evaluated 73 patients, 72.6% were men, the most common comorbidities were obesity (68.5%), type 2 diabetes mellitus (35.6%), and arterial hypertension (34.2%). Thirty-seven percent of the participants died during their stay at the ICU. The median time from intubation to tracheostomy and the duration of tracheostomy was 17 (RIC: 15-21) and 21 (RIC: 3-39) days, respectively. Multivariate analysis showed that the factors associated with mortality were procalcitonin > 0.50 ng/dL at the time of tracheostomy (HRa: 2.40 95%CI: 1.03-5.59) and a PaO2/FiO2 ratio less than or equal to 150 mmHg (HRa: 4.44 95%CI: 1.56-12.60). Conclusions. The factors associated with mortality at the time of tracheostomy were procalcitonin > 0.50 ng/dL and a PaO2/FiO2 ratio less than or equal to 150 mmHg.

A descriptive study was carried out, in which clinical and laboratory characteristics were evaluated in patients with a diagnosis of acute respiratory distress syndrome (ARDS) secondary to SARS-CoV-2 infection and who received Tocilizumab. Twentyfour patients received Tocilizumab, the majority were male (95.8%), the most frequent comorbidity was obesity (33.3%). At the time of receiving Tocilizumab the median PAO2 / FiO2 was 159.5 (IQR 114.5-255, 3). Twenty-one (87.5%) patients presented clinical improvement and 3 (12.5%) died. Fifteen patients (62.5%) developed hepatotoxicity, the majority grade 3 (33.3%) and three (12.5%) patients presented grade 4 liver injury. Eleven patients (45.8%) presented bacterial superinfection, the more common organism being Acinetobacter baumannii. After the administration of Tocilizumab, more than half of the patients presented an adverse reaction; despite this, mortality was low, and the majority had a clinical improvement.

Background: To identify the predictive factors of maternal near miss in caesarean patients in the obstetrics and gynaecology service at Hospital III Daniel Alcides Carrión, Tacna, Peru. Methods: A retrospective cohort study was conducted from 1 January 2022 to 31 December 2023. Preoperative, intraoperative and postoperative clinical and laboratory characteristics of caesarean patients hospitalized in the obstetrics and gynaecology service were analysed. Cox proportional hazards regression was used to identify predictors. Results: We identified 264 caesarean patients, of which 49 experienced maternal near miss. The mean age was 32.81±5.13 y, the median number of prenatal visits was 7 (interquartile range [IQR] 6–9) and the median gestational age was 39 weeks (IQR 37.5–40). Identified predictive factors for maternal near miss were systolic blood pressure ≥140 mmHg before caesarean (adjusted hazard ratio [aHR] 2.20), duration of the caesarean (aHR 1.02) and number of prenatal visits (aHR 0.90). Conclusions: The findings suggest that systolic hypertension before caesarean delivery, caesarean duration and number of prenatal visits are significant predictors of maternal near miss. These results underscore the importance of early prenatal care, monitoring blood pressure levels and optimizing surgical duration to improve maternal outcomes. Future research should focus on the implementation of targeted interventions based on these predictors to reduce maternal morbidity and improve health policies in low-resource settings.

Introduction: Women remain underrepresented in science despite global initiatives, necessitating context-specific analyses. Objective: To examine the scientific productivity of Peruvian female researchers in the National Register of Science, Technology and Technological Innovation (RENACYT), identifying publication levels, research fields, and factors associated with high output through a critical gender lens. Methodology: Quantitative cross-sectional study combining documentary analysis and multivariate regression of 341 researchers. Results: Only 22.3% achieved high productivity, concentrated in Medical (34%), Natural (29%), and Social Sciences (22%). Four factors showed significant association (p<0.05): ≥3 years in RENACYT (aPR=5.97), H-index≥5 (aPR=2.28), RENACYT score≥35 (aPR=2.24), and thesis supervision (aPR=1.58). Conclusion: Findings reveal structural inequalities and highlight how accumulated experience and institutional incentives shape productivity patterns, demanding gender-responsive policies to promote equitable scientific careers.

Paradoxical cerebral embolism always requires the presence of a patent foramen ovale (PFO); in our case, this event occurred due to a transient phenomenon, which was the acute overload of the right heart chambers and the opening of the PFO due to increased pressures as a consequence of massive pulmonary thromboembolism. After undergoing arthroscopy, this patient presented with visual field loss and progressive dyspnea, ultimately leading to mechanical ventilation and severe obstructive shock. An angiotomography was performed, revealing an obstructive thrombus in the right pulmonary artery. The patient successfully underwent thrombolysis, and she was discharged from the intensive care unit after 45 days. Ultimately, protein C deficiency was diagnosed, and permanent anticoagulation was initiated. The presence of motor deficit and dyspnea in a post-knee surgery patient should raise suspicion of pulmonary thromboembolism. Thrombolysis remains the treatment of choice, and it should be timely prescribed and performed. La embolia cerebral paradójica siempre requiere la presencia de foramen oval; en nuestro caso, este evento sucedió por un fenómeno temporal, el cual fue la sobrecarga aguda de cavidades derechas, y apertura de foramen oval por aumento de presiones como consecuencia de un tromboembolismo pulmonar masivo. Luego de una artroscopia, nuestra paciente presento perdida de campo visual y la disnea, esta última progresiva, hasta llegar a la ventilación mecánica, shock obstructivo grave. Se realizó una Angiotomografía, donde se evidencio un trombo obstructivo en la arterial pulmonar derecha, la paciente fue trombolisada con éxito, fue dada de alta de la unidad de cuidados intensivos luego de 45 días. Finalmente, se le diagnostico deficiencia de proteína C, fue anticoagulada de manera permanente. La presencia de déficit motor y disnea una paciente post cirugía de rodilla, debe hacer sospechar de una tromboembolia pulmonar, la trombolisis sigue siendo el tratamiento de elección, su indicación debe ser precoz.