• Gait speed and the appearance of neurocognitive disorders in older adults: Results of a Peruvian cohort

      Parodi, José F; Nieto-Gutierrez, Wendy; Tellez, Walter A; Ventocilla-Gonzales, Iris; Runzer-Colmenares, Fernando M; Taype-Rondan, Alvaro (Elsevier España, 2017-09-07)
      Introducción La prevención y el manejo de los trastornos neurocognitivos (TNC) en adultos mayores puede mejorar si se identifica tempranamente sus factores de riesgo, como la velocidad de marcha. El objetivo del estudio es evaluar la asociación entre velocidad de la marcha y el desarrollo de TNC en una población de adultos mayores del Perú. Material y métodos Cohorte realizada en adultos mayores que acudieron al servicio de geriatría del Centro Médico Naval (Callao, Perú). Se registró la velocidad de la marcha de los participantes durante la evaluación basal, sometiéndoles a seguimiento anualmente hasta 60 meses, con un promedio de 21 meses. El desarrollo de TNC fue definido como la ocurrencia de una puntuación≤24 puntos en el Mini Mental State Examination (test de cribado) durante el seguimiento. Se hallaron hazard ratio (HR) y sus intervalos de confianza al 95% (IC 95%) usando regresiones de Cox. Resultados Se incluyeron 657 adultos mayores, con edad promedio de 73,4±9,2 (DE) años, de los cuales el 47,0% fueron varones. El 47,8% reportaron una velocidad de marcha <0,8 m/s, y el 20,1% desarrollaron TNC durante el seguimiento. Se encontró que los adultos mayores con una velocidad de marcha <0,8 m/s en la evaluación basal tuvieron más probabilidades de desarrollar TNC que aquellos con una velocidad de marcha ≥0,8 m/s (HR ajustada=1,41; IC 95%=1,34-1,47). Conclusión Encontramos asociación entre la velocidad de marcha disminuida y el desarrollo de TNC, lo cual sugeriría que la velocidad de marcha podría ser útil para identificar pacientes en riesgo para tal trastorno. Abstract Introduction The prevention and management of neurocognitive disorders (NCD) among older adults can be improved by early identification of risk factors such as walking speed. The objective of the study is to assess the association between gait speed and NCD onset in a population of Peruvian older adults. Material and methods Cohort conducted in older adults who attended the geriatrics service of Naval Medical Center (Callao, Peru). During the baseline assessment, participants’ gait speed was recorded. Subsequently, participants were followed-up annually for 5 years, with a mean of 21 months. NCD onset was defined as the occurrence of a score ≤24 points on the Mini Mental State Examination (screening test) during follow-up. The hazard ratios (HR) and their 95% confidence intervals (95% CI) were calculated using Cox regression. Results The study included 657 participants, with a mean age of 73.4±9.2 (SD) years, of whom 47.0% were male, 47.8% had a gait speed <0.8 m/s, and 20.1% developed NCD during the follow up. It was found that older adults who had gait speed <0.8 m/s at baseline were more likely to develop NCD than those who had a gait speed ≥0.8 m/s (adjusted HR=1.41, 95% CI=1.34-1.47). Conclusion A longitudinal association was found between decreased gait speed and NCD onset, suggesting that gait speed could be useful to identify patients at risk of NCD onset.
    • Gender Associated with the Intention to Choose a Medical Specialty in Medical Students: A Cross-Sectional Study in 11 Countries in Latin America

      Ng-Sueng, Luis Fernando; Vargas Matos, Iván; Mayta-Tristan, Percy; Pereyra Elías, Reneé; Montenegro Idrogo, Juan José; Inga Berrospi, Fiorella; Ancalli, Felix; Bonilla Escobar, Francisco; Diaz Velez, Cristian; Gutierrez Quezada, Erick; Gomez Alhach, Jennifer; Muñoz Medina, Carlos E.; Sanchez Pozo, Adriana; Vidal, Milisen; [email protected] (2016-08-12)
      The selection of a medical specialty has been associated with multiple factors, such as personal preferences, academic exposure, motivational factors and sociodemographic factors, such as gender. The number of women in the medical field has increased in recent years. In Latin America, we have not found any studies that explore this relationship.Secondary analysis of the Collaborative Working Group for the Research of Human Resources for Health (Red-LIRHUS) data; a multi-country project of students in their first year and fifth year of study, from 63 medical schools in 11 Latin American countries. All students who referred intention to choose a certain medical specialty were considered as participants.There is an association between the female gender and the intention to choose Obstetrics/ Gynecology, Pediatrics, Pediatric Surgery, Dermatology, and Oncology. We recommend conducting studies that consider other factors that can influence the choice of a medical specialty.
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    • Genetic diversity of locus of enterocyte effacement genes of enteropathogenic Escherichia coli isolated from Peruvian children.

      Contreras, C. A.; Ochoa, T. J.; Ruiz, J.; Lacher, D. W.; Durand, D.; DebRoy, C.; Lanata, C. F.; Cleary, T. G. (Society for General Microbiology, 2014-03-19)
      The aim of this study was to determine the frequency and allele associations of locus of enterocyte effacement encoded esp and tir genes among 181 enteropathogenic Escherichia coli (EPEC) strains (90 diarrhoea-associated and 91 controls) isolated from Peruvian children under 18 months of age. We analysed espA, espB, espD and tir alleles by PCR-RFLP. EPEC strains were isolated with higher frequency from healthy controls (91/424, 21.7 %) than from diarrhoeal samples (90/936, 9.6 %) (P,0.001); 28.9% of diarrhoeal and 17.6% of control samples were typical EPEC (tEPEC). The distribution of espA alleles (alpha, beta, beta2 and gamma) and espD alleles (alpha, beta, gamma and a new variant, espD-N1) between tEPEC and atypical EPEC (aEPEC) was significantly different (P,0.05). espD-alpha was more common among acute episodes (P,0.05). espB typing resulted in five alleles (alpha, beta, gamma and two new suballeles, espB-alpha2 and espB-alpha3), while tir-beta and tir-gamma2 were the most common intimin receptor subtypes. Seventy-two combinations of espA, espB, espD and tir alleles were found; the most prevalent combination was espA-beta, espB-beta, espD-beta, tir-beta (34/181 strains), which was more frequent among tEPEC strains (P,0.05). Our findings indicate that there is a high degree of heterogeneity among EPEC strains isolated from Peruvian children and that aEPEC and tEPEC variants cluster.
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    • Genotype-specific prevalence of human papillomavirus infection in asymptomatic Peruvian women: a community-based study

      del Valle-Mendoza, Juana; Becerra-Goicochea, Lorena; Aguilar-Luis, Miguel Angel; Pinillos-Vilca, Luis; Carrillo-Ng, Hugo; Silva-Caso, Wilmer; Palomares-Reyes, Carlos; Taco-Masias, Andre Alonso; Aquino-Ortega, Ronald; Tinco-Valdez, Carmen; Tarazona-Castro, Yordi; Sarmiento-Ramirez, Cynthia Wendy; Del Valle, Luis J. (BioMed Central Ltd, 2021-12-01)
      Objective: To determine the general and genotype-specific prevalence of HPV and to identify potential risk factors for the infection in a population-based screening of Peruvian women. Results: A total of 524 samples were analyzed by PCR and a total of 100 HPV positive samples were found, of which 89 were high-risk, 19 were probably oncogenic, 9 were low-risk and 27 other HPV types. The 26–35 and 36–45 age groups showed the highest proportion of HPV positive samples with a total of 37% (37/100) and 30% (30/100), respectively. Moreover, high-risk HPV was found in 33.7% of both groups and probably oncogenic HPV in 52.6% and 31.6%, respectively. High-risk HPV were the most frequent types identified in the population studied, being HPV-52, HPV-31 and HPV-16 the most commonly detected with 17.6%, 15.7% y 12.9%, respectively. Demographic characteristics and habits were assessed in the studied population. A total of 62% high-risk HPV were detected in married/cohabiting women. Women with two children showed the highest proportion (33.8%) of high-risk HPV, followed by women with only one child (26.9%). Those women without history of abortion had a higher frequency of high-risk HPV (71.9%), followed by those with one abortion (25.8%).
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    • Genotypic and Phenotypic Characterization of Enterotoxigenic Escherichia coli Strains Isolated from Peruvian Children

      Rivera, F. P.; Ochoa, T. J.; Maves, R. C.; Bernal, M.; Medina, A. M.; Meza, R.; Barletta, F.; Mercado, E.; Ecker, L.; Gil, A. I.; Hall, E. R.; Huicho, L.; Lanata, C. F. (American Society for Microbiology, 2014-03-19)
      Enterotoxigenic Escherichia coli (ETEC) is a major cause of childhood diarrhea. The present study sought to determine the prevalence and distribution of toxin types, colonization factors (CFs), and antimicrobial susceptibility of ETEC strains isolated from Peruvian children. We analyzed ETEC strains isolated from Peruvian children between 2 and 24 months of age in a passive surveillance study. Five E. coli colonies per patient were studied by multiplex real-time PCR to identify ETEC virulence factors. ETEC-associated toxins were confirmed using a GM1-based enzyme-linked immunosorbent assay. Confirmed strains were tested for CFs by dot blot assay using 21 monoclonal antibodies. We analyzed 1,129 samples from children with diarrhea and 744 control children and found ETEC in 5.3% and 4.3%, respectively. ETEC was more frequently isolated from children >12 months of age than from children <12 months of age (P < 0.001). Fifty-two percent of ETEC isolates from children with diarrhea and 72% of isolates from controls were heat-labile enterotoxin (LT) positive and heat-stable enterotoxin (ST) negative; 25% and 19%, respectively, were LT negative and ST positive; and 23% and 9%, respectively, were LT positive and ST positive. CFs were identified in 64% of diarrheal samples and 37% of control samples (P < 0.05). The most common CFs were CS6 (14% and 7%, respectively), CS12 (12% and 4%, respectively), and CS1 (9% and 4%, respectively). ST-producing ETEC strains caused more severe diarrhea than non-ST-producing ETEC strains. The strains were most frequently resistant to ampicillin (71%) and co-trimoxazole (61%). ETEC was thus found to be more prevalent in older infants. LT was the most common toxin type; 64% of strains had an identified CF. These data are relevant in estimating the burden of disease due to ETEC and the potential coverage of children in Peru by investigational vaccines.
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    • Global Causes of Diarrheal Disease Mortality in Children <5 Years of Age: A Systematic Review.

      Claudio F. Lanata; Christa L. Fischer-Walker; Ana C. Olascoaga; Carla X. Torres; Martin J. Aryee; Robert E. Black (Public Library of Science (PLoS), 2014-03-19)
      Estimation of pathogen-specific causes of child diarrhea deaths is needed to guide vaccine development and other prevention strategies. We did a systematic review of articles published between 1990 and 2011 reporting at least one of 13 pathogens in children ,5 years of age hospitalized with diarrhea. We included 2011 rotavirus data from the Rotavirus Surveillance Network coordinated by WHO. We excluded studies conducted during diarrhea outbreaks that did not discriminate between inpatient and outpatient cases, reporting nosocomial infections, those conducted in special populations, not done with adequate methods, and rotavirus studies in countries where the rotavirus vaccine was used. Age-adjusted median proportions for each pathogen were calculated and applied to 712 000 deaths due to diarrhea in children under 5 years for 2011, assuming that those observed among children hospitalized for diarrhea represent those causing child diarrhea deaths. 163 articles and WHO studies done in 31 countries were selected representing 286 inpatient studies. Studies seeking only one pathogen found higher proportions for some pathogens than studies seeking multiple pathogens (e.g. 39% rotavirus in 180 single-pathogen studies vs. 20% in 24 studies with 5–13 pathogens, p,0?0001). The percentage of episodes for which no pathogen could be identified was estimated to be 34%; the total of all age-adjusted percentages for pathogens and no-pathogen cases was 138%. Adjusting all proportions, including unknowns, to add to 100%, we estimated that rotavirus caused 197 000 [Uncertainty range (UR) 110 000–295 000], enteropathogenic E. coli 79 000 (UR 31 000–146 000), calicivirus 71 000 (UR 39 000–113 000), and enterotoxigenic E. coli 42 000 (UR 20 000–76 000) deaths. Rotavirus, calicivirus, enteropathogenic and enterotoxigenic E. coli cause more than half of all diarrheal deaths in children ,5 years in the world.
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    • Global kidney disease

      Herrera Añazco, Percy; Mezones-Holguín, Edward; Hernández, Adrian V. (Elsevier B.V., 2014-07-03)
      We read with interest the Lancet Series on Global Kidney Disease. Valerie Luyckx and colleagues describe the economics and medical management of chronic kidney disease in sub-Saharan Africa.1 We note clear similarities with patients in Peru. Indeed, in Peru, the Ministry of Health (MINSA)—which covers 70% of the population—does not have a comprehensive programme for the management of patients with chronic kidney disease, including renal replacement therapies. However, the Social Security System (Essalud)—which covers 20% of the population—has a chronic kidney disease programme.
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    • Global research priorities for COVID-19 in maternal, reproductive and child health: Results of an international survey

      Etti, Melanie; Alger, Jackeline; Salas, Sofia P.; Saggers, Robin; Ramdin, Tanusha; Endler, Margit; Gemzell-Danielsson, Kristina; Alfven, Tobias; Ahmed, Yusuf; Callejas, Allison; Eskenazi, Deborah; Khalil, Asma; Le Doare, Kirsty (Public Library of Science, 2021-09-01)
      Background The World Health Organization's "Coordinated Global Research Roadmap: 2019 Novel Coronavirus"outlined the need for research that focuses on the impact of COVID-19 on pregnant women and children. More than one year after the first reported case significant knowledge gaps remain, highlighting the need for a coordinated approach. To address this need, the Maternal, Newborn and Child Health Working Group (MNCH WG) of the COVID- 19 Clinical Research Coalition conducted an international survey to identify global research priorities for COVID-19 in maternal, reproductive and child health. Method This project was undertaken using a modified Delphi method. An electronic questionnaire was disseminated to clinicians and researchers in three different languages (English, French and Spanish) via MNCH WG affiliated networks. Respondents were asked to select the five most urgent research priorities among a list of 17 identified by the MNCH WG. Analysis of questionnaire data was undertaken to identify key similarities and differences among respondents according to questionnaire language, location and specialty. Following elimination of the seven lowest ranking priorities, the questionnaire was recirculated to the original pool of respondents. Thematic analysis of final questionnaire data was undertaken by the MNCH WG from which four priority research themes emerged. Results Questionnaire 1 was completed by 225 respondents from 29 countries. Questionnaire 2 was returned by 49 respondents. The four priority research themes which emerged from the analysis were 1) access to healthcare during the COVID-19 pandemic, 2) the direct and 3) indirect effects of COVID-19 on pregnant and breastfeeding women and children and 4) the transmission of COVID-19 and protection from infection. Conclusion The results of these questionnaires indicated a high level of concordance among continents and specialties regarding priority research themes. This prioritized list of research uncertainties, developed to specifically highlight the most urgent clinical needs as perceived by healthcare professionals and researchers, could help funding organizations and researchers to answer the most pressing questions for clinicians and public health professionals during the pandemic. It is hoped that these identified priority research themes can help focus the discussion regarding the allocation of limited resources to enhance COVID-19 research in MNCH globally.
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    • Global variations in prevalence of eczema symptoms in children from ISAAC Phase Three.

      Odhiambo, Joseph A; Williams, Hywel C; Clayton, Tadd O; Robertson, Colin F; Asher, M Innes; Chiarella, Pascual; ISAAC Phase Three Study Group.; [email protected] (Mosby Inc., 2009-12-01)
      Background: In 1999, The International Study of Asthma and Allergies in Childhood (ISAAC) Phase One reported the prevalence of eczema symptoms in 715,033 children from 154 centers in 56 countries by using standardized epidemiologic tools. Objective: To update the world map of eczema prevalence after 5 to 10 years (ISAAC Phase Three) and include additional data from over 100 new centers. Methods: Cross-sectional surveys using the ISAAC questionnaire on eczema symptoms were completed by adolescents 13 to 14 years old and by parents of children 6 to 7 years old. Current eczema was defined as an itchy flexural rash in the past 12 months and was considered severe eczema if associated with 1 or more nights per week of sleep disturbance. Results: For the age group 6 to 7 years, data on 385,853 participants from 143 centers in 60 countries showed that the prevalence of current eczema ranged from 0.9% in India to 22.5% in Ecuador, with new data showing high values in Asia and Latin America. For the age group 13 to 14 years, data on 663,256 participants from 230 centers in 96 countries showed prevalence values ranging from 0.2% in China to 24.6% in Columbia with the highest values in Africa and Latin America. Current eczema was lower for boys than girls (odds ratio, 0.94 and 0.72 at ages 6 to 7 years and 13 to 14 years, respectively). Conclusion:ISAAC Phase Three provides comprehensive global data on the prevalence of eczema symptoms that is essential for public health planning. New data reveal that eczema is a disease of developing as well as developed countries.
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    • Gravedad de la gastroenteritis causada por Vibrio parahaemolyticus del grupo pandémic o en el Perú

      Gil, Ana I.; Lanata, Claudio F.; Miranda, Hernán; Prada, Ana; Seas, Carlos; Hall, Eric R.; Meza, Rina; Barreno, Carmen M.; Maúrtua, Dora; G. Balakrish Nair; [email protected] (Instituto Nacional de Salud (INS), 2014-08-11)
      Objective. To determine the epidemiological and clinic characteristics of gastroenteritis caused by Vibrio parahaemolyticus strains of the pandemic group in Peru. Material and methods. Clinical and laboratory records were searched in 100 cases of gastroenteritis caused by V parahaemolyticus, either of the pandemic or non pandemic group. Clinical and epidemiological data were collected and statistical analysis was done to evaluate if the severity of illness was associated with the pandemic group. Results. Epidemiological data were collected in 85% of cases, and clinical data were only available in 37% of cases, mainly on those hospitalized. Cases associated with the pandemic strains had a higher probability of liquid stools (96.3% vs. 62.5%, p<0.05), moderate or severe dehydration (100% vs. 60%, p<0.05), and hospital care (98% vs. 42.9%, p<0.0001). Cases aged thirty or older were associated with the pandemic strains (63% vs. 39.5%, p<0.05). Conclusions. Vibrio parahaemolyticus of the pandemic group causes more severe gastrointestinal disease than none pandemic strains, with higher probability of requiring hospital care. Based on this report, it is advisable to include the identification of V. parahaemolyticus in the etiological diagnosis of agents causing severe gastroenteritis in the Peruvian health system.
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    • Guía para diagnóstico y tratamiento de la Enfermedad de Gaucher

      Colquicocha Murillo, Maria; Cucho Jurado, Janetliz; Eyzaguirre Zapata, Renee Mercedes; Manassero Morales, Gioconda; Moreno Larrea, Mariela del Carmen; Salas Arbizu, Katia Liliana; Torres Argandoña, Aimee Margarita; Vargas Castro, Jesús Olga (Universidad Peruana Cayetano Heredia. Facultad de Medicina "Alberto Hurtado", 2015-07-06)
      La enfermedad de Gaucher (EG), debe su nombre por haber sido descrita por Phillipe Gaucher en 1882. Es la enfermedad más frecuente del grupo de las enfermedades de depósito lisosomal comprendidas dentro de los errores innatos del metabolismo (1). La enfermedad de Gaucher se debe a mutaciones en el gen responsable de la síntesis de la enzima lisosomal b-glucocerebrosidasa ácida, también llamada ß-Glucosidasa ácida, (o ß-GA), cuyos locus se ubica en 1q21, es decir en la banda uno de la región 2 del brazo largo del cromosoma 1. El patrón de herencia es autosómico recesivo, es decir que la mutación en éste gen debe darse en estado de homocigocia (2).
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    • Guías de práctica clínica en el Perú: evaluación de su calidad usando el instrumento AGREE II

      Canelo-Aybar, Carlos; Balbin, Graciela; Perez-Gomez, Ángela; Florez, Iván D. (2016-12-13)
      Con el fin de evaluar la calidad metodológica de las guías de práctica clínica (GPC) desarrolladas por el Ministerio de Salud (MINSA) de Perú, se evaluaron 17 GPC del MINSA publicadas entre 2009-2014, por tres expertos metodológicos, de forma independiente, usando el instrumento AGREE II. La puntuación de los dominios del AGREE II fue baja y muy baja en todas las GPC: alcance y propósito (mediana, 44%), claridad de la presentación (mediana, 47%), participación de decisores (mediana, 8%), rigor metodológico (mediana 5%), aplicabilidad (mediana, 5%), e independencia editorial (mediana, 8%). Se concluye que la calidad metodológica de las GPC del MINSA es baja. Como consecuencia, no es posible recomendar su uso. Urge la incorporación de metodología estandarizada para el desarrollo de GPC de calidad en el Perú.
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    • Guías de Reanimación Cardiopulmonar

      Escalante-Kanashiro, Raffo; [email protected] (Colegio Médico del Perú, 2014-07-18)
      El presente artículo busca como objetivo primordial, una aproximación a las Guías 2010 y principales cambios; estamos convencidos que el entrenamiento y aprendizaje de ella se basa en los conceptos de metodología activa y simulación clínica, no podemos tener un conocimiento de la ciencia y protocolos de reanimación cardiopulmonar sin antes no haber experimentado la discusión de temas y desarrollo de casos escenarios vivenciales, para cada uno de los tópicos descritos a continuación. Una de las estrategias más importantes es la diseminación de los conceptos contenidos en las Guías ILCOR de Reanimación Cardiopulmonar que se han consensuado en la ERC y AHA. Ello ha permitido que el personal de salud trate a los pacientes victimas de paro cardiaco o emergencias cardiacas con mayor eficiencia. Las guías actuales fundamentan todos sus aspectos en investigación y recomendaciones, los cambios se iniciaron con una variación sustantiva de la cadena de supervivencia incorporando conceptos de integración de cuidados postparo1,2. Las Guías de Reanimación Cardiopulmonar fueron publicadas y puestas on-line (Resuscitation y American Heart Association) en Octubre 18, 20109,10.
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    • Gut microbiota in hospitalized children with acute infective gastroenteritis caused by virus or bacteria in a regional Peruvian hospital

      Taco-Masias, Andre Alonso; Fernandez-Aristi, Augusto R.; Cornejo-Tapia, Angela; Aguilar-Luis, Miguel Angel; Del Valle, Luis J.; Silva-Caso, Wilmer; Zavaleta-Gavidia, Victor; Weilg, Pablo; Cornejo-Pacherres, Hernán; Bazán-Mayra, Jorge; Puyen, Zully M.; del Valle-Mendoza, Juana (PeerJ Inc., 2020-11-03)
      Background. Acute infective gastroenteritis (AIG) is a leading cause of mortality in children worldwide. In Peru, more than 40% of cases of AIG occurring in children under 5 years old. The disruption of the gut microbiota can increase risk for several health complications especially in patients with gastric infections caused by viruses or bacteria. Objective. The main objective of this study was to describe the prevalence of 13 representative bacteria from the gut microbiota (GM) in stools samples from children under 5 years of age with acute infective gastroenteritis. Results. The most commonly isolated bacteria from the GM were Firmicutes (63.2% 74/117) Bacteriodetes (62.4%; 73/117), Lactobacillus (59.8%; 70/117), Prevotella (57.2%; 67/117), Proteobacterium (53.8%; 63/117), regardless of the etiological agent responsible for the AIG. Interestingly, despite the high prevalence of Firmicutes, Bacteroidetes, Lactobacillus and Prevotella across all samples, a visible reduction of these agents was observed especially among patients with a single bacterial infection or even bacteria–bacteria coinfections when compared to viral etiologies. Patients with exclusive or mixed breastfeeding registered the highest amount of gut microbiota bacteria, in contrast to infants who received formula or were not breastfed.
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    • Head-to-head comparison between endoscopic ultrasound guided lumen apposing metal stent and plastic stents for the treatment of pancreatic fluid collections: A systematic review and meta-analysis

      Guzmán-Calderón, Edson; Chacaltana, Alfonso; Díaz, Ramiro; Li, Bruno; Martinez-Moreno, Belen; Aparicio, José Ramón (John Wiley and Sons Inc, 2022-02-01)
      Background/Aims: Peripancreatic fluid collections (PFCs) result from acute or chronic pancreatic inflammation that suffers a rupture of its ducts. Currently, there exists three options for drainage or debridement of pancreatic pseudocysts and walled-off necrosis (WON). The traditional procedure is drainage by placing double pigtail plastic stents (DPPS); lumen-apposing metal stent (LAMS) has a biflanged design with a wide lumen that avoids occlusion with necrotic tissue, which is more common with DPPS and reduces the possibility of migration. We performed a systematic review and meta-analyses head-to-head, including only studies that compare the two main techniques to drainage of PFCs: LAMS vs DPPS. Methods: We conducted a systematic review in different databases, such as PubMed, OVID, Medline, and Cochrane Databases. This meta-analysis considers studies published from 2014 to 2020, including only studies that compare the two main techniques to drainage of PFCs: LAMS vs DPPS. Results: Thirteen studies were included in the meta-analyses. Only one of all studies was a randomized controlled trial. These studies comprise 1584 patients; 68.2% were male, and 31.8% were female. Six hundred sixty-three patients (41.9%) were treated with LAMS, and 921 (58.1%) were treated with DPPS. Six studies included only WON in their analysis, two included only pancreatic pseudocysts, and five studies included both pancreatic pseudocysts and WON. The technical success was similar in patients treated with LAMS and DPPS (97.6% vs 97.5%, respectively, P =.986, RR = 1.00 [95% CI 0.93-1.08]). The clinical success was similar in both groups (LAMS: 90.1% vs DPPS: 84.2%, P =.139, RR = 1.063 [95% CI 0.98-1.15]). Patients treated with LAMS had a lower complication rate than the DPPS groups, with a significant statistical difference (LAMS: 16.0% vs DPPS: 20.2%, P =.009, RR = 0.746 [95% CI 0.60-0.93]). Bleeding was the most common complication in the LAMS group (33 patients, [5.0%]), whereas infection was the most common complication in the DPPS group (56 patients, [6.1%]). The LAMS migration rate was lower than in the DPPS (0.9% vs 2.2%, respectively, P =.05). The mortality rate was similar in both groups, 0.6% in the LAMS group (four patients) and 0.4% in the DPPS group (four patients; P =.640). Conclusion: The PFCs drainage is an indication when persistent symptoms or PFCs-related complications exist. EUS guided drainage with LAMS has similar technical and clinical success to DPPS drainage for the management of PFCs. The technical and clinical success rates are high in both groups. However, LAMS drainage has a lower adverse events rate than DPPS drainage. More randomized controlled trials are needed to confirm the real advantage of LAMS drainage over DPPS drainage.
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    • Helicobacter pylori and its relationship with variations of gut microbiota in asymptomatic children between 6 and 12 years

      Benavides-Ward, Araceli; Vasquez-Achaya, Fernando; Silva-Caso, Wilmer; Aguilar-Luis, Miguel Angel; Mazulis, Fernando; Urteaga, Numan; del Valle-Mendoza, Juana; [email protected] (BioMed Central Ltd., 2018-07-13)
      Objective: To determine the variations in the composition of the intestinal microbiota in asymptomatic children infected with Helicobacter pylori in comparison with children without the infection. Results: Children infected with H. pylori doubled their probability of presenting 3 of 9 genera of bacteria from the gut microbiota, including: Proteobacteria (p = 0.008), Clostridium (p = 0.040), Firmicutes (p = 0.001) and Prevotella (p = 0.006) in comparison to patients without the infection. We performed a nutritional assessment and found that growth stunting was statistically significantly higher in patients infected with H. pylori (p = 0.046).
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    • Hepatitis B virus, syphilis, and HIV seroprevalence in pregnant women and their male partners from six indigenous populations of the Peruvian Amazon Basin, 2007–2008

      Ormaeche, Melvy; Whittembury, Alvaro; Pun, Mónica; Suárez Ognio, Luis (Elsevier B.V., 2014-07-17)
      Objective: To assess the seroprevalence of hepatitis B virus (HBV), syphilis, and HIV and associated risk factors in pregnant women and their male partners from six indigenous populations of the Peruvian Amazon Basin. Methods: A cross-sectional study was performed in six indigenous populations from the Peruvian Amazon Basin. Blood samples were obtained and tested for HBV (antibodies to the hepatitis B core antigen (anti-HBc) and hepatitis B surface antigen (HBsAg)), for syphilis (rapid plasma reagin and microhemagglutination assay for Treponema pallidum antibodies), and for HIV (ELISA and indirect immunofluorescence test). A survey was also performed to identify associated risk factors. Results: One thousand two hundred and fifty-one pregnant women and 778 male partners were enrolled in the study. The seroprevalence of anti-HBc in pregnant women was 42.06% (95% confidence interval (CI) 39.28–44.85%) and in their male partners was 54.09% (95% CI 50.32–57.86%). The seroprevalence of HBsAg in pregnant women was 2.11% (95% CI 0.78–3.44%) and in their male partners was 3.98% (95% CI 1.87–6.08%). The seroprevalence of syphilis in pregnant women was 1.60% (95% CI 0.86–2.33%) and in their male partners was 2.44% (95% CI 1.22–3.66%). HIV seroprevalence in pregnant women was 0.16% (95% CI 0.02–0.58%) and in their male partners was 0.29% (95% CI 0.04–1.03%). Sexual risk factors were strongly related to blood markers of syphilis and HBV. Conclusions: Hepatitis B was found to be hyperendemic and strongly related to sexual factors, suggesting an important sexual component in the transmission of the disease in the populations studied. Syphilis was found to have an endemicity in pregnant women above the national level and this may be indicative of high mother-to-child transmission. HIV has started to show its presence in indigenous populations of the Amazon Basin and the results suggest the epidemic is concentrated.
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    • Hepatitis C: retos pendientes

      Montes Teves, Pedro (Sociedad de Gastroenterología del Perú, 2014-09-29)
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    • Hepatocellular carcinoma in a woman with 34 weeks gestation and chronic hepatitis b

      Sato-Espinoza, Karina; Ferrer, Javier Díaz; Ventura, Yessica Mitzy Jaramillo (Sociedad Argentina de Gastroenterologia, 2021-01-01)
      A 24-year-old pregnant woman arrived at the emergency service at 34 weeks of gestational age with intermittent right upper abdominal pain. An abdominal ultrasound was performed showing signs of hepatopathy with multiple neo-formative nodules with mild ascites and fetal biometry confirmed at 34 weeks gestation. During her hospitalization, an emergency caesarean was induced with favorable result in the survival of the mother and the baby.
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    • High anti-SARS-CoV-2 antibody seroconversion rates before the second wave in Manaus, Brazil, and the protective effect of social behaviour measures: results from the prospective DETECTCoV-19 cohort

      Lalwani, Pritesh; Araujo-Castillo, Roger V.; Ganoza, Christian A.; Salgado, Bárbara Batista; Pereira Filho, Ivanildo Vieira; da Silva, Danielle Severino Sena; de Morais, Thiago Barros do Nascimento; Jordão, Maele Ferreira; Ortiz, Jessica Vanina; Barbosa, Aguyda Rayany Cavalcante; Sobrinho, Wlademir Braga Salgado; Cordeiro, Isabelle Bezerra; de Souza Neto, Júlio Nino; de Assunção, Enedina Nogueira; da Costa, Cristiano Fernandes; de Souza, Pedro Elias; de Albuquerque, Bernardino Claudio; Astofi-Filho, Spartaco; Holanda, Aldina Iacy Paulain; Gomes, Ana Lúcia Silva; França, Ana Paula Souza de; Monteiro, André Victor Rabelo; Santos, Andressa dos Passos; Teixeira, Antônia de Sousa; Souza, Antônio Vinicius Soares de; Pinheiro, Beatriz; Santos, Bianca Pires dos; Farias, Brenda Pereira; Paulino, Bruno Nicolau; Silva, Caio Lúcio Andreola da; Oliveira, Cinthya Iamile Frithz Brandão de; Martins, Dalila de Alcântara; Oliveira, Eline Araújo de; Carvalho, Elisson Denny da Costa; Costa, Evillyn Fernandes Da; Simplicio, Fernanda Guilhon; Pereira, Fernanda Serrão; Sinimbu, Gabriele Pimentel; Cardenes, Genilton de Oliveira; Silva, Giane Alves da; Costa, Iago Sampaio Fernandes da; Correia, Ingrid Silva; Santos, Ilia Gilmara Carvalho dos; Guimarães, Jackeline Vieira; Pinheiro, Jessica Samile Batista; Romana, Juliana Correa; França, Josineide de Oliveira Novo; Pinto, Kerollen Runa; Freitas, Maria Fiamma Farias; Vasconcellos, Marne Carvalho de; Moraes, Marizete Candido; Damasceno, Matheus da Silva; Ruiz, Michelle Araújo; Lemos, Milena Maria Cardoso de; Picanço, Neila Soares; Maia, Rayara Gonzaga; Bezerra, Regiane Carneiro; Souza, Romeu Santos de; Harjani, Susy Cavalcante; Souza, Vitor Batista de; Melo, Wellington Barbosa de; Lalwani, Jaila Dias Borges (Elsevier Ltd, 2021-11-01)
      Background: The city of Manaus, Brazil, has seen two collapses of the health system due to the COVID-19 pandemic. We report anti-SARS-CoV-2 nucleocapsid IgG antibody seroconversion rates and associated risk factors in Manaus residents before the second wave of the epidemic in Brazil. Methods: A convenience sample of adult (aged ≥18 years) residents of Manaus was recruited through online and university website advertising into the DETECTCoV-19 study cohort. The current analysis of seroconversion included a subgroup of DETECTCoV-19 participants who had at least two serum sample collections separated by at least 4 weeks between Aug 19 and Oct 2, 2020 (visit 1), and Oct 19 and Nov 27, 2020 (visit 2). Those who reported (or had no data on) having a COVID-19 diagnosis before visit 1, and who were positive for anti-SARS-CoV-2 nucleocapsid IgG antibodies at visit 1 were excluded. Using an in-house ELISA, the reactivity index (RI; calculated as the optical density ratio of the sample to the negative control) for serum anti-SARS-CoV-2 nucleocapsid IgG antibodies was measured at both visits. We calculated the incidence of seroconversion (defined as RI values ≤1·5 at visit 1 and ≥1·5 at visit 2, and a ratio >2 between the visit 2 and visit 1 RI values) during the study period, as well as incidence rate ratios (IRRs) through cluster-corrected and adjusted Poisson regression models to analyse associations between seroconversion and variables related to sociodemographic characteristics, health access, comorbidities, COVID-19 exposure, protective behaviours, and symptoms. Findings: 2496 DETECTCoV-19 cohort participants returned for a follow-up visit between Oct 19 and Nov 27, 2020, of whom 204 reported having COVID-19 before the first visit and 24 had no data regarding previous disease status. 559 participants were seropositive for anti-SARS-CoV-2 nucleocapsid IgG antibodies at baseline. Of the remaining 1709 participants who were seronegative at baseline, 71 did not meet the criteria for seroconversion and were excluded from the analyses. Among the remaining 1638 participants who were seronegative at baseline, 214 showed seroconversion at visit 2. The seroconversion incidence was 13·06% (95% CI 11·52–14·79) overall and 6·78% (5·61–8·10) for symptomatic seroconversion, over a median follow-up period of 57 days (IQR 54–61). 48·1% of seroconversion events were estimated to be asymptomatic. The sample had higher proportions of affluent and higher-educated people than those reported for the Manaus city population. In the fully adjusted and corrected model, risk factors for seroconversion before visit 2 were having a COVID-19 case in the household (IRR 1·49 [95% CI 1·21–1·83]), not wearing a mask during contact with a person with COVID-19 (1·25 [1·09–1·45]), relaxation of physical distancing (1·31 [1·05–1·64]), and having flu-like symptoms (1·79 [1·23–2·59]) or a COVID-19 diagnosis (3·57 [2·27–5·63]) between the first and second visits, whereas working remotely was associated with lower incidence (0·74 [0·56–0·97]). Interpretation: An intense infection transmission period preceded the second wave of COVID-19 in Manaus. Several modifiable behaviours increased the risk of seroconversion, including non-compliance with non-pharmaceutical interventions measures such as not wearing a mask during contact, relaxation of protective measures, and non-remote working. Increased testing in high-transmission areas is needed to provide timely information about ongoing transmission and aid appropriate implementation of transmission mitigation measures. Funding: Ministry of Education, Brazil; Fundação de Amparo à Pesquisa do Estado do Amazonas; Pan American Health Organization (PAHO)/WHO.
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