ABSTRACT
BACKGROUND: Strongyloidiasis is a disease of great public health significance, caused by the parasitic nematodes Strongyloides stercoralis, Strongyloides fuelleborni, and Strongyloides fuelleborni subsp. kellyi. This systematic review and meta-analysis aimed to assess the prevalence of Strongyloides stercoralis infection in Peru. METHODS: The review was based on a literature search in PubMed, SciELO and Google Scholar using the key words or root words "strongyl*" AND "Peru" on 15 July 2020. Eligible studies were published from 1 January 1981 to 15 July 2020 and written in English, Spanish, Italian, or French. RESULTS: We included 21 papers in the analysis. Studies were heterogeneous in terms of study population and diagnostic methods (e.g. Baermann technique, agar, Dancescu or charcoal cultures, serology, string capsule). Prevalence of S. stercoralis ranged from 0.3 to 45%. The pooled proportion of Strongyloides in the general population was 7.34% (95% CI 4.97 to 10.13%). Half the studies were designed to detect parasites in general. In studies designed to detect S. stercoralis, the most widely used diagnostic method was the Baermann technique. CONCLUSION: Prevalence of S. stercoralis in Peru was high but varied by geographic area, techniques for stool examination, and participant characteristics.
Subject(s)
Strongyloides stercoralis , Strongyloidiasis , Animals , Feces , Humans , Peru/epidemiology , Prevalence , Strongyloidiasis/diagnosis , Strongyloidiasis/epidemiologyABSTRACT
Background. Human T-cell lymphotropic virus type 1 (HTLV-1) is responsible for tropical spastic paraparesis and HTLV-1-associated leukemia/lymphoma. The infection is endemic in some areas of Peru, but its prevalence in the Peruvian Amazon is not well established. We aimed to assess the seroprevalence of HTLV-1 infection in pregnant women in the Peruvian Amazon. Moreover, we performed a systematic literature review and meta-analysis of the seroprevalence of HTLV infection in Peru. (2) Methods. This is a prospective cross-sectional study involving pregnant women attending health centers in the city of Iquitos, Peru, in May and June 2019. The presence of antibodies against HTLV-1 was assessed using ELISA (HTLV I + II ELISA recombinant v.4.0, Wiener lab, Rosario, Argentina). Positive cases were confirmed by Western Blot and HTLV-1 proviral load. (3) Results. The study included 300 pregnant women with a mean age of 26 years (standard deviation [SD] 6.4). Five patients were diagnosed with HTLV-1 infection (prevalence 1.7%, 95% confidence interval (CI) 0.7% to 3.8%). Pregnant women with HTLV-1 infection were discretely younger (mean age 22.6 [SD 22.6] vs 26.8 [SD 6.3]; p = 0.128). None of the five women had been transfused, and all were asymptomatic. Two (40%) also had a positive serology for Strongyloides, but larvae were not detected in any of the parasitological stool studies. The systematic review component identified 40 studies, which showed that the prevalence of HTLV infection in the general population was 2.9% (95% CI 1.2% to 5.3%) and in women of childbearing age, 2.5% (95% CI 1.2% to 4.0%). (4) Conclusion. The prevalence of HTLV-1 in the Peruvian Amazon basin is about 1.7%, indicating an endemic presence. Screening for HTLV-1 in prenatal care is warranted.
ABSTRACT
La Teoría de la Acción Razonada (TAR) ha permitido identificar las variables que predicen la intención de los y las adolescentes para comenzar a tener relaciones sexuales, y se ha demostrado que la inclusión de la variable norma moral incrementa el poder explicativo de la TAR para las adolescentes mujeres, pero no se había establecido si ésto aplica a los hombres. Es por ello que este estudio pretendió, en primera instancia, corroborar la consistencia de la TAR y la inclusión de la variable norma moral, para predecir la intención de los y las adolescentes para iniciar sus relaciones sexuales, así como establecer si las variables que predicen la intención son las mismas para ambos sexos. Se tomó una muestra de 355 estudiantes voluntarios de tres colegios privados de Bogotá, Colombia, militar (33,5%), laico (32,7%) y religioso (33,8%). Del total de la muestra el 52% fueron hombres y 48% mujeres. El 41% pertenecían al 9º grado, 42% a 10º grado y 17% al grado 11. La edad promedio fue 15,33 años (DT = 1,03). Se les aplicó un cuestionario estructurado de autoinforme con 136 preguntas, previo consentimiento informado pasivo escrito de sus padres de familia. Para este artículo solamente se tuvieron en cuenta las variables: actitudes hacia las relaciones sexuales en la adolescencia, norma moral, norma social subjetiva (norma de padre y amigos) e intención de tener relaciones sexuales. Con el análisis de regresión múltiple se confirmó que la variable norma moral mejora el poder predictivo de la TAR para predecir la intención para iniciar a tener relaciones sexuales en la adolescencia, que la norma social subjetiva de los amigos es determinante en la intención de los hombres, mientras que para las mujeres es la norma social subjetiva de los padres. Los hallazgos son determinantes para el diseño de estrategias que permitan prevenir el embarazo adolescente.
The Theory of Reasoned Action (TRA) has identified the variables that predict the intention of adolescents to start having sexual intercourse, and has been shown that the inclusion of moral norm variable increases the explanatory power of TRA for adolescent girls, but it had not been established if this applies to men. Therefore, this study aimed at first instance to check the consistency of the TRA and the inclusion of moral norm variable to predict the intention of adolescents to initiate sexual intercourse and to establish whether the variables that predict intention are the same for both sexes. A sample of 355 volunteer students from three private schools in Bogotá, Colombia was used: military (33.5%) secular (32.7%) and religious (33.8 % of the total sample 52% were men and 48% female. 41% belonged to 9th grade, 42% to 10th grade and 17% to 11th grade. The mean age was 15.33 years (SD =1.03). They answered a structured self-report questionnaire with 136 questions, previous passive informed consent of their parents. This article only took into account the variables: attitudes toward sexual intercourse in adolescence, moral norm, subjective social norm (norm of parents and friends) and intention to have intercourse. With multiple regression analysis, it was confirmed that the moral norm variable improves the predictive power of TRA to predict the intention to initiate sexual intercourse during adolescence, that subjective social norm of friends is determinant in the intention of men, while for women is the parental social subjective norm. The findings are critical for designing strategies to prevent teen pregnancy.
A Teoria da Ação Razoada (TAR) tem permitido identificar as variáveis que predizem a intenção dos e das adolescentes para começar a ter relações sexuais, e tem-se demonstrado que a inclusão da variável norma moral incrementa o poder explicativo da TAR para as adolescentes mulheres, mas não se tinha estabelecido se isto aplica aos homens. É por isso, que este estudo pretendeu, em primeira instância, corroborar a consistência da TAR e a inclusão da variável norma moral, para predizer a intenção dos e das adolescentes para iniciar as suas relações sexuais, assim como estabelecer se as variáveis que predizem a intenção são as mesmas para os dois sexos. Tomou-se uma amostra de 355 estudantes voluntários de três colégios privados de Bogotá, Colômbia, militar (33,5%), laico (32,7%) e religioso (33,8%). Do total da amostra o 52% foram homens e 48% mulheres. O 41% pertenciam à 9º série, 42% à 10º série e 17% à série 11. A idade média foi 15,33 anos (DT = 1,03). Se lhes aplicou um questionário estruturado de autoinforme com 136 perguntas, prévio consentimento informado passivo escrito dos seus pais de família. Para este artigo somente se tiveram em conta as variáveis: atitudes para as relações sexuais na adolescência, norma moral, norma social subjetiva (norma de pai e amigos) e intenção de ter relações sexuais. Com a análise de regressão múltipla se confirmou que a variável norma moral melhora o poder preditivo da TAR para predizer a intenção para começar a ter relações sexuais na adolescência, que a norma social subjetiva dos amigos é determinante na intenção dos homens, enquanto que para as mulheres é a norma social subjetiva dos pais. As descobertas são determinantes para o desenho de estratégias que permitam prevenir a gravidez adolescente.
Subject(s)
Humans , Adolescent , Coitus , Adolescent , Colombia , Intention , MoraleABSTRACT
Tradicionalmente, los estudios de "Bullying", también conocido como intimidación o matoneo, se han concentrado en la enseñanza primaria y secundaria, pero pocos han dirigido su interés al ámbito de la educación superior y en menor número en los programas de salud. En este artículo se presenta los resultados de un estudio diseñado para identificar y caracterizar la presencia del "bullying" en los estudiantes de pregrado de 22 facultades de medicina en Colombia, como un aporte para la generación de políticas de calidad de la educación médica en el país. Se utilizó un diseño transversal de tipo descriptivo-comparativo, con una muestra probabilística de 1.500 estudiantes de pregrado de los primeros diez semestres. La prevalencia general encontrada de "bullying" fue del 19,68% (IC 95%= 17,5-22,32). Las zonas de mayor prevalencia fueron la costa (28,01%, IC95%= 22,53-33,48), la zona oriental (26,29, IC95%=21,38-31,19) y la zona central (23,56, IC95%= 17,40-29,71). La fuente más frecuente de matoneo fueron los docentes y los compañeros, siendo más común la intimidación por humillación y de tipo verbal. No se encontraron diferencias significativas entre los diferentes tipos de universidades, sexos ni semestres cursados. Se evidencia, por tanto, que el "bullying" no es un mito sino una realidad, y que debe ser un tema de preocupación para las facultades y hospitales universitarios, en la medida que podría estar afectando la dinámica de relaciones interpersonales, la permanencia en la carrera, el rendimiento académico, la productividad e incluso la salud de los médicos y de sus pacientes, siendo este último un aspecto importante por estudiar. Los resultados obtenidos hacen pensar que es urgente desarrollar programas de intervención para la prevención y manejo de comportamientos que ocasionan "bullying" en las facultades de medicina...
Research on bullying or intimidation have mainly focus in the elementary and secondary education, while few have been conducted on superior education and even less in the health programs. This article presents the results of a study designed to identify and to characterise the presence of bullying in undergraduate students of 22 medicine faculties of Colombia, as a contribution for the generation of quality policies underproducate for the medical education in this country. A transversal, descriptive and comparative design was used, with a probabilistic sample of 1,500 undergraduate students of the first ten semesters. The general prevalence found for bullyng was of 19,68% (IC 95%= 17,5-22,32). The areas of higher prevalence were the coast (28,01%, IC95%= 22,53-33,48), the eastern zone (26,29, IC95%=21,38-31,19) and the central zone (23,56, IC95%= 17,40-29,71). The bullies were lecturers and class mates and the most common form was intimidation by humiliation of verbal type. Non significant differences were found among different types of universities, the gender or coursed semesters. Evidences are presented supporting that bullying is a reality not a myth, and hence it must be a matter of attention for faculties and hospitals, since it is affecting the dynamics of interpersonal relationship, the permanence in the program, the academic performance, the productivity and even the health of the practitioners and their patients. For all these reasons, it becomes imperative to develop intervention programs in preventing and handling of bullying behaviours in the medicine faculties...
Tradicionalmente, os estudos de "bullying", também conhecido como intimidação ou assédio moral, centraram-se na educação primária e secundária, mas poucos se voltaram seu interesse para o campo do ensino superior e menos para os programas de saúde. Este artigo apresenta os resultados de um estudo destinado a identificar e caracterizar a presença do bullying em estudantes universitários de 22 faculdades de medicina na Colômbia, como uma contribuição para o desenvolvimento de políticas de qualidade da educação médica no país. Utilizou-se um estudo de corte transversal, descritivo-comparativo, com uma amostra probabilística de 1.500 alunos de graduação nos primeiros dez semestres. Foi encontrada uma prevalência global de bullying foi 19,68% (95% CI = 17,5-22,32). As áreas de maior prevalência foram o litoral (28,01%, IC 95% = 22,53-33,48), leste (26,29, IC 95% = 21,38-31,19) e centrais (23,56, IC 95% = 17,40-29,71). A fonte mais comum de assédio moral foram os professores e colegas, sendo mais comum a intimidação pela humilhação é de tipo verbal. Não houve diferenças significativas entre os diferentes tipos de universidades, sexos e semestres tomadas. É evidente, portanto, que o "bullying" não é um mito, mas uma realidade, e deve ser uma preocupação para os faculdades e hospitais universitários, como pode estar afetando a dinâmica das relações interpessoais, a permanência na faculdade, o desempenho acadêmico, as produtividades e até mesmo a saúde dos médicos e seus pacientes, sendo isto último um aspecto importante para estudo. Os resultados sugerem que é urgente o desenvolvimento de programas de intervenção para a prevenção e abordagem de comportamentos que provocam "bullying" nas escolas de medicina...
Subject(s)
Humans , Bullying , Students, Medical/statistics & numerical data , Students, Medical , Violence , Violence/statistics & numerical dataABSTRACT
Introducción: El poroma es un tumor benigno de la glándula sudorípara, que se presenta usualmente en plantas y palmas. Se confunde con numerosos cuadros cutáneos y es casi siempre diagnosticado erróneamente. Objetivo: Describir las características clínicas y patológicas de los poromas vistos en el HNSE EsSalud del Cusco entre febrero del 2006 y diciembre del 2008. Tratamos de dar una guía para el enfoque de este tumor. Material y métodos: Estudio descriptivo de ocho casos de poromas que fueron confirmados por histopatología. Adicionalmente en tres casos realizamos estudios con inmunohistoquímica con CEA y EMA. Seis casos fueron tratados con electrocirugía de radiofrecuencia y dos con exéresis convencional. Resultados: Reportamos ocho casos de poromas, cuatro de sexo femenino, con un tiempo de enfermedad entre tres meses y 20 años,dos casos con tiempo de evolución de tres meses se presentaron en mujeres de 25 y 30 años. Siete casos fueron asintomáticos. Cinco casos se ubicaron en miembros inferiores, dos en cuello y uno en cara. La apariencia de las lesiones fue polipoide en un caso, uno con aspecto de placa verrucoide, dos angioides, dos tipo placas anfractuosas, uno fue nodular lobulado oscuro y otro papuloso oscuro. El patrón histopatológico fue epidérmico en dos casos, yuxtaepidérmico en tres y tres correspondieron al tipo dérmico. Tres casos marcaron positivamente con ECA y EMA. La respuesta al tratamiento quirúrgico fue óptima. No se objetivaron recidivas. Conclusiones: Los poromas tienen diversidad clínica, de modo que se pueden confundir con otros cuadros. Es de esperar que ocurran también en adultos jóvenes y en localizaciones insospechadas. Generalmente no dan molestias. El estudio histopatológico es de rigor, mostrando patrones variados, finalmente la inmunohistoquímica afianza el diagnóstico.
Background: Poroma is a benign sweat gland tumor, usually seen in the palm and sole. It may be confused with numerous skin diseases, and it is almost always misdiagnosed. Objective: To describe the clinical and histopathologic features of 8 patients with poroma, seen at the EsSalud National Hospital of Cusco, Peru, between February 2006 and December 2008. We try to give guidance for the management of poromas. Methods: Descriptive study of 8 cases of poroma, confirmed with histopathologic examination. Additionally we made inmunohistochemical evaluation with CEA and EMA in 3 cases. Six patients were treated with radiofrequency surgery and 2 with standard local excision. Results: We report 8 patients with poromas, there were 4 females, with a time of disease between three months and 20 years, the two cases where it was three months occurred in women between 25 and 30. Seven cases were asymptomatic. The lesions in 5 cases were located in the lower limbs, 2 cases in the neck and one in the face. The appearance of the lesions was polypoid in one case, one was a verrucous plaque, 2 had angioid appearance, 2 had simplex plaques, one was a dark multilobulated nodule and one was a dark papule. The histological pattern was epidermic in 2 cases, yuxtaepidermic in 3 and 3 belonged to the dermal type. Three of them marked positive with ECA and EMA. The treatment, mainly with radiosurgery, was satisfactory in all cases. No local recurrences were observed. Conclusions: Poromas have a wide range of clinical presentations, the reason why it can be confused with other conditions. It is also expected to occur in young adults and in unusual locations. They are almost always asymptomatic. Histopatologic evaluation is very important showing varied patterns ant it is immunohistochemistry what ultimately enhances the diagnostic.