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  • Association between knowledge and attitudes towards pediatric obstructive sleep apnea and dental specialty

    Díaz-Díaz, María Fernanda; Schlaefli-Arrieta, Ximena; Caballero García, Stefany; Geller Palti, Dafna (Taylor and Francis Ltd., 2023-01-01)
    Objective: To associate the knowledge and attitudes about Pediatric Obstructive Sleep Apnea (POSA) with the specialty of dentists in Metropolitan Lima, Peru. Methods: A cross-sectional, analytical observational study was carried out during 2021–2022. Two hundred and ten orthodontists and pediatric dentists were surveyed using the adapted and validated Spanish translation of the OSAKA-KIDS questionnaire and additional sociodemographic questions. Results: The data indicated an association between dental specialty and the professional’s knowledge about POSA. Orthodontists were 59% less likely to have acceptable knowledge, compared to pediatric dentists (p =.013, IC 95% 0.21–0.83). The study revealed an association between the professional’s attitudes and three intervening variables: age (p =.025), clinical experience (p =.049) and sector of practice (p =.020). Conclusion: Knowledge was associated with the dental specialty of professionals in the sample included, whilst attitudes were not.
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  • Call for emergency action to restore dietary diversity and protect global food systems in times of COVID-19 and beyond: Results from a cross-sectional study in 38 countries

    Hoteit, Maha; Hoteit, Reem; Aljawaldeh, Ayoub; Van Royen, Kathleen; Pabian, Sara; Decorte, Paulien; Cuykx, Isabelle; Teunissen, Lauranna; De Backer, Charlotte; Bergheim, Ina; Staltner, Raphaela; Devine, Amanda; Sambell, Ros; Wallace, Ruth; Allehdan, Sabika Salem; Alalwan, Tariq Abdulkarim; Al-Mannai, Mariam Ahamad; Ouvrein, Gaëlle; Poels, Karolien; Vandebosch, Heidi; Maldoy, Katrien; Matthys, Christophe; Smits, Tim; Vrinten, Jules; DeSmet, Ann; Teughels, Nelleke; Geuens, Maggie; Vermeir, Iris; Proesmans, Viktor; Hudders, Liselot; De Barcellos, Marcia Dutra; Ostermann, Cristina; Brock, Ana Luiza; Favieiro, Cynthia; Trizotto, Rafaela; Stangherlin, Isadora; Mafra, Anthonieta Looman; Correa Varella, Marco Antônio; Valentova, Jaroslava Varella; Fisher, Maryanne L.; MacEacheron, Melanie; White, Katherine; Habib, Rishad; Dobson, David S.; Schnettler, Berta; Orellana, Ligia; Miranda-Zapata, Edgardo; Wen-Yu Chang, Angela; Jiao, Wen; Liu, Matthew Tingchi; Grunert, Klaus G.; Christensen, Rikke Nyland; Reisch, Lucia; Janssen, Meike; Abril-Ulloa, Victoria; Encalada, Lorena; Kamel, Iman; Vainio, Annukka; Niva, Mari; Salmivaara, Laura; Mäkelä, Johanna; Torkkeli, Kaisa; Mai, Robert; Risch, Pamela Kerschke; Altsitsiadis, Efthymios; Stamos, Angelos; Antronikidis, Andreas; Henchion, Maeve; McCarthy, Sinead; McCarthy, Mary; Micalizzi, Alessandra; Schulz, Peter J.; Farinosi, Manuela; Komatsu, Hidenori; Tanaka, Nobuyuki; Kubota, Hiromi; Tayyem, Reema; Al-Awwad, Narmeen J.; Al-Bayyari, Nahla; Ibrahim, Mohammed O.; Hammouh, Fadwa; Dashti, Somaia; Dashti, Basma; Alkharaif, Dhuha; Alshatti, Amani; Al Mazedi, Maryam; Mansour, Rania; Naim, Elissa; Mortada, Hussein; Gutierrez Gomez, Yareni Yunuen; Geyskens, Kelly; Goukens, Caroline; Roy, Rajshri; Egli, Victoria; Morenga, Lisa Te; Waly, Mostafa; Qasrawi, Radwan; Hamdan, Motasem; Sier, Rania Abu; Al Halawa, Diala Abu (Elsevier Ltd, 2023-11-01)
    Background: The COVID-19 pandemic has revealed the fragility of the global food system, sending shockwaves across countries' societies and economy. This has presented formidable challenges to sustaining a healthy and resilient lifestyle. The objective of this study is to examine the food consumption patterns and assess diet diversity indicators, primarily focusing on the food consumption score (FCS), among households in 38 countries both before and during the first wave of the COVID-19 pandemic. Methods: A cross-sectional study with 37 207 participants (mean age: 36.70 ± 14.79, with 77 % women) was conducted in 38 countries through an online survey administered between April and June 2020. The study utilized a pre-tested food frequency questionnaire to explore food consumption patterns both before and during the COVID-19 periods. Additionally, the study computed Food Consumption Score (FCS) as a proxy indicator for assessing the dietary diversity of households. Findings: This quantification of global, regional and national dietary diversity across 38 countries showed an increment in the consumption of all food groups but a drop in the intake of vegetables and in the dietary diversity. The household's food consumption scores indicating dietary diversity varied across regions. It decreased in the Middle East and North Africa (MENA) countries, including Lebanon (p < 0.001) and increased in the Gulf Cooperation Council countries including Bahrain (p = 0.003), Egypt (p < 0.001) and United Arab Emirates (p = 0.013). A decline in the household's dietary diversity was observed in Australia (p < 0.001), in South Africa including Uganda (p < 0.001), in Europe including Belgium (p < 0.001), Denmark (p = 0.002), Finland (p < 0.001) and Netherland (p = 0.027) and in South America including Ecuador (p < 0.001), Brazil (p < 0.001), Mexico (p < 0.0001) and Peru (p < 0.001). Middle and older ages [OR = 1.2; 95 % CI = [1.125–1.426] [OR = 2.5; 95 % CI = [1.951–3.064], being a woman [OR = 1.2; 95 % CI = [1.117–1.367], having a high education (p < 0.001), and showing amelioration in food-related behaviors [OR = 1.4; 95 % CI = [1.292–1.709] were all linked to having a higher dietary diversity. Conclusion: The minor to moderate changes in food consumption patterns observed across the 38 countries within relatively short time frames could become lasting, leading to a significant and prolonged reduction in dietary diversity, as demonstrated by our findings.
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  • Time-on-task effects on human pupillary and saccadic metrics after theta burst transcranial magnetic stimulation over the frontal eye field

    Wang, Chin An; Muggleton, Neil G.; Chang, Yi Hsuan; Barquero, Cesar; Kuo, Ying Chun (Elsevier B.V., 2023-12-01)
    Pupil size undergoes constant changes primarily influenced by ambient luminance. These changes are referred to as the pupillary light reflex (PLR), where the pupil transiently constricts in response to light. PLR kinematics provides valuable insights into autonomic nervous system function and have significant clinical applications. Recent research indicates that attention plays a role in modulating the PLR, and the circuit involving the frontal eye field (FEF) and superior colliculus is causally involved in controlling this pupillary modulation. However, there is limited research exploring the role of the human FEF in these pupillary responses, and its impact on PLR metrics remains unexplored. Additionally, although the protocol of continuous theta-burst stimulation (cTBS) is well-established, the period of disruption after cTBS is yet to be examined in pupillary responses. Our study aimed to investigate the effects of FEF cTBS on pupillary and saccadic metrics in relation to time spent performing a task (referred to as time-on-task). We presented a bright stimulus to induce the PLR in visual- and memory-delay saccade tasks following cTBS over the right FEF or vertex. FEF cTBS, compared to vertex cTBS, resulted in decreased baseline pupil size, peak constriction velocities, and amplitude. Furthermore, the time-on-task effects on baseline pupil size, peak amplitude, and peak time differed between the two stimulation conditions. In contrast, the time-on-task effects on saccadic metrics were less pronounced between the two conditions. In summary, our study provides the first evidence that FEF cTBS affects human PLR metrics and that these effects are modulated by time-on-task.
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  • Respiratory, Cardiac, and Neuropsychiatric Manifestations of Postacute Sequelae of Coronavirus Disease 2019 in Lima, Peru

    Rahman, Rifat S.; Tovar, Marco A.; Peinado, Jesús; Palomino, J. Santiago; Ramirez, Claudio; Llanos-Zavalaga, Fernando; Peralta, Ernesto; Valderrama, Gissela; Ramos Cordova, Lourdes B.; Sanchez Cortez, Lucero I.; Rodriguez, German; Lahood, Allison N.; Franke, Molly F.; Mitnick, Carole D.; Lecca, Leonid; Velásquez, Gustavo E. (Oxford University Press, 2023-07-01)
    Background: Few studies have examined the burden of postacute sequelae of coronavirus disease 2019 (COVID-19) (PASC) in low- and middle-income countries. We sought to characterize PASC with self-reported questionnaires and clinical examinations of end-organ function in Lima, Peru. Methods: From January to July 2021, we recruited participants at least 8 weeks after COVID-19 diagnosis from a case registry in Lima, Peru. We evaluated participants for PASC with questionnaires, neuropsychiatric evaluations, chest X-ray, spirometry, electrocardiogram, and echocardiogram. We used multivariable models to identify risk factors for PASC. Results: We assessed 989 participants for PASC at a median 4.7 months after diagnosis. Clinically significant respiratory symptoms were reported by 68.3% of participants, particularly those who had been severely ill during acute COVID-19, and were associated with cardiac findings of ventricular hypertrophy or dilation on echocardiogram. Neuropsychiatric questionnaires were consistent with depression in 20.7% and cognitive impairment in 8.0%. Female sex and older age were associated with increased risk of respiratory (adjusted odds ratio [aOR], 2.36 [95% confidence interval {CI}, 1.69-3.31] and aOR, 1.01 [95% CI, 1.00-1.03], respectively) and neuropsychiatric sequelae (aOR, 2.99 [95% CI, 2.16-4.18] and aOR, 1.02 [95% CI, 1.01-1.03], respectively). Conclusions: COVID-19 survivors in Lima, Peru, experienced frequent postacute respiratory symptoms and depression, particularly among older and female participants. Clinical examinations highlighted the need for cardiopulmonary rehabilitation among persons with severe COVID-19; psychosocial support may be required among all COVID-19 survivors.
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  • Diversity and dissemination of viruses in pathogenic protozoa

    Heeren, Senne; Maes, Ilse; Sanders, Mandy; Lye, Lon Fye; Adaui, Vanessa; Arevalo, Jorge; Llanos-Cuentas, Alejandro; Garcia, Lineth; Lemey, Philippe; Beverley, Stephen M.; Cotton, James A.; Dujardin, Jean Claude; Van den Broeck, Frederik (Nature Research, 2023-12-01)
    Viruses are the most abundant biological entities on Earth and play a significant role in the evolution of many organisms and ecosystems. In pathogenic protozoa, the presence of viruses has been linked to an increased risk of treatment failure and severe clinical outcome. Here, we studied the molecular epidemiology of the zoonotic disease cutaneous leishmaniasis in Peru and Bolivia through a joint evolutionary analysis of Leishmania braziliensis and their dsRNA Leishmania virus 1. We show that parasite populations circulate in tropical rainforests and are associated with single viral lineages that appear in low prevalence. In contrast, groups of hybrid parasites are geographically and ecologically more dispersed and associated with an increased prevalence, diversity and spread of viruses. Our results suggest that parasite gene flow and hybridization increased the frequency of parasite-virus symbioses, a process that may change the epidemiology of leishmaniasis in the region.
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  • Confidence when performing single root canal treatments of the 4th and 5th year students of the Dentistry at a Private University of Lima

    Valdez Sosa, A. F.; Ayma-León, V.; Caballero-García, Carmen Stefany (Ediciones Avances S.L., 2023-04-01)
    Objective: To determine the confidence when performing single root canal treatments of the 4th and 5th year students of the Dentistry at a Private University of Lima. Materials and Methods: Eighty-one dental students from a private university in Lima were evaluated through a survey of the article prepared by Davey to measure their confidence when performing single root canal treatment. Internal validity was verified through questionnaire translation processes, expert judgment and a pilot test. Adequate coefficient of Aiken’s V (0.91), Cronbach’s Alpha (0.89), and Spearman’s correlation (0.61) were obtained. Descriptive statistical measures were obtained (Mean, S.D, Median, and IQR) and for the bivariate analysis, U Mann Whitney’s, Kruskal Wa-llis, Dunn Test and Spearman’s Correlation tests were used. Results: Students had a high confidence score (8.51) when performing a single root canal treatment and the lowest scores were when determining the length of work and the obturation of the canals with an average of 8.19 and 8.01 respectively. Likewise, the variables as previous experience, perception of complication and having had difficulties were statistically significant. Finally, a positive correlation was found between the dimensions of the variable perception of teaching in endodontics (p=0.003) (p=0.000) (p=0.000) and the variable confidence. Conclusions: There is high confidence when performing single root canal treatment by the students of 4th and 5th year of the Dentistry career.
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  • Protocol for a Randomized Trial Comparing Intracranial Pressure Monitor?Based Management of Severe Pediatric Traumatic Brain Injury with Management Based on Imaging and Clinical Examination Without Intracranial Pressure Monitoring

    Chesnut, Randall; Temkin, Nancy; Pridgeon, James; Sulzbacher, Stephen; Lujan, Silvia; Videtta, Walter; Moya-Barquín, Luis; Chaddock, Kelley; Bonow, Robert; Petroni, Gustavo; Guadagnoli, Nahuel; Hendrickson, Peter; Ramírez Cortez, Grimaldo; Carreazo, Nilton Yhuri; Vargas Aymituma, Alcides; Anchante, Daniel; Caqui, Patrick; Ramírez, Alberto; Munaico Abanto, Manuel; Ortiz Chicchon, Manuel; Cenzano Ramos, José; Mazate-Mazariegos, Analy; Castro Darce, María Del Carmen; Sierra Morales, Roberto; Brol Lopez, Pedro; Menendez, Willy; Posadas Gutierrez, Sofía; Kevin, Vicente; Mazariegos, Andrea; De Leon, Elie; Rodas Barrios, Rodolfo Enrique; Rodríguez, Sandra; Flores, Sandra; Alvarado, Ovidio; Guzman Flores, Luis José; Moisa Martinez, Melvin; Gonzalez, Pablo (Wolters Kluwer Medknow Publications CODEN NRSRD, 2023-07-06)
    BACKGROUND AND OBJECTIVES: Traumatic brain injury (TBI) is a major global public health problem. It is a leading cause of death and disability in children and adolescents worldwide. Although increased intracranial pressure (ICP) is common and associated with death and poor outcome after pediatric TBI, the efficacy of current ICP-based management remains controversial. We intend to provide Class I evidence testing the efficacy of a protocol based on current ICP monitor-based management vs care based on imaging and clinical examination without ICP monitoring in pediatric severe TBI. METHODS: A phase III, multicenter, parallel-group, randomized superiority trial performed in intensive care units in Central and South America to determine the impact on 6-month outcome of children aged 1-12 years with severe TBI (age-Appropriate Glasgow Coma Scale score ?8) randomized to ICP-based or non-ICP-based management. EXPECTED OUTCOMES: Primary outcome is 6-month Pediatric Quality of Life. Secondary outcomes are 3-month Pediatric Quality of Life, mortality, 3-month and 6-month Pediatric extended Glasgow Outcome Score, intensive care unit length of stay, and number of interventions focused on treating measured or suspected intracranial hypertension. DISCUSSION: This is not a study of the value of knowing the ICP in sTBI. This research question is protocol-based. We are investigating the added value of protocolized ICP management to treatment based on imaging and clinical examination in the global population of severe pediatric TBI. Demonstrating efficacy should standardize ICP monitoring in severe pediatric TBI. Alternate results should prompt reassessment of how and in which patients ICP data should be applied in neurotrauma care.
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  • Association between supplementation with vitamin A, iron and micronutrients with adequate psychomotor development in children from 9 to 36 months in Peru

    Chaponan-Lavalle, Andres; Randich, Karla Hernandez; Araujo-Castillo, Roger V. (Elsevier B.V., 2023-11-01)
    Background: Worldwide, it is estimated that 52.9 million children <5 years of age experience delayed psychomotor development, which is associated with multiple factors. Our primary objective is to evaluate whether there is an association between supplementation with Vitamin A, Iron, and Micronutrients and Adequate Psychomotor Development in children aged 9–36 months at the national level in Peru. Methods: The study was an observational, analytical, cross-sectional study based on the secondary analysis of the Demographic and Family Health Survey databases from 2018 to 2020. The independent variables include the consumption of Vitamin A, Iron, and Micronutrients. The dependent variables encompass Motor Development in children aged 9–18 months, Psychological Development in children aged 9–18 months, and Psychological Development in children aged 19–36 months. Results: The study included a total of 24 838 participants. In the adjusted regression model, the factors associated with adequate motor development between 9 and 18 months of age were: region of residence, overcrowding, and exclusive breastfeeding. For adequate cognitive development between 9 and 18 months of age, the associated factors were: vitamin A consumption, mother's education, child sex, delivery complications, and complete vaccinations. Regarding adequate psychological development in children aged 19–36 months, the associated factors were: mother's education, maternal employment, child sex, and birth weight. Conclusions: There was no association found between nutritional supplementation and adequate development, except for the relationship between Vitamin A consumption and adequate psychological development in children aged 9–18 months. Therefore, further research, such as cohort studies and clinical trials, is suggested to corroborate this association.
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  • Linking tonic and phasic pupil responses to P300 amplitude in an emotional face-word Stroop task

    Chang, Yi Hsuan; Chen, He Jun; Barquero, Cesar; Tsai, Hsu Jung; Liang, Wei Kuang; Hsu, Chun Hsien; Muggleton, Neil G.; Wang, Chin An (John Wiley and Sons Inc CODEN PSPHA, 2024-04-01)
    The locus coeruleus-norepinephrine (LC-NE) system, which regulates arousal levels, is important for cognitive control, including emotional conflict resolution. Additionally, the LC-NE system is implicated in P300 generation. If the P300 is mediated by the LC-NE system, and considering the established correlations between LC activity and pupil dilation, P300 amplitude should correlate with task-evoked (phasic) pupil dilation on a trial-by-trial basis. However, prior studies, predominantly utilizing oddball-type paradigms, have not demonstrated correlations between concurrently recorded task-evoked pupil dilation and P300 responses. Using a recently developed emotional face-word Stroop task that links pupil dilation to the LC-NE system, here, we examined both intra- and inter-individual correlations between task-evoked pupil dilation and P300 amplitude. We found that lower accuracy, slower reaction times, and larger task-evoked pupil dilation were obtained in the incongruent compared to the congruent condition. Furthermore, we observed intra-individual correlations between task-evoked pupil dilation and P300 amplitude, with larger pupil dilation correlating with a greater P300 amplitude. In contrast, pupil dilation did not exhibit consistent correlations with N450 and N170 amplitudes. Baseline (tonic) pupil size also showed correlations with P300 and N170 amplitudes, with smaller pupil size corresponding to larger amplitude. Moreover, inter-individual differences in task-evoked pupil dilation between the congruent and incongruent conditions correlated with differences in reaction time and P300 amplitude, though these effects only approached significance. To summarize, our study provides evidence for a connection between task-evoked pupil dilation and P300 amplitude at the single-trial level, suggesting the involvement of the LC-NE system in P300 generation.
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  • ASSOCIATION BETWEEN SCREEN TIME AND PHYSICAL ACTIVITY PERFORMED BY SCHOOLCHILDREN IN METROPOLITAN LIMA DURING THE STATE OF EMERGENCY DUE TO COVID-19

    Alegre-Navarro, Y.; Sánchez-Yaipén, N.; Uriarte-Delgado, M.; Bravo-Cucci, S. (Didactic Asociation Andalucia, 2023-09-01)
    Nowadays in the pandemic of Covid-19, it is important to know the ravages of the state of emergency in schoolchildren. For this reason, this cross-sectional analytical study aims to determine the association between screen time and the level of physical activity (PA). A total of 169 primary school students from Metropolitan Lima participated. They were evaluated through the screen time questionnaire, the Physical Activity Questionnaire for Children (PAQ-C) and a sociodemographic report. The results indicate that 52.1% gained weight during the pandemic and 62.7% of students used screens for more than 5 hours on a typical day from Monday to Friday. The PAQ-C determined that 74.6% did not comply with the recommended physical activity times (AF-NR= < 2.73). In this study, no statistical association was found between children's screen time and meeting recommended physical activity levels. However, variables such as the number of siblings, having had household members with Covid-19 symptoms, and the time per week receiving remote PA workshops were found to be associated with PA-NR.
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  • A digital technique for cloning the emergence profile of the interim to the definitive implant-supported restoration

    Gallardo, Yolanda Natali Raico; Noriega, Jorge; Rodrigues-Olivio, Isabela; Sesma, Newton (Elsevier Inc., 2023-01-01)
    The subgingival contour of implant-supported restorations is key to ensuring the long-term health of the peri-implant bone and soft tissues. This report describes a step-by-step technique used to accurately clone the emergence profile of the interim crown for the definitive implant-supported restoration.
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  • IMPACT OF E-CIGARETTES USE ON THE ORAL HEALTH-RELATED QUALITY OF LIFE AMONG YOUNG PEOPLE IN METROPOLITAN LIMA

    Vargas-Claudio, Fernando; Castilla-Minaya, Olga; Leon-Rios, Ximena (Universidad de Concepcion, 2023-04-04)
    Aim: To determine the ef fects of e-cigarette use on oral health-related quality of life (OHRQOL) in young people in Metropolitan Lima. Materials and Methods: This observational, analytical and cross-sectional study was performed with 189 individuals (age, 18–29 years) who used electronic cigarettes. The OHIP-Sp5 instrument was used to assess OHRQOL. Results: The use of e-cigarettes was higher among male participants (47.79%) than that among the female participants (26.32%). The mean OHRQOL scores of individuals who did and did not use e-cigarettes were 3.17 (2.26) and 3.12 (2.47), respectively These scores for people who did and did not use mouthwash were 2.92 (2.34) and 3.57 (2.43), respectively. Regarding orofacial pain 2.65% participants frequently reported “painful discomfort” and 7.41% of the young people presented such discomfort of orofacial aspect “frequently.” Conclusions: Recording e-cigarette uses and frequency in patients’ medical records is important, as well as incorporating educational strategies to reduce e-cigarette consumption and avoiding harmful ef fects on general health.
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  • Evaluating the Thickness of the Root Canal Dentin Wall in Primary First Molars Using Cone-beam Computed Tomography

    Justiniano-Navarro, Carlos; Caballero-García, Stefany; López-Rodriguez, Gabriela; Geller-Palti, Dafna (Jaypee Brothers Medical Publishers (P) Ltd, 2023-09-01)
    Aim: To evaluate the thickness of the root canal dentin wall in the cervical, middle, and apical third of primary first molars. Materials and methods: Cross-sectional study consisting of 30 cone-beam computed tomography (CBCT) images of primary maxillary and mandibular first molars, with crown, and root integrity. The wall dentin thickness of each canal was measured in three axial views, divided into distal (D), mesial, lingual/palatine, and buccal surfaces. Results: The smallest dentin wall thickness of the maxillary molar was located on the mesial surface of the mesiobuccal (MB) canal apical third (mean 0.55 ± 0.04 mm). The buccal and palatal (P) surfaces of the distobuccal (DB) and P canals showed the smallest dentin thickness on the cervical third (0.62 ± 0.02 mm). On the mandibular molar, we found the smallest dentin thickness on the apical third [lingual surface of the MB canal and buccal surface of the mesiolingual (ML) canal] with a mean of 0.41 ± 0.07 mm. Additionally, the dentin thickness is average of the D canal was about 0.67 ± 0.11 mm. Conclusion: It is essential to understand the primary first molar’s anatomy to reduce possible complications in pediatric patients from instrumentation during root canal treatments. Clinical significance: Pulpectomy is among the most challenging procedures in pediatric dentistry and the knowledge of the root anatomy of primary teeth allows the professional to make better clinical decisions and reduce possible risks during root canal treatment.
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  • Preclinical Evidence for the Use of Oral Mesenchymal Stem Cell-Derived Extracellular Vesicles in Bone Regenerative Therapy: A Systematic Review

    Olaechea, Allinson; Benabdellah, Karim; Vergara-Buenaventura, Andrea; Gómez-Melero, Sara; Cafferata, Emilio A.; Meza-Mauricio, Jonathan; Padial-Molina, Miguel; Galindo-Moreno, Pablo (Oxford University Press, 2023-12-01)
    The development of extracellular vesicles (EVs) therapies has revolutionized personalized medicine, opening up new possibilities for treatment. EVs have emerged as a promising therapeutic tool within this field due to their crucial role in intercellular communication across various cell types and organisms. This systematic review aims to evaluate the therapeutic potential of oral mesenchymal stem cell (MSC)-derived EVs for bone regeneration, specifically focusing on findings from preclinical models. Sixteen articles meeting the inclusion criteria were selected following document analysis. The biological effects of oral MSC-derived EVs predominantly involve the upregulation of proteins associated with angiogenesis, and inflammation resolution, alongside the downregulation of proinflammatory cytokines. Moreover, these therapeutic agents have been found to contain a significant quantity of different molecules (proteins, lipids, DNA, microRNAs, etc) further contributing to their modulatory potential. The findings from this systematic review underscore that oral MSC-derived EVs, irrespective of their specific population, have the ability to enhance the osteogenic repair response in maxillary bone or periodontal defects. In summary, this systematic review highlights the promising potential of oral MSC-derived EVs for bone regeneration based on evidence from preclinical models. The comprehensive assessment of their biological effects and the presence of microRNAs underscores their therapeutic significance. These findings support the utilization of oral MSC-derived EVs in enhancing the osteogenic repair response in various maxillary bone or periodontal defects, providing insights into the mechanisms involved and potential therapeutic applications in the field of personalized medicine.
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  • Impact of the national vaccination campaign against COVID-19 on patient attendance to the emergency department of the Pediatric Emergency Hospital

    Stramandinoli, Angela; Galdos-Bejar, Marcelo; Llave-Sangiacomo, Barbara; Diaz-Alvites, Ana Lucia; Carreazo, Nilton Yhuri (Medical Body of the Almanzor Aguinaga Asenjo National Hospital, 2023-01-01)
    Objective: To analyze the variation in attendance and diagnoses after the national vaccination campaign against COVID-19 in the pediatric emergency department. The study: Analytical retrospective cross-sectional study. Pediatric emergency department visits were compared between epidemiological weeks 1 and 52 of the years 2020 and 2021, analyzing sociodemographic characteristics, condition and diagnosis. Chi-square was used for bivariate analysis. Findings: A 77.8% increase was found in the number of attentions during the year 2021 compared to 2020. There was a 4% increase in infectious diseases and a 9.2% increase in respiratory diseases. In addition, a decrease of 8.7% was observed in gastrointestinal diseases. Conclusion: The results indicate that after the start of the national vaccination campaign, there was a significant increase in the number of patients compared to 2020, mainly for respiratory and infectious or parasitic diseases.
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  • Epidemiology of neurocognitive disorders in adults from urban-marginalized areas: a door-to-door population-based study in Puente Piedra, Lima, Peru

    Herrera-Perez, Eder; Custodio, Nilton; Diaz, Monica; Montesinos, Rosa; Chang, Alexandra; Villafuerte, Mirla; Lanata, Serggio (Frontiers Media SA, 2023-01-01)
    Background: In Latin America (LA), the prevalence of dementia is expected to triple to 150 million people by 2050. The 2020 Lancet Commission report identified several modifiable dementia risk factors, yet few social and environmental factors, most relevant to vulnerable regions of LA, were highlighted in this report. We sought to assess the epidemiology of neurocognitive disorders (NCD) in Puente Piedra, one of the most socially and economically vulnerable districts of Lima, the capital of Peru. Methodology: This was a cross-sectional door-to-door observational study that used two-stage household sampling. One young adult (30–59 years) and one older adult (>60 years) per household were enrolled. We collected demographic, clinical, and neurocognitive data. Addenbrooke’s Cognitive Examination (young adults) and the RUDAS-PE (older adults) were used, classifying participants as cognitively normal, possible mild NCD, or possible major NCD. Results: We enrolled 247 participants (median age 46 years; 67% female). One-fourth had not completed secondary school and more than 50% completed only secondary school. Most participants were housewives (46%) and 21% did not have health insurance. The overall prevalence of possible NCD was 30% (25.6 and 41.8% among younger adults and older adults, respectively). Among younger adults, those ages 55–59 years more frequently had NCD (70%) compared to younger age ranges. Among older adults, only 3 subjects (4.5%) had major NCD. Conclusion: We found a high frequency of possible NCDs in a socially and economically vulnerable community in Lima, Peru, with younger adults showing levels of NCD higher than expected. Our findings support the need for health systems to incorporate cognitive screenings programs for NCD in younger ages. Future research on NCD would include younger populations, particularly in vulnerable communities.
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  • Child maltreatment and resilience in adulthood: a protocol for a systematic review and meta-analysis

    Fares-Otero, Natalia E.; O, Jiaqing; Spies, Georgina; Womersley, Jacqueline S.; Gonzalez, Carolina; Ayas, Görkem; Mossie, Tilahun Belete; Carranza-Neira, Julia; Estrada-Lorenzo, Jose Manuel; Vieta, Eduard; Schalinski, Inga; Schnyder, Ulrich; Seedat, Soraya (Taylor and Francis Ltd., 2023-01-01)
    Background: Although child maltreatment (CM) has been linked to health problems and poor psychosocial functioning, not all individuals exposed to CM develop or experience negative consequences later in life. This suggests that some individuals show resilience after being exposed to CM. However, conclusions have been limited by inconsistent findings across different CM subtypes and resilience domains. Objective: To develop a protocol for conducting a systematic review and meta-analysis to quantify associations between CM (overall and its subtypes) and resilience (global and its multiple domains) in adulthood, and to examine moderators and mediators of these associations. Method: PubMed, PsycINFO, Embase, Scopus, and Web of Science will be searched to identify relevant studies on the association between CM (exposure) and resilience (outcome) in adults (≥ 18 years). Data will be screened and extracted by at least two independent reviewers. The methodological quality of the included studies will be independently assessed with a modified version of the Newcastle–Ottawa Scale (NOS). If deemed viable, a meta-analysis will be conducted using a random effects model. Heterogeneity of evidence will be estimated with the I2 statistic, and publication bias will be assessed. The effects of potential moderators (e.g. timing and severity of CM, age, sex, family cohesion, socio-economic status, country/region) will be analysed using meta-regression and subgroup analyses, and meta-analytical structural equation modelling will be employed to synthesise indirect mediation effects. Candidate moderators and mediators (e.g. genetic factors, brain functioning, attachment style, personality traits, physical activity, and social support) will be also examined qualitatively. Conclusions: This protocol will facilitate a systematic review and meta-analysis that has the potential to enhance our knowledge about the association between CM exposure in early life and resilience in adulthood. Understanding associations and underlying mechanisms between CM and resilience is potentially important in informing prevention and interventions to sustain health and improve outcomes among adults with a history of CM. PROSPERO registration: CRD42023394120.
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  • Considerations in Forehead Reduction for Men

    Núñez-Castañeda, José Miguel; Chang-Grozo, Silvana Lucia (Thieme Medical Publishers, Inc. CODEN FPSUE, 2023-01-01)
    Although frontal prominence is an infrequent benign defect that causes no sequelae, it gives the patient distress due to its unaesthetic visual aspect. Proper surgical recontouring of the forehead can radically change one's appearance. In consequence, different techniques have been proposed for its management and correction. The aim of this study is to describe a surgical algorithm to treat male patients with forehead reduction to soften the forceful look. An observational cross-sectional study was conducted at the head and neck surgery ward of a general hospital between 2019 and 2022. We performed 35 forehead reduction operations on male patients. The median age was 29 years (range, 26-32 years). The forehead reduction procedures performed was categorized as follows: 27 anterior table osteotomy and 8 anterior table osteotomy contouring. Median forehead reduction was 2.7 mm (range, 2-3.2 mm). The average medical follow-up for patients was 6 months, with an interval ranging from 4 to 8 months. Surgery of the forehead in properly selected male patients is sufficiently safe that it can be done for entirely aesthetic reasons. The choice of surgical technique depends on the presence or absence of the pneumatized frontal sinus. If the frontal sinus is not pneumatized, an anterior table contouring is performed and if the frontal sinus is pneumatized, an anterior table osteotomy is preferred.
    Acceso restringido temporalmente
  • Relationship between dyslipidemia and diabetic retinopathy in type II diabetic patients: A case-control study in Peru

    Paucar-Huamani, Milssa; Abado, Karla; Carreazo, Nilton Yhuri; Huamani-Leandro, Milssa (Medical Body of the Almanzor Aguinaga Asenjo National Hospital, 2023-01-01)
    Background: Diabetic retinopathy (DR) is a primarily asymptomatic microvascular complication. Even though it is preventable, it is the first cause of irreversible blindness among working-age adults. Due to recent meta-analysis results, dyslipidemia is an inconclusive risk factor; therefore, the importance of accomplishing our study in the Peruvian population. Objective: Evaluate the relationship between dyslipidemia and DR in type II diabetic patients of the Ophthalmology area from the Edgardo Rebagliati Martins National Hospital in Lima-Peru, from 2018 to 2020. Methods: Case-control study, 219 cases and 219 controls were included. Diabetic patients will be classified based on the presence or absence of DR lesions on the ocular fundus determined by the specialist. Lipids parameters (triglyceride, LDL, HDL, total cholesterol) and other variables were recollected and analyzed in STATA 14. Multivariate logistic regression was used to obtain a crude and adjusted Odds Ratio. Results: Dyslipidemia (OR 2.7, p=0.03), elevated triglycerides (OR 1.0044, p=0.03), and low HDL cholesterol (OR 2.16, p=0.03) were significantly associated with DR. Conclusion: Dyslipidemia is an independent risk factor for DR in type II diabetic patients. This result emphasizes the importance of evaluating a lipid panel in diabetic patients.
    Acceso abierto
  • Atypical perianal and buttocks epidermal-dermal necrosis in Human Monkeypox. Histopathological study of the lesion in Peru

    Terry Castellano, Luis E.; Gonzáles, Víctor Delgado; Terry Ulloa, Luis Saúl J. (Universidad Nacional Mayor de San Marcos, Facultad de Medicina, 2023-01-01)
    We report the histopathological study of a large, black, crusted lesion with symmetrical distribution in both buttocks and perineum, never described, in a man who has sex with men (MSM) and proctitis associated with Human Monkey Pox Virus (hMPXV) and HIV-AIDS infection never treated. A 39-year-old male, homosexual, HIV-AIDS without Highly Active Antiretroviral Therapy (HAART), was admitted to a hospital in Lima, Peru, with papulopustular lesions on the body and perianal area. Days later, a large, crusty, black lesion with a symmetrical distribution appeared on the buttocks and perineum. The tissue culture was negative. Wedge biopsy of the lesion showed typical MPXV cytopathogenics lesions in addition to fibrin micro thrombosis in the underlying papillary dermis. The histopathological findings of the scabby and black lesion are the classic ones described by Stagles, except for the phenomenon of fibrin micro thrombosis in the papillary dermis, a novel cytopathogenic effect of MPXV with clinical relevance (epidermal-dermal necrosis).
    Acceso abierto

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