To determine the usefulness of lactate as a prognostic factor of death in severe sepsis. Setting: Material and Methods: those with lactate < 2 mmol/l. overall burden of comorbidity are the main risk factors associated with hospital complications in older adults.

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To determine efficacy of mydriatic-digital images (MDI) when screening retinal complications in people living with HIV, in this study, a consecutive series of 79 people living with HIV (PLHIV) were evaluated. Two series of MDI were taken: - macula and optic nerve - nine gaze fields, which findings were compared with those obtained by a retina specialist. Both examiners were unaware of each other’s results. Average age was 32.2 years old, predominantly male (75.9%). Most frequent complications were HIV retina microangiopathies (6.3%) and toxoplasmosis (5.1%), followed by Cytomegalovirus and neuro-retinitis, optic neuritis and vitreitis, each one with 1.3%. Sensitivity with two MDI was 92.8% (CI 95% 66.0–100.0) and with nine 100% (CI 95% 77.0–100.0) and specificity of 95.4% (CI 95% 87.0–99.0) for both series. The positive predictive value was 81.3 and 82.4%, and negative predictive value was 98.4 and 100% respectively. The strength of agreement was substantial for the two series with the retina specialist examination (Kappa index of 0.836 and 0.888 respectively). Mydriatic-digital-images appear to be an effective method to screen for HIV-related retinal-complications in a regional hospital in Perú.

Objectives To describe the HIV treatment cascade and care continuum in regions of highest HIV prevalence in Peru. Methods An observational longitudinal study was carried out in 14 tertiary hospitals in Peru. These are the main hospitals that administer antiretroviral treatment (ART) in the regions that represent approximately 95% of reports of HIV/AIDS cases in Peru in 2013. We included individuals older than 18 years newly diagnosed with HIV from 1 January 2011 to 31 December 2012. Medical records were reviewed until 2015. Results A total of 2119 people living with HIV (PLHIV) were identified in the selected health facilities (mean age = 35.26 years, 78% male). 97.25% [1845/1897; 95% confidence interval (CI): 96.4–97.9%] of the patients attended the consultation at least once during the follow‐up, but only 64.84% (885/1365; 95% CI: 62.2–67.4%) attended within a month after the diagnosis. After starting ART, 74.63% (95% CI: 71.9–77.2%) of PLHIV remained in healthcare. Regardless of the time after diagnosis, 88.40% (1837/2078; 95% CI: 86.9–89.7%) of PLHIV started ART during the observation time. However, 78.68% (95% CI: 76.8–80.4%) did so during the first post‐treatment year and only 28.88% (95% CI: 27.9–31.9%) after 1 month. After starting treatment, it was observed that 51.60% (95% CI: 49.2–54%) of PLHIV reached viral suppression during the follow‐up period. Conclusions Further analysis and improvements in the definition of indicators are required to achieve conclusive results; however, these data will give us a general understanding of the progress of Peruvian health policies in achieving the goal established by the WHO.