There is currently no vaccine available and no specific medication against Coronavirus 2019 disease (COVID-19). The treatment is mainly based on support measures. In this context, several potentially useful therapies have been approved for use in clinical trials, such as convalescent plasma transfusion (CPT). PubMed was searched for studies on convalescent plasma and COVID-19, SARS or MERS. Studies on clinical efficacy in diseases caused by other coronaviruses (SARS-CoV and MERS-CoV) showed clinical improvement, increase of neutralizing antibodies, decreased mortality and absence of adverse events during and after treatment. We found 13 studies on this type of treatment used in patients with severe and critical COVID-19. Despite limitations regarding methodology, number of patients and the protocols for the analysis of donors' convalescent plasma, patients who received CPT showed clinical improvement, improvement of ventilatory patterns, resolution of lung injuries, decreased mortality, improvement of laboratory parameters, increase of neutralizing antibodies, decreased viral load and low frequency of adverse events.A descriptive observational study was carried out to identify the characteristics of the oncological clinical trials submitted to the Instituto Nacional de Salud del Perú during the period from 1995 to 2019. The information was obtained from the Peruvian Registry of Clinical Trials. We identified 1,996 clinical trials during the studied period, from which 470 were oncological (23.5%); 74.9% of the oncological clinical trials were mainly sponsored by the pharmaceutical industry, 61.9% were phase III and 86.2% were authorized. Regarding those authorized clinical trials, 55.6% were on chemical research products and 35.9% were on therapeutic indication for breast cancer. The most frequent study designs found were parallel arm (84.7%), randomized (85.2%) and blinded (51.0%); the most frequently used main endpoint was the objective response rate (46.7%). We conclude that the number of oncological clinical trials has been increasing over the years, often with different characteristics.In order to describe the early functional and morphological changes in the remnant kidney of living donors, a retrospective study was carried out at the Cayetano Heredia Hospital. Data from 55 individuals was included. Clinical and demographic data were obtained from the clinical records, as well as data for creatinine clearance, proteinuria, blood pressure and renal dimensions at 1, 2, 3, 6 and 12 months after kidney donation. The mean age was 40.88 (±9.84) years; 80% were women and the mean body mass index was 25.68 (±3.5) kg/m2. Linear and quadratic models were used to study physiological and morphological variables. https://www.selleckchem.com/products/nvp-bsk805.html During the follow-up time, glomerular filtration rate, proteinuria, diastolic blood pressure, and kidney length showed significant changes (p less then 0.05).This study aimed to describe the supply and advertising of foods and beverages both inside educational institutions and in their respective local areas in 15 public and private schools in Lima during 2019. Unbiased observations were recorded regarding the types of food available, the presence of octagons, and advertisements used in kiosks and cafeterias. Mobile food vendors were observed at the end of the school day. All schools offered processed products, 73.3% sold food with octagons, and 60% displayed advertising for processed and ultraprocessed foods. Mobile food vendors were observed in 86.7% of schools, several of which were found to sell ultraprocessed products. The results suggest an unhealthy food environment both inside and outside schools, and a noncompliance with current regulations. It is therefore necessary to improve the dissemination and supervision of the food policy, and develop strategies with schools to promote healthy eating.The aim of this study was to measure the frequency of nosocomial infections in the internal medicine observation units of the emergency services in two level III hospitals in Lima. A 5-day prevalence study was carried out on patients admitted after a 72 hours observation period, in whom community-based infections were ruled out. Data was obtained from clinical records. Additionally, overcrowding and ventilation in the hospitalization rooms were evaluated. The frequency of nosocomial infections in the emergency services was found to be 8.1%, four times what was reported as period prevalence in Peru. The associated risk factors were prolonged length of stay and lack of proper ventilation in the hospital environment. Inadequate ventilation triples the risk of nosocomial infections.The objective of this study was to evaluate the presence of colistin- and carbapenemic-resistant genes in multidrug-resistant Klebsiella pneumoniae strains isolated at the Instituto Materno Perinatal de Lima (2015-2018). Susceptibility levels were analyzed by disk diffusion and microdilution. The presence of colistin- and carbapenemic-resistant genes was determined by polymerase chain reaction (PCR) and was related to clonality. A total of 36 K. pneumoniae strains were analyzed, 5 (13.8%) were resistant to colistin and belonged to different clonal groups. Only 2 strains were found with carbapenemases (bla KPC and bla NDM), and no colistin plasmid genes were detected. High resistance levels to the other tested antimicrobials were observed, except for amikacin (13.9%). The results highlight the presence of colistin-resistant strains (33.3% in 2018), a worrying situation as they are part of the latest treatment alternatives for infections caused by multiresistant pathogens.We analyzed the presence of the mcr-1 gene in 165 extended-spectrum beta-lactamase-producing enterobacterales (ESBL-PE) obtained during 2017, from blood (40), urine (57), lower respiratory secretions (12) and rectal swabs (56) of patients hospitalized in the Instituto Nacional de Enfermedades Neoplásicas (Peru). Antimicrobial identification and susceptibility were determined by the Phoenix M50 automated system; colistin resistance by Colistin Agar-Spot (CAS); ****1 detection by colistin pre-diffusion and inhibition with EDTA test (CPD-E) and by polymerase chain reaction (PCR). We found that from the 165 ESBL-PE, 25 were positive for mcr-1 by the CPD-E method and confirmed by PCR. Colistin resistance was found in 20/165 by using the CAS method. Additionally, they showed resistance to fluoroquinolones and gentamicin, while remaining sensitive to amikacin; two isolates presented metallo-carbapenemases. Obtaining data on resistance to last-line antimicrobials (colistin) is crucial to establish measures for its control.
There is currently no vaccine available and no specific medication against Coronavirus 2019 disease (COVID-19). The treatment is mainly based on support measures. In this context, several potentially useful therapies have been approved for use in clinical trials, such as convalescent plasma transfusion (CPT). PubMed was searched for studies on convalescent plasma and COVID-19, SARS or MERS. Studies on clinical efficacy in diseases caused by other coronaviruses (SARS-CoV and MERS-CoV) showed clinical improvement, increase of neutralizing antibodies, decreased mortality and absence of adverse events during and after treatment. We found 13 studies on this type of treatment used in patients with severe and critical COVID-19. Despite limitations regarding methodology, number of patients and the protocols for the analysis of donors' convalescent plasma, patients who received CPT showed clinical improvement, improvement of ventilatory patterns, resolution of lung injuries, decreased mortality, improvement of laboratory parameters, increase of neutralizing antibodies, decreased viral load and low frequency of adverse events.A descriptive observational study was carried out to identify the characteristics of the oncological clinical trials submitted to the Instituto Nacional de Salud del Perú during the period from 1995 to 2019. The information was obtained from the Peruvian Registry of Clinical Trials. We identified 1,996 clinical trials during the studied period, from which 470 were oncological (23.5%); 74.9% of the oncological clinical trials were mainly sponsored by the pharmaceutical industry, 61.9% were phase III and 86.2% were authorized. Regarding those authorized clinical trials, 55.6% were on chemical research products and 35.9% were on therapeutic indication for breast cancer. The most frequent study designs found were parallel arm (84.7%), randomized (85.2%) and blinded (51.0%); the most frequently used main endpoint was the objective response rate (46.7%). We conclude that the number of oncological clinical trials has been increasing over the years, often with different characteristics.In order to describe the early functional and morphological changes in the remnant kidney of living donors, a retrospective study was carried out at the Cayetano Heredia Hospital. Data from 55 individuals was included. Clinical and demographic data were obtained from the clinical records, as well as data for creatinine clearance, proteinuria, blood pressure and renal dimensions at 1, 2, 3, 6 and 12 months after kidney donation. The mean age was 40.88 (±9.84) years; 80% were women and the mean body mass index was 25.68 (±3.5) kg/m2. Linear and quadratic models were used to study physiological and morphological variables. https://www.selleckchem.com/products/nvp-bsk805.html During the follow-up time, glomerular filtration rate, proteinuria, diastolic blood pressure, and kidney length showed significant changes (p less then 0.05).This study aimed to describe the supply and advertising of foods and beverages both inside educational institutions and in their respective local areas in 15 public and private schools in Lima during 2019. Unbiased observations were recorded regarding the types of food available, the presence of octagons, and advertisements used in kiosks and cafeterias. Mobile food vendors were observed at the end of the school day. All schools offered processed products, 73.3% sold food with octagons, and 60% displayed advertising for processed and ultraprocessed foods. Mobile food vendors were observed in 86.7% of schools, several of which were found to sell ultraprocessed products. The results suggest an unhealthy food environment both inside and outside schools, and a noncompliance with current regulations. It is therefore necessary to improve the dissemination and supervision of the food policy, and develop strategies with schools to promote healthy eating.The aim of this study was to measure the frequency of nosocomial infections in the internal medicine observation units of the emergency services in two level III hospitals in Lima. A 5-day prevalence study was carried out on patients admitted after a 72 hours observation period, in whom community-based infections were ruled out. Data was obtained from clinical records. Additionally, overcrowding and ventilation in the hospitalization rooms were evaluated. The frequency of nosocomial infections in the emergency services was found to be 8.1%, four times what was reported as period prevalence in Peru. The associated risk factors were prolonged length of stay and lack of proper ventilation in the hospital environment. Inadequate ventilation triples the risk of nosocomial infections.The objective of this study was to evaluate the presence of colistin- and carbapenemic-resistant genes in multidrug-resistant Klebsiella pneumoniae strains isolated at the Instituto Materno Perinatal de Lima (2015-2018). Susceptibility levels were analyzed by disk diffusion and microdilution. The presence of colistin- and carbapenemic-resistant genes was determined by polymerase chain reaction (PCR) and was related to clonality. A total of 36 K. pneumoniae strains were analyzed, 5 (13.8%) were resistant to colistin and belonged to different clonal groups. Only 2 strains were found with carbapenemases (bla KPC and bla NDM), and no colistin plasmid genes were detected. High resistance levels to the other tested antimicrobials were observed, except for amikacin (13.9%). The results highlight the presence of colistin-resistant strains (33.3% in 2018), a worrying situation as they are part of the latest treatment alternatives for infections caused by multiresistant pathogens.We analyzed the presence of the mcr-1 gene in 165 extended-spectrum beta-lactamase-producing enterobacterales (ESBL-PE) obtained during 2017, from blood (40), urine (57), lower respiratory secretions (12) and rectal swabs (56) of patients hospitalized in the Instituto Nacional de Enfermedades Neoplásicas (Peru). Antimicrobial identification and susceptibility were determined by the Phoenix M50 automated system; colistin resistance by Colistin Agar-Spot (CAS); mrc-1 detection by colistin pre-diffusion and inhibition with EDTA test (CPD-E) and by polymerase chain reaction (PCR). We found that from the 165 ESBL-PE, 25 were positive for mcr-1 by the CPD-E method and confirmed by PCR. Colistin resistance was found in 20/165 by using the CAS method. Additionally, they showed resistance to fluoroquinolones and gentamicin, while remaining sensitive to amikacin; two isolates presented metallo-carbapenemases. Obtaining data on resistance to last-line antimicrobials (colistin) is crucial to establish measures for its control.
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