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PubMed2000

Distinct patterns of glomerular disease in Lima, Peru.

AIM: We performed both a retrospective and prospective study to elucidate the types of glomerular diseases present in adults in Lima, Peru. MATERIAL AND METHODS: In the retrospective study, we analyzed 1,263 renal biopsies over a 10-year period (1985 -1995) that were processed at a central reference renal pathology laboratory in Lima. 101 cases were examined in the prospective study. RESULTS: The most common glomerular diseases observed were those due to systemic lupus erythematosus (30.2%), membranoproliferative glomerulonephritis (MPGN, 14.8%), and focal and segmental glomerulosclerosis (FSGS, 13.9%). Although mesangial-proliferative nephritis was observed in 9.5% of cases, IgA nephropathy was rare (0.9%). Examination of the year to year frequency showed that MPGN has tended to decrease in frequency with time whereas FSGS has been increasing. Although there is known to be a high frequency of infections in Peru, only 4.2% of the cases in the retrospective study were associated with infection. Furthermore, in the prospective study, only one case of hepatitis C and no cases of hepatitis B viral infection were detected, including in the 11 cases of MPGN observed. CONCLUSION: We conclude that the epidemiology of glomerular disease in Lima, Peru, is distinct from most areas of the world, but has similarities to certain regions in Africa, in that MPGN is common whereas IgA nephropathy appears to be rare. Further studies are necessary to elucidate the reasons why the patterns of glomerular disease are different from that observed in other parts of the world.

Adult↗
PubMedDate not supplied

HIV-1 infection may be on the rise in Peru.

The results of a national survey have indicated that "... HIV-1 infection is epidemic in Peru among groups at high risk of sexually and parenterally transmitted diseases," a multicenter group reported (AIDS 1996; 10: 1141-1145). Although the risk of infection appears to be very low in the general population, it may possibly be increasing, according to Dr. Michael C. McCarthy, US National Naval Medical Center in Bethesda, Maryland. McCarthy's group evaluated over 140,000 serum samples for antibodies to HIV-1 between January 1986 and December 1990 in Peru. HIV-1 antibody was detected in 26% of samples from homosexual men, 10% of samples from male sexually transmitted disease patients, and 13% of samples from drug users. 10% of the samples from hemophiliacs and unlicensed female prostitutes were positive for antibodies to HIV-1. In general, he concluded that the patterns of the HIV-1 epidemic in Peru are similar to those seen in Brazil and "... are also similar to initial transmission patterns of HIV-1 infection of North America." However, McCarthy also noted a substantial increase in the prevalence of HIV-1 infection between the beginning and the end of the survey period. Although there was a low prevalence of HIV-1 infection among military personnel and among women seen at prenatal clinics, a "low but rising prevalence of HIV-1 antibody" among military personnel points to a potential increase in the general population. "The fact that many HIV-1 antibody-positive men were married and reported bisexual behavior (28%) highlights the potential of this group to transmit HIV-1 to female partners," he added.

Americas↗
PubMed2003

Mummified trophy heads from Peru: diagnostic features and medicolegal significance.

Several forms of mummified human trophy heads were produced by prehistoric and historic native groups in South America. This paper describes the diagnostic features of trophy heads produced by the Nasca culture of ancient Peru. A growing interest in these mummified heads among collectors of Pre-Columbian art and antiquities has led to their illegal exportation from Peru, in violation of national and international antiquities laws. Requests from the Peruvian government to protect its cultural patrimony led the United States in 1997 to declare these heads as items subject to U.S. import restriction, along with six other categories of human remains. Despite such restrictions, Nasca trophy heads continue to reach private collectors outside of Peru and thus may be encountered by local, state, or federal law enforcement officials unfamiliar with their characteristic features and origin. The objective of this paper is to describe the features that allow Nasca trophy heads to be identified and distinguished from other archaeological and forensic specimens that may be submitted to a forensic anthropologist for identification.

Forensic Anthropology↗
PubMed2003

[Sociodemographic and environmental factors associated with sports physical activity in the urban population of Peru].

OBJECTIVES: To determine the frequency of sports physical activity in the urban population of Peru and to identify the sociodemographic, economic, and environmental factors associated with that activity. METHODS: This study utilized information collected by the country's National Household Survey (Encuesta Nacional de Hogares) in the second quarter of 1997. That Survey is overseen by Peru's National Institute of Statistics and Informatics (Instituto Nacional de Estadística e Informática). The Survey was based on a probabilistic, multistage sample that was stratified for all the urban areas of the country, which was divided into eight geographic regions: metropolitan Lima, northern coast, central coast, southern coast, northern mountains, central mountains, southern mountains, and jungle. In total, 14 913 homes were visited and 45 319 people at least 15 years of age were interviewed. The frequency of engaging in sports physical activity was classified as daily, every other day, weekly, or occasional. "Regular sports activity" (RSA) was defined as engaging in sports either every day or every other day. The preferences for and obstacles to sports practice were also examined. A descriptive analysis of the levels of RSA was carried out for gender, using the chi-square test. The factors associated with RSA were analyzed through conditional multiple logistic regression and analysis of residuals, multicollinearity, and interactions. The level of significance was set at P < 0.05. RESULTS: Practicing sports at least once a week was more common among men (44.5%) than among women (32.4%), and the same was true for RSA (12.8% versus 10.5%). The age group with the highest level of RSA was 50-55 years for men (20%), and 40-45 years for women (18%). RSA was most common in three geographic regions: jungle (15.3%), central mountains (12.8%), and central coast (12.1%). RSA was least common in two regions: southern mountains (9.7%) and metropolitan Lima (10.6%). The income bracket was not associated with RSA. However, other variables associated indirectly with the socioeconomic level - such as having more formal education, being employed, and having access to the Internet or cable television - and consumption of sports information were significantly and directly associated with RSA. The most frequent barriers to practicing sports were the lack of time, the lack of nearby sports infrastructure (playing fields or courts, etc.), and people's lack of interest. RSA on the part of the members of a household was significantly associated with RSA performed by the head of the household (male or female). CONCLUSIONS: RSA is limited in the urban areas of Peru. This is most true for persons who are less than 30 years old, for women, and for residents of the Lima metropolitan area. This low RSA level is a challenge for public health, and it confirms the need for promoting active lifestyles. More study is needed on the observed positive influence when the head of the household performs RSA and on the fact that RSA is more common in urban areas outside metropolitan Lima. These two findings should also be taken into consideration in designing specific interventions.

Adolescent↗
PubMed2003

Geographical distribution of Anopheles darlingi in the Amazon Basin region of Peru.

Malaria has reemerged as a significant public health disease threat in Peru, especially within the Amazon Basin region. This resurgence of human cases caused by infection with Plasmodium falciparum and Plasmodium vivax is thought to be associated with the spread of Anopheles darlingi, the principal South American malaria vector, into new areas of the Amazon Basin. However, comprehensive studies of the distribution for this species have not been conducted in Peru for several years, nor are historical accounts accurate enough to determine if An. darlingi was actually present and not collected or misidentified. Therefore, the objective of this study is to define the distribution of An. darlingi as well as obtain data on distribution and abundance of other Anopheles species in this region. Mosquitoes were collected during 2001 in the Departments of Loreto and Ucayali, the two largest Amazonian Departments of Peru. A total of 60,585 specimens representing 12 species of the subgenera Nyssorhynchus and Anopheles were collected at 82 (88.2%) of 93 collecting sites. The majority of mosquitoes obtained were identified as An. benarrochi, comprising 70.7% of mosquitoes collected, followed by An. darlingi (24.0%), Anopheles mattogrosensis (2.4%), and Anopheles triannulatus (1.5%). Anopheles darlingi was collected from 48.8% of sites, indicating that this species is established throughout central Loreto, including further west in the Amazon Basin than previously reported. These data suggest that this species is now found in areas of the Amazon Basin region where it has not been previously reported.

Animals↗
PubMedDate not supplied

[Anisakidosis a marine parasitic zoonosis: unknown or emerging in Peru?].

The purpose of this review is to show the experimental studies carried out on the biological cycle, culture, pathogenicity of the anisakidae nematode larvae and to disseminate the information regarding current epidemy and the probable emergence of anisakidosis in Peru, and in addition, to propose measures of prevention and control, as well as the perspective and need for investigation. The studies of experimental pathogenicity in cats, dos, and hamsters are incomplete. Eight cases of acute human anisakidosis have been reported (5 confirmed and 3 unconfirmed). It is probable that it emerges during the "El Niño" Weather Phenomenon; however, during normal conditions it is probably due to the increase of raw fish consumption and other factors. In the coast of Peru, five and four fishes of direct human consumption are parasited by the Anisakis simplex and Anisakis physeteris larva, respectively, and two fishes are parasited by the Pseudoterranova decipiens. The main host for the Anisakis simplex is the dolphin (Delphinus delphia), but the Contracaecum osculatum is hosted by the sea lion: Otaria byronia and Arctocephalus australis, P. decipiens parasita a O. byronia. Eviscerating the fish would be most adequate prevention method to lessen the risk of human infection. There is evidence that anisakidosis is an underestimated zoonosis in Peru, and that it is probably and emerging disease. Therefore, its presence is to be suspected in patients with the prototype clinical syndrome.

Animals↗
PubMedDate not supplied

[Report of cases of human fascioliosis in the Specialized Children's Health Institute, Lima, Peru (1988'-2003)].

Human fascioliosis is one of the most important parasitic diseases in Peru, due to the high prevalence rates reported in the last few years, mainly in the Andean Trapeze. The most affected group is that of children and the clinical manifestations of the disease can be very varied. In this study we reported seven cases of human fascioliosis diagnosed in the Specialized Children's Health Institute (IESN) Lima, Peru, between 1988 and 2003. From 168 medical histories checked with the final diagnosis of parasitosis, 7 children (2 boys and 5 girls), between 2 and 14 years (average +/- DS: 8.52 +/- 1.43) were diagnosed with fascioliosis by a parasitic and/or serological examinations. Six of the seven cases came from cattle raising areas such as: Cajamarca, Ancash, Huancavelica and Junín. The most frequent clinical signs were prolonged fever (up to 42 days), hepatomegaly, moderate abdominal pain (right hypochondriac region and epigastrium), eosinophils count (between 132 and 8321/mm > or =), anemia (hematocrit up to 15%), jaundice and hypergammaglobulinemia. In some cases the diagnosis was difficult to reach with a delay between 1 and 24 weeks. It should be pointed out that one of these patients had hepatic cirrhosis diagnosed by anatomopathological investigations. Finally, we propose that in pediatric patients coming from endemic areas of animal fasciolosis who have prolonged fever, abdominal pain and hepatomegaly, should be considered suspicious and the infection of eliminated, to avoid hepatic damage caused by this parasite. We conclude that human fascioliosis must not be under-estimated as a secondary parasitic disease in patients coming from endemic areas in Peru.

Abdominal Pain↗
PubMed1987

Isoenzyme studies on Leishmania stocks from Peru by ultrathin-layer isoelectrofocusing.

17 Leishmania stocks isolated from the Andean and Amazonean region of Peru were compared isoenzymatically with reference stocks of New World Leishmania subspecies by ultra-thin-layer isoelectric focusing. The enzymes tested were: non-specific esterase (NSE), alcohol dehydrogenase (ADH) (NADP+), glucosephosphate isomerase (GPI) and superoxide dismutases (SOD). Two enzymes, GPI and SOD, gave a promising tool for differentiation of the majority of subspecies. These enzymes classify the stocks from Peru into the L. brasiliensis complex. However, none of the Peruvian stocks were absolutely identical to the reference stocks. Further specific enzyme patterns were found which may probably be an expression of greater heterogeneity of Leishmania parasites than is known today. There were neither correlation between clinical manifestation and enzymic patterns of stocks nor differences between stocks from the Andean or Amazonean region of Peru.

Alcohol Dehydrogenase↗
PubMed1996

The epidemiology of HIV-1 infection in Peru, 1986-1990.

OBJECTIVE: To determine the extent of the HIV-1 epidemic in Peru. DESIGN: Part of a national serosurvey in Peru. METHODS: Between January 1986 and December 1990, 140,976 serum samples were tested for HIV-1 antibody. RESULTS: HIV-1 antibody was found in a high percentage of serum samples provided by 4300 homosexual men (26%), 2204 male sexually transmitted disease patients (10%), 145 drug users (13%), 269 hemophiliacs (10%), and 146 unlicensed female prostitutes (10%). In addition, the prevalence of HIV-1 infection increased substantially among these groups between the beginning and end of the survey period. A low but rising prevalence of HIV-1 antibody was found during this period among serum samples provided by 83,526 blood donors and 11,101 military personnel:total period prevalence, 0.25 and 0.32%, respectively. CONCLUSION: These data indicate that HIV-1 infection is epidemic in Peru among groups at high risk of sexually and parenterally transmitted diseases, and that the risk of infection appears to be low but possibly increasing among the general population.

Disease Outbreaks↗
PubMed2000

Assessment of balsam of Peru patch tests.

To find an ideal test technique for as low a dose of balsam of Peru (Myroxylon Pereirae) as possible, subjects testing positive to balsam of Peru are re-tested with a 25% concentration of balsam of Peru in petrolatum. Applications are with Finn Chambers for 6 different application times, and directly by foils for 96 h (4 days (D)). The goals are to confirm which subjects are positive and which are not, and, using that information, to see if it is possible to distinguish between these 2 groups, tested concomitantly at much lower serial dose levels, in terms of perfusion or by visual assessments. 5 different serial doses are applied with strips for 3-96 h (4D) and with foils for 96 h (4D). The Finn Chamber tests allow a distinction between visually positive and negative subjects supported by perfusion assessments. With the foils, a 24x lower serial dose level than with the 25% test substance is sufficient to distinguish between positive and negative subjects in terms of perfusion values. This approach requires readings up to 9 days. With this test, the visual approach yields only 3 of 10 positive subjects. This study demonstrates that a lower test dose is possible with perfusion assessments compared to visual ones.

Adult↗
PubMed2002

Molecular Epidemiology of HIV Type 1 in Ecuador, Peru, Bolivia, Uruguay, and Argentina.

Surveillance for HIV infection among people at increased risk was conducted in five countries in South America. Seroprevalence studies were conducted in more than 36,000 people in Ecuador, Peru, Boliva, Uruguay, and Argentina, along with genetic analysis of the HIV-1 strains. In all countries, the prevalence of HIV-1 among men who have sex with men (MSM) was high (3-30%), whereas the prevalence among female commercial sex workers (FCSMs) was low (0.3-6%). By envelope heteroduplex mobility assay, subtype B predominated in MSM communities and in FCSWs in Ecuador, Bolivia, and Peru. A new genetic screening assay, the multiregion hybridization assay for subtypes B and F (MHA-bf), was developed to improve large-scale genetic screening in South America. MHA-bf can screen four regions of the genome for subtype B or subtype F, and thus can detect most recombinants. The sensitivity of MHA-bf when applied to a panel of pure subtypes and CRF12_BF was 100%, and 88% of unique recombinants were also detected as recombinant. Using MHA-bf, more than 80% of samples from Ecuador, Peru, and Bolivia were classified as pure subtype B, whereas in Uruguay and Argentina this proportion was only 30 to 40%. BF recombinants were the most prevalent form of HIV-1 in Uruguay and Argentina. Subtype B is the most common subtype in countries lacking injecting drug use (IDU) epidemics, whereas BF recombinants are more common in countries where extensive IDU epidemics have been documented, suggesting the ontogeny of recombinant strains in particular risk groups in South America.

DNA, Viral↗
PubMed1977

Immediate reactions to patch tests with balsam of Peru.

Closed patch tests with balsam of Peru gave rise to nine immediate reactions among 121 patients with different dermatoses and to 10 reactions among 57 patients with chronic urticaria. Among compounds of balsam of Peru, cinnamic aldehyde, cinnamic acid benzoic acid and benzaldehyde also gave the same reactions. The reactions could not passively be transferred with serum from patients. They were abolished by antihistamine given before testing, and by pretreatment with compound 48/80. Balsam of Peru and cinnamic aldehyde did not provoke new symptoms when given orally to patients.

Balsams↗
PubMed1985

Oral challenge with balsam of Peru.

A placebo-controlled, double-blind, oral challenge with balsam of Peru was carried out in 221 patients with various types of dermatitis. 210 patients completed the study, and 45 of them experienced a flare of their symptoms after challenge with balsam of Peru but not after placebo. 15 patients reacted to the placebo, and 5 reacted to both balsam and placebo. Specific reactivity to balsam of Peru was seen particularly in patients with positive patch tests to this compound and in some patch-test-negative patients with vesicular hand eczema, ano-genital and axillary eczema. Dietary restriction of the intake of balsams was followed by marked improvement or clearance of the dermatitis in approximately half of the patients who adhered to the diet for at least 1 month.

Administration, Oral↗
PubMed1992

Propolis allergy (IV). Studies with further sensitizers from propolis and constituents common to propolis, poplar buds and balsam of Peru.

26 different compounds have been investigated experimentally for their sensitizing capacity in guinea pigs. 19 of these occur in propolis as well as in poplar bud exudates, and 14 of them are also found in balsam of Peru. 4 caffeates and benzyl isoferulate were found to be strong sensitizers. 7 compounds were moderate, and 13 compounds showed only weak sensitizing potency. Methyl cinnamate was negative. Patch tests in 11 propolis-sensitive patients once more revealed 3-methyl-2-butenyl caffeate and phenylethyl caffeate as the major sensitizers. In addition to the 8 compounds already known to occur in propolis as well as in balsam of Peru, we detected 5 further substances that both materials have in common. Among these, benzyl isoferulate is considered a noteworthy sensitizer. Coniferyl benzoate, which was shown to be a moderate sensitizer, is present in fresh samples of balsam of Peru, while in propolis it has been detected only once so far. The flavonoid aglycones occurring in poplar bud exudates, and hence also in propolis, are weak sensitizers which play only a minor role in propolis hypersensitivity.

Allergens↗
PubMed2005

[The prevalence of Chagas' disease in puerperal women and congenital transmission in an endemic area of Peru].

OBJECTIVES: To determine the prevalence of antibodies against Trypanosoma cruzi in puerperal women and to assess possible congenital transmission of Chagas' disease in the department of Arequipa, Peru, where the disease is endemic. METHODS: Women who had given birth between December 2001 and July 2002 in three hospitals (two urban and one rural) and four health centers (three rural and one urban) of the department of Arequipa, Peru, were studied. The serological study included screening all the puerperal women in order to detect antibodies against T. cruzi through indirect immunofluorescence (IIF), with confirmatory testing done with enzyme-linked immunosorbent assay (ELISA) testing and the titration of immunoglobulin G (IgG) antibodies by IIF. IIF tests to screen for immunoglobulin M (IgM) antibodies were done with the seropositive women and their newborns, and infection was evaluated through xenodiagnosis (evaluated at 30 and 60 days) and the direct micromethod of Freilij et al. The results were analyzed in terms of the presence of the vector and of cases of Chagas' disease in the places where the puerperal women had been born and where they were living. Two neonatologists clinically evaluated the newborns in order to detect abnormalities and signs of congenital Chagas' disease. RESULTS: The overall prevalence of Chagas' disease in the 3 000 puerperal women studied was 0.73%. Prevalence was highest in two health centers located in rural areas (2.2% in El Pedregal and 4.1% in La Joya) (P=0.018). The disease was associated with previous direct contact with the vector (P<0.05) and with having been born in an area considered endemic (P<0.01). Four (20%) of the 20 seropositive puerperal women were also positive by xenodiagnosis. However, none of the women was aware of her infectious carrier state, and none showed the characteristic symptoms or signs of acute or chronic Chagas' disease. IgM antibodies were not detected in any of the puerperal women. One neonate (whose mother did not have evidence of parasitemia) presented an IgM titer of 1/8, but in later controls neither IgM nor IgG antibodies were detected. Parasites were not detected in the blood of the neonates by either of the two testing methods used. Of the 20 neonates evaluated, one presented microcephaly and hepatosplenomegaly; although the child had specific IgG antibodies against T. cruzi at birth, the antibodies were not present at the age of two months. The growth and development of the other 19 newborns were normal. CONCLUSIONS: The prevalence of Chagas' disease in puerperal women of the department of Arequipa, Peru, is low. No cases of intrauterine congenital transmission were found. We recommend carrying out studies on prenatal detection that evaluate more mothers and in which women who give birth at home also participate.

Adolescent↗
PubMed2003

[Gonadal development and reproductive cycle of Lutjanus peru (Pisces: Lutjanidae) in Guerrero, Mexico].

In this paper, aspects of the reproductive biology of Lutjanus peru that can be used for the fishery management are described. Samples were taken monthly in 1993 and 1994, from commercial catches in the southern coast of Guerrero, Mexico. A global sex ratio of 1:1.37 (M:F) was found, but the sex ratio was highly variable each month. The condition factor, gonadosomatic, hepatosomatic and stomach fullness indexes were analyzed. None of the morphophysiological indexes showed any clear tendency. From 377 gonads, both male and female, five developmental stages were characterized for each sex. L. peru shows asynchronous gonad development and multiple spawning. Two spawning period were observed in 1993 (March, and August-September) and three in 1994 (April-May, July-August, and November), with a maximum in August of both years. Length at first maturity for the females of L. peru was estimated at 295 mm fork length.

Animals↗
PubMed1990

Perfume dermatitis in children sensitized to balsam of Peru in topical agents.

Hjorth in his classic monogram "Eczematous Allergy to Balsams" emphasized that sensitization to balsam of Peru is most important since secondary allergens such as "fragrances" are ubiquitous. The application of a topical medication containing balsam of Peru to the skin of an infant, particularly in the occluded diaper area, seems a great way to sensitize the infant not only to balsam of Peru but also to our fragrant environment.

Administration, Topical↗
PubMed1982

Crown dimensions of deciduous teeth from pre-Columbian Peru.

The mean mesiodistal and buccolingual diameters are presented for the deciduous teeth from Pre-Columbian Peru. Generally, the deciduous teeth from Pre-Columbian Peru are larger in most dimensions than the deciduous teeth of modern populations of European descent and smaller than those of modern Australian aboriginals. Differences in crown dimensions between the Pre-Columbian Peruvian deciduous teeth and those from Prehistoric Inamgaon and Mesolithic Europe are inconsistent. However, the maxillary and mandibular second molars are larger in the Peruvian population while the incisors are smaller. Since comparative data for prehistoric deciduous teeth are rare, this paper adds valuable data to the growing literature on deciduous crown dimensions.

Child↗