Revista Peruana de Medicina de Experimental y Salud Publica最新文献

Background: Motivation for the study. There are few clinical and survival studies in Peru on thyroid cancer.

Background: Main findings. Between the years 2010 to 2020, differentiated thyroid cancer was more frequent in women with early-stage disease, but survival was lower at five years compared to reports from other countries.

Background: Implications. Thyroid cancer has increased in recent decades worldwide. It is important to have specialized and decentralized centers for the initial management and follow-up of these patients to avoid long-term complications or fatal outcomes and to have updated epidemiological information.

Background: This study aimed at studying the clinical and anatomopathological characteristics, treatment and survival of patients with differentiated thyroid cancer. A retrospective cohort study was conducted with data from 150 patients from a Peruvian hospital between the years 2010 to 2020. Characteristics and survival (Kaplan-Meier method) were described. The mean age was 48.3 years, 130 participants (86.7%) were women and the most frequent histologic type was papillary 94.6%. Of the participants, 74.2% had TNM stage I, 70.7% had total thyroidectomy and 68.7% received radioactive iodine. Overall survival at 5 years was 89.3%, being lower in those with TNM stage IV and higher in those who used radioactive iodine. In conclusion, in a hospital in Cusco, differentiated thyroid cancer was more frequent in women and survival was lower compared to reports from other countries.

Autoimmune hepatitis (AIH) is a complex condition with unclear origins, involving genetic susceptibility and environmental triggers that lead to immune system dysfunction. We report a case of a pregnant woman from a mosquito-borne disease-endemic area who presented jaundice, abdominal pain, and pruritus, complicated by acute liver failure. Immunological markers showed AIH triggered by dengue virus infection, which was confirmed by a positive IgM test. Treatment with supportive care followed by steroids and azathioprine resulted in favorable outcomes, averting the need for a liver transplant. Although AIH can be triggered by viruses, the role of dengue in its pathogenesis remains poorly understood. Regular clinical monitoring is vital for managing AIH, particularly during pregnancy, due to variable immune status and treatment responses. Further research is necessary to understand the link between dengue infection and AIH. Individualized treatment strategies are crucial, especially during pregnancy, in order to ensure favorable outcomes.

Objective.: To identify the presence of the SARS-CoV-2 virus in wastewater from hospitals in Peru.

Materials and methods.: Water samples were collected from the effluents of nine hospitals in Peru during March and September 2022. SARS-CoV-2 was identified by using Illumina sequencing. Variant, lineage and clade assignments were carried out using the Illumina and Nextclado tools. We verified whether the SARS-CoV-2 variants obtained from wastewater were similar to those reported by the National Institute of Health of Peru from patients during the same period and region.

Results.: Eighteen of the 20 hospital wastewater samples (90%) provided sequences of sufficient quality to be classified as the Omicron variant according to the WHO classification. Among them, six (30%) were assigned by Nextclade to clades 21K lineage BA.1.1 (n=1), 21L lineage BA.2 (n=2), and 22B lineages BA.5.1 (n=2) and BA .5.5 (n=1).

Conclusions.: SARS-CoV-2 variants were found in hospital wastewater samples and were similar to those reported by the surveillance system in patients during the same weeks and geographic areas. Wastewater monitoring could provide information on the environmental and temporal variation of viruses such as SARS-CoV-2.

Motivation for the study. To contribute to the surveillance of environmental samples from hospital effluents in order to achieve early warning of possible infectious disease outbreaks. Main findings. The Omicron variant of the COVID-19 virus was detected in wastewater from hospitals in Puno, Cuzco and Cajamarca; these results are similar to the reports by the Peruvian National Institute of Health based on nasopharyngeal swab samples. Implications. The presence of the Omicron variant in hospital wastewater during the third wave of the pandemic should raise awareness of the treatment system before wastewater is discharged into the public sewer system.

We present a historical account of autism in Peru. Currently, the term "autism spectrum conditions", from the neurodiversity paradigm, is used to describe neurodevelopmental disorders characterized by persistent difficulties in communication, social interaction, and restricted and repetitive behaviors and interests. In Peru, the scientific study of nervous and mental diseases began around 1920 and although the diagnosis of "childhood autism" was proposed in 1959, it only began to spread in the 1980s. Although significant advances were made in the 21st century, Peru still faces many challenges in addressing autism.

Objective.: To determine the effects of aerobic exercise on the components of the metabolic syndrome in older adult diabetic patients by means of a systematic review with meta-analysis.

Materials and methods.: We used the PubMed/Medline, Scopus, Cochrane library, Web of Science databases and the Google Scholar search engine. Randomized controlled trials (RCTs) were selected according to the inclusion criteria. Two reviewers independently determined whether studies met the inclusion criteria, extracted data, and used the Cochrane risk of bias tool (RoB 2). Quantitative analyses were performed in R v 4.0.5, using random effects.

Results.: We identified 8697 studies, of which 7 RCTs were included in the qualitative synthesis. Most studies were assessed as having a high or low RoB in at least three domains. Meta-analysis showed that aerobic exercise was effective in improving glucose levels (standardized mean difference [SMD]: -1.04; 95% confidence interval [95% CI] -1.27, -0.81), systolic blood pressure (SMD: -0.79; 95% CI: -1.02, -0.56), diastolic blood pressure (SMD: -0.75; 95% CI: -0.98, -0.52), glycosylated hemoglobin (SMD: -0.57, 95% CI: -0.77, -0.37), HDL (SMD: 0.35, 95% CI: 0.15, 0.55), triglycerides (SMD: -0.26, 95% CI: -0.47, -0.06). No significant adverse effects were reported. The level of certainty of the results was low for fasting glucose, moderate for systolic and diastolic blood pressure, and very low for the other outcomes, in addition to few adverse effects. However, these results should be interpreted with caution due to the use of surrogate markers.

Conclusions.: Aerobic exercise was shown to have a significant improvement in the components of the metabolic syndrome in older diabetic adults, and no major adverse effects were reported. However, we recommend more RCTs with longer intervention time to establish the impact on symptoms and complications.

Motivation for the study. The motivation for this research arises from the high prevalence of metabolic syndrome and diabetes mellitus around the world. Despite their impact, there is a gap in knowledge regarding non-pharmacological interventions in older adults aimed at improving the metabolic profile of these patients. Main findings. Our results show a significant improvement in glucose, blood pressure, glycosylated hemoglobin, HDL, and triglyceride levels after the aerobic exercise intervention. In addition, no significant adverse effects were observed. Public health implications. Physical exercise is an affordable and globally available strategy. It improves the metabolic profile of older adult patients with metabolic syndrome.

Motivation for the study. The presence of antibiotic resistance genes in bacteria isolated from common flies is a potential public health hazard because it facilitates the presence and spread of antibiotic resistance genes in the environment. Main findings. Thirty-eight bacterial strains identified in 14 species were isolated from within the fly bodies, of which 31 strains showed resistance to carbapenems and 26 strains showed resistance to colistin. Seven bacterial strains showed carbapenem resistance genes and one Escherichia coli strain had resistance to KPC, OXA-48 and mcr-1. Implications. This is the first report of antibiotic resistance genes in bacteria carried by common flies in Peru. The objective was to determine the presence of carbapenem resistance genes and plasmid resistance to colistin (mcr-1) in bacteria isolated from Musca domestica in a garbage dump near a hospital in Lima, Peru. Bacteria with phenotypic resistance to carbapenemics were isolated on CHROMagar mSuperCARBATM medium and colistin resistance profiling was performed using the colistin disk elution method. Detection of blaKPC, blaNDM, blaIMP, blaOXA-48, blaVIM and mcr-1 genes was performed by conventional PCR. The antimicrobial susceptibility profile was determined using the automated MicroScan system. We found that 31/38 strains had phenotypic resistance to carbapenemics and 26/38 strains had phenotypic resistance to colistin with a minimum inhibitory concentration ≥ 4 µg/ml. Finally, we identified seven bacterial strains with carbapenem resistance genes (OXA-48 and KPC) and one bacterial strain with plasmid resistance to colistin (mcr-1). One Escherichia coli strain had three resistance genes: KPC, OXA-48 and mcr-1.

Motivation for the study. There is a gap in knowledge about vertical transmission of SARS- CoV-2 and its implications for maternal and neonatal health, despite evidence of multisystem involvement in pregnant women with COVID-19. Main findings. The study results suggest low incidence of vertical transmission during pregnancy, with only one PCR-positive case in the placenta and one asymptomatic neonate. Implications. Our results can inform strategies for prevention and management of COVID-19 in pregnant women, as well as guide the development of health policies aimed at protecting maternal and neonatal health during the pandemic. The aim of this study was to analyze the vertical transmission of SARS-CoV-2 in pregnant women with COVID-19 in the Gynecology and Obstetrics Department of the Edgardo Rebagliati Martins National Hospital (HNERM). Twelve pregnant women who met the inclusion criteria were included. Real-time PCR (RT-PCR) tests for SARS-CoV-2 were performed when each woman was admitted to the hospital, placenta samples were collected for pathological evaluation as well. The results showed that vertical transmission of the virus was rare, with an overall low positivity rate in newborns. Although the study has limitations, such as the small number of cases and the lack of electron microscope analysis, it is the first attempt to evaluate vertical transmission in Peru. It is concluded that more research is needed to better understand the relationship between COVID-19 infection and complications during pregnancy.

Objectives.: To adapt the 7-item Generalized Anxiety Questionnaire (GAD-7) from English to the cultural and linguistic context of Quechua Collao and to analyze its psychometric properties in Puno, Peru.

Material and methods.: The GAD-7 in its original version was translated into the Collao Quechua variety and its psychometric properties were analyzed. The participants were bilingual (Spanish and Quechua), over 18 years of age and of both sexes. The exploratory factor analysis (EFA) was evaluated using parallel analysis, confirmatory factor analysis (CFA) and goodness-of-fit indices; reliability was also analyzed using McDonald's classic alpha and Omega.

Results.: Judges and focus group participants conducted the cultural and linguistic adaptation of the GAD-7 to Quechua Collao; the EFA reported the presence of a single factor (KMO=0.88, p=0.01); while the CFA confirmed adequate adjustments in the unifactorial model (CFI=0.994; TLI=0.991; SRMR=0.027; RMSEA=0.092), good reliability (α=0.896; ω=0.894) and was also invariant across age groups, sex, marital status and educational level.

Conclusions.: The questionnaire showed validity for a unidimensional model of the GAD-7 adapted to the Collao Quechua, as well as optimal reliability and invariance by the evaluated groups. Its use could benefit anxiety research and care.

Motivation for the study. Peru has the largest Quechua population; however, the measurement of anxiety is not validated in the cultural and linguistic context of the Collao Quechua variety mainly spoken in Puno. Main findings. The adaptation of the 7-item Generalized Anxiety Questionnaire (GAD-7) to Collao Quechua reported adequate internal validity, invariance, and optimal reliability. Implications. The GAD-7 adapted to Collao Quechua could be implemented in primary health care for screening for generalized anxiety symptoms.