The genus Gromphas Brullé, 1837 in Peru (Coleoptera: Scarabaeidae: Scarabaeinae: Phanaeini)

The genus Gromphas Brullé (Coleoptera: Scarabaeidae) comprises four species, of which G. aeruginosa (Perty) and G. amazonica Bates are known to occur in Peru. This paper presents a revised description of Gromphas as well as illustrated diagnoses and distributional and ecological data on the Peruvian species

The genus \u3ci\u3eGromphas\u3c/i\u3e Brullé, 1837 in Peru (Coleoptera: Scarabaeidae: Scarabaeinae: Phanaeini)

The genus Gromphas Brullé (Coleoptera: Scarabaeidae) comprises four species, of which G. aeruginosa (Perty) and G. amazonica Bates are known to occur in Peru. This paper presents a revised description of Gromphas as well as illustrated diagnoses and distributional and ecological data on the Peruvian species

Diurnal Butterflies (Lepidoptera:Papilionoidea) of Claverito community, Loreto, Iquitos, Peru

Durante los años 2016 al 2019 por un período de muestreo de 15 días en el mes de setiembre en la comunidad Claverito, ubicada en la parte baja de la plaza Clavero en la zona oriental y periurbana de la ciudad de Iquitos (Perú), con la finalidad de monitorear la riqueza y abundancia de mariposas diurnas empleando red entomológica y trampas Van Someren Rydon, se registraron 3738 individuos, pertenecientes a 6 familias, 26 géneros y 32 especies. La familia Nymphalidae obtuvo la mayor riqueza de especies (21) representando el 65,63 % del total, Pieridae 7 especies (21,88 %), Hesperidae, Lycaenidae, Papilionidae y Riodinidae con solo 1 especie (3,13 %). La zona de camu camu reportó 29 especies y 3341 individuos, mientras que la zona urbana obtuvo 19 especies y 397 individuos; de las 32 especies registradas, 9 de ellas representaron el 96,84 % del total, siendo estas: Anarthia amathea, Anarthia jatrophae, Ascia monuste, Eurema agave agave, Eurema elathea, Mazia amazonica, Phoebis sennae marcellina, Pieriballia viardi y Pyrisitia nise. La riqueza y abundancia varió constantemente: 2016 (12 especies y 667 individuos); 2017 (23 especies y 447 individuos); 2018 (15 especies y 1539 individuos); y 2019 (15 especies y 1085 individuos).This study took place from 2016 to 2019 over a sampling period of 15 days each September in the community of Claverito, located in the lower part of the Plaza Clavero in the eastern and peri-urban zone of the city of Iquitos, Peru. The purpose was to monitor species richness and abundance of diurnal butterflies using entomological nets and Van Someren Rydon traps. A total of 3,738 individuals were recorded, belonging to 6 families, 26 genera, and 32 species. The Nymphalidae family obtained the highest species richness (21), representing 65,63 % of the total; Pieridae had 7 species (21,88%), and Hesperidae, Lycaenidae, Papilionidae and Riodinidae had only 1 species each (3,13 %). The camu camu zone reported 39 species and 3341 individuals, while the urban zone obtained 19 species and 397 individuals. Of the 32 recorded species, 9 of them represented 96,84 % of the total: Anarthia amathea, Anarthia jatrophae, Ascia monuste, Eurema agave agave, Eurema elathea, Mazia amazonica, Phoebis sennae marcellina, Pieriballia viardi and Pyrisitia nise. While the study took place at the same time each year, the richness and abundance varied: 2016 (12 species and 667 individuals); 2017 (23 species and 447 individuals); 2018 (15 species and 1539 individuals); and 2019 (15 species and 1085 individuals)

Proyecto de Investigación 2 - ME173 - 202102

Descripción: Proyecto de Investigación 2 es un curso de la carrera de Medicina, eminentemente práctico, que complementa lo desarrollado en el curso Proyecto de Investigación 1. Utilizando como base el protocolo de investigación desarrollado en el curso previo, durante este semestre el estudiante desarrolla, empleando la data recogida, el informe final de su investigación. Este informe final (tesis) corresponde a una investigación científica potencialmente publicable en una revista indexada. Propósito: El curso Proyecto de Investigación 2 permite al estudiante de Medicina culminar una investigación científica relevante y, de esta manera, generar nueva evidencia en el campo de la Medicina, logrando que dicha práctica le sea habitual cuando realice su ejercicio profesional. Busca desarrollar las competencias generales de razonamiento cuantitativo, manejo de la información y pensamiento innovador; así como la competencia específica de investigación, todas a nivel tres

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research