Search

Objectives: To characterize, by means of bibliometric indicators, the scientific publications of the Peruvian Experimental Medicine and Public Health Journal, 2010-2017., Materials and Methods: A bibliometric study in which the publications were retrieved from the data base of Scopus. The bibliometric production indicators were: number of publications per year and type of publication. Brief original and original articles were considered as units of analysis based on number of authors, institutional affiliation, and country of corresponding author, type of research and study design. The impact indicators were: number of citations by publication according to Scopus, metric of impact, such as CiteScore, Scimago Journal & Country Rank (SJR), and SciELO Public Health., Results: A total of 1,045 publications were made by the RPMESP: 40.1% of publications corresponded to original articles and original briefs; 1,837 authors contributed with these publications; 134 institutional affiliations were declared by the corresponding authors; 48,0% were research works on determinants of a health problem; on the other hand, 90.5% corresponded to observational studies. The publications analyzed received 945 citations, of which 78.5% were for publications for the 2010-2013 period., Conclusions: Four of ten publications of the RPMESP correspond to brief original or original articles. According to diverse formulas of calculation, the impact metric of the RPMESP shows an ascending trend; however, their magnitude is lower versus other regional journals.

Objectives: To determine the proportion of abstracts presented at the Congreso Peruano de Gastroenterología (the major Peruvian gastroenterological scientific meeting), that had been published in scientific journals, the date of publication and its associated factors., Materials & Methods: Longitudinal retrospective and analytic study; the publicationrate of all the abstracts presented in the biennial Congreso Peruano de Gastroenterología between 1998 and 2008 was assessed. Google Scholar engine was used. The searching strategy performed included: ("Study location" AND "population studied" AND "main outcome") AND (autor:First OR autor:Second OR autor:Last). Logistic regression was used, considering p<0.05 statistically significant., Results: Publication rate was 8.2% (34/217), statistically significant differences were found among meeting years (p<0.001). There were also differences between study design, objectives (more in analytic studies) and measurement (more in longitudinal studies (p<0.001). 82.4% were published in the Revista de Gastroenterología del Perú. The median time for publication was 10.8±10.4 months; this variable and the meeting year, study type, journal of publication or accordance between the abstract and publication characteristic showed no statistical differences. The mean authors' number was 5.02±2.4; analytic studies have less authors than the descriptive ones (3.6 vs 6.1; p=0.012)., Conclusion: The Congreso Peruano de Gastroenterología presents a low publication rate of the abstracts presented, which can be used as a quality indicator of the abstracts and the reviewing process.

Objective: Atopic dermatitis is a chronic, systemic, relapsing disease with dermatological manifestations, which imposes a high burden on patients, families and the health care system and has a high psychological, social, and economic impact and on the quality of life of patients. It mainly affects the pediatric population and, to a lesser extent, the adult population. The clinical presentation varies according to the age and evolution of the disease, and currently there are multiple pharmacological and non-pharmacological therapies available for the symptomatic management of patients., Methods: To present an algorithm for the management of atopic dermatitis, proposed as a series of recommendations on the management, diagnosis, education, and follow-up of these patients., Results: A consensus was reached using the nominal group technique. The methodology was developed in 7 phases, including: posing the research questions, literature search, an initial proposal of recommendations, elaboration of the final recommendations and the management algorithm with three voting cycles, consensus was established with 80% favorability., Conclusions: The result of the consensus process is a management algorithm for patients with mild, moderate/severe atopic dermatitis derived from expert recommendations. The algorithm establishes diagnostic and treatment criteria and provides updated recommendations, including all therapeutic alternatives available in Peru for the management of patients with mild, moderate, and severe atopic dermatitis., (Este obra está bajo una licencia de Creative Commons Reconocimiento-NoComercial 4.0 Internacional.)

Discusses empowering parents and communities to enhance loving and healthy family relationships through the concept of resilience and other factors, irrespective of different cultural understandings about bringing up children. Argues that good child-adult relations can reduce stress and help children develop tolerance, understanding, cooperation, honesty, and trust. Reviews the values on which early childhood services in Peru are based. (JPB)

This issue contains two articles in Spanish and three in English on the following topics: the practical presentation of English for Special Purposes (ESP) materials in science programs at the National University of Trujillo, "notional syllabus" and "discourse analysis" in relation to ESP materials, extra-linguistic principles in explaining language facts, diphthongation in "Kechwa de Ancash-Huaylas," and a typology of language situations. The first article is a discussion of some aspects of the practical classroom presentation of texts in scientific English using recently published textbooks. The second article is a discussion of terms: notional syllabus refers to the organization of a syllabus according to semantic expression. Discourse analysis refers to the informational coherence of texts, and the markers used to point the way to understanding such texts. In the third paper, some of the extra-linguistic principles related to language use that enable human beings to interact socially are discussed. The distinctive features of one of the dialects in the Quechua group of dialects are analyzed in the fourth article. Thirty types of communication situations involving interaction of the five factors: "speaker, listener, channel, code and information" are discussed and classified in the last article. (AMH)

Hermilio Valdizán published several papers on what was called psychiatric folklore, understood as the ways of understanding and treating mental illnesses by indigenous people, both from the colonial and pre-Hispanic past and from the author's present. In this article, we analyze Valdizán's texts on the psychiatric and psychological characteristics of indigenous Peruvians. From the perspective of this psychiatrist, contemporary indigenous people were archaeological remains of the ancient Inca empire, ruins in the process of degeneration. In a context marked by indigenism, in which it was sought to integrate the Indians, psychiatry played a conservative and racist role that reproduced evolutionary models of the nineteenth century.

Introduction: This article summarizes the clinical practice guide (CPG) for the diagnosis and management of cholelithiasis, acute cholecystitis and choledocholithiasis in the Peruvian Social Security (EsSalud)., Objective: To provide clinical recommendations based on evidence for the management of patients with cholelithiasis, acute cholecystitis and choledocholithiasis in EsSalud., Methods: a guideline task force (GTF) was formed with internists, general surgeons, gastroenterologists, and methodologists. The group proposed 10 clinical questions to be answered in this Clinical practice guideline (CPG). Systematic searches of preview reviews were performed and when it was necessary, primary studies from PubMed and CENTRAL during 2017 were reviewed. The evidence was selected aiming to answer each proposed question. Certainty of evidence was evaluated using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodical work sessions, the group used GRADE methodology for reviewing the evidence and formulating recommendations, good clinical practice items and three flowcharts for diagnosis and treatment. Finally, the CPG was approved by Resolution Nº 046-IETSI-ESSALUD-2017., Results: This CPG approached 10 clinical questions divided into two topics: diagnosis and management. Based on these questions; one strong recommendation, five weak recommendations, and 17 good clinical practice items and three flowcharts were formulated., Conclusion: This paper abstracts the methodology and evidence-based conclusions of the CPG for diagnosis and management of cholelithiasis, acute cholecystitis and choledocholithiasis in EsSalud.

Objective: . To determine the prevalence and incidence of arterial hypertension, as well as the prevalence of previous diagnosis of arterial hypertension (self-reported) among the adult population of Peru., Materials and Methods.: Systematic review and meta-analysis of epidemiological studies available in LILACS, EMBASE, MEDLINE and Global Health. Studies were included if they followed a random sampling approach in adult population. Screening and assessment of manuscripts was carried out independently by two researchers. A random-effects meta-analysis was conducted to quantify the overall prevalence and incidence of hypertension. The Newcastle-Ottawa scale was used to assess the risk of bias in the manuscripts., Results.: A total of 903 papers were screened, and only 15 were included in the estimation of hypertension prevalence, 8 in the assessment of previous hypertension diagnosis, and 4 for incidence estimations. The pooled prevalence of hypertension was 22.0% (95% CI: 20.0% - 25.0%; I2=99.2%). This estimate was lower in national studies [20.0% (95% CI: 17.0% - 22.0%; I2=99.4%] than in sub-national studies [24.0% (95% CI: 17.0% - 30.0%; I2=99.2%]. The pooled prevalence of previous hypertension diagnosis was 51.0% (95% CI: 43.0% - 59.0%; I2=99.9%). The pooled incidence of hypertension was 4.2 (95% CI: 2.0 - 6.4; I2=98.6%) per 100 person-years. The included studies did not present high risk of bias., Conclusions.: Our findings show that one in five Peruvians has hypertension, and that four new cases appear per 100 persons per year; in addition, only half of the subjects with hypertension are previously diagnosed.

Introduction: This article summarizes the clinical practice guidelines (CPG) for the diagnosis and treatment of chronic infection of hepatitis viral C of the Peruvian Health Social Security (EsSalud)., Objective: To provide clinical recommendations based on evidence for the diagnosis and treatment of chronic infection of hepatitis viral C in EsSalud., Methods: A guideline development group (GDG) was established, including medical specialists and methodologists. The GDG formulated 4 clinical questions to be answered in this CPG. Systematic searches of systematic reviews and primary studies (when pertinent) were conducted in PubMed, and Central (Cochrane) during 2019. The evidence was selected to answer each of the clinical questions. The accuracy of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic work meetings, the GEG used the GRADE methodology to review the evidence and formulate the recommendations, the points of good clinical practice and the treatment flowchart. Finally, the CPG was approved with Resolution No. 151-IETSIESSALUD-2019., Results: The present CPG addressed 4 clinical questions of four topics: screening, diagnosis, staging and treatment. Based on these questions, 13 recommendations (8 strong recommendations and 5 weak recommendations), 27 points of good clinical practice, and 1 flowchart were formulated., Conclusion: This paper summarizes the methodology and evidencebased conclusions from the CPG for for the diagnosis and treatment of chronic infection of hepatitis viral C of the EsSalud.

The native community Shonori is made up of Ashaninka families of the Peruvian Amazon. This paper addresses community health through an assessment and nursing care plan based on the Purnell cultural competency model and the standardized nurse taxonomy (NANDA, NIC, NOC). The assessment is based on 12 domains related to inheritance and biocultural ecology, communication, roles and family organization, risk behaviours, nutrition, pregnancy, death and spirituality rituals, and health care providers and practices. A diagnosis of «Poor health of the community r /t insufficient resources m/b health problems suffered by the community» is detected. The expected results criteria in the care plan are: social competence, community health status and control of social risk related to communicable diseases. The interventions consist of promoting community health, analyzing and identifying the health situation and risks, and controlling and protecting from communicable diseases and environmental risks. Interventions of the public water supply network and subsidies for agricultural and housing support, allowed vectors to be reduced, costs of safe water supply to be covered, and food to be bought to improve child nutrition. The use of traditional medicine was enhanced and health and sexual education campaigns were carried out in coordination with the official health system. A follow-up was carried out for 40 days, corroborating the improvement of community health, and the need for a group approach with all actors., (Copyright © 2019 Elsevier España, S.L.U. All rights reserved.)

This paper analyzes the implementation, initial results, and sustainability of innovations in the provision, financing, and management of mental health services in Peru, carried out during 2013-2018. By applying new financing mechanisms and public management strategies, 104 Community Mental Health Centers and eight Protected Homes were implemented, which prove to be more efficient than psychiatric hospitals. The set of 29 centers created between 2015 and 2017 produced in 2018 an equivalent number in consultations (244,000 vs. 246,000) and patients attended (46,000 vs. 48,000) than the set of three psychiatric hospitals, but with 11% of financing and 43% of psychiatrists. The way mental health care is being provided is changing in Peru by involving citizens and communities in ongoing care and creating better conditions for the exercise of mental health rights. Community mental health reform has gained broad support from political, international, and academic sectors, and from the media. We conclude that the reform of community-based mental health services in Peru is viable and sustainable. It is in a position to scale up the entire health sector throughout the country, subject to the commitment of the authorities, the progressive increase in public financing, and national and international collaborative strategies.

In 2013, the Joint United Nations Programme on HIV/AIDS (UNAIDS) proposed, in terms of public health, to end the HIV epidemic by 2030 by achieving the so-called 90-90-90 targets by 2020. This goal will only be possible if coverage in the HIV care continuum indicators is increased. With the methodology proposed by PAHO/WHO, this paper estimates the indicators of the continuum of care in Peru for 2014, consisting of diagnostic coverage, antiretroviral treatment (ART), and viral suppression in people living with HIV (PLHIV). Of the 72,000 PLHIV estimated in Peru for 2014, 64% were diagnosed, 56% and 55% were linked and retained in the system, respectively; 46% were receiving ART, and 36% had viral suppression. The main gaps identified were: 19,917 PLHIV did not know their diagnosis, 25,078 had no access to treatment, and 25,633 did not achieve viral suppression at study closing. This is the first estimation exercise of the continuum of care indicators in Peru. These indicators will serve as a baseline for the monitoring progress toward the 90- 90-90 Targets. It is also the starting point for analysis and research on the determinants of each gap and new proposals by authorities and actors involved in the fight against HIV in Peru.

Health information systems play a key role in enabling high quality, complete health information to be available in a timely fashion for operational and strategic decision-making that makes it possible to save lives and improve the health and quality of life of the population. In many countries, health information systems are weak, incomplete, and fragmented. However, there is broad consensus in the literature of the need to strengthen health information systems in countries around the world. The objective of this paper is to present the essential components of the conceptual framework to strengthen health information systems in Peru. It describes the principal actions and strategies of the Ministry of Health of Peru during the process of strengthening health information systems. These systems make it possible to orient policies for appropriate decision-making in public health.

Anopheles (Nyssorhynchus) darlingi has been reported since 1931 in border areas of the department of Loreto, mainly along the borders with Brazil and Colombia. In 1994, during an outbreak of malaria, An. darlingi was found in neighboring towns to Iquitos. At present, its distribution has expanded considerably in Loreto. This paper reviews literature available for all possible information on the distribution of mosquitoes, particularly anopheline in the Amazon region of the country, with special emphasis on An darlingi. Entomological collections were also conducted in the departments of Madre de Dios and Ucayali in order to know and verify the distribution of An. darlingi. At present, the distribution of the species is confined to localities in southeastern Peru with Bolivia border towns, in a town near the Abujao River in the department of Ucayali, and widely in the northeastern region of the Amazon basin of Loreto in Peru.

The epidemiological picture of sporotrichosis and paracoccidioidomycosis in Peru and Latin America is sporadic, fragmented, and geographically limited, mainly due to lack of mandatory reporting and limited diagnostic coverage. However, research contributions related to understanding the interaction of these fungi, the response of the host and the environment, the use of spatial analysis that relates the distribution of these mycoses, population density and climate, contributes to the design of prevention and control strategies of these mycosis and suggest epidemiological risk maps management, based on the habitat of the fungus. This information will be used by doctors, tourists and people living in rural areas where mycoses are endemic. The aim of the paper is to present a review of the topic through research findings that contribute to the prevention and control of these mycosis.

Objectives: To estimate the prevalence of antibodies against measles, rubella and hepatitis B in children aged between 1 and 4 years in Peru., Materials and Methods: A national survey was conducted based on a questionnaire and capillary blood sample taken on filter paper in order to study antibodies against measles, rubella and hepatitis B in children from 1 to 4 years of age. A stratified, multistage, probability sampling design was used to be representative at the national level and at level of seven ambits, including the Metropolitan Lima Area, the rest of the urban coast, the rural coast, the urban highlands, the rural highlands, the urban jungle and the rural jungle. The capillary blood samples were processed according to the standardized protocols for detection of antibodies using the ELISA technique and commercial reagents., Results: The survey showed a national prevalence of antibodies against measles, rubella and hepatitis B of 91.6% (CI 95%: 90.6%; 92.7%), 91.3% (CI 95%: 90.3%; 92.4%) and 95.9% (CI 95%: 95.0%; 96.8%) respectively. There was no evidence of significant differences in the prevalence among the ambits of study or among the socioeconomic strata of the conglomerates for any of the three types of antibodies., Conclusions: In children from 1 to 4 years of age, the national prevalence of antibodies against measles and Rubella was between 90-93%, while the prevalence of antibodies against Hepatitis B (anti-HBsAg) was between 95-97%.

Tuberculosis (TB) persists as a major public health problem in our country. The appearance of resistant strains has complicated its control and questioned the appropriateness of the current measures towards prevention and control. An analysis from social determinants related to TB, converge on irregular treatment that generates disease persistence and appearance of resistance to TB drugs. The objective of this paper is to identify the role of the government in the treatment of TB patients, to recognize difficulties of treatment adherence considering that its fulfillment depends on the patient, despite that it has direct consequences on public health, and to discuss TB management alternatives with an approach based on individual and collective human rights. International literature shows limit experiences of individual rights and collective ones, but based on health policies and health legislation. In Peru, a new approach is required to guarantee population health without infringing individual rights.

Objective: To analyze the evolution of published scientific articles on HIV/AIDS in Peru., Methods: A bibliometric analysis of papers on HIV/AIDS published in journals indexed in MEDLINE, SciELO and LILACS until October 2010. We selected research papers fully developed in Peru, and multicenter studies with participating Peruvian sites., Results: We identified 257 publications on HIV/AIDS, showing an increase since 2003. The average publication delay was 2.8±1.8 years. Only 94 (36.6 %) articles were published in Spanish. The most studied areas were epidemiology (36.6 %) and clinical topics (35.8 %). The cross-sectional design was the most frequent (56.8 %) followed by case series. According to the WHO classification, studies to learn more about the disease and risk factors predominated (85.6 %) and according to the intervention areas, 46.7 % focused on diagnosis and treatment. Most studies were conducted in Lima (65.9 %). 48.2 % of studies focused on people living with HIV/AIDS. Finally, Revista Peruana de Medicina Experimental y Salud Pública was the journal that published most articles on HIV/AIDS (9.7 %)., Conclusions: We found a growth in scientific production on HIV/AIDS in Peru; however, we believe that the research undertaken was not based on an agreed national agenda or national research priorities, which might have limitted its dissemination and application.

Neurocysticercosis, the infection of the human central nervous system by the larval stage of the cestode Taenia solium, is an important cause of epilepsy and other neurological manifestations in Peru and most developing countries. Since 1987, the Cysticercosis Working Group in Peru has performed a series of epidemiological studies which led to estimate the impact and to better understand the transmission of Taenia solium. This information was later applied to the design and execution of a control program in Tumbes, in the Northern Coast of Peru. This paper reviews the main epidemiological findings, as well as the conceptual framework of the elimination program and the tools used. Advances in the control of taeniasis/cysticercosis in our country open the road towards its elimination and potential eradication.

In the year 2003, in the Faculty of Medicine of the Universidad Nacional Mayor de San Marcos, the Permanent Program of Training for the Integral Attention of the Victims of Violence was created, has been training human resources for the comprehensive health care to victims of violence. In this sense, we was considered necessary to develop a methodology for health professionals, identifying their training needs and the conditions under how they work. It is in this context, that the year 2004, a base line study was delineated in the Microrred de Salud Huaycán, in the east of Lima city; that included diverse stages with a multisectorial approach with the aim to identify the training needs of the health professionals, as well as the evaluation of the logistic and administrative support for the development of training activities to diverse levels. In this paper, the procedures and principal results are exposed, in a succinct way. There was demonstrated that the population of Huaycán were affected by the sequels of the political violence; nevertheless, the health services have severe limited resources to give appropriate health care to victims of violence. The health professionals require an intensive training on this issue. An adequate logistic and administrative conditions allowed to carry out an appropriate training program. We suggest that this methodology will facilitate to construct products and instruments for a suitable and specific training for the integral health care to the victims of the violence.

The objective of this paper is to present the situational status of the National Health Research System of Peru (NHRS), the lessons learnt during the building process, the opportunities to improve it and the challenges. A description of the functions of the peruvian NHRS is done, in relation to governance, legal framework, research priorities, funding, creation and sustainability of resources and research production and utilization. It describes that in Peru we excert governance in research, we count with regulations, policy and research priorities, these last developed in the framework of a participatory, inclusive process. The conclusion reached is that the challenges of the peruvian NHRS are to consolidate the governance and to develop the mechanisms to articulate the stakeholders involved in research, to improve the resources allocation for research and innovation, to elaborate a plan for the development of human resources dedicated to research, to develop institutions and regional competences in order to perform research, and to link research in order to solve problems and make national research policies sustainable.

Objectives: To describe the Peruvian scientific production in indexed journals in the Institute for Scientific Information (ISI) and the characteristics of the institutional collaborative networks., Material and Methods: All papers published in the ISI database (Clinical Medicine collection) were included during 2000 to 2009 with at least one author with a Peruvian affiliation. The publication trend, address of corresponding author, type of article, institution, city (only for Peru), and country were evaluated. The collaborative networks were analized using the Pajek® software., Results: 1210 papers were found, increasing from 61 in 2000 to 200 in 2009 (average of 121 articles/year). 30.4% articles included a corresponding author from a Peruvian institution. The average of authors per article was 8.3. Original articles represented 82.1% of total articles. Infectious diseases-related journals concentrated most of the articles. The main countries that collaborate with Peru are: USA (60.4%), England (12.9%), and Brazil (8.0%). Lima concentrated 94.7% of the publications and three regions (Huancavelica, Moquegua and Tacna) did not register any publication. Only two universities published more than one article/year and four institutions published more than 10 articles/year. Universidad Peruana Cayetano Heredia published 45% of the total number of articles, being the most productive institution and which concentrated the most number of collaborations with foreign institutions. The ministry of Health--including all dependencies--published 37.3% of the total number of publications. There is a higher level of collaboration with foreign institutions rather than local institutions., Conclusions: The Peruvian scientific production in medicine represented in the ISI database is very low but growing, and is concentrated in Lima and in a few institutions. The most productive Peruvian institutions collaborate more intensively with foreign journals rather than local institutions.

This paper will contribute to the scientific development of a new approach on the pishtaco in Peru by means of medical anthropological analysis. The model emphasizes presentation and analysis of historical, pharmaceutical, and anthropological evidence supporting use of human tissues with specific medical goals in Peruvian and European regions. We can find the origin of this phenomenon around the sixteen and seventeen centuries in Europe: The pishtaco has no an Andean origin. The methodology and main conclusions of this paper could provide to the scientific community an alternative perspective to the conventional anthropological and ethnological research, as an example of a medical anthropological analysis of the pishtaco character. Professionals involved in intercultural health projects could have a new insight on this issue thanks to these results. They will obtain an adequate historical-cultural context for the interpretation and understanding of people and native communities' beliefs about health, body and medical systems.

Introduction: References are fundamental in our studies; an adequate selection is asimportant as an adequate description., Objectives: To determine the number of errors in a sample of references found in Peruvian medical journals., Methods: We reviewed 515 scientific papers references selected by systematic randomized sampling and corroborated reference information with the original document or its citation in Pubmed, LILACS or SciELO-Peru., Results: We found errors in 47,6% (245) of the references, identifying 372 types of errors; the most frequent were errors in presentation style (120), authorship (100) and title (100), mainly due to spelling mistakes (91)., Conclusions: References error percentage was high, varied and multiple. We suggest systematic revision of references in the editorial process as well as to extend the discussion on this theme., Keywords: references, periodicals, research, bibliometrics.

This paper focuses on risk, conceived not as an individual action, but considering its social dimension, analyzing the various forms in the socio-cultural context related to internalized homophobia and hegemonic gender norms that allow barriers to be constructed in risk perception. Such barriers hinder negotiation and protection among homosexual men that have adopted a female gender identity, living in low-income barrios of Lima and Trujillo, Peru. Risk perception is analyzed on the socio-cultural plane, allowing one to explain the limited negotiating capacity of this population, even though they have extensive knowledge of HIV/AIDS and its consequences.

Objective: To assess the association of knowledge and attitudes about family planning (FP) with its practice in couples of the Peruvian jungle region., Material and Methods: A cross-sectional study was carried out in the jungle region in Peru (Pucallpa and Tarapoto), among 600 couples. Males were > or = 15 years old and females between 15 and 49 years old, who had resided in the area for at least two years. A questionnaire was used to determine FP practices (defined as the use of modern contraceptive methods (MCM) for > or = 12 months), as well as attitudes and knowledge regarding FP. Frequencies were compared using the chi-squared test. Logistic regression was used to assess the association between demographic variables and MCM knowledge as well as MCM utilization. The association between sociodemographic variables and attitudes toward MCM was assessed with linear regression models., Results: Males with primary education or with no formal education were twice as likely to have no knowledge about MCM compared with males with professional education (OR: 2.18, 95% CI: 1.05, 4.50). Females with a catholic partner were more likely to know about MCM than those whose partners did not practice any religion (OR: 0.60, 95% CI: 0.37, 0.97). Partner's lower education, older age of women, and rural background of males were all factors associated with a less favorable attitude toward FP practices. Couples in which the man did not know about contraceptive methods were more likely not to use MCM than couples where the man knew about MCM (OR: 1.57, 95% CI: 1.07, 2.30). Couples where the man had an intermediate level of acceptance towards FP were more likely not to use MCM than those where the man had a high level of acceptance (OR: 1.90, 95% CI: 1.03, 3.48). The strength of association was higher when the man had a low level of acceptance toward PF (OR: 2.23, 95% CI: 10, 4.51)., Conclusions: Knowledge of contraceptive methods and attitudes toward FP among men are associated with the practice of FP by couples. Study findings show that male acceptance of MCM and FP is a necessary, important, and influential factor in FP promotion and practice. The English version of this paper is available at:http://www.insp.mx/salud/index.html.

This paper describes Peru's experiences with its National Blood Banking Program. Until the mid-1990s, the country faced a host of problems, including the lack of a legal framework to regulate blood banks, a high maternal mortality rate due to a shortage of blood, virtually no voluntary donations, a high risk of infection from transfusions, the use of only whole blood for transfusion, serious disorganization in the blood banks, deficiencies in blood bank supervision and control, no training programs, indifference on the part of health officials, frequent selling of blood, and limited community awareness. Subsequently, a strategic plan was prepared that made it possible to solve many of those problems. Legal instruments were prepared; the rate of voluntary donations rose from 0% to 19.5%; the safety of the blood was improved through compulsory screening of all donated blood units for seven markers of infectious diseases, as well as by placing a national seal of quality on all screened units. The availability of blood doubled, thus meeting 70% of the need; sales of blood decreased; and the use of blood components was improved, with 80% of the blood being fractionated. In addition, supervisory control of 100% of the blood banks in the country was achieved, a national registry was established, the cost-benefit relationship for blood units was improved through centralized screening, internal and external quality control was made mandatory, and pro-donation campaigns led to commitments from civil society. While important, all these achievements represent just a first step. This is especially true given that developing the National Blood Banking Program required the participation of outside organizations, such as the Pan American Health Organization, whose support, together with the experience provided by other countries, was key. The Program is facing a number of new challenges, and the progress that has been achieved could be threatened if current activities stagnate or if officials become complacent.

The production of articles resulting from biomedical, clinical, and public health studies that originated in Argentina, Brazil, Chile, Cuba, Mexico, and Venezuela from 1973 through 1992 was analyzed to discover trends in health research in Latin America. From the database of the Institute for Scientific Information (ISI), 41,238 articles with first authors who resided in those countries were extracted. These articles were analyzed by subject area, type of study, country, number of authors and institutions that participated in the investigation, and citations received by each article. Also analyzed were 95 articles in epidemiology selected from a pool of 570 published by authors from the six countries in 11 public health journals that enjoy international prestige. The results showed that the number of published works increased by 117% between the first and last five-year periods within the study period. Clinical research was distributed the most evenly among the countries, and public health research was the most concentrated (60.7% originated in Brazil). The numbers of biomedical and public health research articles showed relatively more growth than those reporting on clinical research throughout the period. A relative decrease was found in articles by only one author, which suggests a greater frequency of team efforts, and an increase was seen in articles with authors tied to two or more national or foreign institutions, which indicates greater cooperation between institutions and countries. The average number of citations received by each article was 3, which was less than half the number received by the articles in the ISI database (7.78). Regarding the subset of 95 articles in epidemiology, the great majority (96%) dealt with infectious diseases or maternal and child health, while in the international literature 78% of such articles were about chronic diseases. This group of articles gave evidence of more cooperation with international institutions and had a citation index of 4.36 per article. It is concluded that, despite the inherent limitations, this type of study reveals some general trends in the development of research in the six Latin American countries with the greatest scientific production and makes it possible to formulate hypotheses on the factors that influence these trends. Taken with the paper caution, the results of studies like this one can be of great value in defining health science and technology policies.

Unlabelled: In large areas of the Amazon jungle from Brazil, Colombia, Venezuela and Peru, it has been reported hyperendemic HBV and delta focus. In the Peruvian jungle we found up to 97% of prevalence of HBV, on the northern Jívaro tribes vs the southern tribes, Arawak, (65%). In this paper we studied 226 volunteers from 6 Jívaro and 3 Arawak villages, who accepted to be vaccinated with a DNA recombinant vaccine (ENGERIX B); all of them were previously HBsAg/Ab negatives but 55.5% of them were anti-core (IgG) positive. Our results show 84.9% of seroconversion to anti-HBs, and 73.5% was consider to be immunized (> 10 mIU/ml). Better response was observed in those that were HBcAb negative, coming from a low endemic area. We also observed a good vaccine response although we had to change months the response decreased up to 51.8% of seroimmunity. Higher anti-HBs titles was observed in the southern tribes: MGC of 416.3 mIU/ml. compared with the south: MGC: 182.2 mIU/ml., Conclusions: It is important to check previously, in hyperendemic areas, HBV markers, specially. It is important to receive the second dose between with the third dose up to 14 month. The immune response overall was good: the ABsAb titles obtained was in average, 290 mIU/ml (10.2-41,00). Apparently the vaccine do not suffer during the difficulties in transportation in the jungle. No side effects we shown during the vaccination program.

A methodological experiment was conducted as part of the Demographic and Health Surveys (DHS) project to determine whether different approaches to measuring the same variables would yield similar results. The experiment consisted of the use of a new questionnaire, incorporating variants of many of the traditional approaches to the collection of demographic and health data. The experimental questionnaire was applied in 2 countries, Peru and the Dominican Republic at the same time as the standard survey. The most salient feature of this new questionnaire pregnancies, contraceptive practice, and postpartum, marriage, employment, and migration information. In this paper, the authors evaluate whether the use of the calendar in the experimental questionnaire improved the quality of the resulting information on contraception in the DHS surveys from the abovementioned countries. Specifically, the author determine whether the monthly calendar led to better estimates of contraceptive prevalence, failure, and discontinuation, and discuss the advantages and drawbacks of the calendar over the more standard approach. Results from this evaluation suggest that the major advantages of the calendar over the more standard questionnaire are 3-fold: it allows for more complete reports of use for periods prior to the survey; it allows for a detailed study of contraceptive use patterns; and it obtains information which is more internally consistent with other types of information. On the bases of these findings, the DHS project will include a calendar in the new standard questionnaire to be used in the 2nd round of surveys (DHS II).

This paper, a reminder of Hermilio Valdizan's death semicentennial, reviews an aspect of this renowned investigator's work, the formal founder of Psychiatry and the most representative figure of its initial development in Peru. Firstly, it examines the theoretical frame eclosing Valdizan's thought aimed at searching for the Peruvian roots of Medicine and Psychiatry remarking the influence of positivism and the culturalist gravitation. Afterwards, it lingers over a biographical sketch with emphasis laid upon those circumstances that explain the Master's vocational trends and his especial concern on the analysis of Peruvian reality. It reviews Valdizan's innovative contributions to Comparative Psychiatry revealing that his production is considered as the first systematic one in this field in Latin America. It inquires into the sense, orientation, and content of Valdizan's work on Peruvian Traditional Medicine research, the fullest intent on approaching the masses's "sanitarian consciousness" and their closeties with the oral tradition fostered by the conceptions and practice of the healing art in Ancient Peru. Finally, as a distinctive note of this original written production, its main concern on the search for the sense and identity of Peruvian nationality is pointed out. And, after establishing Valdizan's position as the founder of the Peruvian School of Folkloric Medicine, the post-Valdizannian contributions and an actual view of the investigation in this field are concisely and panoramically presented.

Much has been written about gastric mucosae behavior and the occurrence of intestinal metaplasia. The aim of this paper is to learn something more about these matters in peruvian population. We selected 100 patients with endoscopically no localized lesions between 30 to 70 years of age. We took 8 samples of gastric mucosae in each patient which were carefully examined for the presence of inflammatory changes, settle the line type between antral and fundic mucosae and the frequency of intestinal metaplasia finding. The results showed disagreement between endoscopic and histological findings, so we conclude it is better to diagnose chronic gastritis on the basis of histological parameters. The line between antral and fundic mucosae was of the close type one found in 87% of all cases and it advanced proximally with increasing age. Intestinal metaplasia was present in 46% of the whole number of patients and the rate of occurrence increased in 50% over 50 years age. These findings will let us compare future investigations of gastric mucosae behavior with localized benign or malign lesions.

"This paper describes the historical evolution of five populations and analyzes the circumstances under which data on maternal and paternal orphanhood of couples at the moment of marriage were collected and compiled." The data, which concern historical populations in Mexico, Chile, Peru, Brazil, and Argentina, are used to construct life tables for male and female adults. Consideration is given to mortality differentials by sex. (summary in ENG), (excerpt)

The purpose of this paper is to analyze the differentials and detect factors affecting infant mortality on the basis of data obtained from the fertility surveys from those countries participating in the World Fertility Survey. In particular, this includes the surveys carried out in Colombia, Peru, Costa Rica, Panama, and the Dominican Republic. 3 types of explanatory variables may be considered from the information available: 1) context variables related to the mother's environment; 2) socioeconomic variables based on the educational and economic characteristics of the mother and her last husband; and 3) biological factors (from each woman's pregnancy history) such as mother's age at birth of the child, order of birth, interbirth interval, etc. The countries, whether high or low mortality, present great differences in child mortality in most of the variables considered. In Panama and Costa Rica there are population sectors with infant mortality rates of around 100/1000 live births, whereas in Peru these are over 150/1000 (children from mothers without education, low agricultural strata, etc.). Besides presenting the differentials, a methodological test is made through the application to Costa Rica and Peru of the Proportional Hazards Model which permits analysis of the effects of variables when acting simultaneously upon mortality in early childhood. The variables which show the highest disparity in mortality level are: natural region among the context variables, education of mother among the socioeconomic variables, and interbirth interval and maternal age at birth of their children among the biological ones.

"During the latter part of 1986, national probability sample surveys of women of reproductive ages were carried out in... Peru and the Dominican Republic. These surveys were made as part of the Demographic Health Surveys project (DHS). In each country, one survey was conducted with the standard core questionnaire developed for DHS; the other survey was based on an experimental questionnaire. The major difference between the two questionnaires is the inclusion in the experimental one of a monthly calendar, which records pregnancies, contraceptive use, reasons for contraceptive discontinuation, breastfeeding, post-partum amenorrhea, post-partum abstinence, women's employment and place of residence for the period 1981-1986. This paper presents results from the first stage of the analysis of the Peruvian data: a comparison of basic characteristics of the two samples and an assessment of the completeness of reporting of recent births and infant and child deaths, i.e., a comparison of information in the truncated and full birth histories." (SUMMARY IN ENG), (excerpt)

In the ancient Peru, particularly in the Inca Empire, the review of alcohol use and abuse must be made according to the ethnohistorical and cultural context with special emphasis on ideological and customary aspects. The outstanding research sources of alcohol consume types and characteristics are: a) The examination of chronicles of the Spanish Conquest and related papers on a textual criticism; b) The study of language from its semantic scope; and c) The archaeological and ethnological testimony. The only alcoholic beverage existing in the Inca's times was "chicha", mainly that of corn fermentation which was used under the ceremonial, ritual and convivial modalities. The pathological drinking types are clearly defined in the lexicon of the Pre-Columbian Peru prevailing languages, mainly Quechua. The social control of drinking overindulgence was evident and the repressive and punitive measures were similar to those of the great ancient civilizations. The image conveyed by most of the chroniclers as to alcohol excessive drinking among Inca people belongs to the trauma of Conquest which suppressed the psychopolitical and sociocultural control that supported their universe of values generating all sort of misbehaviors and selfdestructive types of toxic consume.

In the present paper, the serologic markers of Hepatitis B virus were studied in 123 people belonging to the Hospital Central de la Fuerza Aérea del Perú that had been working in areas of high risk to get contact with this virus. The determination was done with the enzimo inmuno assay (EIA Abbot) and the results were the following: In 15 individuals (12.1%), at least one positive marker was found, evidence which proved to have been in contact with the virus in some moment of his life. Only one carrier (0.8%) was found, in 6 (4.8%) the presence of anti-HBc as only marker was found and in 8 (6.5%) the presence of Anti-HBc and Anti-HBs was observed which means post infection immunity. The great number of the individuals in which the markers were found, were male: 13 (16.0%) against only 2 (4.7%) female. There wasn't great difference with relation to the prevalency of markers according to the years of work like there has been observed in other greater series. It can be concluded that in this group the incidence of infection due to VHB was no greater than that of general population, which indicates us the little contact that they have had with the contaminating material during their professional life.