Revista Peruana de Medicina de Experimental y Salud Publica最新文献

{"title":"Bullous pemphigoid associated with vildagliptin in an elderly adult with diabetes mellitus. First case in Peru.","authors":"Marcio Concepción-Zavaleta, Cristian D Armas, Juan Eduardo Quiroz-Aldave, Janet Ángeles-Zavaleta, María Del Carmen Durand-Vásquez, José Paz-Ibarra, Janneth Y Quispe-Meza, Luis Concepción-Urteaga","doi":"10.17843/rpmesp.2025.421.13871","DOIUrl":"https://doi.org/10.17843/rpmesp.2025.421.13871","url":null,"abstract":"<p><p>Vildagliptin, a dipeptidyl peptidase-4 inhibitor (DPP-4i) used in the treatment of type 2 diabetes mellitus (DM2), stands out for its safety in older adults. However, it is associated with adverse reactions, such as bullous pemphigoid (BP), although no cases have been documented in Peru to date. We report the case of a 76-year-old male patient with hypertension and DM2 who started treatment with vildagliptin and metformin. After one month, he presented pruritic, bullous and ulcerated skin lesions, leading to the diagnosis of BP. BP, associated with DPP-4i, mainly affects older adults, manifesting on average about 9 months after the start of treatment. Its diagnosis is based on clinical criteria, histopathology and immunofluorescence. Treatment includes discontinuation of the drug and the use of corticosteroids. Vildagliptin, although safe and effective, can cause BP, which requires timely diagnosis and treatment due to its high mortality.</p>","PeriodicalId":53651,"journal":{"name":"Revista Peruana de Medicina de Experimental y Salud Publica","volume":"42 1","pages":"97-101"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crisis and uncertainty in global health.","authors":"Marcos Cueto","doi":"10.17843/rpmesp.2025.421.14784","DOIUrl":"https://doi.org/10.17843/rpmesp.2025.421.14784","url":null,"abstract":"","PeriodicalId":53651,"journal":{"name":"Revista Peruana de Medicina de Experimental y Salud Publica","volume":"42 1","pages":"4-5"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic performance of Ziehl-Neelsen staining and Auramine-Rhodamine staining techniques in the detection of pulmonary and extrapulmonary tuberculosis.","authors":"Gustavo Tapia-Sequeiros, Miguel Hueda-Zavaleta, Juan Carlos Gómez de la Torre, Arantsa Hernandez-Vargas, Claudia Barletta-Carrillo, Cinthya Flores, Cristian Piscoche, Cecilia Miranda, Ada Mendoza","doi":"10.17843/rpmesp.2025.421.14062","DOIUrl":"https://doi.org/10.17843/rpmesp.2025.421.14062","url":null,"abstract":"<p><strong>Background: </strong>Motivation for the study. Peru has a high prevalence of tuberculosis, therefore, it is necessary to use diagnostic methods with high sensitivity and specificity to adequately identify cases and provide timely treatment. Main findings. Our results indicate that, when comparing the smear microscopy techniques commonly used in Peru with the molecular tests recommended by the WHO, direct microscopy techniques show low sensitivity, less than 50%, but high specificity, greater than 95%. Implications for public health. It is necessary to evaluate the implementation and associated costs of new rapid diagnostic alternatives that have adequate capacity to identify the majority of tuberculosis cases.</p><p><strong>Objective.: </strong>To determine the diagnostic performance of Ziehl-Neelsen and Auramine-Rhodamine staining for pulmonary and extrapulmonary tuberculosis.</p><p><strong>Materials and methods.: </strong>This was a cross-sectional diagnostic test study. We used a database of processed samples from patients with suspected pulmonary and extrapulmonary tuberculosis in a private laboratory in Peru between 2011 and 2022. Ziehl-Neelsen staining and Auramine-Rhodamine staining were the index tests. The reference tests were Xpert MTB/RIF and Xpert Ultra. The receiver operating characteristics and area under the curve (AUC/ROC) were calculated to determine the diagnostic performance of each staining technique.</p><p><strong>Results.: </strong>We analyzed 908 samples processed by Ziehl-Neelsen staining and 623 samples by Auramine-Rhodamine staining, most were lung tissue samples. Using the Xpert MTB/RIF as a reference test, the Ziehl-Neelsen staining obtained an AUC=0.72, a sensitivity of 44.2% and specificity of 99.3%; and Auramine-Rhodamine staining showed an AUC=0.73, a sensitivity of 46.8% and specificity of 100%. Considering the Xpert Ultra test as a reference, the diagnostic performance for Ziehl-Neelsen showed an AUC=0.63 with a sensitivity of 26.9% and specificity of 98.5%; and an AUC=0.64 with a sensitivity of 30% and specificity of 98.2% for the Auramine-Rhodamine staining.</p><p><strong>Conclusion.: </strong>The diagnostic performance for both staining techniques is fair, and decreases when taking Xpert Ultra as a reference. New diagnostic alternatives with adequate performance are needed to detect tuberculosis.</p>","PeriodicalId":53651,"journal":{"name":"Revista Peruana de Medicina de Experimental y Salud Publica","volume":"42 1","pages":"37-45"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with childhood chronic malnutrition during the first 12 months of life in children from a peruvian cohort.","authors":"Bladimir Morales-Cahuancama, Elena Gonzales-Achuy, Gilmer Solis-Sánchez, Cinthia Quispe-Gala, William Bautista-Olortegui, Gabriela Santos-Antonio, Paúl Hinojosa, Juan Pablo Aparco","doi":"10.17843/rpmesp.2025.421.13662","DOIUrl":"https://doi.org/10.17843/rpmesp.2025.421.13662","url":null,"abstract":"<p><strong>Backgroud: </strong>Motivation for the study. Chronic child malnutrition (CCM) remains a critical problem, especially in regions such as Huancavelica and Loreto. The specific factors that affect children during their first year of life are not fully understood, in spite of existing programs aimed at this issue. Main findings. Being male, bottle feeding, and using polluting fuels were identified as factors that increase the risk of CCM, while attending six or more prenatal checkups and receiving support from the JUNTOS program help prevent it. Factors such as maternal language and limited maternal participation also play a role. Implications for public health. These findings highlight the need for policies that strengthen prenatal care, promote healthy feeding practices, and empower mothers in decision-making.</p><p><strong>Objective.: </strong>To determine the factors associated with chronic child malnutrition (CCM) in two Peruvian regions: Huancavelica and Loreto.</p><p><strong>Materials and methods.: </strong>We analyzed four repeated cross-sectional evaluations nested in a prospective cohort of children treated in primary healthcare facilities. Data was collected on the characteristics of the child, the mother and the household, including anthropometric information, breastfeeding, complementary feeding, and socioeconomic conditions. A generalized linear model was used to calculate the prevalence ratios (PR) for each of the four quarterly evaluations of the cohort (3rd, 6th, 9th and 12th months).</p><p><strong>Results.: </strong>Factors such as male sex, bottle feeding and the use of polluting fuels were associated with a higher risk of CCM, on the other hand, having six or more prenatal check-ups and being a beneficiary of the JUNTOS program acted as protective factors. Mothers who did not speak Spanish as their native language, who worked or studied, or who had limited participation in family decisions, were also at higher risk of CCM. In addition, we identified unexpected associations, such as food insecurity acting as a protective factor, reflecting possible biases or confounding effects.</p><p><strong>Conclusions.: </strong>Our findings highlight the importance of addressing inequalities in prenatal care, dietary practices, and mothers' participation in household decision-making to prevent CCM in vulnerable contexts.</p>","PeriodicalId":53651,"journal":{"name":"Revista Peruana de Medicina de Experimental y Salud Publica","volume":"42 1","pages":"14-27"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and microbiological characteristics of pediatric patients hospitalized for pneumococcal pneumonia before and after the introduction of pneumococcal conjugate vaccines.","authors":"Carolina A Gomez, Brayan E Gonzales, Roger A Hernández, Francisco Campos, Eduardo Chaparro, Olguita Del Águila, María E Castillo, Andrés Saenz, Isabel Reyes, Theresa J Ochoa","doi":"10.17843/rpmesp.2025.421.13847","DOIUrl":"https://doi.org/10.17843/rpmesp.2025.421.13847","url":null,"abstract":"<p><p>The clinical and microbiological characteristics of pneumococcal pneumonia in children hospitalized in Lima were analyzed, before and after the introduction of pneumococcal conjugate vaccines (PCV). We reviewed cases that occurred between 2006-2019, in the pre-PCV7 (2006-2008), post-PCV7 (2009-2011) and post-PCV13 (2016-2019) periods. Of 128 patients with positive cultures (92 blood and 36 pleural fluid), most were infants in the pre-PCV7 (77.1%) and post-PCV7 (43.3%) studies, while in the post-PCV13 study they were mostly preschoolers (62%). We found an increase in complicated pneumonia cases from 14.6% to 72% and an increase in serotype 19A (6.3% to 68%). The most frequent sequence type was ST320 (31 isolates). Resistance to penicillin and ceftriaxone was low (6% and 2%, respectively), although higher in empyema (21.4% and 14.3%, respectively). Resistance to azithromycin increased from 27% to 92%. Penicillin remains the antibiotic of choice for the treatment of uncomplicated pneumococcal pneumonia in Lima. Motivation for the study. Although studies on invasive pneumococcal disease have been conducted in Lima, the characteristics of pneumococcal pneumonia before and after the introduction of pneumococcal conjugate vaccines are unknown. Main findings. We found an increase in complicated pneumococcal pneumonia cases, particularly empyema and an increase in serotype 19A. Resistance to penicillin and ceftriaxone was found to be low; however, in cases of empyema, antibiotic resistance was higher. Public health implications. Penicillin or amoxicillin should continue to be prescribed for the empirical management of pneumococcal pneumonia; however, ceftriaxone is recommended for cases with empyema. Continued local monitoring of pneumococcal resistance and serotypes is recommended.</p>","PeriodicalId":53651,"journal":{"name":"Revista Peruana de Medicina de Experimental y Salud Publica","volume":"42 1","pages":"63-69"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of policies restricting advertising, promotion, and sponsorship of sugar-sweetened beverages: A systematic review.","authors":"Leila Guarnieri, Lucas Perelli, Marcos Clausen, Germán Guaresti, Natalia Espinola, Andrea Graciano, Andrea Alcaraz","doi":"10.17843/rpmesp.2025.421.14023","DOIUrl":"https://doi.org/10.17843/rpmesp.2025.421.14023","url":null,"abstract":"<p><strong>Background: </strong>Motivation for the study. Restrictions on advertising, promotion, and sponsorship (APS) of unhealthy food and beverage products aim to reduce their consumption and protect public health. No reviews have yet evaluated the impact of restricting APS of sugary drinks (SD). Main findings. We found that comprehensive policies that include TV advertising restrictions, as well as restrictions at points of sale and in schools, can effectively reduce SD consumption, especially among children and adolescents, decrease obesity, cardiovascular disease, diabetes, and cancer, and generate economic benefits. Implications. Evidence on the health impact of such interventions is essential to promote effective measures.</p><p><strong>Objectives.: </strong>To summarize the evidence on the impact of the implementation of the ban on the advertising, promotion and sponsorship (APS) of sugar-sweetened beverages (SSBs) in terms of decreased consumption, advertising exposure and relevant clinical outcomes.</p><p><strong>Materials and methods.: </strong>Systematic review of articles published between 2001-2021 in the PubMed, Embase, Global Health, CINAHL and LILACS databases written in English, Portuguese or Spanish. We included experimental, observational and economic model studies. Risk of bias was assessed using RoB2, Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies, Quality Assessment Tool for Before-After (Pre-Post) Studies With No Control Group and Consolidated Health Economic Evaluation Reporting Standards 2022. We carried out a descriptive synthesis of the studies.</p><p><strong>Results.: </strong>We selected 11 out of 1146 identified studies. Due to the heterogeneity of the outcomes, it was not possible to conduct a meta-analysis. The interventions corresponded to a comprehensive policy; restrictions on television advertising, promotions, point-of-sale advertising and advertising in schools. We found changes in clinical outcomes (obesity, cardiovascular disease, diabetes, cancer), economic outcomes (purchase, sale, cost-effectiveness, other economic outcomes), exposure and consumption. Most of the effect measures decreased as a result of the interventions. More studies on effectively implemented policies are still needed. The results of the included studies should be interpreted taking into account their methodological limitations.</p><p><strong>Conclusions.: </strong>Policies to restrict the APS of SSBs may be effective, particularly in reducing their consumption in children and adolescents, with a positive impact on their health.</p>","PeriodicalId":53651,"journal":{"name":"Revista Peruana de Medicina de Experimental y Salud Publica","volume":"42 1","pages":"28-36"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional content of vitamin and mineral supplements aimed at children in the peruvian market: analysis of compliance with recommendations.","authors":"Lorena Saavedra-Garcia, Anna Magdalena Gawlas, Antonella Quiroz-Macukachi, Hans Genmayel Donayre-Huamán, Raquel Idelsa Basurco-Olazabal, Jamee Guerra Valencia","doi":"10.17843/rpmesp.2025.421.14256","DOIUrl":"https://doi.org/10.17843/rpmesp.2025.421.14256","url":null,"abstract":"<p><p>We described the nutritional content of vitamin and mineral dietary supplements for children on the Peruvian market and their compliance to the recommended dietary intake. A cross-sectional study was carried out with the information declared on the packaging of 34 products sold in pharmacies during 2022. The daily doses of each micronutrient were calculated according to the manufacturer's instructions; we also estimated the compliance with the recommended dietary allowance (RDA) and the tolerable upper intake level (UL) by age group. The most common micronutrients were vitamins C (n=23), D (n=22), A (n=16), zinc (n=15) and B6 (n=14). In all groups, vitamin D, thiamine, riboflavin, folate, vitamin B12 and vitamin C exceeded the RDA. Zinc and copper also exceeded the recommendations in some groups. Vitamin A and folate most frequently exceeded the UL. Our findings highlight the need for greater health surveillance.</p>","PeriodicalId":53651,"journal":{"name":"Revista Peruana de Medicina de Experimental y Salud Publica","volume":"42 1","pages":"82-87"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the ability to predict complications of the Risk Factor Scale for Pre-eclampsia Complications and the fullPIERS scale in pregnant women in a Hospital in Lima, Peru.","authors":"Patricia N Aquino-Vásquez, Luis Gm Chuquipoma-Zanabria, Maria Lazo-Porras, Mónica Flores-Noriega","doi":"10.17843/rpmesp.2025.421.14041","DOIUrl":"https://doi.org/10.17843/rpmesp.2025.421.14041","url":null,"abstract":"<p><strong>Objectives.: </strong>To evaluate the ability of the Risk Factor Scale for Preeclampsia Complications (RFSPC) and the fullPIERS (Pre-eclampsia Integrated Estimate of RiSk) scale to predict complications of preeclampsia in pregnant women diagnosed with preeclampsia who were admitted to the obstetrics and gynecology department of a referral hospital, from October 2021 to December 2022.</p><p><strong>Materials and methods.: </strong>This was a retrospective cohort design study. Data was collected from the medical records of patients diagnosed with preeclampsia, and both scales (RFSPC and fullPIERS) were applied. With these results, the sensitivity, specificity and the area under the ROC curve (AUC) were obtained by taking different cut-off points. The best score was selected as the one with the highest AUC. The differences between the scales were explored by comparing their AUCs.</p><p><strong>Results.: </strong>We included 367 pregnant women. The RFSPC had a sensitivity of 71%, a specificity of 73% and an AUC of 0.722 with a cutoff point of 3 points. Whereas the fullPIERS scale showed 76%, 84% and 0.804 respectively with a cutoff point of 0.75%.</p><p><strong>Conclusions.: </strong>Both scales can be useful for identifying pregnant women at risk of complications with cutoff points different from those defined internationally.</p>","PeriodicalId":53651,"journal":{"name":"Revista Peruana de Medicina de Experimental y Salud Publica","volume":"42 1","pages":"46-53"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of Streptococcus pneumoniae in sterile liquids using real-time PCR (qPCR) in hospitalized patients with suspected invasive pneumococcal disease.","authors":"Brayan E Gonzales, Erik H Mercado, Marcela Lopez-Briceño, David Durand Vara, Francisco Campos, Eduardo Chaparro, Olguita Del Águila, María E Castillo, Andrés Saenz, Isabel Reyes, Roger Hernandez, Theresa J Ochoa","doi":"10.17843/rpmesp.2025.421.14390","DOIUrl":"https://doi.org/10.17843/rpmesp.2025.421.14390","url":null,"abstract":"<p><p>The standard for diagnosing invasive pneumococcal disease (IPD) is to isolate pneumococcus in culture. However, the etiological agent cannot be identified in some patients, especially those who received empirical antibiotic therapy. This study aimed to detect pneumococcus in normally sterile fluids by qPCR in patients with suspected IPD hospitalized in Lima. qPCR had a detection limit of 1.2 x 101 genome copies/uL. Of the 71 clinical samples (51 were pleural fluid [PF] and 20 were cerebrospinal fluid [CSF]), 29.4% (28/71) were positive for pneumococcus by culture and 71.8% (51/71) were positive by qPCR, including 78.4% (40/51) in PF and 55.0% (11/20) in CSF. Of the positive samples, 13/51 were serotype 19A. The detection of pneumococcus was almost double by qPCR compared to the conventional microbiological method. Therefore, molecular methods such as qPCR should be implemented to improve the identification and timely treatment of IPD in Peru and in the region. Motivation for the study. Invasive pneumococcal disease (IPD) is usually diagnosed by microbiological culture to detect pneumococcus. However, this is sometimes not possible, particularly in patients who have previously received antibiotics. This study sought to detect pneumococcus using a molecular technique such as qPCR in hospitalized patients in Lima with suspected IPD. Main findings. qPCR detected a higher frequency of pneumococcus than the standard microbiological technique. Implications for public health. These findings suggest that the implementation of qPCR could significantly improve the identification and treatment of IPD in Peru.</p>","PeriodicalId":53651,"journal":{"name":"Revista Peruana de Medicina de Experimental y Salud Publica","volume":"42 1","pages":"70-75"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary adrenal insufficiency and systemic tuberculosis in a 10-year-old boy: case report.","authors":"Sandra Schult-Montoya, Felipe Ricardo Lindo-Pérez","doi":"10.17843/rpmesp.2025.421.14092","DOIUrl":"https://doi.org/10.17843/rpmesp.2025.421.14092","url":null,"abstract":"<p><p>Primary adrenal insufficiency is the result of impaired steroid synthesis, adrenal destruction or abnormal development of the adrenal gland affecting the adrenal cortex. Tuberculosis is one of the main causes in developing countries. We present the case of a 10-year-old male patient diagnosed with adrenal insufficiency two years earlier with regular treatment, who was admitted for adrenal crisis. A thoraco-abdominal tomography was carried out during hospitalization, which showed cylindrical and traction bronchiectasis associated with cicatricial atelectasis in the right upper pulmonary lobe, enlarged adrenal glands with foci of calcification, as well as a dense posterior perivertebral mediastinal collection also involving vertebral bodies with lytic resorptive foci, findings consistent with systemic tuberculosis. Treatment for tuberculosis started based on this diagnosis. During course of the disease, the first phase was completed with four drugs, and the second phase included isoniazid and rifampicin with favorable clinical response.</p>","PeriodicalId":53651,"journal":{"name":"Revista Peruana de Medicina de Experimental y Salud Publica","volume":"42 1","pages":"92-96"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}