Case description: 32-month-old boy, IgG positive for SARS-CoV-2, presented to the emergency department with dermatologic lesions. Clinical findings: Four days before admission, he presented skin eruptions with redness and pruritus on hands and feet. Generalized papular erythema was evidenced, upper extremities with diffuse erythematosquamous plaques, palmoplantar keratoderma, so he was evaluated by a dermatologist who diagnosed pityriasis rubra pilaris. Treatment and outcome: rehydrating cream, cetirizine 0.5 mg/kg/day every two days, and prednisolone 2 mg/kg/day in the morning. He was discharged after 14 days, the patient presented clinical improvement, but the erythematous lesion persisted on the trunk and extremities. In the evaluation, after three months, the patient did not show the described lesions, evidencing an improvement and clinical resolution of the dermatological problems. Clinical relevance: We report a patient with pityriasis rubra piloris associated with a post-infection by SARS-CoV-2 that had not been described before.

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Background Estimating the cumulative prevalence of SARS-COV-2 will help to understand the epidemic, contagion, and immunity to COVID-19 in vulnerable populations. The objective is to determine the extent of infection in the general population and the cumulative incidence by age group. Methods It was carried out with a longitudinal analytical study, in the population of the Lambayeque region, located in the north of Peru. The selection was carried out in multistages (districts, area, household, and finally choosing the interviewee within the house). Seroprevalence was estimated as a positive result of the rapid test whether it was positive IgM or positive IgG. An adjustment was made for the sampling weights used. Results The seroprevalence found in the region was 29.5%. Young people between 21 and 50 years old presented the highest seroprevalence frequencies. A total of 25.4% were asymptomatic. The most frequent complaint was dysgeusia and dysosmia (85.3% and 83.6%). Dysosmia (PR = 1.69), chest pain (PR = 1.49), back pain (PR = 1.45), cough (PR = 1.44), fever (PR = 1.41), general malaise (PR = 1.27) were associated factors with the higher the frequency of seropositivity for SARS-CoV-2. Reporting of complete isolation at home decreased the frequency of positivity (PR = 0.80), however, reporting having ARI contact (PR = 1.60), having contact with a confirmed case (PR = 1.51), and going to market (PR = 1.26) increased the frequency of positivity for SARS-CoV-2. Conclusion These results suggest that Lambayeque is the region with the highest seroprevalence in the world, well above Spain, the United States and similar to a study in India.

Background Oral ivermectin is a safe broad spectrum anthelminthic used for treating several neglected tropical diseases (NTDs). Currently, ivermectin use is contraindicated in children weighing less than 15 kg, restricting access to this drug for the treatment of NTDs. Here we provide an updated systematic review of the literature and we conducted an individual-level patient data (IPD) meta-analysis describing the safety of ivermectin in children weighing less than 15 kg. Methodology/Principal findings A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for IPD guidelines by searching MEDLINE via PubMed, Web of Science, Ovid Embase, LILACS, Cochrane Database of Systematic Reviews, TOXLINE for all clinical trials, case series, case reports, and database entries for reports on the use of ivermectin in children weighing less than 15 kg that were published between 1 January 1980 to 25 October 2019. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO): CRD42017056515. A total of 3,730 publications were identified, 97 were selected for potential inclusion, but only 17 sources describing 15 studies met the minimum criteria which consisted of known weights of children less than 15 kg linked to possible adverse events, and provided comprehensive IPD. A total of 1,088 children weighing less than 15 kg were administered oral ivermectin for one of the following indications: scabies, mass drug administration for scabies control, crusted scabies, cutaneous larva migrans, myiasis, pthiriasis, strongyloidiasis, trichuriasis, and parasitic disease of unknown origin. Overall a total of 1.4% (15/1,088) of children experienced 18 adverse events all of which were mild and self-limiting. No serious adverse events were reported. Conclusions/Significance Existing limited data suggest that oral ivermectin in children weighing less than 15 kilograms is safe. Data from well-designed clinical trials are needed to provide further assurance.

Background: Hypokalemic periodic paralysis (HypoKPP) is characterized by transient episodes of flaccid muscle weakness. We describe the case of a teenaged boy with HypoKPP and hyperthyroidism due to Hashimoto's thyroiditis with initial manifestation of renal tubular acidosis. This combination is rare and little described previously in men. Case presentation: A 17-year-old boy was admitted after three days of muscular weakness and paresthesia in the lower limbs with an ascending evolution, leading to prostration. Decreased strength was found in the lower limbs without a defined sensory level, reduced patellar and ankle reflexes. Positive antithyroid antibodies were found. He received hydration treatment, IV potassium and levothyroxine, with which there was a clinical improvement. Other examinations led to the diagnosis of type 1 renal tubular acidosis. Conclusion: HypoKPP is a rare disorder characterized by acute episodes of muscle weakness. Type 1 renal tubular acidosis can occur as a consequence of thyroiditis, which is explained by the loss of potassium. This combination is unusually rare, and has not been described before in men. The etiopathogenesis of the disease as well as a dynamic explanation of what happened with the patient are discussed in this report.

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Objetivos: Identificar la frecuencia de síndrome de burnout (SBO) en los estudiantes de Medicina pertenecientes a sociedades científicas peruanas en el 2015. Material y Métodos:Estudio observacional, descriptivo y transversal. La población estudiada fueron todos los estudiantes de medicina humana pertenecientes a 9 sociedades científicas de diferentes departamentos del Perú y afiliadas a la Sociedad Científica Médica Estudiantil Peruana (SOCIMEP). La recolección de datos fue a través de un cuestionario para datos biográficos y el Maslach Burnout Inventory. Resultados: Se encuestó a 158 estudiantes de medicina humana pertenecientes a 9 sociedades científicas peruanas. El 24,1 % tuvo un nivel severo de agotamiento emocional, el 45,6% un nivel severo de despersonalización, el 25,3% un nivel bajo de realización personal y 57,6% tuvieron SBO. El 60,8% de los estudiantes se encontraba realizando algún trabajo de investigación y el 49,4% ocupaba algún cargo en su sociedad científica. Conclusiones: Se identificó una importante frecuencia de SBO en los estudiantes de Medicina pertenecientes a las sociedadescientíficas estudiadas.

Introduction: Approximately three billion people in Asia, Africa, and the Americas cook with biomass, cleaner cooking technologies with the potential to reduce household air pollution exposure. It is necessary to assess the adoption and long-term use of these stoves, measure perceived benefits among users, and use this information to provide feedback to programs that are implementing new cooking technologies. The aim of this study is to determine the level of adoption and impact of improved biomass cookstoves in the rural area of Lambayeque, Peru, in 2017. Methods: A descriptive cross-sectional study was conducted. A total of 52 homes were surveyed in the districts of Pacora and Íllimo where improved biomass stoves were introduced between 2005 and 2013. A questionnaire for the assessment of adoption and impact indexes proposed by the Global Alliance for Clean Cookstoves was applied. The STROBE checklist was used. Results: The mean number of years with the improved biomass cookstove was 9.1 (standard deviation: 2.9); 51.9% always used the improved stove, and 34.6% never used it due to destruction during the El Niño phenomenon in 2017. The median impact index was 5.62; 19.2% had a very good/good adoption. The median adoption index was 6.5; 25% had a very high/high impact. The use of the traditional or open fire biomass stove persisted in 61.5% of the houses. Conclusion: The adoption and impact of improved biomass cookstoves were acceptable, but traditional stove use persisted in more than half of the houses. Households used a mix of different stove technologies. Gas stoves were used more frequently for breakfast or dinner, while the traditional biomass stoves were used for larger lunchtime meals.