https://hdl.handle.net/20.500.12959/77 Artículos de revistas escritos por profesionales de la salud de EsSalud Sat, 14 Nov 2026 07:39:01 GMT 2026-11-14T07:39:01Z http://repositorio.essalud.gob.pe:80/bitstream/id/a2e969d3-9910-4462-aea0-7baa7f54a109/ https://hdl.handle.net/20.500.12959/77 https://hdl.handle.net/20.500.12959/6083 Malignant cutaneous adnexal neoplasms with distant brain metastasis: an aggressive behavior. Illustrative cases Vargas-Urbina, John; Martinez-Silva, Raúl; Rojas-Panta, Giuseppe; Ponce-Manrique, Gabriel; Flores-Castillo, Jerson; Anicama-Lima, William BACKGROUND: Primary malignant cutaneous adnexal neoplasms are rare and can spread locally or to lymph nodes, and very infrequently to distant sites, such as the brain. Their management is poorly documented, and there are no established clinical practice guidelines for treatment. OBSERVATIONS: A 57-year-old male underwent surgery 2 years earlier for adenocarcinoma of the cutaneous adnexa of the right arm. He was admitted to the emergency department with a 15-day history of drowsiness, dysarthria, and signs consistent with frontal lobe involvement. Preoperative MRI revealed a heterogeneous left frontal lobe tumor with contrast enhancement of a solid mass. A craniotomy and complete tumor resection were performed. He then received radiosurgery (27 Gy). MRI studies at 1 and 6 months postoperatively showed complete resection. These tumors are rare and originate from hair follicles, sebaceous glands, or sweat glands. They have an overall 5-year survival rate of 78.2%, but the metastasis rate can range from 15% to 30%. The treatment approaches are not well described in the literature; combinations of surgery, chemotherapy, immunotherapy, targeted therapy, and radiotherapy are utilized. LESSONS: Malignant cutaneous adnexal neoplasms are rare conditions that need precise diagnosis and prompt multidisciplinary treatment. Wed, 01 Oct 2025 00:00:00 GMT https://hdl.handle.net/20.500.12959/6083 2025-10-01T00:00:00Z https://hdl.handle.net/20.500.12959/6082 Does modified Blumgart pancreatojejunostomy compared with original Blumgart pancreatojejunostomy decrease the rate of clinically relevant postoperative pancreatic fistula? A single-center propensity score-matched analysis Revoredo Rego, Fernando; Reaño Paredes, Gustavo; Kometter Barrios, Fritz; Wang, Tongbo; Herrera Chávez, Guillermo; Villanueva Alegre, Luis; Tang Sing, Jorge; Uribe León, Mónica; Ludeña Hurtado, Wuilber; Arenas Gamio, José; Alfaro Ita, Sheyla; Bermúdez Alfaro, Vanessa; Fonseca Cavero, Liliana; Carrasco Mascaro, Félix; Landeo Aliaga, Italo; Castillo Flores, Samy; de Vinatea de Cárdenas, José Backgrounds/Aims: The most common cause of morbidity following pancreatoduodenectomy (PD) is the clinically relevant postoperative pancreatic fistula (CR-POPF). There is currently no universally accepted technique for pancreato-enteric anastomosis. This study aims to compare the Blumgart technique (B-PJ) with the modified Blumgart technique (mB-PJ). Methods: This is a retrospective study involving patients who underwent PD between January 2011 and December 2021. The primary endpoint was to compare the incidence of CR-POPF. Secondary endpoints included major morbidity, length of postoperative stay, rates of reoperation, hospital readmission, postoperative mortality, and predictors of CR-POPF. Propensity score matching (PSM) was employed to minimize potential selection bias. Results: The study included 292 patients. After PSM, the incidence of CR-POPF was not significantly different between B-PJ and mB-PJ (18.9% vs. 15.8%, p = 0.566). No statistical differences were observed in the secondary endpoints. Independent predictors of CR-POPF included preoperative cholangitis (odds ratio [OR]: 4.906, 95% confidence interval [CI]: 1.440–16.713, p = 0.011), soft pancreas (OR: 4.259, 95% CI: 1.043–17.376, p = 0.043), and main pancreatic duct size ≤ 3 mm (OR: 5.229, 95% CI: 1.865–14.656, p = 0.002). Conclusions: This study did not demonstrate that mB-PJ is superior to B-PJ in reducing the incidence of CR-POPF. Factors such as soft pancreas, main pancreatic duct size, and preoperative cholangitis are identified as independent risk factors for CR-POPF. Sun, 31 May 2026 00:00:00 GMT https://hdl.handle.net/20.500.12959/6082 2026-05-31T00:00:00Z https://hdl.handle.net/20.500.12959/6081 Profiles of inpatient psychiatry referrals: a 4-year analysis in a Consultation-Liaison Psychiatry service Huarcaya-Victoria, Jeff; Villarreal-Zegarra, David; Alarcón-Guzmán, Renato D. Background :Consultation-Liaison Psychiatry (CLP) services are essential for addressing the psychiatric needs of patients with complex medical conditions in general hospitals. Aims: The study aims to characterize profiles of inpatient psychiatry referrals and describe referral patterns and evaluate temporal trends between referrals, patient demographics, and psychiatric and somatic diagnoses. Method: Data from January 2020 to December 2023 were collected from a CLP service during and after the pandemic, using psychiatric diagnoses from the International Classification of Diseases, Tenth Revision (ICD-10). Statistical analyses, including interrupted time series analysis with four periods, and including linear and segmented analyses, plus selective use of autocorrelation tests, were conducted to examine referral patterns and their associations with socio-demographic factors. Results : 6,105 patients were referred to the CLP Service during the study period, which was 6.73% of all hospital admissions. Internal medicine and Pneumology exhibited consistently high referrals, while services like Rheumatology and Endocrinology had lower rates. Common somatic diagnoses included neoplasms (20.7%) and respiratory diseases (9.4%), while neurotic, stress-related, and somatoform disorders were prevalent psychiatric diagnoses (42.5%). Interrupted time series analysis revealed fluctuations in monthly care visits, with notable decreases coinciding with the onset of the COVID-19 pandemic. Conclusions: Our study elucidated the characteristics of patients receiving CLP services at a major Peruvian general hospital, revealing depression as a prevalent reason for consultation, and highlighting the dynamic nature of psychiatric care delivery, especially amidst the COVID-19 pandemic. Sat, 16 May 2026 00:00:00 GMT https://hdl.handle.net/20.500.12959/6081 2026-05-16T00:00:00Z https://hdl.handle.net/20.500.12959/6080 Oncological outcomes with and without axillary lymph node dissection in patients with residual micrometastases after neoadjuvant chemotherapy (OPBC-07/microNAC): an international, retrospective cohort study Montagna, Giacomo; Alvarado, Michael; Myers, Sara; Mrdutt, Mary M.; Sun, Susie X.; Sevilimedu, Varadan; Barrio, Andrea V.; van den Bruele, Astrid Botty; Boughey, Judy C.; Boyle, Marissa K.; Crown, Angelena; Kesmodel, Susan B.; King, Tari A.; Kuerer, Henry M.; Leisha, Elmore C.; Moo, Tracy-Ann; Weiss, Anna; Williams, Austin D; Parmar, Priyanka; Diskin, Brian; Hlavin, Callie; Diego, Emilia J.; Polidorio, Natália; Abdelwahab, Khaled; Banys-Paluchowski, Maggie; Kurzeder, Christian; Heidinger, Martin; MicroNAC Study Group Background: Despite the paucity of outcome data, axillary lymph node dissection (ALND) is increasingly being omitted in patients with positive sentinel lymph nodes after neoadjuvant chemotherapy, particularly in those with low-volume residual disease. We investigated oncological outcomes in patients with breast cancer and residual micrometastases in the sentinel lymph nodes treated with or without ALND. Methods: OPBC-07/microNAC was a retrospective cohort study, using data obtained from the institutional databases of 84 cancer centres in 30 countries. Patients aged 18 years or older with clinical T1–4, N0–3 breast cancer at diagnosis treated with neoadjuvant chemotherapy followed by surgery between Jan 1, 2013, and May 31, 2023, who were found to have residual micrometastases (metastasis measuring >0·2 mm or >200 cells, not exceeding 2·0 mm in size) on frozen section or on final paraffin sections as determined by sentinel lymph node biopsy, targeted axillary dissection (sentinel lymph node biopsy with single or dual-tracer mapping plus image-guided localisation of the initially biopsy-proven and clipped node), or the marking axillary lymph nodes with radioactive iodine seeds (MARI) procedure were eligible for inclusion. The primary endpoint was the 5-year rate of any axillary recurrence (isolated or combined with local or distant recurrence) stratified by type of axillary surgery. Given the median follow-up, here we report 3-year rates and exploratory 5-year estimates. This study was registered with ClinicalTrials.gov, NCT06529302. Findings: 1585 female patients with ypN1mi disease were analysed, of whom 804 (50·7%) underwent ALND and 781 (49·3%) did not. Of 1585 women, 238 (15·0%) self-identified as Asian, 65 (4·1%) as Black, 200 (12·6%) as Hispanic, 968 (61·1%) as White, and 114 (7·2%) as unknown race and ethnicity. 925 (58·4%) of 1585 women had cT2 tumours, 1054 (66·5%) were node positive, and 1267 (79·9%) received nodal radiotherapy. The median follow-up was 3·1 years (IQR 1·8–5·2). The 3-year rate of any axillary recurrence (isolated or combined with local or distant recurrence) for the entire cohort was 2·0% (95% CI 1·3–2·9), with no statistical difference identified by extent of axillary surgery. However, patients with triple-negative disease who did not receive ALND had significantly higher rates of any axillary recurrence than women treated with ALND (8·7% [95% CI 4·4–15·0] vs 2·4% [95% CI 0·7–6·5], p=0·018). On multivariable analysis, triple-negative breast cancer (hazard ratio 3·83 [95% CI 1·72–8·52]) and omission of nodal radiotherapy (2·62 [1·19–5·73]) but not omission of ALND (0·86 [0·37–2·00]) were independently associated with an increased risk of any axillary recurrence. Interpretation: Overall, these results do not support ALND for all patients with ypN1mi on sentinel lymph node biopsy treated with nodal radiotherapy; however, tumour biology should be taken into account when considering ALND omission. Thu, 01 Jan 2026 00:00:00 GMT https://hdl.handle.net/20.500.12959/6080 2026-01-01T00:00:00Z