Lenin Rueda-Torres

Mercury exposure poses a critical public health challenge, highlighting the need for accurate and portable analytical methods for its biomonitoring. This experimental analytical study develops an analytical method and evaluates the performance of square wave anodic stripping voltammetry (VRAO) for quantifying mercury in urine. To this end, the operating conditions of the VRAO system were optimized through testingwith standard mercury solutions. Commercial urine (BIO-RAD®) pretreated with nitric acid was used. Linearity, precision, accuracy, and the limits of detection (LDD) and quantification (LDC) were evaluated. The results showed high accuracy, with a relative standard deviation (%RSD) of 6.21. Furthermore, the accuracy analysis revealed no significant differences between VRAO and the cold vapor atomic absorption (AAVF) method (p = 0.2601). The LDD and LDC values were 0.68 and 2.2 μg L⁻¹, respectively. These findings suggest that VRAO is an accurate method, comparable to AAVF, for detecting mercury in urine under controlled laboratory conditions. Further studies are needed to assess its applicability in real-world population biomonitoring settings.

Objetivo: este estudio evaluó la asociación y el rendimiento diagnóstico del cociente aspartato-aminotransferasa/alanina-aminotransferasa (AST/ALT) en la detección de litiasis biliar en pacientes con cólico biliar. Métodos: en este estudio transversal se analizaron retrospectivamente las historias clínicas de pacientes atendidos por cólico biliar en el servicio de emergencias de un hospital regional del Perú. El diagnóstico confirmatorio de litiasis biliar se realizó con base en la evaluación clínica y hallazgos ecográficos abdominales. Se obtuvieron los valores de actividad enzimática sérica de AST y ALT para calcular el cociente AST/ALT. El rendimiento diagnóstico se evaluó mediante análisis ROC. Resultados: se revisaron 191 historias clínicas, correspondientes a 94 y 97 pacientes con y sin litiasis biliar, respectivamente. La edad promedio fue de 49,6 ± 15,1 años, y el 72 % eran mujeres. Se observaron niveles elevados de ALT y AST en el 34% y 31,9% de los pacientes, respectivamente. El área bajo la curva (AUC) para el cociente AST/ALT fue de 0,52, que indican un valor diagnóstico mínimo, mientras que los AUC para AST y ALT fueron de 0,67 y 0,65, respectivamente. En el modelo ajustado por edad y sexo, la asociación entre el cociente AST/ALT y la litiasis biliar mostró una razón de prevalencia de 1,16 (intervalo de confianza (IC) del 95%: 0,56-2,41). Conclusión: el cociente AST/ALT mostró una eficacia limitada como marcador diagnóstico de litiasis biliar en pacientes con cólico biliar. Aunque los niveles individuales de AST y ALT demostraron un potencial diagnóstico moderado, el cociente AST/ALT no mejoró significativamente la identificación de la litiasis biliar en este contexto clínico.

Growing evidence suggests an association between SARS‐CoV‐2 infection and oxidative stress–related genomic damage, primarily from cross‐sectional studies. However, longitudinal evaluations remain limited. Here, we assessed DNA damage in peripheral blood mononuclear cells (PBMCs) from hospitalized COVID‐19 patients during the first days of hospitalization, using the alkaline comet assay. A longitudinal descriptive study was conducted at a modular COVID‐19 hospital in Lima, Peru, throughout October 2020. Blood samples were collected at admission (day 0), day 3, and day 6. DNA damage was assessed by measuring tail length, tail moment, and tail intensity, which were modeled using mixed‐effects linear models. Concurrent hematological parameters and acute‐phase proteins were also analyzed to characterize their time‐course patterns in conjunction with DNA damage. Results from the adjusted mixed‐effects model showed a significant temporal increase in DNA damage parameters, particularly tail intensity ( β = 0.25 per day, p = 0.003), relative to baseline measurements, with a peak observed on day 3 of hospitalization. These changes aligned with variations in platelet counts and transferrin levels, while lymphocyte and monocyte counts, along with C‐reactive protein, showed an inverse trend, reflecting the dynamic interplay of the inflammatory response and DNA damage. No significant differences in comet assay parameters were observed between survivors and non‐survivors, likely due to the limited and unbalanced sample. The findings indicate the presence of a measurable DNA damage burden in PBMCs of hospitalized COVID‐19 patients, highlighting the need to further studies to clarify the mechanisms underlying DNA damage and its potential long‐term biological implications.

Air-quality standards (AQS) are key regulatory tools to protect public health by setting pollutant thresholds. However, most are based on sea-level data. High-altitude (HA) environments differ in atmospheric conditions, influencing pollutant behavior and human vulnerability. These differences have prompted proposals for altitude-specific AQS adjustments. This systematic review identifies models and criteria supporting such adaptations and examines regulatory air-quality frameworks in countries with substantial populations living at very high altitudes (VHA). This review follows PRISMA-P guidelines, focusing on studies examining AQS adjustment approaches based on altitude. The Population/Concept/Context (PCC) framework was used to define search terms: population (AQS), concept (air pollutants), and context (altitude), with equivalents. The literature was retrieved from PubMed, Scopus, Web of Science, and Gale OneFile: Environmental Studies and Policy. A total of 2974 articles were identified, with 2093 remaining after duplicate removal. Following title and abstract screening, 2081 papers were excluded, leaving 12 for full-text evaluation. Ultimately, six studies met the eligibility criteria. Three studies focused on adjustment models based on atmospheric conditions, such as temperature and pressure changes, while the other three examined human physiological responses, particularly the increased inhaled air volume. China, Peru, and Bolivia have the largest populations living above 3500 m a.s.l., yet none of these countries have specific air-quality regulations tailored to HA conditions. The review underscores the necessity for tailored AQS in HA environments, highlighting specific criteria related to both atmospheric conditions and human physiological responses.

Air quality standards (AQS) are key regulatory tools to protect public health by setting pollutant thresholds. However, most are based on sea-level data. High-altitude (HA) environments differ in atmospheric conditions, influencing pollutant behavior and human vulnerability. These conditions have prompted proposals for altitude-specific AQS adjustments. This systematic review identifies models and criteria supporting such adapta-tions and examines regulatory air quality frameworks in countries with substantial populations living in HA. PRISMA-P guidelines and a Population/Concept/Context (PCC) framework were used to define the search terms: Population (Air Quality Standards), Concept (Air Pollutants), and Context (Altitude). Relevant literature was retrieved from MEDLINE, SCOPUS, Web of Science, and Gale OneFile: Environmental Studies and Poli-cy. A total of 2,093 articles were identified after duplicate removal. Following title and ab-stract screening, 2,081 papers were excluded, leaving 12 for full-text evaluation. Ultimately, six studies met the eligibility criteria. Three studies focused on adjustment models based on atmospheric conditions, such as temperature and pressure changes, while the other three examined human physiological responses, particularly the increased inhaled air volume. China, Peru, and Bolivia have the largest populations living above 3,500 m a.s.l., yet none of these countries have specific air quality regulations tailored to HA conditions. The review underscores the necessity for tailored AQS in HA environments.

Background. Lead exposure is an environmental and occupational health problem associated with different clinical outcomes; however, its relationship with anemia in mining workers is not well characterized. This study evaluated the relationship between blood lead level (BLL) and anemia in mining workers who underwent annual medical‐occupational evaluations. Methods. We conducted a cross‐sectional study to estimate the association between the BLL and anemia in workers of a mining company during the year 2019. We obtained occupational information and laboratory test results, with the hemoglobin level for identifying anemia and BLL measured by atomic absorption spectrophotometry. The relationship between BLL and anemia was evaluated in a generalized linear model with a log link and the Poisson family to obtain crude and adjusted prevalence ratio (aPR) and its 95% confidence intervals (95% CIs). Results. Three hundred forty mining workers, mainly male (95%), with a mean age of 36.8 ± 9.4 years, were evaluated. The median hemoglobin and BLL were 14.1 g/dL (Interquartile range (IQR): 13.0–15.3) and 3.4 µg/dL (IQR: 2.1−4.8). Only one worker presented a BLL exceeding the upper limit value established by the Ministry of Health of Peru (up to 40.0 µg/dL). We found anemia in 21.8% of the mining workers (CI95%: 17.5–26.5). A low and inverse correlation between hemoglobin and BLL (rho: −0.169) was obtained in this study. BLLs were significantly associated with anemia (aPR: 1.04; 95% CI: 1.01–1.08). Conclusion. Occupational exposure to lead is weakly associated with anemia in mining company workers. Strengthening actions to prevent and control lead exposure is relevant and guarantees the comprehensive promotion of worker health and healthy workplaces.

Managing contaminated waste in blood banks is a crucial process that must end with the safe disposal of blood products. In this sense, practical methods and indicators must be used to guarantee the operability of autoclave equipment and the sterility of treated waste to mitigate the risk of biological exposure and hospital biosafety. We designed a cross-sectional study to evaluate the performance the autoclaving process with Bowie & Dick test and biological indicator at the Hemotherapy and Blood Bank Unit of the Cayetano Heredia Hospital in Peru. Fifty autoclaving processes were carried out independently for the Bowie & Dick tests and biological indicators based on Geobacillus stearothermophilus spores. Autoclaving was programmed at 134°C for 3.5 minutes for the Bowie & Dick test, while, for the biological indicator, it was programmed at 121°C for 5 minutes. Both in the presence of contaminated waste. The autoclaving process evaluated by the Bowie & Dick test had a compliance rate of 80% (CI95: 66.3%–90.0%), while, by the biological indicator, 90% (CI95: 78.2%–96.7%). We did not find significant differences between the results of both tests (P = .689; Fisher exact test). The compliance rate in the autoclaving process within the blood bank of a Peruvian Hospital is acceptable; however, there are actions for continuous improvement, especially at the vacuum level in the autoclaving process.

Peru is one of the countries with the highest lead contamination in the world. Biological monitoring has limitations due to the shortage of laboratories with validated methodologies for the measurement of blood lead, and it is necessary to use alternative methods for its measurement in high-altitude cities. We aimed to compare the blood lead levels (BLL) measured by the LeadCare II (LC) method and Graphite Furnace Atomic Absorption Spectrometry (GF-AAS). We measured the BLL of 108 children from the city of La Oroya. The mean and median BLL for GF-AAS were 10.77 ± 4.18 and 10.44 µg/dL, respectively; for the LC method, the mean was 11.71 ± 4.28 and the median was 11.60 µg/dL. We found a positive linear correlation (Rho = 0.923) between both methods. Notwithstanding, the Wilcoxon test suggests a significant difference between both methods (ρ = 0.000). In addition, the Bland–Altman analysis indicates that there is a positive bias (0.94) in the LC method, and this method tends to overestimate the BLL. Likewise, we performed a generalized linear model to evaluate the influence of age and hemoglobin on BLL. We found that age and hemoglobin had a significant influence on BLL measured by the LC method. Finally, we used two non-parametric linear regression methods (Deming and Passing-Bablok regression) to compare the LC method with the GF-AAS. We found that these methods differ by at least a constant amount, and there would be a proportional difference between both. Although in general there is a positive linear correlation, the results of both methods differ significantly. Therefore, its use in cities located at high altitudes (higher than 2440 m.a.s.l.) would not be recommended.

Objetivo: Desarrollar una metodología para evaluar el nivel de protección respiratoria de respiradores, mascarillas quirúrgicas y mascarillas comunitarias que usa la población peruana, usando partículas de un tamaño similar a las que contienen al virus activo del SARS-CoV-2. Materiales y métodos: Se ha determinado una relación lineal directa entre el logaritmo de la concentración de partículas suspendidas en aire y el tiempo transcurrido; por lo cual es posible comparar la cantidad de partículas internas y externas a la mascarilla o respirador en un mismo periodo y conocer el porcentaje de protección respiratoria de cada muestra evaluada. Resultados: Se ha logrado implementar una metodología para evaluar el nivel de protección respiratoria ante aerosoles menores a 5,0 μm. Asimismo, el empleo de accesorios como ligas o ajustadores detrás de cabeza y nuca, y el uso de clips nasales robustos, incrementan significativamente el nivel de protección respiratoria ante partículas con alta probabilidad de contener al SARS-CoV-2. Conclusiones: Se observa una concordancia entre los valores de protección respiratoria obtenidos y los esperados, considerando el nivel de filtración del material empleado de cada mascarilla quirúrgica o respirador, y su nivel de ajuste. Se observó un incremento significativo en los niveles de protección respiratoria.