Producción Científica UPeU

URI permanente para esta comunidadhttps://cris.upeu.edu.pe/handle/123456789/1

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Status of the neuromyelitis optica spectrum disorder in Latin America
(2021-06-15)
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Fernando Hamuy
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Verónica Rivas
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Fernando Gracia
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Juan Ignacio Rojas
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A case of monkeypox and cytomegalovirus coinfection manifesting with crusted lesions mimicking rupiod syphilis
(2023-11-03)
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Jhoann Aurich
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José Quiroz
Human monkeypox is a viral zoonosis that has recently emerged worldwide. Clinical cutaneous features include papules, vesicles, and pustules. However, atypical manifestations mimicking other infectious diseases are being reported more frequently. We present a 41-year-old man patient with untreated HIV with generalized rupioid crusted ulcerated plaques with perineal ulceration that were found to represent monkeypox and cytomegalovirus infections.
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Simultaneous onset of acute myocardial infarction, bicuspid aortic stenosis, and cardiac transthyretin amyloidosis—A clinically complex confluence
(2024-01-01)
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Paol Rojas
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Roberto Baltodano‐Arellano
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Angela Cachicatari
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Jose A. Quiroz
The coexistence of bicuspid aortic valve disease and coronary artery disease is well-established, but the identification of cardiac amyloidosis in this population has surged with advancing imaging techniques, introducing complexities in patient management. This case report emphasizes the pivotal role of multimodality imaging in accurately diagnosing three concurrent pathologies.
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Novel Biomarkers for the diagnosis of diabetic nephropathy.
(2024-01-01)
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Juan Carlos Quiroz
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Jacsel Suárez
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José Enrique López Paz
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Pela J Roseboom
Diabetes mellitus and its complications are a known public health problem nowadays. Diabetic nephropathy is one of the main complications and the result of multiple mechanisms, including: activation of the renin-angiotensin-aldosterone system, formation of advanced glycation end products and chronic inflammation that led to glomerular and tubulo-interstitial damage producing mesangial expansion and glomerulosclerosis, which finally results in chronic kidney disease. Early detection of diabetic nephropathy is essential for adequate intervention to stop, or at least slow down its progression. Multiple markers have been described, not only the classic ones such as serum creatinine, urea, and albuminuria, but at this point also novel biomarkers such as neutrophil gelatinase-associated lipocalin, tumor necrosis factor 1 receptor and monocyte chemoattractant protein-1, among others. The aim of this article was to provide an update review of the role of biomarkers in the diagnosis of diabetic nephropathy.
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Workload and quality of life in Peruvian university professors
(2024-01-01)
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Claudia Melissa Mamani Poma
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Jeyzi Sarai Mamani Churayra
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Universidad Peruana Unión, Lima, Peru
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Introduction: The quality of life of professors is an important standard for their job performance. Objective: To determine the influence of workload on the quality of life of professors at a Peruvian university. Materials and Methods: This was a study with a quantitative, explanatory, cross-sectional approach applied to 326 active employees and professors at a Peruvian university during the years 2023 and 2024. Two questionnaires validated in Peru were administered. The questionnaires asked about sociodemographic data, SF-36 quality of life, and the workload scale. The data were analyzed using Studio R software, correlation analysis with Pearson R, and the explanatory model with linear regression methods. Results: It was found that, in the workload, an average of 11.56 was obtained, which shows a workload with low distribution among professors. Discussion: It was found that there is a positive and moderate correlation between workload and four dimensions of quality of life, which are physical role, bodily pain, emotional role, and social functioning; it was observed that these are significant predictors of workload. Conclusion: It is concluded that workload and quality of life influence each other. However, no relationship was found between the variables; important specific correlations were identified between workload and three dimensions of quality of life (emotional role, bodily pain, and social functioning).
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Proceso de enseñanza – aprendizaje en modalidad virtual y los estresores en las prácticas clínicas
(2025-06-30)
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Samuel Esau Quispe Taipe
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La pandemia por la COVID-19 obligó a migrar la educación presencial a la virtual, generando nuevos desafíos para los estudiantes de enfermería, quienes enfrentaron altos niveles de estrés durante sus prácticas clínicas. Objetivo: Determinar la relación entre el proceso de enseñanza-aprendizaje en modalidad virtual y los estresores en las prácticas clínicas en estudiantes de enfermería peruanos. Metodología: Estudio cuantitativo, no experimental, correlacional y de corte transversal, con una muestra de 350 estudiantes. Resultados: No se hallaron diferencias significativas entre las variables principales; sin embargo, se identificaron correlaciones relevantes entre dimensiones específicas del proceso de enseñanza virtual, como el acompañamiento y la colaboración, con factores de estrés como la impotencia e incertidumbre. Conclusión: Ciertas dimensiones del entorno virtual influyen en la percepción de estresores durante las prácticas clínicas, lo cual sugiere la necesidad de fortalecer el soporte académico en entornos no presenciales.
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Sexual Behavior and Sexually Transmitted Infection Outcomes Among Men Who Have Sex With Men and Transgender Women Participating in a Study of the Timing of Antiretroviral Therapy in Lima, Peru
(2020-11-11)
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Ricardo Alfaro
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Tara Ness
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Carmela Ganoza
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Pedro Gonzáles
BACKGROUND: We assessed sexual behavior and incidence of sexually transmitted infections (STIs) among men who have sex with men and transgender women participating in Sabes, a study of an expanded treatment as prevention strategy focused on early diagnosis and treatment of HIV infection in Lima, Peru (2013-2017). METHODS: Sabes participants were tested monthly for HIV to identify acute or early infections, and HIV-positive participants were randomized to receive antiretroviral therapy immediately (immediate arm) or after 24 weeks (deferred arm) during a 48-week follow-up period. Sexual behavior was assessed at randomization (baseline) and every 12 weeks thereafter. Participants were tested for urethral and rectal chlamydia and gonorrhea and for syphilis at baseline, 12, 24, and 48 weeks. We describe patterns of sexual behavior during the 48-week follow-up period and compare sexual behavior and STI incidence between study arms. RESULTS: After randomization, 207 HIV-positive participants completed questionnaires and STI testing at 2 or more visits. After HIV diagnosis, participants in both arms reported increases in condom use with main and casual partners and decreased drug and alcohol use before or during anal sex. We observed no between-arm differences in sexual behavior. Deferred arm participants had higher incidence of chlamydia (incidence rate ratio, 2.33; 95% confidence interval, 1.14-4.77) but not gonorrhea or syphilis. CONCLUSIONS: Despite reported increases in condom use, the overall high incidence of STIs reflects some ongoing condomless sex among HIV-positive men who have sex with men and transgender women, highlighting the importance of regular STI screening and counseling to support consistent condom use among HIV-positive individuals at risk for STIs.
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Clinical and Immunologic Outcomes After Immediate or Deferred Antiretroviral Therapy Initiation During Primary Human Immunodeficiency Virus Infection: The <i>Sabes</i> Randomized Clinical Study
(2020-02-26)
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Rachel Bender Ignacio
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Ricardo Alfaro
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Jessica Ríos
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Jorge A. Gallardo-Cartagena
BACKGROUND: In addition to demonstrated public health benefits on reducing transmission, it remains unclear how early antiretroviral therapy (ART) must be started after acquisition of human immunodeficiency virus (HIV) to maximize individual benefits. METHODS: We conducted an open-label randomized clinical study in Lima, Peru among adult men who have sex with men and transgender women with acute (HIV-antibody negative/HIV-1 RNA positive) or recent (confirmed negative HIV-antibody or RNA test within 3 months) HIV infection, who were randomized to start ART immediately versus defer by 24 weeks. We evaluated outcomes by treatment arm and immunologic markers by days since estimated date of detectible infection (EDDI). RESULTS: Of 216 participants, 105 were assigned to immediate arm and 111 to deferred arm (median age 26.8 years, 37% with acute HIV). The incidence of non-ART-related adverse events was lower in immediate versus deferred arm (83 vs 123/100 person-years, IRR 0.67 (95% confidence interval [CI] .47, .95; P = .02), the difference dominated by fewer infections in those treated immediately. After 24 weeks of ART, between-group differences in CD4/CD8 cell ratio lessened (P = .09 overall), but differences between those initiating ART ≤ 30 days from EDDI (median 1.03, interquartile range [IQR] 0.84, 1.37), and those initiating > 90 days (0.88, IQR 0.61, 1.11) remained, P = .02. Principal components analysis of 20 immune biomarkers demonstrated distinct patterns between those starting ART > 90 days from EDDI versus those starting within 30 or 90 days (both P < .001). CONCLUSIONS: To our knowledge, this is the only evaluation of randomized ART initiation during primary HIV and provides evidence to explicitly consider acute HIV in World Health Organization recommendations for universal ART. CLINICAL TRIALS REGISTRATION: NCT01815580.
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Two Randomized Trials of Neutralizing Antibodies to Prevent HIV-1 Acquisition
(2021-03-17)
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Peter B. Gilbert
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Michal Juraska
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David C. Montefiori
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Lynn Morris
BACKGROUND: Whether a broadly neutralizing antibody (bnAb) can be used to prevent human immunodeficiency virus type 1 (HIV-1) acquisition is unclear. METHODS: ) of acquired isolates was measured with the TZM-bl assay. RESULTS: <1 μg per milliliter) per 100 person-years was 0.20 among VRC01 recipients and 0.86 among placebo recipients (estimated prevention efficacy, 75.4%; 95% CI, 45.5 to 88.9). The prevention efficacy against sensitive isolates was similar for each VRC01 dose and trial; VRC01 did not prevent acquisition of other HIV-1 isolates. CONCLUSIONS: VRC01 did not prevent overall HIV-1 acquisition more effectively than placebo, but analyses of VRC01-sensitive HIV-1 isolates provided proof-of-concept that bnAb prophylaxis can be effective. (Supported by the National Institute of Allergy and Infectious Diseases; HVTN 704/HPTN 085 and HVTN 703/HPTN 081 ClinicalTrials.gov numbers, NCT02716675 and NCT02568215.).
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Long-term effects of early antiretroviral initiation on HIV reservoir markers: a longitudinal analysis of the MERLIN clinical study
(2021-03-23)
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Rachel Bender Ignacio
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Javier R. Lama
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Amélie Pagliuzza
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Sayan Dasgupta
BACKGROUND: Early antiretroviral therapy (ART) initiation (ie, within 3 months of infection) limits establishment of the HIV reservoir. However, the effect of early ART initiation on the long-term dynamics of the pool of infected cells remains unclear. METHODS: In this longitudinal analysis, we included cisgender men who have sex with men (MSM) and transgender women (aged 18-54 years) at high risk for HIV infection, enrolled in the ongoing longitudinal MERLIN study in Peru between Oct 28, 2014, and Nov 8, 2018. Participants were eligible if they had been infected with HIV less than 90 days before enrolment, and if they had cryopreserved peripheral blood mononuclear cell (PBMC) samples. Participants were stratified into three groups on the basis of whether they initiated ART at 30 days or less (acute group), at 31-90 days (early group), or more than 24 weeks (deferred group) after the estimated date of detectable infection. PBMC samples were collected before ART initiation and longitudinally for up to 4 years on ART. The main outcomes were to establish the size of the HIV reservoir before ART initiation and to assess the effect of the timing of ART initiation on the decay of the HIV reservoir over 4 years follow-up. We quantified viral load, and isolated CD4 cells to quantify total HIV DNA, integrated HIV DNA and 2-long terminal repeat circles. Longitudinal analysis of active and inducible HIV reservoirs were measured by quantifying the frequency of CD4 cells producing multiply-spliced HIV RNA ex vivo and after in-vitro stimulation with a tat/rev induced limiting dilution assay (TILDA). A mixed-effects model from the time of ART initiation was used to measure longitudinal decays in viral loads and each HIV reservoir measure in each of the three groups. FINDINGS: We included 56 participants in this analysis, all of whom were MSM: 15 were in the acute group, 19 were in the early group, and 22 were in the deferred group. Participants in all three groups had similar levels of all HIV reservoir markers before ART initiation. All participants, including those in the acute group, had a pool of transcriptionally silent HIV-infected cells before ART initiation, as indicated by a substantial increase in TILDA measures upon stimulation. Longitudinal analysis over 4 years of ART revealed a biphasic decay of all HIV persistence markers, with a rapid initial decline followed by a slower decay in all participants. During the first-phase decay, the half-lives of both total and integrated HIV DNA and TILDA measures were significantly shorter in the acute group than in the early and deferred groups. During the second-phase decay, HIV reservoir markers continued to decline only in participants in the acute group. INTERPRETATION: Participants who initiated ART within 30 days or less of HIV infection showed a steeper and more sustained decay in HIV reservoir measures, suggesting long-term benefit of acute ART initiation on reservoir clearance. FUNDING: The US National Institutes of Health and the Canadian Institutes for Health Research.

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