1
artículo
Publicado 2016
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In the developing world, most patients with hepatocellular carcinoma present with advanced-stage disease, considered to be incurable based on current therapeutic algorithms. Here, we demonstrate that curative liver resection is achievable in a portion of Peruvian patients not addressed by these treatment algorithms. We conducted a retrospective cohort study of 253 hepatocellular carcinoma patients that underwent a curative hepatectomy between 1991 and 2011 at the National Cancer Institute of Peru. The median age of the cohort was 36 years, and merely 15.4% of the patients displayed cirrhosis. The average tumor size was over 14 cm in diameter, resulting in 76.3% of major hepatectomies performed. The 5- and 10-year survival probability estimates were 37.5% and 26.2%, respectively. Age (>44 vs. ≤44 years old; P = 0.005), tumor size (>10 cm vs. ≤10 cm in diameter; P = 0.009), cirrhosis (...
2
artículo
Publicado 2018
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Investigations about the fortifications of northern New Spain are scarce. Besides, even though there are isolated writings on some types of fortification, no studies have been carried out that comprehensively track each fortified enclosure. The Camino Real de Tierra Adentro, the reason for this article, has left us an immense testimony of various historical processes forged in it. This testimony translates into a range of patrimonial assets that were built individually and collectively over the course of three centuries. Its transformation gives an account of the inherited knowledge of techniques or constructive models, and of the occupation strategies, which impress on it a sense of permanence in time.
3
artículo
Publicado 2018
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Investigations about the fortifications of northern New Spain are scarce. Besides, even though there are isolated writings on some types of fortification, no studies have been carried out that comprehensively track each fortified enclosure. The Camino Real de Tierra Adentro, the reason for this article, has left us an immense testimony of various historical processes forged in it. This testimony translates into a range of patrimonial assets that were built individually and collectively over the course of three centuries. Its transformation gives an account of the inherited knowledge of techniques or constructive models, and of the occupation strategies, which impress on it a sense of permanence in time.
4
artículo
Publicado 2018
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Con el objetivo de establecer diferencias hipométricas entre el Caballo Peruano de Paso del Norte y Centro sur del Perú para mantener la pureza racial -belleza exterior y funcionalidad-, el cual no es solo importante para la Asociación Nacional de Criadores de Caballo Peruano de Paso sino también para el Estado Peruano, se revisó datos de 715 Caballos Peruano de Paso con registro genealógico, tomando como referencia los seis primeros puestos por categoría. Se encontraron diferencias estadísticas (P≤0,05) del centro sur y norte en potrancas de bozal de 3 a 4 años en altura de grupa (146,84cmª y 144,50cmb) y ángulo de espalda (59,20cmb y 61,10cmª); en yeguas de freno y espuelas de más de 12 años en el largo de cabeza (60,60cmª y 59,20cmb), largo de cuello (60,08cmª y 58,00cmb), altura de grupa (146,00cma y 143,95cmb), perímetro torácico (182,68cmª y 177,50cmb), ancho d...
5
artículo
Publicado 2017
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Señor editor: El cáncer de mama es la neoplasia más frecuente entre las mujeres, con un estimado de 1.67 millones de nuevos casos diagnosticados en 2012 (25% de todos los cánceres). Entre 1990 y 2013, las tasas de incidencia estandarizada por edad por cada 100 000 mujeres han incrementado en 17% a nivel mundial, siendo más afectados los países en desarrollo, donde cerca de la mitad de los casos corresponden a una enfermedad avanzada debido al diagnóstico tardío y al pobre acceso al tratamiento. En Perú, el cáncer de mama ocupa la segunda causa de muerte por cáncer en mujeres, detrás del cervicouterino, y su supervivencia se estima en alrededor de 60 a 70% a los cinco años del diagnóstico...
6
artículo
Publicado 2017
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OBJETIVO: Determinar la frecuencia de litiasis vesicular en pacientes post-operados con gastrectomía por adenocarcinoma gástrico, determinar el tiempo de aparición de litiasis vesicular en pacientes gastrectomizados por Adenocarcinoma Gástrico. MÉTODOS: Se realizo un estudio observacional, descriptivo retrospectivo. Se revisó un total de 148 historias clínicas de pacientes sometidos a gastrectomía por adenocarcinoma gástrico en el Instituto Nacional de Enfermedades Neoplásicas en el periodo de 1990 al 2000. RESULTADOS: De los 148 casos de pacientes post gastrectomizados por adenocarcinoma gástrico que fueron enrolados, 29(19.6%) presentaron litiasis vesicular versus 119(80.9%) que no presentaron litiasis vesicular como complicación post gastrectomía. La media de edad de 29 pacientes con litiasis vesicular post gastrectomía por adenocarcinoma gástrico fue de 59.9años (min....
7
artículo
Publicado 2018
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In Peru, hepatocellular carcinoma (HCC) arises in young non-cirrhotic patients. Hepatitis B virus (HBV) is suspected to be the prominent etiological agent. We thus performed a comprehensive molecular study of HBV infection in 65 Peruvian HCC patients. Only 51% were considered as persistently infected at the onset. HBV DNA was found by PCR in the tumor and/or matched non-tumor liver tissues in more than 80% of cases (n = 53/65). HBV DNA was significantly more abundant in livers of younger patients than in those of the older ones. We consistently observed low viral DNA burden (0.1-6.5 copies for 100 cells), with viral genomes in younger patients displaying higher proportion of mutations at di-pyrimidines (TpT and CpC, P = 0.006). A drastic activation of multiple DNA repair pathways in tumors of younger patients was observed. Our observations clearly challenge the current vision that associ...
8
artículo
Publicado 2018
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Introducción La motivación en los estudiantes de medicina está asociada positivamente con las estrategias de aprendizaje. Sin embargo, la evidencia de una relación directa entre la motivación y el rendimiento es vaga. El objetivo de este estudio es determinar si la motivación que empujó a los estudiantes a elegir la carrera médica está asociada con su rendimiento académico durante sus años universitarios. Métodos El estudio se realizó en 4.290 estudiantes de medicina de 10 países de América Latina. La "Escala de atribución de la motivación de logro general" se utilizó para evaluar su desempeño general. La prueba "Escala de motivación médica" se usó para medir motivadores sociales, altruistas, económicos y de prestigio. Para los análisis estadísticos, se describieron las frecuencias y los porcentajes, y se utilizaron modelos lineales generalizados para establecer ...
9
artículo
Publicado 2021
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Hepatocellular carcinoma (HCC) usually afflicts individuals in their maturity after a protracted liver disease. Contrasting with this pattern, the age structure of HCC in Andean people displays a bimodal distribution with half of the patients developing HCC in adolescence and early adulthood. To deepen our understanding of the molecular determinants of the disease in this population, we conducted an integrative analysis of gene expression and DNA methylation in HCC developed by 74 Peruvian patients, including 39 adolescents and young adults. While genome-wide hypomethylation is considered as a paradigm in human HCCs, our analysis revealed that Peruvian tumors are associated with a global DNA hypermethylation. Moreover, pathway enrichment analysis of transcriptome data characterized an original combination of signatures. Peruvian HCC forgoes canonical activations of IGF2, Notch, Ras/MAPK,...
10
artículo
Publicado 2018
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We previously described a divergent clinical and molecular presentation of hepatocellular carcinoma (HCC) in Peru. The present study aimed to further characterize the tissue features associated with this singular nosological form of HCC in order to gain insight into the natural history of the disease. We performed an exploratory analysis of the histology of both tumor and non-tumor liver (NTL) tissues from 50 Peruvian HCC patients, and compared with that of 75 individuals with non-HCC liver tumor or benign liver lesions as a baseline for NTL features. We complemented this approach with a transcriptome analysis in a subset of NTL tissue samples and also performed an ultra-sensitive hepatitis B virus (HBV) detection in liver tissues of the patients. Overall, results highlighted the low rate of liver parenchymal alterations in a young patient cohort (median age: 40 years old), despite a str...
11
artículo
Publicado 2021
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This study was funded by the French National Alliance for Life Sciences and Health (ENV201408); LC was a recipient of a doctoral fellowship from French National Research Institute for Sustainable Development (IRD) (EMHE-ARTS-2016-878573B); JPC was a recipient of a doctoral fellowship from the Peruvian National Council for Science and Technology (212-2015-FONDECYT); SB has received funding from the European Union’s Horizon 2020 Framework program under the Marie Sk?odowska-Curie Actions 823935 and from the Alliance pour les Sciences de la Vie et de la Santé (AVIESAN), ITMO Cancer ENV201408, and LC, ER, and SCZ have received funding from the World Bank Group and FONDECYT-CONCYTEC 016-2018-FONDECYT/BM. The authors are grateful to Karina Cancino, Danny Cordova (INEN Cancer Research Biobank), Patricia Leroyer (NUMECAN), Alain Fautrel, Marine Seffals, Gevorg Ghukasyan (H2P2 platform). They a...
12
artículo
Publicado 2019
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Purpose: Helicobacter pylori (HP) and Epstein Barr virus (EBV) infections induce chronic gastritis (CG) and are accepted carcinogenics of gastric cancer (GC). Our objective for this study was to determine the prevalence of these agents and clinicopathological features of GC and CG associated with the infection. Patients and methods: A single-center cohort of 375 Peruvian patients with GC and 165 control subjects with CG were analyzed. Evaluation of HP and EBV genes was performed through quantitative polymerase chain reaction. Results: Prevalence of HP was 62.9% in the whole population and 60.8% in the GC subset. The cagA gene was detected in 79.9%; vacAs1 and vacAm1 alleles in 41.6% and 60.7%, respectively; and concurrent expression of vacAs1 and vacAm1 in 30.4% of infected patients in the whole series. The prevalence of EBV was 14.1% in the whole population and was higher in GC (P < .00...
13
artículo
Publicado 2019
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PURPOSE Helicobacter pylori (HP) and Epstein Barr virus (EBV) infections induce chronic gastritis (CG) and are accepted carcinogenics of gastric cancer (GC). Our objective for this study was to determine the prevalence of these agents and clinicopathological features of GC and CG associated with the infection. PATIENTS AND METHODS A single-center cohort of 375 Peruvian patients with GC and 165 control subjects with CG were analyzed. Evaluation of HP and EBV genes was performed through quantitative polymerase chain reaction. RESULTS Prevalence of HP was 62.9% in the whole population and 60.8% in the GC subset. The cagA gene was detected in 79.9%; vacAs1 and vacAm1 alleles in 41.6% and 60.7%, respectively; and concurrent expression of vacAs1 and vacAm1 in 30.4% of infected patients in the whole series. The prevalence of EBV was 14.1% in the whole population and was higher in GC (P , .001)....
14
artículo
Publicado 2020
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Aim: Helicobacter pylori is usually detected based on hematoxylin-eosin (H-E) features, but, immunohistochemistry (IHC) and real-time PCR (RT-PCR) are more precise in chronic-gastritis. We evaluated the relevance of these tests in Peruvian gastric cancer samples. Materials & methods: We performed and evaluated H-E, IHC staining and RT-PCR in 288 gastric tumors. Slides were independently evaluated by three pathologists. Results: H. pylori was detected in 167/287 through H-E, 140/288 through IHC and 175/288 through RT-PCR, and positive-status were associated (p < 0.001). H. pylori detection by H-E had a good concordance with IHC (kappa index = 0.632) but poor with RT-PCR (kappa index = 0.317). Higher median gene-copies were found in high H. pylori density through H-E or IHC (p < 0.001). Conclusion: H-E evaluation is accurate in gastric cancer, and IHC and RT-PCR can complement its results....
15
artículo
Publicado 2019
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Aim: To correlate levels of tumor-infiltrating lymphocytes (TIL) evaluated using the International Immuno-Oncology Biomarker Working Group methodology, and both density of tumor-infiltrating immune cell and clinicopathological features in different malignancies. Methods: 209 pathological samples from gastric cancer, cervical cancer (CC), non-small-lung cancer, cutaneous melanoma (CM) and glioblastoma were tested for TIL in hematoxylin eosin, and density of CD3+, CD4+, CD8+, CD20+, CD68+ and CD163+ cells by digital analysis. Results: TIL levels were higher in invasive margin compartments (IMC). TIL in IMC, intratumoral and stromal compartments predicted survival. CC and gastric cancer had higher TIL in intratumoral; CC and CM had higher TIL in stromal compartment and IMC. CM had the highest density of lymphocyte and macrophage populations. CD20 density was associated with survival in the ...
16
artículo
Publicado 2021
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Purpose: The COVID-19 pandemic is a colossal challenge for global health; nonetheless, specific subgroups face considerably higher risks for infection and mortality. Among patients with malignant diseases, those with hematologic neoplasms are at a higher risk for poor outcomes. The objective of this study was to register treatment modifications associated with the COVID-19 pandemic and their short-term consequences in Latin America. Methods: Multicenter, prospective, observational, cohort study including patients older than 14 years from 14 centers in four countries (Mexico, Peru, Guatemala, and Panama) who had a confirmed diagnosis of acute leukemia, and who were undergoing active treatment since the first COVID-19 case in each country until the cutoff on July 15, 2020. Results: We recruited 635 patients. Treatment modifications because of the COVID-19 pandemic were reported in 40.8% of...
17
artículo
Publicado 2021
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Purpose: The COVID-19 pandemic is a colossal challenge for global health; nonetheless, specific subgroups face considerably higher risks for infection and mortality. Among patients with malignant diseases, those with hematologic neoplasms are at a higher risk for poor outcomes. The objective of this study was to register treatment modifications associated with the COVID-19 pandemic and their short-term consequences in Latin America.Methods: Multicenter, prospective, observational, cohort study including patients older than 14 years from 14 centers in four countries (Mexico, Peru, Guatemala, and Panama) who had a confirmed diagnosis of acute leukemia, and who were undergoing active treatment since the first COVID-19 case in each country until the cutoff on July 15, 2020.Results: We recruited 635 patients. Treatment modifications because of the COVID-19 pandemic were reported in 40.8% of c...
