Search

(1) Background: Current diagnosis of anemia in high altitude populations uses an adjustment of observed hemoglobin (Hb) values. Such an approach has been challenged by findings in different populations in Tibet, Ethiopia and the Andes as inappropriate, as it might incorrectly classify an individual with complete iron stores as anemic. We aimed to assess the suitability of this approach in adult men and women from Cusco, Peru (3400 m); (2) Methods: Complete blood count and iron status biomarkers were measured in 345 subjects (189 females and 156 males), iron status biomarkers were quantified with enzyme-linked immunoassays; (3) Results: Anemia prevalence was overestimated when the altitude-adjustment factor was applied. Hematological parameters were better correlated to iron status biomarkers in the non-adjusted anemia category. When stratified by sex, only women showed a significant association between Hb and other hematological parameters with iron storage and availability (Hepcidin and TFR-F); (4) Conclusion: The prevalence of anemia is overestimated with current guidelines. The rate of anemia using non-adjusted Hb values is more closely related to the rates of anemia or iron deficiency when used hematological parameters, markers of iron status, and measurements of hepcidin and erythropoietin. Sex differences related to iron status were observed, suggesting that men are at a higher risk of iron overload than women at high altitudes. It could be highlighted that a personalized approach is important when assessing a subject, taking in to account hematological parameters as well as origin (Southern Andean or other).

The Instituto de Investigaciones de la Altura (IIA) was born 60 years ago with the creation of the Cayetano Heredia University (UPCH).It is oriented to the investigation of the adaptation and acclimatization to the altitude, and without pretending it to the solution of the national problems in health. The eradication of endemic goiter, the consolidation of the Tuberculosis Pilot Program and its expansion to a community model, the proposition that anemia in Peru is due to overdiagnosis by using an inadequate correction formula for height and a flat cut-off point for the children, knowing the beneficial effect of native plants such as maca, treatment for COVID-19 with second-indication drugs, damage to health from the use of traditional biomass stoves are some of the problems whose solutions have been born from his investigations, in addition to those found by his investigations on the problems of height. El Instituto de Investigaciones de Altura (IIA) nace hace 60 años con la creación de la Universidad Cayetano Heredia (UPCH). Está orientado a la investigación de la adaptación y aclimatación a la altura, y sin pretenderlo a la solución de los problemas nacionales en salud. La erradicación del bocio endémico, la consolidación del Programa Piloto de Tuberculosis y su expansión a un modelo comunitario, el plantear que la anemia en el Perú es por sobrediagnóstico al usar una inadecuada fórmula de corrección por la altura y un punto de corte plano para los niños, el conocer el efecto beneficioso de plantas originarias como la maca, el tratamiento para el COVID-19 con medicamentos en segunda indicación, el daño a la salud por el uso de cocinas tradicionales de biomasa son algunos de los problemas cuyas soluciones han nacido de sus investigaciones, además de las encontradas por sus investigaciones sobre los problemas de la altura.

Durante muchos años, el dióxido de cloro ha sido utilizado por su principal característica como desinfectante, abarcando diversas áreas de aplicación como la sanitaria, alimenticia, industrial, etc. La evidencia reportada hasta la fecha cita diversos estudios en modelos animales, desde revisiones sobre la toxicocinética hasta la aplicación o usos del compuesto. Su poder como bactericida, virucida y eliminador microbiológico lo convirtió en una fuente de control y potabilización de aguas. La controversia generada actualmente es sobre el uso de este compuesto para el tratamiento y control de la COVID-19. Se ha evidenciado incongruencia con algunos resultados reportados y que su aplicación en pacientes positivos a SARS-CoV-2 o para prevenir COVID-19 puede tener efectos adversos, como un acrecentado número de intoxicaciones y, en otros casos, la muerte. En la presente revisión se detalla, a partir de la evidencia científica reportada, los efectos de este compuesto sobre la salud y la interacción con el virus SARS-CoV-2.

Introduction: Exposure to high environmental temperature during pregnancy has been associated with lower birth weight, and an increased risk of preterm birth (PTB). The province of Piura is a region with a higher environmental temperature than the rest of the country; however, it is unknown how temperature would be impacting reproductive health in populations exposed to high basal temperatures.Objective: To determine the association between maximum apparent temperature (HImax) during pregnancy with birth weight and preterm birth in newborns in the province of Piura, 2011-2016.Methods: Semi-ecological study, where maternal-perinatal data from Santa Rosa Hospital (N=17,788); and maximum apparent temperature data were evaluated. Four exposure windows were analyzed: the entire pregnancy, and each gestational trimester, which were assigned according to date of birth and gestational age, categorized into quartiles. The association with birth weight was assessed by linear regression; and Cox regression for PTB.Results: A negative association was found between birth weight and HImax in all exposure windows, except for the first trimester, the effect being greater during the third trimester. As for preterm birth, higher HImax increased the hazard of PTB, with the highest effect seen in the P95 exposed group in every exposure window; nonetheless, the first and second trimester being the most temperature-sensitive exposure windows.Conclusion: HImax during pregnancy is related to lower birth weight and higher PTB hazards, but with different susceptibility according to the stage of pregnancy.

Dear Editor, Monkeypox is a zoonotic disease caused by the monkeypox virus, and symptoms include fever, muscle pain, headache, fatigue, swollen lymph nodes, and the appearance of pustules and wounds on different parts of the body. Transmission is through direct contact with infected animals or people, or through contact with fluids such as respiratory droplets...

El reciente derrame de petróleo ocurrido el 15 de enero del 2022 en Ventanilla, Callao, durante un procedimiento de carga y descarga de combustible en el terminal de la Refinería La Pampilla, donde se estima que cerca de 12 000 barriles de petróleo fueron vertidos en el mar (Figura1), nos debe hacer reflexionar sobre el impacto que tienen estos desastres no solo en el aspecto ecológico y económico sino también en la salud humana.

Los derrames de petróleo son desastres naturales que pueden ocurrir por diversos factores. En nuestro país no es una realidad ajena este tipo de contaminación acuática, terrestre y biológica, la cual afecta diversos sectores siendo el de mayor impacto la salud humana y animal (Tabla 1). En el Perú son escasos por no decir nulos los estudios de la salud de la población expuesta a estos derrames. Tenemos, sin embargo, la literatura internacional que nos proporciona información útil que puede ser aplicable a nuestra realidad. En el corto plazo un derrame de petróleo impacta a los pescadores, la seguridad alimentaria, y a los negocios que ofrecen productos marinos, por el temor.

Objectives: Peru has had the highest death toll from the pandemic worldwide; however, it is not clear what the effects of the different variants on these outcomes are. The study aimed to evaluate the risk of death, hospitalization, and intensive care unit (ICU) admission rates of COVID-19 according to the SARS-CoV-2 variants detected in Peru from March 2020-February 2022. Methods: Retrospective study using open-access databases were published by the Peruvian Ministry of Health. Databases of genomic sequencing, death, COVID-19 cases, hospitalization and ICU, and vaccination were used. Crude and adjusted Cox proportional hazards regressions with clustered variances were modeled to calculate the hazard ratio (HR) of outcomes by variant. Results: Lambda variant had the highest risk of death (HR 1.92, 95% CI 1.37-2.68), whereas the Delta variant had the lowest risk (HR 0.50, 95% CI 0.31-0.82). Mu variant had the highest risk of hospitalization (HR: 2.39, 95% CI 1.56-3.67), Omicron the lowest (HR 0.45, 95%CI 0.23-0.90), and Gamma had the highest ICU admission rate (HR 1.95, 95%CI 1.40-2.71). Conclusion: SARS-CoV-2 variants showed distinctive risks of clinical outcomes, which could have implications for the management of infected persons during the pandemic.

The COVID-19 pandemic highlighted a health problem in various parts of the world, and measures to curb the spread of the virus were based on the use of masks, social immobilisation, preventive and constant cleanliness, etc. Likewise, other public health problems such as anemia could not be tackled as in previous years. National surveys show that the consumption of iron, the main measure for the preventive and therapeutic treatment of this hematological condition, was significantly reduced. On the other hand, anemia figures in the Andean region were not affected, remaining at a similar value as in 2019. Therefore, the hypothesis supported is whether policies have been based on scientific evidence, given that despite the great efforts of multimicronutrient supplementation interventions, prevalences did not decrease. The present analysis is based on the formulations of the misdiagnosis of this condition, anemia, since the hemoglobin value is considered as a universal and unique marker. And the other point to support is the multi-causality of anemia, since iron deficiency is the only one addressed, however, recent reviews show that this aetiology is neither the only one nor the one of major consideration for the progressive progression of this disease. La pandemia por la COVID-19 evidenció un problema sanitario en diversas partes del mundo, las medidas para el freno del avance del virus se basaron en el uso de mascarilla, inmovilización social, aseo preventivo y constante, etc. Así mismo, otros problemas de salud pública como la anemia no pudieron ser abordados como los años pasados. En las encuestas nacionales se refleja que el consumo de hierro, principal medida para el tratamiento preventivo y terapéutico de esta condición hematológica, se redujo significativamente. Por otro lado las cifras de anemia en la región andina no se vieron afectadas, manteniéndose en su valor similar que el año 2019, debido a ello, la hipótesis sustentada es si las políticas han estado basadas en evidencia científica, puesto que a pesar de los grandes esfuerzos por las intervenciones de suplementación con multimicronutrientes, las prevalencias no descendían. El presente análisis está basado en las formulaciones del mal diagnóstico de esta condición, anemia, puesto que se considera como marcador universal y único al valor de hemoglobina. Y el otro punto a sustentar es la multicausalidad de la anemia, debido que la deficiencia de hierro es la única abordada, sin embargo, revisiones recientes muestran que esta etiología no es la única ni la de mayor consideración para el avance progresivo de esta enfermedad.

El petróleo está constituido principalmente por hidrocarburos y metales, en distintas concentraciones. Su naturaleza es altamente inflamable y a lo largo de la historia ha sido usado como combustible y fuente energética. Los derrames de petróleos son desastres que alteran distintos pisos ecológicos y afectan distintos sectores, principalmente el ambiental, el de salud, la economía y el turismo. Diversos estudios han evidenciado efectos tanto a corto como a largo plazo en la salud humana, especialmente a nivel reproductivo, cardio-respiratorio, hepático, renal, metabólico y mental. La exposición ocurre por ingestión, absorción a través de la piel intacta e inhalación. En Perú, el 15 de enero de 2022, un derrame de petróleo en Ventanilla, Callao, de alrededor de 12,000 barriles de petróleo generó efectos nocivos sobre especies marinas, ornitológicas y sobre la calidad de vida de pescadores artesanales. Su impacto aún está en evaluación debido a que a ello se suma lenta respuesta de los responsables por mermar el avance del derrame en la zona, habiéndose extendido 34.4 km hasta la zona de Chancay. Es por ello, que en la presente revisión se detalla la evidencia científica a nivel internacional de los efectos principalmente en la salud, que puede generar un derrame de petróleo. Los hallazgos reportados en la literatura contribuyen a ampliar el conocimiento sobre los efectos a largo plazo de los derrames de petróleo en la salud, considerando la necesidad de estudios longitudinales en especies y poblaciones aledañas a las zonas directamente afectadas por estos desastres ecológicos.

The World Health Organization (WHO) estimates that around ~ 150 million people in 70 different countries have been consuming water with arsenic levels higher than the recommended limit of 10 µg/L. Here we describe the concentrations of inorganic arsenic in drinking water in homes of pregnant women living in the province of Tacna, near the southern border of Peru. 161 pregnant women were enrolled in their second trimester of pregnancy. A total of 100 mL drinking water was collected in each household from the source of most common use. Inorganic arsenic was categorized into three levels with a commercial kit. Thirty percent of women had drinking water ≤ 10 µg/L (the WHO recommended level), 35% had 25 µg/L, and 35% had greater than 50 µg/L. Low arsenic levels were found in the southernmost homes, supplied by groundwater, while high levels were found in the northern and metropolitan homes supplied by river water.

Actualmente, el cáncer de cuello uterino es un problema de salud pública mundial. Por ende, las políticas de detección, diagnóstico y tratamiento preventivo deben ser efectivos para evitar la metástasis de esta enfermedad. Solo en el 2020, la incidencia de contraer cáncer de cuello uterino en mujeres fue del 0.0133% con una mortalidad de 0.0073% ocupando el cuarto lugar a nivel mundial.

Native American populations have been using herbs for millennia to treat ailments and diseases. Male sexual and reproductive health has also been addressed by traditional American herbal medicine using mainly native plants. As a megadiverse zone, the materia prima of this therapeutic approach is vast. In recent years, scientific methods have been used to test the validity of traditional knowledge and to find novel pharmacological agents to treat the ever-growing demand for andrological therapies. This chapter aims to gather evidence of American herbs with attributed effects in andrological issues. Species from North America, Central America, and the Caribbean and South America are reviewed. The majority of studies have been done with in vitro and in vivo models and lack human trials to confirm reliably their properties but enough evidence to justify further research is provided, especially in species such as Lepidium meyenii (Maca), Serenoa repens, and Cucurbita pepo.

The Peruvian Region of Tacna has the highest prevalence of macrosomia (15%), but also the highest arsenic (As) concentration in tap water. The consumption of tap water contaminated with arsenic is associated with low birth weight. To address this discrepancy in this Region, the objective of this study is to evaluate the averages of arsenic concentration in tap water with diferent reproductive outcomes

Lepidium meyenii, better known as maca, is a plant that grows 4000 m above sea level in the Central Andes. It has been used in Peruvian traditional medicine for centuries, with reports of its use to increase the offspring of domestic animals dating back from the 16th century. Traditional knowledge about its handling, preparation methods, and beneficial properties have survived until today, and guided the scientific community to conduct experimental trials to test the veracity behind these claims. The main health effects of maca as an energy booster and fertility enhancer herb has been confirmed in animal models and clinical trials. Other properties unknown to native Peruvians have also been discovered. This chapter aims to cover the tradition behind the medicinal usage of this nutritional plant and the scientific research that demonstrates its properties.

According to the World Health Organization, the cutoff hemoglobin (Hb) value for defining anemia is 11 g/dL in preschool-aged children, and Hb measurements should be corrected above an altitude of 1000 meters. This study sought to determine the altitude at which the Hb value increases compared with that at sea level, Hb changes with age and region in Peru, the prevalence of anemia according to three different models used to correct Hb for altitude, and the association of the Hb value with stunting. Two individual-based Peruvian national databases were analyzed. Hb increased from an altitude of 375 meters. Hb concentration was lower at younger ages and higher at older ages. The increase in Hb with increasing altitude was lower in southern Peru. Implementing the different models for Hb measurement correction resulted in a higher and lower prevalence of anemia at altitudes >2500 and

Benign prostatic hyperplasia (BPH) is a pathology characterised by an increase in prostate size associated with low urinary tract symptoms. Finasteride (F), a 5a-reductase inhibitor, is the standard treatment for BPH reducing prostate weight but also sexual desire. The Peruvian plant known as Red Maca (RM) (Lepidium meyenii) inhibits BPH in rats and mice. The aim of the study was to assess the inflammatory effect of RM and finasteride in rats with testosterone enanthate (TE)-induced BPH. Thirty rats were divided into 5 groups: Control, TE (50 mg/rat), TE + F (0.6 mg/kg), and two groups of TE + RM 40/80 (40 or 80 mg). After treatments, tumour necrosis factor alpha (TNFa), interleukin 4 (IL4) and interferon gamma (INFg) as well as testosterone and oestradiol were evaluated and inflammatory cells (neutrophils, mast cells and lymphocytes) in prostate were quantified. Red Maca and finasteride treatments decreased inflammatory cells counts in prostate, inhibiting TNFa by different pathways. Finasteride increased IL4 whereas Red Maca increased INFg. In conclusion, data suggest that finasteride acts on Th2 response by increasing IL4 in prostate, while Red Maca acts on Th1 response mediated by INFg.

Inorganic arsenic exposure has been linked to the development of several health conditions, including adverse birth outcomes, and around 150 million of people worldwide are exposed to levels above the WHO suggested limit of 10 μg/L. A recent risk assessment in pregnant women of Tacna, of this same population performed by our group, found that 70.25% were exposed to arsenic concentrations in drinking water ≥ 25 μg/L. The present study aimed to evaluate the relationship between prenatal total urinary arsenic (U-tAs) and inorganic arsenic (U-iAs) with adverse birth outcomes. A total of 147 pregnant women from the province of Tacna, Peru, during February–March, 2019, were evaluated for U-tAs and U-iAs exposure during their second trimester of pregnancy, while the birth records of their children were collected from the local hospital. The geometric mean U-tAs was 43.97 ± 25.88 μg/L (P50 22.30, range 5.99–181.94 μg/L) and U-iAs was 5.27 ± 2.91 μg/L. Controlling for maternal age, pre-pregnancy BMI, parity, mother’s education, and newborn sex, no relationship was observed between tertile of U-tAs and the birth outcomes considered, although we found an apparent but statistically non-significant dose–response relationship for small for gestational age 2.38% (95% CI 0.003, 0.16), versus 7.32% (95% CI 0.02, 0.21%), and versus 8.57% (95% CI 0.03, 0.25%). This finding requires further evaluation considering other factors such as metabolic arsenic species, additional maternal covariates, and ethnicity.

La rápida propagación mundial de un nuevo coronavirus denominado SARS-CoV-2, detectado en la cuidad de Wuhan, China, hace necesario del conocimiento e implementación de métodos de diagnóstico confiables para detectar y tratar adecuadamente a los pacientes. Para ello, los métodos más utilizados para el diagnóstico son: la técnica de inmunocromatografía (IC), la cual enmarca tanto a las pruebas detectoras de anticuerpos como a la prueba de detección de antígenos; y las pruebas de diagnóstico molecular basadas en tecnología de PCR, detectando cuantitativa y cualitativamente al virus, como por ejemplo qRT-PCR y al LAMP. Mediante la revisión de las bases de Scielo, Pubmed y Scopus se compara la utilidad diagnóstica de las pruebas LAMP, qRT-PCR e IC aplicadas al diagnóstico de SARS-CoV-2, y cómo las distintas variantes del virus han impactado sobre la confiabilidad de estas pruebas.

Objetivo Determinar si el volumen corpuscular medio (VCM) alto se relaciona con el recuento de glóbulos blancos (GB) en gestantes atendidas en el Instituto Nacional Materno Perinatal. Materiales y métodos. Estudio observacional transversal, compuesto por 8590 hemogramas obtenidos de gestantes atendidas en el Instituto Nacional Materno Perinatal durante el segundo semestre del 2018. Se utilizó el equipo automatizado CELL-DYN Ruby ®. Para el análisis estadístico, se usó el paquete estadístico STATA versión 15.0. Los datos son presentados como medias ± error estándar. La variable VCM se categorizó como normal (80≤MCV≤97fL), baja (MCV 97fL). La prueba ANOVA se empleó para evaluar la diferencia entre los grupos de VCM y los diversos parámetros hematológicos; en caso de resultar significativo, se empleó la prueba post-hoc de Scheffé. La prueba de regresión lineal se realizó para determinar el coeficiente de los grupos de VCM y su variación con el recuento de Glóbulos Blancos (GB). Resultados. El VCM alto en gestantes se asocia a un aumento de GB. En el análisis de cada tipo de célula blanca, se observan que todas ellas, con excepción de los neutrófilos, se encuentran elevadas cuando VCM es categorizado como alto. Las plaquetas muestran un valor menor en la categoría de VCM alto a diferencia de lo observado en las categorías de VCM normal y bajo. Conclusión. El VCM elevado parece asociarse a un proceso inflamatorio, evidenciado en un aumento de la serie blanca con excepción de los neutrófilos.

De acuerdo con la Organización Mundial de la Salud (OMS), hay 802 millones de personas entre niños en edad pre-escolar, y mujeres en edad reproductiva que son diagnosticadas de anemia. Estas cifras muestran un panorama poco alentador para los gobiernos, puesto que vemos el gran énfasis en los programas de suplementación de hierro, con distribución a nivel nacional. Sin embargo, los valores reportados en las encuestas y las grandes bases de datos que se utilizan para la elaboración de estadísticas nacionales se basa en la medición de la hemoglobina mediante el equipo HemoCue®, que presenta variantes entre los equipos y que reportan valores que no permiten determinar la causa de la anemia, basando la intervención solo en la suplementación de hierro, cuando a nivel mundial se ha determinado que solo el 50% de casos de anemia se deben a deficiencia de hierro, 42% a causas inflamatorias y 8% a otras causas. En el reporte de 2016, la OMS recomendó como primera prioridad la evaluación del hemograma completo para definir anemia, y cuando no exista esta facilidad usar la medición de la hemoglobina. En la presente revisión narrativa se hará un análisis de cada metodología y la utilidad tanto para la práctica clínica como para el uso poblacional en el diagnóstico de la anemia gestacional.

Anemia is a worldwide public health problem that affects both the health and survival of people. It is estimated that 25% of the world population suffers it. Although most of the countries have been intervening during fifty years to reduce the rates of anemia, these efforts are unsatisfactory. Among the arguments used to explain this low success, is the low adherence to the consumption of iron supplements. The hepcidin discovery in 2000 has changed our knowledge about the mechanisms that regulate iron homeostasis, which shows that the inflammatory processes, which are responsible for 42% of anemia cases in the world will not respond to the intervention with oral iron, due to the increase in the value of hepcidin by inflammation. In this review it is also argued that the criteria used to determine the cut-off points in children and pregnant women to define iron deficiency anemia do not agree with the normality figures established in several countries in the world. Thus, the cut-off point of 11 g / dL of Hb defined to determine anemia in pregnant women and children is above the mean-two standard deviations of the populations evaluated. Evidence is also described that suggests that the correction of hemoglobin by altitude of residence would be unnecessary and erroneously increasing the prevalence of anemia in high-altitude populations. To sum up, the evidence suggests that adjusting hemoglobin for altitude is unnecessary, and significantly increases the prevalence of anemia in high altitude population. The Hb cut-off point 11 g / dL should be redefined to diagnose anemia in children under 60 months of age and in pregnant women. In a way to better define iron deficiency anemia, other biomarkers should be considered to evaluate the content of body iron, always adjusting for the inflammatory contribution. By these means we can accurately distinguish the prevalence of iron deficiency anemia, excluding the other types. La anemia es un problema de salud pública mundial que afecta tanto la salud como la supervivencia de las personas. Se estima que 25% de la población mundial la padece. A pesar de que las mayorías de países del mundo realizan intervenciones desde hace cincuenta años para reducir las tasas de anemia, estas han resultado poco satisfactorias. Entre los argumentos que se plantean a este bajo éxito se considera a una baja adherencia al consumo de suplementos de hierro. El descubrimiento de la hepcidina en el año 2000 ha cambiado nuestro conocimiento sobre los mecanismos que regulan la homeostasis de hierro, con lo cual se demuestra que los procesos inflamatorios que en 42% se asocia a anemia en el mundo no va a responder a la intervención con hierro oral, debido al incremento en el valor de hepcidina por la inflamación. En esta revisión igualmente se discute que los criterios empleados para determinar los puntos de corte en niños y gestantes para definir anemia por deficiencia de hierro no concuerdan con las cifras de normalidad establecidas en varios países en el mundo. Así, el punto de corte de 11 g/dL de Hb definido para determinar anemia en gestantes y niños está por encima de la media-dos desviaciones standard de las poblaciones evaluadas. Igualmente se describen evidencias que permiten sugerir que la corrección de la hemoglobina por la altura sería innecesaria y estaría aumentando erróneamente las prevalencia de anemia en poblaciones de altura. En conclusión, las evidencias sugieren que el ajuste de hemoglobina por la altura es innecesario y aumenta de manera significativa la prevalencia de anemia en la altura. Se debe redefinir el punto de corte de Hb 11 g/dL para diagnosticar anemia en niños menores de 60 meses y en gestantes. Se deben de considerar evaluar el contenido de hierro corporal y otros biomarcadores del hierro, siempre ajustándolos por el aporte inflamatorio, de esta manera podemos distinguir exactamente la prevalencia de anemia por deficiencia de hierro, excluyendo los demás tipos.

Objetivos. Evaluar el cambio en los niveles ambientales de material particulado (2,5 y 10) (PM2,5 y PM10), dióxido de azufre (SO2) y dióxido de nitrógeno (NO2), posterior al reordenamiento vehicular en la avenida Abancay, entre 2013-2015 respecto a 2007-2009, comparando con otras dos avenidas sin implementación de un reordenamiento, la avenida Guillermo de La Fuente en el distrito de Comas y la avenida César Vallejo en el distrito de El Agustino. Materiales y métodos. Los datos ambientales fueron colectados por tres monitores de Dirección General de Salud Ambiental e Inocuidad Alimentaria del Ministerio de Salud como parte de la red de Vigilancia de la calidad del aire de la ciudad de Lima. El coeficiente beta de la regresión lineal permitió evaluar el cambio en la concentración de cada contaminante. Resultados. El reordenamiento de la Av. Abancay redujo 62% los niveles de PM2,5; 55% los niveles de PM10; 65% los niveles NO2; y 82% los de SO2. En las otras dos avenidas evaluadas no se observó disminución. Una reducción significativa de PM 2,5 (β: -53,11 μg/m³; IC 95%: -63,92 a -42,30), PM10 (β: -47,95 μg/m³; IC 95%: -62,61 a -33,37), NO2 (β:-41,71 μg/m³, IC 95%: -48,18 a -35,23) y SO2 (β: -28,59 μg/m³; IC 95%: -35,23 a -21,95) fueron observados en la Av. Abancay, respecto a las otras dos avenidas, posterior al reordenamiento vehicular. Conclusiones. El reordenamiento vehicular puede contribuir con la disminución continua de diversos contaminantes ambientales. La extensión de esta medida podría mejoraría la calidad de aire y estado de salud de la población residente en la ciudad de Lima. Objective. To assess the change in environmental levels of PM2.5, PM10, SO2, and NO2, after the application of a traffic regulation plan in Abancay Avenue between the years 2013-2015 vs. to 2007-2009, and comparing it against two other avenues, in which no traffic regulation was implemented: Guillermo de La Fuente Avenue in the district of Comas and Cesar Vallejo Avenue in El Agustino. Materials and Methods. Environmental data were collected by three air monitors from the Ministry of Health’s Environmental Health and Food Safety General Directorate (Dirección General de Salud Ambiental e Inocuidad Alimentaria) that are part of the Air Quality Surveillance network of the city of Lima. The beta coefficient of the linear regression allowed to assess change in the concentration of each pollutant. Results. The traffic regulation plan of Abancay Av. reduced the levels of PM2.5 by 62%; 55% for PM10 levels; 65% for the NO2 levels, and 82% for the SO2 levels. In the other two avenues assess, this reduction was not observed. A significant reduction in PM2.5 (β: -53.11 μg/m3; 95% CI: -63.92 to -42.30), PM10 (β: -47.99 μg/m3; 95% CI: -62.61 to -33.37), NO2 (β: -41.71 μg/m3; 95% CI: -48.18 to -35.23), and SO2 (β: -28.59 μg/m3; 95% CI: -35.23 to -21.95) was observed in Abancay Av., with respect to the other two avenues, after the traffic regulation plan was implemented. Conclusions. Traffic regulation can contribute to the continuous reduction of different air pollutants. The expansion of this measure could improve air quality and the health status of the residents of Lima.

Iron deficiency and overload are risk factors for numerous poor health outcomes, and thus the maintenance of iron homeostasis is vital. Considering that hemoglobin contains 70% of the total iron in the body, the World Health Organization (WHO) recommends the measurement of iron levels to calculate the rate of iron deficiency anemia (IDA), although WHO recognizes that IDA is not the only cause of anemia. As hemoglobin increases with altitude, WHO recommends correcting the cut-off point to define anemia at high altitudes. An objection to this correction is that the increase in hemoglobin at high altitudes is not universal and is not linear. In addition, individuals in older age groups have lower hemoglobin levels than those in younger age groups. In infants, children, pregnant women, and adults, the prevalence of anemia using corrected hemoglobin is 3-5 times higher than that using markers of iron status. State programs seek to control anemia by means of iron supplementation. However, these programs are ineffective, particularly for high-altitude populations. Therefore, the occurrence of iron deficiency at high altitudes is controversial. The serum levels of the hormone hepcidin, which regulates iron availability, are similar in individuals at high altitudes to those of individuals at sea level, indicating that iron deficiency does not occur at high altitudes. An additional problem when correcting hemoglobin at high altitudes is that the frequency of erythrocytosis is decreased. In conclusion, the correction of the cut-off point of hemoglobin at high altitudes to determine iron deficiency is inadequate.Tanto la deficiencia como la sobrecarga de hierro son situaciones que ponen en riesgo la salud y la vida de las personas, por lo que es importante mantener su homeostasis. Como la hemoglobina contiene 70% del hierro del organismo, la OMS recomienda su medición para determinar la prevalencia de anemia por deficiencia de hierro (ID), a pesar que ellos mismos reconocen que la anemia no es específica de ID. Como la hemoglobina aumenta con la altitud de residencia, la OMS recomienda corregir el punto de corte para definir anemia en la altura. Una objeción a esta corrección es que el aumento de la hemoglobina en la altura no es universal ni aumenta de manera lineal. Además, las poblaciones de mayor antigüedad generacional tienen menos hemoglobina que las más recientes. En infantes, niños, gestantes y adultos, la prevalencia de anemia usando hemoglobina corregida es 3-5 veces mayor que usando marcadores del estatus de hierro. Los programas estatales buscan combatir la anemia mediante la suplementación de hierro; no obstante, resultan ineficaces, especialmente en las poblaciones de altura. Entonces, ¿hay deficiencia de hierro en la altura? Los niveles de hepcidina sérica, hormona que regula la disponibilidad de hierro, son similares a los de nivel del mar indicando que en la altura no hay deficiencia de hierro. Un problema adicional al corregir la hemoglobina por la altura, es que las prevalencias de eritrocitosis disminuyen. En conclusión, la corrección del punto de corte de la hemoglobina en la altura para determinar deficiencia de hierro es inadecuada.

Tanto la deficiencia como la sobrecarga de hierro son situaciones que ponen en riesgo la salud y la vida de las personas, por lo que es importante mantener su homeostasis. Como la hemoglobina contiene 70% del hierro del organismo, la OMS recomienda su medición para determinar la prevalencia de anemia por deficiencia de hierro (ID), a pesar que ellos mismos reconocen que la anemia no es específica de ID. Como la hemoglobina aumenta con la altitud de residencia, la OMS recomienda corregir el punto de corte para definir anemia en la altura. Una objeción a esta corrección es que el aumento de la hemoglobina en la altura no es universal ni aumenta de manera lineal. Además, las poblaciones de mayor antigüedad generacional tienen menos hemoglobina que las más recientes. En infantes, niños, gestantes y adultos, la prevalencia de anemia usando hemoglobina corregida es 3-5 veces mayor que usando marcadores del estatus de hierro. Los programas estatales buscan combatir la anemia mediante la suplementación de hierro; no obstante, resultan ineficaces, especialmente en las poblaciones de altura. Entonces, ¿hay deficiencia de hierro en la altura? Los niveles de hepcidina sérica, hormona que regula la disponibilidad de hierro, son similares a los de nivel del mar indicando que en la altura no hay deficiencia de hierro. Un problema adicional al corregir la hemoglobina por la altura, es que las prevalencias de eritrocitosis disminuyen. En conclusión, la corrección del punto de corte de la hemoglobina en la altura para determinar deficiencia de hierro es inadecuada. Iron deficiency and overload are risk factors for numerous poor health outcomes, and thus the maintenance of iron homeostasis is vital. Considering that hemoglobin contains 70% of the total iron in the body, the World Health Organization (WHO) recommends the measurement of iron levels to calculate the rate of iron deficiency anemia (IDA), although WHO recognizes that IDA is not the only cause of anemia. As hemoglobin increases with altitude, WHO recommends correcting the cut-off point to define anemia at high altitudes. An objection to this correction is that the increase in hemoglobin at high altitudes is not universal and is not linear. In addition, individuals in older age groups have lower hemoglobin levels than those in younger age groups. In infants, children, pregnant women, and adults, the prevalence of anemia using corrected hemoglobin is 3-5 times higher than that using markers of iron status. State programs seek to control anemia by means of iron supplementation. However, these programs are ineffective, particularly for high-altitude populations. Therefore, the occurrence of iron deficiency at high altitudes is controversial. The serum levels of the hormone hepcidin, which regulates iron availability, are similar in individuals at high altitudes to those of individuals at sea level, indicating that iron deficiency does not occur at high altitudes. An additional problem when correcting hemoglobin at high altitudes is that the frequency of erythrocytosis is decreased. In conclusion, the correction of the cut-off point of hemoglobin at high altitudes to determine iron deficiency is inadequate.

Benign Prostatic Hyperplasia (BPH) affects, worldwide, 50% of 60-year-old men. The Peruvian plant red maca (Lepidium meyenii) inhibits BPH in rodents. This study aimed to determine the effects of methanolic red maca extract and its n-butanol and aqueous fractions on expression of androgen and oestrogen receptors in rats with testosterone enanthate-induced BPH. Thirty-six rats in six groups were studied. Control group received 2 mL of vehicle orally and 0.1 mL of propylene glycol intramuscularly. The second group received vehicle orally and testosterone enanthate (TE) (25 mg/0.1 mL) intramuscularly in days 1 and 7. The other four groups were BPH-induced with TE and received, during 21 days, 3.78 mg/mL of finasteride, 18.3 mg/mL methanol extract of red maca, 2 mg/mL of n-butanol fraction, or 16.3 mg/mL of aqueous fraction from red maca. Treatments with red maca extract and its n-butanol but not aqueous fraction reduced prostate weight similar to finasteride. All maca treated groups restored the expression of ERβ, but only the aqueous fraction increased androgen receptors and ERα. In conclusion, butanol fraction of red maca reduced prostate size in BPH by restoring expression of ERβ without affecting androgen receptors and ERα. This effect was not observed with aqueous fraction of methanolic extract of red maca.