A nationwide pilot study on breast cancer screening in Peru.

Introduction: A high prevalence of advanced breast cancer (BC) is a common scenario in Latin America. In Peru, the frequency of BC at Stages III/IV is ≈50% despite implementation of a programme for breast cancer screening (BCS) along the country. We carried out a study to assess the feasibility and develop an instrument to evaluate the knowledge, barriers and perception about BCS in a nationwide pilot study in Peru among candidates for BCS. Methods: We conducted a systematic review of 2,558 reports indexed in PubMed, Scopus, Web of Science, Medline-Ovid and EMBASE, regarding to our study theme. In total, 111 were selected and a 51-items survey was developed (eight items about sociodemographic characteristics). Patients were recruited in public hospitals or private clinics, in rural and urban areas of nine departments of Peru. Results: We surveyed 488 women from: Lima (150), Cajamarca (93), Ica (59), Arequipa (56), Loreto (48), Ancash (38), Junín (15), Puerto Maldonado (15) and Huancavelica (14); 27.9% of them were from rural areas. The mean of age was 53.3 years (standard deviation ± 9.1). Regarding education level, 29.8% had primary, 33.2% secondary and 37.0% higher education. In total, 28.7% of women did not know the term 'mammogram' and 47.1% reported never receiving a BCS (36.9% from urban and 73.5% from rural population). In women that underwent BCS, only 67% knew it is for healthy women. In total, 54.1% of patients had low levels of knowledge about risk factors for BC (i.e. 87.5% of women respond that injuries in the breast produce cancer). Cultural, economic and geographic barriers were significantly associated with having a mammogram where 56.9% of participants considered a cost ≤ 7 USD as appropriate. Mammogram was perceived as too painful for 54.9% of women. In addition, women with a self-perception of low-risk for BC and a fatalistic perception of cancer were less likely to have a BCS. Conclusion: We found that it is feasible to conduct a large-scale study in Peru. The results of this pilot study highlight an urgent need of extensive education and awareness about BCS in Peru.

Preliminary molecular detection of the somatic embryogenesis receptor-like kinase (VpSERK) and knotted-like homeobox (VpKNOX1) genes during in vitro morphogenesis of Vanilla planifolia Jacks.

This work aimed to evaluate the embryogenic competence of different tissues from different stages (friable callus, bud-regenerating callus, and whole buds) of Vanilla planifolia, through the molecular detection of the somatic embryogenesis receptor-like kinase (VpSERK) and knotted-like homeobox (VpKNOX1) genes. RNA was extracted with Trizol®, cDNA was obtained, and the studied transcripts were amplified. Using non-specific primers, VpSERK and VpSTM gene expression was detected in the three stages evaluated. This study might contribute to providing an explanation for the recalcitrance of this Vanilla species to somatic embryogenesis.

Interactions Between Trypanosoma cruzi the Chagas Disease Parasite and Naturally Infected Wild Mepraia Vectors of Chile.

Chagas disease, which ranks among the world's most neglected diseases, is a chronic, systemic, parasitic infection caused by the protozoan Trypanosoma cruzi. Mepraia species are the wild vectors of this parasite in Chile. Host-parasite interactions can occur at several levels, such as co-speciation and ecological host fitting, among others. Thus, we are exploring the interactions between T. cruzi circulating in naturally infected Mepraia species in all areas endemic of Chile. We evaluated T. cruzi infection rates of 27 different haplotypes of the wild Mepraia species and identified their parasite genotypes using minicircle PCR amplification and hybridization tests with genotype-specific DNA probes. Infection rates were lower in northern Chile where Mepraia gajardoi circulates (10-35%); in central Chile, Mepraia spinolai is most abundant, and infection rates varied in space and time (0-55%). T. cruzi discrete typing units (DTUs) TcI, TcII, TcV, and Tc VI were detected. Mixed infections with two or more DTUs are frequently found in highly infected insects. T. cruzi DTUs have distinct, but not exclusive, ecological and epidemiological associations with their hosts. T. cruzi infection rates of M. spinolai were higher than in M. gajardoi, but the presence of mixed infection with more than one T. cruzi DTU was the same. The same T. cruzi DTUs (TcI, TcII, TcV, and TcVI) were found circulating in both vector species, even though TcI was not equally distributed. These results suggest that T. cruzi DTUs are not associated with any of the two genetically related vector species nor with the geographic area. The T. cruzi vectors interactions are discussed in terms of old and recent events. By exploring T. cruzi DTUs present in Mepraia haplotypes and species from northern to central Chile, we open the analysis on these invertebrate host-parasite interactions.

Trombocitopenia como predictor de sepsis tardía en neonatos atendidos en el Hospital III de Emergencias Grau en el periodo 2012-2013 / Thrombocytopenia as a predictor of late-onset sepsis in neonates treated at the Hospital III Emergency Grau in the period 2012-2013

Objetivo: Demostrar que la trombocitopenia tiene valor predictor de sepsis tardía en neonatos para una identificación precoz de este diagnóstico. Diseño: El presente estudio es observacional, retrospectivo, transversal de tipo prueba diagnóstica. Lugar: Hospital III Emergencias Grau (H. docente). Materiales: historias clínicas de neonatos con diagnóstico de sepsis tardía corroborado por dos hemocultivos positivos y un grupo control de recién nacidos sanos. Intervenciones: Se recogió la muestra indicada. Se usó R statistic versión 2.13.2, y el paquete EPIDAT. Se aplicó un modelo de regresión logística por pasos para evaluar la capacidad predictiva de la trombocitopenia. Se evaluó la utilidad diagnóstica mediante la sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo. Finalmente mediante la curva ROC se valoró la exactitud diagnóstica. Resultados: De 202 recién nacidos, 37 de ellos tuvieron sepsis tardía confirmada por hemocultivo frente a 165 controles. El germen más frecuente aislado fue Staphylococcus. Se confirmó que la trombocitopenia es un predictor estadísticamente significativo de sepsis (valor p=0,007) e independiente de los otros factores incluidos en el modelo. La trombocitopenia muestra una sensibilidad del 18,9 por ciento, especificidad de 95,8 por ciento, valor predictivo positivo de 50 por ciento y un valor predictivo negativo de 84 por ciento. Tiene una exactitud diagnóstica regular para la detección de sepsis neonatal tardía según el área bajo la curva (prueba ROC). Conclusiones: Se demostró que la trombocitopenia puede ser usada como predictor de sepsis tardía con una especificidad superior al 95 por ciento, sin embargo no es suficiente para ser el único predictor de sepsis.

Objective: To demonstrate that thrombocytopenia has predictive value of late sepsis in neonates for early identification of this diagnosis. Design: This study is observational, retrospective, cross, diagnostic tests routine. Location: Emergency Grau III Hospital (A teaching hospital). Materials: newborns wit Late-onset sepsis confirmed by two positive blood cultures and a control group of healthy newborns. Interventions: these were collected. To use R version 2.13.2 statistic and EPIDAT package. Logistic regression model was applied in steps to evaluate the predictivecapacity of thrombocytopenia. Diagnostic utility by sensitivity, specificity, positive predictive value and negative predictive value were evaluated. Finally by ROC curve the diagnostic accuracy was assessed. Results: Of 202 infants, 37 of them had sepsis confirmed by blood culture late compared to 165 controls. The most common pathogen isolated was Staphylococcus. It was confirmed that thrombocytopenia is a statistically significant predictor of sepsis (p value=0.007) and independent of the other factors included in the model. Thrombocytopenia shows a sensitivity of 18.9 per cent, specificity 95.8 per cent, positive predictive value of 50 per cent and a negative predictive value of 84 per cent. Has a regular diagnostic accuracy for detecting late onset sepsis as the area under the curve (ROC test). Conclusions: We demonstrated that thrombocytopenia can be used as a predictor of late sepsis with specificity greater than 95 per cent, however it is not enough to be the only predictor of sepsis.

In situ PCR detection of phytoplasma DNA in embryos from coconut palms with lethal yellowing disease.

SUMMARY DNA of the lethal yellowing (LY) phytoplasma was detected in 13 of 72 embryos from fruits of four diseased Atlantic tall coconut palms by polymerase chain reaction (PCR) assays employing phytoplasma universal rRNA primer pair P1/P7, nested LY group-specific rRNA primer pair 503f/LY16Sr or LY phytoplasma-specific nonribosomal primer pair LYF1/R1. Phytoplasma distribution in sectioned tissues from six PCR positive embryos was determined by in situ PCR and digoxigenin-11-deoxy-UTP (Dig) labelling of amplification products. Dig-labeled DNA products detected by colourimetric assay were clearly evident on sections from the same three embryos investigated in detail by in situ PCRs employing primer pairs P1/P7 or LYF1/R1. Deposition of blue-green stain on sections as a result of each assay was restricted to areas of the embryos corresponding to the plumule and cells ensheathing it. By comparison, similarly treated embryo sections derived from fruits of a symptomless Atlantic tall coconut palm were consistently devoid of any stain. Presence of phytoplasma DNA in embryo tissues suggests the possible potential for seed transmission which remains to be demonstrated.