Estado de hierro y propuesta de ajuste de hemoglobina por altitud en niños de 6 a 8 meses residentes en Lima, Arequipa, Cusco y Puno / Iron status and hemoglobin adjustment by altitude to define anemia in children aged 6 to 8 months living in Lima, Arequipa, Cusco and Puno

RESUMEN Objetivos. Caracterizar el estado del hierro y proponer factores de ajuste de hemoglobina por altitud, en niños de 6 a 8 meses de Lima, Arequipa, Cusco y Puno. Materiales y métodos. Estudio transversal en niños de 6 a 8 meses de edad en cuatro ciudades, se midió hemoglobina y otros biomarcadores de hierro, Proteína C reactiva (PCR), entre otros. Para estimar la ecuación de ajuste, se aplicó una regresión exponencial y excluimos a los niños con deficiencia de hierro (DH) y/o inflamación. Resultados. Las proporciones de DH fueron mayores en Puno y Arequipa, mientras que la inflamación no superó el 19% en ninguna de las ciudades. La hemoglobina mostró un incremento exponencial a mayor altitud. La ecuación de ajuste fue: 10,34249 x (1,00007 ^ Alt). Conclusiones. Los niños residentes en Arequipa y Puno mostraron mayores proporciones de DH y menores reservas de hierro; además el aumento de la hemoglobina por altitud fue exponencial evidenciando la necesidad de ajustar la hemoglobina en altura.

ABSTRACT Objective. To describe the iron status profile and to propose hemoglobin adjustment factors for altitude for children aged 6 to 8 months in Lima, Arequipa, Cusco and Puno. Materials and methods. Cross-sectional study in children aged 6 to 8 months from four cities. We measured hemoglobin and other iron biomarkers, C-reactive protein (CRP), among others. To estimate the adjustment equation, we applied an exponential regression. We excluded children with iron deficiency (ID) and/or inflammation. Results. The proportions of ID were higher in Puno and Arequipa, while inflammation did not exceed 19% in any of the cities. Hemoglobin showed an exponential increase at higher altitude. The adjustment equation was: 10.34249 x (1.00007 ^ Alt). Conclusions. Children residing in Arequipa and Puno showed higher rates of ID and lower iron reserves; furthermore, the increase in hemoglobin by altitude was exponential, showing the need to adjust hemoglobin at altitude.

Iron status and hemoglobin adjustment by altitude to define anemia in children aged 6 to 8 months living in Lima, Arequipa, Cusco and Puno. / Estado de hierro y propuesta de ajuste de hemoglobina por altitud en niños de 6 a 8 meses residentes en Lima, Arequipa, Cusco y Puno.

OBJECTIVE.: To describe the iron status profile and to propose hemoglobin adjustment factors for altitude for children aged 6 to 8 months in Lima, Arequipa, Cusco and Puno. MATERIALS AND METHODS.: Cross-sectional study in children aged 6 to 8 months from four cities. We measured hemoglobin and other iron biomarkers, C-reactive protein (CRP), among others. To estimate the adjustment equation, we applied an exponential regression. We excluded children with iron deficiency (ID) and/or inflammation. RESULTS.: The proportions of ID were higher in Puno and Arequipa, while inflammation did not exceed 19% in any of the cities. Hemoglobin showed an exponential increase at higher altitude. The adjustment equation was: 10.34249 x (1.00007 ^ Alt). CONCLUSIONS.: Children residing in Arequipa and Puno showed higher rates of ID and lower iron reserves; furthermore, the increase in hemoglobin by altitude was exponential, showing the need to adjust hemoglobin at altitude.

OBJETIVOS.: Caracterizar el estado del hierro y proponer factores de ajuste de hemoglobina por altitud, en niños de 6 a 8 meses de Lima, Arequipa, Cusco y Puno. MATERIALES Y MÉTODOS.: Estudio transversal en niños de 6 a 8 meses de edad en cuatro ciudades, se midió hemoglobina y otros biomarcadores de hierro, Proteína C reactiva (PCR), entre otros. Para estimar la ecuación de ajuste, se aplicó una regresión exponencial y excluimos a los niños con deficiencia de hierro (DH) y/o inflamación. RESULTADOS.: Las proporciones de DH fueron mayores en Puno y Arequipa, mientras que la inflamación no superó el 19% en ninguna de las ciudades. La hemoglobina mostró un incremento exponencial a mayor altitud. La ecuación de ajuste fue: 10,34249 x (1,00007

Body mass index and coronary revascularization in women with coronary artery disease: insight into obesity paradox / Índice de masa corporal y revascularización coronaria en mujeres con cardiopatía coronaria: comprensión de la paradoja de la obesidad

Abstract Objective: To determine the association between body mass index and indication of angioplasty with stent implantation in women over 50 years of age. Material and methods: Retrospective analytical study, cross-sectional. It were evaluated 83 clinical records of women older than 50 years of age who underwent angiography due to coronary artery disease and were hospitalized in Peruvian Naval Medical Center between 2010 and 2017. A Poisson regression analysis was performed to determine the association. Results: The mean ± standard deviation of age was 66.51 ± 8.94 years. 81.93% had two or more comorbidities. The frequency of angioplasties with stent implantation was 58%. Body mass index in range of obesity (45.83%) was more frequent in patients who received the implant. In the adjusted regression model, overweight patients had lower probability (PR 0.83, 95% CI 0.68 - 0.98) to have the indication of implantation as compared to patients with body mass index less than 25 kg/m2. Conclusions: Although obesity paradox relationship between body mass index and angioplasty with stent indication has been demonstrated by the multivariate analysis of this study, it is necessary to evaluate obesity with better markers than body mass index before assuming that obesity is a good prognostic factor for coronary artery disease in our patient.

Resumen Objetivo: Determinar la asociación entre índice de masa corporal e indicación de angioplastia con implantación de stent en mujeres mayores de 50 años. Material y métodos: Estudio analítico retrospectivo y transversal. Se evaluaron 83 historias clínicas de mujeres mayores de 50 años, a quienes se les practicó angiografía debido a cardiopatía coronaria y fueron hospitalizadas en el Centro Médico Naval de Perú entre 2010 y 2017. Se realizó un análisis de regresión de Poisson para determinar la asociación. Resultados: La media ± desviación estándar de la edad fue de 66,51 ± 8,94 años. El 81,93% de los casos tenía dos o más comorbilidades. La frecuencia de angioplastias con implantación de stent fue del 58%. El índice de masa corporal en rango de obesidad (45,83%) fue más frecuente en las pacientes que recibieron el implante. En el modelo de regresión ajustado, las pacientes con sobrepeso tuvieron menor probabilidad (PR 0,83, 95% IC 0,68 - 0,98) de indicación de implantación, en comparación con las pacientes con índice de masa corporal inferior a 25 kg/m2. Conclusiones: Aunque la paradoja de la relación de la obesidad entre índice de masa corporal y angioplastia con indicación de stent ha sido demostrada por el análisis multivariante de este estudio, es necesario evaluar la obesidad con mejores marcadores que el índice de masa corporal, antes de asumir que la obesidad es un buen factor pronóstico de cardiopatía coronaria en las pacientes.

The immunogenetic diversity of the HLA system in Mexico correlates with underlying population genetic structure.

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) allele groups and alleles by PCR-SSP based typing in a total of 15,318 mixed ancestry Mexicans from all the states of the country divided into 78 sample sets, providing information regarding allelic and haplotypic frequencies and their linkage disequilibrium, as well as admixture estimates and genetic substructure. We identified the presence of 4268 unique HLA extended haplotypes across Mexico and find that the ten most frequent (HF > 1%) HLA haplotypes with significant linkage disequilibrium (Δ'≥0.1) in Mexico (accounting for 20% of the haplotypic diversity of the country) are of primarily Native American ancestry (A*02~B*39~DRB1*04~DQB1*03:02, A*02~B*35~DRB1*08~DQB1*04, A*68~B*39~DRB1*04~DQB1*03:02, A*02~B*35~DRB1*04~DQB1*03:02, A*24~B*39~DRB1*14~DQB1*03:01, A*24~B*35~DRB1*04~DQB1*03:02, A*24~B*39~DRB1*04~DQB1*03:02, A*02~B*40:02~DRB1*04~DQB1*03:02, A*68~B*35~DRB1*04~DQB1*03:02, A*02~B*15:01~DRB1*04~DQB1*03:02). Admixture estimates obtained by a maximum likelihood method using HLA-A/-B/-DRB1 as genetic estimators revealed that the main genetic components in Mexico as a whole are Native American (ranging from 37.8% in the northern part of the country to 81.5% in the southeastern region) and European (ranging from 11.5% in the southeast to 62.6% in northern Mexico). African admixture ranged from 0.0 to 12.7% not following any specific pattern. We were able to detect three major immunogenetic clusters correlating with genetic diversity and differential admixture within Mexico: North, Central and Southeast, which is in accordance with previous reports using genome-wide data. Our findings provide insights into the population immunogenetic substructure of the whole country and add to the knowledge of mixed ancestry Latin American population genetics, important for disease association studies, detection of demographic signatures on population variation and improved allocation of public health resources.

Genetic diversity of HLA system in two populations from Hidalgo, Mexico: Pachuca and rural Hidalgo.

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 122 Mexicans from the state of Hidalgo living in the city of Pachuca (N = 41) and rural communities (N = 81), to obtain information regarding allelic and haplotypic frequencies. We find that the most frequent haplotypes in Hidalgo include eight Native American and one European haplotypes. Admixture estimates revealed that the main genetic components in Hidalgo are Native American (58.93 ±â€¯2.16% by ML; 54.51% of Native American haplotypes) and European (32.49 ±â€¯2.88% by ML; 28.69% of European haplotypes), and a relatively high African genetic component (8.58 ±â€¯0.93% by ML; 6.97% of African haplotypes).

Genetic diversity of HLA system in seven populations from Veracruz, Mexico: Veracruz city, Coatzacoalcos, Córdoba, Orizaba, Poza Rica, Xalapa and rural Veracruz.

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 1113 Mexicans from the state of Veracruz living in the cities of Coatzacoalcos (N = 55), Orizaba (N = 60), Córdoba (N = 56), Poza Rica (N = 45), Veracruz (N = 171), Xalapa (N = 187) and rural communities (N = 539) to obtain information regarding allelic and haplotypic frequencies. We found that the most frequent haplotypes include 12 Native American haplotypes. Admixture estimates revealed that the main genetic components are Native American (64.93 ±â€¯1.27% by ML; 55.10% of Native American haplotypes) and European (26.56 ±â€¯0.89% by ML; 28.38% of European haplotypes), and a relatively high African genetic component (8.52 ±â€¯1.82% by ML; 8.78% of African haplotypes).

Genetic diversity of HLA system in two populations from Oaxaca, Mexico: Oaxaca city and rural Oaxaca.

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 636 Mexicans from the state of Oaxaca living in the city of Oaxaca (N = 151) and rural communities (N = 485), to obtain information regarding allelic and haplotypic frequencies. We found that the 13 most frequent haplotypes in Oaxaca are all of putative Native American origin. Admixture estimates revealed that the main genetic components in the state of Oaxaca are Native American (73.12 ±â€¯2.77% by ML; 61.52% of Native American haplotypes) and European (17.36 ±â€¯2.07% by ML; 20.69% of European haplotypes), and a relatively high African genetic component (9.52 ±â€¯0.88% by ML; 8.94% of African haplotypes).

Genetic diversity of HLA system in two populations from Puebla, Mexico: Puebla city and rural Puebla.

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 2827 Mexicans from the state of Puebla living in the city of Puebla (N = 1994) and rural communities (N = 833), to obtain information regarding allelic and haplotypic frequencies. We found that the 16 most frequent haplotypes in Puebla are all of them Native American. Admixture estimates revealed that the main genetic components in the state of Puebla are Native American (72.21 ±â€¯1.25% by ML; 63.30% of Native American haplotypes) and European (21.05 ±â€¯1.92% by ML; 23.86% of European haplotypes), and a less prominent African genetic component (6.74 ±â€¯2.20% by ML; 6.20% of African haplotypes).

Genetic diversity of HLA system in two populations from Tlaxcala, Mexico: Tlaxcala city and rural Tlaxcala.

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 1011 Mexicans from the state of Tlaxcala residing in the city of Tlaxcala (N = 181) and rural communities (N = 830), to obtain information regarding allelic and haplotypic frequencies. We find that the ten most frequent haplotypes in Tlaxcala are all of Native American origin. Admixture estimates revealed that the main genetic components are Native American (75.13 ±â€¯1.56% by ML; 69.24% based on of Native American haplotypes) and European (16.10 ±â€¯4.98% by ML; 19.74% of European haplotypes), with a less prominent African genetic component (8.78 ±â€¯4.09% by ML; 4.35% of African haplotypes).

Genetic diversity of HLA system in six populations from Mexico City Metropolitan Area, Mexico: Mexico City North, Mexico City South, Mexico City East, Mexico City West, Mexico City Center and rural Mexico City.

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 1217 Mexicans from the Mexico City Metropolitan Area living in the northern (N = 751), southern (N = 52), eastern (N = 79), western (N = 33), and central (N = 152) Mexico City, and rural communities (N = 150), to obtain information regarding allelic and haplotypic frequencies. We found that the most frequent haplotypes include 11 Native American haplotypes. Admixture estimates revealed that the main genetic components are Native American (63.85 ±â€¯1.55% by ML; 57.19% of Native American haplotypes) and European (28.53 ±â€¯3.13% by ML; 28.40% of European haplotypes), and a less apparent African genetic component (7.61 ±â€¯1.96% by ML; 7.17% of African haplotypes).

Disciplina positiva para el desarrollo de las habilidades emocionales

Equilibrar la enseñanza - aprendizaje con el aspecto emocional, y permitir desarrollar habilidades emocionales necesarias para manejar adecuadamente las relaciones interpersonales en distintos contextos, se ha convertido en una medida necesaria. El propósito del estudio fue determinar la influencia de las herramientas para la vida con disciplina positiva en el fortalecimiento de la inteligencia emocional de los adolescentes entre las edades de 12 a 13 años, en una institución educativa privada femenina del distrito de Trujillo, en Perú. El tipo de investigación es aplicada, con diseño cuasi experimental. Se trabajó con una muestra de 51 alumnas y se aplicó el Inventario de Inteligencia emocional de Bar-On. Los resultados demostraron el logro de un fortalecimiento moderado y estadísticamente significativo (p<.05) de la inteligencia emocional del grupo experimental. Asimismo, cada dimensión de la inteligencia emocional logró un aumento porcentual significativo al comparar el pre-test con el post-test en cada una, a excepción del componente manejo del estrés.

Balance the teaching - learning with the emotional aspect, and allow to develop emotional skills necessary to properly handle the relationships in different contexts, has become a necessary measure. The purpose of the study was to determine the influence of the tools for life with positive discipline in strengthening the emotional intelligence of adolescents between the ages of 12 to 13 years, in a female private educational institution of the District of Trujillo - Peru. The type of research is applied, with almost experimental design. It worked with a sample of 51 students and applied Bar-On's Emotional Intelligence Inventory. The results demonstrated the achievement of a moderate and statistically significant strengthening (p<.05) of the emotional intelligence of the experimental group. In addition, each dimension of emotional intelligence achieved a significant percentage increase by comparing the pre-test with the post-test in each, with the exception of the stress management component.

Equilibrar o ensino - aprender com o aspecto emocional e permitir o desenvolvimento de habilidades emocionais necessárias para gerenciar adequadamente as relações interpessoais em diferentes contextos, tornou-se uma medida necessária. O objetivo do estudo foi determinar a influência de ferramentas de vida disciplinadas positivas no fortalecimento da inteligência emocional dos adolescentes entre as idades de 12 a 13 anos, em uma instituição de ensino privada feminina no Trujillo, Peru. O tipo de pesquisa é aplicado, com design quase experimental. Ele trabalhou com uma amostra de 51 alunos e aplicou o Inventário de Inteligência Emocional da Bar-On. Os resultados demonstraram a realização de um fortalecimento moderado e estatisticamente significativo (p<.05) da inteligência emocional do grupo experimental. Além disso, cada dimensão da inteligência emocional alcançou um aumento percentual significativo ao comparar o pré-teste com o pós-teste em cada um, com exceção do componente de gerenciamento de estresse.

A rapid, direct, quantitative, and label-free detector of cardiac biomarker troponin T using near-infrared fluorescent single-walled carbon nanotube sensors.

Patients with chest pain account for 10% of US emergency room visits according to data from the Center for Disease Control and Prevention (2013). For triage of these patients, cardiac biomarkers troponin I and T are endorsed as standard indicators for acute myocardial infarction (AMI, or heart attack). Thus, there is significant interest in developing a rapid, point-of-care (POC) device for troponin detection. In this work, a rapid, quantitative, and label-free assay, which is specific for cardiac troponin T (cTnT) detection, using fluorescent single-walled carbon nanotubes (SWCNTs), is demonstrated. Chitosan-wrapped carbon nanotubes are cross-linked to form a thin gel that is further functionalized with nitrilotriacetic acid (NTA) moieties. Upon chelation of Ni(2+) , the Ni(2+) -NTA group binds to a hexa-histidine-modified troponin antibody, which specifically recognizes the target protein, troponin T. As the troponin T binds to the antibody, the local environment of the sensor changes, allowing direct troponin detection through intensity changes in SWCNT bandgap fluorescence. This platform represents the first near-infrared SWCNT sensor array for cTnT detection. Detection can be completed within 5 min, demonstrating a linear response to cTnT concentration and an experimental detection limit of 100 ng mL(-1) (2.5 nm). This platform provides a promising new tool for POC AMI detection in the future. Moreover, the work presents two new methods of quantifying the number of amines and carboxylic groups, respectively, in a carbon hydrogel matrices.

Hiperoxia por dos horas produce daño morfológico cerebral luego de asfixia neonatal experimental / Two-hour hyperoxia following experimental neonatal asphyxia produces morphological brain damage

Objetivos: Determinar el efecto de una exposición de dos horas de hiperoxia al 21%, 40% y 100% sobre la morfología cerebral, en un modelo experimental de asfixia neonatal. Diseño: Estudio experimental. Institución: Instituto Nacional de Salud del Niño, Lima, Perú. Material biológico: Ratas albinas Holtzmann. Intervenciones: Ciento veinte ratas albinas Holtzmann de una semana de nacidas (a excepción del grupo control) fueron sometidas a asfixia experimental por ligadura de la arteria carótida izquierda y luego expuestas a hipoxia (oxígeno al 8%). Después fueron asignadas aleatoriamente a uno de los siguientes grupos: exposición por dos horas a O2 al 100%, a O2 al 40%, a O2 al 21% y un grupo control (no expuesto a asfixia experimental). El daño cerebral fue evaluado mediante la medición del peso cerebral y el porcentaje del área cerebral con daño microscópico. Principales medidas de resultados: Daño cerebral. Resultados: El peso cerebral promedio fue menor en los animales de los grupos sometidos a hiperoxia experimental (ANOVA; p<0,001). Se presentó daño cerebral microscópico con mayor frecuencia en el grupo sometido a hipoxia experimental que recibió O2 100% por dos horas y con menor frecuencia en el que recibió O2 al 40% (60% versus 43,3%), diferencia que fue estadísticamente significativa (prueba χ²; p<0,001). El grupo sometido a hipoxia experimental que recibió O2 100% tuvo un mayor porcentaje promedio de área cerebral con daño microscópico (18,3%), en comparación con los otros grupos de hipoxia experimental, aunque la diferencia no fue estadísticamente significativa (ANOVA; p=0,123). Conclusiones: La hiperoxia al 100% por dos horas se asoció con menor peso cerebral y mayor daño cerebral en animales de experimentación sometidos a asfixia neonatal experimental.

Objectives: To determine the effect of 2-hour exposure to 21% O2, 40% O2 and 100% O2 on cerebral morphology in an experimental model of neonatal asphyxia. Design: Experimental study. Setting: Instituto Nacional de Salud del Niño, Lima, Peru. Biologic material: Holtzman albino rats. Interventions: A sample of 120 one week-old Holtzman albino rats (with the exception of the control group) underwent experimental asphyxia by left carotid artery ligation and then exposition to hypoxia (8% O2); thereafter rats were randomly assigned to one of the following groups: exposition for two hours to 100% O2, to 40% O2, to 21% O2, and a control group (not exposed to experimental asphyxia). Brain damage was determined by brain weight and percentage of microscopic brain area damage. Main outcome measures: Brain damage. Results: Brain weight was lower in animals with experimental hyperoxia (ANOVA, p<0.001). Microscopic damage was more frequent in the group receiving 100% O2 for two hours and with less frequency in the group receiving 40% O2 (60% versus 43.3%). The difference was statistically significant (χ2 test: p<0.001). The group receiving 100% O2 had more microscopic brain damage (18.3 %) in comparison with the other groups of experimental hypoxia, but the difference was not statistically significant (ANOVA, p=0.123). Conclusions: Following neonatal asphyxia 100% two-hour hyperoxia was associated with less brain weight and more damage in experimental animals.

Violencia psicológica y disfunción sexual de la mujer, Hospital Loayza-2009 / Psychological violence and sexual dysfunction of the woman, Hospital Loayza-2009

Objetivo: Analizar la relación entre la violencia psicológica por parte de la pareja y la disfunción sexual de origen no orgánico de la mujer en edad fértil, que asiste a la consulta externa del Hospital Arzobispo Loayza-2009. Metodología: Estudio observacional, analítico, de casos y controles, de dos grupos seleccionados bajo diagnóstico, a cuyas poblaciones se les aplicó el cuestionario de Tamizaje de violencia psicológica (estandarizado en el Hospital Arzobispo Loayza y MINDES) y cuestionario de Disfunción Sexual de origen no orgánico. Resultados: Se estudiaron 91 mujeres con disfunción sexual (casos) y 91 sin disfunción sexual (Controles), donde la edad promedio de los casos y los controles fue de 31 ± 9 años. El análisis bivariado demostró asociación significativa (p<0,05) de la violencia psicológica, nivel educativo (secundaria y superior), estado civil y el tiempo de vivir en pareja. Al aplicar el análisis multivariado a los factores significativos con el modelo de regresión logística, fueron confirmado los factores de riesgo: violencia psicológica (OR=9.64: lC 95 por ciento: 4.71-19.8), tiempo de vivir en pareja (OR=2.54; lC 95 por ciento: 1.2-5.3) y nivel educativo (OR=1.79; lC 95 por ciento: 0.6-5.6). Conclusiones: La mujer con violencia psicológica de parte de la pareja, tiene mayor posibilidad de presentar Disfunción Sexual de origen no orgánico, se debe prevenir que la violencia psicológica forme parte de la vida de la mujer.

Objective: Analysis of the relationship between psychological violence from the partner and sexual dysfunction of non organic origin the women of childbearing age attending the outpatient department of the Arzobispo Loayza Hospital-2009. Methodology: Observational, analytic study of cases and controls, between two groups selected under diagnostic, to whose populations were applied a questionnaire of psychological violence screening (standardized in Arzobispo Loayza Hospital and MINDES-Ministry of Women and Social Developing) and survey of sexual dysfunction of non organlc origin. Results: 91 women with sexual dysfunction were studied (cases) and 91 without sexual dysfunction (Controls), whose average in age was 31 ± 9 years. Bivariate analysis demonstrated there is a significant association (p<0,05) in psychological violence, higher educational proficiency (secondary and post-secondary), civil status and cohabitation time in couples. Upon applying the multivariate analysis model to the significant factors with logistic regression, only two risk factors were confirmed: Psychological violence (OR=9.64; Cl 95 per cent: 4.71-19.8), cohabitation time (OR=2.54; Cl 95 per cent: 1.2-5.3) and higher educational proficiency (OR=1.79; Cl 95 per cent: 0.6-5.6). Conclusions: Women experiencing psychological violence caused by the partner have higher chances of having sexual dysfunction from non-organic origin; it must be prevented psychological violence to be part of women's life.