Christian Alberto Rodriguez-Saldaña

Introduction: GeneXpert is a revolutionary tool for tuberculosis (TB) detection, with its main advantage being its speed and accuracy in identifying the pathogen and detecting rifampicin resistance within hours. Objective: To determine the diagnostic performance of GeneXpert MTB/RIF compared with bacilloscopy for the diagnosis of pulmonary tuberculosis in adult Peruvian patients. Methods: A cross-sectional analytical study was conducted based on a review of secondary databases. The study population included patients treated at a hospital in northern Peru between 2019 and 2022 who underwent diagnostic tests for tuberculosis, such as bacilloscopy, GeneXpert, and culture. Patients with incomplete records and those with results reported as errors were excluded. Results: A total of 800 out of 1,044 samples were selected for tuberculosis diagnosis, of which 75.3% (n = 601) were positive. The median age was 43 years; 66.5% (n = 532) were men, and 22.3% (n = 178) were older adults. Culture for acid-fast bacilli (AFB) was positive in 89.5% (n = 538) of the 601 samples, while GeneXpert detected tuberculosis in 73.5% (n = 585) and bacilloscopy in 58.4% (n = 466) of 798 samples. GeneXpert showed higher sensitivity than bacilloscopy (97.9% vs. 77.4%), with almost perfect agreement with culture (kappa index = 0.847). Conclusion: These findings highlight the importance of considering GeneXpert as an effective diagnostic tool for pulmonary tuberculosis in similar settings

Background Neuropathic pain is a frequent and disabling complication of type 2 diabetes mellitus. Although poor glycemic control is known to contribute to diabetic neuropathy, its specific relationship with painful manifestations remains incompletely characterized. Objective The aim of this study was to evaluate the association between hemoglobin A1c levels and the presence of neuropathic pain in patients with type 2 diabetes mellitus. Methods A cross-sectional analytical study was conducted in 172 adults with type 2 diabetes mellitus attending outpatient clinics at a tertiary hospital in northern Peru. Neuropathic pain was assessed using the validated Spanish version of the Self-Administered Leeds Assessment of Neuropathic Symptoms and Signs questionnaire. Glycemic control was evaluated using hemoglobin A1c, analyzed both as a continuous variable and a dichotomous variable at 7%. Clinical, metabolic, and demographic variables were compared between patients with and without neuropathic pain. Associations were examined using Poisson regression with robust variance and logistic regression, estimating crude and adjusted effect measures with 95% confidence intervals. Results Neuropathic pain was identified in 50% of participants. Patients with neuropathic pain showed higher hemoglobin A1c values and a greater proportion of values equal to or above 7%. In adjusted models, elevated hemoglobin A1c levels remained independently associated with neuropathic pain, when analyzed both as a dichotomous variable and as a continuous variable. Dyslipidemia and hypertension also showed independent associations. Conclusions Higher hemoglobin A1c levels are independently associated with neuropathic pain in patients with type 2 diabetes mellitus, underscoring the importance of sustained glycemic control.

Background: Ralstonia pickettii has gained relevance in pediatric healthcare due to its persistence in water systems, biofilm formation and contamination of medical solutions. This review summarizes current evidence on its epidemiology, environ-mental reservoirs, clinical features, diagnostic limitations and therapeutic considera-tions in children. Methods: A narrative search was conducted in PubMed, Scopus, Web of Science and Embase for studies published from January 1990 to 30 November 2025. Pediatric cases, outbreak reports, environmental studies with clinical relevance and microbiological reviews were included. Heterogeneity in design and reporting justified a narrative synthesis. Results: R. pickettii is the predominant Ralstonia species in pedi-atric infections and is closely linked to contaminated aqueous products and respiratory equipment. Neonates and immunocompromised children are most affected, with man-ifestations ranging from colonization to severe sepsis. Diagnostic systems frequently misidentify the organism, and molecular tools improve accuracy when combined with clinical assessment. Susceptibility patterns are variable and influenced by intrinsic re-sistance mechanisms and biofilm. Effective treatment often requires targeted therapy and device removal. Outbreak investigations consistently identify contaminated solu-tions and water systems as primary sources. Conclusions: R. pickettii is an emerging pathogen in pediatric care. Improving diagnostic accuracy, strengthening environ-mental control and ensuring safe handling of water-based solutions and medical devices are essential to reduce its clinical impact.

Introduction: Antimicrobial resistance in uropathogenic Escherichia coli (UPEC) compromises urinary tract infection management, yet analytical evidence from northern Peru remains limited. This study evaluated demographic and clinical factors associated with resistance in UPEC isolates from a regional referral hospital. Methods: A retrospective analytical cross‐sectional study included 350 patients with monomicrobial urine cultures positive for UPEC during 2024. Resistance was defined as resistance to at least one of 19 antimicrobials. Associations were estimated using modified Poisson regression with robust variance. Results: Overall, 323 isolates (92.3%) showed resistance. The highest resistance proportions were observed for ciprofloxacin (70.9%), ceftriaxone (65.4%), ceftazidime (62.0%), and trimethoprim/sulfamethoxazole (46.3%). Age showed a significant nonlinear association with resistance ( p = 0.033). No statistically conclusive independent associations were observed for sex, prior antibiotic use, diabetes mellitus, hypertension, or obesity after adjustment. Conclusion: UPEC resistance was highly frequent and concentrated in commonly used agents, supporting local surveillance and susceptibility‐guided empirical therapy.

Background. Postoperative pulmonary complications (PPCs) are frequent and associated with increased morbidity and mortality. The ARISCAT index offers a preoperative stratification method to identify surgical patients at elevated respiratory risk. Methods. We conducted a prospective observational study in December 2024 at Hospital III-1 José Cayetano Heredia in northern Peru. Adult patients undergoing elective surgery were evaluated using the ARISCAT score and followed for 14 postoperative days. Data were collected through electronic medical records and analyzed with Stata 17. Categorical variables were summarized as frequencies, and continuous variables as medians. Binary logistic regression was used to assess the association between ARISCAT score and PPCs, adjusting for age, sex, comorbidities, surgical site, and ICU admission. The study was approved by the institutional ethics committee, and all patients provided written informed consent. Results. A total of 202 patients were included; 43% developed PPCs, mainly atelectasis and bronchospasm. The ARISCAT index showed a strong association with PPCs. Compared to the low-risk group, patients in the intermediate and high-risk categories had significantly increased odds of complications (aOR: 6.42 and 6.81, respectively; p < 0,001). Comorbidities such as diabetes, asthma, cancer, and COPD were also independently associated with PPCs, confirming the ARISCAT score’s predictive value in this population. Conclusion. The ARISCAT score is a valid tool for predicting postoperative pulmonary complications in elective surgery patients and should be integrated into preoperative assessments to improve perioperative risk stratification.

La cibercondría se ha agudizado en contextos de brotes infecciosos, como la COVID-19, y podría estar influenciada por factores locales como la endemicidad del dengue en ciertas regiones del Perú. Objetivo: Explorar la cibercondría relacionada al dengue en estudiantes de Medicina de una zona endémica del norte del Perú. Materiales y métodos: Se realizó un estudio transversal en la Universidad Nacional de Piura utilizando cuestionarios autoinformados: Escala de Severidad de Cibercondría (CSS-12) y Escala de Depresión, Ansiedad y Estrés (DASS-21). Se excluyeron estudiantes que no hayan brindado su consentimiento informado o con diagnóstico reciente de dengue. Resultados: En una muestra total de 192 participantes, la media de severidad de cibercondría fue de 27,7 ± 7,2. Variables significativas incluyeron procedencia rural (p = 0,029), pertenecer a ciclos medios de la carrera (p = 0,001), y tener altos niveles de ansiedad (p < 0,001) y estrés (p = 0,030) según la DASS-21. Los análisis multivariados revelaron que la ansiedad es un predictor significativo de la severidad de la cibercondría. Conclusión: La ansiedad es un significativo factor predictivo de severidad de cibercondría en estudiantes de Medicina que viven en zonas endémicas de dengue.

Paciente varón de 22 años que acude a emergencia de Hospital III-1 José Cayetano Heredia de Piura por presentar síntomas respiratorios agudos, se hospitaliza como Insuficiencia Respiratoria Aguda asociada a Crisis asmática moderada, Neumonía Adquirida en la Comunidad y Lupus Eritematoso Sistémico como antecedente. A lo largo de su curso hospitalario, se evidencia una interacción compleja entre el asma y las manifestaciones pulmonares del LES. Por tal motivo se planteó como diagnóstico Neumonitis lúpica, con buena respuesta a tratamiento antibiótico y pulsos de corticoides.

We present the case of a 27‐year‐old woman who ingested aluminum phosphide (AlP) in a suicide attempt, leading to severe toxic myocarditis and a transient Brugada pattern (Brugada phenocopy [BrP]) on her electrocardiogram (ECG). The initial treatment included supportive measures and management of a non‐ST elevation acute coronary syndrome. Despite the severity of her condition, the patient stabilized, with normalization of ECG findings and improvement in left ventricular function. This case highlights the importance of recognizing BrP as a potential manifestation of toxic myocarditis, especially in the context of AlP poisoning, and underscores the critical need for early intervention and appropriate management.

We present the case of a woman with a history of autoimmune hemolytic anemia (AIHA), untreated for 1 year, who presented with fever, myalgia, arthralgia, anemia, and thrombocytopenia, along with a positive nonstructural protein antigen 1 (NS1Ag) test. During the course of dengue, the patient developed severe hemolytic anemia, posing a potentially life‐threatening scenario due to the rapid decline in hemoglobin levels and the risk of multiorgan failure. Treatment with methylprednisolone was initiated alongside supportive care for dengue, and balancing corticosteroid risks in a viral infection was crucial to stabilize the patient, ultimately leading to a favorable outcome. This case highlights the importance of prompt diagnosis and integrated management of autoimmune diseases and viral coinfections in dengue‐endemic areas.

Studies have demonstrated that patients with diabetes mellitus have higher risk of developing Atrial Fibrillation compared to those without Diabetes Mellitus. The aim of this research was to identify the factors associated with AF in diabetic patients in Piura, Peru. A cross-sectional study included diabetic patients over 18 years old, treated in the internal medicine department for hospitalization, emergencies, and referrals. Conducted at a Hospital, located in Piura in northern Peru. A frequency of 50.36% of diabetic patients with AF was determined. For the adjusted model, age, alcoholism, and elevated glycosylated hemoglobin levels were considered for inclusion, in addition to gender due to biological reasoning to suspect an association with AF. Only age (Adjusted Prevalence Ratio (aPR): 0.97; 95% CI: 0.968-0.987; p-value < 0.001) and alcoholism (aPR: 1.44; 95% CI: 1.132-1.835; p-value = 0.003) were found as associated factors. Being younger and having alcoholism were significantly associated with the onset of atrial fibrillation in diabetic patients.