High Altitudes In Peru Research Articles

Forage yield and nutritive value of plantain and chicory for livestock feed at high altitudes in Peru

AbstractBackgroundEvaluation of forage resources is vital for the sustainability of livestock farming in the South American Andes, especially under conditions of low water availability for irrigation and acid soils.MethodsWe evaluated the productivity and nutritive value of two cultivars of chicory (Cichorium intybus L.) and one of plantain (Plantago lanceolata L.) in three high‐altitude sites (AL) of the northern highlands of Peru: AL‐I: 2300–2800 m.a.s.l, AL‐II: 2801–3300 m.a.s.l. and AL‐III: 3301–3800 m.a.s.l., for 1 year. The parameters evaluated were dry matter yield (DMY), plant height (PH), growth rate (GR) and nutritional value.ResultsPlantain achieved the greatest annual DMY (ADMY), PH and GR compared to the two chicory cultivars (9.34, 9.56 and 13.39 Mg ha−1 for Puna II and Sese 100 chicory and Tonic plantain, respectively; p = 0.0019). The greatest ADMY and GR occurred at AL‐I. Regarding nutritional value, differences were observed only for in vitro digestibility of dry matter and metabolisable energy with chicory cultivars higher than plantain.ConclusionsThe results indicate that the three cultivars evaluated may be used as a nutritional supplement in cattle feed, associated with grasses because they have high nutritive value suitable for milk production in the mountain regions of Peru.

Hypertension subtypes at high altitude in Peru: Analysis of the Demographic and Family Health Survey 2016-2019.

The prevalence of hypertension in Peru has increased over the years. Approximately one third of the Peruvian population lives at high altitudes. This population presents particular physiological, genetic and environmental characteristics that could be related to the prevalence of hypertension and its subtypes. To assess the association between altitude and hypertension in the Peruvian population through an analysis of a nationally representative survey. We conducted a cross-sectional analysis of the Demographic and Family Health Survey for the period 2016-2019. We included 122,336 individuals aged 18 years and older. Hypertension was defined according to the JNC-7 guidelines. High-altitude location was defined as a residential cluster located above 2,500 meters above sea level. We utilized generalized linear models from the Poisson family with a log-link function to assess the magnitude of the association between high altitude and hypertension. Additionally, we employed multinomial regression models to analyze the association between high altitude and subtypes of hypertension, including isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic-diastolic hypertension (SDH). In the adjusted Poisson regression model, we found that the prevalence of hypertension among participants living at high altitudes was lower compared to those living at low altitudes (aPR: 0.89; 95% CI: 0.86-0.93). In the adjusted multinomial regression model, we observed a lower prevalence rate of ISH among participants residing at high altitudes (aRPR: 0.68; 95% CI: 0.61-0.73) and a higher prevalence rate of IDH among participants residing at high altitudes (aRPR: 1.60; 95% CI: 1.32-1.94). Residents at high altitudes in Peru have a lower prevalence rate of ISH and a higher prevalence rate of IDH compared to those living at low altitudes. Further studies are needed to determine the influence of other biological, environmental, and healthcare access factors on this relationship.

Parameters of pubertal growth spurt in children and adolescents living at high altitude in Peru

ObjectivesThe aim was to estimate the pubertal growth height of children and adolescents living in a high-altitude region of Peru using the Preece-Baines model 1 (1 PB). MethodsA cross-sectional study was conducted in schoolchildren from the department of Puno (Peru) between 3841 and 3874 masl. The age range was between 4 and 17 years. Standing height was evaluated. 1 PB was used to infer the mathematical and biological parameters of stature. ResultsMathematical parameters estimated by the 1 PB model reflected small residual standard error (RSE) values in both sexes (0.25 in boys and 0.27 in girls). In boys, the age at which peak velocity was reached (APHV) was estimated at 13.21 ± 0.33years. While in girls it was 9.96 ± 0.26years (p < 0.05). In general, girls reached APHV (y) 3.25 years earlier than boys. On the other hand, the growth velocity of maximum height [APHV (cm/y)] of boys was higher (6.33 ± 6.06 cm/y) relative to girls (6.06 ± 0.32 cm/y). Estimated final adult height (EFAH) in boys was reached at 166.020 ± 0.99 cm and height at maximum growth velocity (HPHV) was 153.07 ± 0.67 cm, while in girls they were significantly lower (EFAH; 153.74 ± 0.44 cm and HPHV: 139.73 ± 0.84 cm). ConclusionsThis study showed that girls living in Puno at a high altitude in Peru reached APHV 3 years earlier than boys and at the same time reflected slower PHV. These results suggest that pubertal growth at high altitudes is slower in both sexes and especially in girls. Thus, modeling physical growth may be an important step in understanding the onset of puberty at different latitudes.

Towards a nomenclatural clarification of the Peltigera ponojensis/monticola clade including metagenomic sequencing of type material and the introduction of P. globulata Miadl. &amp; Magain sp. nov.

AbstractPeltigera globulata Miadl. &amp; Magain, a new species in the P. ponojensis/monticola species complex of section Peltigera, is formally described. This clade was previously given the interim designation Peltigera sp. 17. It is found in sun-exposed and xeric habitats at high altitudes in Peru and Ecuador. Peltigera globulata can be easily recognized by its irregularly globulated margins covered mostly by thick, white pruina, somewhat resembling the sorediate thallus margins of P. soredians, another South American species from section Peltigera. The hypervariable region of ITS1 (ITS1-HR), which is in general highly variable among species of section Peltigera, does not have diagnostic value for species identification within the P. ponojensis/monticola complex. Nevertheless, no significant level of gene flow was detected among eight lineages representing a clade of putative species (including P. globulata) within this complex. ITS sequences from the holotype specimens of P. monticola Vitik. (collected in 1979) and P. soredians Vitik. (collected in 1981) and lectotype specimens of P. antarctica C. W. Dodge (collected in 1941) and P. aubertii C. W. Dodge (collected in 1952) were successfully obtained through Sanger and Illumina metagenomic sequencing. BLAST results of these sequences revealed that the type specimen of P. monticola falls within the P. monticola/ponojensis 7 clade, which represents P. monticola s. str., and confirmed that the type specimen of P. aubertii falls within a clade identified previously as P. aubertii based on morphology. The ITS sequence from the type specimen of P. soredians, which superficially resembles P. globulata, confirms its placement in the P. rufescens clade. Finally, we discovered that the name P. antarctica was erroneously applied to a lineage in the P. ponojensis/monticola clade. The ITS sequence from the type specimen of P. antarctica represents a lineage within the P. rufescens clade, which is sister to the P. ponojensis/monticola clade.

Validation of a belief scale regarding adherence to iron supplementation treatment in mothers of children with anemia

Introduction: anemia in children can cause cognitive and motor deficits that can lead to difficulties in academic performance, physical endurance, affecting health and well-being Objective: to develop and validate a scale of beliefs about adherence to iron supplementation treatment in mothers of children with anemia (SBAIST) living in a high altitude region of Peru. Methods: a cross-sectional study was conducted in 192 mothers of children with anemia living in a high altitude region of Peru. The Health Belief Model (HBM) was used to develop and validate the SBAIST. Expert judgment analysis (Aiken's V) was used for content validity and exploratory factor analysis for construct validity. Reliability was determined by internal consistency. Results: for content validity, Aiken's V test showed concordant values for relevance (0.60 to 0.90), relevance (0.75 to 0.95), clarity (0.80 to 0.90) and total scale (0.75 to 0.92). Cronbach's alpha values per question ranged from α = 0.70 to 0.81, and for total scale was α = 0.75. The exploratory factor analysis (EFA) reflected Kaiser-Meyer-Olkin (KMO) values of 0.733, Bartlett's test of sphericity indicated a value of 968.680 (p < 0.001). The eigenvalues in the five dimensions reflected values from 1.05 to 4.03. The percentage of variance for factor 1 (barriers = 33.58 %), factor 2 (severity = 12.61 %), factor 3 (action cues = 10.78 %), factor 4 (barriers = 8.07 %), factor 5 (susceptibility = 7.63 %), and for the total scale was 74.12 %. Conclusion: HBM is a useful tool that allowed validation of the scale of beliefs about adherence to iron supplementation treatment in mothers of children with anemia living at high altitude in Peru.

Physical growth and body adiposity patterns in children and adolescents at high altitudes in Peru: Proposed percentiles for assessment.

This study's purpose was to compare physical growth (PG) patterns of children and adolescents living at high elevations with those of other geographic regions, relate body adiposity indicators, and develop percentile reference tables for assessing physical growth and body adiposity. The sample included 1536 children and adolescents ages 5.0 to 17.9 years from Puno (Peru) located between 3821 and 4349 m above sea level. Weight, height, arm and waist circumferences (WC), and three skinfolds measurements were recorded. Body mass index (BMI) and waist-height Index (WHI) were calculated. PG patterns for children living at a high altitude reflected similar values for weight, height, and arm circumference (AC) to those of their counterparts living in Puno (Peru) and La Paz (Bolivia). When compared with children living at moderate altitudes in Peru, they showed slightly lower PG values. BMI explained between 41% and 64% of the variance in sum of the skinfolds, while WC explained between 47% and 66%. HWI was not a strong predictor of variation in sum of skinfolds. Percentiles were generated for WC and the sum of skinfolds. Weight, height, and, arm and waist circumference patterns for children and adolescents living at high altitudes were similar to those of La Paz (Bolivia). WC and the sum of the skinfolds were better indicators for analyzing abdominal obesity compared to BMI and WHI. The percentiles proposed may be a useful tool for identifying high risk of developing overweight disorders in pediatric populations living at high altitudes.

Prevalence of Musculoskeletal Manifestations and Related Disabilities in a Peruvian Urban Population Living at High Altitude. COPCORD Study. Stage I

ObjectiveEstimate the prevalence of musculoskeletal manifestations and related disabilities of an urban population living at high altitude in Juliaca, Puno, Peru, using the Community Oriented Program for Control of Rheumatic Diseases (COPCORD) questionnaire and Health Assessment Questionnaire (HAQ) Disability Index. MethodsA cross-sectional study was performed in a sample of 1095 people. In each interview, the COPCORD methodology and the HAQ were applied. The city was divided into 8 sectors. ResultsIn all, 614 (56.1%) women were evaluated; 44% were from the Quechua community and 5.1% were Aymara. Before the final 7 days of the study, 132 people (12.05%; 95% CI 9.99–14.11) reported musculoskeletal pain. During the final 7 days of the study, 347 people (31.69%; 95% CI 28.36–35.02) who were predominately women (218; 35.5%; 95% CI 30.8–40.2) reported musculoskeletal pain. The most frequent rheumatic diseases were rheumatoid arthritis (1.27%), gout (0.64%), hand osteoarthritis (OA) (2.83%), knee OA (1.55%), hip OA (0.37%), fibromyalgia (1.09%), and soft tissue rheumatism (8.86%). The HAQ showed an incremental increase proportional to age. The HAQ average for the population was 0.18 (±0.36). Ten people (5.71%) of 175 with rheumatic disease received the services of a shaman. ConclusionIt is the first COPCORD study in an urban native population living at high altitude in Peru. The population affected by chronic rheumatic disease preferred professional rather than traditional care; this population had access to limited medical services. Impaired functional capacity measured by HAQ was associated with advanced age.

Surname-inferred Andean ancestry is associated with child stature and limb lengths at high altitude in Peru, but not at sea level.

ObjectivesNative Andean ancestry gives partial protection from reduced birthweight at high altitude in the Andes compared with European ancestry. Whether Andean ancestry is also associated with body proportions and greater postnatal body size at altitude is unknown. Therefore, we tested whether a greater proportion of Andean ancestry is associated with stature and body proportions among Peruvian children at high and low altitude.MethodsHeight, head circumference, head‐trunk height, upper and lower limb lengths, and tibia, ulna, hand and foot lengths, were measured in 133 highland and 169 lowland children aged 6 months to 8.5 years. For highland and lowland groups separately, age‐sex‐adjusted anthropometry z scores were regressed on the number of indigenous parental surnames as a proxy for Andean ancestry, adjusting for potential confounders (maternal age and education, parity, altitude [highlands only]).ResultsAmong highland children, greater Andean ancestry was negatively associated with stature and tibia, ulna, and lower limb lengths, independent of negative associations with greater altitude for these measurements. Relationships were strongest for tibia length: each additional Andean surname or 1,000 m increase at altitude among highland children was associated with 0.18 and 0.65 z score decreases in tibia length, respectively. Anthropometry was not significantly associated with ancestry among lowland children.ConclusionsGreater Andean ancestry is associated with shorter stature and limb measurements at high but not low altitude. Gene‐environment interactions between high altitude and Andean ancestry may exacerbate the trade‐off between chest dimensions and stature that was proposed previously, though we could not test this directly. Am. J. Hum. Biol. 27:798–806, 2015. © 2015 The Authors American Journal of Human Biology Published by Wiley Periodicals, Inc.

Preterm birth risk at high altitude in Peru

High altitude has been implicated in a variety of adverse pregnancy outcomes including preeclampsia and stillbirth. Smaller studies show conflicting data on the association between high altitude and preterm birth (PTB). The objective of this study was to assess the association between altitude and PTB. A retrospective cohort study was performed using data from the Perinatal Information System, which includes deliveries from 43 hospitals in Peru from 2000 through 2010. Altitude was classified into the following categories: low (0-1999 m), moderate (2000-2900 m), and high (3000-4340 m). The primary outcome was PTB (delivery <37 weeks). Secondary outcomes were cesarean delivery and small for gestational age (SGA). Deliveries less than 23 weeks are not included in the database. χ(2) analyses were performed to compare categorical variables, and a logistic regression was used to calculate the odds ratios and control for confounders. Clustering by hospital was accounted for using generalized estimating equations. A total of 550,166 women were included (68% low, 15% moderate, 17% high altitude). The overall PTB rate was 5.9%, with no difference in the PTB rate among the 3 altitudes (5.6%, 6.2%, 6.8%, P = .13). There was a significant difference in cesarean rates (28.0%, 26.6%, 20.6%, P < .001) with a 34% decreased risk at high vs low altitude adjusted for confounders (adjusted odds ratio, 0.66; 95% confidence interval, 0.51-0.85). There was a difference in SGA (3.3%, 3.6%, 5.0%, P = .02) with a 51% increased risk at high vs low altitude adjusted for confounders (adjusted odds ratio, 1.49; 95% confidence interval, 1.14-1.93). High altitude is not associated with PTB. At high altitude, the cesarean rate was reduced and the SGA rate was increased.

Maternal exposure to biomass smoke and carbon monoxide in relation to adverse pregnancy outcome in two high altitude cities of Peru

BackgroundExposure to pollution from biomass fuel has been associated with low birthweight in some studies. Few studies have included exposure-response analyses. MethodWe conducted a case-control study of biomass fuel use and reproductive outcome at high altitude in Peru. Cases (n=101) were full term births who were SGA (birth weight <10th percentile for gestational age). Controls (n=101) had a birthweight ≥10th percentile, and were matched to cases on birth week and residence. Biomass fuel use during pregnancy was determined by questionnaire. Carbon monoxide (CO) in the kitchen was measured in a subgroup (n=72). Logistic regression was used to estimate the effects of biofuel and CO on the risk of SGA, controlling for maternal education and parity. ResultsAmong cases, 30%, 27% and 44% used gas, gas+biomass, and biomass, respectively, while the figures for controls were 39%, 33%, and 29%. The adjusted odds ratio (OR) for biomass fuel alone compared with gas alone was 4.5 (95% CI: 1.3, 15.5, p=0.02), while the OR for biomass+gas vs. gas alone was 2.1 (0.80–5.5) (p=0.13). Among the subgroup with measured CO, the mean 48-h kitchen CO levels were 4.8, 2.2 and 0.4ppm for biofuel only, biofuel+gas, and gas respectively. ORs by increasing tertile of CO level were 1.0, 1.16, and 3.53 (test for trend, p=0.02). The exposure-response trend corresponds well with one other study with analogous data. ConclusionDespite limited sample size, our data suggest that maternal exposure to biomass smoke and CO, at high altitude, is associated with SGA among term births.

Aromatase Activity After a Short-course of Letrozole Administration in Adult Men at Sea Level and at High Altitude (with or without Excessive Erythrocytosis)

Men living at high altitudes in Peru compared to sea level counterparts have erythrocytosis (hemoglobin 16-21 g/dl) or excessive erythrocytosis (hemoglobin>21 g/dl). High testosterone (T) levels in men at high altitude (HA) were associated with excessive erythrocytosis. High androgen levels could be due to a low aromatase activity or to an elevated rate of conversion from precursors to testosterone. The aim of this study was to evaluate aromatase activity and rate of conversion from precursors to testosterone before and after administration of the aromatase enzyme inhibitor letrozole (5 mg/day) for a 5-day period to men at HA and at sea level (SL). The response to short term aromatase inhibition was assessed in 30 adult men living at sea level, 31 native men at HA with erythrocytosis (Hb 16-21 g/dl), and 35 men at HA with excessive erythrocytosis (Hb>21 g/dl). Serum hormone levels, estradiol/testosterone, testosterone/androstenedione, and testosterone/dehydroepiandrosterone sulfate (DHEAS) ratios were measured. Men with erythrocytosis had lower basal serum T/androstenedione ratios than men with excessive erythrocytosis at HA and men at sea level. Men at HA with excessive erythrocytosis had higher T/DHEAS ratios than men with erythrocytosis and than those at sea level before and after letrozole administration. After letrozole administration, both groups of men at high altitude (with erythrocytosis or with excessive erythrocytosis) showed lower aromatase activities than those at sea level. In conclusion, higher serum testosterone levels in men with excessive erythrocytosis were associated with an increased rate of conversion from DHEAS to testosterone rather than to a lower aromatase activity.

Association Between Biofuel Exposure and Adverse Birth Outcomes at High Altitudes in Peru: A Matched Case-control Study

Nearly one-third of the Peruvian population burns biofuels for cooking. Similarly, approximately one-third of this population lives at high altitudes. Cooking with biofuels and living at high altitudes have been implicated in adverse perinatal outcomes. This study attempted to determine the risk of low birth weight (LBW) and/or preterm delivery in relation to biofuel use in inhabitants at high altitudes in Peru. A matched-case study was performed in two high-altitude cities. All subjects (n=190) were identified from public-hospital records. Cases were matched by hospital by week of birth and area of residence. Cases were defined as: women with an at-term but LBW newborn; or women with a preterm birth. Adjusted conditional logistic regression analyses were used to determine odds ratio. Fifty-two percent of the cases used biofuel whereas only 30% of the controls used biofuel. The use of biofuel for cooking was found to be strongly associated with increased risks of LBW, but was not significantly linked to preterm births.

Association Between Biofuel Exposure and Adverse Birth Outcomes at High Altitudes in Peru: A Matched Case-control Study

Association Between Biofuel Exposure and Adverse Birth Outcomes at High Altitudes in Peru: A Matched Case-control Study

Birth weight at high altitudes in Peru

Birth weight at high altitudes in Peru

Birth weight at high altitudes in Peru

Objective To determine whether birth weights are lower at high altitudes, and whether gestational age at birth and a population's length of residence mitigate the effect of high altitude. Methods The birth weights of 84,173 neonates recorded in the Peruvian Perinatal Information System Database were analyzed between 1995 and 2002 for the cities of Lima (150 m), Huancayo (3280 m), Cuzco (3400 m), and Juliaca (3800 m). Results Birth weight was lower at high altitude, but there was no linear relation between altitude of residence and birth weight. Mean birth weight was higher in Juliaca than in Huancayo. There were no significant differences between the 4 cities regarding birth weights of infants born between 28 and 35 weeks of gestation. However, for infants born between 36 and 42 weeks, birth weight was lower at higher altitudes. This may be due to inadequate maternal oxygenation later in pregnancy at high altitude. In the multivariate analysis, after controlling for maternal age, marital status, parity, body mass index, pre-eclampsia or hemorrhage during pregnancy, and education, as well as sex of the newborn and gestational age at birth, birth weight was lower in all cities located at a higher altitude than Lima. Yet, longer residence at high altitudes may play a protective role. Juliaca (3800 m), where the population has resided the longest, had the lowest reduction in birth weight compared with Lima (150 m); Cuzco had intermediate values; and Huancayo (3280 m), where the population has resided the shortest, had the highest reduction in birth weight. Conclusions Birth weight reduction, which is independent of socioeconomic factors, occurs only in births at term and may be less severe in populations that have resided longer at high altitudes.

Differences in physical growth of Aymara and Quechua children living at high altitude in Peru.

Physical growth of Amerindian children living in two Aymara and three Quechua peasant communities in the Andean highlands of southern Peru (altitude 3,810-3,840 m) was studied, taking into account differences in the microclimate, agronomic situation, and sociodemographic variables. Anthropometric measurements were taken in 395 children aged under 14 years of age in a sample of 151 families in these communities, who were surveyed for sociodemographic variables as well. Data on the land system were available for 77 families. In comparison with reference populations from the United States (NCHS) and The Netherlands, stature, weight, head circumference, and midupper arm circumference (but not weight for stature) in the sample children were reduced. Growth retardation increased after the age of 1 year. Stature and weight in the present sample were very similar compared with previously published data on growth of rural Aymara children living near Lake Titicaca in Bolivia. Head circumference, midupper arm circumference, and weight for stature were significantly larger in Aymara children compared with Quechua children. Land was significantly more fragmented in Aymara compared with Quechua families, but amount of land owned was not different. Perinatal and infant mortality was elevated in Aymara vs. Quechua communities. Most families in Aymara communities used protected drinking water. One Quechua community had a severe microclimate, grim economic outlook, and weak social cohesion. Children in this community showed significant reductions in weight and midupper arm circumference compared with their peers in the other communities. We conclude that (presumably nutritionally mediated) intervillage and Aymara-Quechua differences in childhood physical growth existed in this rural high-altitude population in Peru and were associated with microclimate and the village economy, sociodemographic factors, and differences in the land system.

The early days of insulin use in Edinburgh.

BrMedJ 1990;301:1452-4 The Royal Infirmary of Edinburgh has long been associated with the treatment of diabetes mellitus, particularly with diet and insulin. This has been due more to the teams of workers who came together than to individual specialists, but even more so to the initial impetus when insulin was discovered. Before insulin was successfully isolated by B-anting the existence of an internal secretion of the pancreas that would influence carbohydrate metabolism had been postulated. In fact it had been named in 1916 by Sir Edward Sharpey-Schaffer, the professor of physiology in Edinburgh University. At the end of the first world war it was decided to establish a chair of therapeutics in Edinburgh, and the appointment went to Jonathan Campbell-Meakins, a Canadian who had been in London before the war with Sir Thomas Lewis and Sir James Mackenzie and again on war service. He showed a research instinct with a strong physiological bias in his clinical practice. With the appointment came an offer to establish a laboratory for biochemistry and for physiological investigation. When Meakins took up his duties in October 1919 the other members of the team were David Murray Lyon, assistant physician, and Charles George Lambie, clinical assistant. About this time Chas Harington (later Sir Charles) and William Robson, who were both working with Professor Barger (in medical chemistry), were added to the team as biochemists. Even before the arrival of insulin they were interested in diabetes and writing about it.12 Their main treatment was with the Allen regimen of controlled starvation. In November 1921 Meakins was granted leave of absence to join in experiments on respiratory physi? ology at high altitude in Peru. He wrote in his unpublished autobiography that on returning through Canada about February 1922 he heard rumours about a spectacular advance in the control of carbohydrate. It will be remembered that Banting and Best started their work together in May 1921 and treated their first patient in January 1922. Banting announced his

Thermoregulation of Lizards and Toads at High Altitudes in Peru

CLOUDSLEY-THOMPSON, J. L. 1971. The temperature and water relations of reptiles. Merrow Publ. Co. Ltd., England. CUNNINGHAM, J. D. 1966. Thermal relations of the alligator lizard, Gerrhonotus multicarinatus webbi. Herpetologica 22:1-7. HEATWOLE, H. 1970. Thermal ecology of the desert dragon Amphibolurus inermis. Ecol. Monogr. 40:425-457. f California at Berkel y, supported the field ork. HUEY, R. B. 1974a. Winter thermal ecology of the iguanid lizard, Tropidurus peruvianus. Copeia 1974:149-155. . 1974b. Behavioral thermoregulation in lizards: Importance of associated costs. Science 184:1001-1003.

Histology, extensibility, and chemical composition of pulmonary trunk in persons living at sea-level and at high altitude in Peru.

Histology, extensibility, and chemical composition of pulmonary trunk in persons living at sea-level and at high altitude in Peru.

Lightning Stroke Protection at High Altitude in Peru [includes discussion

Lightning Stroke Protection at High Altitude in Peru [includes discussion