• A 12-month clinical trial examining the effects of a surface sealant on Class I composite resin restorations.

      Nahsan, Flavia Pardo Salata; Wang, Linda; Modena, Karin Silva; Francisconi Dos Rios, Luciana Fàvaro; Silva, Luciana Mendonça da; Calabria, Marcela Pagani; Casas Apayco, Leslie Caroll; Mondelli, Rafael Francisco Lia (Chicago, Academy of General Dentistry, 2016-03)
      A split-mouth, double-blind trial evaluated the effects of a surface sealant on the clinical performance of Class I composite resin restorations. In 16 patients, 27 pairs of maxillary and mandibular molars or premolars with Class I carious lesions or unsatisfactory restorations were restored with composite resin. For each pair, 1 surface was sealed with surface sealant. Clinical evaluations of marginal integrity, marginal discoloration, anatomical form, and secondary caries were performed by 2 experienced operators using modified US Public Health Service criteria 1-2 weeks and 6 and 12 months after treatment. Data were analyzed with the McNemar test (P < 0.05). After 6 months, only 1 (4%) sealed restoration presented a Bravo rating for marginal integrity. After 12 months, the Bravo ratings for marginal integrity were 2 (7%) for sealed restorations and 1 (4%) for nonsealed restorations. Restorations received a score of Alfa for all other parameters at all time periods. There were no statistically significant differences within or between the sealed and nonsealed groups (P = 1.0). The use of a surface sealant did not improve the clinical performance of posterior composite resin Class I restorations.
      Acceso restringido temporalmente
    • A biometric method based on the matching of dilated and skeletonized IR images of the veins map of the dorsum of the hand

      Universidad Peruana de Ciencias Aplicadas (UPC) (IEEE, 2015-06-02)
      This work proposes a biometric identification system that works together with a palm vein reader sensor and a hand-clenching support, designed to perform the capture the back of the hand. Several processing steps were performed: extraction of the region of interest, binarization, dilation, noise filtering, skeletonization, as well as extraction and verification of patterns based on the measurment of coincidence of vertical and horizontal displacements of skeletonized and dilated images. The proposed method achieved the following results: processing time post capture of 1.8 seconds, FRR of 0.47% and FAR of 0,00%, with a referential database of 50 people from a total of 1500 random captures.
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    • A comment on “Body image and paranoia”

      Jeri-Yabar, Antoine; Marin-Leiva, Javiera; Tejada, Romina A. (Elsevier Ireland Ltd, 2018-01)
      Cartas al Editor
    • A community randomised controlled trial evaluating a home-based environmental intervention package of improved stoves, solar water disinfection and kitchen sinks in rural Peru: Rationale, trial design and baseline findings

      Hartinger, S.M.; Lanata, Claudio F.; Hattendorf, J.; Gil, I.; Verastegui, H.; Ochoa, T.; Mäusezahl, D. (Elsevier B.V., 2015-03-24)
      Introduction: Pneumonia and diarrhoea are leading causes of death in children. There is a need to develop effective interventions. Objective: We present the design and baseline findings of a community-randomised controlled trial in rural Peru to evaluate the health impact of an Integrated Home-based Intervention Package in children aged 6 to 35 months. Methods: We randomised 51 communities. The intervention was developed through a community-participatory approach prior to the trial. They comprised the construction of improved stoves and kitchen sinks, the promotion of hand washing, and solar drinking water disinfection (SODIS). To reduce the potential impact of non-blinding bias, a psychomotor stimulation intervention was implemented in the control arm. The baseline survey included anthropometric and socio-economic characteristics. In a sub-sample we determined the level of faecal contamination of drinking water, hands and kitchen utensils and the prevalence of diarrhoegenic Escherichia coli in stool specimen. Results: We enrolled 534 children. At baseline all households used open fires and 77% had access to piped water supplies. E. coli was found in drinking water in 68% and 64% of the intervention and control households. Diarrhoegenic E. coli strains were isolated from 45/139 stool samples. The proportion of stunted children was 54%. Conclusions: Randomization resulted in comparable study arms. Recently, several critical reviews raised major concerns on the reliability of open health intervention trials, because of uncertain sustainability and non-blinding bias. In this regard, the presented trial featuring objective outcome measures, a simultaneous intervention in the control communities and a 12- month follow up period will provide valuable evidence.
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    • A Cost Analysis of Gyrase A Testing and Targeted Ciprofloxacin Therapy Versus Recommended 2-Drug Therapy for Neisseria gonorrhoeae Infection

      Allan-Blitz, Lao-Tzu; Hemarajata, Peera; Humphries, Romney M.; Wynn, Adriane; Segura, Eddy R.; Klausner, Jeffrey D. (Lippincott Williams and Wilkins, 2018-02)
      From the *Division of Infectious Diseases, Department of Medicine, †Department of Laboratory Medicine, David Geffen School of Medicine, Department of Medicine, ‡Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA; §Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru; and ¶Division of Infectious Diseases, Department of Medicine, University of California Los Angeles, Los Angeles, CA Conflict of Interest and Sources of Funding: None declared. This research was supported by the United States National Institutes of Health grants R21AI117256 and R21AI109005 as well as the South American Program in HIV Prevention Research NIH/NIMH R25MH087222. Correspondence: Lao-Tzu Allan-Blitz, MD Candidate, 2018, David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Ave, Los Angeles, CA 90095. E‐mail: lallanblitz@mednet.ucla.edu. Received for publication February 21, 2017, and accepted July 30, 2017. DOI: 10.1097/OLQ.0000000000000698
    • A critical appraisal on the association and effects of magnesium and bone density on physical performance in elderly women.

      Unocc, Carla P; Valdez, Laura I; Segura, Eddy R.; laura_valdez25@hotmail.com (American Society for Nutrition, 2015-04)
      Cartas al editor
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    • A middle rate of failed extubation is desirable?: Questions unanswered (reply).

      Kapnadak, Siddhartha G; Herndon, Steve E; Burns, Suzanne M; Shim, Y Michael; Enfield, Kyle; Brown, Cynthia; Truwit, Jonathon D; Vinayak, Ajeet G; aracely.silva44@gmail.com (Elsevier B.V., 2015-12)
      Cartas al editor
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    • A Novel Steganography Technique for SDTV-H.264/AVC Encoded Video

      Di Laura, Christian; Pajuelo, Diego; Kemper, Guillermo (Hindawi Publishing Corporation, 2016-04)
      Today, eavesdropping is becoming a common issue in the rapidly growing digital network and has foreseen the need for secret communication channels embedded in digital media. In this paper, a novel steganography technique designed for Standard Definition Digital Television (SDTV) H.264/AVC encoded video sequences is presented. The algorithm introduced here makes use of the compression properties of the Context Adaptive Variable Length Coding (CAVLC) entropy encoder to achieve a low complexity and real-time inserting method. The chosen scheme hides the private message directly in the H.264/AVC bit stream by modifying the AC frequency quantized residual luminance coefficients of intrapredicted I-frames. In order to avoid error propagation in adjacent blocks, an interlaced embedding strategy is applied. Likewise, the steganography technique proposed allows self-detection of the hidden message at the target destination. The code source was implemented by mixing MATLAB 2010 b and Java development environments. Finally, experimental results have been assessed through objective and subjective quality measures and reveal that less visible artifacts are produced with the technique proposed by reaching PSNR values above 40.0 dB and an embedding bit rate average per secret communication channel of 425 bits/sec. This exemplifies that steganography is affordable in digital television.
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    • A population-based study of cervical cytology findings and human papillomavirus infection in a suburban area of Thailand

      Phoolcharoen, Natacha; Kantathavorn, Nuttavut; Sricharunrat, Thaniya; Saeloo, Siriporn; Krongthong, Waraphorn (Elsevier B.V., 2017-08)
      Cartas al Editor
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    • A Shocking Cystory

      Cayo Quiñe, Alexandra; Bustamante Voysest, Rossi; Martínez Vargas, Valeria (Elsevier B.V., 2015-04-09)
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    • A systematic review and meta-analysis of the relative efficacy and safety of treatment regimens for HIV-associated cerebral toxoplasmosis: is trimethoprim-sulfamethoxazole a real option?

      Hernandez, Adrian V.; Thota, P; Pellegrino, D; Pasupuleti, V; Benites Zapata, Vicente A.; Deshpande, A; Penalva de Oliveira, AC; Vidal, JE; School of Medicine; Universidad Peruana de Ciencias Aplicadas (UPC); Lima Peru; Department of Medicine; Case Western Reserve University; Cleveland OH USA; Department of Infectious Diseases; Instituto de Infectologia Emilio Ribas; Sao Paulo Brazil; Department of Medicine; Case Western Reserve University; Cleveland OH USA; Center for Public Health Research; Research Institute, Faculty of Medicine; Universidad de San Martin de Porres; Lima Peru; Medicine Institute Center for Value Based Care Research; Cleveland Clinic; Cleveland OH USA; Department of Neurology; Instituto de Infectologia Emilio Ribas; Sao Paulo Brazil; Department of Neurology; Instituto de Infectologia Emilio Ribas; Sao Paulo Brazil (Blackwell Publishing Ltd, 2017-02)
      OBJECTIVES: The objective of this study was to perform a systematic review and meta-analysis of the literature to evaluate the efficacy and safety of therapies for cerebral toxoplasmosis in HIV-infected adults. The pyrimethamine plus sulfadiazine (P-S) combination is considered the mainstay therapy for cerebral toxoplasmosis and pyrimethamine plus clindamycin (P-C) is the most common alternative treatment. Although trimethoprim-sulfamethoxazole (TMP-SMX) has potential advantages, its use is infrequent. METHODS: We searched PubMed and four other databases to identify randomized controlled trials (RCTs) and cohort studies. Two independent reviewers searched the databases, identified studies and extracted data. Risk ratios (RRs) were pooled across studies using random-effects models. RESULTS: Nine studies were included (five RCTs, three retrospective cohort studies and one prospective cohort study). In comparison to P-S, treatment with P-C or TMP-SMX was associated with similar rates of partial or complete clinical response [P-C: RR 0.87; 95% confidence interval (CI) 0.70-1.08; TMP-SMX: RR 0.97; 95% CI 0.78-1.21], radiological response (P-C: RR 0.92; 95% CI 0.82-1.03), skin rash (P-C: RR 0.81; 95% CI 0.56-1.17; TMP-SMX: RR 0.17; 95% CI 0.02-1.29), gastrointestinal impairment (P-C: RR 5.16; 95% CI 0.66-40.11), and drug discontinuation because of adverse events (P-C: RR 0.32; 95% CI 0.07-1.47). Liver impairment was more frequent with P-S than P-C (P-C vs. P-S: RR 0.48; 95% CI 0.24-0.97). CONCLUSIONS: The current evidence fails to identify a superior regimen in terms of relative efficacy or safety for the treatment of HIV-associated cerebral toxoplasmosis. Use of TMP-SMX as preferred treatment may be consistent with the available evidence and other real-world considerations. Larger comparative studies are needed.
    • Abandono de la terapia nutricional y pérdida de peso en pacientes bariátricos: Cohorte retrospectiva en Lima, Perú

      Giacchetti-Vega, Monica; Baquerizo-vonBerswordts, Pamela; Carbone-Moane, Camila; Bernabe-Ortiz, Antonio; m.giacchetti4@gmail.com (Fundación Española de Dietistas-Nutricionistas (FEDN), 2017-04-04)
      Introduction: The aims of this study were to determine the proportion of patients who meet international recommendations for bariatric surgery and to assess the association between weight loss and dropout rate during diet therapy. Material and Methods: Retrospective cohort study performed using data from clinical records of patients who underwent sleeve gastrectomy in a private clinic of Lima, Peru. Two outcomes were evaluated, eligibility for bariatric surgery according to international recommendations (BMI≥40kg/m2 or ≥35kg/m2 with comorbidities) and abandonment before and after starting nutritional management (no nutritional assessment after 60 days from the previous visit without achieving ideal BMI). The exposure was the percentage of weight lost in the first five weeks after surgery split into <10% and ≥10%. Poisson regression was used and relative risks and 95% confidence intervals (95%CI) were calculated. Results: Data from 423 medical records of bariatric patients, mean age 39.2 years (±12.3), 294 (69.5%) women, were analyzed. Only 117 (27.7%) patients met international recommendations for bariatric surgery. Before starting nutritional management, 48/117 (41%) abandoned treatment, whereas an additional 29/69 (42.0%) abandoned before six months of nutritional management. Patient losing ≥10% of weight in the first month had 90% lower risk (RR=0.10; 95%CI:0.01-0.68) of nutritional therapy dropout compared to those who lost <10% of weight, controlling for sex and age. Conclusions: A great proportion of patients undergoing bariatric surgery did not meet the international criteria. A greater loss of weight during the first month was associated a lower dropout rate during nutritional therapy.
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    • About «Factors determining irregular attendance to follow-up visits among human immunodeficiency virus patients: Results of a hospital survey of patients infected with human immunodeficiency virus, 2002-2012»

      Guillermo Ladera, Dayana Sianny; Ventocilla Gonzales, Iris Janet; iris.vg.30@gmail.com (Elsevier B.V., 2016-04)
      Cartas al editor
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    • Acciones de prevención y control de la legionelosis: un reto para la salud pública española.

      Gea-Izquierdo, Enrique; Mezones Holguín, Edward; Haro-García, Luis (Instituto Nacional de Salud (INS), 2014-03-20)
      Legionellosis is a respiratory disease originating in systems that produce aerosol and contain Legionella sp. In recent decades, Spain has developed a regulatory framework for prevention and control of legionellosis. This article describes the epidemiology of legionellosis and the importance of controlling the transmission of bacteria in the fight against the disease. In that regard, it becomes clear the role of reviewing critical facilities and the inclusion of new ones in the preventive legislation, the estimation of risk, and the improvement in the diagnostic processes and progress in new prevention protocols.
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    • Accuracy of loop-mediated isothermal amplification for the diagnosis of Clostridium difficile infection: a systematic review

      Lloyd, Aaron; Pasupuleti, Vinay; Thota, Priyaleela; Pant, Chaitanya; Rolston, David D.K; Hernández, Adrian V.; Benites Zapata, Vicente A.; Fraser, Thomas G.; Donskey, Curtis J.; Deshpande, Abhishek (Elsevier B.V., 2015-02-24)
      Loop-mediated isothermal DNA amplification (LAMP) are currently used as standalone diagnostic test for C. difficile infection (CDI). We assessed the diagnostic accuracy of LAMP for the diagnosis of CDI. We searched 5 databases to identify studies that compared LAMP with culture cytotoxicity neutralization assay or anaerobic toxigenic culture (TC) of C. difficile. We used the random-effects model to calculate pooled sensitivities, specificities, diagnostic odds ratios and their 95% confidence intervals (CIs). The search of the databases yielded 16 studies (6,979 samples) that met inclusion criteria. When TC was used as the gold standard (6,572 samples), bivariate analysis yielded a mean sensitivity of 0.95 (95%CI, 0.93-0.97; I2 = 67.4) and a mean specificity of 0.99 (95%CI, 0.96-1.00; I2 = 97.0). LAMP is a useful diagnostic tool with high sensitivity and specificity for detecting CDI. The results should however be interpreted only in the presence of clinical suspicion and symptoms of CDI.
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    • Aceptabilidad del sabor de preparaciones hiposódicas con sustitutos de sal en pacientes diabéticos e hipertensos

      Ayerbe-Azabache, Angela; Calderón-Ramírez, Nancy; Taboada,Marco; Mayta-Tristan, Percy; angela_ayer@hotmail.com (2016-12)
      l objetivo de este estudio experimental fue comparar la aceptabilidad del sabor entre diferentes preparaciones con bajo contenido de sodio en pacientes diabéticos e hipertensos. Se realizó entre abril y mayo del 2015 en el Centro de Atención Integral de Diabetes e Hipertensión (CEDHI) en Lima, Perú. Las personas evaluadas fueron 67 pacientes ambulatorios del CEDHI, mayores de 18 años de ambos géneros, diagnosticados de hipertensión arterial o diabetes tipo 2. En total fueron aplicadas 134 pruebas sensoriales y 402 muestras preparadas. Las preparaciones que fueron sometidas a evaluación fueron arroz, caldo, pollo y verduras cocidas, adicionándoles sal común, cloruro de potasio [25%] con sal común [75%] y glutamato monosódico. Para medir los resultados se utilizaron dos pruebas hedónicas, de preferencia por ordenamiento y prueba de aceptabilidad (puntuación del 1 al 5). En los resultados no se encontraron diferencias significativas a nivel global en cuanto a la aceptabilidad y preferencia de las preparaciones con bajo contenido de sodio. Por lo cual, el reemplazo de la sal común por cualquiera de los sustitutos es viable para pacientes con prescripción de dieta hiposódica (1500 mg Na/día).
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    • Acerca de "Mapeo político de la discriminación y homofobia asociadas con la epidemia de VIH en México"

      Ochoa-Fernández, Andrea Carolina; Sánchez-Siancas, Johanna Edith; Ueda-Muro, Daniela Alexandra; Ugarte-Gil, César; danauedamuro@hotmail.com (Instituto Nacional de Salud Pública, 2017-02)
      Cartas al Editor
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    • ¿Activación o estiramiento muscularpara el alivio del dolor?

      Vega Bazán, Liliana (Elsevier B.V., 2015-04-09)
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    • Acuerdo de asociación transpacífico: cuando la cura es peor que la enfermedad

      Solari, Lely; lelysol@hotmail.com (Instituto Nacional de Salud (INS), 2015-09)
      Peru is negotiating the Transpacific Partnership Agreement, a commercial treaty that could have deleterious implications for the health systems of the included partners. Transparency and Intellectual Property chapters are the most controversial elements. The first mostly because it opens the possibility for groups of interest to refuse decisions being taken by the sanitary authorities concerning the incorporation of health technologies to the public health systems. The second because it poses restrictions to the entrance of generic medical products, widening the period of data exclusivity and implementing mechanisms of opposition to their registry. Other chapters include strategies to block the states from regulating the consumption of alcohol, tobacco and processed foods. We ought to create surveillance systems to evaluate the impact of the agreement if it is signed, and generate mechanisms that prevent the little resources we already have devoted for health to be deviated to top technology that will not necessarily have a positive impact at a population level.
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    • El Acuerdo Nacional como espacio de consenso para la definición de los objetivos de la reforma de salud y establecer políticas de salud en el Perú

      Nepo Linares, Edgardo; Velásquez, Aníbal; gabnepo@minsa.gob.pe (Instituto Nacional de Salud (INS), 2016-09)
      After several months of arduous deliberations, the National Agreement, a policy coordination forum highest level in Peru, approved a document entitled “The objectives of health care reform.” In this article it review the work done and the product reached by consensus, which includes as priorities, among others, strengthening of SIS like public insurance, implementation of a policy of multi-year investment, strengthening the protection of health rights outlined, strengthening the primary health care and improving access to safe and effective medicines. The effect is an agreement that gives significance to a process that has the character of state policy and defines the framework within which they must develop health policies in the following years.
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