Revista Vive

Knowledge and attitudes about HIV/AIDS among rural adolescents in Cañar, Ecuador

Sandy Bravo-Cuzco — 2025-08-28

Introduction: HIV/AIDS is a critical public health problem, with a particular impact on adolescents in rural areas, who face barriers to accessing health information and services, thereby increasing their vulnerability. Objectives: To describe knowledge and attitudes regarding prevention methods, transmission routes, information strategies and HIV/AIDS risk perception among rural adolescents Materials and methods: Cross-sectional analytical study of 151 adolescents aged 12 to 19 years in a rural community in Cañar, Ecuador, using the validated KARP-HIV/AIDS questionnaire and descriptive and inferential statistical analysis. Results: Only 50.0% had correct knowledge about HIV/AIDS, while 25.4% held misconceptions, considering physical contact as a means of transmission. Furthermore, 81.5% expressed confidence in their partner as a preventive method, 58.3% preferred to receive information from health professionals, 62.3% showed empathy towards people living with HIV/AIDS, and 35.1% did not perceive a personal risk of acquiring the infection. Discussion: The findings reveal significant gaps in knowledge, with concerning misconceptions about transmission and prevention methods. Conclusions: The findings reflect the urgent need to implement culturally adapted educational programs that correct misconceptions, strengthen preventive attitudes, and improve risk perception among rural adolescents, who are considered a highly vulnerable population for HIV/AIDS.

Clinical process management as a theoretical model for psychosocial well-being in hospital physicians

Shirley Patricia Valeriano Gurumendi — 2025-08-28

Latin American public hospitals face significant crisis in medical staff psychosocial well-being, evidenced by 62% of Ecuadorian physicians considering their workload unmanageable. Objective: To analyze the theoretical-conceptual framework of clinical process management for psychosocial risk reduction in hospital physicians. Method: Conceptual theoretical review through systematic documentary analysis of 57 scientific references specialized in health management and medical occupational well-being, published 2015-2025. Four theoretical foundations were identified: Theory of Diagnostic Uncertainty Reduction, Theory of Specific Cognitive Load, Theory of Equitable Distribution of Care Load, and Theory of Medical Professional Self-Efficacy. Results: Clinical process management is articulated through four strategies with sixteen operational components. Four causal mechanisms were identified: clinical standardization reduces diagnostic uncertainty, flow optimization decreases cognitive load, balanced management prevents overload, and quality-safety systems improve professional self-efficacy. Discussion: Theories converge demonstrating that physicians face differentiated psychosocial challenges requiring specific interventions. Conclusion: Clinical process management constitutes scientifically-based systemic intervention transcending generic administrative approaches, requiring specific conceptual frameworks for hospital medical staff.

Gross motor development in CHD8 mutation: case report of a girl with intellectual developmental disorder, autism spectrum disorder, and macrocephaly

Jesús Alberto Soto-Manrique — 2025-09-02

This case report describes the gross motor development of a 17-month-old girl diagnosed with an intellectual developmental disorder, autism, and macrocephaly, associated with a mutation in the CHD8 gene. Assessment using the Psychomotor Developmental Assessment Scale revealed psychomotor delay. In motor areas, she walked with hand support; in language and social skills, she was able to respond to verbal requests; and in coordination, she brought her hands together along the midline. These results indicate a base age of 9 months.

Factors associated with obstetric complications before and during the COVID-19 pandemic: Analysis in a referral hospital in Cajamarca

Rosa Luz Carbajal Gutierrez — 2025-09-02

The research aimed to establish an association between sociodemographic, obstetric and clinical factors with obstetric complications during pregnancy, delivery and puerperium before and during the COVID-19 pandemic in patients attended at the Regional Teaching Hospital of Cajamarca, 2019 - 2020. Materials and methods: quantitative study of non-experimental design, cross-sectional, correlational, retrospective. Two hundred medical records were analyzed. Results: in 2019, the most frequent complication during pregnancy was hypertensive diseases, which increased in 2020. During delivery, the most frequent complications were vulvo-perineal tears, uterine hypoactivity and hypertensive disorders. During the puerperium, postpartum hemorrhage increased from 10% in 2019 to 16% in 2020, and the most frequent complications were retained placenta, chorioamnionitis, and maternal sepsis. Factors significantly associated with obstetric complications (p < 0.005) in 2019 were maternal age, type of delivery, presentation dystocia, urinary tract infection, anemia, and gestational diabetes. In 2020, provenance, marital status, hypertensive disorder of pregnancy, preterm delivery, cephalo-pelvic dystocia, and obesity were added. Conclusion: Obstetric complications increased during the pandemic, with higher incidence of hypertensive disorders, postpartum hemorrhage and maternal sepsis. There was a significant association between complications with sociodemographic, obstetric and clinical factors, highlighting the need to strengthen maternal care through rigorous prenatal follow-up, early detection of risk factors and optimization of perinatal management.

Sociodemographic and clinical profile of cancer patients in Cajamarca, Peru: 2020-2024

Janner Alexis Núñez Mejía — 2025-09-02

Cancer is a public health problem in Peru, with high mortality due to late diagnosis. Objective: To describe the sociodemographic and clinical profile of cancer patients at Hospital II EsSalud Cajamarca, 2020–2024. Materials and methods: A descriptive, cross-sectional study was conducted based on the review of 464 clinical records. Sociodemographic and clinical variables were analyzed. Results: A peak of 142 cases was observed in 2023. The majority were housewives (44.2%) and farmers (19.0%), with a low educational level (primary 30.6%, secondary 25.6%). 85.3% came from the province of Cajamarca. The most frequent cancers were breast (15.5%), prostate (11.6%), colorectal (8.0%), and cervical (8.0%). Conclusions: Cancer affects vulnerable populations with limited access to preventive services. Prevention and detection strategies adapted to the region are required.

Social determinants and their influence on anemia in children under 5 years of age in urban slums of Puno, 2024

Jhosselim Vaneza Huarachi Huacantara — 2025-09-02

Childhood anemia is a critical public health problem in Puno, Peru, with significant impacts on children's physical and cognitive development. This study aimed to analyze the social determinants and their relationship with the incidence of anemia in children under 5 years of age in marginal urban areas of the city. Materials and Methods: A mixed-method study was developed, combining a longitudinal quasi-experimental design (2019-2024) and a cross-sectional analysis in a sample of 120 children. Biochemical, anthropometric, and socioeconomic data were collected through questionnaires administered to parents. Nutritional status was assessed using height-for-age and weight-for-height indicators, and Spearman's correlation analysis was applied to determine associations between social determinants and child nutrition. Results: The total prevalence of anemia was 80.7%, predominantly moderate (54.7%). A double burden of malnutrition was evident: chronic malnutrition (height/age < -2 SD) in 40.7% and acute malnutrition (weight/height < -2 SD) in 23.3%. A positive and significant association was found between social determinants (education and family economy) and nutritional status (rho = 0.350; p = 0.002). In addition, the deterioration in height/age worsened with age (p = 0.035), indicating cumulative damage. Although average hemoglobin levels improved slightly from 5.8 g/dL in 2019 to 7.2 g/dL in 2024, they remain insufficient. Conclusions: Social determinants are key factors in the persistence of childhood anemia. Targeted interventions are insufficient, highlighting the urgent need for a comprehensive multisectoral approach to mitigate this structural problem in marginal urban areas of Puno.

Strengthening cognitive skills in older adults

Vania Laura Padilla Sanchez — 2025-09-02

Aging is characterized by irreversible biological changes that include cognitive transformations. Objectives: To propose strategies for strengthening cognitive skills in older adults at the Santo Domingo de Cantumarca Productive Rehabilitation Center. Methods: Mixed propositional and descriptive study with 22 male older adults deprived of liberty. Direct non-participant observation, semi-structured interviews, Clock Test, Raven's Progressive Matrices, ACE-R-CH and Senior Apperception Technique were employed. Results: Results showed significant cognitive deterioration in 54.5% of participants according to the Clock Test. Raven's Matrices showed generalized diminished intellectual capacity. The ACE-R-CH confirmed variability in cognitive functioning with scores from severe deterioration (7 points) to normal functioning (28 points). Discussion: Deterioration is influenced by factors of age, confinement, lack of social interaction and limited family support, exacerbating the natural cognitive decline of aging. Conclusions: Implementation of psychological strategies based on cognitive approach is imperative to promote autonomy, emotional well-being and quality of life in this vulnerable population.

Jaundice and Oxytocin According to Clinical, Maternal, and Neonatal Factors. Correlational Design

Liv Jois Cortez Fuentes Rivera — 2025-09-02

Introduction: Neonatal jaundice is a common cause of hospitalization, affecting approximately 59% of full-term newborns in the Neonatology Service of the National Maternal and Perinatal Institute, Lima, Peru. Therefore, it is a priority issue in Peru. Objective: To determine the validity of regression models compared to neural network models to evaluate the relationship between oxytocin use and the presence of jaundice in newborns. Materials and methods: This study is a quantitative, observational, cross-sectional, and retrospective approach, using a case-control design. The sample consisted of 22 newborns from the National Maternal and Perinatal Institute during 2020. A bivariate analysis was performed between oxytocin use, neonatal jaundice, and independent variables for pregnant women and newborns. Results: There was no relationship between sex and neonatal jaundice (p=0.566). A significant association was found between oxytocin use and neonatal jaundice (p=0.050) at the 90% confidence level, representing a risk of OR=10.52 (95% CI: 1.52-72.8). This is consistent with the validity of the Hosmer-Lemeshow model (chi²=9.73, p=0.284, and null pseudo R²). Furthermore, the model classifies jaundice cases with an overall percentage of 66.3%, considering maternal age. Conclusions: Birth weight and oxytocin use are considered risk factors for the development of neonatal jaundice. The prevalence curve predicts that for mothers over 40 years of age, the probability of neonatal jaundice is greater than 34%.

Flexural strength of self-curing bis-acrylic resins: in-vitro study

Ariel Mauricio Jiménez Albán — 2025-09-02

This study compares the flexural strength of three self-curing bis-acrylic resins, evaluating their performance before and after undergoing thermocycling. Objective: To compare the flexural strength of three self-curing bis-acrylic resins before and after thermocycling. Methods: Ninety specimens of 25×2×2mm were equally divided into three groups: Protemp 4 (3M), PrimmaArt (FGM), and Yprov Bisacryl (Yller). Samples were fabricated using auto-mix dispensing systems in metallic molds, polished with silicon carbide, and randomly divided: 15 specimens per group underwent direct flexural testing, while another 15 were exposed to 5000 thermal cycles (5-55°C/35s) before evaluation. Three-point bending tests were performed using a universal testing machine at 1.0mm/min. Statistical analysis employed Shapiro-Wilk, t-Student, and ANOVA with Tukey post-hoc (?=0.05). Results: Before thermocycling, all groups exceeded 80MPa: PrimmaArt (148.17±1.92MPa), Protemp (140.55±2.80MPa), and Yprov (84.73±2.01MPa), showing significant differences between groups (p<0.0001). Post-thermocycling, resistance decreased significantly in all groups (p<0.0001): PrimmaArt (94.09±3.04MPa), Protemp (85.36±2.20MPa), and Yprov (43.43±2.28MPa). Conclusion: Thermocycling significantly reduced flexural strength of all evaluated bis-acrylic resins. PrimmaArt demonstrated superior resistance before and after artificial aging, while Yprov presented substandard post-thermocycling values.

Clinical and sociodemographic overview of cancer cases treated at the Cajamarca Regional Teaching Hospital in 2023

Lorena Judith Becerra Goicochea — 2025-09-02

Cancer represents a significant public health problem in Peru, with incidence and characteristics influenced by sociodemographic and structural factors. Objective: To describe the sociodemographic and clinical characteristics of patients with a diagnosis of cancer treated at the Regional Teaching Hospital of Cajamarca during the year 2023. Materials and methods: Descriptive, cross-sectional study based on the analysis of 411 clinical records of cancer patients, collected from the institutional database. Variables such as type of cancer, age, sex, education and occupation were evaluated. Results: Of the total number of patients, 55.5% were women, with gynecologic (29.7%), digestive (19.7%) and skin (12.4%) cancers being the most frequent. The highest concentration of cases was between 60 and 79 years of age. The 68.1% had at most primary education or no education, and most were housewives (59.37%) or farmers (18.98%). Cajamarca was the province with the highest number of cases (210; 52.2%), followed by San Marcos, Celandine and Hualgayoc. Conclusion: The high burden of gynecologic and digestive cancer is associated with structural factors such as low educational level, rural occupations and limited accessibility to health services. An unequal geographic distribution and a higher burden in older women were evidenced, which requires more effective preventive, educational and territorial approaches.

Impact of socioeconomic factors on academic stress among social work students, UNA Puno 2024

Cathy Ivonne Alarcón Portugal — 2025-09-02

The study on the incidence of socioeconomic factors in academic stress among students of the Professional School of Social Work at the National University of the Altiplano of Puno in 2024. Objective: to determine the relationship of these factors with the level of academic stress. Materials and Methods: it was conducted under a quantitative approach, with a hypothetical-deductive method, basic theoretical type, explanatory scope, and non-experimental cross-sectional design; the population consisted of 283 students from the first to the fifth cycle, and the stratified sample included 163 participants. Data collection was carried out through a validated questionnaire survey, and data processing employed Spearman’s Rho statistical test and the multiple linear regression model in STATA. Results: socioeconomic factors significantly affected academic stress (p = 0.000; R² = 0.98), explaining 97.99% of its variability. In particular, social factors (Rho = -0.776) and economic factors (Rho = -0.999) showed strong and significant negative correlations, indicating that lack of social support and economic limitations markedly increase the frequency of academic stress. Conclusions: it is concluded that socioeconomic factors have a decisive impact on the presence of academic stress among students, with economic and social aspects exerting the greatest influence. These findings highlight the need to design university policies and support programs that strengthen students’ socioeconomic conditions to mitigate the effects of stress on academic performance.

Comparison of maternal and neonatal outcomes in vertical and horizontal births in a Peruvian hospital

Jenny Elenisse Zavaleta Luján — 2025-09-02

The management of position during labor directly influences the maternal experience and obstetric outcomes. Objective: To compare the incidence of maternal and neonatal adverse outcomes between women who delivered in vertical versus horizontal birthing positions at the National Maternal Perinatal Institute. Methods: Analytical, observational, retrospective cohort study. A total of 304 women with singleton, term, vaginal deliveries between September and November 2022 were included, categorized into vertical (n=130) and horizontal (n=174) birth groups. Bivariate analyses and multivariate logistic regression were used to compare outcomes. Results: Women in the vertical birth group had a significantly lower rate of severe perineal tears (1,5% vs. 5,2%, p=0,041) and shorter duration of the second stage of labor (45,2 vs. 58,9 minutes, p<0,001). After adjustment, vertical position remained an independent protective factor against severe tears (Adjusted OR 0,28; 95% CI 0,09-0,89). No significant differences were observed in postpartum hemorrhage or neonatal adverse outcomes. Conclusion: In our cohort, vertical position was associated with more favorable maternal perineal outcomes, supporting its promotion as a safe option in clinical practice.

Determinants of childhood stunting in Bolivia: a national cross-sectional analysis

Ana María López-González — 2025-09-02

Objective: To analyze multifactorial determinants of stunting in Bolivian children under five years. Methods: Analytical cross-sectional study using Bolivia’s Demographic and Health Survey data. Nationally representative sample of 3,650 children aged 0-59 months. Stunting was defined as height-for-age <-2 standard deviations (WHO). Multiple logistic regression identified independent determinants. Results: Stunting prevalence was 21,4%. Main associated determinants included: rural residence (aOR=1,85), low maternal education (aOR=3,10), extreme poverty (aOR=4,50), poor access to safe water (aOR=1,60) and sanitation (aOR=1,45), short maternal stature (aOR=2,05), insufficient prenatal care (aOR=1,30), and non-exclusive breastfeeding (aOR=1,25). Conclusions: Stunting in Bolivia results from complex socioeconomic, maternal-child, and environmental factors, requiring targeted multisectoral interventions. These findings provide robust empirical evidence for implementing comprehensive strategies addressing structural vulnerabilities and promoting optimal child care practices in Bolivia’s public health context.

Bibliometric analysis of scientific knowledge on lophomonas sp infection

Blanca Estefanía Echeverría Coronel — 2025-09-02

Introduction: Infection by Lophomonas sp represents an emerging diagnostic and therapeutic challenge in respiratory medicine. Although considered rare, cases have been reported globally, especially in immunocompromised patients. Objective: To analyze global trends in scientific production on Lophomonas sp infection during the period 2000-2024 through a bibliometric study. Methodology: A bibliometric analysis was conducted using the Scopus database, with advanced search limited to articles, reviews, and letters to the editor in medicine, parasitology, and microbiology areas related to humans, published between 2000 and 2024. Data were processed using R Studio and the Bibliometrix/Biblioshiny package, analyzing annual production, geographical distribution, most productive authors, institutions, journals, and keywords. Results: Thirty-six scientific documents were identified since 2006, with an annual growth rate of 11.42 %, participation of 137 authors, and 25 % international collaboration. The years 2016 and 2021 showed higher production. Discussion: Gradual growth evidences consolidation as an emerging topic in respiratory diseases, although with less centrality compared to other pathogens. Conclusions: Lophomonas positions itself as a specialized niche topic with opportunities for interdisciplinary research and international collaboration.

Dedifferentiated liposarcoma in the retroperitoneum: A case report

Karla Alejandra Fabiani Portilla — 2025-09-02

Retroperitoneal lipomatous tumor, characterized by its high proportion of fatty tissue, is a rare condition in the medical literature, with few documented series. Frequently found incidentally through imaging techniques such as ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET), this tumor can manifest in malignant forms such as liposarcoma. Although liposarcoma is rare, it represents a considerable proportion of retroperitoneal malignancies. Primary adrenal lipomatous tumors, such as liposarcoma and hibernoma, are very unusual and poorly understood clinically. Patients usually present asymptomatic until the tumor grows significantly. Case report: We present the case of a 58-year-old man with intermittent abdominal pain in the right upper quadrant, highlighting the need for better understanding and management of these rare neoplasms. Conclusion: Adrenal lipomatous tumors, although rare and frequently found incidentally, require thorough evaluation and precise management due to their low prevalence and possible malignancy so that timely treatment can be achieved.

Epidemiological situation of monkeypox cases in Bolivia

Paola Andrea Santos Magne — 2025-09-02

The objective is to describe the epidemiological characteristics of discarded and confirmed cases of Monkeypox in Bolivia during the 2022, 2023 and 2024 administrations. Material and method: a quantitative study, observational, descriptive, cross-sectional and multicenter research type was carried out in nine cities in Bolivia from May 2022 to December 2024. The method was the documentary analysis of cases of Monkeypox, the instrument used was the epidemiological record of the Ministry of Health and Sports, and the SEDES database. Results: of 1,468 records, in 2022 there was the highest number of cases discarded and confirmed by Mpox 1,235 (84.2%), compared to other administrations, with more cases in SE36, 37 and 39, with a higher proportion for the male sex 967 (65.9%), of the age group 20 to 29 years (28.8%). The department with the highest number of cases was Santa Cruz 789 (53.7%). CENETROP processed 1088 (74.1%) laboratory reports. The isolation measure was home 882 (60.2%). 1204 negative cases and 264 positive Mpox cases were reported. The highest comorbidity was P.V.V.S 137 (9.6%). The frequent differential diagnosis was Varicela Zoster 61 (4.2%). Conclusion: after hard work by health professionals in 3 administrations, the highest number of cases was in 2022, in young men in the city of Santa Cruz, home isolation was an important measure, Bolivia presented 18% of positive cases of Mpox, it is necessary to continue with the epidemiological measure in the high-risk population.

Professional nurse's perception of professional practice in healthcare levels, Arequipa 2025

Edy Luz Condori Llasa — 2025-09-02

The quality of care from the perception of nursing professional practice constitutes a fundamental element for disciplinary development. Objective: To analyze the nurse's perception of the exercise of professional practice at different levels of care in the Arequipa department, considering dimensions of autonomy, leadership, and care. Methods: This study is qualitative with a descriptive phenomenological approach. Semi-structured interviews were conducted with 15 nursing professionals from different levels of care (primary, secondary, and tertiary) selected through intentional sampling by criteria. The collected data were analyzed using thematic content analysis with ATLAS.ti version 22 software. Results: Three main categories emerged: (1) Perceived professional autonomy with limitations due to organizational and normative factors, with greater decision-making freedom in primary care; (2) Leadership exercised mainly in team coordination, with variations depending on the level of care; (3) Comprehensive care as the central core of practice, influenced by available resources and case complexity. Participants expressed moderate satisfaction with their professional practice, identified administrative barriers, and recognized facilitators related to specialized training. Conclusions: The perception of nursing professional practice in the city of Arequipa shows disparities between levels of care, with specific needs for strengthening autonomy and leadership. These findings contribute to the development of strategies that will optimize professional practice and improve the quality of care.

Nursing research output in indexed scientific journals: an integrative review

Emilce Salamanca Ramos — 2025-09-02

Nursing research constitutes a strategic pillar for disciplinary development, care improvement, and health systems transformation. Objective: To characterize nursing scientific production in publications from journals indexed in scientific databases. Method: Descriptive integrative review including 3,798 publications from 2016-2020, identified in EBSCO, LILACS, MEDLINE, SciELO, Scopus, ClinicalKey and ScienceDirect databases, using DeCS/MeSH descriptors "Research" and "Nursing". Results: Methodological approaches were qualitative (48.07%), quantitative (39.65%) and mixed methods (6.55%). Countries with highest production: Brazil (31.62%), United States (27.08%) and United Kingdom (18.33%). Topics were grouped into nine categories: clinical care and innovation; education, ethics and communication; life cycle; policies, management and advanced practice; public and community health; mental health; occupational and environmental health; home care; and others. Conclusion: Nursing scientific production shows increasing methodological and thematic diversification, strengthening the disciplinary body and promoting evidence-based practice. Consolidation requires institutional policies, curricular integration and doctoral training with ethical approach and social relevance.

Meanings of chemotherapy for breast cancer in women from Florianópolis, Medellín, and San Luis Potosí

María Angélica Arzuaga Salazar — 2025-09-02

Breast cancer is the most common cancer among women and constitutes a public health problem, affecting individual, family, and community health. Diagnosis and treatment can have significant effects on all spheres of a woman's and her family's life. The objective of this study is to understand the meanings attributed to the chemotherapy process by women who have suffered from breast cancer in the cities of Florianópolis (Brazil), Medellín (Colombia), and San Luis Potosí (Mexico). A qualitative methodology with a phenomenological-hermeneutic approach was used. In-depth interviews were conducted with 43 women between 43 and 70 years of age, selected through snowball sampling. The results reveal that chemotherapy is experienced as a difficult, transformative, and emotionally complex process. Alopecia emerges as the most impactful symptom, affecting female identity and self-esteem. The participants redefine their life purpose, reorganize values, and develop coping strategies that include family, spiritual, and professional support. The experience generates vulnerability, an awareness of mortality, and a need for comprehensive support. It is concluded that chemotherapy profoundly transforms women's lives, and that humanized, empathetic, and person-centered care promotes resilience and the reconstruction of their sense of self.

Social actors’ perceptions of opportunities for a humanizing alliance in community nursing care

Marilyn Marivel Vila Maffare — 2025-09-02

Introduction. Care should be approached from a human perspective, focusing on the needs of vulnerable individuals and groups within the community who require assistance, while ensuring the quality of healthcare services. The objective of this study was to reveal opportunities for a humanizing alliance in community nursing care from the perspective of social actors in the canton of Esmeraldas, Ecuador. Materials and Methods. A qualitative study with a descriptive and dialectical design was conducted. Participants included six social actors and eight nurses, selected through convenience sampling and data saturation. An in-depth, semi-structured interview guide was applied. Results. The findings revealed two key categories: Category Nurses’ experiences in the field of community care, with the subcategories: Providing comprehensive care weakened by work overload that undermines humanized care and Delivering intra- and extramural nursing care with difficulty, risk, and effort; and Category Social actors’ perceptions of humanized community care, with the subcategories: Perceiving adequate and inadequate care, Perceiving human and inhuman intramural care, and Perceiving difficulties in patient care due to limited accessibility and large populations. Conclusions. The study showed that the perceptions of social actors are essential to humanized community care, ensuring that health interventions are culturally relevant, accessible, effective, and timely. Strengthening primary healthcare (PHC) with a focus on humanized care contributes to sustainable and inclusive community development.

Neuroinfection in neurosurgery by Salmonella enterica ssp enterica, a case report

María Lisseth Vera Roldán — 2025-09-02

This case report describes an invasive neuroinfection caused by Salmonella enterica ssp. enterica, with the development of a brain abscess in an adult post-neurosurgery patient. The initial clinical presentation was atypical, manifesting with neurological symptoms suggestive of a neoplastic lesion, confirmed by imaging studies. The diagnosis was confirmed after the isolation of the etiologic agent, Salmonella enterica ssp. enterica, in both blood and cerebrospinal fluid cultures. The case highlights the ability of this pathogen, commonly associated with gastroenteritis, to cause severe invasive extraintestinal diseases, even in settings not classically associated with immunosuppression. Antibiogram analysis revealed a favorable susceptibility profile, which contrasted with global multidrug resistance trends and was crucial for the success of the therapeutic approach. The patient's clinical resolution, achieved through the combination of targeted antimicrobial therapy and neurosurgical intervention to drain the abscess, underscores the importance of high clinical suspicion and timely microbiological diagnosis in the management of this rare but potentially fatal complication of salmonellosis.

Evaluation of the pertussis surveillance system: progress and challenges

Nancy Carolina Cuevas — 2025-09-02

Introduction: Whooping cough is a vaccine-preventable disease that primarily affects unvaccinated infants, representing a public health challenge that requires effective epidemiological surveillance. Objective: To evaluate the whooping cough surveillance system in Alto Paraná, Paraguay, analyzing its epidemiological behavior between 2019 and 2023. Materials and Method: A quantitative, descriptive, and cross-sectional study was conducted in two phases: the first analyzed reported cases using the Expanded Program on Immunization database; the second evaluated qualitative attributes of the system (simplicity, acceptability, and usefulness) through surveys of 110 physicians. Results: A total of 66 suspected cases were reported, with a median age of 0.5 years and a predominance in children under one year of age (68.2%); 67% were hospitalized, all had cough, and 50% had fever. The incidence was 0.5 cases per 100,000 inhabitants, higher than the national average, with vaccination coverage <80%. Ninety-two percent of physicians perceived the system as fair; usefulness was the most highly valued attribute (79%). Conclusions: The system requires strengthening active surveillance, operational simplification, and improved vaccination coverage to optimize early detection and outbreak control.

Bibliometric study on psychometric investigations of the PHQ-9 in the Scopus database

Iris Gladys Correa Aranguren — 2025-09-02

A bibliometric analysis study was conducted regarding psychometric research with the Patient Health Questionnaire, version 9 (PHQ-9). The objectives were: to identify the bibliometric characteristics of research related to psychometric studies with the PHQ-9 and to analyze the distribution of publications according to: year, author, institution, country-region, publication sources, co-citations and keyword analysis. The sample was 290 articles published in the Scopus database from 2001 to 2023 for the analysis. The search equation was: Subject = (PHQ-9) and (validity), (PHQ-9) and (reliability), (PHQ-9) and (psychometric); language (English and Spanish) and type of literature (article or review article). It was found that the journal with the highest impact was Journal of Affective Disorders and Kurt Kroenke and Scott Patten were the most productive authors. Likewise, the Autonomous University of Madrid had the largest psychometric publication of the PHQ-9; in co-authorship, three institutions produced three documents with 413 citations: Department of Medicine and Department of Psychiatry of McGill University, as well as the Lady Davis Medical Research Institute of the Jewish General Hospital of Montreal; in terms of the largest contribution to scientific research, the United States with 97 articles (33.44%)

Beyond Parkinson's: ALS with non-Guam extrapyramidal phenotype, a progressive clinical challenge

José Enrique Bombón Chico — 2025-09-02

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease characterized by the degeneration of upper and lower motor neurons. While its conventional manifestation is pyramidal in nature, atypical extrapyramidal phenotypes exist that broaden its clinical scope and challenge established diagnostic parameters. We present the case of a 64-year-old female patient initially diagnosed with parkinsonian disorder, with physical examination findings consistent with rigidity, bradykinesia, dystonic postures, and tongue fasciculations, all unresponsive to levodopa treatment. Electromyographic evaluations revealed both active and chronic denervation, while brain magnetic resonance imaging indicated generalized cortical atrophy and morphological features consistent with the "hummingbird sign" and "morning glory sign," suggesting involvement of the midbrain and pons without distinctive markers of atypical parkinsonism. The presence of signs in both upper and lower motor neurons, along with extrapyramidal symptoms, supported the diagnosis of extrapyramidal ALS in Guam. Treatment included riluzole, biperiden, and a multidisciplinary rehabilitation approach, with the goal of maintaining function and improving quality of life. This case underscores the need for a holistic clinical methodology, in which the integration of clinical findings, electromyographic data, and neuroimaging is crucial for identifying non-traditional manifestations of ALS. Recognizing these phenotypes is fundamental for refining diagnostic criteria and optimizing therapeutic strategies in a disease whose neurodegenerative spectrum continues to evolve.

Effectiveness of a culturally adapted intervention to increase adherence to colorectal cancer screening

Marco Antonio Melchor Acevedo — 2025-09-02

Introduction: Colorectal cancer (CRC) represents a serious public health problem in Latin América, especially in rural Andean populations, where significant screening gaps exist. Cultural, geographic, and socioeconomic barriers limit participation in early detection programs. Objectives: This study evaluates the effectiveness of a culturally adapted intervention to improve knowledge, attitudes, and adherence to CRC screening using the fecal immunochemical test (FIT) in a rural community in the Peruvian Andes. Methods: A quasi-experimental pre-test/post-test study with a non-equivalent control group was conducted. Participants included 450 individuals aged 50 to 74 years in Huancavelica, Peru (220 in the intervention group and 230 in the control group). The intervention included educational workshops in Quechua and Spanish, bilingual materials, and patient navigation, all based on the Health Belief Model. Results: Adherence to FIT screening increased significantly in the intervention group (28.2% vs. 6.1%, p < 0.001). There were improvements in knowledge about colorectal cancer (from 3.1 to 8.9 vs. 3.3 to 3.8) and in attitudes toward screening (from 2.5 to 4.1 vs. 2.6 to 2.8). These findings support the effectiveness of multicomponent, culturally adapted interventions in reducing health disparities. Patient navigation and bilingual materials were essential in overcoming access barriers. Conclusions: Culturally adapted interventions are effective in increasing early detection of colorectal cancer in vulnerable rural populations.

Hemineglect and motor function in patients with hemiplegia in a hospital in Callao

Jack Quispe Romero — 2025-09-02

After a stroke, hemineglect is one of the factors that affect functional recovery, limiting the patient's ability to perform activities of daily living and their independence. The objective of the research was to determine the relationship between hemineglect and motor function in patients with hemiplegia. A quantitative, applied, non-experimental, correlational cross-sectional approach was used. The Kessler Foundation Neglect Assessment Process and the Fugl-Meyer scale were applied to 40 hemiplegic patients. The results showed that the Pearson correlation coefficient was -0.401, interpreted as a moderate inverse relationship between hemineglect and motor function in patients with hemiplegia, with p<0.05, rejecting the null hypothesis and accepting the alternative hypothesis. It is concluded that there is a moderate inverse relationship between hemineglect and motor function in patients with hemiplegia, i.e., greater hemineglect is associated with lower motor function, and less hemineglect is associated with higher motor function.

Suicidal ideation in adolescents

Mariella Judith Lopez Quispe — 2025-09-02

Suicide represents a serious public health problem that is often ignored and surrounded by stigma, myths, and taboos that hinder effective intervention. This article sought to identify factors related to suicidal ideation in adolescents in order to provide evidence for the implementation of preventive strategies. The research was conducted at the Agroindustrial Secondary Educational Institution of Nicasio, in the Puno region, with a sample of 212 adolescent students, whose average age was 15.48 ± 1.45 years. A descriptive-correlational cross-sectional design was used during the months of September and October 2025. The results showed a moderate and significant correlation between suicidal ideation and three key psychological variables: stress (rho = 0.4833; P<0.01), depression (rho = 0.513; P<0.01), and anxiety (rho = 0.392; P<0.01). This association indicates that high levels of stress, depression, and anxiety significantly increase the risk of suicidal thoughts in this population group. Therefore, the importance of addressing these emotional disorders to prevent suicide in adolescents is highlighted. The findings underscore the urgent need to develop and implement psychosocial intervention programs that promote mental health within the educational setting, with a focus on prevention and psychological support. This could reduce risk factors and provide students with tools to cope with emotional difficulties in a healthy way, thereby helping to reduce the incidence of suicidal ideation.

Risk-prevention style for health in the use of insecticides in a peri-urban community of Huánuco, Peru

Nicolás Magno Fretel Quiroz — 2025-09-02

Introduction: The style of health risk prevention in the use of insecticides in Peru is relevant, as intoxication remains a major health problem among male and female farmers engaged in agricultural activities. Farmers in rural communities are influential actors in the adoption of health risk–prevention practices; therefore, assessing their knowledge is essential. Objective: To determine the style of health risk prevention in the use of insecticides among farmers in the Centro Poblado de Malconga, Huánuco–Peru. Methodology: A basic, descriptive, and prospective study was conducted with a sample of 110 farmers. A valid and reliable instrument was used, and the research was guided at all times by ethical principles. Results: Regarding the style of health risk prevention in the use of insecticides, 83.6% reported not knowing about risk-prevention practices. Based on each dimension, 76.4%, 82.7%, 81.8%, and 77.3% did not know the conceptual aspects. Conclusions: The high percentage of farmers who do not practice health risk–prevention measures highlights the need for community health nursing in Peru to promote preventive and educational activities in rural communities, including training and allocation of resources to strengthen primary prevention of intoxication, a condition that continues to claim the lives of farmers worldwide.

Simulation-based teaching methodologies in the practical learning of nursing students: a systematic review

Ivonne Maricela Yaguarema Pincay — 2025-09-02

As clinical settings have become more sophisticated, assessment and teaching strategies have been developed that involve the use of mannequins, standardized patients, and even fully immersive virtual reality. This study aimed to analyze the impact of simulation on the acquisition of practical skills by nursing students in training. A systematic review was conducted following the PRISMA methodology in the PubMed, MDPI, SciELO, and ScienceDirect databases. After removing duplicates and filtering titles, abstracts, and references, 23 studies with a total of 2,098 students were included. The results showed that the interventions consisted of high-, medium-, and low-fidelity multiplayer virtual reality simulations, structured pairs, and hybrid environments, resulting in significant improvements in clinical knowledge retention, clinical and practical skills, clinical communication, and clinical decision-making. Additionally, favorable trends were observed in personal effectiveness, overall satisfaction, leadership, collaboration, critical thinking, and work performed. The findings indicate that clinical simulation methodologies improve practical learning and essential nursing skills, recommending their permanent integration into curricula with homogeneous protocols, cost-effective evaluations, and longitudinal studies that analyze the transfer of learning to real practice.