BACKGROUND & AIMS: Purpose:Describe the characteristics of patients seen at the Cancer Prevention and Control Service at a Peruvian private cancer clinic in 2014. Patients and methods:This retrospective clinical study analyzed the prevalence of 10 cancers and characteristics of patients seen at a private cancer center located in Lima, Peru. The study sample included 7680 adults, and data were collected from de-identified medical records. Results:The average age of the patients was 44.71 years and 98,82% of them had private insurance. The majority of patients were women (67.69%). Our gross incidence rate of cancer was 35.16 per 100,000 in the Cancer Prevention and Control Service in 2014. Only 0.35% had cancer, and most of those diagnosed with cancer (77.78%) were diagnosed in the early stages, stages I and II. The two most common cancers observed were breast and thyroid cancer. Conclusions:The high rates of early, rather than late-stage diagnoses at this clinic are dramatically different than national rates. This difference may be because we are analyzing data from a prevention service seeing mainly patients with private insurance as opposed to national data, which consists primarily of patients seen in oncologic services with national insurance.

背景与目标：

BACKGROUND & AIMS: :Recent research has demonstrated some growth recovery among children stunted in infancy. Less is known about key age ranges for such growth recovery, and what factors are correlates with this growth. This study characterized child growth up to age 1 year, and from ages 1 to 5 and 5 to 8 years controlling for initial height-for-age z-score (HAZ), and identified key distal household and community factors associated with these growth measures using longitudinal data on 7266 children in the Young Lives (YL) study in Ethiopia, India, Peru and Vietnam. HAZ at about age 1 year and age in months predicted much of the variation in HAZ at age 5 years, but 40-71% was not predicted. Similarly, HAZ at age 5 years and age in months did not predict 26-47% of variation in HAZ at 8 years. Multiple regression analysis suggests that parental schooling, consumption, and mothers' height are key correlates of HAZ at about age 1 and also are associated with unpredicted change in HAZ from ages 1 to 5 and 5 to 8 years, given initial HAZ. These results underline the importance of a child's starting point in infancy in determining his or her growth, point to key distal household and community factors that may determine early growth in early life and subsequent growth recovery and growth failure, and indicate that these factors vary some by country, urban/rural designation, and child sex.

背景与目标： : 最近的研究表明，婴儿期发育不良的儿童有一些生长恢复。人们对这种增长恢复的关键年龄范围知之甚少，以及哪些因素与这种增长相关。这项研究以1岁以下的儿童生长为特征，并控制了1至5岁和5至8岁的初始年龄z得分 (HAZ)，并使用埃塞俄比亚，印度，秘鲁和越南的青年生活 (YL) 研究中的7266名儿童的纵向数据，确定了与这些生长措施相关的关键远端家庭和社区因素。大约1岁的HAZ和月龄的HAZ预测了5岁的HAZ的大部分变化，但未预测40-71%。同样，5岁的HAZ和月龄的HAZ不能预测8岁的HAZ变异的26-47%。多元回归分析表明，父母的教育，消费和母亲的身高是大约1岁时HAZ的关键相关性，并且还与初始HAZ的1至5岁和5至8岁HAZ的不可预测的变化有关。这些结果强调了儿童在婴儿期的起点在决定其成长中的重要性，指出了可能决定早期成长以及随后的成长恢复和成长失败的关键家庭和社区因素，并表明这些因素因国家，城市/农村指定而有所不同，和儿童性爱。

BACKGROUND & AIMS: CONTEXT:Despite a rich tradition of folk medicinal usage of plants in the Peruvian Amazon, no studies documenting ethnobotanical information of Coronel Portillo Province of Ucayali Department have been published at an international level. OBJECTIVE:This field research documented traditional ethnobotanical knowledge related to the local use of medicinal plants. MATERIALS AND METHODS:Ethnobotanical data were collected in native communities around Pucallpa city (Coronel Portillo Province of Ucayali Department, Peru) and in the city itself during the period June-October 2007. The data were collected through direct interviews with 23 people. RESULTS:Uses of 30 plant species belonging to 18 families in traditional medicine are described in this article. Botanical and vernacular names, plant part used, popular medicinal use, forms of preparation and applications of the herbal remedies for each species are reported. DISCUSSION AND CONCLUSION:Among investigated species, Brunfelsia grandiflora D. Don (Solanaceae), Calycophyllum spruceanum (Benth.) K. Schum. (Rubiaceae), Naucleopsis glabra Spruce (Moraceae), Phthirusa pyrifolia Eichler (Loranthaceae) were identified to be widely used in the studied area. However their beneficial health properties have not been well studied.

背景与目标：

BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: :People with disabilities (PWD) face several challenges accessing medical services. However, the extent to which architectural and transportation barriers impede access to healthcare is unknown. In Peru, despite laws requiring that buildings be accessible for PWD, no report confirms that medical facilities comply with such regulations. Thus, we aim to provide an association between these barriers and access to medical facilities. Data from a Peruvian disability survey were analyzed. Participants were 18 years of age and older people who reported having a physical disability. Accessibility was defined by reported struggles accessing medical facilities (health or rehabilitation centers). Absence of ramps, handrails, elevators, adapted bathrooms, and information counters in medical facilities were reported as architectural barriers. The transportation barriers analyzed included struggles using buses or trains. Poisson regression models with robust variance were used to estimate prevalence ratios (PR) and to control for confounding variables. 20,663 participants were included, their mean age was 66.5 years and 57.5% were females. Architectural and transportation barriers reported were 40% and 61%, respectively. All barriers reported were more prevalent in rural compared to urban areas (p < 0.001). Inadequacy of ramps, handrails, and adapted elevators and bathrooms were associated with limited use of rehabilitation centers (p < 0.001) but not of health centers (p > 0.05). Architectural and transportation barriers represent a hindrance to seeking treatment at rehabilitation centers. Actions to improve this situation are needed.

背景与目标： : 残疾人 (PWD) 在获得医疗服务方面面临若干挑战。然而，建筑和交通障碍阻碍获得医疗保健的程度尚不清楚。在秘鲁，尽管法律要求残疾人必须进入建筑物，但没有报告证实医疗设施符合此类规定。因此，我们的目标是在这些障碍和获得医疗设施之间提供联系。分析了秘鲁残疾调查的数据。参与者为18岁以上的老年人，他们报告有身体残疾。可访问性是由报告的进入医疗设施 (健康或康复中心) 的斗争定义的。据报道，医疗设施中没有坡道，扶手，电梯，改建的浴室和信息柜台是建筑障碍。所分析的交通障碍包括使用公共汽车或火车的挣扎。使用具有稳健方差的泊松回归模型来估计患病率比 (PR) 并控制混杂变量。包括20,663名参与者，他们的平均年龄是66.5岁，57.5% 是女性。报告的建筑和交通障碍分别为40% 和61%。与城市地区相比，农村地区的所有障碍都更为普遍 (p <0.001)。坡道，扶手以及经过改装的电梯和浴室的不足与康复中心的使用有限 (p < 0.001) 有关，但与健康中心无关 (p> 0.05)。建筑和交通障碍是在康复中心寻求治疗的障碍。需要采取行动改善这种情况。

BACKGROUND & AIMS: Objective:Describe the clinical and epidemiological characteristics and resistance profile of cases of extensively drug-resistant tuberculosis (XDR-TB) diagnosed in Peru from 2013 to 2015. Methods:This descriptive study included patients who met the definition of XDR-TB and were reported to the national epidemiological surveillance system of Peru's Ministry of Health. It used a descriptive analysis and, to identify spatial distribution, a heat map based on kernel density estimation. Results:It was estimated that XDR-TB cases diagnosed as new represented 7.3% of all multidrug-resistant tuberculosis (MDR-TB) cases reported during the study period; 74% of patients were aged 15 to 44 years old; and the male-female ratio was 1.7. Half of the country's departments reported at least one case of XDR-TB, and 42% of new cases had no history of resistance or previous treatment. In the other half of the departments, the majority had previous MDR and pre-XDR resistance. Among the cases, 57.7% presented resistance to 5 and 7 first- and second-line drugs and 41.6% presented resistance to 8 and 10 drugs. Conclusions:This study offers important details of the epidemiological profile of XDR-TB in Peru, where there has been an increase in cases of primary XDR-TB; that is, cases with no prior history of disease. Furthermore, this form of tuberculosis has spread to a greater number of departments in the country. Objetivo:Descrever as características clínico-epidemiológicas e o perfil de resistência dos casos de tuberculose extremamente resistente (TB-XDR) diagnosticados no Peru entre 2013 e 2015. Métodos:Estudo descritivo que incluiu pacientes que cumpriam a definição de TB-XDR e foram notificados ao sistema nacional de vigilância epidemiológica do Ministério da Saúde do Peru. Foi realizada uma análise descritiva e elaborado um mapa de calor (heat map) com base na estimativa de densidade de Kernel para identificar a distribuição espacial. Resultados:Estimou-se que os casos de TB-XDR diagnosticados como novos representaram 7,3% do número total de casos de tuberculose multidrogarresistente (TB-MDR) notificados no período do estudo, 74% dos casos tiveram entre 15 e 44 anos de idade, e a relação homem/mulher foi de 1,7. A metade dos departamentos notificou pelo menos um caso de TB-XDR, e 42% dos casos novos não tinham histórico de resistência ou tratamento prévio. Na outra metade dos departamentos, a maioria tinha resistência prévia do tipo MDR e pré-XDR. Ao todo, 57,7% dos casos apresentaram resistência a 5 e 7 medicamentos e 41,6% apresentaram resistência a 8 e 10 medicamentos de primeira e segunda linha. Conclusões:Este estudo apresenta detalhes importantes do perfil epidemiológico da TB-XDR no Peru, onde se observa um aumento no número de casos de TB-XDR primária, isto é, casos sem histórico de doença anterior. Além disso, esta forma de TB estendeu-se a um maior número de departamentos do país.

背景与目标：

BACKGROUND & AIMS: :Six strains of extremely halophilic bacteria were isolated from several crystallizer ponds of the Maras solar salterns in the Peruvian Andes. On the basis of 16S rRNA gene sequence similarity, G+C contents and DNA-DNA hybridization results, the six isolates constituted a genomically homogeneous group affiliated with the Gammaproteobacteria. The closest relatives were members of the halophilic genera Halovibrio and Halospina, which showed 16S rRNA gene sequence similarities below 97 % and whole-genome hybridization levels below 33 % for the type strain, 7Sm5(T). From the genomic and phenotypic properties of the six novel isolates and phylogenetic reconstruction based on 16S rRNA gene sequence analysis, they can be considered to represent a novel genus within the Gammaproteobacteria. On the basis of the taxonomic study, a novel genus, Salicola gen. nov., is proposed containing the single species Salicola marasensis sp. nov., which is the type species. The type strain of Salicola marasensis is 7Sm5(T) (=CECT 7107(T)=CIP 108835(T)).

背景与目标： : 从秘鲁安第斯山脉的Maras太阳盐沼的几个结晶器池中分离出六株极嗜盐细菌。根据16S rRNA基因序列相似性，G C含量和dna-dna杂交结果，这六个分离株构成了与Gammaproteobacteria相关的基因组同质组。最接近的近亲是嗜盐属Halovibrio和Halospina的成员，它们在类型菌株7Sm5(T) 的情况下显示16S rRNA基因序列相似性低于97%，全基因组杂交水平低于33%。根据六个新分离株的基因组和表型特性以及基于16S rRNA基因序列分析的系统发育重建，可以认为它们代表了Gammaproteobacteria中的一个新属。在分类学研究的基础上，提出了一个新的属Salicola gen。11月，其中包含单一物种Salicola marasensis sp。11月，这是类型种。盐藻的类型菌株为7Sm5(T) (= CECT 7107(T)= CIP 108835(T))。

BACKGROUND & AIMS: OBJECTIVES:Chlamydia trachomatis, which is asymptomatic in most women, causes significant adverse effects for pregnant women and neonates. No programmes conduct antenatal screening in Latin America. We determined chlamydia prevalence, feasibility and acceptability of chlamydia screening, and adherence to treatment in pregnant women in two urban public hospitals in Lima, Peru. METHODS:We offered chlamydia screening using self-collected vaginal swabs to pregnant women ≥ 16 years of age during their first antenatal visit. Chlamydia-infected women were contacted within 14 days and asked to bring partners for counselling and directly observed therapy with oral azithromycin. Unaccompanied women received counselling, directly observed therapy, and azithromycin to take to partners. Test of cure was performed ≥ 3 weeks after treatment. RESULTS:We approached 640 women for the study and enrolled 600 (93.8%). Median age was 27.3 years (range 16-47), median lifetime partners 2.3 (range 1-50), and median gestational age 26.1 weeks (range 4-41). Chlamydia prevalence was 10% (95% CI 7.7% to 12.7%). Of 60 infected patients, 59 (98%) were treated with one dose of azithromycin. Fifty-two of 59 (88%) returned for test of cure, all of whom were treated successfully, with 46 (86%) achieving negative test of cure with one dose of azithromycin, and 6 (12%) after retreatment with a second dose. CONCLUSIONS:C. trachomatis screening and treatment in pregnancy was feasible and highly acceptable in two urban hospitals in Peru. Chlamydia prevalence was high. Clinical trials to evaluate efficacy and cost-effectiveness of chlamydia screening, and treatment of pregnant women to prevent adverse pregnancy outcomes in low-resource settings, are warranted.

背景与目标：

BACKGROUND & AIMS: :Surface-mediated disease transmission is understudied in developing countries, particularly in light of the evidence that surface concentrations of fecal bacteria typically exceed concentrations in developed countries by 10- to 100-fold. In this study, we examined fecal indicator bacterial contamination of dinner plates at 21 households in four peri-urban communities in the Peruvian Amazon. We also used surveys to estimate household use of and demand for surface disinfectants at 280 households. Despite detecting total coliform, enterococci, and Escherichia coli on 86%, 43%, and 24% of plates sampled, respectively, less than one-third of households were regularly using bleach to disinfect surfaces. Among non-users of bleach, only 3.2% of respondents reported a new demand for bleach, defined as a high likelihood of using bleach within the next year. This study highlights the potential for marketing approaches to increase use of and demand for surface disinfectants to improve domestic hygiene.

背景与目标： : 在发展中国家，对表面介导的疾病传播的研究不足，特别是鉴于有证据表明，粪便细菌的表面浓度通常比发达国家的浓度高出10至100倍。在这项研究中，我们检查了秘鲁亚马逊地区四个城市周围社区的21户家庭的餐盘粪便指示细菌污染。我们还使用调查来估计280家庭对表面消毒剂的家庭使用和需求。尽管分别在86%，43% 和24% 采样的平板上检测到总大肠菌群，肠球菌和大肠杆菌，但仍有不到3分之1的家庭定期使用漂白剂对表面进行消毒。在非漂白剂使用者中，只有3.2% 的受访者报告了对漂白剂的新需求，定义为在下一年内使用漂白剂的可能性很高。这项研究强调了营销方法的潜力，以增加对表面消毒剂的使用和需求，以改善家庭卫生。

BACKGROUND & AIMS: :Most candidate HIV vaccines are directed at priming memory T cell responses and are being evaluated on their effects on post acquisition viremia and/or disease progression. These vaccines are being studied in areas of high HIV-1 prevalence. As such, we evaluated the frequency of CD4+ T cell decline and time course of opportunistic infections of patients presenting at a major metropolitan hospital in Lima, Peru, an area where such candidate vaccines are being tested. We examined 92 patients with untreated HIV-1 in calendar year 2002: 35% presented with CD4+ T cell counts of <200, 25% between 201 and 400, and 17% with >400 cells/mm3, 30 of 92 patients presented with overt AIDS, 6 were without an AIDS defining OI but CD4 counts <200. Over the course of follow-up, CD4 count decreased by a mean of 31 cells/mm3/year in women and 28 in men (p>0.5). Among persons presenting with CD4 counts >250 cells/mm3, the median time to first OI was 3.5 years. If clinical endpoints are required to evaluate the clinical effectiveness of T cell based vaccines, extended clinical follow-up of subjects enrolled in such trials will be required.

背景与目标： : 大多数候选HIV疫苗都针对启动记忆T细胞反应，并正在评估其对获取后病毒血症和/或疾病进展的影响。这些疫苗正在HIV-1高流行的地区进行研究。因此，我们评估了在秘鲁利马的一家主要大都会医院就诊的患者的CD4 T细胞下降的频率和机会性感染的时间过程，该地区正在测试此类候选疫苗。我们在日历2002年中检查了92例未经治疗的HIV-1患者: 35% 例CD4 T细胞计数 <200，25% 201至400之间，17% 例> 400细胞/mm3，92例患者中有30例患有明显的AIDS，6例没有定义OI的AIDS，但CD4计数 <200。在随访过程中，女性CD4计数平均减少31个细胞/mm3/年，男性减少28个 (p>0.5)。在CD4计数> 250细胞/mm3的人中，首次OI的中位时间为3.5年。如果需要临床终点来评估基于T细胞的疫苗的临床有效性，则需要对参加此类试验的受试者进行长期的临床随访。

BACKGROUND & AIMS: :Several potyviruses are found infecting sweet potato (Ipomoea batatas) in Peru, of which sweet potato feathery mottle virus (SPFMV, genus Potyvirus) is the most common. However, sequence data for these viruses are not available from Peru. In this study, the 3'-terminal approximately 1,800 nucleotide sequences of 17 potyvirus samples collected from the six main sweet potato-producing areas of Peru over the past 20 years were determined and analyzed. Results of sequence comparisons and phylogenetic analysis showed that three of the four recognized SPFMV strain groups, including the East African strain, are established in Peru as well as two other potyviruses: sweet potato virus G (SPVG) and sweet potato virus 2 (SPV2). The analysis further revealed that SPFMV, SPVG and SPV2 are related and form an Ipomoea-specific phylogenetic lineage within the genus Potyvirus and identified for the first time recombination events between viruses from different strain groups of SPFMV.

背景与目标： : 在秘鲁发现了几种poty病毒感染甘薯 (Ipomoea batatas)，其中甘薯羽毛状斑驳病毒 (SPFMV，Poty病毒属) 最常见。但是，这些病毒的序列数据无法从秘鲁获得。在这项研究中，确定并分析了过去20年从秘鲁六个主要甘薯产区收集的17个马铃薯病毒样品的3' 末端约1,800个核苷酸序列。序列比较和系统发育分析的结果表明，在秘鲁建立了四个公认的SPFMV毒株组中的三个，包括东非毒株，以及另外两个poty病毒: 甘薯病毒G (SPVG) 和甘薯病毒2 (SPV2)。分析进一步表明，SPFMV，SPVG和SPV2是相关的，并在Potyvirus属内形成了番薯特异性系统发育谱系，并首次鉴定了来自SPFMV不同毒株组的病毒之间的重组事件。

BACKGROUND & AIMS: : Background: Helicobacter pylori prevalence and gastric cancer rates are remarkably high in Peru. Effective antimicrobial regimens are essential for successful H. pylori eradication. We aimed at assessing antimicrobial resistance rates to first- and second-line therapeutic agents in H. pylori strains detected in gastric biopsy samples. Materials and Methods: Gastric biopsy samples (antrum and corpus) were collected from therapy-naive patients (n = 154). H. pylori presence in the samples was confirmed by histopathology. Genotypic resistance to clarithromycin and quinolones was determined by real-time PCR. Results: Histology results were 100% concordant with PCR results (97/154; 63% H. pylori-positive in both). In 6% (6/97) of the patients, we found discordant results of H. pylori infection in antrum and corpus samples from the same patient. Resistance rates to clarithromycin and quinolone were 34% (33/97) and 68% (56/82), respectively. Antimicrobial resistance to both antimicrobials was 30% (25/82). Conclusion: Antimicrobial resistance rates of H. pylori to clarithromycin and quinolones are very high in Lima, Peru. Many first- and second-line, empiric eradication regimens may not be recommended for Peruvian patients.

背景与目标：

BACKGROUND & AIMS: SETTING:In 2003, Peru and Bolivia reported the highest annual tuberculosis (TB) incidence rates in the Americas. Neighboring Colombia and Chile had lower annual incidence rates despite their proximity. OBJECTIVE:To determine what factors contribute to differences in TB incidence rates among Chile, Colombia, Bolivia and Peru. DESIGN:Multiple sources of literature dating between 1990 and 2005 were used and World Health Organization TB control guidelines were consulted for policy level comparisons. RESULTS:Comprehensive implementation of the DOTS strategy is the main factor explaining the differences in TB incidence rates, even after considering socio-economic factors. CONCLUSION:Cross-national comparisons suggest ways to improve regional DOTS implementation.

背景与目标：

BACKGROUND & AIMS: :We investigated the prevalence and molecular epidemiology of human T cell lymphotropic virus type 1 in Peruvian HIV-1-positive subjects, and found a 10.1% prevalence in a consecutive series of 318 HIV-1-positive patients living in Lima. Phylogenetic analysis of the long terminal repeat of 10 patient isolates showed that all of them belonged to the HTLV-1aA (Transcontinental) subgroup. Although the majority of the Peruvian sequences included in the analysis formed a clade with other Latin American sequences, the isolates of three patients clustered significantly with South African strains. These data show a high prevalence of HTLV-1 infection in HIV-1-positive subjects living in Lima and confirm the presence in Latin America of HTLV-1 strains probably arising from South Africa.

背景与目标： : 我们调查了秘鲁HIV-1-positive受试者中1型人类T细胞淋巴细胞病毒的患病率和分子流行病学，并在连续318名HIV-1-positive患者中发现了10.1% 的患病率。对10个患者分离株的长末端重复序列的系统发育分析表明，它们全部属于HTLV-1aA (跨大陆) 亚组。尽管分析中包含的大多数秘鲁序列与其他拉丁美洲序列形成了进化枝，但三名患者的分离株与南非菌株显着聚集。这些数据表明，生活在利马的HIV-1-positive受试者中HTLV-1感染的患病率很高，并证实了拉丁美洲可能来自南非的HTLV-1菌株的存在。

BACKGROUND & AIMS: :Tuberculosis control is hampered by the widespread increase in multidrug resistance. Rapid drug susceptibility testing would greatly aid in the adequate treatment of the disease. This study evaluates the usefulness of the colorimetric method using Alamar Blue for the rapid detection of resistance to rifampicin and isoniazid in 63 clinical isolates of Mycobacterium tuberculosis in Peru. Results obtained by receiver operating characteristic curve analysis and measures of gain in certainty showed greater diagnostic accuracy than with the gold standard, the proportion method on Löwenstein-Jensen medium.

背景与目标： : 多药耐药性的广泛增加阻碍了结核病的控制。快速的药物敏感性测试将极大地帮助该疾病的适当治疗。这项研究评估了使用Alamar Blue的比色法在秘鲁63种结核分枝杆菌临床分离株中快速检测对利福平和异烟肼的耐药性的有用性。通过接收器工作特性曲线分析和确定性增益测量获得的结果显示出比金标准 (Löwenstein-Jensen培养基上的比例方法) 更高的诊断准确性。