Universidad de Lambayeque

The present study examined the impact of agricultural exports on economic growth in Lambayeque, Peru, during the period 2010–2023. An ordinary least squares (OLS) econometric model was employed to analyze the relationship between gross value added (GVA) and key macroeconomic variables, including agricultural exports, private investment, real wages, terms of trade, and the real multilateral exchange rate. The findings indicate that the model possesses considerable explanatory power (R2 = 0.973) and that agricultural exports exert a positive and significant influence on regional GVA. In addition, private investment and real wages demonstrate positive elasticities, while terms of trade exhibit a negative relationship with regional economic growth. This highlights Lambayeque’s vulnerability to external price shocks. The study thus underscores the pivotal role of the Olmos Project, which has been instrumental in transforming arid land into fruitful agricultural zones through the implementation of an irrigation system encompassing over 22,000 hectares. This initiative has not only augmented agricultural exports, accounting for an impressive 90% of Lambayeque’s supply, but also contributed significantly to regional economic development by supporting employment generation and poverty reduction. Nevertheless, the presence of negative terms of trade indicates that the regional economy exhibits structural vulnerability in the face of external shocks. Notwithstanding the intrinsic limitations of regional, trade, and macroeconomic statistics, an understanding of the correlation between agro-exports and economic growth in a paradigmatic region of northern Peru provides substantial evidence for formulating policies to enhance the competitiveness and sustainability of the agro-export model.

Background:Cancer stem cells (CSCs) are increasingly recognised as pivotal drivers of tumour recurrence and treatment resistance across multiple malignancies. Despite extensive preclinical investigations, the mechanisms by which CSCs mediate relapse after therapy remain insufficiently integrated and poorly translated into clinical frameworks.Objective:This systematic review aimed to synthesise current mechanistic evidence linking CSC biology to post-therapeutic recurrence in solid and hematologic tumours, highlighting recurrent molecular pathways, experimental models and translational gaps.Methods:Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, five major databases (PubMed, Scopus, Web of Science, Embase and ResearchRabbit) were searched without time or language restriction. Eligible studies included original experimental articles investigating the mechanistic role of CSCs in tumour recurrence, therapy resistance or metastatic relapse. A total of 23 studies were included after rigorous screening and data extraction. Risk of bias was assessed using predefined methodological criteria. No meta-analysis was conducted due to mechanistic and qualitative heterogeneity.Results:Included studies spanned diverse tumour types, including glioblastoma, breast, pancreatic, hepatocellular, colorectal, lung, thyroid and hematologic cancers. CSC-related recurrence was linked to key mechanistic axes: chromatin remodeling (e.g., suppressor of variegation 3-9 Homolog 1, methyltransferase like 16), transcriptional regulators (e.g., SRY-box transcription factor 2, MYC and Transcription factor activating enhancer-binding protein 4), epithelial-to-mesenchymal transition-associated plasticity, immune evasion (Programmed death-ligand 1, stimulator of interferon genes pathway suppression), metabolic rewiring (P-element induced WImpy Testis-like 2–PDK1, ribosomal biosynthesis) and microenvironmental crosstalk (cancer-associated fibroblasts- and myeloid-derived suppressor cells-mediated niches). Across studies, CSCs demonstrated higher resistance to chemotherapy, prolonged survival under treatment stress and robust capacity for tumour regeneration.Limitations:The majority of studies were preclinical and varied in CSC definitions and recurrence models. Few incorporated longitudinal tracking or patient-level validation. Overall risk of bias was moderate due to lack of blinding, protocol registration or replication.ConclusionCSC-driven recurrence is a multifaceted and dynamic process shaped by epigenetic, transcriptional, metabolic and immunologic adaptations. Single-target strategies are unlikely to achieve durable eradication. Future research must prioritise multi-targeted approaches, integrate CSC endpoints into clinical trials and develop predictive biomarkers of CSC burden. Addressing CSC-mediated relapse is essential for advancing precision oncology and achieving lasting therapeutic responses.

El sistema de salud peruano avanza entre promesas de cobertura universal y realidades fragmentadas: coexisten regímenes con reglas de financiamiento distintas, débiles mecanismos de coordinación entre niveles, déficits de calidad y una inversión pública que, en contexto, sigue paralizada. La evaluación más reciente de la Organización para la Cooperación y el Desarrollo Económicos (OCDE), sobre el sistema peruano recuerda que el gasto sanitario como proporción del PBI (6,2 % en 2022), se mantiene por debajo de referentes regionales y de países OCDE, y que la gobernanza desintegrada limita la eficiencia y la equidad del acceso. Este diagnóstico no es una condena, sino un punto de partida. Sin integrar los subsistemas y sin mejorar la rendición de cuentas por resultados, la cobertura universal será más nominal que efectiva. Finalmente, nuestra región puede convertirse en referente nacional en gestión sanitaria si articula: innovación tecnológica, telesalud y desarrollo de talento especializado. La integración de estos componentes transformaría un modelo fragmentado en una red de atención resiliente, anticipatoria y centrada en las personas. Con ello, la región no solo respondería mejor a epidemias recurrentes, sino que consolidaría una gestión pública moderna y sostenible. Esta visión demuestra que la evidencia y los resultados pueden guiar cambios concretos en la práctica local.

Earthen archaeological sites are particularly vulnerable to rain and winds, whose effects may compromise their integrity. The Huaca Chotuna (HC; 8th–16th Century AD) is an adobe platform in Peru’s semi-arid Lambayeque region, and it is in an area with exposure to rain and winds associated with the El Niño Southern Oscillation (ENSO) events. Here we present the results from an orthophotogrammetric and morphometric study aimed at quantifying the effects of erosion and deposition at the HC. The novelty of our approach consists of merging topographic, hydrological, and wind parameters to recognize the sector of the HC with exposure to potentially damaging natural climatic phenomena. We identify zones affected by erosion and deposition processes. Results of a diffusion model aimed to estimate the HC sectors where these processes will act in the next century are also presented. Gully erosion from rainfall indicates a vertical erosion rate of approximately 0.2 m/century, demonstrating the low preservation potential of the HC. Rainwater also deteriorates adobe bricks and triggers water/mud flows. Conversely, sediment-laden winds contribute to the partial burial of the HC. The findings highlight significant hazards to the HC’s structural integrity, including gravity instability. The interdisciplinary methodology we adopt offers a key framework for assessing and protecting other earthen sites globally against the escalating impacts of climate change.

ABSTRACT Objective The main aim is to evaluate the efficacy and safety of corticosteroid administration as adjuvant therapy in patients with odontogenic cervicofacial infections. Methods We searched five databases, grey literature and manually reviewed bibliographic references for observational studies. Outcomes included hospital length of stay, intensive care unit admission, reoperation and other postoperative complications. The risk of bias was assessed using the Newcastle‐Ottawa Scale. Meta‐analyses were not performed due to the heterogeneity of the results. Results We included four observational studies. Dexamethasone use reduced the odds of reoperation (odds ratio (OR): 0.9; 95% CI: 0.8–0.98). Additionally, higher doses of dexamethasone were associated with a shorter hospital stay (β: −0.2; 95% CI: −0.3 to −0.07). However, another study reported a longer hospital stay among patients who received corticosteroids than those who did not; p < 0.001. Furthermore, corticosteroid use was associated with lower odds of intensive care unit admission (OR: 0.51; 95% CI: 0.09–2.72); p > 0.05. The only reported adverse event was prolonged hyperglycemia (0.8%). Conclusions The adjuvant use of corticosteroids in managing patients with odontogenic cervicofacial infections has potential beneficial effects and appears safe. However, the evidence remains unclear, and further studies are needed to evaluate potential benefits and harms.

Introducción. El lipoblastoma es un tumor mesenquimatoso benigno que se presenta en niños menores de 3 años, típicamente en las extremidades inferiores y con síntomas limitados. El objetivo de este artículo fue presentar un caso clínico de lipoblastoma retroperitoneal atípico y revisar la literatura sobre esta condición. Caso clínico. Niño de 3 años de edad con cuadro de dolor abdominal difuso e hiperoxia. La madre refirió una masa abdominal indolora y de crecimiento progresivo en la región pélvica. Los estudios de imagen confirmaron un tumor retroperitoneal compatible con lipoblastoma. Resultados. Se hizo una resección quirúrgica exitosa y el examen histopatológico confirmó el diagnóstico. El paciente no experimentó recurrencias y tuvo una evolución favorable después de dos años de seguimiento. Conclusiones. Este caso subraya la importancia de considerar el lipoblastoma en el diagnóstico diferencial de las masas abdominales en niños, así como la necesidad de estudios complementarios para un diagnóstico definitivo y un manejo adecuado. El lipoblastoma es una afección rara con un diagnóstico diferencial desafiante, por lo que se destaca la importancia de los estudios histopatológicos y citogenéticos para un diagnóstico preciso.

Objetive: In this study we aimed to evaluate echocardiographic hemodynamic variables predictive of mortality in patients with septic shock on mechanical ventilation. Methods: We conducted a prospective cohort study in the Emergency and Critical Areas Service of the Hospital Regional Lambayeque, 104 patients with septic shock connected to mechanical ventilation. Results: The exposed cohort included patients with systolic and diastolic dysfunction, while the unexposed cohort included those without ventricular dysfunction. Cox regression analysis determined that predictors of mortality were Left Ventricular Ejection Fraction <50% Hazard Ratio 3.57 (95%confidence interval 1.25-10) and cardiac index <2.5 Hazard Ratio 7.69 (95% confidence interval 2.5 - 25). In diastolic dysfunction, the only predictor variable for mortality was the mitral flow E wave to mitral annulus tissue Doppler e' wave ratio (E/e') > 15 Hazard ratio 0.11 (95% confidence interval 0.02-0.48). In Kaplan Meier analysis, patients with Tricuspid Annular Plane Systolic Excursion < 17 had a median survival of 3.8 days with Hazard ratio 0.14 (95% confidence interval 0.07-0.28). Conclusion: Echocardiographic monitoring of hemodynamic variables predictive of mortality of left ventricular systolic and diastolic dysfunction as well as right ventricular dysfunction could be a valuable strategy to improve the management of patients with septic shock on mechanical ventilation.

Abstract Background Carbapenem-resistant Enterobacterales (CRE) are a public health threat due to their rapid worldwide spreading and the limited options to treat these infections. Our aim was to describe the distribution and the type of carbapenemases produced by CRE isolates recovered in ten hospitals of Peru. Methods A prospective collection of CRE isolates from clinical sources was obtained from 10 hospitals, located in Lima (capital of Peru) and other five Peruvian regions (Piura, Lambayeque, Loreto, Pucallpa and Tacna). Only one isolate per patient was included. The present work represents the first 171 consecutive isolates analyzed. Identification and antimicrobial susceptibility were performed by the Phoenix ID-406 (Becton Dickinson, USA). For the determination of carbapenemase production the modified Carbapenem Inactivation Method was used. For the identification of carbapenemase types the NG-TEST CARBA-5, (Biotech, France) which identifies five carbapenemase families (blaKPC, blaNDM, blaVIM, blaIMP y blaOXA-48), was used.Figure 1:Distribution of Carbapenem resistance genes among hospitals surveilled. 1. Hospital III José Cayetano Heredia Red Asistencial EsSalud Piura; 2. Hospital Regional de Lambayeque, Lambayeque; 3. Hospital Nacional Cayetano Heredia, Lima; 4. Hospital Nacional Dos de Mayo, Lima; 5. Hospital Nacional Guillermo Almenara Irigoyen, Lima; 6. Hospital Regional de Loreto “Felipe Arriola Iglesias”, Loreto; 7. Hospital Nacional Sergio E. Bernales, Lima; 8. Hospital Nacional Daniel Alcides Carrión, Callao; 9. Hospital III Daniel Carrión de EsSalud, Tacna. Results CRE isolates (n = 171) were recovered in 9/10 surveilled hospitals. Carbapenemase detection occurred in 94.7% of isolates distributed among 10 species, the most common ones were Klebsiella pneumoniae (66.6%) and Escherichia coli (24.0%) (Table 1). NDM was the most common carbapenemase detected (59.9%) followed by KPC (25.3%) and OXA-48 (8.0%) distributed mainly among K. pneumoniae and E. coli isolates. Co-production of carbapenemases were identified in 6.8% of CRE isolates, including OXA+NDM among eight E. coli and KPC+NDM in three K. pneumoniae isolates (Table 1). Regarding the distribution of carbapenemases, NDM was present in 9 hospitals and was the predominant in 6 of them; followed by KPC that was found in 6/9 hospitals and was predominant in one. OXA-48 was found in 4 hospitals (Figure 1). Conclusion The most common CRE in Peruvian hospitals are K. pneumoniae and E. coli species, accounting for 90% of all CRE isolates recovered from clinical sources. NDM is the most common carbapenemase, being predominant in 6 out of 9 surveilled hospitals. Double carbapenemase production was detected in over 6% of CRE isolates, both in K. pneumoniae and E.coli isolates. Disclosures Giancarlo Pérez-Lazo, n/a, Pfizer: Grant/Research Support|Pfizer: Honoraria Arnaldo Lachira, n/a, MSD: Advisor/Consultant Coralith Garcia, PhD, Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support

Sepsis is a systemic process that refers to a deregulated immune response of the host against an infectious agent, involving multiple organ dysfunction. It is rapidly progressive and has a dismal prognosis, with high mortality rates. For this reason, it is necessary to have a tool for early recognition of these patients, with the aim of treating them appropriately in a timely manner. This research is a systematic review based on bibliography indexed in four online scientific databases for studies published since inception to February 2024, which was obtained through the use of a search strategy. Eight studies were identified for quantitative analysis and included in our meta-analysis. The meta-analysis revealed that among 23,551 patients diagnosed with sepsis, 5,825 had a positive LqSOFA, and 3,086 experienced the primary outcome (mortality). For LqSOFA, a sensitivity of 0.61 (95% CI 0.60-0.63), specificity of 0.81 (95% CI 0.80-0.81), positive likelihood ratio (LR+) of 3.46 (95% CI 2.86-4.18), negative likelihood ratio (LR-) of 0.47 (95% CI 0.38-0.59), and odds ratio (OR) of 7.43 (95% CI 6.01-9.20) were determined. The area under the curve (AUC) was 0.807. The LqSOFA score demonstrates a good predictive capacity for in-hospital mortality in septic patients, showing clinically significant levels of sensitivity (69%) and specificity (79%).