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1.
J Asthma ; 53(10): 1018-25, 2016 12.
Artículo en Inglés | MEDLINE | ID: mdl-27437609

RESUMEN

OBJECTIVES: An increased asthma prevalence was found in cleaners. Many of them work in precarious employment conditions, potentially leading to stress, a known risk factor for asthma. We aimed to analyze whether asthma in cleaners might partly be explained by psychosocial working conditions. METHODS: The study population of this cross-sectional study included 199 cleaners employed at regional public health services in Puno Province (Peru). They were compared to 79 unexposed workers from Lima, Peru (response 83%). Both groups answered the short version of the European Working Condition Survey and a modified version of the European Community Respiratory Health screening questionnaire. After multiple imputation, the association between psychosocial working conditions and asthma (wheeze without cold or use of asthma medication) was assessed. RESULTS: The 12-months prevalence of asthma was 22% among cleaners versus 5% among unexposed workers (pChi(2) = .001). Cleaners were more likely than unexposed workers to work with temporary or sub-contracts, have a high employment insecurity, high strain working conditions and low social support (all pChi(2) < .05). Twenty-six percent vs. 10% reported a high bullying score; 39% vs. 8% had experienced violence at work (both pChi(2) < .001). High bullying score (adjusted Odds Ratio 5.6; 95% Confidence Interval 1.5-21.4) and violence (2.4; 1.1-5.4) were the main predictors of asthma. Taking these factors into account, being a cleaner was not statistically significantly associated with the outcome (3.5; 0.9-13.8). CONCLUSIONS: Poor psychosocial working conditions of cleaners may partly explain the high prevalence of asthma. The underlying mechanism might be a stress-induced inflammatory immune response.


Asunto(s)
Asma/epidemiología , Acoso Escolar , Servicio de Limpieza/estadística & datos numéricos , Violencia Laboral , Femenino , Humanos , Satisfacción en el Trabajo , Masculino , Oportunidad Relativa , Perú/epidemiología , Estrés Psicológico , Lugar de Trabajo , Adulto Joven
2.
J Appl Physiol (1985) ; 121(3): 709-15, 2016 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-27445300

RESUMEN

The developing human fetus is able to cope with the physiological reduction in oxygen supply occurring in utero. However, it is not known if microvascularization of the fetus is augmented when pregnancy occurs at high altitude. Fifty-three healthy term newborns in Puno, Peru (3,840 m) were compared with sea-level controls. Pre- and postductal arterial oxygen saturation (SpO2) was determined. Cerebral and calf muscle regional tissue oxygenation was measured using near infrared spectroscopy (NIRS). Skin microcirculation was noninvasively measured using incident dark field imaging. Pre- and postductal SpO2 in Peruvian babies was 88.1 and 88.4%, respectively, which was 10.4 and 9.7% lower than in newborns at sea level (P < 0.001). Cerebral and regional oxygen saturation was significantly lower in the Peruvian newborns (cerebral: 71.0 vs. 74.9%; regional: 68.5 vs. 76.0%, P < 0.001). Transcutaneously measured total vessel density in the Peruvian newborns was 14% higher than that in the newborns born at sea level (29.7 vs. 26.0 mm/mm(2); P ≤ 0.001). This study demonstrates that microvascular vessel density in neonates born to mothers living at high altitude is higher than that in neonates born at sea level.


Asunto(s)
Aclimatación/fisiología , Altitud , Recién Nacido/fisiología , Microcirculación/fisiología , Microvasos/anatomía & histología , Microvasos/fisiología , Embarazo/fisiología , Adulto , Femenino , Humanos , Masculino , Perú , Estudios Prospectivos , Adulto Joven
3.
Rev Peru Med Exp Salud Publica ; 28(2): 177-85, 2011 Jun.
Artículo en Español | MEDLINE | ID: mdl-21845296

RESUMEN

OBJECTIVES: To characterize the supply, demand and the gap of medical specialists in facilities of the Ministry of Health of Peru (MINSA) at the national, regional and specialty type levels. MATERIALS AND METHODS: Observational, descriptive study through which we calculated the supply of medical specialists using secondary sources of MINSA. The analysis of the demand for medical specialists was based on two methodologies: the need for specialists according to the guidelines of classification of the health facilities and according to the epidemiological and demographic profile. The arithmetic difference between the estimated demand and the supply was the procedure used to calculate the gap of medical specialists. RESULTS: The Ministry of Health has a total supply at the national level of 6,074 medical specialists of which 61.5% belong to the clinical specialties, 33.2% to the surgical specialties, 4.9% specialities related to aid to diagnosis and treatment and 0.4% to public health specialties. According to the categorization guideline there is a total demand of 11,176 medical specialists and according to the epidemiological and demographic profile of 11,738. The national estimated gaps found are similar in both methods, although they differ widely across regions and by type of specialty. At the regional level, the gaps are greater in Loreto, Piura, Puno and Madre de Dios when estimating the defficit in relation to the supply. Regarding the speciality, the gap is greater in the four basic specialties: gynecology and obstetrics, pediatrics, internal medicine and general surgery. CONCLUSIONS: There is a waid gap between supply and demand of medical specialists at the national and regional levels, as a whole representing approximately 45% of the current offer, regardless of the estimation method.


Asunto(s)
Instituciones de Salud , Fuerza Laboral en Salud , Médicos/provisión & distribución , Gobierno , Perú
4.
Rev. peru. med. exp. salud publica ; 28(2): 177-185, jun. 2011. ilus, graf, mapas, tab
Artículo en Español | LILACS, LIPECS | ID: lil-596554

RESUMEN

Objetivos. Caracterizar la oferta, la demanda y la brecha de médicos especialistas en establecimientos del Ministerio de Salud del Perú a nivel nacional, regional y por tipo de especialidad. Materiales y métodos. Estudio descriptivo, observacional a través del cual se calculó la oferta de médicos especialistas utilizando fuentes secundarias del MINSA. El análisis de la demanda de médicos especialistas se basó en dos metodologías: necesidades de especialistas según la norma de categorización de los establecimientos de salud y según el perfil epidemiológico y demográfico. La diferencia aritmética entre la demanda calculada y la oferta fue el procedimiento utilizado para calcular la brecha de médicos especialistas. Resultados. El MINSA, a nivel nacional, tiene una oferta total de 6074 médicos especialistas de los cuales el 61,5 por ciento pertenecen a las especialidades clínicas, 33,2 por ciento a especialidades quirúrgicas, 4,9 por ciento a especialidades de apoyo al diagnóstico y tratamiento y 0,4 por ciento a las especialidades de salud pública. Según la norma de categorización existe una demanda total de 11 176 médicos especialistas y según el perfil epidemiológico y demográfico, de 11 738. Las brechas estimadas a nivel nacional son similares en ambos métodos, aunque difieren ampliamente en las regiones y por tipo de especialidad. A nivel de región, las brechas son mayores en Loreto, Piura, Puno y Madre de Dios cuando se usa la valoración del déficit en forma relativa a la oferta. En cuanto a especialidad, la brecha es mayor en las cuatro especialidades básicas: ginecología-obstetricia, pediatría, medicina interna y cirugía general. Conclusiones. Existe una gran brecha entre la oferta y la demanda de médicos especialistas a nivel nacional y regional que, de forma agregada, representa aproximadamente el 45 por ciento de la oferta actual, independientemente del método de estimación empleado.


Objectives. To characterize the supply, demand and the gap of medical specialists in facilities of the Ministry of Health of Peru (MINSA) at the national, regional and specialty type levels. Materials and methods. Observational, descriptive study through which we calculated the supply of medical specialists using secondary sources of MINSA. The analysis of the demand for medical specialists was based on two methodologies: the need for specialists according to the guidelines of classification of the health facilities and according to the epidemiological and demographic profile. The arithmetic difference between the estimated demand and the supply was the procedure used to calculate the gap of medical specialists. Results. The Ministry of Health has a total supply at the national level of 6,074 medical specialists of which 61.5 percent belong to the clinical specialties, 33.2 percent to the surgical specialties, 4.9 percent specialities related to aid to diagnosis and treatment and 0.4 percent to public health specialties. According to the categorization guideline there is a total demand of 11,176 medical specialists and according to the epidemiological and demographic profile of 11,738. The national estimated gaps found are similar in both methods, although they differ widely across regions and by type of specialty. At the regional level, the gaps are greater in Loreto, Piura, Puno and Madre de Dios when estimating the defficit in relation to the supply. Regarding the speciality, the gap is greater in the four basic specialties: gynecology and obstetrics, pediatrics, internal medicine and general surgery. Conclusions. There is a waid gap between supply and demand of medical specialists at the national and regional levels, as a whole representing approximately 45 percent of the current offer, regardless of the estimation method.


Asunto(s)
Instituciones de Salud , Fuerza Laboral en Salud , Médicos/provisión & distribución , Gobierno , Perú
5.
Int J Immunogenet ; 36(3): 159-67, 2009 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-19490211

RESUMEN

Uros population from the Titikaka Lake live in about 42 floating reed ('totora') islands in front of Puno City (Peru) at a 4000 m high altiplano. They present both an mtDNA and a human leucocyte antigen (HLA) profile different from the surrounding populations: mtDNA A2 haplogroup is common to Uros and Amazon forest lowland Amerindians. HLA genetic distances between populations have been calculated and neighbour-joining dendrograms and correspondence analyses were carried out. Approximately 15 006 HLA chromosomes from worldwide populations have been used for comparisons. Only eight HLA-A alleles have been found, three of them accounting for most of the frequencies. The same phenomenon is seen for HLA-B, HLA-DRB1 and HLA-DQB1 alleles: a few alleles (3, 4 and 3, respectively) are present in most individuals. The presence of HLA-B*4801 and HLA-DRB1*0901 alleles in a relatively high frequency (although not the most frequent alleles found) is a characteristic shared with Asians and some populations from the Andean altiplano. Three specific Uros haplotypes have been found among the most frequent ones: HLA-A*680102-B*3505-DRB1*0403-DQB1*0302; HLA-A*2402-B*1504-DRB1*1402-DQB1*0301; and HLA-A*2402-B*4801-DRB1*0403-DQB1*0302. The present study suggests that Uros may have been one of the first populations from the shores of the Titikaka Lake coming from the Amazonian forest, which might have given rise to other later differentiated ethnic group (i.e. Aymaras). Uros HLA profile is also useful to study genetic epidemiology of diseases linked to HLA and to construct a future transplant waiting list by adding up regional lists in order to get a bigger pool for transplanting with better HLA matching.


Asunto(s)
Antígenos HLA/genética , Indios Sudamericanos/genética , Alelos , Frecuencia de los Genes , Variación Genética , Genotipo , Antígenos HLA-A/genética , Antígenos HLA-B/genética , Antígenos HLA-DQ/genética , Cadenas beta de HLA-DQ , Antígenos HLA-DR/genética , Cadenas HLA-DRB1 , Haplotipos/genética , Humanos , Perú
6.
Hum Biol ; 79(2): 159-78, 2007 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-18027812

RESUMEN

The initial peopling of South America is largely unresolved, in part because of the unique distribution of genetic diversity in native South Americans. On average, genetic diversity estimated within Andean populations is higher than that estimated within Amazonian populations. Yet there is less genetic differentiation estimated among Andean populations than estimated among Amazonian populations. One hypothesis is that this pattern is a product of independent migrations of genetically differentiated people into South America. A competing hypothesis is that there was a single migration followed by regional isolation. In this study we address these hypotheses using mtDNA hypervariable region 1 sequences representing 21 South American groups and include new data sets for four native Peruvian communities from Tupe, Yungay, and Puno. An analysis of variance that compared the combined data from western South America to the combined data from eastern South America determined that these two regional data sets are not significantly different. As a result, a migration from a single source population into South America serves as the simplest explanation of the data.


Asunto(s)
ADN Mitocondrial , Variación Genética , Genética de Población , Análisis de Varianza , Haplotipos , Humanos , Perú , Proyectos Piloto , América del Sur
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