Los cambios en los marcadores de composición corporal (peso, masa grasa, masa magra e IMC) a lo largo del tiempo pueden asociarse con el resultado del tratamiento de la TB en pacientes infectados por el VIH. El objetivo de este estudio fue investigar si los cambios en la masa grasa y magra se asociaron con la respuesta al tratamiento entre los pacientes con infección por VIH y tuberculosis pulmonar. Materiales y métodos: Este fue un estudio de cohorte prospectivo. Se analizaron los datos de pacientes infectados por el VIH que comenzaron la terapia contra la tuberculosis. Esto incluyó la medición del peso corporal con equipo de bioimpedancia al inicio del estudio, un mes y dos meses después de comenzar el tratamiento de la TB. Resultados: El estudio se realizó en 125 pacientes, 17 pacientes (13,6%) murieron durante el tratamiento, de los cuales 5 murieron durante el primer mes de t...

This study was funded in part by NIH grant no.U01A135894-01 and funds by CONCYTEC, Lima, Peru.The authors thank J.D. Moro, N. Perez-Palma, J.B. Phu, D.Sara, Amanda Chavez and Eva Casas for editorial help.We also thank Armando Gonzales, Cesar Gavidia, NestorFalcon for helpful comments and M. Gamarra and R.Zarate from Tupac Amaru for their cooperation.

This study was funded by Consejo Nacional de Ciencia y Tecnolog ??a (CONCYTEC).We wish to thank Dr. Peter Schantz for manuscript review and the people and authoritiesof the farming cooperative of Tupac Amaru in Junin, Peru.

This study was funded by Consejo Nacional de Ciencia y Tecnologia (CONCYTEC), Lima, Peru. We thank Dr. Peter Schantz for constructive comments and review of the manuscript.

This study was funded in part by the National Institutes of Health (grant no. U01-A135894, awarded to The Johns Hopkins University), the RG-ER Fund, and Consejo Nacional de Ciencia y Tecnologı´a (CONCYTEC; Lima, Peru).

Aims: To determine the predictive performance of well-known obesity markers: body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), waist-height ratio (WHtR), and total body fat percentage (TBF%), to identify incident cases of type 2 diabetes mellitus T2DM. Methods: Secondary data analysis of the CRONICAS Cohort Study, conducted in 3 regions of Peru. Participants without T2DM at baseline were selected for analyses. The obesity markers were evaluated at the beginning of the study, and the development of T2DM was determined at 30 months of follow-up. The predictive performance of the markers was calculated using areas under the curve (AUC), and sensitivity and specificity of the best cutoff points were estimated. Results: A total of 2510 participants with no diabetes at baseline, median age 54.1 years (inter-quartile range: 44.6 to 63.5), were included in the analysis. The...

Pyrazinamide (PZA) is considered the pivot drug in all tuberculosis treatment regimens due to its particular action on the persistent forms of Mycobacterium tuberculosis. However, no drug susceptibility test (DST) is considered sufficiently reliable for routine application. Although molecular tests are endorsed, their application is limited to known PZA resistance associated mutations. Microbiological DSTs for PZA have been restricted by technical limitations, especially the necessity for an acidic pH. Here, for the first time, MODS culture at neutral pH was evaluated using high PZA concentrations (400 and 800 _g/ml) to determine PZA susceptibility directly from sputum samples. Sputum samples were cultured with PZA for up to 21 days at 37°C. Plate reading was performed at two time points: R1 (mean, 10 days) and R2 (mean, 13 days) for each PZA concentration. A consensus reference test, c...

Una sola lesión realzada en el parénquima cerebral, también llamado granuloma inflamatorio, es un diagnóstico neurológico frecuente. Una de las causas más comunes de esta lesión es la neurocisticercosis humana, la infección por las larvas de la tenia porcina, Taenia solium. Luego de la demostración de que los quistes de cisticercosis viables sobreviven en buenas condiciones durante varios años en el cerebro humano, los granulomas de cisticerco individual se han interpretado de manera sistemática como una degeneración tardía de un parásito de larga data. Sobre la base de la evidencia epidemiológica, clínica y de laboratorio detallada en este artículo, planteamos la hipótesis de que, en la mayoría de los casos, estas lesiones inflamatorias se corresponden con parásitos que mueren en los primeros pasos de la infección, probablemente como resultado natural de la inmunida...

Although pyrazinamide (PZA) is a key component of first- and second-line tuberculosis treatment regimens, there is no gold standard to determine PZA resistance. Approximately 50% of multidrug-resistant tuberculosis (MDR-TB) and over 90% of extensively drug-resistant tuberculosis (XDR-TB) strains are also PZA resistant. pncA sequencing is the endorsed test to evaluate PZA susceptibility. However, molecular methods have limitations for their wide application. In this study, we standardized and evaluated a new method, MODS-Wayne, to determine PZA resistance. MODS-Wayne is based on the detection of pyrazinoic acid, the hydrolysis product of PZA, directly in the supernatant of sputum cultures by detecting a color change following the addition of 10% ferrous ammonium sulfate. Using a PZA concentration of 800 μg/ml, sensitivity and specificity were evaluated at three different periods of incub...

Geographical and environmental features such as urbanization and altitude may influence individual's lipid profiles because of the diversity of human-environment interactions including lifestyles.

Tuberculosis (TB) is a significant cause of morbidity and mortality worldwide. The patient compliance with the long treatment regimens is essential for successful eradication. Pyrazinamide (PZA) shortens these regimens from 9 to 6 months, and therefore, improves treatment completion rates. Although PZA is a first-line medication for the treatment of TB, no simple or reliable assay to determine PZA resistance is yet available. In the presence of PZA, only susceptible Mycobacterium tuberculosis strains release pyrazinoic acid (POA). Therefore, the measurement and quantification of released POA is an indicator of PZA resistance.

Mycobacterium tuberculosis nicotinamidase-pyrazinamidase (PZAse) is a metalloenzyme that catalyzes conversion of nicotinamide-pyrazinamide to nicotinic acid-pyrazinoic acid. This study investigated whether a metallochaperone is required for optimal PZAse activity. M. tuberculosis and Escherichia coli PZAses (PZAse-MT and PZAse-EC, respectively) were inactivated by metal depletion (giving PZAse-MT–Apo and PZAse-EC–Apo). Reactivation with the E. coli metallochaperone ZnuA or Rv2059 (the M. tuberculosis analog) was measured. This was repeated following proteolytic and thermal treatment of ZnuA and Rv2059. The CDC1551 M. tuberculosis reference strain had the Rv2059 coding gene knocked out, and PZA susceptibility and the pyrazinoic acid (POA) efflux rate were measured. ZnuA (200 M) achieved 65% PZAse-EC–Apo reactivation. Rv2059 (1 M) and ZnuA (1 M) achieved 69% and 34.3% PZAse-MT–Apo ...

Pyrazinamide (PZA) is an antibiotic used in first- and second-line tuberculosis treatment regimens. Approximately 50% of multidrug-resistant tuberculosis and over 90% of extensively drug-resistant tuberculosis strains are also PZA resistant. Despite the key role played by PZA, its mechanisms of action are not yet fully understood. It has been postulated that pyrazinoic acid (POA), the hydrolyzed product of PZA, could inhibit trans-translation by binding to Ribosomal protein S1 (RpsA) and competing with tmRNA, the natural cofactor of RpsA. Subsequent data, however, indicate that these early findings resulted from experimental artifact. Hence, in this study we assess the capacity of POA to compete with tmRNA for RpsA. We evaluated RpsA wild type (WT), RpsA A438, and RpsA A438 variants with truncations towards the carboxy terminal end. Interactions were measured using Nuclear Magnetic Reson...

Las Plantas de Tratamiento de Aguas Residuales (PTAR) son ambientes ideales para la recombinación de genes de resistencia a antibióticos (GRA) entre bacterias: colectan heces de miles de personas y las mezclan bajo condiciones que promueven el crecimiento bacteriano para convertir materia orgánica en inorgánica, usualmente en presencia de antibióticos de uso clínico y veterinario. Las aguas tratadas son descargadas en ríos y océanos o utilizados para la irrigación de cultivos y áreas verdes en la ciudad, promoviendo la reintroducción de bacterias resistentes y GRAs en el ambiente y en poblaciones humanas. Es así como los microbiomas de aguas residuales se convierten en potenciales reservorios de GRAs disponibles para patógenos humanos. Entre 2013 y 2015, realizamos muestreos mensuales de aguas pre y post-tratamiento de una PTAR de Lima que procesa residuos de casi un millón...

Pneumonia is one of the major causes of child mortality, but it is curable if one can achieves early diagnostics. Unfortunately, in developing countries there is a lack of infrastructure and medical experts in rural areas to provide the required diagnostics opportunely. Lung ultrasound echography has proved to be an important tool to detect lung consolidates as evidence of pneumonia. The use of ultrasound to detect pneumonia is limited by the image analysis for interpretation, which is carried by human experts. Pattern recognition and image analysis is a potential tool to facilitate recognition of pneumonia consolidates in absence of medical experts for automatic diagnostics. To perform an automatic analysis of lung ultrasound images for pneumonia detection, the noise introduced by the image portion of the skin, notably complicates the processing and interpretation. This paper presents a...

Sapovirus is one of the primary viral causes of acute gastroenteritis (AGE), especially where rotavirus vaccination has been implemented. The characteristics and impact of natural infection at the community level, however, have not been well documented.

Background The parasite Taenia solium causes neurocysticercosis (NCC) in humans and is a common cause of adult-onset epilepsy in the developing world. Hippocampal atrophy, which occurs far from the cyst, is an emerging new complication of NCC. Evaluation of molecular pathways in brain regions close to and distant from the cyst could offer insight into this pathology. Methods Rats were inoculated intracranially with T. solium oncospheres. After 4 months, RNA was extracted from brain tissue samples in rats with NCC and uninfected controls, and cDNA was generated. Expression of 38 genes related to different molecular pathways involved in the inflammatory response and healing was assessed by RT-PCR array. Results Inflammatory cytokines IFN-?, TNF-?, and IL-1, together with TGF-? and ARG-1, were overexpressed in tissue close to the parasite compared to non-infected tissue. Genes for IL-1A, CS...

The widespread and poorly regulated use of antibiotics in animal production in low- and middle-income countries (LMICs) is increasingly associated with the emergence and dissemination of antibiotic resistance genes (ARGs) in retail animal products. Here, we compared Escherichia coli from chickens and humans with varying levels of exposure to chicken meat in a low-income community in the southern outskirts of Lima, Peru. We hypothesize that current practices in local poultry production result in highly resistant commensal bacteria in chickens that can potentially colonize the human gut. E. coli was isolated from cloacal swabs of non-organic (n = 41) and organic chickens (n = 20), as well as from stools of market chicken vendors (n = 23), non-vendors (n = 48), and babies (n = 60). 315 E. coli isolates from humans (n = 150) and chickens (n = 165) were identified, with chickens showing highe...

Taenia solium is known to cause human cysticercosis while T. saginata does not. Comparative in vitro and in vivo studies on the oncosphere and the postoncospheral (PO) forms of T. solium and T. saginata may help to elucidate why cysticercosis can occur from one and not the other. The aim of this study was to use in vitro culture assays and in vivo models to study the differences in the development of the T. solium and T. saginata oncosphere. Furthermore, this study aimed to evaluate the expression of cytokines and metalloproteinases (MMPs) in human peripheral blood mononuclear cells (PBMCs), which were stimulated by these oncospheres and PO antigens. T. solium and T. saginata activated oncospheres (AO) were cultured in INT-407 and HCT-8 intestinal cells for 180 days. The T. solium began to die while the T. saginata grew for 180 days and developed to cysticerci in INT-407 cells. Rats were...

Neurocysticercosis (NCC) is a helminth infection affecting the central nervous system caused by the larval stage (cysticercus) of Taenia solium. Since vascular alteration and blood–brain barrier (BBB) disruption contribute to NCC pathology, it is postulated that angiogenesis could contribute to the pathology of this disease. This study used a rat model for NCC and evaluated the expression of two angiogenic factors called vascular endothelial growth factor (VEGF-A) and fibroblast growth factor (FGF2). Also, two markers for BBB disruption, the endothelial barrier antigen and immunoglobulin G, were evaluated using immunohistochemical and immunofluorescence techniques. Brain vasculature changes, BBB disruption, and overexpression of angiogenesis markers surrounding viable cysts were observed. Both VEGF-A and FGF2 were overexpressed in the tissue surrounding the cysticerci, and VEGF-A was o...