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Formative research to develop a nutrition education intervention to improve dietary iron intake among women and adolescent girls through community kitchens in Lima, Peru.

Formative research was conducted with 26 women and 16 adolescent girls to develop an education intervention through community kitchens (CK) in Lima, to increase their dietary iron intake and improve their iron status. A combination of qualitative research methods was used to explore perceptions about foods, nutrition, health, anemia and body image. The women recognized that there was a close association among eating well, "alimentarse bien", their health and prevention and treatment of anemia. They perceived that the nutritive value of a meal is determined primarily by its content of "nutritious" foods and by its being "balanced". Using this information the conceptual model of the education intervention was developed. The vulnerability of women to anemia was presented with the relationship between anemia and diet as the central focus. Feasible ways of achieving a nutritious diet were introduced to the community kitchens through promoting local heme iron sources and the consumption of beans with a vitamin C source. Animal source foods were amongst those considered to be nutritious and were "best buys" for iron content. CK searched for ways of assuring accessibility to these foods. The use of animal source foods in the community kitchen menus increased during the intervention.

Adolescent↗

Longitudinal studies of infectious diseases and physical growth of infants in Huascar, an underprivileged peri-urban community in Lima, Peru.

Longitudinal studies of morbidity from infectious diseases and physical growth were completed from July 1982-June 1984 for 153 Peruvian newborns during the first year of life. Admission to the cohort was restricted to infants with birth weights greater than 2,500 g. Surveillance workers inquired about symptoms of diarrheal, respiratory, and other illnesses during thrice-weekly home visits; anthropometrists measured weight and length each month to assess the infants' patterns of physical growth and relative nutritional status. During 48,209 child-days of observation, upper respiratory infections were present on 13,409 child-days (27.8% prevalence) and diarrhea on 7,466 child-days (15.5% prevalence). The diarrhea incidence rate averaged 9.8 episodes per child-year of observation; all children had at least one episode of diarrhea. Average weights approximated those of the National Center for Health Statistics reference population during the first five to six months, but declined thereafter in relation to reference data. Average lengths were less than the reference data at all ages. The average weights for age and lengths for age of girls were generally greater than those of boys relative to the reference population. Rates of stunting and wasting increased progressively during the first year of life.

Anthropometry↗

Low prevalence of gastric metaplasia in the duodenal mucosa in Peru.

We compared the prevalence of gastric metaplasia of the duodenal mucosa (GM) and its characteristics in 204 Peruvian patients from a low socioeconomic level with the corresponding prevalence reported in dyspeptic patients from a developed country, the United Kingdom. Gastric metaplasia was significantly less prevalent in the Peruvian than in the United Kingdom series. However, when present, GM was not significantly different in extent or frequency of colonization by Helicobacter pylori or association with active duodenitis, despite a higher prevalence of H. pylori-associated gastritis. Hypochlorhydria was markedly more frequent in the Peruvian than in the United Kingdom series. The finding of a low prevalence of H. pylori-colonized GM in patients with previously reported low prevalence of duodenal ulcer gives further support to a pathogenic link between both conditions.

Adolescent↗

Preconquest Peruvian neurosurgeons: a study of Inca and pre-Columbian trephination and the art of medicine in ancient Peru.

Trephination and craniotomy performed by abrasion, scraping, crosscut sawing, and drilling are the oldest known surgical techniques used by primitive peoples. As a result of archaeological findings, the human skull is the most frequently studied part of the excavated body, leading to the creation of a new aspect of anthropology known as "cultural osteology." Found in ancient tombs, the human remains, mummies, skeletons, and their belongings, including war instruments, pottery, clothing, jewels, and surgical instruments, constitute the richest source of insight into the lives and pragmatic activities of ancient cultures. This study summarizes thousands of years of pre-Columbian history and medical evolution, specifically in the early and primitive practice of trephination, as precursors of neurosurgery. Comparative osteology studies have demonstrated that using primitive stone or metal instruments, the sirkaks (Inca surgeons) achieved an average survival rate of 50 to 70% of their craniectomy patients, with little incidence of infection or other complications. Despite their rudimentary knowledge of disease and pathology, a considerable knowledge of anatomy and natural medicine provided them with hemostatic agents, antiseptics, and other medical drugs, such as quinine for fever and malaria, as well as gold, silver, and other products to perform cranioplasties. Living in a world of continuous hand-to-hand combat, they also developed aggressive and defensive weapons that necessitated refinement of surgical techniques to save soldiers from battle wounds to their poorly protected crania.

History, Ancient↗

Hydroa-like cutaneous T-cell lymphoma: a clinicopathologic and molecular genetic study of 16 pediatric cases from Peru.

Hydroa-like cutaneous T-cell lymphoma (hydroa-like CTCL) is an unusual pediatric malignancy with a poor prognosis. An impressive cutaneous rash characterized by edema, blisters, ulcers, crusts, and scars, resembling hidroa vacciniforme, is seen mainly on the face and sometimes on the extremities. The lesion consists of lymphomatous T-cell infiltration of the skin and subcutis with variable exocytosis and angiocentricity. It has been also called edematous, scarring vasculitic panniculitis and hydroa-like lymphoma. An association with Epstein-Barr virus has been suggested. The differential diagnosis includes other cutaneous lymphomas, particularly the cutaneous nasal type T/natural killer-cell lymphoma, mycosis fungoides, precursor T-cell lymphoblastic lymphoma, nonspecific peripheral T-cell lymphoma, cutaneous anaplastic large cell lymphoma, and subcutaneous panniculitic T-cell lymphoma. Other differential diagnoses are inflammatory dermatopathies and panniculitides. Based on a series of 16 such cases referred to the Institute of Neoplastic Diseases, the objective of this report is not only to provide a better clinicopathologic understanding of this entity but also a reappraisal of it as a malignancy. The male/female frequency ratio was 1:1. The median age was 10 years old. All cases showed predominant facial involvement with edema, blisters, ulcers, crusts, and scars. Chemotherapy and/or radiotherapy had little or no benefit. The prognosis was usually dismal. The lymphoma extended from the epidermis to the subcutis, with frequent angiocentric and periadnexal array. Lymphoma cells were mostly of intermediate size with dense hyperchromatic nuclei, inconspicuous nucleoli, and infrequent mitosis. A scanty and variable inflammatory background was found. The lymphoma cells displayed T-cell cytotoxic phenotype. In addition, they were negative for the natural killer cell antigens CD56 and CD57. Epstein-Barr virus in situ hybridization was positive in the six cases in which it was assayed. T-cell receptor gamma (TCRgamma) displayed monoclonal-type rearrangement in four cases studied. Our findings indicate that hydroa-like CTCL is an independent clinicopathologic entity that affects children. Consequently, it should be considered an independent subset of CTCLs and be included as such in the classification of neoplastic diseases of the lymphoid tissues.

Adolescent↗

Ceramic representations of facial paralysis in ancient Peru.

OBJECTIVE: To provide interested scholars with a historical perspective of facial paralysis as interpreted by the ceramists of the ancient Moche culture. METHODS: The authorities and curators of the Museo Arqueológico Rafael Larco Herrera, and the Museo Nacional de Arqueología, Antropología e Historia del Perú, in Lima, Perú, provided photographs of some of the more salient examples of facial paralysis in their Moche ceramic collections. Four of these were selected for inclusion in this article. CONCLUSION: Moche pathologic portraits establish a unique point of reference in the history of facial paralysis and its sequelae. They stand alone as a prehistoric record of this disorder, unsurpassed until the appearance of Bell's work and illustrations.

Ceramics↗

Salicola marasensis gen. nov., sp. nov., an extremely halophilic bacterium isolated from the Maras solar salterns in Peru.

Six strains of extremely halophilic bacteria were isolated from several crystallizer ponds of the Maras solar salterns in the Peruvian Andes. On the basis of 16S rRNA gene sequence similarity, G+C contents and DNA-DNA hybridization results, the six isolates constituted a genomically homogeneous group affiliated with the Gammaproteobacteria. The closest relatives were members of the halophilic genera Halovibrio and Halospina, which showed 16S rRNA gene sequence similarities below 97 % and whole-genome hybridization levels below 33 % for the type strain, 7Sm5(T). From the genomic and phenotypic properties of the six novel isolates and phylogenetic reconstruction based on 16S rRNA gene sequence analysis, they can be considered to represent a novel genus within the Gammaproteobacteria. On the basis of the taxonomic study, a novel genus, Salicola gen. nov., is proposed containing the single species Salicola marasensis sp. nov., which is the type species. The type strain of Salicola marasensis is 7Sm5(T) (=CECT 7107(T)=CIP 108835(T)).

Bacterial Typing Techniques↗