Artykuły w czasopismach na temat „Signos (Lima, Peru)”

The aim of this study was to assess the seroprevalence of human toxocariasis in three Andean communities from the Northeast of Lima, Peru. A total of 303 subjects including children and adults were studied and blood samples were collected to detect anti-Toxocara antibodies by ELISA-IgG test and by hematological examination; stool samples were collected also for parasitological examination. The overall seroprevalence of toxocariasis observed in the total population was 20.46%, with a significant high proportion in children from one to 10 years old (p = 0.034). Among the subjects with positive serology, 32.26% of them had respiratory disturbances, 22.58% hepatomegaly, 17.74% ocular signs or symptoms, 14.51% abdominal pain, 9.68% neurological involvement, and 4.84% cutaneous signs, but none of these clinical features were associated to a positive serology by multivariate analysis. Furthermore, 79.03% of seropositive subjects also harbored at least one intestinal parasite, which was associated to a positive serology (p < 0.05). The presence of pets within the houses, a previous history of pica or geophagia and the use of public places were also present in this population, but only the latter was associated to the serology (p < 0.05). In conclusion, clinical, serological, and epidemiological evidences for larval Toxocara infection were found in the studied population.

Dengue fever is caused by the dengue virus (DENV) and affects over 390 million people yearly. It is prevalent in tropical areas, and warning signs have been established to easily identify patients who need further medical attention. In this article, we report the case of an 18–year–old female patient in Lima, Peru, during a dengue outbreak, presenting with abdominal pain, fever, and gingival bleeding. She tested positive for the NS1 antigen and was also diagnosed with mild acute pancreatitis. It is important to note that DENV infection may lead to acute pancreatitis during outbreaks, which could be underdiagnosed due to symptoms similar to dengue fever.

Introduction Human rhinovirus is a major cause of acute respiratory infections (ARIs) worldwide. Epidemiological data on human rhinovirus (RV) in Peru is still scarce, as well as its role in respiratory infections in children. Therefore, the aim of this study was to describe the prevalence of rhinovirus and to identify the circulating species in nasopharyngeal swabs from children with acute respiratory infections. Materials and methods We analyzed nasopharyngeal swab samples that were collected from children younger than 17 years old, who had a clinical diagnosis of ARI from the “Hospital Nacional Cayetano Heredia” between May 2009 and December 2010. The original study recruited 767 inpatients with ARI, 559 samples of which were included and analyzed in the current study. Detection of rhinovirus and determination of rhinovirus species were characterized by PCR. Results Rhinovirus was detected in 42.22% samples (236/559), RV-A was detected in 10.17% (24/236) of the cases, RV-B in 16.53% (39/236), and RV-C in 73.31% (173/236). The age group with the highest number of cases was the 0–5 months group with 45.97%, followed by the 1–5 years group with 25.22%. Most of the positive RV cases, i.e., 86.44% (204/236), were hospitalized. The most common signs and symptoms found in patients who tested positive for RV were cough (72.88%), fever (68.64%), rhinorrhea (68.22%), and respiratory distress (61.44%). Infection with RV-A was associated with wheezing (p = 0.02). Furthermore, RV-C was related to cough (p = 0.01), wheezing (p = 0.002), and conjunctival injection (p = 0.03). A peak in RV-C cases was found in March (32 cases in 2010); June (18 cases in 2009 and 12 cases in 2010), which corresponds to the fall season in Peru; and also November (17 cases in 2009 and 4 cases in 2010), which corresponds to spring. RV-A and RV-B cases were constant throughout the year. Conclusion In conclusion, we found a high prevalence of rhinovirus C infection among pediatric patients with acute respiratory infections in Lima, Peru. This viral infection was more common in children between 0 to 5 months old, and was associated with cough, wheezing, and conjunctival injection. Epidemiological surveillance of this virus should be strengthened/encouraged in Peru to determine its real impact on respiratory infections.

Abstract Peru’s first cancer control public outreach scheme started in the 1910s, but ground to a standstill as it attained official governmental recognition in 1926 as the Liga Anti-Cancerosa (LAC). This paper explains the developments leading to that earliest effort to enlist a coalition of State health agencies, physicians, and lay people in a campaign to publicize early signs of this disease, as well as the medical and political reasons for and implications of its decline. Besides highlighting the importance of professional initiatives shaping cancer activism, contextualizing the rise and fall of the LAC calls attention to the effects that hospitalization of cancer treatment had on aspects of cancer care that were not directly treatment-related, such as public outreach.

Abstract Introduction Computer Vision Syndrome (CVS) is currently considered an emerging public health problem due to the increase in economic activities associated with the use of data display screens (DDS). However, the lack of an instrument to identify the early symptoms and signs, can originate a prolonged exposure to the use of DDS and increase the prevalence of symptoms. Material and Methods A validation study incorporating content and discriminant validation of the CVS-Q instrument was carried out on administrative sector workers, susceptible to presenting risk factors associated with CVS in a company in Lima, Peru. The sample size consisted of 181 workers (91workers with risk factors for CVS and 90 workers without risk factors). Results The content validity was determined using the Aiken's method with average values greater than 0.7 for the coherence and clarity of the questions. The discriminant validity, an area under the ROC curve of 82.5% was obtained with a sensitivity of 70% and specificity of 89% for distinguishing between administrative and operative workers. Reliability was analysed using Cronbach's alpha method resulting in a value of 0,87 indicating high internal consistency. The Test-Retest reliability analysis for reproducibility was significant with a value of r=0,715. Conclusions The CVS-Q instrument demonstrated discriminant validity reaching high levels of sensitivy and specificity, being specific for measuring exposure to risk factors for CVS. The reliability of the instrument was confirmed through statistical Test-Retest analysis and the calculation of Cronbach's alpha. In conclusion, the study validates the CVS-Q among administrative workers.

Objective: To describe the characteristics of fetal death cases reported between 2017 and 2021 in a public hospital in Peru. Methods: Descriptive and cross-sectional study, which was conducted in confirmed cases of fetal death in mothers with gestational age greater than 22 weeks presented at the Vitarte Hospital in Lima, Peru. The sample consisted of 137 cases during the period from 2017 to 2021. Frequencies and percentages were presented. Results: Fetal death had a rate of 14,8 per 1000 live births. Most of the women were between 20 and 24 years old (27%), in addition, 70,1% were cohabiting, 92% were housewives and 83,2% studied up to high school. On the other hand, 50,4% were multigestational and 29,9% had a history of abortion and 16,7% had a history of cesarean section. Prenatal service attendance was the most frequent (67,2%) and 29,2% were overweight. Regarding maternal pathologies, 38% had urinary tract infection, 17,5% had preeclampsia without signs of safety and 2,9% had gestational diabetes. Congenital malformations were present in 19% of cases; in addition, 23,4% of fetal deaths had a maternal cause. Conclusions: The rate of fetal death is high. The cases were characterized mostly by mothers with qualities of social vulnerability, in addition to presenting characteristics of higher obstetric risk. Maternal causes of fetal death were the most frequent. Keywords: Fetal death, pregnancy, delivery, risk factors.

Introduction: Coronavirus disease 2019 (COVID-19) fatal outcomes have been associated with multiple cardiovascular risk factors. In new epidemic areas, such as Latin America, there is a lack of studies about this. Objectives: To evaluate demographic data, signs and symptoms during emergency arrival, prevalence of cardiovascular risk factors, laboratory and ECG findings and their influence in mortality, in a retrospective cohort of patients in a national reference hospital of Lima, Peru. Methods: Review the clinical records of the patients attended at Hospital Rebagliati Hospital during March 6th and April 30th, 2020, using rRT-PCR was used for the detection of the RNA of SARS-CoV-2 following the protocol Charité, Berlin, Germany, from nasopharyngeal swabs at the National Institute of Health. Bivariate analysis and multivariate analysis using logistic regression was done. Values of p < 0.05 were considered significant for all analyses. Results: One hundred six hospitalized patients were evaluated. The mean age of patients was 61.58 years (SD 16.81). Cardiovascular risk factors among them were hypertension (46.2%), diabetes (28.3%), and obesity (28.3%), among others. Fifty-six patients died (52.8%). Mortality associated factors at the multivariate analysis were arterial hypertension (OR=1.343, 95% 1.089-1.667), myocardial injury (OR=1.303, 95% 1.031-1.642), and mechanical ventilation (OR 1.262, 95% 1.034-1.665), as associated factors. Conclusion: Cardiovascular risk factors and cardiovascular signs or symptoms are common during emergency arrival in patients with COVID-19. Arterial hypertension, myocardial injury and mechanical ventilation were associated with mortality in multivariate analysis, as observed in other regions of the world.

During a health survey in a primary school from the district of Carabayllo (North of Lima, Peru), 200 schoolchildren (96 male and 104 female between five to 12 years old) were randomly selected and divided in two groups (as positive or negative group), according to the serologic result of the Toxocara ELISA test from a total population of 646 schoolchildren. All children were analyzed by hematologic tests to determinate the frequency of eosinophilia and leukocytosis. Additionally, all clinical and epidemiological data were also analyzed to determine their association with toxocariasis. From group of children with positive serology, 40% had some type of eosinophilia in contrast to 19% of children with negative serology, and their association was statistically significant (OR = 2.84, p < 0.001). From all signs and symptoms evaluated, only 'dry cough' was more frequent and statistically significant in the positive serology group (OR = 2.79, p < 0.001). Almost all risk factors evaluated were highly frequent and statistically associated to the positive serology. In conclusion, the presence of eosinophilia and the risk factors evaluated in this population were frequently associated to human toxocariasis.

The Historic Center of Lima currently shows signs of urban deterioration as a result of the processes of exclusion and spatial segregation that have characterized the intense urban growth of the city of Lima. In the face of this urban deterioration, urban renewal processes are an instrument of transformation that acts as surgery for the recovery and reintegration of deteriorated central areas into the functioning of the current city. As a general, urban law regulates urban problems resulting from the transformation of urban lands, including the deterioration of central areas. In particular, actions in traditional central areas have regulations for the protection of cultural heritage. Therefore, the execution of the urban renewal process requires different regulatory instruments to plan and manage the renewal process, which defines its scope. In this sense, the present research has been proposed to address the implementation process of three urban renewal projects in collective housing located in the Historic Center of Lima; "Casa de las Columnas", the "Conjunto de Vivienda La Muralla" and the "Proyecto Piloto Martinete", to identify the effectiveness of the scope of the legal framework of urban renewal, as well as the procedures of intervention in historic centers and monumental areas. Focus on the analysis of the public administration's management, execution, and control activities in the land transformation process of deteriorated traditional urban areas. The article consists of the following parts. First, some conceptual considerations on urban renewal and its relationship with urban law are presented. The next section provides an overview of the state of the regulatory framework for urban renewal in Peru, which is key to contextualize the analysis of the case studies. The third part presents the study methodology and the limitations of the study. The fourth part presents the case studies and develops the scope of the legal framework of urban renewal in the case studies. Finally, some final reflections and conclusions are presented that establish the important elements that should be considered in the legal framework of urban renewal.

OBJECTIVE: To evaluate the performance of a survey that quantifies the intensity of household tuberculosis (TB) exposure among children.METHODS: Children aged 0–14 years in Lima, Peru, with ≥1 signs and/or symptoms of TB and a history of contact with an adult TB patient were included. The 10-question survey was administered to caregivers and addressed sleep proximity, frequency of exposure, and infectiousness of the contact. Infection status was determined using tuberculin skin tests (TSTs). The exposure scale was evaluated for association with TST positivity using mixed-effects regression analyses.RESULTS: The exposure score was significantly associated with TST positivity (age-adjusted odds ratio [aOR] 1.14, 95%CI 1.02–1.28). We observed a stronger association with TST positivity in children aged ≤5 years; (aOR 1.23, 95%CI 1.07–1.41) and no association in children 6–14 years of age (aOR 0.99, 95%CI 0.82–1.20).CONCLUSION: This survey was easy to use and modestly successful in predicting TST positivity in children aged ≤5 years. It may be a useful resource for clinicians for diagnosing TB in children, and for national TB programs aiming to scale up preventive therapy initiatives.

The most significant football stadium riot tragedy occurred at the National Stadium (Estadio Nacional) in Lima, Peru, resulting in 362 fatalities. The second largest tragedy transpired at the Kanjuruhan Stadium, Malang Regency, Indonesia, leading to 135 deaths. This research aims to evaluate the conformity of evacuation routes and fire protection systems at the one of Football Stadium in Greater Malang, in accordance with the standards and regulations applicable in Indonesia. This analytical descriptive study employs a quantitative research design. The research process involved examining the factual conditions on the ground and subsequently comparing the suitability of evacuation routes and fire protection systems against the standard benchmarks and regulations in place in Indonesia. The results of this study indicate that the conformity level of the evacuation routes, comprising emergency stairs, evacuation routes, safety signs, assembly points, and emergency exits, is at 61.9 percent, denoting adequate compliance. Conversely, the active fire protection systems, encompassing portable fire extinguishers (APAR), hydrants, fire alarms, fire detectors, and sprinklers, show 0 percent compliance, meaning no conformity exists. This study is anticipated to serve as a reference for enhancing evacuation routes and fire protection systems at Football Stadium X: stadium in Greater Malang.

<span lang="EN-US">The Chilca 2 thermoelectric power plant, located in the province of Lima, Peru, has an open cycle gas turbine and a combined cycle steam turbine, whose combined capacity is 112.8 MW (Mega Watts). This plant requires auxiliary equipment for its operation, which is why it consists of electrical systems, lubrication system, hydraulic ventilation, pumps, vacuum systems and drainage of condensate generated by the difference in temperature in the steam conductor. Said drainage system is inside a 5-meter-deep basement that, being exposed to the elements, is exposed to falling drops of water that are generated by the vapors that are released due to the difference in temperature, repeatedly flooding and exposing to hazards that affect the normal operation of the thermoelectric plant. The proposed solution is based on the philosophy of a feedback control system, which uses a programmable logic controller (PLC) Siemens 1214AC/DC/Relay programmable logic controller, which, through a frequency inverter, activates the drainage pumps; the frequency range at which the variator works is linked to a 4-position level sensor. The result shows that it was possible to activate the frequency variator in a controlled manner through frequencies of 10 Hz, 30 Hz </span><span lang="EN-US">and 60 Hz, in this way a sustained operation of the drainage system is guaranteed.</span>

RESUMENEl objetivo de este artículo es reflexionar sobre los mecanismos de financiación y de control de las instituciones religiosas por los laicos en las primeras décadas de la conquista y colonización de Hispanoamérica. Investigar sobre la inversión laica en lo sagrado supone en un primer lugar aclarar la historiografía sobre laicos, religión y dinero en las sociedades de Antiguo Régimen y su trasposición en América, planteando una mirada desde el punto de vista de las motivaciones múltiples de los actores seglares. A través del ejemplo de restituciones, donaciones y legados en losAndes, se explora el papel de los laicos españoles, y también de las poblaciones indígenas, en el establecimiento de la densa red de instituciones católicas que se construye entonces. La propuesta postula el protagonismo de actores laicos en la construcción de un espacio cristiano en los Andes peruanos en el siglo XVI y principios del XVII, donde la inversión económica permite contribuir a la transición de una sociedad de guerra y conquista a una sociedad corporativa pacificada.PALABRAS CLAVE: Hispanoamérica-Andes, religión, economía, encomienda, siglos XVI y XVII.ABSTRACTThis article aims to reflect on the mechanisms of financing and control of religious institutions by the laity in the first decades of the conquest and colonization of Spanish America. Investigating lay investment in the sacred sphere means first of all to clarifying historiography on laity, religion and money within Ancien Régime societies and their transposition to America, taking into account the multiple motivations of secular actors. The example of restitutions, donations and legacies inthe Andes enables us to explore the role of the Spanish laity and indigenous populations in the establishment of the dense network of Catholic institutions that was established during this period. The proposal postulates the role of lay actors in the construction of a Christian space in the Peruvian Andes in the sixteenth and early seventeenth centuries, when economic investment contributed to the transition from a society of war and conquest to a pacified, corporate society.KEY WORDS: Hispanic America-Andes, religion, economics, encomienda, 16th and 17th centuries. BIBLIOGRAFIAAbercrombie, T., “Tributes to Bad Conscience: Charity, Restitution, and Inheritance in Cacique and Encomendero Testaments of 16th-Century Charcas”, en Kellogg, S. y Restall, M. 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El patrimonio entendido como una construcción social, trasciende las consideraciones estrictamente materiales concernientes al patrimonio edificado. En pleno siglo XX, a raíz de los acelerados procesos de urbanización, el lugar y la función del monumento valorado como objeto único, cambia y se transforma en patrimonio urbano. El conjunto de elementos urbanos que lo rodea y sus relaciones recíprocas participan ahora de su valor patrimonial. Pero también, participan sus respectivos entornos humanos, que no son otros que los depositarios de su significación simbólica. En tanto proceso, el patrimonio ha sabido reconocer la dificultad para su definición (en constante revisión) y, sus implicaciones en la formulación de estrategias de conservación capaces de justipreciar, en cada caso, la importancia de la relación de los habitantes con su patrimonio. El artículo ofrece una breve descripción de un edificio patrimonial en ruinas, cuya selección no lo ha sido por su valor de antigüedad, sino por el atractivo que presenta su situación actual, la cual ha sido objeto de una estimulante reflexión teórica y crítica en torno al patrimonio y su conservación. A través de un proceso inductivo se propone un conjunto de marcos conceptuales asociados a los atributos y atribuciones que el tiempo ha sabido otorgar a los bienes de valor patrimonial, a fin de establecer los límites que, en algunos casos presenta, la restauración.

A Revista Textos & Debates do Centro de Ciências Humanas da Universidade Federal de Roraima, nessa Edição 26 (2015), abre espaço para publicação de algumas pesquisas que representam o aprofundamento de estudos relacionados com a temática das migrações, fronteiras, grandes projetos, territórios e conflitos na Pan-Amazônia. Nessa perspectiva, acredita-se que os textos publicados nessa edição representam uma forma de dar continuidade ao debate e aprofundamento de temas relevantes para a produção do conhecimento nessa região, marcada pela complexidade de suas fronteiras. O texto Dificuldade de demarcação da Pan-Amazônia e dos territórios indígenas na região, de Paulo Henrique Faria Nunes, analisa dois problemas relacionados à cooperação amazônica: a delimitação da área de aplicação do Tratado de Cooperação Amazônica - TCA, conhecida como Amazônia pactual ou Pan-amazônia e a demarcação de terras indígenas. Segundo o autor parece não haver um diálogo que possibilite a adoção de critérios harmônicos na definição das áreas nacionais e, no tocante às terras indígenas, percebe-se que as diferenças e a ineficiência na condução das políticas nacionais têm aberto o caminho para que as terras indígenas e o conhecimento tradicional se tornem possíveis instrumentos de ingerência estrangeira na Amazônia. Dando continuidade ao debate da Pan-Amazônia, o texto IIRSA – Possibilidades e Desafios: Eixo Peru-Brasil-Bolívia, de autoria de Suely Aparecida de Lima e Maria de Jesus Morais, avalia as relações do Brasil com o Peru e a Bolívia baseadas na Iniciativa para a Integração da Infraestrutura Regional Sul-Americana - IIRSA, a partir de sua incorporação pela UNASUL, em 2008. As autoras aprofundam as formulações da política externa brasileira e o projeto geopolítico dispensado à América do Sul e os benefícios resultantes do processo de integração regional Sul-americano promovido pelo Brasil. Entretanto, alertam que os ganhos comerciais não refletem em ganhos sociais no tocante às populações das localidades atingidas, podendo resultar em conflitos nas fronteiras. Outras modalidades de conflitos são abordados no texto Antigas e novas dinâmicas de poder e território no Médio Purus/AM, de Willas Dias da Costa e Thereza Cristina Cardoso Menezes, que apresentam um quadro complexo de conflitos socioambientais no sul do Estado do Amazonas envolvendo patrões, lideranças das associações de agricultores e das etnias indígenas com os agentes do Estado. A temática dos conflitos é retomada também no texto Tríplice fronteira Brasil, Peru e Colômbia e as implicações com o narcotráfico, de Luiz Felipe de Vasconcelos Dias Balieiro e Izaura Rodrigues Nascimento. Os/as autores/as observam as caracerísticas do narcotráfico na tríplice fronteira amazônica, seu processo de formação histórica, a dinâmica da atividade cocaleira e do narcotráfico nos países vizinhos e suas implicações nas relações transfronteiriças. O texto de Alan Robson Alexandrino Ramos, A prisão para efetivação da deportação no Brasil: inconsistências com as normas da convenção americana de direitos humanos, aborda o instituto jurídico da deportação no Brasil, com análise da medida de prisão administrativa para efetivação da deportação de estrangeiros no Brasil em confronto com as normas da Convenção Americana de Direitos Humanos. Adentrando as fronteiras da Amazônia Brasileira, Débora Assumpção e Lima, tendo por base a formação do estado do Tocantins, apresenta a hinterlândia, como uma releitura do sertão, não apenas como um lugar, mas uma condição atribuída a variados lugares. Segundo a autora, a hinterlândia pode ser também um símbolo imposto, uma realidade simbólica onde o sertão não pode ser mensurável, já que a fronteira é movimento. Nessa perspectiva, o “fim do atraso” do sertão seria a maneira de se reconfigurá-lo, produzindo-o a partir do mesmo modo de circulação, de trabalho e de signos em suas diversas temporalidades, criadas pelos diversos atores e suas complexidades históricas, velocidades, conflitos e intencionalidades que formam um território integrado ao sistema do capital, mesmo que localizado na margem. Por fim, e não menos importante, Gil Almeida Felix, em seu texto Trabalho e mobilidade: trajetórias sociais de trabalhadores em Ourilândia do Norte/PA, aborda a questão da expansão das atividades industriais de mineração dirigidas pelo grande capital, em especial, pela empresa Vale e associadas, que tem sido anunciada como promotora do “desenvolvimento” local no Pará. Entretanto, o autor afirma que tal expansão se dá através da atração de enormes contingentes de trabalhadores que antes circulavam em atividades da rede de produção agropecuária e que, em sua maioria, encontram trabalho apenas no período de implantação das unidades industriais. O autor analisa determinadas características de processos de proletarização em uma área de expansão da indústria da mineração e apresenta os desafios metodológicos que tal contingente de trabalhadores representa para a pesquisa sócio-antropológica, em especial, para a devida compreensão das suas trajetórias sociais e das atuais formas de acumulação de capital. Fica claro, assim, que a edição número 26 da Revista Textos & Debates nos apresenta importantes contribuições para ampliar o conhecimento acerca da região Amazônica. Agradecemos a contribuição de todos/as os/as pesquisadores/as que tornaram possível essa edição contribuindo para o debate e o aprofundamento das temáticas ora apresentadas.

Origen de los manantiales de La Costa Verde Rubén Rojas, Modesto Montoya, Enoc Mamani, José Maguiña, Eduardo Montoya, Óscar Baltuano, Patricia Bedregal, Lucy Coria, Alcides Guerra, Santiago Justo y Tania Churasacari Instituto Peruano de Energía Nuclear, Canadá 1470, San Borja, Lima, Perú Facultad de Ciencias, Universidad Nacional de Ingeniería, Av. Túpac Amaru 210, Lima, Perú Universidad Ricardo Palma, Av. Benavides 5440, Santiago de Surco, Lima, Perú DOI: https://doi.org/10.33017/RevECIPeru2012.0016/ Resumen Este trabajo trata de determinar el origen los manantiales de la playa Costa Verde, situada en los distritos de Barranco, Miraflores y Magdalena de la provincia de Lima, Perú. Esos manantiales, cerca y a nivel del mar, sobreviven al proceso de urbanización de los terrenos de cultivo, iniciado en la década de los años 70, el que mermó el nivel freático del acuífero de Lima, e hizo desaparecer las filtraciones de agua en los acantilados. Para identificar el origen se ha efectuado análisis isotópico, físico químico y bacteriológico de muestras tomadas de 5 manantiales. Los valores de conductividad y temperatura, determinados in situ, son similares a los obtenidos en aguas del acuífero de Lima. Los análisis en laboratorio no mostraron indicios significativos de coliformes fecales ni totales, descartando posibles filtraciones de la red de alcantarillado de Lima. Las concentraciones isotópicas del agua difieren del promedio de las obtenidas para las aguas del acuífero de Lima, recargado por infiltraciones del río Rímac. Estos resultados sugieren que las aguas de los manantiales de la Costa Verde provienen de una recarga directa en la cuenca media del río, producto de la infiltración del río o de precipitaciones a una altitud del orden de 3600 m. Descriptores: acuífero, agua, costa, Lima, Perú. Abstract This paper tries to determine the origin of springs on the beach Costa Verde, located in the district of Barranco, Miraflores and Magdalena province of Lima, Peru. These springs, near and at sea level, survive the process of urbanization of agricultural land, started in the early 70s, which decreased the water table aquifer of Lima, and wiped the water leaks into the cliffs. To identify the source isotope physical, chemical and bacteriological of samples taken from five springs analysis has been carried out. The conductivity and temperature, measured in situ, are similar to those obtained on Lima aquifer waters. The laboratory analysis showed no significant signs of total or fecal coliform, discarding possible leakage from sewerage Lima. The water isotopic concentrations on springs differ from the average obtained on Lima aquifer waters, recharged by infiltration of the Rimac River. These results suggest that the water from the springs of Costa Verde come from a direct recharge in the basin of the river, due to infiltration of rainfall or river at an altitude of about 3600 m. Keywords: aquifer, water, coast, Lima, Peru.

Abstract This article examines the relationship between local scientific ideas about the natural world and the economic potential to transform the modern nation-state in Peru during the late nineteenth century. Writings by the Peruvian scientist Luis Carranza indicate how support for a distinctive environmental imaginary of the country’s geography made it possible to conceptualize nature as an essential component of Peruvian identity. As a result, local scientists had to “imaginatively” reshape the nature of the Andes for modernization purposes. The social and political ramifications of these ideas in Carranza’s work were key to the foundation of scientific institutions such as the Geographical Society of Lima.

Abstract Clinical Case A 68–year–old male patient with a history of ischemic heart disease in three vessel coronary artery disease who underwent surgical myocardial revascularization in 2012 by CABG (LIMA to LAD); previous aortic valve replacement with mechanical prosthesis (2012); previous PMK implant in permanent AF. The patient arrived at our observation transferred from another hospital where, due to heart failure with new–onset severe left ventricular dysfunction, he had undergone a coronary examination with evidence of occlusion of LAD in the middle tract, patency of LIMA to LAD, severe LM/LCx stenosis followed by IVUS guided PTCA–DES stenting with final TIMI 3. During his hospitalization in our care unit he repeated trans–thoracic echocardiogram examination which documented: severe left ventricular dilatation with reduced EF (40%), left atriomegaly, bileaflet mechanical aortic prosthesis in place with normal systolic opening, normal trans–prosthetic gradients, absent peri or intraprosthetic regurgitation jet, moderate mitral valve regurgitation with central jet, right–sided sections of normal size and contractility in the absence of signs of increased pulmonary pressures. Color Doppler also documented a high–speed jet starting from the prosthesis–LAM interface directed towards the left atrium of unclear interpretation. To better interpretate this finding a transesophageal echocardiogram was performed which confirmed the correct functioning of the aortic mechanical prosthesis, absence of periprosthetic leaks and confirmed a high–speed jet directed from the prosthesis–LAM interface towards the left atrium compatible with perforation of the mitro–aortic continuity tissue. The patient was therefore sent for cardiac surgery and is currently awaiting reoperation.

Background: Comorbidities in idiopathic pulmonary fibrosis (IPF) affect quality of life, symptoms, disease progression and survival. It is unknown what are the comorbidities in patients with IPF in Latin America (LA) and if there are differences between countries. Our objective was to compare IPF comorbidities in four countries and analyze possible differences by altitude.Methods: Patients with IPF according 2012 ATS/ERS/JRS/ALAT guidelines, from two cities with an altitude of ≥2,250 m: Mexico City (Mexico) and Bogotá (Colombia) and from three at sea level: Buenos Aires (Argentina) and Lima and Trujillo (Peru). Comorbidities and pulmonary function tests were taken from clinical records. Possible pulmonary hypertension (PH) was defined by findings in the transthoracic echocardiogram of systolic pulmonary arterial pressure (sPAP) &gt;36 mmHg or indirect signs of PH in the absence of other causes of PH. Emphysema as the concomitant finding of IPF criteria on chest tomography plus emphysema in the upper lobes. ANOVA or Kruskal Wallis and χ2-tests were used for comparison.Results: Two hundred and seventy-six patients were included, 50 from Argentina, 86 from Colombia, 91 from Mexico and 49 from Peru. There prevalence of PH was higher in Colombia and Mexico (p &lt; 0.001), systemic arterial hypertension in Argentina (p &lt; 0.015), gastro-esophageal reflux and dyslipidemia in Colombia and Argentina (p &lt; 0.001) and diabetes mellitus in Mexico (p &lt; 0.007). Other comorbidities were obesity (28.4%), coronary artery disease (15.2%) and emphysema (14.9%), with no differences between countries. There was more PH in the altitude cities than those at sea level (51.7 vs. 15.3%, p &lt; 0.001). In patients from Bogotá and Mexico City, arterial oxygen pressure, saturation (p &lt; 0.001) and carbon monoxide diffusing capacity (p = 0.004) were significantly lower than in cities at sea level.Conclusions: In this study with a significant number of patients, we were able to describe and compare the comorbidities of IPF in four LA countries, which contributes to the epidemiological data of this disease in the region. The main results were the differences in comorbidities between the countries and more PH in the subjects residing in the cities of higher altitude, a finding that should be validated in future studies.

This article is concerned with dance as an embodied form of collective remembering in the Andean department of Ayacucho in Peru. Andean dance and fiesta are inextricably linked with notions of identity, cultural heritage and history. Rather than being simply aesthetic —steps to music or a series of movements — dance is readable as being a deeper embodiment of the broader struggles and concerns of a people. As anthropologist Zoila Mendoza writes, in post-colonial countries such as those in Africa and Latin America, dance is and was a means “through which people contested, domesticated and reworked signs of domination in their society” (39). Andean dance has long been a space of contestation and resistance (Abercrombie; Bigenho; Isbell; Mendoza; Stern). It also functions as a repository, a dynamic archive which holds and tells the collective narrative of a cultural time and space. As Jane Cowan observes “dance is much more than knowing the steps; it involves both social knowledge and social power” (xii). In cultures where the written word has not played a central role in the construction and transmission of knowledge, dance is a particularly rich resource for understanding. “Embodied practice, along with and bound up with other cultural practices, offers a way of knowing” (Taylor 3). This is certainly true in the Andes of Peru where dance, music and fiesta are central to social, cultural, economic and political life. This article combines the areas of cultural memory with aspects of dance anthropology in a bid to reveal what is often unspoken and discover new ways of accessing and understanding non-verbal forms of memory through the embodied medium of dance. In societies where dance is integral to daily life the dance becomes an important resource for a deeper understanding of social and cultural memory. However, this characteristic of the dance has been largely overlooked in the field of memory studies. Paul Connerton writes, “… that there is an aspect of social memory which has been greatly ignored but is absolutely essential: bodily social memory” (382). I am interested in the role of dance as a site memory because as a dancer I am acutely aware of embodied memory and of the importance of dance as a narrative mode, not only for the dancer but also for the spectator. This article explores the case study of rural carnival performed in the city of Huamanga, in the Andean department of Ayacucho and includes interviews I conducted with rural campesinos (this literally translates as people from the country, however, it is a complex term imbedded with notions of class and race) between June 2009 and March 2010. Through examining the transformative effect of what I call the chorography of place, I argue that rural campesinos embody the memory of place, dancing that place into being in the urban setting as a means of remembering and maintaining connection to their homeland and salvaging cultural heritage.The department of Ayacucho is located in the South-Central Andes of Peru. The majority of the population are Quechua-speaking campesinos many of whom live in extreme poverty. Nestled in a cradle of mountains at 2,700 meters above sea level is the capital city of the same name. However, residents prefer the pre-revolutionary name of Huamanga. This is largely due to the fact that the word Ayacucho is a combination of two Quechua words Aya and Kucho which translate as Corner of the Dead. Given the recent history of the department it is not surprising that residents refer to their city as Huamanga instead of Ayacucho. Since 1980 the department of Ayacucho has become known as the birthplace of Sendero Luminoso (Shining Path) and the ensuing 20 years of political violence between Sendero and counter insurgency forces. In 2000, the interim government convened the Peruvian Truth and Reconciliation Commission (TRC – CVR Spanish). In 2003, the TRC released its report which found that over 69,000 people were killed or disappeared during the conflict and hundreds of thousands more were forced to leave their homes (CVR). Those most affected by the violence and human rights abuses were predominantly from the rural population of the central-southern Andes (CVR). Following the release of the TRC Report the department of Ayacucho has become a centre for memory studies investigations and commemorative ceremonies. Whilst there are many traditional arts and creative expressions which commemorate or depict some aspect of the violence, dance is not used it this way. Rather, I contend that the dance is being salvaged as a means of remembering and connecting to place. Migration Brings ChangeAs a direct result of the political violence, the city of Huamanga experienced a large influx of people from the surrounding rural areas, who moved to the city in search of relative safety. Rapid forced migration from the country to the city made integration very difficult due to the sheer volume of displaced populations (Coronel 2). As a result of the internal conflict approximately 450 rural communities in the southern-central Andes were either abandoned or destroyed; 300 of these were in the department of Ayacucho. As a result, Huamanga experienced an enormous influx of rural migrants. In fact, according to the United Nations International Human Rights Instruments, 30 per cent of all people displaced by the violence moved to Ayacucho (par. 39). As campesinos moved to the city in search of safety they formed new neighbourhoods on the outskirts of the city. Although many are now settled in Huamanga, holding professional positions, working in restaurants, running stalls, or owning shops, most maintain strong links to their community of origin. The ways in which individuals sustain connection to their homelands are many and varied. However, dance and fiesta play a central role in maintaining connection.During the years of violence, Sendero Luminoso actively prohibited the celebration of traditional ceremonies and festivals which they considered to be “archaic superstition” (Garcia 40). Reprisals for defying Sendero Luminoso directives were brutal; as a result many rural inhabitants restricted their ritual practices for fear of the tuta puriqkuna or literally, night walkers (Ritter 27). This caused a sharp decline in ritual custom during the conflict (27).As a result, many Ayacuchano campesinos feel they have been robbed of their cultural heritage and identity. There is now a conscious effort to rescatar y recorder or to salvage and remember what was been taken from them, or, in the words of Ruben Romani, a dance teacher from Huanta, “to salvage what was killed during the difficult years.”Los Carnavales Ayacuchanos Whilst carnival is celebrated in many parts of the world, the mention of carnival often evokes images of scantily clad Brazilians dancing to the samba rhythms in the streets of Rio de Janeiro, or visions of elaborate floats and extravagant costumes. None of these are to be found in Huamanga. Rather, the carnival dances celebrated by campesinos in Huamanga are not celebrations of ‘the now’ or for the benefit of tourists, but rather they are embodiments of the memory of a lost place. During carnival, that lost or left homeland is danced into being in the urban setting as a means of maintaining a connection to the homeland and of salvaging cultural heritage.In the Andes, carnival coincides with the first harvest and is associated with fertility and giving thanks. It is considered a time of joy and to be a great leveller. In Huamanga carnival is one of the most anticipated fiestas of the year. As I was told many times “carnival is for everyone” and “we all participate.” From the old to the very young, the rich and poor, men and women all participate in carnival."We all participate." Carnavales Rurales (rural carnival) is celebrated each Sunday during the three weeks leading up to the official time of carnival before Lent. Campesinos from the same rural communities, join together to form comparsas, or groups. Those who participate identify as campesinos; even though many participants have lived in the city for more than 20 years. Some of the younger participants were born in the city. Whilst some campesinos, displaced by the violence, are now returning to their communities, many more have chosen to remain in Huamanga. One such person is Rómulo Canales Bautista. Rómulo dances with the comparsa Claveles de Vinchos.Rómulo Bautista dancing the carnival of VinchosOriginally from Vinchos, Rómulo moved to Huamanga in search of safety when he was a boy after his father was killed. Like many who participate in rural carnival, Rómulo has lived in Huamanga for a many years and for the most part he lives a very urban existence. He completed his studies at the university and works as a professional with no plans to return permanently to Vinchos. However, Rómulo considers himself to be campesino, stating “I am campesino. I identify myself as I am.” Rómulo laughed as he explained “I was not born dancing.” Since moving to Huamanga, Rómulo learned the carnival dance of Vinchos as a means of feeling a connection to his place of origin. He now participates in rural carnival each year and is the captain of his comparsa. For Rómulo, carnival is his cultural inheritance and that which connects him to his homeland. Living and working in the urban setting whilst maintaining strong links to their homelands through the embodied expressions of fiesta, migrants like Rómulo negotiate and move between an urbanised mestizo identity and a rural campesino identity. However, for rural migrants living in Huamanga, it is campesino identity which holds greater importance during carnival. This is because carnival allows participants to feel a visceral connection to both land and ancestry. As Gerardo Muñoz, a sixty-seven year old migrant from Chilcas explained “We want to make our culture live again, it is our patrimony, it is what our grandfathers have left us of their wisdom and how it used to be. This is what we cultivate through our carnival.”The Plaza TransformedComparsa from Huanta enter the PlazaEach Sunday during the three weeks leading up to the official time of carnival the central Plaza is transformed by the dance, music and song of up to seventy comparsas participating in Carnavales Rurales. Rural Carnival has a transformative effect not only on participants but also on the wider urban population. At this time campesinos, who are generally marginalised, discounted or actively discriminated against, briefly hold a place of power and respect. For a few hours each Sunday they are treated as masters of an ancient art. It is no easy task to conjure the dynamic sensory world of dance in words. As Deidre Sklar questions, “how is the ineffable to be made available in words? How shall I draw out the effects of dancing? Imperfectly, and slowly, bit by bit, building fragments of sensation and association so that its pieces lock in with your sensory memories like a jigsaw puzzle” (17).Recalling the DanceAs comparsas arrive in the Plaza there is creative chaos and the atmosphere hums with excitement as more and more comparsas gather for the pasecalle or parade. At the corner of the plaza, the deafening crack of fire works, accompanied by the sounds of music and the blasting of whistles announce the impending arrival of another comparsa. They are Los Hijos de Chilcas from Chilcas in La Mar in the north-east of the department. They proudly dance and sing their way into the Plaza – bodies strong, their movements powerful yet fluid. Their heads are lifted to greet the crowd, their chests wide and open, eyes bright with pride. Led by the capitán, the dancers form two long lines in pairs the men at the front, followed by the women. All the men carry warakas, long whips of plaited leather which they crack in the air as they dance. These are ancient weapons which are later used in a ritual battle. They dance in a swinging stepping motion that swerves and snakes, winds and weaves along the road. At various intervals the two lines open out, doubling back on themselves creating two semicircles. The men wear frontales, pieces of material which hang down the front of the legs, attached with long brightly coloured ribbons. The dancers make high stepping motions, kicking the frontales up in the air as they go; as if moving through high grasses. The ribbons swish and fly around the men and they are clouded in a blur of colour and movement. The women follow carrying warakitas, which are shorter and much finer. They hold their whips in two hands, stretched wide in front of their bodies or sweeping from side to side above their heads. They wear large brightly coloured skirts known as polleras made from heavy material which swish and swoosh as they dance from side to side – step, touch together, bounce; step, touch together, bounce. The women follow the serpent pattern of the men. Behind the women are the musicians playing guitars, quenas and tinyas. The musicians are followed by five older men dressed in pants and suit coats carrying ponchos draped over the right shoulder. They represent the traditional community authorities known as Varayuq and karguyuq. The oldest of the men is carrying the symbols of leadership – the staff and the whip.The Choreography of PlaceFor the members of Los Hijos de Chilcas the dance represents the topography of their homeland. The steps and choreography are created and informed by the dancers’ relationship to the land from which they come. La Mar is a very mountainous region where, as one dancer explained, it is impossible to walk a straight line up or down the terrain. One must therefore weave a winding path so as not to slip and fall. As the dancers snake and weave, curl and wind they literally dance their “place” of origin into being. With each swaying movement of their body, with each turn and with every footfall on the earth, dancers lay the mountainous terrain of La Mar along the paved roads of the Plaza. The flying ribbons of the frontales evoke the long grasses of the hillsides. “The steps are danced in the form of a zigzag which represents the changeable and curvilinear paths that join the towns, as well as creating the figure eight which represents the eight anexos of the district” (Carnaval Tradicional). Los Hijos de ChilcasThe weaving patterns and the figure eights of the dance create a choreography of place, which reflects and evoke the land. This choreography of place is built upon with each step of the dance many of which emulate the native fauna. One of the dancers explained whilst demonstrating a hopping step “this is the step of a little bird” common to La Mar. With his body bent forward from the waist, left hand behind his back and elbow out to the side like a wing, stepping forward on the left leg and sweeping the right leg in half circle motion, he indeed resembled a little bird hopping along the ground. Other animals such as the luwichu or deer are also represented through movement and costume.Katrina Teaiwa notes that the peoples of the South Pacific dance to embody “not space but place”. This is true also for campesinos from Chilcas living in the urban setting, who invoke their place of origin and the time of the ancestors as they dance their carnival. The notion of place is not merely terrain. It includes the nature elements, the ancestors and those who also those who have passed away. The province of La Mar was one of the most severely affected areas during the years of internal armed conflict especially during 1983-1984. More than 1,400 deaths and disappearances were reported to the TRC for this period alone (CVR). Hundreds of people were forced to leave their homes and in many communities it became impossible to celebrate fiestas. Through the choreography of place dancers transform the urban streets and dance the very land of their origin into being, claiming the urban streets as their own. The importance of this act can not be overstated for campesinos who have lost family members and were forced to leave their communities during the years of violence. As Deborah Poole has noted dance is “…the active Andean voice …” (99). As comparsa members teach their children the carnival dance of their parents and grandparents they maintain ancestral connections and pass on the stories and embodied memories of their homes. Much of the literature on carnival views it as a release valve which allows a temporary freedom but which ultimately functions to reinforce established structures. This is no longer the case in Huamanga. The transformative effect of rural carnival goes beyond the moment of the dance. Through dancing the choreography of place campesinos salvage and restore that which was taken from them; the effects of which are felt by both the dancer and spectator.ConclusionThe closer examination of dance as embodied memory reveals those memory practices which may not necessarily voice the violence directly, but which are enacted, funded and embodied and thus, important to the people most affected by the years of conflict and violence. In conclusion, the dance of rural carnival functions as embodied memory which is danced into being through collective participation; through many bodies working together. Dancers who participate in rural carnival have absorbed the land sensorially and embodied it. Through dancing the land they give it form and bring embodied memory into being, imbuing the paved roads of the plaza with the mountainous terrain of their home land. For those born in the city, they come to know their ancestral land through the Andean voice of dance. The dance of carnival functions in a unique way making it possible for participants recall their homelands through a physical memory and to dance their place into being wherever they are. This corporeal memory goes beyond the normal understanding of memory as being of the mind for as Connerton notes “images of the past are remembered by way of ritual performances that are ‘stored’ in a bodily memory” (89). 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