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The synchronous presentation of venolymphatic anomalies of the orbit and noncontiguous intracranial cavernous malformations is uncommon. Herein, we present a case of an 11-month-old female patient diagnosed with orbital venolymphatic anomaly associated with a large cavernous malformation in the posterior fossa, who underwent complete surgical resection of the latter. The immunohistochemical analysis was positive for podoplanin, a marker expressed by lymphatic endothelial cells, but not vascular endothelium. This exceptional finding suggests lymphatic involvement in the etiology of the lesion. In our review of the literature, we did not find similar cases in patients under 1 year of age.

BackgroundThe establishment of metagenomics seems a suitable approach to assess the abundance and diversity of antibiotic resistance genes (ARG)MethodsMetagenomics study in a Peruvian city from the highlands, where samples were derived from sewage waters from two hospitals and the urban setting. DNA extraction was performed in 250 mL and then 16S rRNA gene amplification and shotgun sequencing were carried out. The bioinformatics pipeline was performed following recommendations for metagenomics analysis. Alpha diversity was evaluated with the Shannon and Simpson’s indices; whereas beta diversity was evaluated through the Bray-Curtis index, and using the principal coordinate analysis (PCoA) to explore and visualize the differences.ResultsWe found a high abundance of bacteria related to resistance to beta-lactams, macrolides, aminoglycosides, fluoroquinolones, and tetracyclines. The urban sample did not differ significantly from the wastewater ARG presence from the hospitals in Huanuco.ConclusionMetagenomics analysis through sewage strategies seems to help to monitor the AMR to establish local public health policies, especially in cities or countries with limited resources to establish large projects conceiving the One Health approach.

Objectives. The analysis of transmission dynamics is crucial to determine whether mitigation or suppression measures reduce the spread of coronavirus disease 2019 (COVID-19). This study sought to estimate the basic (R0) and time-varying (Rt) reproduction number of COVID-19 and contrast the public health measures for ten South American countries. Methods. Data was obtained from the European Centre for Disease Prevention and Control. Country-specific R0 values during the first two weeks of the outbreak and Rt values after 90 days were estimated. Results. Countries used a combination of isolation, physical distancing, quarantine, and community-wide containment measures to staunch the spread of COVID-19 at different points in time. R0 ranged from 1.52 (95% confidence interval: 1.13-1.99) in Venezuela to 3.83 (3.04-4.75) in Chile, whereas Rt after 90 days ranged from 0.71 (95% credible interval: 0.39-1.05) in Uruguay to 1.20 (1.19-1.20) in Brazil. Different R0 and Rt values may be related to the testing capacity of each country. Conclusion. R0 in the early phase of the outbreak varied across the South American countries. The public health measures adopted in the initial period of the pandemic appear to have reduced Rt over time in each country, albeit to different levels.

During a pandemic, science needs data to generate helpful evidence, and researchers assume this responsibility despite the risk of potential bias. This is the response to the comment made by Pedro Romero, who argued that our manuscript did not use reassembling and mapping strategies for corroborating mutations, and lacked bootstrap support in the phylogenetic analysis.

ObjectivesThe analysis of transmission dynamics is crucial to determine whether mitigation or suppression measures reduce the spread of Coronavirus disease 2019 (COVID-19). This study sought to estimate the basic (R0) and time-varying (Rt) reproduction number of COVID-19 and contrast the public health measures for ten South American countries.MethodsData was obtained from the European Centre for Disease Prevention and Control. Country-specific R0 estimates during the first two weeks of the outbreak and Rt estimates after 90 days were estimated.ResultsCountries used a combination of isolation, physical distancing, quarantine, and community-wide containment measures to staunch the spread of COVID-19 at different points in time. R0 ranged from 1.52 (95% confidence interval: 1.13-1.99) in Venezuela to 3.83 (3.04-4.75) in Chile, whereas Rt after 90 days ranged from 0.71 (95% credible interval: 0.39-1.05) in Uruguay to 1.20 (1.19-1.20) in Brazil. Different R0 and Rt values may be related to the testing capacity of each country.ConclusionR0 in the early phase of the outbreak varied across the South American countries. The public health measures adopted in the initial period of the pandemic appear to have reduced Rt over time in each country, albeit to different levels.

Objetivo: determinar las variantes en el número de copias y regiones de homocigosidad mediante el análisis cromosómico por micromatrices, en niños con diagnóstico de trastorno del neurodesarrollo: retraso del desarrollo psicomotor (RDPM), discapacidad intelectual (DI) y trastorno del espectro autista (TEA), así como pacientes con síndrome malformativo (SM) y talla baja idiopática (TBI). Materiales y métodos: se evaluaron a 367 niños peruanos diagnosticados clínicamente con DI, RDPM, TEA, TBI y SM a quienes se les realizó el análisis cromosómico por micromatrices (CMA 750K CGH+SNP) en sangre periférica, entre los años 2016-2018. Resultados: las edades fluctuaron entre los 4,8 meses y los 18 años, con una media de 5,6 años. Los diagnósticos más frecuentes fueron RDPM (48%) y DI (30%). Se reportaron resultados anormales (variantes patogénicas, probablemente patogénicas, disomías uniparentales y regiones de homocigosidad superiores a 2,56%) en el 50,3% de los pacientes. Los resultados anormales se observaron en el 53,3% de los casos con diagnóstico de DI y el 47,9% de RDPM; mientras que en el resto de los casos con TBI sindrómica, SM y TEA tuvieron resultados anormales en el 52,4%, 52% y 20% respectivamente. Por otro lado, encontramos hasta un 6,2% de los padres eran consanguíneos no declarados. Conclusiones: la tasa de detección de las variantes en el número de copias (CNVs) encontrada en nuestro estudio fue superior a la reportada en estudios internacionales independientemente del diagnóstico clínico. Además, se pudo encontrar una mayor frecuencia de consanguinidad no declarada con relación a estudios anteriores.

After more than four months of the COVID‐19 pandemics with genomic information of SARS‐CoV‐2 around the globe, there are more than 1000 complete genomes of this virus. We used 691 genomes from the GISAID database. Several studies have been reporting mutations and hotspots according to the viral evolution. Our work intends to show and compare positions that have variants in 30 complete viral genomes from South American countries. We classified strains according to point alterations and portray the source where strains came into this region. Most viruses entered to South America from Europe, followed by Oceania. Only Chilean isolates demonstrated a relationship to Asian isolates. Some changes in South American genomes are near to specific domains related to replication or S protein. Our work contributes to global understanding of which sort of strains are spreading throughout South American countries, and the differences among them according to the first isolates introduced in this region. This article is protected by copyright. All rights reserved.

El cáncer medular de tiroides (CMT) es un tumor maligno de las células C parafoliculares secretoras de calcitonina. Se estima que el 25% de los casos de CMT se asocian a variantes patogénicas a nivel de línea germinal en el protooncogen RET (locus 10q11.2), que son las causantes del desarrollo de Carcinoma Medular de Tiroides Familiar (CMTF) o de la Neoplasia Endocrina Múltiple tipo 2 (NEM2); condiciones genéticas con patrón de herencia autosómico dominante. Presentamos el primer reporte de una familia peruana con CMTF y con variante patogénica identificada a nivel de línea germinal en el gen RET, mediante secuenciamiento Sanger. Este manuscrito también muestra una revisión de la literatura de este síndrome hereditario oncológico, donde se resalta su importancia en la prevención primaria y potencial efecto en la salud pública en casos de portadores de variantes patogénicas germinales aparentemente sanos.

Peru is a pluricultural and ethnically diverse country located in middle west of South America. It is the fourth largest country (1,285,216 km2) in area in South America, bordered in the north by Ecuador and Colombia, in the south by Chile, south east by Bolivia, by Brazil in the east and by the Pacific Ocean in the west. Peru has one of the most diverse climates, geographical and ecological in the world, from tropical or subtropical dessert to glacial in highland mountains to Amazon jungle. Peru is divided into 24 geopolitical regions with a central government. According to last national census in 2017, Peruvian populations accounts for 31,237,385 inhabitants (Instituto Nacional de Estadistica e Informatica [INEI], 2017). Most of Peru's population lives in the Coastal area, with almost one third of the nation's population living in Lima, the largest city with approximately 11 million people. Rural and urban population has changed over the last 50 years due to migration waves in the 1950s from rural to urban sites mainly located in the coast causing decrease or disappearance of native communities. Revisado por pares

Medullary thyroid carcinoma (MTC) is a malignant tumour of the calcitonin-secreting parafollicular C cells of the thyroid gland. Up to 25% of MTC are associated to pathogenic germinal variants on the proto-oncogene RET (locus 10q11.2), which cause Familial Medullary Thyroid Carcinoma (FMTC) or Multiple Endocrine Neoplasia type 2 (MEN2); genetic conditions inherited with autosomal dominant pattern. We present the first report of a Peruvian family with FMTC and a germinal pathogenic variant on RET proto-oncogene, identified with Sanger sequencing. This manuscript also shows a literature review of this hereditary cancer syndrome, where we highlight the relevance of primary prevention and the potential effect on public health in healthy carriers of germinal pathogenic variants.El cáncer medular de tiroides (CMT) es un tumor maligno de las células C parafoliculares secretoras de calcitonina. Se estima que el 25% de los casos de CMT se asocian a variantes patogénicas a nivel de línea germinal en el protooncogen RET (locus 10q11.2), que son las causantes del desarrollo de Carcinoma Medular de Tiroides Familiar (CMTF) o de la Neoplasia Endocrina Múltiple tipo 2 (NEM2); condiciones genéticas con patrón de herencia autosómico dominante. Presentamos el primer reporte de una familia peruana con CMTF y con variante patogénica identificada a nivel de línea germinal en el gen RET, mediante secuenciamiento Sanger. Este manuscrito también muestra una revisión de la literatura de este síndrome hereditario oncológico, donde se resalta su importancia en la prevención primaria y potencial efecto en la salud pública en casos de portadores de variantes patogénicas germinales aparentemente sanos.

La presente investigación permite introducir, dentro de la cadena de valor del sector no metálico, la actividad primaria de beneficio (procesamiento de minerales mediante la flotación diferencial) con el objetivo de incrementar el poder calorífico de los minerales de carbón antracita. El tipo de estudio es de carácter experimental aplicativo que analiza el fenómeno de flotación. La metodología en el trabajo de campo partió de los muestreos de los minerales de carbón antracita ubicados en el departamento de Áncash (Caraz, Huallanca, Sihuas y Mancos) para ser analizados y obtener los parámetros técnicos: poder calorífico, carbono fijo, cenizas, volátiles, humedad y azufre. Para la flotación de las muestras obtenidas se utilizó el laboratorio experimental de la planta Santa Rosa de Jangas de la UNASAM. En el procesamiento y análisis de los datos se utilizó la codificación y tabulación de datos en Excel y el programa estadístico SPSS versión 18; para el análisis se utilizó la prueba estadística t-Student, obteniéndose el requisito de normalidad con un nivel de significación del 5% (p menor 0,05).Se concluye que es factible el empleo de la flotación diferencial para el tratamiento de minerales de carbón del tipo antracita que mejora de manera notable el poder calorífico de 5400 Kcal/kg a 7800 Kcal/Kg.

La presente investigación está orientada a introducir en el proceso de minado el uso de un agente de voladura de baja velocidad de detonación VOD (velocity of detonation) con la finalidad de mejorar los parámetros de voladura en la producción de carbón del tipo antracita, el cual trasciende sustancialmente en la reducción de costos de la operación unitaria de perforación y voladura. Se presenta el procesamiento y análisis de los datos utilizando el análisis antes y después del empleo del agente de voladura, cuyos indicadores son presión en el taladro, fragmentación y costos; para determinar si existen diferencias se utilizó la prueba de T-Student, con un nivel de significación del 5%. Se concluye que es factible el uso de los agentes de voladura de baja velocidad de detonación porque mejora de manera importante la fragmentación y reduce los costos de minado.

Introduction The rise in noncommunicable diseases and their risk factors in developing countries may have changed or intensified the effect of parity on obesity. We aimed to assess this association in Peruvian women using data from a nationally representative survey. Methods We used data from Peru's Demographic and Health Survey, 2012. Parity was defined as the number of children ever born to a woman. We defined overweight as having a body mass index (BMI, kg/m2) of 25.0 to 29.9 and obesity as a BMI ≥30.0. Generalized linear models were used to evaluate the association between parity and BMI and BMI categories, by area of residence and age, adjusting for confounders. Results Data from 16,082 women were analyzed. Mean parity was 2.25 (95% confidence interval [CI], 2.17-2.33) among rural women and 1.40 (95% CI, 1.36-1.43) among urban women. Mean BMI was 26.0 (standard deviation, 4.6). We found evidence of an association between parity and BMI, particularly in younger women; BMI was up to 4 units higher in rural areas and 2 units higher in urban areas. An association between parity and BMI categories was observed in rural areas as a gradient, being highest in younger women. Conclusion We found a positive association between parity and overweight/obesity. This relationship was stronger in rural areas and among younger mothers.

Gorlin syndrome (GS) is a genetic disorder with an autosomal dominant inheritance pattern, with complete penetrance and variable expressivity. GS is caused by germline mutations in the genes PTCH1 or SUFU, which are components of the Sonic hedgehog molecular pathway. GS is characterized by the presence of multiple nevoid basal cell carcinomas, odontogenic cysts, calcification of the brain sickle, and lesions in the palms and soles. This study is the first to report cases in Peru of patients with GS who underwent genetic evaluation and counseling. We present two GS cases that meet the clinical criteria for the syndrome and review the literature.El síndrome Gorlin (SG) es una condición genética, con patrón de herencia autosómico dominante, con penetrancia completa y expresividad variable, debida a mutaciones germinales en los genes PTCH1 o SUFU, los cuales son componentes de la vía molecular Sonic hedgehog. El SG se caracteriza por la presencia de múltiples carcinomas de células basales nevoides, quistes odontogénicos, calcificación de la hoz del cerebro y lesiones en sacabocado en palmas y plantas. Este es el primer reporte de casos en el Perú sobre pacientes con SG, que cuentan con evaluación y asesoría genética. Presentamos dos casos de SG que cumplen criterios clínicos del síndrome y una revisión de la literatura.

Chromosome 18 pericentric inversion carriers could have offspring with recombinant chromosomes, leading to patients with clinical variable manifestations. Patients with 18p-/18q+ rearrangements share some clinical characteristics, while other characteristics differ. Factors for such divergence include the length of the inverted segment, among others. Here, we describe a Peruvian child with dysmorphic features, intellectual disability persistent microscopic hematuria, aortic pseudocoarctation, and descending aorta arteritis, among others. Karyotype analysis of family members determined the mother as the carrier of a pericentric inversion: 18[inv(18)(p11.2q21.3)]. This child carries a recombinant chromosome 18, with chromosomal microarray analysis detecting two genomic imbalances in patient's chromosome 18: one duplicated region and one deleted segment in the large and the short arms, respectively. Persistent microscopic hematuria has not been reported among 18p-/18q+ phenotypes. Our patient elucidates that other factors play significant and yet unknown roles for not fulfilling the proposed genotype–phenotype correlation associated with hemizygosity in this type of recombinant chromosome 18 or presenting these features as the patient ages.

Historically in developing countries, the prevalence of obesity has been greater in more advantaged socioeconomic groups. However, in recent years the association between socioeconomic status (SES) and obesity has changed and varies depending on the country's development stage. This study examines the relationship between SES and obesity using two indicators of SES: education or possession assets. Using the cross-sectional 2008 National Demographic and Family Health Survey of Peru (ENDES 2008), we investigated this relationship in women aged 15-49 years living in rural and urban settings. Descriptive, linear and logistic regressions analyses were conducted accounting for the multistage nature of the sampling design. The overall prevalence of obesity in this study was 14.1% (95% confidence interval (CI): 13.3-14.8); 8.4% (95% CI: 7.5-9.3) in rural areas and 16.2% (95% CI: 15.2-17.2) in urban areas. Wealthier women were more likely to be obese, and this association was stronger in rural areas. Conversely, more educated women were less likely to be obese, especially in urban areas. The distribution of obesity in Peruvian women is strongly related to socioeconomic position, and differs whether measured as possession assets or by level of education. These findings could have important implications for policy development in Peru.

OBJETIVO: Evaluar la asociación entre frecuencia de ver televisión, sobrepeso y obesidad en una muestra representativa de mujeres peruanas a nivel nacional. MÉTODOS: Análisis secundario de la Encuesta Nacional Demográfica y de Salud Familiar incluyendo mujeres de 15 a 49 años. Las variables resultados fueron obesidad (índice de masa corporal >30 kg/m²) y sobrepeso (>25 peso OBJETIVO: Analisar a associação entre frequência de assistir televisão com sobrepeso e obesidade em uma amostra representativa de mulheres peruanas em nível nacional. MÉTODOS: Análise secundária da Pesquisa Nacional Demográfica e de Saúde Familiar incluindo 27.712 mulheres de 15 a 49 anos em 2008. As variáveis-desfecho foram obesidade (índice de massa corporal > 30 kg/m2) e sobrepeso (entre 25 e 30 kg/m2); a variável de exposição foi a frequência de assistir televisão (nunca, ocasionalmente, quase todos os dias). Foi utilizada regressão logística para amostras complexas, ajustada por potenciais confundidores. Os resultados foram apresentados como odds ratios ajustados (ORa) com seus respectivos intervalos de 95% de confiança. RESULTADOS: A prevalência de sobrepeso foi de 34,7% (IC95% 33,8;35,7) e de obesidade, 14,3% (IC95% 13,6;5,1). Mulheres que assistiam televisão ocasionalmente e quase todos os dias tiveram maior probabilidade de ter obesidade em comparação às que não assistiam: ORa = 1,7 (IC95% 1,3;2,3) e ORa 2,6 (IC95% 2,0;3,5), respectivamente. A magnitude da associação foi menor para o sobrepeso: ORa 1,2 (IC95% 1,3;2,3) e ORa 1,6 (IC95% 1,1;1,4), respectivamente. A associação foi mais forte na área urbana. CONCLUSÕES: A frequência de assistir televisão esteve associada à apresentar obesidade e sobrepeso entre mulheres peruanas, e a força da associação variou de acordo com a área de residência. Estes achados podem auxiliar estratégias de prevenção da obesidade no contexto peruano.OBJECTIVE: To assess the association between frequency of television viewing, overweight and obesity in a nationally representative sample of Peruvian women. METHODS: Secondary analysis of the Demographic and Health Survey 2008 including women aged from 15 to 49 years old. The outcome variables were obesity (body mass index >30 kg/m²) and overweight (body mass index >25 but

La presente investigación permite introducir, dentro de la cadena de valor del sector no metálico, la actividad primaria de beneficio (procesamiento de minerales mediante la flotación diferencial) con el objetivo de incrementar el poder calorífico de los minerales de carbón antracita. El tipo de estudio es de carácter experimental aplicativo que analiza el fenómeno de flotación. La metodología en el trabajo de campo partió de los muestreos de los minerales de carbón antracita ubicados en el departamento de Áncash (Caraz, Huallanca, Sihuas y Mancos) para ser analizados y obtener los parámetros técnicos: poder calorífico, carbono fijo, cenizas, volátiles, humedad y azufre. Para la flotación de las muestras obtenidas se utilizó el laboratorio experimental de la planta Santa Rosa de Jangas de la UNASAM. En el procesamiento y análisis de los datos se utilizó la codificación y tabulación de datos en Excel y el programa estadístico SPSS versión 18; para el análisis se utilizó la prueba estadística t-Student, obteniéndose el requisito de normalidad con un nivel de significación del 5% (p menor 0,05).Se concluye que es factible el empleo de la flotación diferencial para el tratamiento de minerales de carbón del tipo antracita que mejora de manera notable el poder calorífico de 5400 Kcal/kg a 7800 Kcal/Kg.

Background Short‐term risk assessment tools for prediction of cardiovascular disease events are widely recommended in clinical practice and are used largely for single time‐point estimations; however, persons with low predicted short‐term risk may have higher risks across longer time horizons. Methods and Results We estimated short‐term and lifetime cardiovascular disease risk in a pooled population from 2 studies of Peruvian populations. Short‐term risk was estimated using the atherosclerotic cardiovascular disease Pooled Cohort Risk Equations. Lifetime risk was evaluated using the algorithm derived from the Framingham Heart Study cohort. Using previously published thresholds, participants were classified into 3 categories: low short‐term and low lifetime risk, low short‐term and high lifetime risk , and high short‐term predicted risk . We also compared the distribution of these risk profiles across educational level, wealth index, and place of residence. We included 2844 participants (50% men, mean age 55.9 years [ SD 10.2 years]) in the analysis. Approximately 1 of every 3 participants (34% [95% CI 33 to 36]) had a high short‐term estimated cardiovascular disease risk. Among those with a low short‐term predicted risk, more than half (54% [95% CI 52 to 56]) had a high lifetime predicted risk. Short‐term and lifetime predicted risks were higher for participants with lower versus higher wealth indexes and educational levels and for those living in urban versus rural areas ( P Conclusions These findings highlight potential shortcomings of using short‐term risk tools for primary prevention strategies because a substantial proportion of Peruvian adults were classified as low short‐term risk but high lifetime risk. Vulnerable adults, such as those from low socioeconomic status and those living in urban areas, may need greater attention regarding cardiovascular preventive strategies.

BACKGROUND: Although migration and urbanization have been linked with higher obesity rates, especially in low-resource settings, prospective information about the magnitude of these effects is lacking. We estimated the risk of obesity and central obesity among rural subjects, rural-to-urban migrants and urban subjects. METHODS: Prospective data from the PERU MIGRANT Study were analyzed. Baseline data were collected in 2007-2008 and participants re-contacted in 2012-2013. At follow-up, outcomes were obesity and central obesity measured by body mass index and waist circumference. At baseline, the primary exposure was demographic group: rural, rural-to-urban migrant and urban. Other exposures included an assets index and educational attainment. Cumulative incidence, incidence ratio (IR) and 95% confidence intervals (95% CI) for obesity and central obesity were estimated with Poisson regression models. RESULTS: At baseline, mean age (+/-s.d.) was 47.9 (+/-12.0) years, and 53.0% were females. Rural subjects comprised 20.2% of the total sample, whereas 59.7% were rural-to-urban migrants and 20.1% were urban dwellers. A total of 3598 and 2174 person-years were analyzed for obesity and central obesity outcomes, respectively. At baseline, the prevalence of obesity and central obesity was 20.0 and 52.5%. In multivariable models, migrant and urban groups had an 8- to 9.5-fold higher IR of obesity compared with the rural group (IR migrants=8.19, 95% CI=2.72-24.67; IR urban=9.51, 95% CI=2.74-33.01). For central obesity, there was a higher IR only among the migrant group (IR=1.95; 95% CI=1.22-3.13). Assets index was associated with a higher IR of central obesity (IR top versus bottom tertile 1.45, 95% CI=1.03-2.06). CONCLUSIONS: Peruvian urban individuals and rural-to-urban migrants show a higher incidence of obesity compared with their rural counterparts. Given the ongoing urbanization occurring in middle-income countries, the rapid development of increased obesity risk by rural-to-urban migrants suggests that measures to reduce obesity should be a priority for this group.

Supplemental Digital Content is available in the text., It is unclear how well currently available risk scores predict cardiovascular disease (CVD) risk in low-income and middle-income countries. We aim to compare the American College of Cardiology/American Heart Association (ACC/AHA) Pooled Cohort risk equations (ACC/AHA model) with 6 other CVD risk tools to assess the concordance of predicted CVD risk in a random sample from 5 geographically diverse Peruvian populations. We used data from 2 Peruvian, age and sex-matched, population-based studies across 5 geographical sites. The ACC/AHA model were compared with 6 other CVD risk prediction tools: laboratory Framingham risk score for CVD, non-laboratory Framingham risk score for CVD, Reynolds risk score, systematic coronary risk evaluation, World Health Organization risk charts, and the Lancet chronic diseases risk charts. Main outcome was in agreement with predicted CVD risk using Lin’s concordance correlation coefficient. Two thousand one hundred and eighty-three subjects, mean age 54.3 (SD ± 5.6) years, were included in the analysis. Overall, we found poor agreement between different scores when compared with ACC/AHA model. When each of the risk scores was used with cut-offs specified in guidelines, ACC/AHA model depicted the highest proportion of people at high CVD risk predicted at 10 years, with a prevalence of 29.0% (95% confidence interval, 26.9–31.0%), whereas prevalence with World Health Organization risk charts was 0.6% (95% confidence interval, 0.2–8.6%). In conclusion, poor concordance between current CVD risk scores demonstrates the uncertainty of choosing any of them for public health and clinical interventions in Latin American populations. There is a need to improve the evidence base of risk scores for CVD in low-income and middle-income countries.

La investigación en ciencia y tecnología (CyT) fortalece al capital social generando desarrollo y crecimiento económico sostenible de un país. En el Perú, se estima que el 2021 habrá una brecha de 17 mil investigadores en las especialidades de ingeniería y tecnología, ciencias naturales, ciencias médicas y ciencias agrícolas; contabilizándose 2555 investigadores en el área de ciencias médicas y de la salud. Recientemente, por medio del Consejo Nacional de Ciencia, Tecnología e Innovación Tecnológica (CONCYTEC) se están implementando estrategias para cerrar esta brecha de investigadores y, al mismo tiempo, fortalecer y promover el desarrollo de la investigación mediante financiamiento académico y transferencias de recursos...

The rural and urban-edge health service (SERUMS) is an activity that only health professionals perform for the Peruvian government, as it is a mandatory requirement to qualify for a second specialty or to work in public hospitals and public health care facilities, and obtain government scholarships for future training. The few legal changes in the rules of this social program and the focus of “service” restricted to health professionals lead to a perception of this policy as discriminatory and unconstitutional because it violates the right to education and work. There is no scientific evidence that supports the usefulness and effectiveness of this program in terms of quality of service and health indicator improvement, as well as in adequate distribution and retention of health professionals. We suggest to abolish the compulsory requirement and to reformulate a political strategy to help attract and retain health professionals in vulnerable areas of Peru. El servicio rural y urbano marginal en salud (SERUMS) es una actividad que realizan solo los profesionales de la salud al Estado peruano, ya que constituye un requisito obligatorio para optar por la segunda especialidad o para trabajar en un centro de salud público, y obtener becas del gobierno para futura capacitación. Los escasos cambios legales en el reglamento de este programa social y el enfoque de “servicio” restringido a los profesionales de salud conllevan a que esta política sea discriminatoria e inconstitucional por atentar contra el derecho a la educación y al trabajo. No hay evidencia científica que sustente la utilidad y efectividad de este programa, tanto en la calidad de servicio y mejora de indicadores sanitarios, como en la adecuada distribución y retención de profesionales de salud. Sugerimos abolir el requisito de obligatoriedad y replantear una estrategia política que ayude a atraer y retener a los profesionales de la salud en zonas vulnerables del Perú.

Background: Evidence denotes a direct association between parity and overnutrition in developing societies. This work aims to assess the relationship between them in Peruvian women, and to investigate whether this association varies by place of residence and socioeconomic status. Methods: We used secondary data from the National Health and Demographic Survey 2011 of Peru (ENDES 2011). Parity was the independent variable, defined as the number of children ever born to a woman. The outcome variable was the body mass index (BMI), with cut-off points of 25-30 kg/m2 and ≥30 kg/m2, for overweight and obesity; respectively. We included other variables due to their potential confounding or modification effect, such as: age, place of residence, wealth index, education, and frequency of watching television. We used a significance level of 5%. Results: We analyzed information of 18262 women. The mean BMI was 25.9 Kg/m2 (SD±4.6). The overall prevalence of obesity and overweight was of 17.2% and 35.0%, respectively. Rural and urban women reported having had 2.5 (95%CI: 2.4-2.6) and 1.5 (95%CI: 1.4-1.5) ever born children, respectively. We found a positive association between parity and overnutrition, and identified the effect modification of place of residence and wealth. The relationship between parity with overweight or obesity was stronger in urban than in rural areas. Women in the bottom and top groups of wealth index showed stronger associations than the other categories of socioeconomic status. Conclusion: Our findings suggest that the more childbirths a woman has, the more likely she is of being overweight or obese. This relationship varies by socioeconomic status and area of residence. Identification of increased BMI in women, especially after the first childbirth, should be evaluated in primary care to establish adequate public health policies to tackle obesity in Peruvian women.

Sr. Editor, las enfermedades cronicas no transmisibles (ENT) constituyen la principal carga de enfermedad en el mundo, que afecta mas a paises de medianos y bajos ingresos. En la actualidad, las organizaciones internacionales exhortan la vigilancia de los factores de riesgo comunes a las ENT: la inactividad fisica, patrones de alimentacion, y consumo de tabaco y alcohol (1). El sobrepeso y la obesidad tambien forman parte de los pilares de la vigilancia de las ENT. La Organizacion Mundial de la Salud (OMS) sugiere el uso del indice de masa corporal (IMC) como un indicador de malnutricion en adultos, asi como otras referencias antropometricas para el caso de los ninos y adolescentes (1).

To assess the association between frequency of television viewing, overweight and obesity in a nationally representative sample of Peruvian women.Secondary analysis of the Demographic and Health Survey 2008 including women aged from 15 to 49 years old. The outcome variables were obesity (body mass index30 kg/m²) and overweight (body mass index25 but30 kg/m²) whereas the exposure variable was frequency of television viewing (never, occasionally, almost every day). Logistic regression taking into account the multistage study design and adjusting for potential confounders was used. Results were presented as adjusted odds ratios (aOR) with 95% confidence intervals (95%CI).A total of 21,712 women were included in the analysis. The prevalence of overweight was 34.7% (95%CI 33.8%;35.7%), and obesity prevalence was 14.3% (95%CI 13.6%;15.1%). Compared to women who never watched television, those who reported watching television occasionally and almost daily were more likely to be obese: aOR 1.7 (95%CI 1.3;-2.3) and aOR 2.6 (95%CI 2.0;3.5), respectively. The magnitude of this association was lower for overweight: aOR 1.2 (95CI 1.3;2.3) and aOR 1.6 (95%CI 1.1;1.4), respectively. The strength of the association was greater in urban areas.Frequency of television viewing was associated with overweight and obesity in Peruvian women and the strength of this association varied by area of residence. These findings can provide input to strategies for obesity prevention in the Peruvian context.