Factors associated with sexually transmitted diseases amongst female prison inmates in Peru.

OBTECTIVES: The number of women in prison is rapidly increasing every year and it is important to establish what factors are related to the probability of presenting STDs in this population to enable health control policies to be established. MATERIAL AND METHOD: An analysis was carried out on the open database of the national prison population survey conducted in 2016 in all Peruvian prisons. The study was based on the census and all female and male adults in prison were surveyed using a validated questionnaire. RESULTS: The sample consisted of 4,574 inmates in 67 institutions, covering 98.8% of the inmate population. It was found that presenting tuberculosis (PR: 2.64; CI 95%, 1.32-5.26), HIV/AIDS (PR 6.54, CI 95% 1.52-28.18), hepatitis (PR: 4.01; CI 95%, 1.23-13.11) and drug use (PR: 2.44; CI 95%, 1.32-4.52), are statistically related (P ≤0.05) are factors associated with the presence of STDs in the multivariate model with a P ≤0.05. DISCUSSION: The inclusion of associated factors (tuberculosis, HIV/AIDS, hepatitis and drug use) should be part of the strategy to control and treat STD in women's prisons in Peru.

Factores asociados a las infecciones de transmisión sexual en mujeres privadas de la libertad en el Perú / Factors associated with sexually transmitted diseases amongst female prison inmates in Peru

Objetivos: El número de mujeres en condición de prisión se incrementa rápidamente todos los años, por lo que es importante establecer cuáles son los factores que se relacionan con la probabilidad de presentar infecciones de trasmisión sexual (ITS) en esta población para establecer políticas de control sanitario. Material y método: Se realizó un análisis de la base de datos abierta de la encuesta nacional de población penitenciaria del año 2016 realizada en todas las prisiones del Perú. El estudio fue censal y se entrevistaron a todas las mujeres y hombres adultos en situación de cárcel mediante un cuestionario validado. Resultados: La muestra abarcó a 4.574 internas de 67 establecimientos penitenciarios, cubriendo el 98,8% de la población penitenciaria. Se encontró que haber presentado tuberculosis (razón de prevalencia ajustada [RPa]: 1,32; intervalo de confianza [IC] del 95%, 1,32-5,26), presentar virus de la inmunodeficiencia humana (VIH)/sida o síndrome de inmunodeficiencia adquirida (RPa: 1,52; IC del 95%, 1,52-28,18), hepatitis (RPa: 4,01; IC del 95%, 1,23-13,11) y consumo de drogas (Rpa: 2,44; IC del 95%, 1,32-4,52) son factores asociados a la presencia de ITS en el modelo multivariado con un valor p ≤0,05. Discusión: Incluir los factores asociados identificados (tuberculosis, VIH/sida, hepatitis y consumo de drogas) debe ser parte de la estrategia de control y tratamiento de las ITS en las prisiones femeninas del Perú. (AU)

Objectives: The number of women in prison is rapidly increasing every year and it is important to establish what factors are related to the probability of presenting STDs in this population to enable health control policies to be established. Material and method: An analysis was carried out on the open database of the national prison population survey conducted in 2016 in all Peruvian prisons. The study was based on the census and all female and male adults in prison were surveyed using a validated questionnaire. Results: The sample consisted of 4,574 inmates in 67 institutions, covering 98.8% of the inmate population. It was found that presenting tuberculosis (PR: 2.64; CI 95%, 1.32-5.26), HIV/AIDS (PR 6.54, CI 95% 1.52-28.18), hepatitis (PR: 4.01; CI 95%, 1.23-13.11) and drug use (PR: 2.44; CI 95%, 1.32-4.52), are statistically related (P ≤0.05) are factors associated with the presence of STDs in the multivariate model with a P ≤0.05.Discussion: The inclusion of associated factors (tuberculosis, HIV/AIDS, hepatitis and drug use) should be part of the strategy to control and treat STD in women’s prisons in Peru. (AU)

Exploring the prevalence of abortion and its characteristics in Perú.

OBJECTIVES: Our paper presents the analysis of a nationwide survey that explored induced abortion among women using a ballot-box technique. Our objective was to determine the prevalence of abortion and the main characteristics of the procedure. STUDY DESIGN: We conducted surveys in households with 2400 women aged 18-49 from urban areas nationwide, between October 15 and 29, 2018. Data collection was overseen by the Instituto de Opinión Pública de la Universidad Católica del Perú. We performed a probabilistic, multistage, and socioeconomic level-stratified sampling. Our study used the "ballot-box technique" to ensure anonymity and reduce the risk of social desirability. RESULTS: We visited 15,433 houses nationwide. Among those households where surveys could not be conducted, it was due to abandoned or inaccessible property, unwilling to participate, absent members, out of quota, or inconclusive survey. On average, 19.0% of Peruvian women at all socioeconomic levels reported having had at least one abortion in their lifetime. Induced abortion is reported at all socioeconomic levels and reported age of the abortion is concentrated between 19 and 29 years old. In 57.7% of cases, women sought healthcare personnel for their last induced abortion. Among them, procedure abortion (45.3%) stands out over medical abortions (34.0%). Thirty-three percent of women who reported having had at least one induced abortion in their lifetime were admitted to a hospital after their last abortion. CONCLUSIONS: The illegality of abortion has not prevented its occurrence in Peru. Our results suggest that, in Peru, legal restrictions on induced abortion create an unfavorable context for women's health, exposing them to services whose safety is not guaranteed. Efforts should be made to increase awareness and education about contraception and family planning methods to prevent unwanted pregnancies and reduce the need for abortion. IMPLICATIONS: These findings should be considered in public policy discussions regarding abortion, since they might have a great impact for better decision making. They demonstrate that legal restrictions have not prevented the occurrence of abortion but has only created unsafe conditions around it.

Effect of Ki-67 assessment in the distribution of breast cancer subtypes: Evaluation in a cohort of Latin American patients.

Breast cancer (BC) is a heterogeneous disease composed of four main subtypes with distinct clinical and epidemiological features. Although several reports have described the distribution of BC subtypes in Latin America, the majority of them have not included the cellular marker, Ki-67, in the immunohistochemical (IHC) panel. The aim of the present study was to describe the distribution of BC subtypes in a cohort of Latin American women using an IHC panel with Ki-67. A prospective cohort of 580 patients in three centers of Peru (the Hospital Nacional Edgardo Rebagliatti Martins, the Hospital Nacional Guillermo Almenara Irigoyen, the Hospital Nacional Alberto Sabogal, Lima) and one in Uruguay (Instituto Nacional del Cáncer, Montevideo) were evaluated. BC phenotypes were classified according to an IHC panel: Estrogen receptor (ER), progesterone receptor (PgR), HER2 and Ki-67. Silver in situ hybridization was used when the HER2 status, as determined by IHC, was equivocal. The associations between the BC phenotypes and their clinicopathological features were evaluated. ER was positive in 65% of the cases (n=377), and PgR in 50% (n=203). In total, 79.1% (n=459) were HER2-negative, 19.8% (n=115) were HER2-positive and 1% (n=6) had an equivocal status. With respect to Ki-67, 44.7% of the patients exhibited staining in >14% of the tumor cells (n=259). The distribution of subtypes was as follows: Luminal A, 31.9% (n=183); luminal B, 35% (n=201); HER2, 12.1% (n=70); and triple-negative, 20.9% (n=120). When Ki-67 was not included in the panel, the frequency of luminal A was 41.1% and luminal B, 25.8% (9.2% of the cases were misclassified). Ki-67 was most highly expressed in triple-negative and HER2 tumors. Inclusion of Ki-67 in the IHC panel to assign subtypes revealed a higher frequency of luminal B tumors than was reported previously for Latin American women with BC, whereas the distribution of triple-negative and HER2 tumors were similar to that previously reported. In conclusion, these results demonstrated that excluding Ki-67 from the panel of IHC markers may lead to an underestimation of the rates of luminal B tumors.

Metaplasia mieloide agnogénica: reporte de un caso atípico / Agnogenic myeloid metaplasia: case of report atipic

Se presenta un paciente varón de 19 años de edad, procedente de Papayacu, departamento de Amazonas, con metaplasia mieloide agnogénica (MMA), cuya sintomatología y evolución-con excepción de la fiebre y la esplenomegalia-fueron inusuales, lo cual obscureció el diagnóstico que sólo pudo evidenciarse post-mortem. Paralelamente era portador de una severa desnutrición calórico-proteica y de parasitismo intestinal múltiple, lo que contribuyó a modificar el curso clínico del proceso. Creemos por ello que este caso de metaplasia mieloide agnogénica de presentación muy singular debe ser reportado en la literatura nacional.