Revista Médica de Trujillo

Heart failure secondary to levantinib. An atypical event: Case Report

2025-10-05T17:24:03+00:00

En este reporte, presentamos el caso de una paciente de 73 años con carcinoma papilar infiltrante de tiroides tratada con lenvatinib, quien desarrolló insuficiencia cardíaca secundaria al fármaco. Inicialmente, presentó disnea progresiva sin antecedentes cardiovasculares previos. La evaluación ecocardiográfica mostró una fracción de eyección reducida al 40%, lo que, junto con la temporalidad de los síntomas, llevó a sospechar cardiotoxicidad inducida por lenvatinib. Se aplicó el algoritmo de Naranjo, estableciendo una relación probable. Se suspendió el fármaco e inició manejo con diuréticos, betabloqueadores e inhibidores del sistema renina-angiotensina, logrando mejoría clínica con recuperación parcial de la fracción de eyección al 50% y normalización del proBNP. Este caso subraya la necesidad de vigilancia cardiovascular en pacientes bajo terapia con inhibidores de tirosina quinasa, destacando la importancia de una detección temprana y el ajuste oportuno del tratamiento para prevenir complicaciones graves.

Multisystem tuberculosis in an immunocompetent patient with lymph node and pleuropulmonary involvement: Case Report

2025-10-05T22:26:57+00:00

La tuberculosis (TB) multisistémica, frecuentemente debido a la diseminación de Mycobacterium tuberculosis por vía linfohematógena durante la infección primaria y postprimaria, es una enfermedad rara en pacientes inmunocompetentes. Presentamos el caso de una paciente femenina de 29 años con diagnóstico de TB ganglionar en tratamiento que acude al servicio de emergencia del Hospital Regional Docente de Trujillo (HRDT) por presentar sintomatología compatible con TB pulmonar y pleural. El objetivo de este artículo es presentar el caso por su inusual evolución y exámenes de laboratorio que demuestran inmunocompetencia de la paciente a pesar de la presentación clínica.

Impact of medical prescription on the proper use of medications in patients of the Trujillo Regional Teaching Hospital 2023

2025-10-04T22:55:34+00:00

Objetive: To determine the relationship between medical prescription and drug use in patients of the Regional Teaching Hospital of Trujillo. Methods: Quantitative, non-experimental, descriptive-correlational study. A total of 302 prescriptions of SIS patients attended in the hospitalization pharmacy were evaluated by means of structured questionnaires and data collection, contrasted with the WHO indicators of rational drug use. Results: The level of medical prescription was good in 41.39%, fair in 34.77% and poor in 23.84%. Medication use was adequate in 57.62% and inadequate in 42.38%. Conclusion: Medical prescription is significantly related to the use of medications in hospitalized patients affiliated to the Comprehensive Health Insurance in the study hospital.

Clinical and radiographic effectiveness of two filling pastes for pulpectomy in primary molars with necrotic pulp

2025-10-04T23:23:41+00:00

Objetive: To compare the effectiveness of two filling pastes METAPEX ® and MCM chemotherapy paste in the treatment of primary molars with necrotic pulp. Methods: A controlled clinical trial with paired data was conducted in 29 six-year-old patients diagnosed with necrotic pulp in their mandibular first primary molars. The children were treated with two molars with necrotic pulp. Two study groups were established: Group A, molars filled with METAPEX, and Group B, molars filled with MCM antibiotic paste. The children received treatment with one technique per session and were subsequently restored with a glass ionomer restorative (Ketac Molar Eaxymix®). These were evaluated clinically and radiographically over time under certain parameters to determine their effectiveness. Results: When comparing the clinical and radiographic effectiveness between the METAPEX and MCM pulpectomy filling pastes, the values indicate that there is no significant difference between them p>0.05 Conclusion: Multibiotic paste (MCM) is highly effective in the treatment of patients diagnosed with pulp necrosis.

Identification methods and susceptibility of Candida spp. isolates in patients with COVID-19: Narrative review

2025-04-25T03:56:46+00:00

Objetive: This integrative review with a descriptive approach aimed to describe the available scientific information on the methods of antifungal identification and susceptibility used to characterize Candida isolates from blood cultures in patients diagnosed with COVID-19. Methods: A systematic search of primary publications was conducted in databases including MEDLINE/PubMed and the Cochrane Library. Specific inclusion and exclusion criteria were established to select studies conducted between 2020 and 2023. Case reports and series, as well as retrospective and prospective analytical studies, were included to describe molecular methods for the identification of Candida species, antifungal susceptibility testing, and the assessment of clonality and resistance genes. Our review process was based on the Whittemore and Knafl model. Results: A total of 446 studies were identified, of which 18 met the criteria for detailed analysis. These studies were evaluated for their level of evidence and quality, and relevant information was extracted regarding the microbiological characterization of Candida isolates and their relationship with COVID-19 coinfection. The studies employed a variety of methodologies, including proteomic and molecular identification techniques, and reported multidrug-resistant Candida isolates, particularly Candida auris. Conclusion: This integrative review provided insights into the species identification, susceptibility, and antifungal resistance genes associated with Candida isolates in patients diagnosed with COVID-19, highlighting the importance of a multidisciplinary approach to address this emerging clinical issue.

Peruvian medical education in the age of artificial intelligence

2025-10-04T22:26:36+00:00