The enterohemorrhagic Escherichia coli insertion sequence-excision enhancer protein is a DNA polymerase with microhomology-mediated end-joining activity.

Bacterial genomes contain an abundance of transposable insertion sequence (IS) elements that are essential for genome evolution and fitness. Among them, IS629 is present in most strains of enterohemorrhagic Escherichia coli O157 and accounts for many polymorphisms associated with gene inactivation and/or genomic deletions. The excision of IS629 from the genome is promoted by IS-excision enhancer (IEE) protein. Despite IEE has been identified in the most pathogenic serotypes of E. coli, its biochemical features that could explain its role in IS excision are not yet understood. We show that IEE is present in >30% of all available E. coli genome assemblies, and is highly conserved and very abundant within enterohemorrhagic, enteropathogenic and enterotoxigenic genomes. In vitro analysis of the recombinant protein from E. coli O157:H7 revealed the presence of a Mn2+-dependent error-prone DNA polymerase activity in its N-terminal archaeo-eukaryotic primase (AEP) domain able to promote dislocations of the primer and template strands. Importantly, IEE could efficiently perform in vitro an end-joining reaction of 3'-single-strand DNA overhangs with ≥4 bp of homology requiring both the N-terminal AEP and C-terminal helicase domains. The proposed role for IEE in the novel IS excision mechanism is discussed.

Role of Government Financial Support and Vulnerability Characteristics Associated with Food Insecurity during the COVID-19 Pandemic among Young Peruvians.

Peruvian households have experienced one of the most prevalent economic shocks due to COVID-19, significantly increasing their vulnerability to food insecurity (FI). To understand the vulnerability characteristics of these households among the Peruvian young population, including the role of the government's response through emergency cash transfer, we analysed longitudinal data from the Young Lives study (n = 2026), a study that follows the livelihoods of two birth cohorts currently aged 18 to 27 years old. FI was assessed using the Food Insecurity Experience Scale. Household characteristics were collected before and during the COVID-19 outbreak in Peru to characterise participants' vulnerability to FI. Multivariate logistic regression was used to evaluate the association between government support and participants' vulnerability characteristics to FI. During the period under study (March to December 2020), 24% (95% CI: 22.1-25.9%) of the participants experienced FI. Families in the top wealth tercile were 49% less likely to experience FI. Larger families (>5 members) and those with increased household expenses and decreased income due to COVID-19 were more likely to experience FI (by 35%, 39% and 42%, respectively). There was no significant association between government support and FI (p = 0.768). We conclude that pre-pandemic socioeconomic status, family size, and the economic disruption during COVID-19 contribute to the risk of FI among the Peruvian young population, while government support insufficiently curtailed the risk to these households.

La realidad del paciente en hemodiálisis antes de la pandemia COVID-19 / The reality of patients in hemodialysis before COVID-19 pandemic

En una prueba piloto realizada en el departamento de Lambayeque (Perú) sobre el perfil del paciente que ingresa por primera vez a hemodiálisis con enfermedad renal crónica grado cinco (ERC 5) se ha encontrado evidencias diferentes a otros países de América Latina. La modalidad de tratamiento para los pacientes con ERC 5 aumentó a través de la hemodiálisis según El Registro Latinoamericano de Diálisis y Trasplante Renal del 2000 al 2008. En el Perú, se registra un 84,75% de pacientes con esta forma de tratamiento, sigue vigente en nuestro país y en los demás.

In a pilot test carried out in the department of Lambayeque (Peru) about the profile of patients who entered hemodialysis for the first time with grade five chronic kidney disease (CKD 5), evidence was found different from other Latin American. The treatment modality for CKD 5 patients increased through hemodialysis according to the Latin American Registry of Dialysis and Kidney Transplantation from 2000 to 2008. In Peru, 84.75% of patients are registered with this form of treatment still in force in our country and others.

Nivel de conocimientos sobre certificados de defunción en médicos recién egresados / Level of knowledge about death certificates in recently graduated physicians

Objetivo: Precisar el nivel de conocimientos sobre el llenado correcto de certificados de defunción en médicos que inician servicio rural urbano marginal de salud (SERUMS). El estudio: Diseño descriptivo transversal. Población: asistentes al curso de inducción SERUMS: 86 recién egresados. Instrumento: cuestionario con preguntas basadas en la "Guía Técnica para el correcto llenado de certificados de defunción 2018" Ministerio de Salud. Hallazgos: 23% del total tiene nivel pésimo, 41% malo, 34% regular y 2% bueno; la mayoría no sabe precisar la causa básica de muerte y 98% no considera como causa básica la circunstancia del accidente y 85% desconocen sobre SINADEF. Conclusiones: El nivel de conocimientos sobre el llenado correcto de certificado de defunción es muy bajo con gran desconocimiento para ubicar causa básica de muerte.

Objetive:specifythelevelofknowledgeaboutthecorrect completion of death certificates in doctors who start the rural urban marginal health service (SERUMS). descriptive cross-The study:sectional design. Population: attending the SERUMS induction course: 86 recent graduates. Instrument: questionnaire with questions based on the "Technical Guide for the correct completion of death certificates 2018" Ministry of Health. 23% of the total have a terrible Findings:level, 41% bad, 34% fair and 2% good; the majority do not know how to specify the basic cause of death and 98% do not consider the accident circumstance as the basic cause and 85% do not know about SINADEF. Conclusions:The level of knowledge about the correct completion of the death certificate is very low with great ignorance to locate the basic cause of death.

Publicaciones en revistas científicas peruanas relacionadas a prioridades de investigación del Perú / Publications in peruvian scientific journals related to research priorities in Peru

La investigación en salud pública es una de las "Funciones Esenciales de la Salud Pública" (OPS- 42º Consejo Directivo 2000) , por tanto constituye una competencia y acción necesaria del sistema de salud para mejorar la calidad de vida de las poblaciones y mejorar la equidad en salud

Research in public health is one of the "Essential Functions of Public Health" (PAHO- 42nd Directing Council 2000), therefore it constitutes a competence and necessary action of the health system to improve the quality of life of populations and improve the equity in health

Características de pacientes con alta clínica post SARS-Cov-2 hospitalizados en EsSalud. Región Lambayeque / Original Characteristics of clinic discharge patients with SARS-Cov-2 hospitalized at EsSalud in the Lambayeque Region

Introducción. La pandemia por Covid 19 ha ocasionado alta letalidad en la región Lambayeque colapsando los hospitales. Objetivos: Describir según genero las características de pacientes con alta clínica post Sars.Cov2 hospitalizados en Essalud de la Región Lambayeque. Material y Métodos: Estudio observacional, retrospectivo, descriptivo, seleccionando una muestra representativa de los casos confirmados COVID 19 entre el 01 de abril al 30 de junio del 2020 en el Hospital Nacional Almanzor Aguinaga Asenjo (HNAAA) y Hospital Luis Heysen Inchaustegui (HLHI); como criterios de exclusión: Aquellos con menos de 48 horas de estancia, los fallecidos y los referidos a otros establecimientos. Se recolectaron los datos de historia clínica en el sistema SGSS, se utilizó el software Excel para el procesamiento de datos. Resultados: se registraron 329 pacientes de los cuales 70% fueron varones, promedio de edad 55,9 +/- 11 años; el diagnóstico fue mediante prueba serológica 80% y Tomografía de tórax 17%. La disnea fue el síntoma predominante 85%, linfopenia 51% y proteína C reactiva alta 39% y LDH alta 35%. El tratamiento fue principalmente oxígeno 89% y enoxaparina 87%, azitromicina 86% y ceftriaxona 70%, las complicaciones hospitalarias fueron el SDRA 88,1% y la neumonía atípica 86,6%, la estancia en hospitalización fue de 7,85 +/- 5,42 días. Conclusiones: La mayoría de hospitalizados en Essalud fueron varones, promedio edad 55,9 años; síntoma principal disnea; predominó la linfopenia con proteína C reactiva y LDH altas; el tratamiento fue en base a oxígeno, y enoxaparina, promedio de estancia en hospitalización de 7,85 días.

Introduction.The Covid 19 pandemic has caused high lethalityintheLambayequeregion,collapsing hospitals.Objectives:describe,bygender,the characteristics of clinic discharge patients with sars-cov2 hospitalized at EsSalud in the Lambayeque region. Material and Methods:Observational, retrospective, descriptive study, selecting a representative sample of confirmed COVID 19 cases between April 1 to June 30, 2020 at the Almanzor Aguinaga Asenjo National Hospital (HNAAA) and the Luis Heysen Inchaustegui Hospital (HLHI) ; as exclusion criteria: those with less than 48 hours of stay, the deceased and those referred to other establishments.Theclinicalhistorydatawere collected in the SGSS system, Excel software was used fordataprocessing.Results:329patientswere registered, of which 70% were male, mean age 55.9 +/- 11 years; Diagnosis was by serological test 80% and chest tomography 17%. Dyspnea was the predominant symptom 85%, lymphopenia 51% and high C-reactive protein 39% and high LDH 35%. Treatment was mainly oxygen 89% and enoxaparin 87%, azithromycin 86% and ceftriaxone 70%, hospital complications were ARDS 88.1% and atypical pneumonia 86.6%, hospital stay was 7.85 + / - 5.42 days. Conclusions:The majority of hospitalized in Essalud were men, average age 55.9 years; main symptom dyspnea; lymphopenia with high C-reactiveproteinandLDHpredominated;the treatment was based on oxygen and enoxaparin, mean hospital stay of 7.85 days.

Centers for Disease Control and Prevention's Temporary Epidemiology Field Assignee program: Supporting state and local preparedness in the wake of Ebola.

OBJECTIVES: The Centers for Disease Control and Prevention launched the Temporary Epidemiology Field Assignee (TEFA) Program to help state and local jurisdictions respond to the risk of Ebola virus importation during the 2014-2016 Ebola Outbreak in West Africa. We describe steps taken to launch the 2-year program, its outcomes and lessons learned. METHODS: State and local health departments submitted proposals for a TEFA to strengthen local capacity in four key public health preparedness areas: 1) epidemiology and surveillance, 2) health systems preparedness, 3) health communications, and 4) incident management. TEFAs and jurisdictions were selected through a competitive process. Descriptions of TEFA activities in their quarterly reports were reviewed to select illustrative examples for each preparedness area. RESULTS: Eleven TEFAs began in the fall of 2015, assigned to 7 states, 2 cities, 1 county and the District of Columbia. TEFAs strengthened epidemiologic capacity, investigating routine and major outbreaks in addition to implementing event-based and syndromic surveillance systems. They supported improvements in health communications, strengthened healthcare coalitions, and enhanced collaboration between local epidemiology and emergency preparedness units. Several TEFAs deployed to United States territories for the 2016 Zika Outbreak response. CONCLUSION: TEFAs made important contributions to their jurisdictions' preparedness. We believe the TEFA model can be a significant component of a national strategy for surging state and local capacity in future high-consequence events.

Valoración de la calidad de prescripción de transfusión sanguínea en un hospital de alta complejidad en la región Lambayeque / Evaluation of the quality of blood transfusion prescriptions in a high-complexity hospital in Lambayeque region

Objetivo: Valorar la calidad de la prescripción en las transfusiones sanguíneas realizadas y conocer los principales diagnósticos por los que se prescribió una transfusión sanguínea en un hospital de Alta Complejidad de la región Lambayeque. Materiales y Métodos: Estudio transversal. Se evaluaron 298 prescripciones de transfusiones sanguíneas efectivizadas, que fueron seleccionadas mediante aleatorización estratificada por departamento hospitalario. Se valoró la calidad de la prescripción en base al cumplimiento de la Guía de Indicaciones Adecuadas de Componentes Sanguíneos del Hospital Edgardo Rebagliati Martins. Se revisó las historias clínicas para obtener información necesaria para el llenado de la ficha de recolección y mediante estadística descriptiva se obtuvieron frecuencias y porcentajes acerca de la calidad de prescripción de transfusión sanguínea. Resultados: El 26,5% de las prescripciones sanguíneas en general se valoraron como inadecuadas [IC95%: 21,7 - 31,3]. El hemocomponente con mayor valoración de calidad inadecuada fue el plasma fresco congelado (52,6% [IC95%: 35,4% - 69,8%]), mientras que se encontró una menor proporción de calidad inadecuada en las solicitudes de crioprecipitado (20,0% [IC95%: 0,5%-71,6%]). Según departamento hospitalario, el departamento de Medicina obtuvo la mayor proporción de prescripciones inadecuadas (36,0%), seguido del departamento de Anestesiología (29,4%) y de Gineco-obstetricia (27,3%). Conclusiones: La calidad de prescripción de transfusión sanguínea se valoró como inadecuada en el 26,5%, siendo mayor en el Departamento de Medicina, y en las solicitudes de plasma fresco congelado.

Objective: To assess the quality of blood transfusion prescriptions and to verify the main diagnoses for prescribing blood transfusions in a high complexity hospital in Lambayeque region. Materials and Methods: This is a cross-sectional study. We assessed 298 blood transfusion prescriptions, which were selected using stratified randomization by hospital areas. Prescription quality was assessed based on compliance with the Guide for Appropriate Indications of Blood Components from Edgardo Rebagliati-Martins Hospital. Clinical records were reviewed aiming to obtain the information required for filling the data collection form. Descriptive statistics was used for obtaining rate regarding quality of blood transfusion prescriptions. Results: Roughly one-quarter (26.5%) of blood transfusion prescriptions were deemed as inadequate [95% CI: 21.7-31.3]. The blood product with the highest inadequate quality rate was frozen plasma (52.6% [95% CI: 35.4% - 69.8%]), while cryoprecipitate requests had the lowest rate of inadequate quality in its prescriptions (20.0% [95% IC: 0.5% -71.6%]). When different hospital areas were assessed, the general medicine department had the highest rate of inadequate quality of blood transfusion prescriptions (36.0%), followed by anesthesiology (29.4%) and gynecology & obstetrics (27.3%) departments. Conclusions: The quality of blood transfusion prescriptions was found to be inadequate in 26.5% of all cases, and the highest inadequacy rates were found in the general medicine department and in frozen plasma requests.

Características del registro y codificación diagnóstica de los pacientes hospitalizados en un hospital del seguro social de Chiclayo / Characteristics of the registration and diagnostic coding of hospitalized patients in a social security hospital of Chiclayo

Objetivo: Describir las características del registro y codificación diagnóstica de los pacientes hospitalizados en el servicio de Medicina interna, Cirugía general, Pediatría, Ginecología y Obstetricia del Hospital Nacional Almanzor Aguinaga Asenjo en el periodo Enero- Junio del 2016. Material y Métodos: Estudio observacional tipo descriptivo, transversal, con una población de 3003 pacientes, muestra de 341 mediante afijación proporcional se obtuvo la cantidad de las historias clínicas a revisar por servicios: Cirugía General (72), Ginecología (38), Medicina Interna (58), Obstetricia (142) y Pediatría (31), finalmente se realizó un muestreo aleatorio simple con reemplazo. Para la recolección de la información se utilizó ficha de recolección de datos y el procesamiento mediante el programa SPSS versión 24, se empleó un análisis descriptivo univariado y bivariado. Resultados: El registro y codificación diagnóstica del CIE 10 en las historias clínicas fue incorrecto al diagnóstico de ingreso 57,8% y diagnóstico de egreso 55,7%. Con respecto al CIE 10 registrado en las historias clínicas y el sistema de gestión hospitalaria se encontró que no concuerda en un 67%. Conclusiones: La codificación y registro diagnóstico del CIE 10 en las historias clínicas y el sistema de gestión hospitalaria es incorrecto, lo que indica la importancia de implementar y reforzar la capacitación adecuada al personal de salud.

Objetive: To describe the characteristics of the registration and diagnostic coding of patients hospitalized in the Internal Medicine, General Surgery, Pediatrics, Gynecology and Obstetrics departments of the Almanzor Aguinaga Asenjo National Hospital in the period January-June 2016. Material and Methods: Observational study descriptive, cross-sectional type, with a population of 3003 patients, sample of 341 by proportional allocation was obtained the number of clinical records to be reviewed by services: General Surgery (72), Gynecology (38), Internal Medicine (58), Obstetrics (142) and Pediatrics (31), finally a simple random sampling with replacement was carried out. To collect the information, a data collection form was used and the processing was carried out through the SPSS program, version 24, using a descriptive univariate and bivariate analysis. Results: The registration and diagnostic coding of the ICD 10 in the medical records was incorrect at diagnosis of 57.8% and diagnosis of discharge 55.7%. Regarding the ICD 10 registered in the medical records and the hospital management system, it was found that it does not agree with 67%. Conclusions: The coding and diagnostic registry of the ICD 10 in the medical records and the hospital management system is incorrect, which indicates the importance of implementing and reinforcing adequate training for health personnel.

Surveillance Training for Ebola Preparedness in Côte d'Ivoire, Guinea-Bissau, Senegal, and Mali.

The 2014-2015 epidemic of Ebola virus disease in West Africa primarily affected Guinea, Liberia, and Sierra Leone. Several countries, including Mali, Nigeria, and Senegal, experienced Ebola importations. Realizing the importance of a trained field epidemiology workforce in neighboring countries to respond to Ebola importations, the Centers for Disease Control and Prevention Field Epidemiology Training Program unit implemented the Surveillance Training for Ebola Preparedness (STEP) initiative. STEP was a mentored, competency-based initiative to rapidly build up surveillance capacity along the borders of the at-risk neighboring countries Côte d'Ivoire, Mali, Senegal, and Guinea-Bissau. The target audience was district surveillance officers. STEP was delivered to 185 participants from 72 health units (districts or regions). Timeliness of reporting and the quality of surveillance analyses improved 3 months after training. STEP demonstrated that mentored, competency-based training, where learners attain competencies while delivering essential public health services, can be successfully implemented in an emergency response setting.

Psicopatología de los pacientes hospitalizados en el Hospital Regional Lambayeque, enero 2015 / Psychopathology of patients in hospitalization at the Regional Hospital Lambayeque, january 2015

Introducción: En los pacientes hospitalizados se espera encontrar niveles importantes de síntomas psiquiátricos. Existen escasos estudios que evalúan la prevalencia de alteraciones psicopatológicas en pacientes hospitalizados por causas médicas, a pesar de la importancia de éstos sobre el diagnóstico, tratamiento, evolución y costos de atención. Objetivo: El objetivo del presente estudio es describir la existencia de psicopatología en los pacientes hospitalizados en el Hospital Regional Lambayeque durante enero 2015. Material y métodos: Estudio observacional, descriptivo, transversal, analítico, con una población de 351 pacientes hospitalizados durante enero- 2015, distribuidos en los servicios de Medicina interna, Cirugía general, gineco-obstetricia y cirugía de especialidades. Muestra: 183 pacientes, con una pérdida de 3 participantes. Previo consentimiento informado se aplicó una ficha de recolección de datos y el Cuestionario de Salud General ­ 12, durante enero del 2015. Los datos recogidos se analizaron con el programa SPSS versión 19.0. Resultados: La presencia de psicopatología en la población estudiada fue de 45% con algún malestar psicopatológico. Conclusiones: Sí, existe psicopatología en los pacientes hospitalizados en el Hospital Regional Lambayeque, durante enero 2015.

Introduction: In the inpatients he expects to find him important levels of psychiatric symptoms. Scarce studies exist that psicopatologycal in inpatients for medical causes, in spite of the importance of these on thediagnosis,treatment,evolution and costs of attention evaluate the prevalence of alterations. Objetive:To objective of this study is describing the existence of psicopatologycal of the inpatients in the Hospital Regional Lambayeque in January 2015. Material and methods: Study observational, Descriptive, Prospect, Transversal­Analytic. Population: 351 in patients during January 2015, distributed in the services of internal Medicine, General Surgery, gineco obstetrics and surgery of specialties. Show: 183 patients, with a loss of 3 all-comers. Previous informed consent applied over itself the collecting chip of data and General Health Questionaire - 12, during January of 2015. The shrunk data analyzed him with the program SPSS version 19,0. Results:The presence of psychopathology in the studied population belonged to 45% with some in disposition psicopatologycal. Conclusions: If there exists psicopatologycal in the inpatients in the Hospital Regional Lambayeque, during January 2015.

Inteligencia emocional y niveles de estrés académico en estudiantes de medicina de la Universidad de San Martin de Porres, Chiclayo-Perú / Emotional intelligence and levels of academic stress in medical students of the Universidad de San Martin de Porres, Chiclayo-Peru

Objetivo: Evaluar si existe asociación entre Inteligencia Emocional y niveles de estrés académico en los estudiantes de la Facultad de Medicina Humana de la Universidad de San Martín de Porres -Filial Norte. Material y Método: Descriptivo transversal, se estudiaron a los 271 alumnos regulares matriculados en la Escuela Profesional de Medicina Humana, durante el semestre académico aplicándoseles el inventario de inteligencia emociona Bar-on y el inventario para estrés académico. (SISCO). Resultados: entre los más frecuentes en la Inteligencia Interpersonal, fue promedio con 47,6%; en la Inteligencia Intrapersonal, fue Muy Bajo con 47,6%; en la adaptabilidad, fue Muy Bajo 37,1%; el manejo del estrés se presentó con mayor frecuencia el nivel Bajo con 51,2%, y en estado de ánimo general fue Promedio con 34,7%. Con relación a la frecuencia con que más se presentó el estrés académico en los estudiantes fue de algunas veces con 64,1%, seguido de casi siempre con 28,8%. No se encontró asociación entre la inteligencia emocional y stress académico (p<0,05). Conclusiones: Se concluye que no existe relación de la inteligencia emocional y niveles de estrés académico en los estudiantes de medicina de la Universidad de San Martín de Porres Filial Norte.

Objetive: To assess the association between emotional intelligence and academic stress levels in students of the Faculty of Human Medicine at the University of San Martin de Porres subsidiary Norte. Material and Methods: Descriptive cross, to 271 regular students enrolled studied at the Professional School of Human Medicine during the academic semester inventory applying to them Bar-on emotional intelligence and academic stress inventory. (SISCO). Results: among the most frequent in the Interpersonal Intelligence, was average with 47.6%; in intrapersonal intelligence, it was very low with 47.6%; in adaptability, it was very low 37.1%; stress management occurred more frequently with 51.2% Low level, and overall mood was average with 34.7%. With regard to the frequency with which more academic stress was presented in students it was sometimes with 64.1%,followed by 28.8% almost always .No se encontró association between emotional intelligenceandacademicstress(p<0,05). Conclusions: We conclude that there is no relationship of emotional intelligence and academic stress levels in medical students at the Universidad de San Martin de Porres-Filial Norte.