The prevalence and demographic associations of headache in the adult population of Peru: a national cross-sectional population-based study.

BACKGROUND: The Global Campaign against Headache is conducting a series of population-based studies to fill the large geographical gaps in knowledge of headache prevalence and attributable burden. One major region not until now included is South America. Here we present a study from Peru, a country of 32.4 million inhabitants located at the west coast of South America, notable for its high Andes mountains. METHODS: The study was conducted in accordance with the standardized methodology used by the Global Campaign. It was a cross-sectional survey using cluster randomised sampling in five regions to derive a nationally representative sample, visiting households unannounced, and interviewing one randomly selected adult member (aged 18-65 years) of each using the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire translated into South American Spanish. The neutral screening question ("Have you had headache in the last year?") was followed by diagnostic questions based on ICHD-3 and demographic enquiry. RESULTS: The study included 2,149 participants from 2,385 eligible households (participating proportion 90.1%): 1,065 males and 1,084 females, mean age 42.0 ± 13.7 years. The observed 1-year prevalence of all headache was 64.6% [95% CI: 62.5-66.6], with age-, gender- and habitation-adjusted prevalences of 22.8% [21.0-24.6] for migraine (definite + probable), 38.9% [36.8-41.0] for tension-type headache (TTH: also definite + probable), 1.2% [0.8-1.8] for probable medication-overuse headache (pMOH) and 2.7% [2.1-3.5] for other headache on ≥ 15 days/month (H15+). One-day prevalence of headache (reported headache yesterday) was 12.1%. Migraine was almost twice as prevalent among females (28.2%) as males (16.4%; aOR = 2.1; p < 0.001), and strongly associated with living at very high altitude (aOR = 2.5 for > 3,500 versus < 350 m). CONCLUSION: The Global Campaign's first population-based study in South America found headache disorders to be common in Peru, with prevalence estimates for both migraine and TTH substantially exceeding global estimates. H15 + was also common, but with fewer than one third of cases diagnosed as pMOH. The association between migraine and altitude was confirmed, and found to be strengthened at very high altitude. This association demands further study.

High-resolution climate projection dataset based on CMIP6 for Peru and Ecuador: BASD-CMIP6-PE.

Here, we present BASD-CMIP6-PE, a high-resolution (1d, 10 km) climate dataset for Peru and Ecuador based on the bias-adjusted and statistically downscaled CMIP6 climate projections of 10 GCMs. This dataset includes both historical simulations (1850-2014) and future projections (2015-2100) for precipitation and minimum, mean, and maximum temperature under three Shared Socioeconomic Pathways (SSP1-2.6, SSP3-7.0, and SSP5-8.5). The BASD-CMIP6-PE climate data were generated using the trend-preserving Bias Adjustment and Statistical Downscaling (BASD) method. The BASD performance was evaluated using observational data and through hydrological modeling across Peruvian and Ecuadorian river basins in the historical period. Results demonstrated that BASD significantly reduced biases between CMIP6-GCM simulations and observational data, enhancing long-term statistical representations, including mean and extreme values, and seasonal patterns. Furthermore, the hydrological evaluation highlighted the appropriateness of adjusted GCM simulations for simulating streamflow, including mean, low, and high flows. These findings underscore the reliability of BASD-CMIP6-PE in assessing regional climate change impacts on agriculture, water resources, and hydrological extremes.

The relevance of electrocardiogram filtering in the differential diagnosis of Brugada syndrome: An illustrative case report.

We present a clinical case of a teenager in whom a Brugada syndrome electrical pattern was found which was finally diagnosed as a Brugada phenocopy due to a wrong setup of the high-pass filter on the electrocardiogram.

The phototoxicity action spectra of visible light in HaCaT keratinocytes.

Visible light (VL) surely affects human skin in several ways, exerting positive (tissue regeneration, pain relief) and negative (oxidation, inflammation) effects, depending on the radiation dose and wavelength. Nevertheless, VL continues to be largely disregarded in photoprotection strategies, perhaps because the molecular mechanisms occurring during the interaction of VL with endogenous photosensitizers (ePS) and the subsequent biological responses are still poorly understood. Besides, VL encompass photons with different properties and interaction capacities with the ePS, but there are no quantitative comparisons of their effects on humans. Here, we studied the effects of physiologically relevant doses of four wavelengths ranges of VL, i.e. (in nm), 408-violet, 466/478-blue, 522-green, 650-red, in immortalized human skin keratinocytes (HaCaT). The level of cytotoxicity/damage follows the order: violet>blue >green>red. Violet and blue light induced the highest levels of Fpg-sensitive lesions in nuclear DNA, oxidative stress, lysosomal and mitochondrial damage, disruption of the lysosomal-mitochondrial axis of cell homeostasis, blockade of the autophagic flux, as well as lipofuscin accumulation, greatly increasing the toxicity of wideband VL to human skin. We hope this work will stimulate in development of optimized sun protection strategies.

Comparison of 3-month visual outcomes of a new multifocal intraocular lens vs a trifocal intraocular lens.

PURPOSE: To compare the clinical performance of the TECNIS Synergy multifocal (model ZFR00V) intraocular lens (IOL) with that of the AcrySof PanOptix Trifocal (model TFNT00) IOL in patients undergoing bilateral cataract surgery. SETTING: Multicenter clinical setting. DESIGN: Prospective randomized comparative study. METHODS: Patients aged 22 years or older were randomly assigned (2:1) to bilateral implantation with ZFR00V or TFNT00 IOLs. End points included the mean binocular distance-corrected near visual acuity (DCNVA) at 40 cm, photopic and mesopic DCNVAs at 33 cm, photopic low-contrast corrected distance visual acuity (CDVA) and mesopic CDVA, nondirected patient responses to an ocular/visual symptoms questionnaire, and safety. RESULTS: Of the 150 patients implanted with IOLs, 95 of the 97 patients with ZFR00V IOLs and 52 of the 53 patients with TFNT00 IOLs completed the 3-month follow-up. Most patients in the ZFR00V and TFNT00 groups achieved 20/25 or better binocular CDVA (100% vs 96.2%) and DCNVA measured at 40 cm (88.4% vs 75.0%) and 33 cm (78.9% vs 51.9%). The mean between-group difference in binocular DCNVA at 40 cm favored ZFR00V IOLs (0.5 lines Snellen; 95% CI, 0.012 to 0.089; P ≤ .05). Similarly, the mean binocular photopic and mesopic DCNVAs at 33 cm (0.8 lines Snellen each; both P ≤ .05 vs TFNT00) and photopic high-contrast and low-contrast CDVA (0.5 lines Snellen each; both P ≤ .05 vs TFNT00) favored ZFR00V IOLs. Patient-reported ocular/visual symptoms and safety were generally similar between the 2 IOLs. CONCLUSIONS: The ZFR00V IOL showed an extensive range of vision, particularly through near distances, and better mesopic performance than the TFNT00 IOL in patients undergoing cataract surgery.

Nivel de conocimiento de manejo de niños y actitud frente a desastres en pediatras del Servicio de Emergencia Pediátrica del Centro Médico Naval del Callao, 2018-2019 / Level of knowledge on disaster management for children and attitude towards disasters of pediatricians from the Pediatric Intensive Care Unit of the Centro Médico Naval - Callao, 2018-2019

RESUMEN Objetivo: Determinar la correlación entre el nivel de conocimiento de manejo de niños en situación de desastre y la actitud frente a los desastres de los médicos pediatras del Servicio de Emergencia Pediátrica del Centro Médico Naval del Callao durante el período de diciembre de 2018 a febrero de 2019. Materiales y métodos: El nivel de conocimiento se determinó con un cuestionario basado en el Curso de Desastres de la Academia Americana de Pediatría. La actitud frente a los desastres fue establecida con un formulario autoadministrado con respuestas en escala tipo Likert validada, que midió los aspectos en las áreas cognitiva, conductual y afectiva. En el análisis estadístico, se utilizó el programa SPSS v.25. Las frecuencias y los porcentajes se emplearon en la estadística descriptiva. Para la estadística inferencial, se utilizó el coeficiente de correlación de Spearman, con un nivel de significancia p < 0,05. Resultados: El 80,00 % de los pediatras tuvo un nivel medio de conocimiento, y el 76,00 % manifestó una actitud indiferente. Se obtuvo un nivel de correlación positivo intermedio (0,505) con significancia estadística (p < 0,05). Conclusiones: Se demostró una correlación entre el nivel de conocimiento y la actitud frente a los desastres. Por ello, es necesario incidir en la capacitación del personal de emergencia, sobre todo, en los pediatras.

ABSTRACT Objective: To determine the correlation between the level of knowledge on disaster management for children and the attitude towards disasters of pediatricians from the Pediatric Intensive Care Unit of the Centro Médico Naval - Callao from December 2018 to February 2019. Materials and methods: The level of knowledge was established using a questionnaire based on a course on disaster management from the American Academy of Pediatrics. The attitude towards disasters was determined using a validated self-administered Likert-scale questionnaire that measured the cognitive, behavioral and affective areas. The IBM SPSS Statistics V25 was used for the statistical analysis. Frequencies and percentages were employed for the descriptive statistics. The Spearman's correlation coefficient with a significance level of p < 0.05 was used for the inferential statistics. Results: Eighty percent (80 %) of the study population had a moderate level of knowledge and 76 % had an indifferent attitude. A moderate positive correlation level (0.505) with a significance level of p < 0.05 was found. Conclusions: A correlation between the level of knowledge and the attitude towards disasters was demonstrated. Therefore, it is necessary to train the emergency personnel, particularly the pediatricians.

Theoretical inspection of the spin-crossover [Fe(tzpy)2(NCS)2] complex on Au(100) surface.

We explore the deposition of the spin-crossover [Fe(tzpy)2(NCS)2] complex on the Au(100) surface by means of density functional theory (DFT) based calculations. Two different routes have been employed: low-cost finite cluster-based calculations, where both the Fe complex and the surface are maintained fixed while the molecule approaches the surface; and periodic DFT plane-wave calculations, where the surface is represented by a four-layer slab and both the molecule and surface are relaxed. Our results show that the bridge adsorption site is preferred over the on-top and fourfold hollow ones for both spin states, although they are energetically close. The LS molecule is stabilized by the surface, and the HS-LS energy difference is enhanced by about 15%-25% once deposited. The different Fe ligand field for LS and HS molecules manifests on the composition and energy of the low-lying bands. Our simulated STM images indicate that it is possible to distinguish the spin state of the deposited molecules by tuning the bias voltage of the STM tip. Finally, it should be noted that the use of a reduced size cluster to simulate the Au(100) surface proves to be a low-cost and reliable strategy, providing results in good agreement with those resulting from state-of-the-art periodic calculations for this system.

ER-Golgi dynamics of HS-modifying enzymes via vesicular trafficking is a critical prerequisite for the delineation of HS biosynthesis.

The cell surface and extracellular matrix polysaccharide, heparan sulfate (HS) conveys chemical information to control crucial biological processes. HS chains are synthesized in a non-template driven process mainly in the Golgi apparatus, involving a large number of enzymes capable of subtly modifying its substitution pattern, hence, its interactions and biological effects. Changes in the localization of HS-modifying enzymes throughout the Golgi were found to correlate with changes in the structure of HS, rather than protein expression levels. Following BFA treatment, the HS-modifying enzymes localized preferentially in COPII vesicles and at the trans-Golgi. Shortly after heparin treatment, the HS-modifying enzyme moved from cis to trans-Golgi, which coincided with increased HS sulfation. Finally, it was shown that COPI subunits and Sec24 gene expression changed. Collectively, these findings demonstrate that knowledge of the ER-Golgi dynamics of HS-modifying enzymes via vesicular trafficking is a critical prerequisite for the complete delineation of HS biosynthesis.

Visual quality after presbyopia correction with excimer laser ablation using micromonovision and modulation of spherical aberration.

PURPOSE: To evaluate the quality of vision after excimer laser (MEL 80) correction of presbyopia using micromonovision and aspheric aberration patterns. SETTING: Hospital Universitario QuirónSalud, Madrid, Spain. DESIGN: Prospective case series. METHODS: Patients were assigned to 1 of 3 groups based on the preoperative spherical equivalent. Visual acuity, spherical aberration, contrast sensitivity, quality of vision, and safety of the procedure were assessed preoperatively and at the end of the study. The dominant eye was treated for distance vision and the nondominant eye for near vision, with modulation of spherical aberration. RESULTS: The study comprised 50 patients (100 eyes). The mean patient age was 46.84 years ± 4.17 (SD). Stereopsis at the end of the study improved in Group 3, from 215.29 ± 99.63 seconds of arc (arcsec) and 169.41 ± 71.10 arcsec (P = .025); no changes were seen in the other groups. Contrast sensitivity at 18 cycles per degree increased in Group 2 (P = .021), with no changes in the other groups. Group 1 and Group 2 had the best optical quality of vision after the surgery based on Optical Quality Analysis System frequency of the modulation transfer function values of 100%, 20%, and 9% and the Strehl ratio. CONCLUSION: The correction of presbyopia by micromonovision and aspheric aberration ablation with an excimer laser led to minimal changes in stereopsis, contrast sensitivity, and optical quality.

Informe de Gestión 2019 del Organismo Andino de Salud ­ Convenio Hipólito Unanue ORAS-CONHU / Management Report 2019 of the Organismo Andino de Salud - Convenio Hipólito Unanue ORAS -CONHU

El presente Informe abarca la gestión desarrollada el año 2019 y consta de cuatro partes. La primera, describe el marco institucional del ORAS - CONHU, la planificación de mediano plazo. La segunda parte contiene la relación de las actividades desarrolladas en cada una de las cuatro líneas estratégicas. La tercera parte, está referida al proyecto de "Fortalecimiento de las Redes de Laboratorios de Tuberculosis en la Región de las Américas" financiado por el Fondo Mundial y que, durante tres años, del 2017 al 2019, el ORAS CONHU, administró como Receptor Principal. La cuarta parte está referida a los aspectos de la gestión administrativa y financiera.

Comparing surgically induced astigmatism calculated by means of simulated keratometry versus total corneal refractive power.

PURPOSE: To evaluate surgically induced astigmatism as computed by means of either simulated keratometry (KSIM) or total corneal refractive power (TCRP) after temporal incisions. METHODS: Prospective observational study including 36 right eyes undergoing cataract surgery. Astigmatism was measured preoperatively during the 3-month follow-up period using Pentacam. Surgically induced astigmatism was computed considering anterior corneal surface astigmatism at 3 mm with KSIM and considering both corneal surfaces with TCRP from 1 to 8 mm (TCRP3 for 3 mm). The eyes under study were divided into two balanced groups: LOW with KSIM astigmatism <0.90 D and HIGH with KSIM astigmatism ≥0.90 D. Resulting surgically induced astigmatism values were compared across groups and measuring techniques by means of flattening, steepening, and torque analysis. RESULTS: Mean surgically induced astigmatism was higher in the HIGH group (0.31 D @ 102°) than in the LOW group (0.04 D @ 16°). The temporal incision resulted in a steepening in the HIGH group of 0.15 D @ 90°, as estimated with KSIM, versus 0.28 D @ 90° with TCRP3, but no significant differences were found for the steepening in the LOW group or for the torque in either group. Differences between KSIM- and TCRP3-based surgically induced astigmatism values were negligible in LOW group. CONCLUSION: Surgically induced astigmatism was considerably higher in the high-astigmatism group and its value was underestimated with the KSIM approach. Eyes having low astigmatism should not be included for computing the surgically induced astigmatism because steepening would be underestimated.

Bloqueo de la conversión periférica de Tiroxina a triyodotironina por el iopodato sódico y su empleo en el control agudo del hipertiroidismo / Block of the peripheral conversion of tiroxinE to triyodotironinE for the iopodato sodico and its employment in the acute control of the hyperthyroidism

El presente trabajo se investigó el efecto de iopodato sódico, en 8 sujetos normales y en 21 hipertirodeos con enfermedad de Graves. A los primeros se les administró 3 gramos de iopodato solo por vía oral y a los segundos junto con 30-45 mg fue mertimazol. Posteriormente se determinó la concentración sérica de T4, T3, THS y I, así como también la excreción urinaria de yodo en forma seriada hasta los 45 días después de la administración de este medicamento. Adicionalmente a los estudios hormonales, en los pacientes hipertiroideos se realizó también una evaluación clínica. Utilizando el índice de Crooks, Wayne y Murray (ICWM) y también cardiovascular, antes y durante el tratamiento. En los sujetos normales se observó una caida significativa en los niveles de T3 equivalente al 22 por ciento del valor basal en el primer día y máxima del 35 por ciento al tercer día después de la administración de iopodato, siguiendo luego una curva de recuperación progresiva hasta alcanzar los niveles basales a los 15 días. Los niveles de T4 experimentaron un discreto aumento. Los niveles de TSH también se elevaron significativamente entre el segundo y tercer día. En los pacientes hipertiroideos la respuesta a la administración de iopodato y metimazol fue más marcada, la caída en los niveles de T3 fue 56.7 por ciento al primer día y 60.6 por ciento al tercer día. Los niveles de T4 también sufrieron una disminución progresiva y los valores de TSH se mantuvieron deprimidos durante el periodo de observación. La evolución clínica de los hipertiroideos mostró franca mejoría en estrecha concordancia con los cambios hormonales, en particular con la caída de T3, y en los pacientes con complicaciones cardiovasculares hubo una regresión de la insuficiencia cardiaca y la fibrilación auricular...