Intestinal microbiota dataset revealed by high-throughput sequencing of 16S rRNA in children with anemia in southern Peru.

Anemia is the most common hematological disorder affecting humans. In Peru, anemia is a pressing issue that present the most significant concern due to its adverse effects, such as delayed growth and psychomotor development, in addition to a deficiency in cognitive development. Anemia is a significant public health issue in Peru, which has one of the highest prevalence rates in infants in the Latin American and Caribbean (LAC) region, affecting approximately 43.6 % of children under three years nationally as of 2017, with rural areas experiencing a higher prevalence of approximately 53.3 %. In 2019, the prevalence was highest in the Sierra (48.8 %) and Selva regions (44.6 %), whereas the coast had a lower rate of 33.9 % in children under 36 months. Although the composition of the gut microbiota is relatively well described in children, there is little information on the identification of the microbiota in iron-deficiency anemia. There is evidence that diseases or health conditions can change the microbiota, or vice versa. This study aimed to identify the microbiota in children with anemia who did not recover after iron treatment. In a previous study, we found that the phylum Actinobacteria was predominant in the microbiota of children with anemia. These data will be useful for understanding the functionality of the most important bacteria found in each group at the genus or species level, especially the metabolic pathways in which they participate and their links with iron metabolism. Microbial composition data were obtained through next-generation 16S rRNA sequencing (NGS) of stool samples from children with anemia in southern Peru. Numerous studies have underscored the importance of early symbiotic development in infant health and its long-term impact on health. From infancy, modulation of the gut microbiota can promote long-term health. According to the National Institute of Health (NIH), iron-deficiency anemia may cause serious complications, such as fatigue, headaches, restless legs syndrome, heart problems, pregnancy complications, and developmental delays in children. The development of the gut microbiota is regulated by a complex interplay between host and environmental factors. The bidirectional link between the gut microbiota and anemia plays an important role in tracking the gut microbiota and will be useful in understanding the composition of the intestinal microbiota and its implications in anemia, which has now become a public health problem. Our previous study investigated the microbial composition in children with iron-deficiency anemia and revealed the presence of several bacterial groups, including Proteobacteria, Actinobacteria, Firmicutes, and Chloroflexi. In addition, these data may be useful for investigating the association between the intestinal microbiota of children with persistent anemia and those who have recovered.

Bioinformatics Analysis Reveals E6 and E7 of HPV 16 Regulate Metabolic Reprogramming in Cervical Cancer, Head and Neck Cancer, and Colorectal Cancer through the PHD2-VHL-CUL2-ELOC-HIF-1α Axis.

Human papillomavirus 16 (HPV 16) infection is associated with several types of cancer, such as head and neck, cervical, anal, and penile cancer. Its oncogenic potential is due to the ability of the E6 and E7 oncoproteins to promote alterations associated with cell transformation. HPV 16 E6 and E7 oncoproteins increase metabolic reprogramming, one of the hallmarks of cancer, by increasing the stability of hypoxia-induced factor 1 α (HIF-1α) and consequently increasing the expression levels of their target genes. In this report, by bioinformatic analysis, we show the possible effect of HPV 16 oncoproteins E6 and E7 on metabolic reprogramming in cancer through the E6-E7-PHD2-VHL-CUL2-ELOC-HIF-1α axis. We proposed that E6 and E7 interact with VHL, CUL2, and ELOC in forming the E3 ubiquitin ligase complex that ubiquitinates HIF-1α for degradation via the proteasome. Based on the information found in the databases, it is proposed that E6 interacts with VHL by blocking its interaction with HIF-1α. On the other hand, E7 interacts with CUL2 and ELOC, preventing their binding to VHL and RBX1, respectively. Consequently, HIF-1α is stabilized and binds with HIF-1ß to form the active HIF1 complex that binds to hypoxia response elements (HREs), allowing the expression of genes related to energy metabolism. In addition, we suggest an effect of E6 and E7 at the level of PHD2, VHL, CUL2, and ELOC gene expression. Here, we propose some miRNAs targeting PHD2, VHL, CUL2, and ELOC mRNAs. The effect of E6 and E7 may be the non-hydroxylation and non-ubiquitination of HIF-1α, which may regulate metabolic processes involved in metabolic reprogramming in cancer upon stabilization, non-degradation, and translocation to the nucleus.

Characterization of Pulmonary Bacteriobiota in Critically Ill Patients in Southern Peru through Next-Generation Sequencing Technology.

Sequence variation in the 16S gene is widely used to characterize diverse microbial communities. This was the first pilot study carried out in our region where the pulmonary microbiota of critically ill patients was investigated and analyzed, with the aim of finding a specific profile for these patients that can be used as a diagnostic marker. An study of critical patients mechanically ventilated for non-respiratory indications, in a polyvalent intensive care unit, was carried out; samplee were extracted by endotracheal aspiration and subsequently the microbiota was characterized through Next-Generation Sequencing Technology (NGS). The predominant phyla among the critically ill patients were Proteobacteria, Firmicutes and Bacteroidata. In the surviving patients group, the predominant phyla were Proteobacteria, Bacteroidata and Firmicutes, in the group of deceased patients thy were Firmicutes, Proteobacteria, and Bacteroidata. We found a decrease in commensal bacteria in deceased patients and a progressive increase in in-hospital germs.

Evaluación de los patrones de farmacorresistencia de mycobacterium tuberculosis en un hospital público de Lima, Perú durante 2022

Antecedentes: La tuberculosis es un problema de salud pública considerado la principal causa mundial de muerte por una enfermedad infecciosa entre los adultos. El diagnóstico suele ser difícil y se basa en hallazgos clínicos, epidemiológicos, radiológicos, bacteriológicos, histológicos y bioquímicos. El diagnóstico oportuno, la identificación del perfil de susceptibilidad y el cumplimiento del seguimiento son importantes para permitir un tratamiento más eficaz y evitar formas graves de la enfermedad. Objetivo: Describir los patrones de resistencia de Mycobacterium tuberculosis identificados en el periodo del año 2022 en el Hospital María Auxiliadora. Material y métodos: Se trata de un estudio observacional, transversal, de pacientes diagnosticados de tuberculosis durante todo el año 2022 en el Centro de Excelencia en Tuberculosis (COE-TB), división del servicio de medicina respiratoria del Hospital María Auxiliadora, Lima, Perú. Los datos fueron recolectados de las historias clínicas que luego fueron incluidas para el análisis estadístico. Las características clínicas y demográficas se describieron mediante frecuencias absolutas y porcentajes. Para evaluar la asociación entre el perfil de sensibilidad de la tuberculosis y las variables independientes se utilizó la prueba de Chi cuadrado y la prueba exacta de Fisher. Un valor p < 0,05 se consideró estadísticamente significativo. Resultados: Se incluyeron en el presente estudio 261 historias clínicas. El grupo de edad más frecuente fue el de 17-59 años, la mayoría eran varones (62,1%) y el 15,7% eran recidivantes, según lo establecido en la norma técnica nacional. Del total, el 89,7% eran sensibles a fármacos de primera línea; el 6,1% de los pacientes eran multirresistentes (MDR), y el 0,8% presentaban resistencia extensiva a fármacos (XDR); asimismo, el 0,8% y el 2,7% presentaban resistencia sólo para rifampicina y resistencia sólo para isoniazida respectivamente. La infección por VIH se detectó en el 14,2%. La forma más frecuente de tuberculosis fue la pulmonar (49%), seguida de la tuberculosis pleural (21,8%). Conclusiones: La tuberculosis es una afección mundial cuyos patrones de farmacorresistencia continúan evolucionando. Sin embargo, en nuestro hospital, un centro de referencia del sur del Perú, la mayoría de los pacientes con TB siguen siendo sensibles a los fármacos de primera línea. Sólo se encontró una pequeña cantidad de pacientes MDR y XDR. Además, la presentación clínica más frecuente fue la tuberculosis pulmonar seguida de la pleural.

Background: Tuberculosis is a public health problem considered to be the world's leading cause of death from an infectious disease among adults. Diagnosis is often challenging and is based on clinical, epidemiological, radiological, bacteriological, histological and biochemical findings. Timely diagnosis, identification of the susceptibility profile and follow-up compliance is important to enable more effective treatment and avoid severe forms of the disease. Objective: Describe the resistance patterns of Mycobacterium tuberculosis identified in the period of the year 2022 at Hospital María Auxiliadora. Material and Methods: This is an observational, cross-sectional study of patients diagnosed with tuberculosis throughout the year 2022 in the Tuberculosis Center of Excellence (TB COE), division of the respiratory medicine department at the Hospital Maria Auxiliadora, Lima, Peru. Data was collected from the medical records which was then included for the statistical analysis. The clinical and demographic characteristics were described by absolute frequencies and percentages. Chi-square test and Fisher's exact test were used to evaluate the association between the sensitivity profile of tuberculosis and the independent variables. A p-value < 0.05 was considered as statistically significant. Results: A total of 261 medical records were included in the present study. The most frequent age group was 17-59 years old, the majority were male (62.1%) and 15.7% were relapses, as established on national technical standard. Of the total, 89.7% were sensitive to first line drugs; 6.1% of the patients were multidrug-resistant (MDR), and 0.8% presented extensively drug-resistance (XDR); likewise, 0.8% and 2.7% presented resistance for rifampicin only and resistance for isoniazid only respectively. HIV infection was found at 14.2%. The most common form of tuberculosis was pulmonary (49%) followed by pleural tuberculosis (21.8%). Conclusion: Tuberculosis is a worldwide condition whose drug-resistance patterns continue evolving. However, in our hospital, a southern Peru reference Center, most TB patients are still sensitive to first line drugs. Only a small amount of MDR and XDR patients were found. Moreover, the most common clinical presentation was pulmonary followed by pleural tuberculosis.

TET Enzymes and 5hmC Levels in Carcinogenesis and Progression of Breast Cancer: Potential Therapeutic Targets.

Breast Cancer (BC) was the most common female cancer in incidence and mortality worldwide in 2020. Similarly, BC was the top female cancer in the USA in 2022. Risk factors include earlier age at menarche, oral contraceptive use, hormone replacement therapy, high body mass index, and mutations in BRCA1/2 genes, among others. BC is classified into Luminal A, Luminal B, HER2-like, and Basal-like subtypes. These BC subtypes present differences in gene expression signatures, which can impact clinical behavior, treatment response, aggressiveness, metastasis, and survival of patients. Therefore, it is necessary to understand the epigenetic molecular mechanism of transcriptional regulation in BC, such as DNA demethylation. Ten-Eleven Translocation (TET) enzymes catalyze the oxidation of 5-methylcytosine (5mC) to 5-hydroxymethylcytosine (5hmC) on DNA, which in turn inhibits or promotes the gene expression. Interestingly, the expression of TET enzymes as well as the levels of the 5hmC epigenetic mark are altered in several types of human cancers, including BC. Several studies have demonstrated that TET enzymes and 5hmC play a key role in the regulation of gene expression in BC, directly (dependent or independent of DNA de-methylation) or indirectly (via interaction with other proteins such as transcription factors). In this review, we describe our recent understanding of the regulatory and physiological function of the TET enzymes, as well as their potential role as biomarkers in BC biology.

Anemia in pregnant women residing at different geographical altitudes in Arequipa, Peru / Anemia en gestantes residentes en diferentes altitudes geográficas de Arequipa, Perú

Purpose: To identify the frequency of anemia in pregnant women at different geographical altitudes in the Arequipa region of Peru. Methods: A quantitative, descriptive, and retrospective study was carried out. The study population consisted of 35,725 pregnant women living in the Arequipa Region at different altitudes. Data on age, gestational age, weight, height, province of residence, altitude, hemoglobin were collected. Results: Using World Health Organization altitude adjusted hemoglobin values, anemia prevalence in pregnant women between 2018-2019 was 13.7 percent in the Arequipa Region, while using unadjusted hemoglobin, the overall prevalence was 4.1 percent. When analyzed by altitudes, the frequency of anemia was 9.77 percent below 1 000 m 13.1 percent between 1 000-1 999 m, 13.1 percent between 2.000-2.999 m, 31.5 percent between 3.000-3.999 and 47.1 percent between 4.000-4.999. Nevertheless, when using unadjusted hemoglobin values rates were 6.67 percent for the 1.000-1.999 range, 2.39 percent for ranges between 2.000-2.999 m and 3.000-3.999 m, and 5.19 percent for altitudes above 4.000 m. Conclusions: There is a directly proportional correlation in the prevalence of anemia in pregnant women and higher altitude (p<0.01) as well as levels of anemia during the last trimester of pregnancy. Adjusting the hemoglobin values by altitude results in triple the prevalence of anemia. A throughout revision of the suitability of current guidelines to diagnose and prevent anemia at high altitude is recommended (AU)

Objetivo: Identificar la frecuencia de anemia en gestantes de diferentes altitudes geográficas en la región Arequipa, Perú. Métodos: Se realizó un estudio cuantitativo, descriptivo y retrospectivo. La población de estudio estuvo constituida por 35 725 gestantes residentes en la Región Arequipa a diferentes altitudes. Se recogieron datos de edad, edad gestacional, peso, talla, provincia de residencia, altitud, hemoglobina. Resultados: Utilizando los valores de hemoglobina ajustados por altitud de la Organización Mundial de la Salud, la prevalencia de anemia en gestantes entre 2018-2019 fue de 13,7 por ciento en la Región Arequipa, mientras que utilizando la hemoglobina no ajustada, la prevalencia global fue de 4,1 por ciento. Al analizar por altitudes, la frecuencia de anemia fue de 9,77 por ciento por debajo de 1 000 m 13,1 por ciento entre 1 000-1 999 m, 13,1 por ciento entre 2 000-2 999 m, 31,5 por ciento entre 3 000-3 999 y 47,1 por ciento entre 4 000-4 999. Sin embargo, cuando se utilizaron valores de hemoglobina no ajustados, las tasas fueron del 6,67 por ciento para el intervalo de 1 000-1 999, del 2,39 por ciento para los intervalos entre 2 000-2 999 m y 3 000-3 999 m, y del 5,19 por ciento para altitudes superiores a 4 000 m. Conclusiones: Existe una correlación directamente proporcional en la prevalencia de anemia en embarazadas y mayor altitud (p<0,01), así como niveles de anemia durante el último trimestre del embarazo. Ajustando los valores de hemoglobina por la altitud se triplica la prevalencia de anemia. Se recomienda una revisión en profundidad de la idoneidad de las directrices actuales para diagnosticar y prevenir la anemia a gran altitud(AU)

Valor diagnóstico del índice de Sokolow-Lyon en la hipertrofia ventricular izquierda

RESUMEN Introducción: La hipertrofia de ventrículo izquierdo constituye un gran problema entre los pacientes con hipertensión arterial a nivel mundial, además se relaciona con diversas enfermedades, las cuales pueden ser fatales. Objetivo: Evaluar el rendimiento diagnóstico del índice de Sokolow-Lyon en derivaciones precordiales para la hipertrofia de ventrículo izquierdo. Método: Se realizó un estudio de medios diagnósticos de tipo observacional, analítico y transversal. Se estudiaron 122 pacientes ingresados en los servicios de Medicina Interna, Nefrología y Neurología del Hospital Militar Carlos J. Finlay (La Habana, Cuba) de enero del 2017 a marzo del 2019, a los cuales se les realizó ecocardiograma y electrocardiograma. Resultados: Existió un predominio de la población mayor de 45 años (77,9%), del sexo masculino (59,8%) y con hipertensión arterial (77,0%). Se realizó una descripción cualitativa del índice electrocardiográfico de Sokolow-Lyon para precordiales en el total de casos estudiados y se encontró una prevalencia de hipertrofia ventricular izquierda de 71,3%. Este criterio de voltaje presentó una alta especificidad (83%), alto valor predictivos positivo (85%) y una razón de verosimilitud (likelihood ratio) positiva de 2,28. Conclusiones: En pacientes hospitalizados, donde la prevalencia de hipertensión arterial es elevada, el criterio de Sokolow-Lyon presentó alta utilidad diagnóstica para la hipertrofia de ventrículo izquierdo, así como para confirmar los casos que verdaderamente la padecían.

ABSTRACT Introduction: Left ventricular hypertrophy is a major problem among patients with high blood pressure worldwide; it is also related to various entities, which can be fatal. Objective: To evaluate the diagnostic performance of the Sokolow-Lyon index in precordial leads for left ventricular hypertrophy. Method: An observational, analytical and cross-sectional study of diagnostic means was carried out. One hundred and twenty-two patients admitted to the Departments of Internal Medicine, Nephrology and Neurology of the Hospital Militar Carlos J. Finlay (Havana, Cuba) were studied from January 2017 to March 2019, who underwent echocardiography and electrocardiogram. Results: There was a predominance of the population over 45 years old (77.9%), males (59.8%) and with high blood pressure (77.0%). A qualitative description of the Sokolow-Lyon electrocardiographic index for precordial leads was performed in the total number of the studied cases, and a prevalence of 71.3% of left ventricular hypertrophy was found. This voltage criterion showed high specificity (83%), high positive predictive values ​​(85%) and positive likelihood ratio at 2.28. Conclusions: In admitted patients, where the prevalence of high blood pressure is elevated, the Sokolow-Lyon criterion presented high diagnostic usefulness for left ventricular hypertrophy as well as to confirm the cases that actually present it.

El plasma de convalecientes como un tratamiento potencial en pacientes con COVID-19 / Convalescent plasma as potential treatment for COVID-19 patients

Introducción: El plasma de convalecientes es una inmunoterapia pasiva que se ha usado para el tratamiento y prevención de muchas enfermedades infecciosas por más de un siglo. Dada la falta de tratamiento específico para el nuevo coronavirus SARS-CoV-2, el plasma de convalecientes es una alternativa terapéutica potencial contra la COVID-19. Objetivo: Realizar una revisión del empleo del plasma de convalecientes como alternativa terapéutica a la COVID-19. Desarrollo: Se empleó la estrategia de búsqueda del tema; consultando las bases de datos Pubmed, SciELO, Lilacs, Cochrane Library y Web of Science. El plasma de convalecientes ha mostrado efectividad en el tratamiento de varias enfermedades virales. Así, la evidencia sobre su uso en los pacientes con COVID-19 es escasa, aunque se han obtenido resultados alentadores, pero no concluyentes por falta de un número mayor ensayos clínicos. Al mismo tiempo, Cuba incluye en sus protocolos de actuación contra la COVID-19 este tratamiento. Conclusiones: Esta alternativa resulta una herramienta inmunoterapéutica en los pacientes con la COVID-19, ya que mejora el estado clínico y disminuir la tasa de letalidad. Sin embargo, se necesitan más ensayos clínicos controlados y aleatorizados que afirmen su efectividad y seguridad(AU)

Introduction: Convalescent plasma is a form of passive immunotherapy which has been used for the treatment and prevention of many infectious diseases for more than one century. Given the absence of a specific treatment for the novel coronavirus SARS-CoV-2, convalescent plasma is a potential therapeutic alternative against COVID-19. Objective: Carry out a review about the use of convalescent plasma as a therapeutic alternative against COVID-19. Discussion: A search was conducted about the topic in the databases Pubmed, SciELO, Lilacs, Cochrane Library and Web of Science. Convalescent plasma has been shown to be effective in the treatment of several viral diseases. However, evidence of its use in COVID-19 patients is scant. Promising results have been obtained, though, but they are not conclusive due to the need of a larger number of clinical trials. In Cuba this treatment is included among the clinical management protocols for COVID-19. Conclusions: This alternative is an immunotherapeutic tool for the treatment of COVID-19 patients, since it improves their clinical status and reduces lethality rates. However, more controlled and randomized clinical trials are required confirming its effectiveness and safety(AU)

Situación actual de Cannabis sativa, beneficios terapéuticos y reacciones adversas / Current status of Cannabis sativa; therapeutic benefits and adverse reactions

Introducción: En la actualidad, uno de los temas más polémicos que involucra en gran proporción al campo de la Medicina es el uso terapéutico de la marihuana y su legalización. Esta planta de reconocimiento milenario ha desatado en las últimas décadas disímiles de controversias dado el descubrimiento del sistema endocannabinoide que revolucionó la investigación sobre ella. Objetivo: Describir la situación actual del cannabis, sus beneficios terapéuticos y sus efectos adversos. Material y métodos: Se realizó una exhaustiva búsqueda y revisión empleando los Descriptores en Ciencias de la Salud, en idioma inglés y español, consultando las bases de datos Pubmed, Scielo, Lilacs, Cochrane Library y Web of Science, para los últimos 10 años, empleándose un total de 45 artículos como referencias bibliográficas. Desarrollo: Al Cannabis se le han atribuido efectos farmacológicos, tales como: antinociceptivo, antiepiléptico, inmunosupresivo, antiemético, estimulante del apetito, antimicrobiano, antiinflamatorio y neuroprotector. A su vez, presenta disímiles reacciones adversas como son la predisposición a varios tipos de cáncer, empeoramiento de desórdenes mentales, dificultades en el aprendizaje y el rendimiento escolar, que constituye una droga portera, entre otros. A pesar de las tendencias legalizadoras no son suficientes las razones para la legalización de esta droga, cuando su principal blanco resulta ser los adolescentes, donde los daños neurológicos que causa son irreversibles. Conclusiones: Se debe continuar explorando las potencialidades terapéuticas de los cannabinoides a partir de la elaboración de productos farmacológicos bien dosificados y controlados, pues el riesgo de sus efectos adversos es innegable y contundente(AU)

Introduction: Currently, one of the most controversial issues that greatly involves the medical field is the therapeutic use and legalization of marijuana. This millennial recognition has led to different controversies in recent decades due to the discovery of the endocannabinoid system which has revolutionized the process of research on this topic. Objective: To describe the current situation of cannabis, its therapeutic benefits and adverse effects. Material and methods: An in-depth search and review was carried out using Health Sciences descriptors in English and Spanish. A search was carried out in PubMed, SciELO, Lilacs, Cochrane Library and Web of Science databases. Publications from the last 10 years were consulted, using a total of 45 articles as bibliographic references. Development: Some pharmacological effects such as antinociceptive, antiepileptic, immunosuppressive, antiemetic, appetite stimulant, antimicrobial, anti-inflammatory and neuroprotective ones have been attributed to Cannabis. In turn, it presents dissimilar adverse reactions such as predisposition to various types of cancer, worsening of mental disorders, and difficulties with learning and school performance. Cannabis, among others, is considered a starter drug. Despite the trend towards legalization, there are not enough reasons for the legalization of this drug. Its main target turns out to be the adolescents, among which the neurological damage it causes is irreversible. Conclusions: The therapeutic potential of cannabinoids should continue to be explored from the production of well dosed and controlled pharmacological products, since the risk of their adverse effects are undeniable and overwhelming(AU)

Tumores hepáticos en edad pediátrica / Hepatic tumors in pediatric ages

Introducción: Los tumores del hígado representan de 1-2 por ciento de todas las neoplasias malignas de la infancia y de 15-20 por ciento de los tumores abdominales. Objetivo: Caracterizar desde el punto de vista clínico-quirúrgico a pacientes pediátricos con diagnóstico de tumor hepático. Métodos: Estudio descriptivo y transversal realizado en el hospital pediátrico Juan Manuel Márquez. Se revisaron historias clínicas, informes histopatológicos e informes operatorios en el periodo comprendido entre el 1ro. de enero de 1997 al 31 de diciembre de 2017, para obtener los datos clínicos necesarios para la investigación. La muestra quedó conformada por 63 pacientes. Se emplearon frecuencias absolutas y porcentajes para variables cualitativas. Para las variables cuantitativas, se emplearon además medidas de tendencia central y de dispersión. Resultados: Se constató que 33 (52,4 por ciento) pacientes fueron del sexo masculino. El mayor número de enfermos se concentró en el grupo de 1 a 5 años con 36 (57,1 por ciento). El tumor más frecuente fue el hepatoblastoma y dentro de este el hepatoblastoma fetal, del cual se registraron 16 pacientes (25,4 por ciento). En 34 pacientes (54 por ciento) se combinó el tratamiento médico y el quirúrgico. Conclusiones: Predominan los pacientes masculinos, entre 1 y 5 años de edad. Se identifican principalmente tumores hepáticos epiteliales, malignos en estadio III y la variedad histológica de hepatoblastoma fetal. El tratamiento más utilizado es el médico-quirúrgico según protocolo del hospital dependiente del tipo histológico(AU)

Introduction: Liver tumors represent 1-2 percent of all the malignant neoplasms in children and the 15-20 percent of abdominal tumors. Objective: To characterize from the clinical surgical perspective the pediatric patients with a diagnosis of hepatic tumor. Methods: Descriptive and cross-sectional study conducted in Juan Manuel Márquez Pediatric Hospital. There were reviewed clinical records, histopathological reports and surgical reports from January 1st, 1997 to December 31st, 2017, to obtain necessary clinical data for the research. The sample was formed by 63 patients. There were used absolute frequencies and percentages for qualitative variables. For quantitative variables, there were used central trend and diffusion measures. Results: It was verified that 33 patients (52.4 percent) were males. The biggest number of patients was in the age group from 1 to 5 years being 36 (57.1 percent). The most frequent tumor was the hepatoblastoma and within this category the fetal hepatoblastoma, with 16 (25.4 percent) patients with that condition. In 34 patients (54 percent) were combined medical and surgical approchaes. Conclusions: There was a predominance of male patients in the ages from 1 to 5 years. There were mainly identified patients with epitelial hepatic tumors, malignant tumors in stage III and the histopatological variation of fetal hepatoblastoma. The most common treatment was the medical-surgical one according to the hospital´s protocols and depending on the histologic type(AU)

Anemia infantil en poblaciones que residen a diferentes altitudes geográficas de Arequipa, Perú: estudio descriptivo y retrospectivo / Childhood anemia in populations residing at different geographical altitudes of Arequipa, Peru: a descriptive and retrospective study

OBJETIVO: Identificar si existe una relación estadística entre el diagnóstico de anemia en niños y vivir a distintas altitudes geográficas de la Región Arequipa, Perú. MÉTODOS: Se realizó un estudio descriptivo y retrospectivo. La población estuvo constituida por 106 499 niños y niñas menores de cinco años que viven en la Región Arequipa a distintas altitudes geográficas, de los cuales presentaron anemia 32 454 que corresponde al 30,5%, atendidos por el Ministerio de Salud de Arequipa. Se tomaron datos sociodemográficos relacionados con edad, provincia, beneficiario del programa de Sistema Integral de Salud (SIS), de visitas domiciliarias, de Control de Crecimiento y Desarrollo (CRED); además de datos vinculados a la anemia como frecuencia, hemoglobina y severidad. RESULTADOS: Los resultados fueron categorizados según la altitud geográfica de procedencia de los niños y niñas de 0 a 59 meses de edad y los niveles de hemoglobina según la altitud geográfica. De la muestra estudiada, la frecuencia de anemia a diferentes altitudes geográficas de Arequipa en niños menores de cinco años para el período de 2017 a 2019 fue de 18,7% entre 0 y 999 metros sobre el nivel del mar; 29,6% entre 1000 y 1999 metros; 31,6% entre 2000 y 2999 metros; 42,9% entre 3000 y 3999 metros, y 54,4% entre 4000 y 4999 metros sobre el nivel del mar. Hubo mayor prevalencia de anemia cuando se utilizó el factor de corrección por altitud geográfica. CONCLUSIONES: Se observó una relación estadística significativa (p < 0,05) entre la hemoglobina corregida según parámetros de la Organización Mundial de la Salud y la altitud en la que viven los niños con anemia, es decir, a mayor altitud geográfica mayor anemia en niños. Los programas de suplementación deben tener correspondencia con las visitas domiciliarias y la evaluación del crecimiento y desarrollo de los niños.

OBJECTIVE: To identify the characteristics of anemia in children living at different geographical altitude in the Arequipa Region of Peru. METHODS: We did a descriptive and retrospective study. The population consisted of 106 499 children under five years of age living in the Arequipa Region at different geographical altitude and receiving care by the Ministry of Health of Arequipa. Of these, 32 454 had anemia (30.5%). Socio-demographic data related to age, province, and beneficiary of the Comprehensive Health System program, home visits, and growth and development were obtained, in addition to data regarding anemia such as frequency, hemoglobin, and severity. RESULTS: The results were categorized by the geographical altitude of origin of children under 0 to 59 months of age and hemoglobin levels according to geographical altitude. Of the sample studied, the frequency of anemia at different geographical altitudes of Arequipa in children under five for the 2017 to 2019 period was: 18.7% at 0 to 999 meters above sea level; 29.6% at 1000 to 1999 meters; 31.6% at 2000 to 2999 meters; 42.9% at 3000 to 3999 meters; and 54.4% at 4000 to 4999 meters. There was a higher prevalence of anemia when the geographic altitude correction factor was used. CONCLUSIONS: A significant statistical relationship (p < 0.05) was observed between the corrected hemoglobin according to the World Health Organization parameters and the altitude at which children with anemia live: the higher the geographical altitude, the greater the anemia in children. Supplementation programs should be included during home visits and at the time of evaluation of children's growth and development.

Percepción de los docentes sobre la evaluación de los logros de aprendizaje en el proceso formativo de la carrera de medicina. Una aproximación desde la percepción de los académicos de la FCM-UNA / Perception of teachers on the evaluation of achievements of learning in race training process of medicine. An approach from the perception of academics FCM-UNA

Considerando que la evaluación en la FCM-UNA se expresa a través un conjunto de reglamentos y normativas que la reducen a un puro formalismo, sin políticas claras que otorguen un marco referencial a la evaluación; adquiere gran relevancia conocer la percepción de los docentes sobre sus procesos evaluativos. Para abordar esta necesidad institucional y contribuir a su solución, hemos desarrollado una investigación cualitativa, con enfoque hermenéutico, de interés comprensivo/fenomenológico. La población de estudio son los docentes universitarios de la UNA. La muestra está dada por los académicos de la FCM-UNA, y el supuesto fundamental del problema es que la percepción sobre la evaluación es distinta según la experiencia y el nivel académico en que desarrollan su docencia. Los seis casos de estudio sirvieron a los investigadores para aproximarse a los actores relevantes porque ilustran y permiten comprender la percepción de los docentes en relación a la evaluación de logros de aprendizaje. A partir del problema de investigación, se determinaron las dimensiones: concepto, objeto, modo, modalidad, propósito y evidencia de la evaluación de logros de aprendizaje, se organizaron los ámbitos y se construyeron los descriptores. Las técnicas utilizadas fueron: la observación y la entrevista semiestructurada. Se realiza la observación directa cumpliendo un propósito exploratorio, para identificar in situ algunas prácticas docentes. Para lograr una comprensión más profunda del problema se realizaron entrevistas con el fin de levantar, caracterizar, comprender, significar, interpretar y analizar el discurso de los docentes. Se efectúa el análisis de contenido subordinadas a la intención y al problema de investigación, siguiendo las diferentes etapas: Validación de los datos transcriptos y codificados; categorización de la información de observaciones y entrevistas; producción de conglomerados de significantes: matrices; y la interpretación de los resultados. La interpretación de la información permitió develar que no se evidencia reflexión crítica sobre el proceso de evaluación por parte de los docentes. La percepción que tienen de este proceso, pone de manifiesto que las posibilidades formativas de la evaluación se dejan de lado, a favor de un significado más bien métrico y acreditativo. Se evidencia el énfasis que hacen algunos docentes sobre las bondades de la evaluación formativa, pero en su práctica ha sido superada por la evaluación sumativa, con un desconocimiento sobre los verdaderos propósitos de la evaluación, no realizan retroalimentación. Atendiendo al propósito de la investigación se hacen recomendaciones y propuestas.

Considering that learning evaluation in FCM-UNA (faculty of medical sciences, National University of Asuncion, Paraguay) is based in regulations that are usually reduced to mere formality, lacking policies for a clear reference, it is important to inquire into the perception of the faculty about the present evaluation processes. In order to deal with this situation and to provide a solution, a qualitative examination has been made, with an hermeneutic approach from a comprehensive and phenomenological perspective. The studied population comprises university-level teachers of FCM-UNA. The object is their perception of the evaluation of learning achievements, being the main postulation that teacher's perception of evaluation as a process varies according to their experience and the academic level where they practice. Six study cases were established in order to identify key players; building from the research questions, the proposed dimensions were: concept, object, mode, modality, purpose and evidence; the scope and descriptors where established accordingly. The chosen techniques were observation and semi-structured interviews. Direct observation was carried on with exploratory pour poses, in order to identify teaching practices. Semi-structured interviews were carried on to collect, characterize, understand, interpret and analyse teachers' discourse. Contents analysis was made based on the intention and the research questions, along the following phases: validation of transcribed and codified data, categorization of observation and interview data, production of conglomerates of signifiers (as matrices) and, finally, interpretation of results. Interpretation led to reveal that there is no evidence of critical considerations (as an analytic thought process) on the current evaluation processes. Teachers' perception of this processes show that the educational potential of evaluation is left aside, favouring instead a more metric (as an accreditation) approach. Even though there is evidence of emphasis made by a few teachers on the merits of the educational uses of evaluation processes, in practice, they favour the metric approach. Feedback is not regularly practiced among faculty members. Finally, drawn upon these findings, recommendations and suggestions were presented.

Calculo aproximado de la edad gestacional mediante estudio ecográfico / Approximate estimation of gestational age through echographic study

Estudiamos 830 gestantes de cronología bien definida entre 20 y 42 semanas mediante ecografía bidimensional de tiempo real, determinando variables antropométricas fetales con el fin de intentar obtener mediante las mismas una estimación aproximada de la edad gestacional. La información fue procesada utilizando máquina IBM-XT y lenguaje fox base. Los cálculos matemáticos se realizaron utilizando los sistemas SAIM-2 y MICROSTAT. Calculamos la edad gestacional correspondiente a cada semana estableciendo coeficientes de correlaciónde las diferentes mensuraciones fetales con la edad gestacional. Con estos resultados preliminares confeccionamos nuestras propias tablas de medidas

cAMP receptor protein from Trypanosoma cruzi: purification and cloning of a short sequence of the corresponding cDNA

cAMP is involved in the differentiation of Trypanosoma cruzi, the causative agent of Chagas' disease. cAMP levels are elevated in the infective, non-dividing metacyclic trypomastigote stage, with respect to the non-infective, proliferative, epimastigote stage. In both stages three is a cAMP receptor protein (CARPT), with unique properties that differentiate it from the regulatory subunits of the cAMP-dependent protein kinase (RI and RII). The CARPT from T. cruzi epimastigotes was purified using ion-exchange chromatography, affinity chromatography and gel filtration. After the final step of purification, two protein bands were obtained, p89 and p70, corresponding to the intact CARPT and its proteolytic product. These two CARPT polypeptides were utilized to prepare polyclonal antibodies in rabbits. Previous results from our laboratory showed that CARPT cross-reacts with polyclonal antibodies prepared against the regulatory subunit (RII) of the cAMP-dependent protein kinase (PKA). As expected from these results, the anti-CARPT antibody recognized purified RII protein in an ELISA assay. The anti-CARPT antibodies were used for immunoblot analyses of epimastigote lysates. The two bands corresponding to the CARPT (p89 and p70), as well as a p40 band, were recognized. Immunoscreening of a T. cruzi lambda ZAP cDNA library with these anti-CARPT polyclonal antibodies yielded one positive clone (pBSCARPT) which contained a 540 bp insert. Northern analyses using the pBSCARPT clone as a probe, showed a 5.2 kb mRNA band in epimastigotes, which were grown in culture from 2 to 10 days in LIT medium. Sequence analyses of the 540 bp insert have failed to show homology to other gene sequences in the database.(ABSTRACT TRUNCATED AT 250 WORDS)