• 7 datos sobre la Enfermedad de Carrión

      Universidad Peruana de Ciencias Aplicadas (UPC) (Universidad Peruana de Ciencias Aplicadas (UPC), 2015-08-20)
      Endémica de los valles andinos de Perú, Ecuador y Colombia, la enfermedad de Carrión, si no es tratada, resulta fatal entre el 44% y el 88% de los casos.
      Acceso abierto
    • Actualización en Covid-19: interpretación de evidencia científica para le manejo médico y escenarios posibles

      Vásquez-Garagatti, Raúl (2020-06-12)
      Segunda conferencia internacional de actualización en COVID-19, brindada por el Dr. Raúl Vásquez-Garagatti. El conferencista una mirada general de la evidencia recientemente publicada para del manejo del paciente crítico con COVID-19.
    • Actualización en COVID-19: Manejo del Paciente Crítico

      Vásquez-Garagatti, Raúl (2020-04-06)
      Conferencia internacional de actualización del manejo del paciente crítico con COVID-19, brindada por el Dr. Raúl Vásquez-Garagatti. El conferencista brinda una mirada integral al origen, epidemiología, diagnóstico y tratamiento de esta enfermedad enmarcada en la coyuntura global.
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    • Assessment with liver function tests and hydroperoxides in short term very-lowbirth-weight neonatal parenteral nutrition

      Universidad Peruana de Ciencias Aplicadas (UPC) (Elsevier B.V., 2015-03-23)
      Rationale: It has been reported that PN (parenteral nutrition) in preterm neonates may have deleterious effects on hepatic function. We also studied the influence of peroxidation in PN bags, with and without light protection. Methods: 30 neonates weighing 1000 1500 g on TPN were studied prospectively. Serum samples were taken at start and at end of PN. Peroxides from 31 bags at 0, 5, 18 and 24 hours were measured. PN samples were taken from both light protected and not light protected PN bags. Results: Patients: (1) With PN: GOT = 28.63±13.00 IU; GPT = 7.37±5.10 IU; TB = 9.03±3.40 IU; DB = 0.845 ±0.43 UI; GGT = 110.41±81.87 IU. (2) Without PN: GOT = 28.73±16.36 IU; GPT = 10.53±8.38 IU; TB = 6.36±3.91 IU; DB = 1.35±1.53 IU; GGT = 128.38±75.74 IU. Significant differences: GPT, TB and DB (p < 0.05). Peroxides in bags: light protected and not, respectively, at 0 hours: 278.01±139.92 and 299.87±166.00, at 5 hours: 142.28±117.93 and 155.11±140.81, at 18 hours 183.39±115.40 and 212.92±133.72 and at 24 hours 258.58±187.81 and 284.55±162.78. At 18 hours the difference was significant (p < 0.05). Conclusions: 1. TB and 18-hour hydroperoxides concentrations were higher in serum, with PN and in light unprotected PN bags, respectively. 2. GPT and DB serum levels were lower with PN. 3. Within the conditions of this study, no association was found between hepatic function alterations and short-term TPN as well as with bag light exposure in neonates.
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    • ¡Bienvenidos Futuros Médicos! – Evento de Bienvenida. Bloque 1

      Chiarella, Pascual (2020-10-11)
      Revive con nosotros el evento de Bienvenida a los ingresantes de la carrera de Medicina del primer examen de admisión de Medicina, el pasado 11 de octubre del 2020.
    • ¡Bienvenidos Futuros Médicos! – Evento de Bienvenida. Bloque 2

      Pascual, Chiarella (2020-10-11)
      Revive con nosotros el evento de Bienvenida a los ingresantes de la carrera de Medicina del primer examen de admisión de Medicina, el pasado 11 de octubre del 2020.
    • Carrion’s Disease: diagnostic and antibody levels in a northern endemic area of Peru

      Universidad Peruana de Ciencias Aplicadas (UPC) (Joint International Tropical Medicine Meeting, 2015-08-13)
      The objective of this study was to compare 2 different techniques used in Peru for diagnostic and evaluate the antibody titters for B. bacilliformis in inhabitants of both post-outbreak and one established endemic area.
      Acceso abierto
    • Conociendo el Sistema de Residencia en EE. UU. y España

      Morales, Andrés (2020-01-22)
      Conversatorio dirigido a estudiantes de diferentes niveles del programa medicina, que desean conocer rutas de acceso a residentados en EE. UU. y España.
    • Covid-19 and the social determinants of health

      Hill, Sarah (2020-03-27)
      Los expertos en salud pública han enfatizado durante mucho tiempo la importancia de los determinantes sociales de la salud, es decir, las condiciones en que las personas viven, trabajan e interactúan entre sí, y su influencia en la salud. La rápida propagación de Covid- 19 ha llevado a muchos gobiernos e instituciones a tomar medidas drásticas para reducir el riesgo de transmisión viral y la consiguiente carga de salud pública. Sin embargo, en muchos contextos, estas medidas de emergencia se llevan a cabo después de años de baja inversión en servicios públicos, lo que hace que las poblaciones y los sistemas de salud sean más vulnerables a los desafíos agudos; y los aspectos de la respuesta de emergencia (incluidas las reducciones dramáticas en el contacto social y la participación en el mercado laboral) probablemente comprometerán aún más los determinantes más amplios de la salud. / Esta conferencia explorará la relación entre la emergencia de Covid-19 y los determinantes sociales de la salud, abordando la cuestión de si las respuestas estatales pueden a largo plazo causar más daño que el coronavirus. También consideraremos si la emergencia actual crea oportunidades para una reorientación política que prioriza la salud y la sostenibilidad sobre el crecimiento económico.
    • Direct blood analysis of Bartonella bacilliformis Multi Locus Sequence Typing in patients with Oroya’s fever during a Peruvian outbreak

      Universidad Peruana de Ciencias Aplicadas (UPC) (Universidad Peruana de Ciencias Aplicadas (UPC), 2015-11-18)
      The bacteria Bartonella bacilliformis is the etiological agent of Carrion’s disease, which is a neglected poverty-related disease, affecting Mountain Andean valleys of Peru, Colombia and Ecuador. This disease, in absence of treatment presents a high mortality during the acute phase, called Oroya’s Fever. The second phase is characterized by the development of dermal eruptions, known as “Peruvian wart”. This bacterium is a fastidious slow growing microorganism, being difficult and cumbersome to culture and isolate from clinical sources. Then, the available data about phylogenetic relationship in clinical samples are really scarce, but suggesting high variability. The aim of the study was to perform direct blood analysis of B. bacilliformis Multi Locus Sequence Typing (MLST), a genotyping tool, in patients with Oroya fever during an outbreak. The present study demonstrate that the direct blood MLST PCR is a technique useful in the phylogenic characterization of this fastidious microorganism endemic from Andean regions. In this study, we demonstrate that the outbreak of Oroya’s fever was caused by closely related Sequence Typing (ST) microorganisms and, additionally, new STs have been described.
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    • Etiological and molecular diagnostic of Carrion’s disease in patients from Cajamarca - Perú

      Ruiz, J; Silva, W.; Tinoco, C.; Pons, Maria J; Pons, Maria J; Del Valle, Luis J.; Gomez, C.; Bazan, Jorge; Vargas, M.; Champin, D.; Mendoza, J. del Valle; juana.delvalle@upc.edu.pe (2014-07-17)
      Background: Bartonellagenus is a group of facultative intracellular pathogens that posses able to survive and proliferate inside of erythrocytes. Classified within this genus,Bartonella bacilliformisis of special relevance. This microorganism is the etiological agent of the so called Carrion’s Disease (Human bartonellosis). Additionally the presence of sub-clinical cases (asymptomatyc carriers) is of special interest, because acts as a reservoir of this illness. Carrión’s Disease is an endemic illnes in Perú, affecting in a special manner the north interandean valleys. However, the current in use diagnostic techniques (Giemsa Stain) possess low sensitivity and specificity, and due to the fact thatB. bacilliformispossess a low growth (weeks), bacterial cultures lacks of clinical utility. Thus suspictious cases frequently are not confirmed, and the real relevance of this illness remains underestimated. This work is addressed to the direct identification from blood samples ofBartonella baciliformisusing a conventional PCR. All patients were from the Cajamarca area being enrolled by the Epidemiological Surveillance program of DIRESA. Methods: The samples were processed at arriving to the laboratory, by molecular and microbiological techniques. Thus samples were cultured in Blood Columbia Agar (10%), in anaerobic conditions at 28 ◦C for a period of 2 months. Positive cultures were both Giemsa stained and identified by the amplification of a fragment the 16S rRNA gene. Genetic material was directly extracted from blood samples using the Kit High Pure (Roche diagnostic), and a fragment of 438 bp of the 16S rRNA gene was amplified withBartonellagenus specific primers. All positive PCR were sequenced (Macrogen-Korea). Results: A total of 134 blood samples were processed, from this 12 (8.9%) grown in blood agar, while in 18 (13.4%), including the aforementioned 12, the 16 s rRNA gene was amplified. In all cases the sequence analysis showed the presence ofB. bacilliformis Conclusion: Although microbiological culture is the gold standard in the identification ofBartonellaspp., this technique possess strong limitations due to the low growth of these microorganisms. However, the PCR is a rapid technique, possessing a high sensibility and specificity that may be used as routine diagnostic tool for the identification of Carrion’s Disease.
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    • Evaluation of three PCR schemes for detection of Bartonella bacilliformis in blood samples: sensitivity, specificity and applicability

      Universidad Peruana de Ciencias Aplicadas (UPC) (Elsevier B.V., 2015-03-24)
      Background: Bartonella bacilliformis is the etiological agent of Carrion’s disease, a neglected illness with a febrile lethal stage and a warty benign phase, being the human the only known reservoir. The diagnostic by microscopy in endemic areas is several times erroneous. Furthermore, the culture of this bacterium is time-consuming, being the diagnostic by PCR the easiest way to perform a correct diagnostic. The objective of this study was to evaluate the detection limit of three PCR schemes, designed to detect B.bacilliformis, both in blood and filter papers to test their potential use for transferring samples from endemic areas to reference centers. Moreover, the specificity was also observed as well as the applicability of the technique with clinical samples from different stages of the disease. Methods & Materials: Fragments of 16SrRNA and fla genes were amplified as well as the variable-intergenic region (its). The detection limit was determined by bacterial quantification with flow cytometry and performing dilutions (106cfu/ml-10cfu/ml) both in blood and filter papers. DNA was extracted and PCRs were performed. Specificity was tested by processing other bacteraemia microorganisms. Clinical samples, 12 from febrile patients, 13 from warty and 71 from healthy asymptomatic individuals living in endemic area(Mandinga-Cajamarca) were also processed. Results: The 16SrRNA PCR scheme showed the lower detection limit (5 cfu from blood and filter paper) being the PCR scheme chosen to be tested in clinical samples. All febrile patients’ samples were positive, whereas in warty individuals only 3(23%) faint bands were obtained. No amplification was obtained in samples from healthy people. Fainter bands were always obtained when PCRs were made of filter papers. All PCRs were specific for B.bacilliformis. Conclusion: The 16SrRNA PCR seems to be the best technique to detect feverish patients. However, the applicability to identify asymptomatic carriers was undetermined. Filter paper may be an alternative for easy transportation of samples but is need to consider the decreasing sensitivity of the results. It is critical to develop rapid, sensitive and specific technique capable of being applied in endemic rural areas, to avoid misdiagnosis and facilitate the detection of asymptomatic carriers that will allow progress towards the eradication of this disease.
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    • Fascioliasis in schoolchildren in the inter andean valley of Cajamarca, Peru

      Rodriguez Ulloa, Claudia; Rivera-Jacinto, Marco; Hobán Vergara, Cristian; Del Valle Mendoza, Juana Mercedes; Ortiz Oblitas, Pedro (WAAVP 2015, 2015-08)
      Fascioliasis, caused by Fasciola hepatica, is a public health problem in Peru, especially in schoolchildren. Prevalence rates in livestock are over 80% in dairy cattle reared in the Andean valley of Cajamarca, Peru. The present investigation aimed to determine the prevalence of F. hepatica infection in schoolchildren and the main risk factors involved in its presentation. Two hundred and seventy schoolchildren nine years old and over from primary public institutions from the district of Los Baños del Inca (Cajamarca) were included in the investigation. Questionnaires were applied to parents and children and fecal samples were taken and evaluated using the rapid sedimentation technique. Blood samples were also collected and analyzed. Seventeen fecal samples were positive to F. hepatica eggs, giving a prevalence of 6.3% (95% CI 3.21 - 9.38). Significant differences were found with origin of the child, history of intestinal parasitism, and the habit of chewing grass (p< 0.05). The rural origin (OR 4.8, 95% CI: 1.53-15.08) and the habit of chewing grass (OR 3.26, CI: 95% 1.07 - 9.96) were the most likely risk factors associated with the acquisition of infection. The leukocyte count of infected children varied between 3900 and 10580 cells /mm3 (mean ± SD = 6458.3 ± 2080.3). Thirty three percent of children positive to F. hepatica eggs presented eosinophilia. We conclude that the prevalence of human fascioliasis in the district of Los Baños del Inca is at the mesoendemic level and rurality provides conditions for acquiring the infection.
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    • High prevalence of Bordetella pertussis in severe acute respiratory infections in hospitalized children under 5 years in Lima, Peru

      Universidad Peruana de Ciencias Aplicadas (UPC) (Universidad Peruana de Ciencias Aplicadas (UPC), 2015-11-18)
      Acute respiratory infections (ARI) are the main cause of morbidity and mortality in children under 5 years worldwide. Bordetella pertussis is a highly contagious bacterium that can cause serious illness, and approximately half of infected infants less than 1 year old are hospitalized. Also, pertussis immunization series is not completed until six months of age, leaving young infants vulnerable to pertussis. In Peru, pertussis is an increasing health problem despite immunization efforts, and the role of B. pertussis in ARI is unknown. We determined the prevalence of B. pertussis among children under 5 years old admitted to Hospital Nacional Cayetano Heredia in Lima with diagnosis of ARI between Jan-2009 and Dec 2010. Epidemiological and clinical features were collected, and presence of B. pertussis was determined by PCR (pertussis toxin and IS481 gene). A total of 596 nasopharyngeal samples among children under 5 years were analyzed. In 114 (19.1%) samples were positive for B. pertussis. 32.5% of sample positive to B. pertussis were diagnosed as viral pneumonia at diagnosis. Importantly, 71.9% of cases were under 12 months of age and 58.8% have been contact with other ARI infected people. Significant differences in clinical symptoms between the total ARI cases and B. pertussis cases were not found. The most frequent symptoms in B. pertussis cases were fever (100%), rhinorrhea 78%, cough 71.9% and respiratory distress 60.5%. One child died due to the infection. B. pertussis cases showed a seasonal distribution with peaks during the months March June and November. This study shows the high prevalence of B. pertussis in infants who were hospitalized due to severe acute respiratory infections in Lima, Peru. Epidemiologic surveillance programs for B. pertussis are essential in the future in Peru
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    • Identification of new antigen candidates of Bartonella bacilliformis

      Universidad Peruana de Ciencias Aplicadas (UPC) (Universidad Peruana de Ciencias Aplicadas (UPC), 2015-11-18)
      Bartonella bacilliformis is the aetiological agent of Carrion's disease, an overlooked illness with a lethal febrile stage and a benign warty phase. Its endemic in Andean areas, mainly affecting Peru, but also reported in Ecuador, Colombia, Bolivia and Chile.
      Acceso abierto
    • Incidencia de virus respiratorios en niños del Hospital Regional de Cajamarca en Perú

      Universidad Peruana de Ciencias Aplicadas (UPC) (Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica, 2015-08-08)
      Antecedentes y Objetivos: El rol de los virus respiratorios ha sido previamente sub-estimado en la comunidad. Por esta razón, el objetivo de este estudio es evaluar la incidencia y las características clínicas de las infecciones respiratorias agudas (IRA) en niños de la Región Sierra Norte del Perú (Cajamarca), para lo cual se utilizó la técnica de RT-PCR multiplex y la RT-PCR a Tiempo Real como prueba de rutina en el laboratorio. Métodos: En este estudio fueron incluidos 55 pacientes entre 0 a 17 años diagnosticados con IRA provenientes del Hospital Regional de Cajamarca (DIRESA-Cajamarca) durante los meses de agosto a diciembre del 2009. Las muestras fueron colectadas mediante hisopados nasofaríngeos y procesados para evaluar microorganismos patógenos respiratorios mediante las técnicas de amplificación de ácidos nucleicos mediante Reacción en Cadena de la Polimerasa: RT-PCR multiplex para la detección de: virus de la gripe A, B y C; virus respiratorio sincitial A y B; adenovirus; virus parainfluenza 1, 2, 3, y 4; rinovirus; enterovirus y coronavirus, RT-PCR a Tiempo Real para el diagnóstico de virus de la gripe A pandémica (H1N1) y PCR convencional para la detección de: Chlamydia pneumoniae, Mycoplasma pneumoniae, Chlamydia trachomatis y Bordetella pertussis. De acuerdo a la etiología, los resultados fueron categorizados en 4 grupos: grupo 1 (sólo detección de virus); grupo 2 (sólo detección de bacterias), grupo 3 (virus + bacterias) y grupo 4 (co-infección bacteriana). Resultados: De los 55 pacientes diagnosticados con IRA se evaluó la etiología de la siguiente manera: grupo 1, n = 29 (52,7%); grupo 2, n= 16 (20,09%); grupo 3, n = 6 (10,9%) y grupo 4, n = 2 (3,6%). De los 29 virus respiratorios identificados se observó: virus de la gripe A pandémica (H1N1) (n = 25, 45,45%), virus de la gripe A estacional (n = 3; 5,45%) y virus parainfluenza 1 (n = 1; 1,81%). De las 16 bacterias identificadas se observo: Chlamydia pneumoniae (n = 7 pacientes, 12,7%), Mycoplasma pneumoniae (n = 6 pacientes, 10,9%), Bordetella pertussis (n = 3 pacientes, 5,45%). De los 55 pacientes, 6 de ellos presentaron co-infección virus-bacteria: virus de la gripe A pandémica (H1N1) + Chlamydia pneumoniae (n = 4; 7,27), virus de la gripe A estacional + Mycoplasma pneumoniae (n = 1; 1,81%) y virus de la gripe A estacional + Bordetella pertussis (n = 1; 1,81%). Sóo 2 casos presentaron co-infección bacteriana: Mycoplasma pneumoniae + Chlamydia pneumoniae (n = 2; 3,62%). Conclusión: La técnica de amplificación de ácidos nucleicos, revela que los virus respiratorios representan el agente etiológico más común del IRA, las características clínicas no pueden distinguir entre infección viral o bacteriana. Por esta razón es importante implementar técnicas moleculares como pruebas de rutina en los laboratorios regionales para ofrecer un diagnóstico adecuado y a tiempo al paciente.
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    • Infectious agents, Leptospira spp. and Bartonella spp., in blood donors from Cajamarca, Peru

      Universidad Peruana de Ciencias Aplicadas (UPC) (2015-08-13)
      In blood banks the sought for a series of relevant pathogens able to be transmitted by blood transfusions is widely implemented; however the presence of a series of pathogens in blood bank donations remained understudied. This is the case of some bacteria such as Leptospira spp. or Bartonella spp. Bartonella species are bloodborne, re-emerging organisms, capable of causing prolonged infections in animals and humans. Meanwhile, Leptospirosis is recognised as an emerging public health problem worldwide. Both infections are considered neglected tropical diseases.
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    • Laser stimulation on adipocytes and stem cells (ASC): Improving our facial rejuvenation

      Centurión, Patricio; Noriega, Adrián (Universidad Peruana de Ciencias Aplicadas (UPC), 2014-08-25)
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