Quinoa, potatoes, and llamas fueled emergent social complexity in the Lake Titicaca Basin of the Andes.

The Lake Titicaca basin was one of the major centers for cultural development in the ancient world. This lacustrine environment is unique in the high, dry Andean altiplano, and its aquatic and terrestrial resources are thought to have contributed to the florescence of complex societies in this region. Nevertheless, it remains unclear to what extent local aquatic resources, particularly fish, and the introduced crop, maize, which can be grown in regions along the lakeshores, contributed to facilitating sustained food production and population growth, which underpinned increasing social political complexity starting in the Formative Period (1400 BCE to 500 CE) and culminating with the Tiwanaku state (500 to 1100 CE). Here, we present direct dietary evidence from stable isotope analysis of human skeletal remains spanning over two millennia, together with faunal and floral reference materials, to reconstruct foodways and ecological interactions in southern Lake Titicaca over time. Bulk stable isotope analysis, coupled with compound-specific amino acid stable isotope analysis, allows better discrimination between resources consumed across aquatic and terrestrial environments. Together, this evidence demonstrates that human diets predominantly relied on C3 plants, particularly quinoa and tubers, along with terrestrial animals, notably domestic camelids. Surprisingly, fish were not a significant source of animal protein, but a slight increase in C4 plant consumption verifies the increasing importance of maize in the Middle Horizon. These results underscore the primary role of local terrestrial food resources in securing a nutritious diet that allowed for sustained population growth, even in the face of documented climate and political change across these periods.

Metabolomic approach of the antiprotozoal activity of medicinal Piper species used in Peruvian Amazon.

ETHNOPHARMACOLOGICAL RELEVANCE: In the Peruvian Amazon as in the tropical countries of South America, the use of medicinal Piper species (cordoncillos) is common practice, particularly against symptoms of infection by protozoal parasites. However, there is few documented information about the practical aspects of their use and few scientific validation. The starting point of this work was a set of interviews of people living in six rural communities from the Peruvian Amazon (Alto Amazonas Province) about their uses of plants from Piper genus: one community of Amerindian native people (Shawi community) and five communities of mestizos. Infections caused by parasitic protozoa take a huge toll on public health in the Amazonian communities, who partly fight it using traditional remedies. Validation of these traditional practices contributes to public health care efficiency and may help to identify new antiprotozoal compounds. AIMS OF STUDY: To record and validate the use of medicinal Piper species by rural people of Alto Amazonas Province (Peru) and annotate active compounds using a correlation study and a data mining approach. MATERIALS AND METHODS: Rural communities were interviewed about traditional medication against parasite infections with medicinal Piper species. Ethnopharmacological surveys were undertaken in five mestizo villages, namely: Nueva Arica, Shucushuyacu, Parinari, Lagunas and Esperanza, and one Shawi community (Balsapuerto village). All communities belong to the Alto Amazonas Province (Loreto region, Peru). Seventeen Piper species were collected according to their traditional use for the treatment of parasitic diseases, 35 extracts (leaves or leaves and stems) were tested in vitro on P. falciparum (3D7 chloroquine-sensitive strain and W2 chloroquine-resistant strain), Leishmania donovani LV9 strain and Trypanosoma brucei gambiense. Assessments were performed on HUVEC cells and RAW 264.7 macrophages. The annotation of active compounds was realized by metabolomic analysis and molecular networking approach. RESULTS: Nine extracts were active (IC50 ≤ 10 µg/mL) on 3D7 P. falciparum and only one on W2 P. falciparum, six on L. donovani (axenic and intramacrophagic amastigotes) and seven on Trypanosoma brucei gambiense. Only one extract was active on all three parasites (P. lineatum). After metabolomic analyses and annotation of compounds active on Leishmania, P. strigosum and P. pseudoarboreum were considered as potential sources of leishmanicidal compounds. CONCLUSIONS: This ethnopharmacological study and the associated in vitro bioassays corroborated the relevance of use of Piper species in the Amazonian traditional medicine, especially in Peru. A series of Piper species with few previously available phytochemical data have good antiprotozoal activity and could be a starting point for subsequent promising work. Metabolomic approach appears to be a smart, quick but still limited methodology to identify compounds with high probability of biological activity.

Revelations of ancient head shape: Cranial modification in the Cuzco region of Peru, Early Horizon to Inca Imperial Period.

OBJECTIVES: Cranial vault modification (CVM), the intentional reshaping of the head, indicated group affiliation in prehistoric Andean South America. This study aims to analyze CVM data from the Cuzco region of Peru to illuminate patterns of early migration and settlement along with the later impact of the Inca Empire (AD 1438-1532) on the ethnic landscape. MATERIALS AND METHODS: 419 individuals from 10 archaeological sites spanning over 2300 years were assessed for CVM using morphological analysis. RESULTS: CVM patterns show distinct temporal attributes: the tabular type of modification appeared first and dominated the early sample (900 BC-AD 600), followed by an influx of unmodified crania during the Middle Horizon (AD 600-1000). The annular type appeared later during the Late Intermediate Period (AD 1000-1438). In the subsequent period of Inca imperialism, modification rates were higher at sites in the Cuzco countryside than in Cuzco city sites. DISCUSSION: The study results, combined with archaeological and ethnohistoric data, reveal the sociopolitical transformations that occurred prior to and during the rise of the Inca Empire. The influx of unmodified crania during the Middle Horizon resulted at least partly from Wari occupation, while the appearance of the annular type during the LIP points to migration into the area, possibly from the Lake Titicaca region. In the Inca Imperial Period, Inca individuals at Cuzco city sites refrained from modification as a sign of their ethnic identity, while modification patterns in the Cuzco countryside likely reflect state-coerced resettlement of different ethnic groups.

Endemic violence in a pre-Hispanic Andean community: A bioarchaeological study of cranial trauma from the Majes Valley, Peru.

OBJECTIVES: This study examines violence-related cranial trauma frequencies and wound characteristics in the pre-Hispanic cemetery of Uraca in the lower Majes Valley, Arequipa, Peru, dating to the pre- and early-Wari periods (200-750 CE). Cranial wounds are compared between status and sex-based subgroups to understand how violence shaped, and was shaped by, these aspects of identity, and to reconstruct the social contexts of violence carried out by and against Uracans. MATERIALS AND METHODS: Presence, location, and characteristics (lethality, penetration, and post-traumatic sequelae) of antemortem and perimortem cranial fractures are documented for 145 crania and compared between subgroups. Cranial wounds are mapped in ArcGIS and the locational distribution of injuries is compared between male and female crania. RESULTS: Middle adult males were disproportionately interred at Uraca, particularly in the elite Sector I. The Uraca mortuary population presents the highest rate of cranial trauma reported for pre-Hispanic Peru: 67% of adults present trauma, and among those, 61.1% present more than one cranial injury. Males exhibit significantly more cranial trauma than females and present a higher mean number of injuries per person. Elite males show the highest mean number of injuries per person, more antemortem injuries, and are the only ones with perimortem cranial trauma, bladed injuries, penetrating injuries, and post-traumatic sequelae. Both sexes were most frequently injured on the anterior of the cranium, while the proportion of posterior injuries was higher for females. DISCUSSION: The rate, intensity, and locational patterns of cranial trauma suggests the community was engaged in raids and/or war with enemy groups, some of which may have increased physical violence between community members. Engaging in violence was likely a prerequisite for burial in the elite sector and was bound up with the generation and maintenance of social status differences linked to male social life.

Identity in a medicine cabinet: Discursive positions of Andean migrants towards their use of herbal remedies in the United Kingdom.

This study explores different rationales for using herbal remedies among people from Andean descent in the United Kingdom, using positioning theory as a conceptual framework. By analysing processes of positioning in narratives about healthcare choices conducted with 40 Bolivian and Peruvian migrants in London (between 2005 and 2009), we examine in which ways talking about personal preferences for herbal medicine can be constitutive of one's health identity. The results reveal three distinct discursive repertoires that frame the use of herbal remedies either as a tradition, a health-conscious consumer choice, or as a coping strategy, each allowing specific health identity outcomes. An enhanced understanding of how people make sense of their use of traditional, plant-based medicines enables healthcare professionals to better assist patients in making meaningful decisions about their health. Through illustrating how treatment choices are discursively linked with identity, the present results debunk the tendency to perceive patients with a migration background as one homogenous group and thus urge for a patient centred approach.

Relationship between the cranial base and the mandible in artificially deformed skulls.

OBJECTIVES: There is controversy regarding the relationship between mandibular position and alterations of the cranial base that provoke a more anterior location of the glenoid fossa. Artificially deformed skulls display marked alterations of the cranial base. This study evaluates mandibular changes as function of the morphology of the cranial base in these skulls. MATERIAL AND METHODS: A geometric morphometric study was performed on lateral cephalometric X-rays of three groups of skulls: 32 with anteroposterior deformity, 17 with circumferential deformity and 39 with no apparent deformity. RESULTS: In artificially deformed skulls, the cranial base was deformed causing the mandibular condyle to be in a more anterior position. There was a complete remodelling of the mandible involving narrowing and elongation of the mandibular ramus, rotation of the corpus of the mandible and increased vertical height of the symphysis. Forward displacement did not occur. Integration between mandible and cranial base is not altered by deformation of the skull. CONCLUSIONS: Deformity of the cranial vault exerts an influence on the mandible, supporting the theory of modular units in complete integration. This also supports the theory that mandibular prognathism is a multifactorial result and not a direct effect of displacement of the cranial base.

Experience of menopause in aboriginal women: a systematic review.

Every woman experiences the menopause transition period in a very individual way. Menopause symptoms and management are greatly influenced by socioeconomic status in addition to genetic background and medical history. Because of their very unique cultural heritage and often holistic view of health and well-being, menopause symptoms and management might differ greatly in aboriginals compared to non-aboriginals. Our aim was to investigate the extent and scope of the current literature in describing the menopause experience of aboriginal women. Our systematic literature review included nine health-related databases using the keywords 'menopause' and 'climacteric symptoms' in combination with various keywords describing aboriginal populations. Data were collected from selected articles and descriptive analysis was applied. Twenty-eight relevant articles were included in our analysis. These articles represent data from 12 countries and aboriginal groups from at least eight distinctive geographical regions. Knowledge of menopause and symptom experience vary greatly among study groups. The average age of menopause onset appears earlier in most aboriginal groups, often attributed to malnutrition and a harsher lifestyle. This literature review highlights a need for further research of the menopause transition period among aboriginal women to fully explore understanding and treatment of menopause symptoms and ultimately advance an important dialogue about women's health care.

Investigación sobre plantas medicinales realizada por estudiantes de medicina en Perú / Investigação sobre plantas medicinais realizada por estudantes de medicina no Peru / Medicinal plant research conducted by medical students in Peru

Con el objetivo de determinar la contribución a la investigación sobre plantas medicinales por estudiantes de medicina en Perú se realizó un estudio bibliométrico, utilizando como fuente de análisis los libros de resúmenes de los Congresos Científicos Nacionales de estudiantes de Medicina realizados en Perú durante los años 2005 al 2011. Se seleccionaron las investigaciones en ciencias básicas que tuvieron como objeto las propiedades medicinales de las plantas. El 17,4% (95/546) de las investigaciones fueren sobre plantas medicinales, el modelo de experimentación en e173,7% era in vivo; en su mayoría el tipo de extracto usado fue el acuoso (29,5%), el alcohólico y/o hidroalcohólico (20,0%) y el aceite esencial (12,6%);se reportaron 21 posibles utilidades medicinales; e1 15,8% de las investigaciones fue pubflcada en alguna revista científica. Concluimos que existe interés hacia el estudio de plantas medicinales desde el pregrado médico, siendo necesario el apoyo de 103 centros educativos para su desarrollo y la comunicación de resultados a través de la publicación (AU)

Como objectivo de determinar a contribuiçao para a investigaçao de plantas medicinais realizada por estudantes de medicina no Peru foi feito um estudo bibliometrico, utilizando como fonte de anélise os livros de resumes dos Congressos Nacionais Cientificos de estudantes de medicina realizados no Peru durante os anos de 2005 a 2011. Foram selecionadas as investigaçoes em ciencias básicas que tiveram como objectivo as propriedades medicinais das plantas. Verificou-se que 17,4% (95/546) das investigaçoes foram sobre plantas medicinais, o modelo experimental em 73,7% foi in vivo; na sua maioria o tipo de extracto utilizado foi o aquoso (29,5%), o alcoólico e/ou hidroalcoólico (20,0%) e o oleo essencial (12,6%); reportaram-se 21 possiveis utilizaçoes medicinais; 15,8% das investigagoes foram publicadas em alguma revista científica. Concluiu-se que ha interesse no estudo de plantas medicinais desde a formaçao medica, sendo necessário o apoio dos centros educativos para o seu desenvolvimento e a comunicaçao de resultados atraves de publicaçoes (AU)

In order to determine the contribution in medicinal plant research conducted by medical students in Peru a bibliometric study was conducted, using as source of analysis the abstract books of the National Scientific Congress of medical students conducted in Peru during the years 2005 to 2011. Research in basic sciences which were aimed at the medicinal properties of plants were selected. As results, 17.4% (95/546) of the investigations were about medicinal plants, experimental model in vivo was 73.7%; mostly type used was the aqueous extract (29.5%), the alcohol-hidroalcohol (20.0%) and essential oil (12.6%); 21 reported possible medicinal utilities; 15.8% of all the investigations was published in a scientific journal. We conclude that there is interest in research on medicinal plants. We conclude that there is interest in the study of medicinal plants in undergraduate medical students. Support of schools for their development and communication of results through the publication is required (AU)

First series of patients with XDR and pre-XDR TB treated with regimens that included meropenen-clavulanate in Argentina.

XDR (extensively drug-resistant) and pre-XDR tuberculosis (TB) seriously compromise prognosis and treatment possibilities, and inevitably require the use of group V drugs (World Health Organization). The progress of all patients with XDR and pre-XDR TB seen in a specialized unit during 2012 and 2013 and treated with regimens that included at least 6 months of meropenem-clavulanate (MPC), capreomycin, moxifloxacin, linezolid, clofazimine, high-dose isoniazid, PAS, and bedaquiline in 1 case, were retrospectively analysed. Ten patients were treated, 9 with an extensive pattern of resistance to at least 6 drugs, and 1 because of adverse reactions and drug interactions leading to a similar situation. Eight of the 10 patients treated achieved bacteriological sputum conversion (2 consecutive negative monthly cultures) over a period of 2-7 months, while 2 died. No adverse reactions attributable to prolonged administration of MPC were observed.

Patterns of persistence amidst medical pluralism: pathways toward cure in the southern Peruvian Andes.

When mental illness and related conditions strike among the Quechua-speaking peasant population of southern Peru, they open wide the question of who is best placed to offer the healing that families seek for their afflicted relative. Biomedical doctors and the traditional healers known as yachaqs are the two most commonly consulted sources of help. Yet most families show different patterns of persistence with each; they frequently give up on biomedical assistance after the initial intervention but continue to consult a succession of yachaqs over considerable periods of time, even if the former has had some limited success and the latter virtually none. I draw on ethnographic fieldwork to show that explanations based on inaccessibility, cultural incongruence between patient and clinician, or stigma are ultimately inadequate; rather, it is necessary to delve into fundamental differences in how the two fields of healing are conceptualized by those negotiating them.

Marcos Zapata's "Last Supper": a feast of European religion and Andean culture.

In Marcos Zapata's 1753 painting of the Last Supper in Cuzco, Peru, Christian symbolism is filtered through Andean cultural tradition. Zapata was a late member of the Cuzco School of Painting, a group comprised of few European immigrants and handfuls of mestizo and Indian artists. The painters in Cuzco learned mostly from prints of European paintings, and their style tends to blend local culture into the traditional painting of their conquistadors. Imagery was the most successful tool used by the Spaniards in their quest to Christianize the Andean population. By teaching locals to paint Christian subjects, they were able to infuse Christianity into Andean traditions. Zapata's rendering of the Last Supper utilizes this cultural blending while staying true to the Christian symbolism within the subject. Instead of the traditional lamb, Zapata's Last Supper features a platter of cuy, or guinea pig, an Andean delicacy stocked with protein as well as cultural significance. Cuy was traditionally a sacrificial animal at Inca agricultural festivals and in this way it offers poignant parallel to the lamb, as a traditional Christian sacrificial animal.

Can coca leaves contribute to improving the nutritional status of the Andean population?

BACKGROUND: Coca leaves (Erythroxylum coca) have been promoted as a food that could address the dietary deficiencies of the Andean population, but this is based on nutrient analyses of a small sample of leaves. OBJECTIVE: We assessed the nutritional potential of eight samples of coca leaves grown in different regions of Peru. METHODS: We used AOAC techniques to measure nutrients, nutrient inhibitors (phytate, polyphenols, oxalic acid, and fiber), and alkaloid concentrations, all expressed per 100 g dry weight (DW) of the ground leaves. Minerals were measured by inductively coupled lasma- mass spectrometry in n twondependent laboratories. RESULTS: The leaves contained protein, , 20.28 g/1 0DW with lysine as the limiting amino acid; n-cbetarotene, 3.51 mg/100gDW ; vitamin E, 16.72 mg/100gDW ; trace amounts of vitamin D; calcium, 990.18 and 1033.17 mg/100 gDW at two different laboratories; iron, 29.16 and 29.16 mg/100 gDW; zinc, 2.71 and 2.63 mg/100 gDW; and magnesium, 225.19 and 196.69 mg/l001gDW Cocaine was the principal alkaloid, with a concentration of 0.56 g/100 gDW; other alkaloids were also identified. The results were compared with those for other edible leaves. The nutrient contributions of coca powder (5 g) and bread made with coca were compared with those of normal portions of alternative foods. CONCLUSIONS: Two spoonfuls of coca leaf flour would satisfy less than 10% of dietary intakes for schoolchildren and adults for critical commonly deficient nutrients in the diet. Coca leaves do not provide nutritional benefits when eaten in the recommended quantities, and the presence of absorbable cocaine and other alkaloids may be potentially harmful; hence coca leaves cannot be recommended as a food.

Ta'ta', Huayani: perception of leishmaniasis and evaluation of medicinal plants used by the Chayahuita in Peru. Part II.

AIM OF THE STUDY: A knowledge attitude and practice study centred on leishmaniasis and its treatment was performed among the Chayahuita, an Amazonian Peruvian ethnic group living in an endemic area. This study documents traditional Chayahuita plant's use and disease concepts. Also, activity of some medicinal plants used by the Chayahuita is highlighted and discussed. MATERIALS AND METHODS: Ninety-three Chayahuita people were interviewed, following a semi-structured questionnaire focussed on disease knowledge and perception, personal attitude and healing practices. Simultaneously, a collection of plants was performed in different ecotopes, in order to make an extensive inventory of the pharmacopoeia. RESULTS: For the Chayahuita, cutaneous (CL) and muco-cutaneous leishmaniasis (MCL) are considered as diseases of their own, with specific names, aetiologies, mode of transmission. Regarding CL, Chayahuita people consider that the humid characteristic of the skin ulcer is a discriminative fact orienting the diagnostic forTa'ta' (leishmaniasis). Forty-six different species were designated useful against LC and /or MCL (29 species by means of the questionnaire and 27 species when collecting in different ecotopes). Thirty-seven extracts corresponding to 31 species used medicinally were screened in vitro against Leishmania amazonensis axenic amastigotes, assessing their viability by the reduction of tetrazolium salt (MTT). Six species displayed a good activity (10 microg/ml

Stable isotope and DNA evidence for ritual sequences in Inca child sacrifice.

Four recently discovered frozen child mummies from two of the highest peaks in the south central Andes now yield tantalizing evidence of the preparatory stages leading to Inca ritual killing as represented by the unique capacocha rite. Our interdisciplinary study examined hair from the mummies to obtain detailed genetic and diachronic isotopic information. This approach has allowed us to reconstruct aspects of individual identity and diet, make inferences concerning social background, and gain insight on the hitherto unknown processes by which victims were selected, elevated in social status, prepared for a high-altitude pilgrimage, and killed. Such direct information amplifies, yet also partly contrasts with, Spanish historical accounts.

Peruvian contributions to the study on human reproduction at high altitude: from the chronicles of the Spanish conquest to the present.

Humans have lived in the Peruvian Andes for about 12,000 years providing adequate time for adaptation to high altitude to have occurred. The arrival of the Spanish conquistadors in the 16th century potentially altered this process through genetic admixture. Early records revealed a potential for reduced fertility and a high perinatal and neonatal mortality amongst the early Spanish inhabitants who settled at high altitude when compared to the native Inca population. It appears that fertility is reduced during acute exposure at high altitude but is normal in populations born and living at high altitude. On the other hand, perinatal and neonatal mortality is presently still high at elevated altitudes, even after taking into account socio-economic status. The rates of perinatal and neonatal mortality are, however, lower in populations that have resided at high altitude for longer; populations inhabiting the southern Andes have a longer antiquity at high altitude and lower rates of fetal and neonatal deaths than those in the central Andes with a shorter residence at high altitude. Clearly, antiquity and genetics are important components in determining survival and quality of life at high altitude.

Interview with Guillermo Arrévalo, a Shipibo urban shaman, by Roger Rumrrill. Interview by Roger Rumrrill.

Roger Rumrrill, a journalist headquartered in Lima, Peru who is a noted expert on the Peruvian Amazon, interviewed Guillermo Arrévalo, a Shipibo urban shaman in Pucallpa, who utilizes ayahuasca in curing rituals. Sr. Arrévalo comments on the phenomenon known as drug tourism, where urban men and women provide tours for foreigners, for a price, to experience drug-induced mystical experiences in urban settings like Iquitos and Pucallpa, Peru, as well as in Brazil, Bolivia and Ecuador. Arrévalo distinguishes between folkloric shamanism and touristic practices which are currently in vogue and, in his opinion, are the result of people trying to resolve personal problems. Arrévalo sees a spiritual and psychological crisis in Europe and North American society. The Shipibo shaman laments the misuse of toxic plants as additives to the ayahuasca potion and the damage that these plants cause to the unsuspecting tourist who doesn't really get his money's worth from shamans without experience, people who are liars and cheats and who don't have the capacity, the preparation or the boldness to do the work.

Dose-response effects of Lepidium meyenii (Maca) aqueous extract on testicular function and weight of different organs in adult rats.

Lepidium meyenii (Brassicaceae) known as Maca grows exclusively between 4000 and 4500 m over the sea level in the Peruvian central Andes. The dried hypocotyls of Maca are traditionally used as food and for its supposed fertility-enhancing properties. A dose-response study was performed to determine the effect of 7 days oral administration of an aqueous lyophilized extract of Maca at 0.01-5 g/kg (corresponding to 0.022-11 g dry hypocotyls of Maca/kg) on body and different organ weights, stages of the seminiferous tubules, epididymal sperm count and motility, and serum testosterone and estradiol levels in rats. In doses up to 5 g extract/kg, no toxicity was observed. Almost all organ weights were similar in controls and in the Maca extract-treated groups. Seminal vesicles weight was significantly reduced at 0.01 and 0.10 g extract/kg. Maca increased in length of stages VII-VIII of the seminiferous tubules in a dose-response fashion, with highest response at 1.0 g/kg, while caput/corpus epididymal sperm count increased at the 1.0 g dose. Cauda epididymal sperm count, sperm motility, and serum estradiol level were not affected at any of the doses studied. Serum testosterone was lower at 0.10 g extract/kg. Low-seminal vesicle weights correlated with low-serum testosterone levels (R2=0.33; P<0.0001) and low-testosterone/estradiol ratio (R2=0.35; P<0.0001). Increase in epididymal sperm count was related to lengths of stages VII-VIII. Highest effect on stages VII-VIII of the seminiferous tubules was observed at 1.0 g Maca aqueous extract/kg. The present study demonstrated that Maca extract in doses up to 5 g/kg (equivalent to the intake of 770 g hypocotyls in a man of 70 kg) was safe and that higher effect on reproductive parameters was elicited with a dose of 1 g extract/kg corresponding to 2.2 g dry Maca hypocotyls/kg.

Epilepsy and its treatment in the ancient cultures of America.

Epilepsy was a well-recognized disease in pre-Columbian America, as appears from the reports of the Spanish chroniclers of the sixteenth century. Both the Aztecs and the Incas strongly associated epilepsy with magic and religion, which is evident from their ideas about the pathogenesis and treatment of the disease. Apart from treatment of epilepsy by magic means, the Incas and especially the Aztecs used in addition a large number of botanic medicines; the use of these medicines probably had an empiric nature.