Clinical, Phenotypic, and Demographic Characteristics of Peruvian Children and Neonates with Autosomal and Sex Chromosome Aneuploidies

"Objective: Autosomal and sex chromosome aneuploidies are associated with multiple risk factors that determine their frequency and their social and health impact. We aimed to determine the clinical, phenotypic, and demographic characteristics of Peruvian children and neonates with autosomal and sex chromosome aneuploidies. Materials and Methods: This was a retrospective study conducted on 510 pediatric patients. We conducted a cytogenetic analysis with G-bands by trypsin using Giemsa (GTG) banding, and the results were reported using the International System for Cytogenetics Nomenclature 2013 system. Results: Of 399 children (mean age 2.1 ± 4 years), 84 (16.47%) had aneuploidies, with 86.90% being autosomal (73.81% trisomies). In autosomal aneuploidies, 67.85% (n=57) of the children had Down syndrome where the most common cause was free trisomy 21 (52 cases, 61.91%), followed by Robertsonian translocation (4 cases, 4.76%). Edwards and Patau syndrome affected 4 (4.76%) and 1 (1.19%) neonate. The most frequent phenotypic characteristics in children with Down syndrome were Down syndrome-like facies (45.61%) and macroglossia (19.29%). Of sex chromosome aneuploidies, 6/7 were abnormalities of the X chromosome (mainly 45,X). Neonate’s age (19 ± 44.9 months), paternal age (49 ± 9 years), height (93.4 ± 176 cm), and gestational age (30 ± 15.4 weeks) were significantly correlated with the presence of sex chromosome and autosomal aneuploidies (P < .001; P=.025; and P=.001). Conclusions: Down syndrome and Turner’s syndrome were the most frequent aneuploidy and sex chromosome aneuploidy, respectively. In addition, some of the clinical, phenotypic, and demographic characteristics, such as newborn’s age, paternal age, gestational age, and height, were significantly correlated with the occurrence of aneuploidy. In this sense, these characteristics could be considered risk factors among this population.

"Detection of Helicobacter pylori in faeces of children of rural human settlements: An exploratory study in Peru"

"Introduction: Helicobacter pylori is one of the major infectious agents in low-income countries, and its clinical characteristics are unknown in many populations. Children are a susceptible population and can contract these pathogens through contaminated food and water. Objectives: To determine the presence of Helicobacter pylori in children under eight years of age of rural human settlements in Peru. Methods: This exploratory study was conducted with 25 child volunteers authorized by the parents for their evaluation, without precedent of any apparent clinical manifestation. Antigen detection of H. pylori in faeces by a rapid assay onsite H. pylori Ag. Rapid test according to the manufacturer’s requirements. Has been evaluated the social determinants related to possible infection. Results: The average age (2±1.8 years) of 14 girls was different from the average age (2.7±2.2 years) of 11 boys included in the study (p=0.010). Of the total we determinate nine (36%) positive tests, which mainly affected boys (five patients 20%) under two years of age (six patients, 24%). In general, ~90% wash their hands with soap and water and ~70% wash fruits and vegetables with water before eating. In addition, >50% ate foods outside of home and ~24% was asymptomatic and did not have a specific meal schedule. Conclusions: Among rural children, Helicobacter pylori antibody was detected in 36% of the participants, unaffected by gender, and presenting specific dietary patterns.

Cytogenetic abnormalities in patients with infertility diagnosis in Lima, Peru

"Introducción: La infertilidad es una enfermedad multicausal y el componente genético representa uno de sus principales eventos. Si bien la distribución de la infertilidad puede variar entre poblaciones, las parejas de los países con bajos y medianos ingresos pueden verse más afectadas por la infertilidad, con una proporción de alteraciones citogenéticas aún no esclarecidas. Objetivo: Evaluar la frecuencia de alteraciones citogenéticas y su correlación con el número de abortos en pacientes peruanas con diagnóstico de infertilidad. Método: Se realizó un estudio de corte transversal en 400 pacientes de 18 a 60 años, de ambos sexos, con diagnóstico de infertilidad. Se registraron las características clínicas disponibles durante el examen genético y el análisis citogenético convencional fue con bandeo GTG en muestras de sangre periférica. El análisis de correlación se realizó con la prueba de Spearman. Resultados: Del total, 389 pacientes cumplieron los criterios de inclusión, y de estos, 169 (43,44%) tuvieron reportes de abortos (promedio: 2,25, rango: 1-7). Hallamos una correlación significativa ente el número de abortos y las alteraciones citogenéticas (p < 0,000). Reportamos 25/289 (6,43%) alteraciones cromosómicas, de las que 11/25 (44%) fueron heterocromatinas constitutivas y 6/25 (24%) fueron translocaciones reciprocas. Las alteraciones citogenéticas más frecuentes fueron 16qh+ y 9qh+ (ambas con un 16%), y afectaron a 17 (68%) varones. Conclusiones: Existe una moderada frecuencia de alteraciones citogenéticas en pacientes peruanos con diagnóstico de infertilidad, y las alteraciones más frecuentes fueron heterocromatina constitutivas. Además, evidenciamos una correlación significativa ente el número de abortos y las alteraciones citogenéticas.

Evaluation of Three Models of Follow-up of Patients with Cervical Cytological Abnormalities in a Peruvian’s Largest Teaching Women’s Hospital

"Introduction: The follow-up of squamous intraepithelial lesions (SIL) allows us to understand their progression and regression, however squamous cell atypia (ASC) can generate confusing follow-up results. We aimed to describe the evolution of ASC and SIL during cyto-histopathological follow-up in a tertiary-care hospital. Materials and methods: we conducted a retrospective study during 2016 in 156 Papanicolaou test (PAP) results under three models: 1) with ≥1 PAP and biopsies, 2) 1 PAP followed by ≥1 biopsy, and 3) ≥1 PAP and a confirmatory biopsy. Progression was defined as ASCUS to low-grade SIL (LSIL) or higher, and LSIL to high-grade SIL (HSIL) or higher; and regression as HSIL to LSIL or lower; and LSIL to ASCUS or lower. Results: In PAP, 57 (36.5%) cases were ASC and in histopathology 56 (39.9%) cases of grade 1 cervical intraepithelial neoplasia. Twenty-nine (18.6%) results were followed: 8 (27.6%), 17 (58.6%), and 4 (13.8%) with models 1, 2, and 3, respectively. The progression of the lesions was reported in ~50% for models 2 and 3. ASCUS was the main cytological finding that indicated biopsies, and for all models, the mean progression and regression time was 4 and 3.1 months, respectively. Conclusions: The follow-up of cytological alterations in three models showed progression of lesions in half of the cases analyzed with a time of four months of evolution; ASCUS was the main finding that indicated histopathological study.

Serum levels of LDH and protein/creatinine index in pregnant women with preeclampsia: A single-center retrospective study

"Introduction: Preeclampsia is the major cause of maternal death in Latin America, which presents with hypertension and proteinuria after 20 weeks of gestation, increasing the levels of inflammatory markers.We aimed to determine the ratio of LDH and protein/creatinine index (PCI) in Peruvian pregnant women with preeclampsia at the Hospital Nacional Docente Madre Niño San Bartolomé in 2017. Materials and methods: we conducted a cross-sectional study in 3415 pregnant preeclamptic women without eclampsia or HELLP syndrome. The kinetic method was used to determine urine creatinine (mg/dl), the turbidimetric method for protein quantification (mg/dl), and the kinetic method for LDH (U/L). Kendall’s Tau-b correlation and non-paired t-test were used. Results: Of the total, 168 (4.9%) had a clinical diagnosis of preeclampsia with a higher frequency in the 25-35 age group (41.7%). We observed 9-fold frequency of multiparous pregnant women (p<0.001). In 121 (72%) pregnant women, LDH was elevated (>414 U/L). The mean LDH was 536±206.7 U/L (range: 264 to 1715 U/L). Seventy-two (42.9%) pregnant women had LDH values between 416-599 U/L, 37 (22%) had LDH values between 600-800 U/L, and 12 (7.1%) had >800 U/L of LDH. Sixty-one percent of pregnant women (n=113) had CPI alterations. We found a correlation between LDH and CPI (p<0.001) and hypertension levels (p<0.05). Conclusions:Ourresults suggest a significant correlation between LDH and CPI in Peruvian pregnant women with preeclampsia allowing the diagnosis of >60% of cases. In addition, all corresponded to the third trimester of gestation, were ≤35 years-old and mostly multiparous.

Six‑sigma and quality planning of TORCH tests in the Peruvian population: a single‑center cross‑sectional study

"Objective: To ensure the health of newborns, it is necessary to perform high-quality diagnostic tests. The TORCH panel is a set of tests that identifes infectious pathogens such as Toxoplasma (Toxo) and Cytomegalovirus (CMV) that are common in low-setting populations. We performed TORCH panel quality planning using six sigma in a reference laboratory at Peru. Results: This was a cross-sectional study. TORCH tests include Toxo, Rubella, CMV, and Herpes. We processed all samples by fourth-generation ELISA on the GEMINI XCR200 analyzer (Diatron, Budapest, Hungary). We obtained the imprecision from the annual data of the external quality assessment plan and we used the CLSI EP12-A3 guideline. In a total of 44,788 analyses, the average imprecision was 3.69±1.47%, and CMV had lower imprecision (2.3 and 2.6% for IgM and IgG, respectively). Quality planning of the TORCH panel allowed estimating the sigma value that ranged from 4 to 10 (average 7±2 sigma), where rubella had the highest values (10 for IgM and 8 for IgG) while HSV2 had the lowest values (4 for IgM and 5 for IgG). Our results suggest the optimal performance of half of the markers including Toxoplasma, Rubella, and CMV in the Peruvian population.

Physical Activity and Body Image Perceived by University Students during the COVID-19 Pandemic: A Systematic Review

Our objective was to assess the perception of body image and physical activity in university students during the COVID-19 pandemic. Of 74,270 papers found on 13 search engines between 12 August 2020, and 2 November 2021, we identified six studies (n = 1392 and 1097 were women). We found several results on the perception of both variables during the pandemic. First, physical activity tended to decrease or have negative changes, either because they dedicated less time to it, decreased the type of intensity or because they dedicated more time to sedentary activities. In addition, women were more physically active than men, since men perceived a decrease in their levels of physical activity. Secondly, there were also slight changes in the perception of body image; several students perceived that they gained weight and others had an increase in their BMI. It is even noted that those who were physically active or who were older in the population studied had a better perception of their actual physical condition. Similarly, we found that a concern for body image and even negative changes in the perception of appearance during confinement were reported. In conclusion, we found changes in the perception of physical activity and body image in college students during the COVID-19 pandemic

High Levels of Academic Procrastination do not Influence the Academic Performance of Nursing Students during Internship

Introducción: La procrastinación académica (AP) es un fenómeno global que afecta significativamente a los estudiantes universitarios, influyendo potencialmente en su rendimiento académico y bienestar mental. Objetivo: Investigar la relación entre los niveles de procrastinación académica y el rendimiento académico de estudiantes de enfermería durante su pasantía en el Perú. Métodos: Se realizó un estudio transversal, involucrando a 112 pasantes de enfermería, de 18 años y más, matriculados en el semestre 2019-I. Los participantes completaron la Escala de Procrastinación Académica (EPA), una escala tipo Likert que consta de 12 ítems, que midió dos dimensiones: autorregulación académica (9 ítems) y procrastinación de actividades (3 ítems). Se utilizó una puntuación umbral de 36 puntos para identificar altos niveles de procrastinación académica. El rendimiento académico se evaluó en una escala de 0 a 10 (reprobado), 11 a 14 (aprobado), 15 a 17 (notable) y 18 a 20 (sobresaliente). Resultados: La edad media de los participantes fue de 29 años, siendo el 88,4% mujeres. El estudio encontró que el 72,3% de los estudiantes de enfermería exhibieron niveles más altos de AP, particularmente entre las mujeres (62,5%) y los estudiantes más jóvenes (59,8%). A escala global, el 70,3% de los estudiantes obtuvo una calificación notable, y el 51,8% de estos estudiantes también exhibió un alto nivel de AP. Sin embargo, no se encontraron diferencias significativas en el rendimiento académico según el nivel de AP (p=0,918). Conclusión: Aunque los estudiantes de enfermería mostraron un mayor nivel de AP, este estudio no encontró una asociación significativa entre la procrastinación académica y el rendimiento académico durante el período de prácticas. Sin embargo, es crucial monitorear la AP en estudiantes de enfermería a lo largo de sus estudios para identificar factores potenciales que puedan contribuir a su impacto y desarrollar estrategias para mitigar sus efectos

Deaths, infections, and herd immunity in the COVID-19 pandemic: a comparative study of the strategies for disease containment implemented in Peru and the United Kingdom

Introduction: In light of the threat posed by the COVID-19 pandemic, most countries have implemented several containment and prevention measures to slow down the rapid spread of the disease.Objectives: To compare the COVID-19 pandemic containment strategies implemented in Peru [World Health Or-ganization (WHO) - confinement and social distancing] and the United Kingdom [herd immunity (HI)] in terms of morbidity and mortality, and to simulate the implementation of HI in Peru during the initial stage of the pandemic.Materials and methods: Exploratory study with a simulation model based on official data obtained from both countries at the beginning of the pandemic. Mortality, case fatality, and infection rates documented within the first 55 days after the first COVID-19 case report in the United Kingdom and the start of the WHO-recommended containment and prevention strategy implementation in Peru were evaluated. Additionally, the impact of applying HI, according to WHO guidelines, as the initial strategy in Peru was simulated. The Paired-samples t-test was used to determine the differences between the two strategies at both stages of the study.Results: During the follow-up period, 15 034 and 33 931 COVID-19 cases were reported in the United Kingdom and Peru, respectively. The case fatality rate was higher in the United Kingdom (7.82% vs. 2.74%), while the cumulative mortality rate was higher in Peru (2.89 vs. 1.74×100 000 inhabitants p= 0.0001). Regarding the simulation, a minimum critical population of 60% (>19 million positive cases) was established for Peru to achieve HI, with 1 223 473.1 deaths and a hospitalization rate of 44 770×100 000 patients.Conclusions: During the follow-up period (55 days), the United Kingdom’s strategy resulted in a higher case fatality rate, while the Peruvian strategy in over twice as many COVID-19 cases. The HI simulation strategy in Peru showed a sharp increase in all unfavorable indicators of the pandemic.Campus Lima Centr

Self-care attitudes of tuberculosis patients in Peruvian nurses after a hospital outbreak

"Introducción: La tuberculosis es una de las principales causas de morbimortalidad en todo el mundo. Las medidas de prevención son clave para evitar su propagación y el contagio entre profesionales de salud. Objetivo: Determinar las actitudes del autocuidado sobre la tuberculosis en el personal de enfermería luego de un brote infeccioso hospitalario. Métodos: Estudio transversal, en personal de enfermería (n= 94; personal técnico n= 44; 46,8 %). Se incluyó al personal de enfermería voluntario > 18 años, de ambos sexos, que trabaje en el Departamento de Emergencia. Se usó el cuestionario de 15 ítems de Valle (2017), para estimar los conocimientos y actitudes sobre el autocuidado, 3 dimensiones: prevención, diagnóstico y tratamiento de la tuberculosis. Resultados: El promedio de edad de los participantes fue de 44,7 ± 8,8 años, el 88,3 % mujeres y el tiempo promedio de trabajo fue 11,2 ± 7,8 años. Se hallaron diferencias entre los años de servicio, entre los técnicos (8,55 ± 7,94 años) y profesionales (13,48 ± 6,98 años) (p< 0,001). El 100 % presentaron actitudes de aceptación del autocuidado en todas las dimensiones. El 4,5 % y el 27,3 % de técnicos presentaron actitudes de indiferencia en la dimensión diagnóstico y tratamiento de tuberculosis (p= 0,001). Conclusiones: Existen actitudes favorables en el personal de enfermería sobre autocuidado de la tuberculosis luego de un brote en un hospital de Lima, aunque en técnicos de enfermería se reportan actitudes de indiferencia en el diagnóstico y tratamiento de tuberculosis.