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Esta investigación constituye un análisis de los portales de internet de SCImago Journal & Country Rank y SCImago Institutions Rankings, bases de datos en el que se incluyen indicadores de la actividad científica utilizados para evaluar la productividad de las universidades o instituciones dedicadas a la investigación, así como todas aquellas organizaciones encargadas de editar revistas científicas. Se fundamentó en los planteamientos de Rodríguez, Socorro y Espinoza (2019); Túñez-López, Valarezo-González y Marín-Gutiérrez (2014), entre otros. La metodología es de tipo documental-bibliográfica, se consultaron los portales de SCImago, así como artículos científicos e investigaciones referentes al tema de estudio. Estos portales ofrecen al usuario una serie de datos, herramientas y servicios de útil importancia para evaluar el desempeño de las instituciones gestoras de investigación, también, permiten medir el impacto de la actividad científica de los países a nivel mundial; se caracterizan por su fácil acceso y disponibilidad en la web, por lo que es importante que las universidades conozcan los indicadores científicos que se manejan en estos portales, con el fin de escalar posiciones dentro de los rankings investigativos, y les permita alcanzar prestigio científico ante comunidad nacional o internacional.

espanolIntroduccion: El presente articulo resume la guia de practica clinica (GPC) para el manejo de pacientes con leucemia linfoblastica aguda (LLA) en el Seguro Social del Peru (EsSalud). Objetivo: Proveer recomendaciones clinicas basadas en evidencia para la evaluacion y el manejo de pacientes con LLA en EsSalud. Metodos: Se conformo un grupo elaborador de la guia (GEG) que incluyo medicos especialistas y metodologos. El GEG formulo 8 preguntas clinicas a ser respondidas por la presente GPC. Se realizo busquedas sistematicas de revisiones sistematicas y –cuando fue considerado pertinente– estudios primarios en PubMed y CENTRAL durante el 2019. Se selecciono la evidencia para responder cada una de las preguntas clinicas planteadas. La certeza de la evidencia fue evaluada usando la metodologia Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones de trabajo periodicas, el GEG uso la metodologia GRADE para revisar la evidencia y formular las recomendaciones, los puntos de buenas practicas clinicas y el flujograma de evaluacion y manejo. Finalmente, la GPC fue aprobada con Resolucion N° 23-DGPCFyT–IETSI-ESSALUD-2019. Resultados: La presente GPC abordo 8 preguntas clinicas, divididas en cuatro temas: diagnostico, medidas generales, manejo farmacologico, y manejo quirurgico de la LLA. En base a dichas preguntas se formulo 5 recomendaciones (3 recomendaciones fuertes y 2 recomendaciones condicionales), 20 puntos de buena practica clinica, y 3 flujogramas. Conclusion: El presente articulo resume la metodologia y las conclusiones basadas en evidencias de la GPC para el diagnostico y manejo de LLA en EsSalud. EnglishIntroduction: This article summarizes the clinical practice guidelines (CPG) for the management of patients with ALL in the Social Security of Peru (EsSalud). Objective: To provide clinical evidence-based recommendations for the evaluation and management of patients with ALL in EsSalud. Methods: A CPG for the diagnosis and management of patients with ALL in EsSalud was developed. To this end, a guideline development group (local GDG) was established, including medical specialists and methodologists. The local GDG formulated 8 clinical questions to be answered by this CPG. Systematic searches of systematic reviews and -when it was considered pertinent- primary studies were conducted in PubMed and CENTRAL during 2019. The evidence to answer each of the posed clinical questions was selected. The quality of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic work meetings, the local GDG used the GRADE methodology to review the evidence and formulate the recommendations, points of good clinical practice, and flowcharts of evaluation and management. Lastly, the CPG was approved with Resolution N° 23-DGPCFyT–IETSI-ESSALUD-2019. Results: This CPG addressed 8 clinical questions, divided into four topics: diagnosis, general measures, pharmacological management, and surgical management of ALL. Based on these questions, 5 recommendations (3 strong recommendations and 2 weak recommendations), 20 points of good clinical practice, and 3 flowcharts were formulated. Conclusion: This article summarizes the methodology and evidence-based conclusions from the CPG for the diagnosis and management of ALL in EsSalud.

Background Diagnosis delay in children and adolescents with cancer is a public health problem in Peru that leads to high rates of advanced disease and mortality. We aimed to assess the implementation feasibility and potential utility of ONCOpeds®, a mobile application that provides consultations with pediatric oncologists, in reducing the latency to diagnosis (LD) and referral time (RT) among children and adolescents in Peru diagnosed with cancer. Material and methods A prospective pilot study was conducted in the region of Callao between November 2017 and April 2018. Primary and secondary care providers were trained on the use of ONCOpeds in five educational sessions. Patients younger than 18 years who resided in Callao and were diagnosed with cancer at four pediatric cancer units in Lima were analyzed by referral type: ONCOpeds facilitated or conventional. Results ONCOpeds was successfully installed in the smartphones of 78 primary and secondary care providers of Callao. During the study period, 23 new cases of cancer in children and adolescents from the region were diagnosed. Ten patients received ONCOpeds-facilitated referrals and 13 received conventional referrals. The RT decreased among those who received ONCOpeds-facilitated referrals by 66% (P = 0.02); however, the LD did not significantly decrease with the use of ONCOpeds. Conclusions The implementation of ONCOpeds was found to be feasible in this pilot study, having a potential utility in improving early diagnosis and referral in children and adolescents newly diagnosed with cancer. Directions for future research include multicenter studies with a larger population to further test the application's effectiveness.

New diagnoses of leukaemia and other malignancies are recently being made in paediatric patients with COVID-19. The rates of mortality and morbidity in some of these children are expected to be higher. In new cases, concurrent diagnosis can be difficult because multisystemic inflammatory syndrome (MIS-C) and malignancies have similar clinical presentations. We present the case of a preteenage child where the diagnosis of leukaemia was complicated and delayed by a multisystem involvement and an inconclusive bone marrow study. Clinical teams managing children with COVID-19 and MIS-C should suspect leukaemia and other malignancies when the clinical course is complicated and bone marrow suppression is persistent. Prompt diagnosis will allow start of treatment on time, minimising complications.

In this article, from the theoretical point of view the role of the research teacher of the curricular unit projects, considered as the nerve unit of the current university programs, where different knowledge and actions for the execution of research that lead to social transformation are articulated. Given the process of university transformation in Venezuela, it is necessary to strengthen the role of the teacher as a researcher, tutor, advisor, facilitator and mediator of learning that contributes to the integral formation of the student with a critical vision for the solution of environmental problems. Theoretically it was based on the postulates of Hernández (2009); Saby (2012); Castro (2014); and Morillo (2009); among others. The methodology used was the literature review consulting research papers and articles of specialized journals. For this, the different actions and strategies to improve teacher performance during the development of research projects are proposed, through the development of competences that encompass the integrality of the human being. Finally, reflections are presented regarding the role of the teacher in the practice of scientific research and its relationship with the teaching-learning process in the context of university education., En este artículo, se aborda desde el punto de vista teórico el rol del docente investigador de la unidad curricular proyectos, considerada unidad neurálgica de los actuales programas universitarios, donde se articulan diferentes saberes y acciones para la ejecución de investigaciones que conduzcan a la transformación social. Ante el proceso de transformación universitaria en Venezuela, se hace necesario potenciar la función del docente como investigador, tutor, asesor, facilitador y mediador de aprendizajes que contribuya a la formación integral del estudiante con una visión crítica para la solución de los problemas del entorno. Teóricamente se fundamentó en los postulados de Hernández (2009); Saby (2012); Castro (2014); y Morillo (2009); entre otros. La metodología utilizada fue la revisión bibliográfica consultándose trabajos de investigaciones y artículos de revistas especializadas. Para ello se plantean las diferentes acciones y estrategias para mejorar el desempeño del docente durante la elaboración de proyectos de investigación, a través del desarrollo de competencias que abarcan la integralidad del ser humano. Finalmente se presentan reflexiones en torno al rol del docente ante la práctica de investigación científica y su relación con el proceso de enseñanza-aprendizaje en el contexto de la educación universitaria.

OBJETIVO: Evaluar el manejo de las pacientes con antecedente de cesareada anterior. DISEÑO: Método descriptivo. LUGAR: Hospital IV Víctor Lazarte Echegaray, EsSalud, Trujillo. MATERIAL y MÉTODOS: Pacientes sometidas a cesárea en el período mayo de 1999 a abril de 2000. RESULTADOS: Se estudió 1322 partos; de las 618 cesáreas, 195 tenían antecedente de cesareada anterior una vez, de las que se seleccionó 97; de ellas, 40,2% tenía entre 26 y 35 años. Las causas más frecuentes de cesárea en cesareada anterior fueron sufrimiento fetal agudo (31,9%) y trabajo de parto disfuncional (28,9%). CONCLUSIONES: En pacientes con antecedente de cesareada anterior, 46,4% terminó en parto vaginal y 53,6% en cesárea.

OBJETIVO: Conocer la relación de algunos factores epidemiológicos, clínicos, diagnósticos y terapéuticos en el embarazo ectópico. DISEÑO: Estudio retrospectivo. LUGAR: Servicio de Ginecología del Hospital Víctor Lazarte Echegaray – EsSalud de Trujillo. MATERIAL Y MÉTODOS: Cincuenta y un pacientes que tuvieron el diagnóstico operatorio de embarazo ectópico en el período comprendido mayo de 1995 y abril de 2000 .RESULTADOS: El embarazo ectópico tuvo una frecuencia de 1 por cada 133 partos; 33,3% de las pacientes tenía entre 36 y 45 años de edad. Los factores predisponentes fueron la enfermedad inflamatoria pélvica, esterilidad quirúrgica y legrados uterinos; el método diagnóstico más utilizado fue el ultrasonido (66,7%); la localización más frecuente fue la tubárica (90,2%); las principales complicaciones fueron la anemia (68,6%) y el choque hipovolémico (13,7%). CONCLUSIÓN: Las características relacionadas al embarazo ectópico fueron similares a las descritas en la literatura.

Abstract 4105 Considering our Pediatric Hematology Unit (PHU), as a social security national reference Unit, one third of the hospitalized children population have acute leukemia in the Pediatrics Department of the National Hospital Hospital Edgardo Rebagliatti Martins- ESSALUD, Lima - Perú. PURPOSE: To analyze survival outcome and behavioral of the disease in children with acute lymphoblastic leukemia (ALL) in a Social Security Hospital of a Developing country. PATIENTS AND METHODS: We analyze 100 pediatrics patients (less than 14 years old) diagnosed with acute lymphoblastic leukemia (ALL) since 2005 to 2008. Disease-free survival (DFS) was computed according to the Kaplan-Meier method and long rank test, using the SPSS 15.0. RESULTS: A total of 100 children were evaluated. The major incidence according to age was in the group of children between 1 and 9 years old (76%); there were no difference between gender: 51% females and 49% males. The B type was the most common diagnosed leukemia: The B CALLA positive (CD10, CD19, HLA, DR) was the most frequent inmunophenotype, present in 87 children (87%). T-cell ALL was seen in 7%, bi-phenotype and Pro B in 3%. According to our risk stratification protocol, 34 patients were in the very high risk group (VHR), 47 patients in the high risk (HR) group and 19 patients in the intermediate-low risk (ILR) group. About Kariotype evaluation, the most common presentations were normal and hyperdiploid kariotype (67%). We achieved Complete Remission in 95% of our patients post 4 weeks Induction therapy (“A” Induction period). The Total 4th year disease free survival was 48.9% (36.3% VHR, 50.4% HR and 75.9% ILR); of these 61.8 ± 6.2% had DFS after 2 years of therapy and 55.9±6.9 % after 3 years. The Disease Free Survival was significantly increased on those with the following risk factors at diagnosis: white blood cell count < 100 000/mm3 (P= 0.002), normal or hyperdiploid kariotype (P CONCLUSION: The Total DFS was 48.9%. WBC count below 100,000 mm3; normal and hyperdiploid kariotypes, correlate with best DFS. The MDR >1%, was correlated with poor DFS (less than 10 months). The no responding prednisone group must receive a more intensive chemotherapy (the treatment of the immediately superior risk group). The poor DFS at 4 years explain the reason of our therapeutic decision to perform a sibling stem cell Transplant, in those pediatric patients with HR or VHR Acute Lymphoblastic Leukemia (BMT with a 12 year disease free survival of 59.8%). Disclosures: No relevant conflicts of interest to declare.

El propósito fue interpretar la disciplina escolar a partir de las opiniones de los docentes expresadas en registros diarios de clase. Se empleó el método interpretativo con enfoque etnográfico. Se revisaron los diarios de clase de siete secciones de 7° grado y se entrevistaron a los docentes. Los datos se organizaron en: indisciplina, agresividad y castigos aplicados por los profesores. Se comprobó que las notas asentadas por los docentes en los diarios no son fiables porque en las entrevistas ellos expresaron contradicciones. En conclusión, la institución debe genera acciones que reviertan comportamientos no deseados en los estudiantes. Se recomienda que las decisiones punitivas a los estudiantes, basadas en los registros diarios s sean revisadas para constatar su pertinencia y aplicabilidad, los consejos de secciones deberían convertirse en espacios de reflexión positiva del desempeño del estudiante, más que un lugar para imponer sanciones por sus posibles comportamientos antisociales The purpose of this study was to interpret school discipline from teachers’ views expressed in class daily records. The interpretive paradigm was used with an ethnographic approach. There were reviewed seven daily class sections and 7th grade teachers were interviewed. The data was categorized in: discipline, aggressiveness and punishments meted out by teachers. It was found that the notes settled by teachers in the records were not reliable because contradictions expressed in interviews. In conclusion, the institution must generate actions to reverse unwanted behaviors in students. It is recommended that students punitive decisions based on class diaries are checked to verify their relevance and applicability. Teachers’ grade councils should become spaces of positive reflection of student performance, rather than a place to impose sanctions for their rough social behavior