Reference values for oxygen saturation from sea level to the highest human habitation in the Andes in acclimatised persons.

Oxygen saturation, measured by pulse oximetry (SpO), is a vital clinical measure. Our descriptive, cross-sectional study describes SpO measurements from 6289 healthy subjects from age 1 to 80 years at 15 locations from sea level up to the highest permanent human habitation. Oxygen saturation measurements are illustrated as percentiles.

Pharmacokinetic Evidence from the HIRIF Trial To Support Increased Doses of Rifampin for Tuberculosis.

Rifamycins exhibit concentration-dependent killing of ; higher exposures potentially induce better outcomes. We randomized 180 tuberculosis patients in Peru to receive rifampin at 10, 15, or 20 mg/kg/day. A total of 168 had noncompartmental pharmacokinetic analyses; 67% were sampled twice, and 33% were sampled six times.

Congenital Atrophic Plaque: Fibroblastic Connective Tissue Nevus.

Fibroblastic connective tissue nevus (FCTN) is a rare, benign, dermal mesenchymal hamartoma that affects children. We report a 15-year-old boy with a congenital FCTN and describe the clinical, dermatoscopic, and histopathologic features.

[Knowledge translation: the basics for public health professionals].

Knowledge translation (KT) in Public Health involves the use of scientific evidence by decision makers when generating health policies directed to accelerate the benefits resulting from research and innovation in health system and ultimately people´s health. In this paper we review the definitions and conceptual frameworks related to systematization of KT processes. The different approaches to KT share the concept that KT is composed by two main elements: a product (information) developed through scientific method with a friendly format for the target public and an action devoted to support or promote a health related practice using the aforementioned product.

Evaluation of high-dose rifampin in patients with new, smear-positive tuberculosis (HIRIF): study protocol for a randomized controlled trial.

Background: Evidence has existed for decades that higher doses of rifampin may be more effective, but potentially more toxic, than standard doses used in tuberculosis treatment. Whether increased doses of rifampin could safely shorten treatment remains an open question.

Methods/design: The HIRIF study is a phase II randomized trial comparing rifampin doses of 20 and 15 mg/kg/day to the standard 10 mg/kg/day for the first 2 months of tuberculosis treatment.

Building clinical trial capacity to develop a new treatment for multidrug-resistant tuberculosis.

Problem: New drugs for infectious diseases often need to be evaluated in low-resource settings. While people working in such settings often provide high-quality care and perform operational research activities, they generally have less experience in conducting clinical trials designed for drug approval by stringent regulatory authorities.

Approach: We carried out a capacity-building programme during a multi-centre randomized controlled trial of delamanid, a new drug for the treatment of multidrug-resistant tuberculosis.

Impact of HIV on mortality among patients treated for tuberculosis in Lima, Peru: a prospective cohort study.

Background: Human immunodeficiency virus (HIV)-associated tuberculosis deaths have decreased worldwide over the past decade. We sought to evaluate the effect of HIV status on tuberculosis mortality among patients undergoing treatment for tuberculosis in Lima, Peru, a low HIV prevalence setting.

Methods: We conducted a prospective cohort study of patients treated for tuberculosis between 2005 and 2008 in two adjacent health regions in Lima, Peru (Lima Ciudad and Lima Este).

Evaluation of a New Immunochromatographic Test Using Recombinant Antigen B8/1 for Diagnosis of Cystic Echinococcosis.

Diagnosis of cystic echinococcosis (CE) is based on the identification of the cyst(s) by imaging, using immunodiagnostic tests mainly as complementary tools in clinical settings. Among the antigens used for immunodiagnosis, previous studies described a good performance of the recombinant antigen B8/1 (rAgB) in an enzyme-linked immunosorbent assay (ELISA) format; however, in remote parts of areas where the disease is endemic, the implementation of an ELISA is difficult, so a more simple, rapid, and reliable method such as the immunochromatographic test (ICT) is required. In this study, using a set of 50 serum samples from patients with surgically confirmed CE, we compared the performance of an ICT and that of an ELISA using the rAgB.

[Acute arterial occlusion associated disseminated hydatidosis].

Hydatidosis or echinococcosis are terms used to denote the zoonotic infestation caused by adult and larval stages (metacestode) of the cestode from the genus Echinococcus (family tenidae). The term hydatidosis should be applied to the infestation caused by the metacestode while echinococcosis for the larval and adult stages. In Peru there is a high prevalence of this infection, liver and lung being the most affected organs.

[Assessment of dot blot tests and latex agglutination for cysticercosis diagnostic in Peru].

In order to evaluate dot blot tests and latex agglutination for the detection of human cysticercosis with liquid antigen of Taenia solium cysticerci, 125 human sera were used, of which 60 were from people with cysticercosis confirmed by Western Blot, 45 with other parasitic diseases and 20 apparently healthy. The optimal concentration of antigen to impregnate dot blot strips was 0.01 ug/uL, and to impregnate the latex particles was 0.

Genome analysis of 17 extensively drug-resistant strains reveals new potential mutations for resistance.

We report the whole-genome sequence of an extensively drug-resistant (XDR) tuberculosis (TB) strain of Latin American-Mediterranean (LAM) lineage. This strain is phenotypically resistant to aminoglycosides, but carries no related mutations in rrs, tlyA, and eis. Through genome analysis comparison with 16 XDR strains, we found 218 non-synonymous single nucleotide polymorphisms (SNPs) shared that could confer resistance.

[Related factors to re-bleeding and mortality in cirrhotic patients with acute variceal bleeding at Hipolito Unanue Hospital, Lima, Peru].

Objectives: To determine related factors to 5 days re-bleeding and 6 week-mortality of an episode of variceal bleeding in cirrhotic patients.

Material And Methods: Observational, descriptive, co relational, retrospective study. In this study were included the cirrhotic patients who entered to Hipolito Unanue Hospital, Lima, Peru, between January 2006 and February 2012 with suspicion of variceal bleeding.

Incremental yield of bronchial washing for diagnosing smear-negative pulmonary tuberculosis.

Objective: To assess the increased diagnostic yield for pulmonary tuberculosis using bronchial washing cultures compared with sputum cultures.

Methods: Study conducted with 61 adults in Lima, Peru, from January 2006 to December 2007. The yield of sputum cultures was compared with the yield of acid-fast bacilli smears and cultures of bronchial washing for diagnosing pulmonary tuberculosis in suspected cases of clinical tuberculosis with negative acid fast bacilli sputum smears.

[Dyspepsia: clinical characteristics, endoscopic and histological findings in patients of the Hospital Nacional Hipolito Unanue, Lima, Peru, during 2010].

Objective: To identify clinical, endoscopic and histological characteristics and their relationship with Helicobacter pylori (Hp) in patients treated with the diagnosis of dyspepsia in our hospital during 2010.

Materials And Methods: We conducted a cross sectional and retrospective study in the population attending our hospital during 2010, a sample of 300 patients was studied. We evaluated clinical, histological and endoscopic findings.

Validation of a clinical-radiographic score to assess the probability of pulmonary tuberculosis in suspect patients with negative sputum smears.

Background: Clinical suspects of pulmonary tuberculosis in which the sputum smears are negative for acid fast bacilli represent a diagnostic challenge in resource constrained settings. Our objective was to validate an existing clinical-radiographic score that assessed the probability of smear-negative pulmonary tuberculosis (SNPT) in high incidence settings in Peru.

Methodology/principal Findings: We included in two referral hospitals in Lima patients with clinical suspicion of pulmonary tuberculosis and two or more negative sputum smears.

Performance of an algorithm based on WHO recommendations for the diagnosis of smear-negative pulmonary tuberculosis in patients without HIV infection.

Objective: To evaluate the performance of an algorithm based on WHO recommendations for diagnosis of smear-negative pulmonary tuberculosis in HIV-negative patients.

Methods: We recruited HIV-negative patients with clinical suspicion of tuberculosis who had had three negative sputum smears in Lima, Peru. All included subjects underwent a complete anamnesis, physical examination and chest X-ray, and had a sputum specimen cultured in Ogawa, Middlebrook 7H9 media and MGIT®.

[Why to audit to research ethics committees?].

Ethics committees in biomedical research have the responsibility to ensure the protection of human participants in the studies. In order to improve the quality of their work they must undergo audit procedures commissioned by the sponsors and inspections done by the regulatory authorities. Through these procedures, improvement of their functions should be guaranteed, so they can optimize their tasks and accomplish in the best way the purpose for which they were created.

[Spontaneous rupture of choriocarcinoma hepatic metastases: Report of a Case].

Choriocarcinoma is a highly vascularized gestational trophoblastic neoplasia, and has a propensity to metastasize hematogenously. Hepatic metastases are less common and spontaneous rupture of them results in a hemoperitoneum. We present a case of a young female with liver metastases from choriocarcinoma, who had severe haemorrhage and died after the second laparotomy.

Challenges of diagnosis and management of tuberculosis and HIV coinfection in resource-limited settings: a case report from Lima, Peru.

We present a Peruvian human immunodeficiency virus (HIV)-positive patient receiving first-line therapy for tuberculosis who presents with neurological complications to highlight some of the major issues in the diagnosis and management of human immunodeficiency virus-related central nervous system complications in resource-poor settings. These include limited options for diagnosing extrapulmonary and drug-resistant tuberculosis; the importance of central nervous system . imaging; and the management conundrum when faced with a broad differential diagnosis.

Evaluation of the performance of two liquid-phase culture media for the diagnosis of pulmonary tuberculosis in a national hospital in Lima, Peru.

Objective: To evaluate the diagnostic performance of two liquid-phase culture media for the diagnosis of pulmonary tuberculosis.

Patients And Methods: From May to July 2003, sputum samples for culture were obtained from patients with respiratory symptoms attending the Hospital Nacional Cayetano Heredia. These were cultured in Ogawa medium, mycobacteria growth indicator tube (MGIT), and modified Middlebrook 7H9.

A clinical prediction rule for pulmonary tuberculosis in emergency departments.

Setting: University-affiliated hospital located in an area with a high incidence of pulmonary tuberculosis (PTB).

Objective: To develop a clinical prediction rule (CPR) based on information obtainable on admission, to permit rapid identification of patients with PTB.

Design: Information from patients with respiratory symptoms who attended the emergency department of Cayetano Heredia Hospital, Lima, Peru, was collected prospectively.