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1.
Zootaxa ; 4801(3): zootaxa.4801.3.1, 2020 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-33056643

RESUMO

We describe and illustrate 15 species of Ptiloneura, from Colombia and Peru. The number of species of Ptiloneura is raised to 34, of which 28 (82.3%) are Colombian. One species is from Brazil, four species are from Peru, one is from Nicaragua and two species are from Venezuela. Two species are shared between Colombia and Peru, one species is shared between Colombia and Venezuela, and 25 species are endemic to Colombia. An identification key to the males and a phylogenetic analysis of Ptiloneura are included.


Assuntos
Insetos , Animais , Colômbia , Masculino , Peru , Filogenia
2.
Zootaxa ; 4834(3): zootaxa.4834.3.3, 2020 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-33056114

RESUMO

We examine the phylogenetic relationships among salamanders of the genus Bolitoglossa (Eladinea) distributed in the Amazonian basin of northern Peru and southern Ecuador and assess species diversity based on morphological and phylogenetic analyses. We infer a molecular phylogeny using sequences from two mitochondrial (Cytb, 16S) and two nuclear genes (RAG-1, POMC). We find two well-supported subclades, one including [B. altamazonica + B. peruviana] + B. awajun sp. n., and the other including Bolitoglossa sp. Ituxi + Bolitoglossa sp. Jurúa. Ecuadorian lineages form divergent clades from the Peruvian lineages. Accordingly, Ecuadorian populations previously assigned to Bolitoglossa peruviana sensu lato are treated as members of a Bolitoglossa equatoriana species complex. A newly defined Bolitoglossa altamazonica species complex contains only populations from the Amazonian rainforest of Peru. Maximum likelihood and Bayesian Inference analyses confirm the phylogenetic placement of B. altamazonica and B. peruviana, and support recognition of a related new species of Bolitoglossa. The uncorrected genetic distances between the new species and B. altamazonica are 6.5% for Cytb and 4.9% for 16S; and the uncorrected genetic distances between the new species and B. peruviana are 8.0% for Cytb and 3.9% for 16S. Additionally, analyses of nuclear gene sequences show no haplotype sharing between the new species and closely related species. The new species is distinguished from its congeners by a combination of the following morphological characters: (1) Standard length mean 37.7 mm in males (range 32.0-42.2; n=5) and 41.4 mm in females (range 34.9-48.2; n=6); (2) in life, dorsal coloration uniformly brown with a dark brown triangular marking between the eyes or some irregular light cream spots or patches on the head, back and flanks; (3) iris pale golden; (4) in preservative, dark brown venter with cream mottlings or moderate-sized blotches on the gular region, belly, cloacal region and tail; (5) tips of third finger and third toe protuberant and pointed with nearly complete webbing on the hands and feet; (6) 11-26 maxillary teeth and 8-24 vomerine teeth. Given that the syntypes of B. altamazonica are lost, we designate a neotype for B. altamazonica from Allpahuayo Mishana National Reserve, Loreto department, Peru. Newly collected specimens from ~30 km NE from Moyobamba (type locality of B. peruviana) provide a better understanding of B. peruviana and enable us to show that it is the sister taxon of B. altamazonica. The new species is known from pre-montane forests in Cordillera Escalera Regional Conservation Area, Cordillera Azul National Park and Shucshuyacu, San Martin department, Peru at 485-1311 m elevation,  ~75 km SE from Moyobamba. Bolitoglossa awajun sp. n. is the fourth endemic species of salamander from Peru.


Assuntos
Urodelos , Animais , Teorema de Bayes , Feminino , Masculino , Peru , Filogenia
3.
Zootaxa ; 4858(4): zootaxa.4858.4.5, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33056214

RESUMO

We describe two new sympatric species of Stenocercus from the seasonally dry forest of the inter-Andean valley of the Mantaro River (Huancavelica department) in the Central Andes of central-southern Peru, at elevations of 1,693 to 2,920 m asl. Stenocercus diploauris sp. nov. is similar to S. formosus and S. ochoai, but differs in having a longitudinal neck fold and C-shaped nuchal mite pocket around the oblique fold and posteriorly limited by the antehumeral fold. Stenocercus nigrobarbatus sp. nov. is similar to S. frittsi and S. variabilis, however it can be distinguished by having a postfemoral mite pocket with one or more vertical folds or ridges and by the presence, in adult males, of a continuous black patch covering the infralabials, throat, chest, ventral surfaces of forelimbs, belly (as a midventral line), ventral surfaces of hind limbs, and pelvic region.


Assuntos
Lagartos , Animais , Florestas , Masculino , Peru , Simpatria
4.
Zootaxa ; 4853(3): zootaxa.4853.3.4, 2020 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-33056367

RESUMO

We describe a new harlequin frog (genus Atelopus) from the cloud forest near Anchihuay (Anco District, Ayacucho Department) from 2000 to 2150 m elevation in southern Peru, representing the first record for the genus in the Department of Ayacucho. The new species has a maximum snout-vent length of 21.5 mm in females and 21.6 mm in males, and resembles A. erythropus in general appearance, small size, and dorsal coloration. The new species can be distinguished from A. erythropus by its unique pattern of ventral coloration, dorsal skin texture, and snout shape. We detected the presence of the pathogenic fungus Batrachochytrium dendrobatidis in individuals of the new species. This pathogen is threatening the survival of harlequin frogs throughout the Neotropics. In addition to chytridiomycosis, habitat loss further threatens the single locality where the new species is known to occur.


Assuntos
Anuros , Bufonidae , Animais , Ecossistema , Feminino , Florestas , Masculino , Peru
5.
Zootaxa ; 4853(3): zootaxa.4853.3.6, 2020 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-33056369

RESUMO

Ciocalypta includes species with finger-shaped fistules emerging from a basal mass and skeleton composed by a central axis and secondary tracts supporting the ectosome. Although worldwide distributed, no species of this genus has been reported from the Eastern Pacific. In this study, a new Ciocalypta is described from shallow waters of the southern coast of Peru. Ciocalypta magnastyla sp. nov. is greenish white, possesses the typical fistules with oscula located at their tips, and it is characterized by the presence of large styles (370-1000/5.0-32.5 µm) in combination with oxeas of intermediate size (160-500/5.0-12.5 µm). This new species constitutes the first record of the genus for the Peruvian coast as well as for the entire Eastern Pacific.


Assuntos
Poríferos , Animais , Peru
6.
Zootaxa ; 4766(4): zootaxa.4766.4.2, 2020 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-33056581

RESUMO

While the Ophiuroidea of Peruvian waters have long been studied, there exists inconsistencies regarding taxonomy and spatial distribution records. Based on literature review and museum records, we provide an updated checklist of the ophiuroids accompanied by the first geographical distribution analysis. Peruvian waters host 36 species of Ophiuroidea (three doubtful), yet 15 previous records of species are considered invalid for the area. We recorded five new records of species for Peru: Amphiodia oerstedi, Diopederma daniana, Ophiocomella alexandri, Ophiolepis crassa, and Ophiophthalmus normani. Peruvian maritime area is divided into four areas: The Tropical Eastern Pacific area where 16 species of ophiuroids occur, the Transition Zone with 13 species, the Warm Temperate Southeastern Pacific with nine species, and the Deep Zone with 14 species. We found significant differences in species composition among areas (except among the Eastern Pacific and the Transitional Zone), and each of them is represented by particular species. According to the rarefaction curve, the inventory of ophiuroids for the country is not yet complete; therefore, we suggest performing more expeditions along the Peruvian waters focusing mainly on the deep zones which remain relatively unexplored to date.


Assuntos
Equinodermos , Animais , Peru
7.
Medwave ; 20(8): e8031, 2020 Sep 25.
Artigo em Espanhol | MEDLINE | ID: mdl-33017383

RESUMO

Objective: To compare excess mortality by district quintiles according to the Human Development Index (HDI) in Metropolitan Lima, the capital of Peru, and analyze the socioeconomic factors associated with excess mortality within the context of COVID-19. Methods: Retrospective cross-sectional analysis of the mortality records from non-violent causes registered in the National Death Information System in the 50 districts of Metropolitan Lima of the first 24 weeks of the years 2019 and 2020. Descriptive analysis was performed using contingency tables and time series graphs by sex, age group, and quintile of the district of residence according to the HDI. Negative binomial regression analysis was performed to identify possible explanatory factors for excess mortality. Results: An excess of 20 093 non-violent deaths and 2,979 confirmed deaths from COVID-19 were registered in Metropolitan Lima during the study period. The increase was observed primarily in men and adults aged 60 and over. Residents in the districts belonging to the fifth quintile, according to HDI, presented, in most cases, the lowest rates. Multivariate analysis revealed that a higher HDI level (p = 0.009) and a higher proportion of inhabitants living in extreme poverty (p = 0.014) decreased the excess mortality. Conclusion: Excess of non-violent deaths in Metropolitan Lima is higher in the quintiles with the lowest HDI, in men, and the age group from 60 to more years of age. The study of social and economic health determinants in Peru is crucial for the design of measures to be taken by the government against the COVID-19 pandemic.


Assuntos
Causas de Morte , Infecções por Coronavirus/epidemiologia , Mortalidade/tendências , Pneumonia Viral/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Criança , Pré-Escolar , Infecções por Coronavirus/mortalidade , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Pandemias , Peru/epidemiologia , Pneumonia Viral/mortalidade , Pobreza , Estudos Retrospectivos , Distribuição por Sexo , Fatores Socioeconômicos , Adulto Jovem
8.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1931-1935, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018380

RESUMO

Anemia is a disease present worldwide. High prevalence of anemia (43%) is found in the child population and its main long-term effect (slow cognitive development) can remain even if the disease has disappeared. One of the main reasons for the high prevalence of anemia in Peru is the poor screening coverage during the growth of the child due to the parents' fear of infringing pain on their children. We take advantage that anemia produces pallor in the hands, fingers and ungueal bed to develop a semaphore for this disease. This screening tool uses photographic images of the patient's ungueal bed to determine if they have a high, medium or low possibility of having anemia. Sixty people participated in the study and 6 photographic images for each participant's right hand were captured. The images were processed to extract regions of interest from each of the fingernails. Datasets were generated and a neural network was used to predict the risk of anemia. Initial results show that the proposed semaphore of anemia reaches a sensitivity of 0.79 and specificity of 0.91. These results indicate that the semaphore of anemia may be used as a screening method to reduce the number of blood tests and the time of evaluation from 15 minutes (rapid test with portable hemoglobinometer) to 1 minute.


Assuntos
Anemia , Programas de Rastreamento , Anemia/diagnóstico , Criança , Humanos , Peru , Pesquisa , Sensibilidade e Especificidade
9.
Zootaxa ; 4820(2): zootaxa.4820.2.6, 2020 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-33056070

RESUMO

Mastiglanis is a genus of heptapterid catfish represented by two valid species. These freshwater species are widely distributed along the Amazon, Orinoco, and Maroni River basins. However, a taxonomic review of specimens collected in the Putumayo and Nanay rivers, Amazon River basin in Peru revealed a new species of Mastiglanis. A morphological analysis was completed for morphometric (36 measurements) and meristic (20 counts) data. Osteological counts and descriptions were made from clear and stained specimens and x-rays images. The new species of Mastiglanis differs from M. asopos and M. durantoni by having a long pelvic fin, short snout, eight branched anal-fin rays, and a higher number of vertebrae and gill rakers. The distribution of the new species is restricted to the upper Amazon River basin.


Assuntos
Peixes-Gato , Animais , Brânquias , Peru , Rios
10.
Zootaxa ; 4801(1): zootaxa.4801.1.11, 2020 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-33056680

RESUMO

A new genus of Deltocephalini Pascoia Duan gen. n. with P. rakitovi Duan sp. n. as type species is described and illustrated from the Andes Mountains in Peru.


Assuntos
Hemípteros , Animais , Peru
11.
Zootaxa ; 4778(3): zootaxa.4778.3.5, 2020 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-33055812

RESUMO

Currently 26 sponge species are known for the Peruvian coast, but so far no raspailiids had been recorded from this region. Raspailiidae are distributed worldwide and its species are characterized by encrusting, massive, lobate, fan-shaped or branching growth forms, usually with a very hispid surface. In the present study, three new species of Raspailiidae are described from the Peruvian coast. Two new Eurypon spp. were collected at Islas Lobos de Afuera (Lambayeque). Eurypon lacertus sp. nov. is a thinly encrusting orange sponge with choanosomal skeleton composed of large tylostyles and small acanthostyles, and ectosomal skeleton with anisoxeas. Eurypon hookeri sp. nov. is a crustose, ruby red sponge, with choanosomal skeleton composed of large (subtylo)styles and acanthostyles, and ectosomal skeleton pierced by acanthostyles and (subtylo)styles, often surrounded by bouquets of smaller styles. The third new species, Plocamione matarani sp. nov., was collected at Matarani (Arequipa). It is a thinly encrusting orange sponge, the only Plocamione with two categories of choanosomal styles, and a single category of ectosomal styles, acanthostyles and anisoacanthostrongyles. These are the first records of Eurypon and Plocamione for the Peruvian coast, and the entire Southeastern Pacific, in the case of the latter.


Assuntos
Poríferos , Animais , Peru
12.
Zootaxa ; 4829(1): zootaxa.4829.1.1, 2020 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-33056261

RESUMO

Tentative studies of Malaise trap samples from different geographic regions and habitats indicate unanimously that Winnertzia, a genus of mycophagous gall midges (Cecidomyiidae), is exceptionally speciose, but hard data in proof of that were previously unavailable. A taxonomic inventory of mycophagous cecidomyiids in Sweden has now revealed that, of 751 species found in total, 93 are Winnertzia. A preliminary census in 2013 had identified only 26 different Winnertzia in Sweden. Two factors are responsible for this increment: the inclusion of large amounts of fresh material to study and the application of a narrower species concept. The latter results from the reevaluation of male morphological characters in the light of COI sequence (DNA barcoding) data. With the inclusion of 37 new Winnertzia described here, the genus now contains 136 extant species. New Winnertzia discovered in Sweden are described here under the following names: W. acutistylus sp. nov., W. angustistylus sp. nov., W. arctostylus sp. nov., W. bicolor sp. nov., W. brachytarsus sp. nov., W. dentata sp. nov., W. egregia sp. nov., W. ekdalensis sp. nov., W. fraxinophila sp. nov., W. grytsjoenensis sp. nov., W. hamatula sp. nov., W. hemisphaerica sp. nov., W. imbecilla sp. nov., W. incisa sp. nov., W. inornata sp. nov., W. lapponica sp. nov., W. lobata sp. nov., W. longicoxa sp. nov., W. normalis sp. nov., W. oelandica sp. nov., W. ombergensis sp. nov., W. parvidens sp. nov., W. pilosistylus sp. nov., W. pratensis sp. nov., W. pustulatula sp. nov., W. quercinophila sp. nov., W. rickebasta sp. nov., W. ruliki sp. nov., W. serri sp. nov., W. setosa sp. nov., W. silvestris sp. nov., W. smalandensis sp. nov., W. sundini sp. nov., W. tumidoides sp. nov., and W. upplandensis sp. nov. Additionally, W. panguana sp. nov. is the first Winnertzia described from the Neotropical region (Peru), and W. warraensis sp. nov. is the first member of the genus described from the Australasian region (Tasmania). Parwinnertzia Felt, 1920 syn. nov. is revealed to be a junior synonym of Winnertzia Rondani, 1860, implying the recombinations of Winnertzia notmani (Felt) comb. nov. and Winnertzia italiana (Mamaev Zaitzev) comb. nov. The intrageneric classification of Winnertzia is reviewed and developed further, with the W. setosa group introduced for species whose gonostylar claw is conspicuously long and exposed, and whose gonocoxal emargination is bordered by dense, large setae. Winnertzia feralis Mamaev, revived here from synonymy with W. tridens Panelius, and W. fusca Kieffer are new faunistic records in Sweden. Swedish records published in the past of W. brachypalpa Mamaev and W. pravdini Mamaeva Mamaev rest on misidentifications, and both species are deleted from the Swedish checklist.


Assuntos
Biodiversidade , Dípteros , Distribuição Animal , Estruturas Animais , Animais , Austrália , Tamanho Corporal , Masculino , Tamanho do Órgão , Peru , Suécia
13.
Zootaxa ; 4852(2): zootaxa.4852.2.1, 2020 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-33056421

RESUMO

We describe four new species of the diving beetle genus Liodessus Guignot from the high Andean regions of Peru: Liodessus alpinus sp. nov. from Junín, L. hauthi sp. nov. from Huánuco and Churubamba, L. rhigos sp. nov. from Junín, and L. thespesios sp. nov. from Cusco. We delineate the species using morphological structures and provide a 5' mitochondrial cytochrome c oxidase 1 database on the Barcode of Life Data System (BOLD). We also provide taxonomic notes on Liodessus acollensis Guignot, 1955 and L. andinus Guignot, 1957, described from the high Andes of Peru and Bolivia. These species occur at higher altitudes above 3,400 m and up to 4,900 m, and were collected in shallow, exposed peatland pools and puddles, mostly in steppes and high Andean Puna. The known distribution and habitat preferences of each species are outlined briefly.


Assuntos
Besouros , Animais , Bases de Dados Factuais , Ecossistema , Peru
14.
Zootaxa ; 4785(1): zootaxa.4785.1.1, 2020 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-33056506

RESUMO

The known cicada fauna of Peru is identified. Fidicinoides ptychodiropeda n. sp., Guyalna capnopteryx n. sp., G. chrysinothrix n. sp., G. dyticamazona n. sp., G. spilonotophora n. sp., Carineta acommosis n. sp., C. bitorquata n. sp., C. castaneopercula n. sp., C. dicrophryxothrix n. sp., C. digitata n. sp., C. nigrafissura n. sp., C. quadrofastigiata n. sp., C. rumipataensis n. sp., C. tingomariaensis n. sp., C. tricuspis n. sp., Herrera castanetorquata n. sp., H. cephalodigramma n. sp., H. chanchamayoensis n. sp., H. dentata n. sp., H. moyabambaensis n. sp., H. nigropercula n. sp., H. polygramma n. sp., H. quadrimacula n. sp., and H. viriventralis n. sp. are described as new. Three taxa, Cicada (Prunasis) pulcherrima var. a Stål, 1862a, C. (P.) pulcherrima var. b Stål, 1862a, and C. (P.) pulcherrima var. c Stål, 1862a are shown to be unavailable as well as junior synonyms of Prunasis pulcherrima (Stål, 1854) which is shown to be the correct name for the taxon over the preoccupied Cicada viridula Walker, 1850. The first records of Durangona tigrina Distant, 1911, Fidicina obscura Boulard Martinelli, 1996, F. robini Boulard Martinelli, 1996, Fidicinoides descampsi Boulard Martinelli, 1996, F. determinata (Walker, 1858a), F. duckensis Boulard Martinelli, 1996, F. pseudethelae Boulard Martinelli, 1996, Proarna bergi (Distant, 1892a), P. dactyliophora Berg, 1879, P. strigicollis Jacobi, 1907, Guyalna aurora Ruschel, 2017, G. bicolor (Olivier, 1790), G. chlorogena (Walker, 1850), G. distanti (Goding, 1925), G. glauca (Goding, 1925), Majeorona aper (Walker, 1850), M. ecuatoriana Goding, 1925, M. truncata Goding, 1925, Orialella aerizulae Boulard, 1986b, Calyria cuna (Walker, 1850), Prunasis pulcherrima (Stål, 1854), Taphura boulardi Sanborn, 2011a, Carineta boulardi Champanhet, 1999, Carineta cearana Distant, 1906b, C. congrua Walker, 1858b, C. dolosa Boulard, 1986a, C. doxiptera Walker, 1858a, C. ecuatoriana Goding, 1925, C. gemella Boulard, 1986a, C. hamata Sanborn, 2019b, C. matura Distant, 1892b, C. pilifera Walker, 1858a, C. pilosa Walker, 1850, C. ventrilloni Boulard, 1986a, Herrera concolor Sanborn, 2019b, H. melanomesocranon Sanborn, 2019b, and H. phyllodes Sanborn, 2019b are provided. The records for Durangona tigrina Distant, 1911 are the first records of the genus Durangona Distant, 1911 and tribe Durangonini Moulds and Marshall, 2018 and the records for Prunasis pulcherrima (Stål, 1854) are the first for the genus Prunasis Stål, 1862a in Peru. Previous records of Zammara tympanum (Fabricius, 1803), Orialella boliviana (Distant, 1904b), Guyalna brisa (Walker, 1850) and Selymbria stigmatica (Germar, 1834) are considered to be misidentifications of Z. hertha Schmidt, 1919, O. aerizulae, G. dyticamazona n. sp. and S. madredediosensis Sanborn, 2019b, respectively, so that Z. tympanum, O. boliviana, G. brisa and S. stigmatica are removed from the cicada fauna of Peru. The Peruvian records of Dorisiana semilata (Walker, 1850) are shown to be due to an incorrect synonymy of D. metcalfi Sanborn Heath, 2014 and the species is removed from the faunal list as well. Additional new records of Fidicinoides poulaini Boulard Martinelli, 1996 are provided for Brazil and Guyalna chlorogena (Walker, 1850) for French Guiana to expand the known distribution of these species. The currently known Peruvian cicada fauna is comprised of 114 described species from 23 genera, eight tribes and three subfamilies with a 115% increase in the known cicada fauna provided here.


Assuntos
Hemípteros , Animais , Peru
15.
J Contemp Dent Pract ; 21(7): 733-740, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-33020355

RESUMO

AIM: Phytomedicine has been commonly practiced as a form of traditional medicine in various cultures for the treatment of oral diseases. Recently, it has gained importance as an alternative to conventional treatment. Several extracts of plants and fruits have been recently evaluated for their potential activity against microorganisms involved in the development of dental caries. The purpose of this study was to evaluate the antimicrobial activity and antiadherent effect of the crude organic extract (COE) and three partitions (aqueous, butanolic, and chloroformic) of Psidium guajava (guava) leaves on a cariogenic biofilm model. MATERIALS AND METHODS: Guava leaves were obtained from the mountains of northern Peru, where they grow wild and free of pesticides. The antimicrobial activity of the COEs and partitions against Streptococcus mutans and Streptococcus gordonii was determined by measuring the inhibition halos, while the effect on biofilm adhesion was determined by measuring the optical density using spectrophotometry. RESULTS: An antibacterial effect of the COE and chloroformic partition against S. gordonii (p < 0.05) was found, as was a significant effect on biofilm adherence, with a minimum inhibitory concentration (MIC) of 0.78 mg/mL, which was maintained throughout the 7 days of evaluation. CONCLUSION: We conclude that the COEs and their chloroformic partition have antimicrobial and antibiotic effects against this strain of S. gordonii, making them of particular interest for evaluation as a promising alternative for the prevention of dental caries. CLINICAL SIGNIFICANCE: By knowing the antimicrobial effect of Psidium guajava, this substance can be effectively used in products aimed to prevent dental caries and periodontal disease.


Assuntos
Anti-Infecciosos/farmacologia , Cárie Dentária/tratamento farmacológico , Psidium , Biofilmes , Humanos , Peru , Folhas de Planta
16.
Lima; Instituto Nacional de Salud; sept. 2020.
Não convencional em Espanhol | BRISA/RedTESA | ID: biblio-1122251

RESUMO

INTRODUCCIÓN: Este documento técnico se realiza a solicitud de la Dirección de Prevención y Control de Enfermedades No Transmisibles, Raras y Huérfanas del Ministerio de Salud; la cual motivó la realización de la pregunta PICO por parte de médicos y especialistas de la siguiente manera, P: pacientes con diagnóstico de diabetes mellitus tipo 1 (DM1); I: análogos de insulina humana; C: insulina humana; O: control glucémico, calidad de vida y eventos adversos. A. Cuadro clínico La DM1 es una forma de enfermedad autoinmune que ocasiona la destrucción de las células que producen insulina. En el Perú, para el 2018, los casos de DM1 representaron el 2,7% del total de casos de diabetes. El uso de insulina representa el pilar de tratamiento farmacológico de las personas con DM1, permitiendo alcanzar un adecuado control glicémico y disminuir las complicaciones macro y microvasculares. En la actualidad, además de la insulina humana recombinante, existen en el mercado nuevas formulaciones denominados análogos de insulina humana, desarrollados con el propósito de imitar de forma más precisa el comportamiento de la insulina fisiológica. B. Tecnología sanitaria Los análogos de insulina son un tipo de insulinas cuyas moléculas han sido modificadas en la secuencia de aminoácidos. Existen tres tipos principales: de acción rápida (aspart, lispro, glulisina), de acción prolongada (glargina, detemir, degludec) y las formulaciones de análogos de insulina premezclados. Los análogos de insulina permiten emular más estrechamente la fisiología normal de la insulina y seleccionar diferentes regímenes según las preferencias y estilo de vida del paciente. Sin embargo, su precio es significativamente más alto que la insulina humana. En Perú, los análogos de insulina humana cuentan con un total de doce registros sanitarios vigentes. OBJETIVO: Describir la evidencia científica disponible sobre la eficacia y seguridad del uso de análogos de insulina humana para el control glicémico de pacientes con diabetes tipo 1. METODOLOGÍA: Se realizó una búsqueda en Medline, Cochrane Database of Systematic Reviews, CENTRAL, EMBASE y LILACS hasta el 01 de setiembre de 2020, complementada con la búsqueda de evidencia en páginas institucionales de agencias gubernamentales y buscadores genéricos. La calidad de la evidencia se valoró usando: AMSTAR 2 para RS y AGREE II para valorar el rigor metodológico de las GPC. RESULTADOS: Se identificó cinco revisiones sistemáticas, siete guías de práctica clínica y cinco evaluaciones de tecnología sanitaria. CONCLUSIONES: En adultos con DM1, los análogos de insulina de acción rápida redujeron en promedio la glucosa postprandial en 19 mg/dL, la hemoglobina glicosilada en 0,13% y el riesgo de hipoglicemia general, nocturna y severa (en 7%, 45% y 32%, respectivamente) comparado con insulina humana. En población pediátrica, no se observó una reducción en los niveles de hemoglobina glicosilada, ni en el riesgo de episodios de hipoglicemia. En ambas poblaciones, el impacto sobre la calidad de vida fue inconsistente. En adultos con DM1, los análogos de insulina de acción lenta redujeron en promedio la hemoglobina glicosilada en 0,17% y el riesgo de hipoglicemia general y nocturna (en 7% y 32%, respectivamente), sin diferencias en el riesgo de hipoglicemia severa. El impacto sobre la calidad de vida fue inconsistente. Las seis GPC incluyen en sus recomendaciones el uso de análogos de insulina e insulina humana para pacientes pediátricos o adultos con DM1. En tres de ellas, se recomienda preferentemente usar análogos de insulina, mientras en otras tres no se establece algún tipo de preferencia entre el uso de ambas formulaciones. Cinco informes de ETS, procedentes de agencias de Canadá, España y Perú, coinciden en no recomendar el uso de análogos de insulina debido a insuficiente evidencia sobre su beneficio clínico y aspectos relacionados con su costo-efectividad. Dos RS fueron consideradas como nivel de confianza críticamente bajo, mientras que tres RS fueron consideradas como nivel de confianza alto. Las GPC incluidas obtuvieron un puntaje global promedio en la evaluación de calidad que varió entre 69,4% y 80,4%.


Assuntos
Humanos , Diabetes Mellitus Tipo 1/prevenção & controle , Insulina Regular Humana/análogos & derivados , Peru , Avaliação da Tecnologia Biomédica , Análise Custo-Benefício
17.
BMC Infect Dis ; 20(1): 686, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32948149

RESUMO

BACKGROUND: There is limited research to guide TB treatment specifically in pregnant women and few studies have described the presentation of TB in pregnant women. We aimed to understand TB presentation and treatment outcomes in pregnant women in a low HIV burden setting. We describe a cohort of women of childbearing age treated for TB disease in Lima, Peru, and compare clinical presentation and treatment outcomes among pregnant and non-pregnant women between 2009 and 2012, including 36 pregnant women. METHODS: This is a prospective cohort study. Subjects were recruited from across 106 public health centers in Lima, Peru. Baseline demographic, medical history, and drug-susceptibility test results were collected. We used descriptive statistics to describe demographic and clinical characteristics of the women using Pearson chi-squared, Fisher's exact tests, or Kruskal-Wallis. RESULTS: Among 4500 individuals with pulmonary TB disease, 1334 women were included in analysis with 36 (2.69%) pregnant women. Pregnant women had similar demographics, past medical histories, and clinical presentation to non-pregnant women, except being more likely to be married (p = 0.01) and have cardiac disease (p = 0.04) and less likely to have weight loss (p = 0.05). Twenty (71.4%) pregnant women had pan-susceptible TB compared with 616 (63.1%) non-pregnant women; four (14.3%) pregnant women had mono-resistant TB compared with 154 (15.8%) non-pregnant women; and four (14.3%) pregnant women had multi-drug-resistant TB compared with 140 (14.3%) of non-pregnant women (p = 0.53). Twenty-eight (96.6%) pregnant women had a successful outcome (cure, completed treatment, treatment ended early by clinical team) while one (3.4%) had an unsuccessful outcome (treatment failed) and 1074 (97.3%) non-pregnant women had a successful outcome while 30 (2.7%) had an unsuccessful outcome (p = 0.56). CONCLUSION: In this cohort with low HIV co-infection, we found high TB treatment success rates in both pregnant and non-pregnant women, irrespective of drug-susceptibility profiles. If treated appropriately, pregnant women with TB disease can have successful outcomes.


Assuntos
Complicações Infecciosas na Gravidez/tratamento farmacológico , Tuberculose/tratamento farmacológico , Adolescente , Adulto , Antituberculosos/uso terapêutico , Coinfecção/tratamento farmacológico , Feminino , Infecções por HIV , Humanos , Pessoa de Meia-Idade , Peru , Gravidez , Estudos Prospectivos , Resultado do Tratamento , Tuberculose Pulmonar/tratamento farmacológico , Adulto Jovem
18.
Rev Panam Salud Publica ; 44, sept. 2020
Artigo em Espanhol | PAHO-IRIS | ID: phr-52326

RESUMO

[RESUMEN]. Objetivo. Detectar la presencia del gen ermB asociado a la resistencia a macrólidos en cepas de Campylobacter spp. aisladas de pollos comercializados en Lima, Perú. Métodos. Se analizaron 120 muestras de piel de pollo provenientes de tres mercados de los distritos de San Martín de Porres (n = 30), Santa Anita (n = 20) e Independencia (n = 70), ubicados en la Provincia de Lima, Perú. Se realizó el análisis microbiológico de las muestras según las recomendaciones de la norma ISO 10272-1:2017. Para la confirmación por reacción en cadena de la polimerasa (PCR, por sus siglas en inglés) de género y especie, se utilizaron los cebadores (primers) 16-rARN y GlyA e hipO, respectivamente. Para evaluar la sensibilidad antibiótica, se utilizó el agar Müller-Hinton sangre al 5% con sensidiscos de azitromicina (15 μg) y eritromicina (15 μg). La detección del gen ermB en cepas con fenotipos resistentes se realizó mediante PCR convencional. Resultados. Se obtuvo un total de 117 muestras positivas (97,5%), de las cuales 100% fueron compatibles con Campylobacter coli (prueba de hipurato negativa) y confirmadas por PCR. La evaluación de resistencia antibiótica en placa para azitromicina y eritromicina dio como resultado 100% de cepas con fenotipo de resistencia a estos macrólidos, mientras que la PCR para la detección del gen ermB indicó un total de 62 positivas (53%), que fueron confirmadas por secuenciamiento. Conclusiones. Estos resultados demuestran que las carcasas de pollo comercializadas en mercados de Lima presentan contaminación por C. coli con una alta resistencia a macrólidos, lo cual puede ser atribuido a la presencia del gen ermB.


[ABSTRACT]. Objective. To detect the presence of the ermB gene associated with macrolide resistance in Campylobacter spp. strains isolated from chickens marketed in Lima, Peru. Methods. 120 samples of chicken skin from three markets in the districts of San Martin de Porres (n = 30), Santa Anita (n = 20), and Independencia (n = 70), located in the Province of Lima, Peru, were analyzed. Microbiological analysis of the samples was carried out according to ISO standard 10272-1:2017. For the polymerase chain reaction (PCR) confirmation of genus and species, 16-rRNA and GlyA and hipO primers, respectively, were used. For the evaluation of antibiotic sensitivity, the Müller-Hinton agar with 5% blood, with sensi-discs for azithromycin (15 μg) and erythromycin (15 μg), was used. For detection of the ermB gene in strains with resistant phenotypes, conventional PCR was used. Results. A total of 117 positive samples (97.5%) were obtained; of these, 100% were compatible with Campylobacter coli (negative hippurate test) and confirmed by PCR. The plate-based assessment of antibiotic resistance to azithromycin and erythromycin resulted in 100% of strains with a phenotype that is resistant to these macrolides, while the PCR to detect the ermB gene indicated a total of 62 positives (53%), which were confirmed through sequencing. Conclusions. These results demonstrate that the chicken carcasses sold in markets in Lima present contamination by C. coli with high resistance to macrolides, which can be attributed to the presence of the ermB gene.


[RESUMO]. Objetivo. Detectar a presença do gene ermB associado à resistência a macrolídeos em cepas de Campylobacter spp. isoladas de frangos comercializados em Lima, no Peru. Métodos. Analisamos 120 amostras de pele de frango provenientes de três mercados nos distritos de San Martín de Porres (n=30), Santa Anita (n=20) e Independencia (n=70), situados na Província de Lima, no Peru. Realizamos uma análise microbiológica das amostras de acordo com as recomendações da norma ISO 10272-1:2017. Para a confirmação do gênero e espécie por reação em cadeia da polimerase (PCR), utilizamos os primers 16-rRNA, GlyA e hypO. Para avaliar a sensibilidade antimicrobiana, utilizamos ágar de Müller-Hinton-sangue a 5% com discos de sensibilidade de azitromicina (15 μg) e eritromicina (15 μg). A detecção do gene ermB em cepas com fenótipos resistentes foi feita por PCR convencional. Resultados. Obtivemos um total de 117 amostras positivas (97,5%), das quais 100% foram compatíveis com Campylobacter coli (teste do hipurato negativo) e confirmadas por PCR. Na avaliação da resistência antimicrobiana em placa para azitromicina e eritromicina, 100% das cepas apresentaram fenótipo de resistência a estes macrolídeos, enquanto a PCR para a detecção do gene ermB indicou um total de 62 cepas positivas (53%), que foram confirmadas por sequenciamento. Conclusões. Estes resultados demonstram que as carcaças de frango comercializadas nos mercados de Lima apresentam contaminação por C. coli com alta resistência a macrolídeos, o que pode ser atribuído à presença do gene ermB.


Assuntos
Campylobacter , Macrolídeos , Galinhas , Resistência Microbiana a Medicamentos , Peru , Galinhas , Resistência Microbiana a Medicamentos , Macrolídeos , Peru , Galinhas , Macrolídeos , Resistência Microbiana a Medicamentos
19.
Rev Panam Salud Publica ; 44, sept. 2020
Artigo em Espanhol | PAHO-IRIS | ID: phr-52264

RESUMO

[RESUMEN]. Objetivo. Describir las características clínico-epidemiológicas y el perfil de resistencia de los casos de tuberculosis extensivamente resistente (TB-XDR) diagnosticados en Perú entre los años 2013 y 2015. Métodos. Estudio descriptivo que incluyó a los pacientes que cumplían con la definición de TB-XDR y que fueron notificados al sistema nacional de vigilancia epidemiológica del Ministerio de Salud del Perú. Se realizó un análisis descriptivo y se elaboró un mapa de calor basado en la estimación de densidad Kernel para identificar la distribución espacial. Resultados. Se estimó que los casos de TB-XDR diagnosticados como nuevos representaron 7,3% del total de casos de tuberculosis multidrogorresistente (TB-MDR) reportados para el período de estudio, 74% de los casos tenían entre 15 y 44 años y la relación hombre/mujer fue de 1,7. La mitad de los departamentos reportó al menos un caso de TB-XDR, con 42% de casos nuevos sin ningún antecedente de resistencia ni tratamiento previo. En la otra mitad de los departamentos, la mayoría tenían resistencia previa tipo MDR y de tipo pre-XDR. El 57,7% de los casos presentaron resistencia a 5 y 7 drogas y 41,6% presentaba resistencia a 8 y 10 drogas de primera y segunda línea. Conclusiones. Este estudio ofrece detalles importantes del perfil epidemiológico de la TB-XDR en el Perú, donde se muestra un incremento de los casos de TB-XDR primario; es decir, casos sin antecedentes de enfermedad previa. Además, esta forma de tuberculosis se ha extendido a un mayor número de departamentos del país.


[ABSTRACT]. Objective. Describe the clinical and epidemiological characteristics and resistance profile of cases of extensively drug-resistant tuberculosis (XDR-TB) diagnosed in Peru from 2013 to 2015. Methods. This descriptive study included patients who met the definition of XDR-TB and were reported to the national epidemiological surveillance system of Peru’s Ministry of Health. It used a descriptive analysis and, to identify spatial distribution, a heat map based on kernel density estimation. Results. It was estimated that XDR-TB cases diagnosed as new represented 7.3% of all multidrug-resistant tuberculosis (MDR-TB) cases reported during the study period; 74% of patients were aged 15 to 44 years old; and the male-female ratio was 1.7. Half of the country’s departments reported at least one case of XDR-TB, and 42% of new cases had no history of resistance or previous treatment. In the other half of the departments, the majority had previous MDR and pre-XDR resistance. Among the cases, 57.7% presented resistance to 5 and 7 first- and second-line drugs and 41.6% presented resistance to 8 and 10 drugs. Conclusions. This study offers important details of the epidemiological profile of XDR-TB in Peru, where there has been an increase in cases of primary XDR-TB; that is, cases with no prior history of disease. Furthermore, this form of tuberculosis has spread to a greater number of departments in the country.


[RESUMO]. Objetivo. Descrever as características clínico-epidemiológicas e o perfil de resistência dos casos de tuberculose extremamente resistente (TB-XDR) diagnosticados no Peru entre 2013 e 2015. Métodos. Estudo descritivo que incluiu pacientes que cumpriam a definição de TB-XDR e foram notificados ao sistema nacional de vigilância epidemiológica do Ministério da Saúde do Peru. Foi realizada uma análise descritiva e elaborado um mapa de calor (heat map) com base na estimativa de densidade de Kernel para identificar a distribuição espacial. Resultados. Estimou-se que os casos de TB-XDR diagnosticados como novos representaram 7,3% do número total de casos de tuberculose multidrogarresistente (TB-MDR) notificados no período do estudo, 74% dos casos tiveram entre 15 e 44 anos de idade, e a relação homem/mulher foi de 1,7. A metade dos departamentos notificou pelo menos um caso de TB-XDR, e 42% dos casos novos não tinham histórico de resistência ou tratamento prévio. Na outra metade dos departamentos, a maioria tinha resistência prévia do tipo MDR e pré-XDR. Ao todo, 57,7% dos casos apresentaram resistência a 5 e 7 medicamentos e 41,6% apresentaram resistência a 8 e 10 medicamentos de primeira e segunda linha. Conclusões. Este estudo apresenta detalhes importantes do perfil epidemiológico da TB-XDR no Peru, onde se observa um aumento no número de casos de TB-XDR primária, isto é, casos sem histórico de doença anterior. Além disso, esta forma de TB estendeu-se a um maior número de departamentos do país.


Assuntos
Tuberculose Extensivamente Resistente a Medicamentos , Farmacorresistência Bacteriana Múltipla , Monitoramento Epidemiológico , Peru , Tuberculose Extensivamente Resistente a Medicamentos , Farmacorresistência Bacteriana Múltipla , Monitoramento Epidemiológico , Peru , Tuberculose Extensivamente Resistente a Medicamentos , Farmacorresistência Bacteriana Múltipla , Monitoramento Epidemiológico
20.
Rev Assoc Med Bras (1992) ; 66(8): 1139-1145, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32935811

RESUMO

OBJECTIVE: To analyze the scientific evidence on the disclosure of the diagnostic of adolescents infected by HIV/AIDS in the South American context. DATABASE: Systematic literature review using the PubMed, Cinahal, Embase, Cochrane, BVS, and Global Health databases and the descriptors: adolescent and HIV and family and Argentina or Bolivia or Brasil or Chile or Colombia or Ecuador or French Guiana or Paraguay or Peru or Uruguay or Venezuela. DATA SYNTHESIS: Brasil was the country highlighted. It was verified that parents have a direct and indirect influence over the adolescents' life, especially regarding behaviors and health care. Dialog among family members can reduce adolescents' vulnerability to HIV and encourage diagnostic disclosure. CONCLUSION: It is necessary to amplify research involving adolescents with HIV/AIDS and their parents/caregivers and family members to improve care and reduce the cases of the disease. It is suggested that policies of prevention and treatment should involve families, caregivers, partners, and the community.


Assuntos
Revelação , Infecções por HIV , Adolescente , Argentina , Brasil , Chile , HIV , Humanos , Peru , Venezuela
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