Alvarez Manrique, Victor Daniel

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Alvarez Manrique, Victor Daniel
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victor.alvarez@upeu.edu.pe
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  • Publicacion
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    Ureterocele urothelial carcinoma: managing a rare presentation
    (2016-02-16)
    Juan Astigueta  
    ;
    Milagros Abad‐Licham
    ;
    Eloy Silva
    ;
    Victor E. Alvarez
    ;
    Francis Piccone
    It is very uncommon for urothelial carcinoma to develop in an ureterocele. It is generally discovered in an imaging study or in connection with haematuria. We found very few reports in the literature. Here, we report on the case of a 71-year-old male who initially presented with haematuria and low back pain and who then underwent transurethral resection for an intraureterocele tumour. Pathology confirmed urothelial carcinoma.
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    Diabetes and cardiac complications: A narrative review
    (2026-01-01)
    Fiorella Gonzales Ishuiza
    ;
    Juan Manuel Gálvez Torres
    ;
    Tahiz Aspajo Isuiza
    ;
    Peggui Zadith Valqui Delgado
    ;
    Xiomara del Carmen Torres Putpaña
    Objective: to carry out a narrative review on diabetes and cardiac complications, through risk factors, treatment and etiology.Method: an information search was conducted in Scoopus, PubMed, and Google Scholar.Data selection: Documents were selected and analyzed through a critical literature review, taking into account inclusion and exclusion criteria.Results: a corpus of 23 articles was analyzed, of which 6 correspond to systematic studies, 6 to literary studies, 3 to narrative studies, 2 to cross-sectional studies, 2 to descriptive studies, 2 to quantitative studies, 2 to multicenter studies.The population studied includes older people, pregnant mothers, young people, the elderly.The studies were carried out in various countries, such as the United Kingdom, Japan, Singapore, the United States, Australia, Ghana-United Arab Emirates, Italy, China, Indonesia and Chile.The diagnoses were characterized by 7 articles that addressed diabetes risk factors, 9 to treatment, 8 to etiology.Regarding socioeconomic level, 2 articles mentioned that they were from low-income countries, 12 articles mentioned that they were from upper-middle countries, 6 articles mentioned that they were medium-high countries, and 3 from countries that do not specify their socioeconomic level.Conclusion: Type 2 diabetes is associated with heart failure in women that worsens with coronary artery disease, directly impacting the myocardium with risk of death.The use of SGLT2 inhibitors represents an important therapeutic advance, since it promotes renal glucose elimination, improves metabolic control and reduces heart failure events.Diabetes causes progressive damage to the cardiovascular system, where endothelial dysfunction plays a central role by promoting inflammation and vascular deterioration.The studies, carried out mostly in middle-and high-income countries, show barriers such as misinformation, failures in prevention and inequality in access to diagnosis.The need to improve education and access to health services is highlighted, especially in low-resource contexts, since this affects patients with DM2, T1D, cardiovascular risk, cardiac complications, heart failure and diabetic cardiomyopathy.
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    Mpox: Transmission, clinical manifestations, prevention, and treatment – a narrative review
    (2025-02-18)
    Erica Sandoval-Urbano
    ;
    Jhonny E. Pimentel-Betancourt
    ;
    Kelita M. Lozano-Gutierres
    ;
    Mirian Julca-Cano
    ;
    Víctor Álvarez-Manrique  
    Objective:To identify the transmission methods, symptoms, complications, prevention, and treatment associated with Mpox. Design:Literature review based on a narrative synthesis. Data Sources:Web of Science, Google Scholar, Scielo, ScienceDirect, Redalyc, and Scopus. Study Selection:Documents were selected and analyzed through a critical literature review, considering inclusion and exclusion criteria. Results:A literature review was conducted with a corpus of 17 articles, including 11 narrative reviews, 2 systematic reviews, and 4 statistical analyses. Mpox is more prevalent among children, adults, pregnant women, and homosexual and bisexual individuals. The regions with the highest outbreak incidence are Asia, South America, Europe, the United States, and especially West and Central Africa, where it is endemic. Clinical conditions associated with Mpox include fever, skin rashes, abdominal pain, and meningitis, and it is strongly linked to HIV. Most reported cases have been among lower-class individuals, with some from the middle class. Conclusions: The Mpox virus is transmitted through various means, primarily contact, bodily fluids, and sexual relations between men. It significantly affects children and pregnant women and presents a range of symptoms, with skin lesions being the most frequent, followed by fever, headaches, oral lesions, and others. If left untreated or inadequately managed, it can lead to severe complications, with HIV-positive individuals and immunocompromised patients at the highest risk. Pneumonia can be fatal in severe cases. Good personal hygiene is recommended, and although there are no approved vaccines for Mpox, Tecovirimat and Brincidofovir show potential for approval in case of future outbreaks.
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    Repurposed Antiviral Drugs for Covid-19 — Interim WHO Solidarity Trial Results
    (2020-12-02)
    WHO Solidarity Trial Consortium  
    BACKGROUND: World Health Organization expert groups recommended mortality trials of four repurposed antiviral drugs - remdesivir, hydroxychloroquine, lopinavir, and interferon beta-1a - in patients hospitalized with coronavirus disease 2019 (Covid-19). METHODS: We randomly assigned inpatients with Covid-19 equally between one of the trial drug regimens that was locally available and open control (up to five options, four active and the local standard of care). The intention-to-treat primary analyses examined in-hospital mortality in the four pairwise comparisons of each trial drug and its control (drug available but patient assigned to the same care without that drug). Rate ratios for death were calculated with stratification according to age and status regarding mechanical ventilation at trial entry. RESULTS: At 405 hospitals in 30 countries, 11,330 adults underwent randomization; 2750 were assigned to receive remdesivir, 954 to hydroxychloroquine, 1411 to lopinavir (without interferon), 2063 to interferon (including 651 to interferon plus lopinavir), and 4088 to no trial drug. Adherence was 94 to 96% midway through treatment, with 2 to 6% crossover. In total, 1253 deaths were reported (median day of death, day 8; interquartile range, 4 to 14). The Kaplan-Meier 28-day mortality was 11.8% (39.0% if the patient was already receiving ventilation at randomization and 9.5% otherwise). Death occurred in 301 of 2743 patients receiving remdesivir and in 303 of 2708 receiving its control (rate ratio, 0.95; 95% confidence interval [CI], 0.81 to 1.11; P = 0.50), in 104 of 947 patients receiving hydroxychloroquine and in 84 of 906 receiving its control (rate ratio, 1.19; 95% CI, 0.89 to 1.59; P = 0.23), in 148 of 1399 patients receiving lopinavir and in 146 of 1372 receiving its control (rate ratio, 1.00; 95% CI, 0.79 to 1.25; P = 0.97), and in 243 of 2050 patients receiving interferon and in 216 of 2050 receiving its control (rate ratio, 1.16; 95% CI, 0.96 to 1.39; P = 0.11). No drug definitely reduced mortality, overall or in any subgroup, or reduced initiation of ventilation or hospitalization duration. CONCLUSIONS: These remdesivir, hydroxychloroquine, lopinavir, and interferon regimens had little or no effect on hospitalized patients with Covid-19, as indicated by overall mortality, initiation of ventilation, and duration of hospital stay. (Funded by the World Health Organization; ISRCTN Registry number, ISRCTN83971151; ClinicalTrials.gov number, NCT04315948.).
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    Bacterial meningitis in adults: a narrative review
    (2025-02-18)
    Azucena Armas-Tarrillo
    ;
    Erliz J. Cieza-Cruz
    ;
    Mauricio A. Mancco-Taco
    ;
    Luciana M. Orellana-Hidalgo
    ;
    Alker Vallejos-Estela
    Objective: To identify the etiology, risk factors, treatment, and associated sequelae of bacterial meningitis in adults. Design: A literature review based on a narrative synthesis. Data Sources: Scopus, Science Direct, Web of Science, Redalyc, Google Scholar, PubMed, and Scielo. Data Selection: Documents were selected and analyzed through a critical literature review, considering inclusion and exclusion criteria. Results: A total of 10 articles were analyzed, including 3 statistical analyses, 3 narrative reviews, 2 systematic reviews, and 2 clinical trials. The study populations included various categories: 6 articles focused on adults, 1 on males, 1 on individuals aged 25 to 50 years, and 2 involving animal experiments. Studies were conducted in various countries, including 2 in Africa, 2 in the U.S., 2 in Germany, and 1 each in Northern Ghana, Sweden, South Korea, and Egypt, contributing unique perspectives to the research. The clinical condition was characterized as follows: 3 articles highlighted the most frequent symptoms of bacterial meningitis, 4 focused on sequelae, 2 reported high fatality rates, and 1 examined early intensive care (EIC) and antibiotic recovery. Regarding socioeconomic status, 4 articles reported cases from low-income countries, 1 from high income countries, and 1 from a middle-income country. Conclusion: Bacterial meningitis represents a severe public health threat, particularly in vulnerable populations, such as older adults and those with underlying conditions. Despite the effectiveness of treatments like dexamethasone and antibiotics, the high mortality and morbidity rates emphasize the importance of early and accurate diagnosis.
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    Embracing Monogenic Parkinson's Disease: The <scp>MJFF</scp> Global Genetic <scp>PD</scp> Cohort
    (2023-01-24)
    Eva‐Juliane Vollstedt  
    ;
    Susen Schaake
    ;
    Katja Lohmann
    ;
    Shalini Padmanabhan
    ;
    Alexis Brice
    BACKGROUND: As gene-targeted therapies are increasingly being developed for Parkinson's disease (PD), identifying and characterizing carriers of specific genetic pathogenic variants is imperative. Only a small fraction of the estimated number of subjects with monogenic PD worldwide are currently represented in the literature and availability of clinical data and clinical trial-ready cohorts is limited. OBJECTIVE: The objectives are to (1) establish an international cohort of affected and unaffected individuals with PD-linked variants; (2) provide harmonized and quality-controlled clinical characterization data for each included individual; and (3) further promote collaboration of researchers in the field of monogenic PD. METHODS: We conducted a worldwide, systematic online survey to collect individual-level data on individuals with PD-linked variants in SNCA, LRRK2, VPS35, PRKN, PINK1, DJ-1, as well as selected pathogenic and risk variants in GBA and corresponding demographic, clinical, and genetic data. All registered cases underwent thorough quality checks, and pathogenicity scoring of the variants and genotype-phenotype relationships were analyzed. RESULTS: We collected 3888 variant carriers for our analyses, reported by 92 centers (42 countries) worldwide. Of the included individuals, 3185 had a diagnosis of PD (ie, 1306 LRRK2, 115 SNCA, 23 VPS35, 429 PRKN, 75 PINK1, 13 DJ-1, and 1224 GBA) and 703 were unaffected (ie, 328 LRRK2, 32 SNCA, 3 VPS35, 1 PRKN, 1 PINK1, and 338 GBA). In total, we identified 269 different pathogenic variants; 1322 individuals in our cohort (34%) were indicated as not previously published. CONCLUSIONS: Within the MJFF Global Genetic PD Study Group, we (1) established the largest international cohort of affected and unaffected individuals carrying PD-linked variants; (2) provide harmonized and quality-controlled clinical and genetic data for each included individual; (3) promote collaboration in the field of genetic PD with a view toward clinical and genetic stratification of patients for gene-targeted clinical trials. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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    Validation of a Job Satisfaction Scale among Health Workers
    (2024-03-10)
    Allison Ramirez-Cruz
    ;
    Caleb Sucapuca
    ;
    Mardel Morales-García  
    ;
    Víctor Álvarez-Manrique  
    ;
    Liset Z. Sairitupa-Sanchez
    Background: job satisfaction is a key focus in organizational behavior studies, particularly relevant in the healthcare sector and nursing. It influences patient care quality and staff retention and is shaped by the work environment, working conditions, managerial support, and interactions among colleagues. However, there is limited research specifically addressing the job satisfaction of nurses in Peru, a critical area in health administration. Objective: this study aimed to evaluate the metric properties of the S20/23 job satisfaction scale among Peruvian nurses. Methods: an instrumental research design was employed using a non-probabilistic sample of 325 nurses from two hospitals in Lima, Peru. The Chilean version of the S20/23 scale was used, comprising four dimensions of job satisfaction (relationship with supervision, physical work space, professional fulfillment, and training and decision-making opportunities). Data analysis included descriptive statistics, confirmatory factor analysis (CFA), and reliability tests using Cronbach's Alpha and McDonald's Omega. Results: the CFA revealed a satisfactory fit for the four-dimensional structure with 18 items (χ2 = 387,290, df = 124, p &lt; ,001, CFI = 0,92, TLI = 0,90, RMSEA = 0,08, SRMR = 0,05). The scale also demonstrated high reliability for each dimension: relationship with supervision (α = 0,90, ꞷ = 0,87), physical work space (α, ꞷ = 0,92), professional fulfillment (α, ꞷ = 0,88), and training and decision-making opportunities (α = 0,88, ꞷ = 0,84), with acceptable factor loadings (&gt;0,70). Conclusions: the adapted 18-item S20/23 scale is a valid and reliable tool for assessing job satisfaction among Peruvian nurses. The study highlights the importance of specific job satisfaction dimensions, such as relationships with supervisors and professional development opportunities, in the Peruvian nursing context
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    Multisystem inflammatory syndrome in children: a narrative review
    (2026-01-01)
    Maisa Flores Yumbato
    ;
    Rut Pardave Ambicho
    ;
    Eliana Alarcón Herrera
    ;
    Alisson Gomez Orosco
    ;
    Víctor Álvarez-Manrique  
    Objective: to conduct a literature review on multisystem inflammatory syndrome in children, focusing on cardiac involvement, complications, and manifestations.Method: literature review based on narrative synthesis.
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    Establishing an online resource to facilitate global collaboration and inclusion of underrepresented populations: Experience from the MJFF Global Genetic Parkinson’s Disease Project
    (2023-10-03)
    Eva‐Juliane Vollstedt  
    ;
    Harutyun Madoev
    ;
    Anna Aasly
    ;
    Azlina Ahmad‐Annuar
    ;
    Bashayer Al‐Mubarak
    Parkinson's disease (PD) is the fastest-growing neurodegenerative disorder, currently affecting ~7 million people worldwide. PD is clinically and genetically heterogeneous, with at least 10% of all cases explained by a monogenic cause or strong genetic risk factor. However, the vast majority of our present data on monogenic PD is based on the investigation of patients of European White ancestry, leaving a large knowledge gap on monogenic PD in underrepresented populations. Gene-targeted therapies are being developed at a fast pace and have started entering clinical trials. In light of these developments, building a global network of centers working on monogenic PD, fostering collaborative research, and establishing a clinical trial-ready cohort is imperative. Based on a systematic review of the English literature on monogenic PD and a successful team science approach, we have built up a network of 59 sites worldwide and have collected information on the availability of data, biomaterials, and facilities. To enable access to this resource and to foster collaboration across centers, as well as between academia and industry, we have developed an interactive map and online tool allowing for a quick overview of available resources, along with an option to filter for specific items of interest. This initiative is currently being merged with the Global Parkinson's Genetics Program (GP2), which will attract additional centers with a focus on underrepresented sites. This growing resource and tool will facilitate collaborative research and impact the development and testing of new therapies for monogenic and potentially for idiopathic PD patients.
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    Factors associated, symptoms, and treatments of guillain-barré syndrome: a narrative review
    (2025-02-18)
    Emilia López-Peña
    ;
    Diana Camizán-Julca
    ;
    Jonathan Dávila-Pezo
    ;
    Sayra Morales-Ruiz
    ;
    Víctor Álvarez-Manrique  
    Objective: To conduct a brief literature review on Guillain-Barré Syndrome (GBS), its associated factors, and available treatments. Design: Literature review based on a narrative synthesis.Databases: Scopus, ScienceDirect, SciELO, Google Scholar, and PubMed. Study Selection: Documents were selected through a critical literature review, considering inclusion and exclusion criteria. Results: The literature analysis included a corpus of 15 articles, comprising 2 statistical analyses, 6 narrative reviews, 3 systematic reviews, 2 observational studies, and 2 clinical cases. The studies primarily involved a population of adult men and women, children, and pregnant women, mostly from low-income and vulnerable backgrounds. Patients diagnosed with GBS were associated with COVID-19, Systemic Lupus Erythematosus (SLE), Posterior Reversible Encephalopathy Syndrome (PRES), Zika virus, and dengue. Conclusions: Research related to GBS highlights numerous causes and complications. GBS is significantly associated with muscle weakness, reduced mobility, and conditions such as SLE and PRES. During the COVID-19 pandemic, a slight increase in GBS cases was recorded. Although uncommon, GBS complications can lead to cardiovascular, respiratory, and gastrointestinal issues. Research does not explore in-depth preventive strategies or early management of these complications. There are currently limited treatments available to improve patient outcomes.
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