Temporal variation of the PM2.5/PM10 ratio and its association with meteorological factors in a South American megacity: Metropolitan Area of Lima-Callao, Peru.

The Metropolitan Area of Lima-Callao (MALC) is a South American megacity that has suffered a serious deterioration in air quality due to high levels of particulate matter (PM2.5 and PM10). Studies on the behavior of the PM2.5/PM10 ratio and its temporal variability in relation to meteorological parameters are still very limited. The objective of this study was to analyze the temporal trends of the PM2.5/PM10 ratio, its temporal variability, and its association with meteorological variables over a period of 5 years (2015-2019). For this, the Theil-Sen estimator, bivariate polar plots, and correlation analysis were used. The regions of highest mean concentrations of PM2.5 and PM10 were identified at eastern Lima (ATE station-41.2 µg/m3) and southern Lima (VMT station-126.7 µg/m3), respectively. The lowest concentrations were recorded in downtown Lima (CDM station-16.8 µg/m3 and 34.0 µg/m3, respectively). The highest average PM2.5/PM10 ratio was found at the CDM station (0.55) and the lowest at the VMT station (0.27), indicating a predominance of emissions from the vehicular fleet within central Lima and a greater emission of coarse particles by resuspension in southern Lima. The temporal progression of the ratio of PM2.5/PM10 showed positive and highly significant trends in northern and central Lima with values of 0.03 and 0.1 units of PM2.5/PM10 per year, respectively. In the southern region of Lima, the trend was also significant, showcasing a value of 0.02 units of PM2.5/PM10 per year. At the hourly and monthly level, the PM2.5/PM10 ratio presented a negative and significant correlation with wind speed and air temperature, and a positive and significant correlation with relative humidity. These findings offer insights into identifying the sources of PM pollution and are useful for implementing regulations to reduce air emissions considering both anthropogenic sources and meteorological dispersion patterns.

Mortalidad por suicidio y sus características de comportamiento en la ciudad de Lima durante los años 2017-2022 / Suicide mortality and its behavioral characteristics in the city of Lima during the years 2017-2022

RESUMEN Describir la mortalidad por suicidio y sus principales características en Lima, Perú, durante el período 2017-2022. Materiales y métodos: Estudio descriptivo observacional que reporta características sociodemográficas y métodos de suicidio durante el período 2017-2022. Se estimaron también las tasas estandarizadas de mortalidad por año y por edad en Lima y sus distritos para cada año del período 2017-2021. Se registró un total de 559 muertes por suicidio durante el período 2017-2022 en Lima Metropolitana, con una razón hombre/mujer de 2,6 y edad mediana de 37. El 68,78% correspondía a personas solteras, el 44,54 % tenía educación secundaria, el 60,82 % de los suicidios ocurrieron en el hogar, y el ahorcamiento fue el método más frecuente (70,98 %). La mortalidad por suicidio alcanzó una proporción de 5,52 por cada 100 000 habitantes para Lima Metropolitana durante el período 2017-2021. Este indicador aumentó hasta un máximo en 2019 y ha disminuido desde entonces. Los distritos con mayor mortalidad fueron Pucusana, Barranco y San Bartolo. Conclusiones: La mortalidad por suicidio en Lima Metropolitana ha mostrado una tendencia decreciente desde el año 2019. Por otro lado, es imperativo mantener una vigilancia exhaustiva a largo plazo e implementar estrategias de prevención y atención en salud mental, particularmente en los distritos y grupos demográficos más afectados.

ABSTRACT To describe suicide mortality and its main characteristics in Lima, Peru during the period 2017-2022. Methods: A descriptive observational study that reports the main sociodemographic characteristics and methods of suicide, during the period 2017-2022 in Metropolitan Lima and its districts. Age-standardized mortality rates were also estimated annually and throughout the period 2017-2021. There were 559 deaths by suicide during 2017-2022 in Lima, with a male/female ratio of 2.6, and a median age of 37; 68,78% were single, 44,54% had secondary education, 60,82% occurred at home, and hanging was the main method (70,98%). Suicide-related mortality was 5.52 per 100 000 habitants for Lima during the period 2017-2021. It increased to a peak in 2019 and then decreased. The districts with the highest mortality were Pucusana, Barranco and San Bartolo. Suicide mortality has shown a decreasing trend since 2019 in Lima; it is imperative to maintain comprehensive long-term surveillance, and to implement prevention and mental health care strategies, particularly in the most affected districts and demographic groups.

Bypass de instrumento endodôntico fraturado: relato de caso / Bypass of a fractured endodontic instrument: case report

Introdução: Mesmo com toda evolução tecnológica desses instrumentos, com o desenvolvimento das limas de liga de níquel-titanio (NiTi) e sistemas mecanizados, as fraturas podem ocorrer durante o preparo químico/mecânico. Existem três abordagens mais regulamente aplicadas para solucionar essa intercorrencia: tentativa de remoção do instrumento com ultrassom, tentativa de ultrapassálo (bypass) ou a obturação do segmento. Objetivo: Relatar um caso da técnica de bypass em instrumento fraturado no canal radicular. Descrição do caso: Paciente, sexo feminino, 47 anos, brasileira, sem condições sistêmicas associadas, foi encaminhada à clínica do Curso de Odontologia da UNIFENAS, Divinópolis, Minas Gerais, Brasil, para resolução de fratura de instrumento no canal mésio- vestibular do primeiro molar superior direito (16). Optou-se pelo tratamento pela técnica de bypass, que envolveu as seguintes etapas: anestesia, abertura, utilização de lima C-Pilot #08 para ultrapassar o instrumento fraturado, odontometria, escalonamento regressivo a partir da lima k#20, desinfecção com hipoclorito de sódio 5%, medicação com hidróxido de cálcio por 21 dias, agitação da substância irrigadora e obturação dos canais radiculares. Conclusão: O bypass ao instrumento é uma técnica conservadora, eficaz e uma solução adequada em casos de fratura de limas endodônticas dentro dos canais radiculares. Essa técnica visa preservar o máximo possível da estrutura dental original, evitando procedimentos mais invasivos.(AU)

Introduction: Even with all technological evolution of these instruments, with the development of nickel-titanium alloy (NiTi) files and mechanized systems, fractures can occur during chemical/mechanical preparation. There are three most commonly applie to resolve this complication: attempting to remove the instrument with ultrasound, attempting to bypass it, or obturating the segment. Objective: To report a case of bypass technique in fractured instrument in the root canal. Case description: A 47-year-old female patient from Brazil, with no associated systemic conditions, was referred to the clinic of the Dentistry Course at UNIFENAS, Divinópolis, Minas Gerais, Brazil, for resolution of an instrument fracture in the mesio-vestibular canal of the right upper first molar (16). Treatment was performed using the bypass technique, which involved the following steps: anesthesia, opening, use of a C-Pilot #08 file to bypass the fractured instrument, odontometry, regressive scaling from the k#20 file, disinfection with 5% sodium hypochlorite, medication with calcium hydroxide for 21 days, agitation of the irrigating substance and root canal filling. Conclusion: Instrument bypass is a conservative, effective technique and an adequate solution in cases of endodontic file fracture within root canals. This technique aims to preserve as much of the original tooth structure as possible, avoiding more invasive procedures.(AU)

Differential response to the South American rice water weevil (Coleoptera: Curculionidae) damage of rice cultivars with contrasting levels of resistance: implications for field management.

BACKGROUND: Oryzophagus oryzae (Costa Lima) (Coleoptera: Curculionidae) is a major pest of flooded rice paddies throughout South America, and species with very similar life histories are present in many rice-producing regions of the world (collectively rice water weevils, RWWs). The damage caused by RWW larvae on rice cultivars with contrasting levels of resistance ('BRS Pampa CL'= 'Pamp': susceptible, 'BRS Atalanta' = 'Atal': resistant-antibiosis) was evaluated in two consecutive years in the field under seven infestation levels: 0, 2, 4, 6, 8, 10 and 20 adult couples per cage with plants. RESULTS: Higher densities of adults increased the number of leaf-feeding scars and larvae on roots, respectively, at the rate ≤2.14 and 2.75 in Pamp and 2.23 and 2.48 in Atal, with the total number of larvae generated being lower in Atal. Grain yield was negatively impacted with increasing larval density on the roots, mainly by decreasing root volume and the number of grains per panicle. Root injury intensity and yield loss showed a nonlinear relationship. It was found that significant yield losses occurred with 8.37 larvae per plant in Pamp and 9.80 larvae per plant in Atal CONCLUSION: The results provided the first evidence of a tolerance limit for RWW larval damage that, even though similar between cultivars of contrasting resistance, corresponds to twice the current conventional level for larval control in Brazil. We also discuss here the potential of applying tolerance limits to manage the RWW adult population in rice fields. © 2022 Society of Chemical Industry.

Embracing the cordillera: Luis Carranza Ayarza and the development of environmental imaginaries in late-nineteenth-century Peru / Abrazando la cordillera: Luis Carranza Ayarza y el desarrollo de los imaginarios ambientales en el Perú de fines del siglo XIX

Abstract This article examines the relationship between local scientific ideas about the natural world and the economic potential to transform the modern nation-state in Peru during the late nineteenth century. Writings by the Peruvian scientist Luis Carranza indicate how support for a distinctive environmental imaginary of the country's geography made it possible to conceptualize nature as an essential component of Peruvian identity. As a result, local scientists had to "imaginatively" reshape the nature of the Andes for modernization purposes. The social and political ramifications of these ideas in Carranza's work were key to the foundation of scientific institutions such as the Geographical Society of Lima.

Resumen Este artículo examina la relación entre las ideas científicas locales sobre el mundo natural y el potencial económico para transformar el Estado-nación moderno en el Perú a fines del siglo XIX. Los escritos del científico peruano Luis Carranza señalan cómo el apoyo a un imaginario ambiental distintivo de la geografía del país permitió conceptualizar la naturaleza como componente esencial de la identidad peruana. Como resultado, los científicos locales tuvieron que remodelar "imaginativamente" la naturaleza de los Andes con fines de modernización. Las ramificaciones sociales y políticas de estas ideas en la obra de Carranza fueron clave para la fundación de instituciones científicas como la Sociedad Geográfica de Lima.

Presencia de ansiedad y depresión en pacientes de consulta externa de gastroenterología en Lima Metropolitana

Los objetivos fueron identificar la presencia de ansiedad y depresión en pacientes que acuden a consultorio externo de gastroenterología en la ciudad de Lima y describir los antecedentes gastroenterológicos y síntomas más relacionados a estos trastornos. La muestra estuvo conformada por 200 pacientes adultos pertenecientes a 32 distritos de Lima Metropolitana, atendidos por la especialidad de Gastroenterología en la modalidad de consultorio externo durante marzo a octubre del 2021, a quienes se les aplicó la Escala de Ansiedad y Depresión Hospitalaria (HADS) adaptada por Vilela. El estudio fue descriptivo-correlacional y la muestra prospectiva. Alrededor de 1 de cada 2 pacientes (49%, n=98) presentó ansiedad, 1 de cada 5 (19%, n=38) depresión y 16,5% (n=33) concomitantemente ambos trastornos. Los antecedentes gastroenterológicos de Dispepsia (v=0,216) y Síndrome de Intestino Irritable (v=0,188) mostraron asociación estadística para ambas variables. Diarrea (v=0,214) y dolor torácico (v=0,215) fueron síntomas asociados a ansiedad, así como dolor torácico, con depresión. Los trastornos de ansiedad y depresión tienen alta prevalencia en la población que acude a consulta externa, sugerimos explorar dichas variables y ofrecer un abordaje multidisciplinario a los pacientes atendidos por esta modalidad.

The objectives were to identify anxiety and depression in patients attending a gastroenterology outpatient clinic in the city of Lima, and to describe the gastroenterological history and symptoms most related to these disorders. 200 adult patients belonging to 32 districts of Metropolitan Lima attended from March to October 2021 were enrolled; the Hospital Anxiety and Depression Scale (HADS) adapted by Vilela was applied. The study was descriptive-correlational and prospective sample. 49% (n=98) reported anxiety, 19% (n=38) depression and 16.5% (n=33) both disorders concomitantly. Dyspepsia (v=0.216) and Irritable Bowel Syndrome (v=0.188) showed a statistical association for both variables. Diarrhea (v=0.214) and chest pain (v=0.215) were symptoms associated with anxiety, as well as chest pain with depression. Anxiety and depression are highly prevalent among patients that come to outpatient office visits, we suggest exploring these variables and offering a multidisciplinary approach to patients treated by this modality.

Intra and Extra-granular Disintegrant Properties of Modified Underutilised Red Lima Bean Starch in Paracetamol Tablet Formulation

Abstract Red lima bean (Phaseolus lunatus Linn) Family Fabaceae, has been modified by succinylation and annealing, and used as intra- and extra-granular disintegrants at concentrations of 5 and 10 %w/w in paracetamol tablet formulation in comparison with corn starch BP. The starches were characterised using FT-IR spectroscopy, SEM, proximate analysis, physicochemical and functional properties. FT-IR spectrometry revealed characteristic peaks at 1575.53 and 1713.99 cm-1 for the succinylated starch while the annealed showed no significant difference from the native starch. Modifications did not alter the ovoid shape of the native starch but reduced the particle size. Succinylation improved water absorption capacity, solubility and swelling of lima bean starch but annealing reduced the parameters. Tablets with disintegrants of lima bean starches generally had higher crushing strengths and lower friability than tablets with corn starch. Modifications reduced the disintegration time of the tablets when the starches were incorporated intra-granularly, which suggested particle-particle bond interruption and destruction of hydrogen bonds as mechanism of disintegration. Tablets containing 10 %w/w succinylated red lima bean starch incorporated intra-granularly had the highest disintegration efficiency ratio, DER, indicating a great balance between mechanical and disintegration properties. Modified red lima bean starches incorporated intra-granularly into paracetamol tablets led to faster disintegration and could efficiently substitute corn starch as disintegrant.

Determining relevant traits for selecting landrace accessions of Phaseolus lunatus L. for insect resistance.

Plant-insect interactions are a determining factor for sustainable crop production. Although plants can resist or tolerate herbivorous insects to varying degrees, even with the use of pesticides, insects can reduce plant net productivity by as much as 20%, so sustainable strategies for pest control with less dependence on chemicals are needed. Selecting plants with optimal resistance and photosynthetic traits can help minimize damage and maintain productivity. Here, 27 landrace accessions of lima beans, Phaseolus lunatus L., from the Yucatan Peninsula were evaluated in the field for morphological resistance traits, photosynthetic characteristics, insect damage and seed yield. Variation was found in physical leaf traits (number, area, and dry mass of leaves; trichome density, specific leaf thickness and hardness) and in physiological traits (photosynthetic rate, stomatal conductance, intercellular carbon, water-use efficiency, and transpiration). Five accessions (JMC1325, JMC1288, JMC1339, JMC1208 and JMC1264) had the lowest index for cumulative damage with the highest seed yield, although RDA analysis uncovered two accessions (JMC1339, JMC1288) with strong positive association of seed yield and the cumulative damage index with leaf production, specific leaf area (SLA) and total leaf area. Leaf traits, including SLA and total leaf area are important drivers for optimizing seed yield. This study identified 12 important morphological and physiological leaf traits for selecting landrace accessions of P. lunatus for high yields (regardless of damage level) to achieve sustainable, environmentally safe crop production.

Una nueva subespecie de Passiflora lobbii (Passifloraceae) para la vertiente occidental de los Andes peruanos

Se describe Passiflora lobbii subsp. limensis Chávez-Corcuera que se distingue del resto de subespecies de Passiflora lobbii por presentar dos ocelos en la cara abaxial de la lámina, pecíolos con glándulas situadas en su zona media y láminas foliares de mayores dimensiones que el resto. Adicionalmente, se presenta una clave para la determinación de las subespecies de P. lobbii y otros taxones afines, acompañada de una tabla comparativa con los caracteres morfológicos foliares de las subespecies de Passiflora lobbii.

Passiflora lobbii subsp. limensis Chávez-Corcuera is described. It differs from the other subspecies of Passiflora lobbii by presenting two ocelli on the abaxial side of the lamina, petioles with two glands located in its middle zone and larger leaf blades. Additionally, a key for determination of the related taxa and a table with morphological characters of the leaves of subspecies of Passiflora lobbii are presented.

SARS-CoV-2 prevalence associated to low socioeconomic status and overcrowding in an LMIC megacity: A population-based seroepidemiological survey in Lima, Peru.

BACKGROUND: Worldwide, Peru has one of the highest infection fatality rates of COVID-19, and its capital city, Lima, accumulates roughly 50% of diagnosed cases. Despite surveillance efforts to assess the extent of the pandemic, reported cases and deaths only capture a fraction of its impact due to COVID-19's broad clinical spectrum. This study aimed to estimate the seroprevalence of SARS-CoV-2 in Lima, stratified by age, sex, region, socioeconomic status (SES), overcrowding, and symptoms. METHODS: We conducted a multi-stage, population-based serosurvey in Lima, between June 28th and July 9th, 2020, after 115 days of the index case and after the first peak cases. We collected whole blood samples by finger-prick and applied a structured questionnaire. A point-of-care rapid serological test assessed IgM and IgG antibodies against SARS-CoV-2. Seroprevalence estimates were adjusted by sampling weights and test performance. Additionally, we performed RT-PCR molecular assays to seronegatives and estimated the infection prevalence. FINDINGS: We enrolled 3212 participants from 797 households and 241 sample clusters from Lima in the analysis. The SARS-CoV-2 seroprevalence was 20·8% (95%CI 17·2-23·5), and the prevalence was 25·2% (95%CI 22·5-28·2). Seroprevalence was equally distributed by sex (aPR=0·96 [95%CI 0·85-1·09, p = 0·547]) and across all age groups, including ≥60 versus ≤11 years old (aPR=0·96 [95%CI 0·73-1·27, p = 0·783]). A gradual decrease in SES was associated with higher seroprevalence (aPR=3·41 [95%CI 1·90-6·12, p<0·001] in low SES). Also, a gradual increase in the overcrowding index was associated with higher seroprevalence (aPR=1·99 [95%CI 1·41-2·81, p<0·001] in the fourth quartile). Seroprevalence was also associated with contact with a suspected or confirmed COVID-19 case, whether a household member (48·9%, aPR=2·67 [95%CI 2·06-3·47, p<0·001]), other family members (27·3%, aPR=1·66 [95%CI 1·15-2·40, p = 0·008]) or a workmate (34·1%, aPR=2·26 [95%CI 1·53-3·35, p<0·001]). More than half of seropositive participants reported never having had symptoms (56·1%, 95% CI 49·7-62·3). INTERPRETATION: This first estimate of SARS-CoV-2 seroprevalence in Lima shows an intense transmission scenario, despite the government's numerous interventions early established. Susceptibles across age groups show that physical distancing interventions must not be relaxed. SES and overcrowding households are associated with seroprevalence. This study highlights the importance of considering the existing social inequalities for implementing the response to control transmission in low- and middle-income countries.

Effects of COVID-19 pandemic control measures on air pollution in Lima metropolitan area, Peru in South America.

The sanitary measures implemented to control and prevent an increase in infections due to the COVID-19 pandemic have produced an improvement in the air quality of many urban areas around the world. We assessed air quality during the COVID-19 pandemic for particulate matter (PM2.5 and PM10), NO2 and O3 in in metropolitan area of Lima, Peru between pre-lockdown period (February 1 and March 15 of 2020), historical period (March 16 to April 30 2017-2019) and lockdown period (March 16 to April 30, 2020). The complete national lockdown that was implemented in Peru produced statistically significant reductions in the in-air pollutant (PM10 (-40% and -58%), PM2.5 (-31% and -43%) and NO2 (-46% and -48%)), as recorded by the by the ground-based air quality monitoring network throughout the metropolitan area, compared with the corresponding concentrations for the previous weeks and over the same period for 2017-2019. Analysis of the spatial Distribution of satellite data also show decreases in the concentrations of PM10, PM2.5 and NO2 as a result of the containment measures and suspension of activities implemented by the Peruvian government. The concentrations of O3 significantly increased (11% and 170%) as a result of the decrease in the concentration of NO2, confirming that the study area is a hydrocarbon-limited system, as previously reported. The results obtained contribute to the assessment by the regulatory agencies of the possible strategies of control and monitoring of air pollution in the study area. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11869-021-00990-3.

Antimicrobial Resistance of Helicobacter pylori in Gastric Biopsy Samples from Lima/Peru.

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

The Surco canal, an ancient irrigation canal in Lima, Peru, and a citizens' campaign for its protection.

The present text discusses a number of pre-Hispanic irrigation canals in Lima, the Peruvian capital, often considered as the second largest city built on a desert. Some of the original canals are still in use but given that most have been excluded from official urban narratives, citizens are not aware of them and the role they still play in the city. A brief description of Lima's canals through the ages is provided, including present day management and the risks affecting them. This paper focuses on the Surco canal and a citizens' campaign carried out between 2016 and 2018 to raise awareness about it. The impact the campaign has had on the wider city is discussed. A general overview of the cultural context in which pre-Hispanic issues have historically been considered in Lima and how this campaign also tried to address them is included as well. As this paper is part of a special issue, Water History in the time of COVID-19, it has undergone modified peer review.

Gaussian approach for probability and correlation between the number of COVID-19 cases and the air pollution in Lima.

At the end of February 2020, Peru started the first cases of pneumonia associated with coronavirus (COVID-19), they were reported in Lima, Peru (Rodriguez-Morales et al., 2020). Therefore, the first week on March started with 72 infected people, the government published new law for a national crisis by COVID-19 pandemic (Vizcarra et al., 2020), with a quarantine in each city of Peru. Our analysis has considered March and April 2020, for air quality measurement and infections in Lima, the data collected on 6 meteorological stations with CO (carbon monoxide), NO2 (nitrogen oxide), O3 (ozone), SO2 (sulfur dioxide), PM10 and PM2.5 (particle matter with diameter aerodynamic less than 2.5 and 10 m respectively). As a result, the average of these concentrations and the hospital information is recollected per hour. This analysis is executed during the quarantine an important correlation is discovered in the zone with highest infection by COVID-19, NO2 and PM10, even though in a reduction of air pollution in Lima. In this paper, we proposed a classification model by Reduced-Space Gaussian Process Regression for air pollution and infections; with technological and environmental dynamics and global change associated COVID-19. An evaluation of zones in Lima city, results have demonstrated influence of industrial influence in air pollution and infections by COVID-19 before and after quarantine during the last 28 days since the first infection in Peru; the problems relating to data management were validated with a successful classification and cluster analysis for future works in COVID-19 influence by environmental conditions.

Gestación en tiempos de pandemia COVID-19. Hospital Nacional Docente Madre Niño San Bartolomé, Lima, Perú / Gestation in times of COVID-19 pandemic. Hospital Nacional Docente Madre Niño San Bartolomé, Lima, Peru / Gestation in times of COVID-19 pandemic. Hospital Nacional Docente Madre Niño San Bartolomé, Lima, Peru

RESUMEN Introducción . El COVID-19 y la gestación es una nueva intercurrencia en la valoración de riesgos para la atención de la gestante. Desde el inicio de la pandemia en el país, los casos han ido en aumento. El primer caso atendido en el Hospital San Bartolomé fue el 12 de abril. Desde los primeros reportes de gestantes COVID+ en China, a la fecha, se tiene cada vez mayor información, siendo importante para fines del manejo de la gestante COVID+ que se conozca su epidemiología y los resultados perinatales. Objetivo . Determinar la epidemiología y resultados materno perinatales de COVID-19 en las gestantes del Hospital Nacional Docente Madre Niño San Bartolomé, Lima, Perú. Método . Estudio observacional de corte transversal, en los meses de abril a julio 2020. Se incluyó a todas las gestantes que llegaron a la emergencia obstétrica del Hospital San Bartolomé, a las cuales se les realizó una prueba de inmunocromatografía para IgM/IgG, para determinar la seroprevalencia de COVID-19. Las variables obstétricas y perinatales fueron recolectadas en una ficha de datos al ingreso a la emergencia. Resultados . Se realizó prueba rápida para SARS-CoV-19 a 345 gestantes que se hospitalizaron para atención de parto. La edad promedio fue 27 años, con 10% de adolescentes y 16% de mayores de 35 años; 60% tenía 2 a 4 embarazos, 38% de los partos fue vaginal, 15% de ellos pretérmino; 1,2% de las gestantes fue sintomática y 0,2% ingresó a la unidad de cuidados intensivos. El 61% de los recién nacidos pesó entre 2 500 y 3 500 g, 53% fue sexo masculino, 94% tuvo Apgar mayor de 7 al minuto, 3,3% con hisopado positivo dentro de las primeras 24 horas. Se presentaron 3% de óbitos. El 48% de las gestantes provino del Cono Norte de la ciudad de Lima. Conclusiones . Casi 100% de las gestantes fue asintomática y solo 0,2% tuvo complicaciones respiratorias. La culminación del parto por vía cesárea fue baja en relación a otras publicaciones; el motivo de cesárea fue por indicación obstétrica. Escaso número de neonatos tuvo hisopado positivo. Hubo mayor incidencia de óbitos en julio 2020. El mayor porcentaje de pacientes provino del Cono Norte de Lima. Palabras clave. Embarazo, Infecciones por coronavirus, SARS-CoV-19, COVID-19, óbito fetal, Lima, Perú.

ABSTRACT Introduction: COVID-19 and pregnancy is a new intercurrence in risk assessment for the care of the pregnant woman. Since the beginning of the pandemic in the country, cases have been increasing. The first case attended at the San Bartolomé Hospital was on April 12. Since the first reports of COVID+ pregnant women in China, to date, there is more important information on epidemiology and perinatal results for the management of the COVID+ pregnant woman. Objective: To determine the epidemiology and maternal perinatal outcomes of COVID-19 in pregnant women at the Hospital Nacional Docente Madre Niño San Bartolomé, Lima, Peru. Methods: Observational cross-sectional study, from April to July 2020. All the pregnant women who arrived at the obstetric emergency at Hospital San Bartolomé were included, and they underwent an immunochromatography test for IgM / IgG, to determine the seroprevalence of COVID-19. Obstetric and perinatal variables were collected in a data sheet upon admission to the emergency room. Results: Rapid test for SARS-CoV-19 was performed in 345 pregnant women who were hospitalized for delivery care. The average age was 27 years, with 10% adolescents and 16% over 35 years; 60% had 2 to 4 pregnancies, 38% of deliveries were vaginal, 15% of them preterm; 1.2% of the pregnant women were symptomatic and 0.2% were admitted to the intensive care unit. 61% of the newborns weighed between 2 500 and 3 500 g, 53% were male, 94% had an Apgar score greater than 7 at one minute, 3.3% with a positive swab within the first 24 hours. There were 3% fetal deaths. 48% of the pregnant women came from the Northern Cone of the city of Lima. Conclusions: Almost 100% of the pregnant women were asymptomatic and only 0.2% had respiratory complications. The mode of delivery by cesarean section was low in relation to other publications, all had obstetric indication. A small number of neonates had a positive swab. There was a higher incidence of fetal deaths in July 2020. The highest percentage of patients came from the Northern Cone of Lima.

SARS-CoV-2 en la segunda mitad del embarazo: resultados materno - perinatales / Sars-CoV-2 in the second half of pregnancy: Maternal and perinatal outcomes / Sars-CoV-2 in the second half of pregnancy: Maternal and perinatal outcomes

RESUMEN Introducción . La pandemia por COVID-19 es una emergencia sanitaria y social mundial. El conocimiento sobre su efecto en las gestantes es todavía limitado. Objetivo . Describir los resultados materno-perinatales de COVID-19 según clasificación de severidad en mujeres hospitalizadas en la segunda mitad del embarazo. Métodos . Estudio observacional, descriptivo, retrospectivo, desde marzo hasta julio del 2020, en el Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima, Perú. Se incluyeron a todas las gestantes hospitalizadas con RT-PCR y/o prueba rápida positiva para SARS-CoV-2. Se excluyeron los embarazos menores a 20 semanas y las altas epidemiológicas. Las características maternas al ingreso y los resultados materno-perinatales fueron agrupados según la clasificación clínica de la enfermedad. Las variables cualitativas son presentadas en recuentos y porcentajes; y las cuantitativas, en medianas y rangos. Resultados . Se estudiaron 247 gestantes. La mayoría correspondía al tercer trimestre (76%). La presentación más frecuente de la virosis fue asintomática (83%) y los casos de neumonía severa fueron pocos (3,2%). La tasa de cesárea fue alta (60%), aunque los partos vaginales se duplicaron en el tiempo (0-24% a 44%). Los casos severos tuvieron mayor tasa de cesárea (100%) y parto prematuro iatrogénico (100%). No se reportaron muertes maternas. Se registraron 9 óbitos fetales y 5 neonatos positivos para SARS-CoV-2, ambos entre las asintomáticas y leves. Conclusiones . En nuestra institución, la posibilidad de cesárea y de parto prematuro iatrogénico fue mayor en los casos severos. La tasa de parto vaginal aumentó en los últimos meses. No se identificaron complicaciones perinatales relacionadas al COVID-19.

ABSTRACT Introduction: The COVID-19 pandemic is a global health and social emergency. Knowledge is still limited about its effect on pregnant women. Objective: To describe maternal-perinatal outcomes of COVID-19 according to severity classification in women hospitalized in the second half of pregnancy. Methods: Retrospective, descriptive, observational study from March to July 2020 at Edgardo Rebagliati Martins National Hospital. All hospitalized pregnant women with RT-PCR and/ or rapid positive test for SARS-CoV-2 were included. Pregnancies less than 20 weeks and epidemiological discharges were excluded. Maternal characteristics at admission and maternal-perinatal outcomes were grouped according to the clinical classification of the disease. The qualitative variables are presented in counts and percentages; and quantitative ones, in medians and ranges. Results: 247 pregnant women were studied. Most of them were in the third trimester (76%). The most frequent presentation of the disease was asymptomatic (83%), and cases of severe pneumonia were few (3.2%). The cesarean section rate was high (60%), although vaginal deliveries doubled over time (0-24 a 44%). Severe cases had a higher rate of cesarean section (100%) and iatrogenic preterm delivery (75%). No maternal deaths were reported. There were 9 stillbirths and 5 positive neonates for SARS-CoV-2, both among asymptomatic and mild patients. 9 stillbirths and 5 positive neonates for SARS-CoV-2, both among asymptomatic and mild cases. Conclusions: The possibility of cesarean section and iatrogenic preterm delivery is greater in severe cases. The vaginal delivery rate increased in recent months. No perinatal complications related to COVID-19 were identified.

Temporal and spatial analysis of traffic - Related pollutant under the influence of the seasonality and meteorological variables over an urban city in Peru.

A four yearlong air monitoring data (since 2015 to 2018) was collected to assess the impact of meteorological parameters such as temperature, relative humidity, wind speed and wind direction on the spatial and temporal variability of CO (carbon monoxide), NO2 (nitrogen oxide), O3 (ozone), SO2 (sulfur dioxide), PM10 and PM2.5 (particulate matter with diameter aerodynamic less than 2.5 µm and 10 µm respectively) in Lima Metropolitan Area (LMA). Data from eight air quality monitoring stations, currently under the supervision of the National Meteorological and Hydrological Service (SENAMHI), was used to capture traffic - related pollutants concentrations under various local traffic conditions. Effects on meteorological events on seasonal traffic-related pollutants concentration variability were identified. Using average data from the eight stations, it was found that the monthly mean traffic-related pollutants since 2015 to 2018 were higher in spring and winter and lower in autumn and summer. Low-wind speed was associated with events that contribute to elevated seasonal PM2.5 levels. Correlation coefficients between PM2.5 concentrations and meteorological variables fluctuated significaly across different seasons. High PM2.5 concentrations were associated with low relative humidity and high wind conditions in spring. Results suggest that there exist a seasonal variation of PM2.5 concentration, and set the need of future work on the understanding of the air pollution effects on human health.

PM2.5 exposure on daily cardio-respiratory mortality in Lima, Peru, from 2010 to 2016.

BACKGROUND: There have been no studies of air pollution and mortality in Lima, Peru. We evaluate whether daily environmental PM2.5 exposure is associated to respiratory and cardiovascular mortality in Lima during 2010 to 2016. METHODS: We analyzed 86,970 deaths from respiratory and cardiovascular diseases in Lima from 2010 to 2016. Estimated daily PM2.5 was assigned based on district of residence. Poisson regression was used to estimate associations between daily district-level PM2.5 exposures and daily counts of deaths. RESULTS: An increase in 10 µg/m3 PM2.5 on the day before was significantly associated with daily cardiorespiratory mortality (RR 1.029; 95% CI: 1.01-1.05) across all ages and in the age group over 65 (RR 1.04; 95% CI: 1.005-1.09) which included 74% of all deaths. We also observed associations with circulatory deaths for all age groups (RR 1.06; 95% CI: 1.01-1.11), and those over 65 (RR 1.06; 95% CI 1.00-1.12). A borderline significant trend was seen (RR 1.05; 95% CI 0.99-1.06; p = 0.10) for respiratory deaths in persons aged over 65. Trends were driven by the highest quintile of exposure. CONCLUSIONS: PM2.5 exposure is associated with daily cardiorespiratory mortality in Lima, especially for older people. Our data suggest that the existing limits on air pollution exposure are too high.

HLA study in Amerindian Bolivia La Paz Aymaras.

Aymara people has been a relatively homogeneous group since Spanish Conquest by 1,532 CE, even if previously represented a group of various cultural defined populations who gave rise to them. They were and are established in Andean Altiplano around Titikaka Lake (Bolivia, Peru), Argentina and Chile neighborhood, speak Aymara language and have been maintained after Europeans arrival at a lower social status than Quechua (Inca) speaking people. However, both Aymara and Quechua populations acknowledge Titikaka Lake as center of their origins; both languages are also related. Specific high frequencies of HLA-A*02, -A*24 and -A*68, HLA-B*35, -B*39 and -B*48, HLA-DRB1*08:02, -DRB1*09:01, and -DRB1*14:02, and HLA-DQB1*04:02, -DQB1*03:02 and -DQB1*03:01 alleles are found in Aymaras and HLA class II haplotypes common to Andean Amerindians (DRB1*08:02-DQB1*04:02 and DRB1*04:03-DQB1*03:02), like Quechua, Aymara, Uros, Lamas and Mapuche are also found in Easter and other Pacific Islands. Giant human head stone statues at Tiwanaku (Titikaka Lake, Bolivia) are also found at Easter Island. Thus, it is possible a gene and cultural flow between Andean Amerindians and Easter and other Pacific Islands, as it was demonstrated by Thor Heyerdahl in his Kon-Tiki expedition which reached Pacific Islands sailing from El Callao Harbour (Lima, Peru).

Increasing PrEP uptake and adherence among MSM and TW sex workers in Lima, Perú: what and whom do different patients trust?

In Perú, men who have sex with men (MSM) and transgender women (TW) suffer rates of HIV 50 times greater than the general population. MSM or TW sex workers (SWs) are at especially high risk. Daily oral pre-exposure prophylaxis (PrEP) effectively prevents HIV infection if patients adhere to a daily or on-demand regimen. Necessary levels of adoption and adherence require data-driven intervention strategies for these marginalized groups. We conducted qualitative content analysis of data obtained from focus groups (FGs) with MSM and TW SWs. Both groups expressed strong skepticism about the motives behind international drug trials, and the safety of participating in them. Important differences between MSM and TW groups' beliefs about trustworthy information as well as community and public institutions also emerged. MSM SWs were less trusting of information from other MSM SWs, and preferred to receive information from institutional medical sources, while TGW SWs preferred to receive information from other TGW SWs. Successful strategies to encourage PrEP uptake and adherence must address the distrust patients feel towards international and institutional actors by providing patients with tailored, reliable information from local and community sources that they trust.