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PubMed1978

[The experience in dental education of Cayetano Heredia University of Peru].

This article describes the educational experience gained in the dentistry program of Cayetano Heredia University in Peru. The programs for professional and auxiliary personnel training were drawn up after analyzing the health needs of the population and the services required to meet them, which resulted in the elaboration of an original methodology and taxonomy. Learning is an integral experience, one that takes place in the dental clinic, the hospital, and the community. The curriculum includes the following components: units for the intensive learning of clinical functions, fewer preclinical activities, clinical training with the ongoing assistance of auxiliary staff, extended interaction with marginal urban communities, rural internships, and hospital externships. A summary account is given of the gains made, the difficulties encountered, and plans for devising in-service teaching approaches that more effectively meet the needs of the community.

Community Dentistry↗

PubMed1976

Alkaloids and procyanidins of an Uncaria sp. from Peru.

The alkaloid and procyanidin composition of Uncaria sp. from eastern Peru, used in folk medicine was studied. Five alkaloids have been separated and identified as pteropodine, speciophylline, isopteropodine, uncarine F and isomytraphylline, all belonging to the oxindole group characteristic of the Rubiaceae. Moreover (--) epicatechin and four dimeric procyanidins A1, B1, B2 and B4 have been shown to constitute the polyphenolic fraction of the plant extract.

Alkaloids↗

PubMed1978

Contact urticaria provoked by balsam of Peru.

Six patients with chronic urticaria are described in whom immediate type hypersensitivity to balsam of Peru was proven by patch test.

Adult↗

PubMed1977

Balsam of Peru as screening agent for essential oils sensitivity.

The standard series and 35 essential oils were tested on 450 patients with dermatitis. It was found that those simultaneously sensitive to essential oils are more frequently negative than positive to balsam of Peru. The remaining 3 balsams, however (colophony, turpentine and wood tars), are also screening agents for essential oils. All four balsams reveal sensitivity to essential oils in most of the subjects tested. In patients negative to all 4 balsams of the standard series, attempts to find an essential oil with which tests would be simultaneously frequently positive with those for other essential oils failed.

Balsams↗

PubMed1978

[Contact urticaria caused by Peru balsam].

By tests on six patients with recurrent urticaria it could be demonstrated that it was caused by an allergy against Peru balsam. Different reaction types seem to have been responsible for the occurrence of the urticaria. Cross reactions with different other substances, mainly luxury food and stimulants, play a particular part.

Adult↗

PubMed1978

Non-specific ileojejunitis in Arequipa, Peru.

Non-specific ileojejunitis, characterised by mild to moderate structural changes in the intestinal mucosa and often associated with asymptomatic malabsorption, is known to occur in the tropics and in countries with hot climates. This acquired condition is probably related to environmental factors, and some consider it to be a subclinical form of tropical sprue. Changes in the intestinal mucosa typical of non-specific ileojejunitis were found in 10 indigenous Indians as well as 5 people of Latin stock living in the Southern Peruvian sierra, where tropical sprue has not as yet been demonstrated and which has a temperate climate.

Adolescent↗

PubMed2025

Effects of commonly used antibiotics on children's developing gut microbiomes and resistomes in peri-urban Lima, Peru.

BACKGROUND: The effects of antibiotic use on children's gut microbiomes and resistomes are not well characterized in middle-income countries, where antibiotic consumption is exceptionally common. OBJECTIVES: We characterized the effects of antibiotics commonly used by Peruvian children (i.e. amoxicillin, azithromycin, cefalexin, trimethoprim/sulfamethoxazole) on the α-diversity, β-diversity and abundance of gut genera and antibiotic resistance genes (ARGs) from 3 to 16 months. METHODS: This study included 54 children from a prospective cohort of enteric infections in peri-urban Lima, 2016-19. Stools collected at 3, 6, 7, 9, 12 and 16 months underwent DNA extraction and short-read metagenomic sequencing. We profiled the taxonomy of stool metagenomes and assessed ARG abundance by aligning reads to the ResFinder database. We used daily surveillance data (40 662 observations) to tabulate the number of antibiotic courses consumed in the 30 days prior to stool sampling. Using linear mixed models, we examined associations of recent antibiotic use with richness, diversity and abundance of gut genera and ARGs over time. RESULTS: Each additional recent antibiotic course decreased Bifidobacterium and Dialister abundance and increased Veillonella abundance, although gut richness and diversity were not affected. Recent use of amoxicillin, azithromycin, cefalexin or trimethoprim/sulfamethoxazole, specifically, did not impact gut microbiome measures. Amoxicillin, azithromycin and trimethoprim/sulfamethoxazole significantly enriched multiple ARGs and amoxicillin use significantly increased total ARGs. CONCLUSIONS: Common antibiotics like amoxicillin and azithromycin appear to be key drivers of the paediatric gut resistome. Resistome perturbations appeared to be stronger, or persist for longer, than gut microbiome effects in this middle-income country setting.

Humans↗

PubMed2026

In vitro susceptibility testing of aztreonam-avibactam against predominantly NDM-producing Enterobacterales in Peru.

Metallo-β-lactamase-producing Enterobacterales are distributed worldwide, but some Latin American countries show a higher prevalence. Aztreonam-avibactam (ATM-AVI) may be an option for treating these infections. To evaluate in vitro susceptibility to aztreonam (ATM) alone and ATM-AVI in carbapenem-non-susceptible Enterobacterales isolates, based on the type of carbapenemase production, we prospectively collected carbapenem-non-susceptible Enterobacterales isolates from Peruvian hospitals during 2023-2024. Identification and susceptibility testing were performed by commercial panels and disk diffusion. Carbapenemases were detected by immunochromatography. ATM and ATM-AVI MICs were determined using broth microdilution panels with avibactam fixed at 4 µg/mL. The non-susceptible isolates to ATM-AVI and those with double production of carbapenemases underwent whole-genome sequencing. A total of 438 Enterobacterales isolates were analyzed; carbapenemase production was detected in 422 (96.3%) and NDM was the most frequent (61.9%). Coproduction of NDM + KPC in K. pneumoniae and NDM + OXA-48-like in Escherichia coli was observed. Overall, 99.3% were susceptible to ATM-AVI; MIC50 and MIC90 were 0.12 and 2 µg/mL, respectively. Overall, K. pneumoniae isolates had lower MIC50 and MIC90 values to ATM-AVI (0.12 and 0.5 µg/mL) compared to E. coli (0.5 and 4 µg/mL). Three E. coli isolates were resistant to ATM-AVI (MIC ≥ 8 µg/mL), they belonged to ST410, ST167, and ST10 and harbored a YRIN insertion in PBP3 along with CYM-type, PER-type, and CTX-M-type beta-lactamase genes. ATM-AVI demonstrated potent activity against carbapenem-non-susceptible Enterobacterales, including those producing NDM, which is the carbapenemase most frequently detected in Peruvian hospitals.IMPORTANCEEnterobacterales isolates cause common illnesses in humans. Carbapenems are the antibiotics used to treat several of these infections, and increasingly, isolates resistant to these antibiotics are found. The most important mechanism of resistance to carbapenem among Enterobacterales is the production of enzymes called carbapenemases. Our results allowed us to recognize that NDM is the most frequent type of carbapenemase detected. Most of the antimicrobials available do not cover the Enterobacterales carrying NDM carbapenemase. In this scenario, we found that the new combination of drugs, aztreonam-avibactam, has high in vitro efficacy against most of the carbapenem-resistant isolates and against those isolates carrying NDM carbapenemase.

Aztreonam↗

PubMed1976