Economic impact of treatment-resistant depression: A retrospective observational study.

BACKGROUND: To determine the incidence of Treatment-Resistant Depression (TRD) in Spain and to estimate its economic burden, using real world data. METHODS: A retrospective, observational-study was carried out using data from the BIG-PAC database®. Patients aged ≥18 years with a diagnosis of major depressive-disorder (MDD) who initiated a new antidepressant treatment in 2015-2017 were included. The patients were classified as TRD and non-TRD. Patients were classified as TRD if they had, during the first year of antidepressant treatment: a) failure with ≥2 antidepressants including the prescription of ≥3 antidepressants (N06A) or ≥2 antidepressant and ≥1 antipsychotic (N05A; including lithium) b) antidepressants administered for ≥ 4 weeks each, and c) the time between the end of one treatment and the initiation of the next was ≤ 90 days. Inherent limitations of data collection from databases should also be considered in this analysis (e.g., lack of information about adherence to treatment). Follow-up period: 18 months. The incidence rate was calculated as the number of TRD patients per 1,000 persons-year divided by the population attended. OUTCOMES: direct healthcare and indirect costs. Two sensitivity analyses were performed varying the index date and the period used to define TRD patients (6 vs.12 months). RESULTS: 21,630 patients with MDD aged ≥ 18 years (mean age: 53.2 years; female: 67.2%) were analyzed, of whom 3,559 met TRD criteria, yielding a 3-year cumulative incidence of 16.5% (95%CI: 16%-17%) among MDD patients. The annual population incidence rate of TRD in 2015-2017, was 0.59, 1.02 and 1.18/1,000 person-years, respectively (mean: 0.93/1,000 person-year). Overall, mean total costs per MDD patient were €4,147.9, being higher for TRD than for non-TRD patients (€6,096 vs. €3,846; p<0.001): a) direct costs (€1,341 vs. €624; p<0.001), b) lost productivity (€1,274 vs. €821; p<0.001) and c) permanent disability (€3,481 vs. €2,401; p<0.001, adjusted). Sensitivity analyses showed no differences with the reported results. CONCLUSIONS: The population based TRD incidence in Spain was similar to recent data from other European countries. TRD is associated with greater resource use and higher costs compared with non-TRD patients.

Epidemiology and costs of depressive disorder in Spain: the EPICO study.

Depressive Disorders are the most common psychiatric diagnoses in the general population. To estimate the frequency, costs associated with Depressive Disorders in usual clinical practice, and in the whole Spanish population, a longitudinal, retrospective, observational study was carried out using data from the BIG-PAC database®. Study population: all patients aged ≥ 18 years with a diagnosis of a Depressive Disorder in 2015-2017. Prevalence was computed as the proportion of Depressive Disorder cases in the adult general population, and the incidence rate, as the number of new Depressive Disorder cases diagnosed per 1,000 person-years in the population using health services, during 2015-2017. We collected demographic variables, comorbidity, direct health costs, and indirect costs (temporary and permanent disability). Health costs related to Depressive Disorders were estimated according to the annual resource use rate (resource/patient/year). Indirect costs were calculated according to the human capital method. Using the study data and information from the Spanish National Institute of Statistics, we estimated the cost of Depressive Disorders corresponding to the Spanish adult population, including premature mortality. 69,217 Depressive Disorder patients aged ≥ 18 years who met the inclusion/exclusion criteria were studied (mean age: 56.8 years; female: 71.4%). Prevalence of Depressive Disorders in the general population was 4.73% (95% CI: 4.70-4.76%). Annual incidence rates (2015-2017) were 7.12, 7.35 and 8.02 per 1,000 person-years, respectively. Total costs observed in our Depressive Disorder patients were € 223.9 million (corresponding to a mean of € 3,235.3; mean/patient/year), of which, 18.4% were direct health care costs and 81.6%, non-health indirect costs (18% temporary occupational disability, 63.6% permanent disability). Considering also the cost of premature death, the mean cost per patient/year was € 3,402 and the estimated societal costs of Depressive Disorders in Spain were € 6,145 million. The prevalence and incidence of Depressive Disorders are consistent with other series reviewed. Resource use and total costs (especially non-health costs) were high.

Functional recovery in patients with schizophrenia: recommendations from a panel of experts.

BACKGROUND: The management of schizophrenia is evolving towards a more comprehensive model based on functional recovery. The concept of functional recovery goes beyond clinical remission and encompasses multiple aspects of the patient's life, making it difficult to settle on a definition and to develop reliable assessment criteria. In this consensus process based on a panel of experts in schizophrenia, we aimed to provide useful insights on functional recovery and its involvement in clinical practice and clinical research. METHODS: After a literature review of functional recovery in schizophrenia, a scientific committee of 8 members prepared a 75-item questionnaire, including 6 sections: (I) the concept of functional recovery (9 items), (II) assessment of functional recovery (23 items), (III) factors influencing functional recovery (16 items), (IV) psychosocial interventions and functional recovery (8 items), (V) pharmacological treatment and functional recovery (14 items), and (VI) the perspective of patients and their relatives on functional recovery (5 items). The questionnaire was sent to a panel of 53 experts, who rated each item on a 9-point Likert scale. Consensus was achieved in a 2-round Delphi dynamics, using the median (interquartile range) scores to consider consensus in either agreement (scores 7-9) or disagreement (scores 1-3). Items not achieving consensus in the first round were sent back to the experts for a second consideration. RESULTS: After the two recursive rounds, consensus was achieved in 64 items (85.3%): 61 items (81.3%) in agreement and 3 (4.0%) in disagreement, all of them from section II (assessment of functional recovery). Items not reaching consensus were related to the concepts of functional recovery (1 item, 1.3%), functional assessment (5 items, 6.7%), factors influencing functional recovery (3 items, 4.0%), and psychosocial interventions (2 items, 5.6%). CONCLUSIONS: Despite the lack of a well-defined concept of functional recovery, we identified a trend towards a common archetype of the definition and factors associated with functional recovery, as well as its applicability in clinical practice and clinical research.

Real-world data on paliperidone palmitate for the treatment of schizophrenia and other psychotic disorders: a systematic review of randomized and nonrandomized studies.

The aim of this study was to perform a systematic review of the effects of 1-month paliperidone palmitate (PP1M) for the treatment of schizophrenia and related psychotic disorders in terms of outcomes reported in real-world evidence studies. A systematic review of real-world randomized and nonrandomized studies with PP1M was performed and is reported according to PRISMA guidelines. Comparative effectiveness data with oral antipsychotics indicate that PP1M has a lower likelihood of relapse-related events, including rehospitalization, and these differences are clinically relevant. A randomized, double-blind study showed that PP1M has no advantage over haloperidol decanoate in the time to treatment failure. Although there was a marked variability across studies, PP1M was not superior to other antipsychotics in terms of study completion rates. Pharmacoeconomic data show that, during a follow-up period of 12 months, the mean total healthcare cost was not significantly different in patients treated with PP1M compared with those receiving oral antipsychotics. The mean maximum prolactin levels were significantly higher with PP1M than with haloperidol decanoate; however, neither drug differs in the frequency of prolactin-related adverse events. Results on prolactin-related adverse events were inconsistent in two randomized comparisons with oral antipsychotics and were not reported in a randomized comparison with aripiprazole. There were no significant differences between haloperidol decanoate and PP1M in the severity of abnormal involuntary movements and parkinsonism, or in the incidence of tardive dyskinesia; however, patients treated with haloperidol decanoate showed greater worsening of akathisia and required treatment for parkinsonism and akathisia significantly more frequently than patients who received PP1M. In conclusion, real-world data that originate from both pragmatic randomized clinical trials and observational studies indicate that PP1M is superior to oral antipsychotics in delaying the time to relapse or treatment failure. Furthermore, the pharmacoeconomic data reviewed for this article suggest that the advantages of PP1M compared with oral antipsychotics are not associated with an increased total cost for healthcare providers.

An open-treatment six-week study of the clinical effectiveness of Paliperidone Palmitate in schizophrenia: data from acute units in Spain (SHADOW study).

OBJECTIVES: To evaluate clinical evolution of patients with schizophrenia admitted in acute units because of a relapse and treated with once-monthly Paliperidone Palmitate (PP1M). METHODS: This multicentre, open-label, prospective observational study followed patients with schizophrenia treated with PP1M in acute psychiatric units for up to 6 weeks. RESULTS: Out of the 280 enrolled patients, 61 received PP1M as antipsychotic monotherapy, and 219 in combination with other antipsychotics. The average Clinical Global Impression-Schizophrenia (CGI-SCH) score decreased from 4.7 at baseline to 3.3 at final visit (p < .0001); the change was clinically and statistically significant both in patients treated with PP1M in monotherapy and in combination with other antipsychotics. Clear improvements in functioning and high patient satisfaction with the treatment were observed. Time from admission to PP1M therapy initiation correlated with the length of hospital stay (p < .0001); earlier start of PP1M treatment was associated with shorter hospital stay. Adverse events were reported in 7.1% of patients (all non-serious). CONCLUSIONS: PP1M was effective and well tolerated in treatment of acute episodes of schizophrenia both in monotherapy and in combination with other antipsychotics in clinical setting. Early start of PP1M therapy in acute schizophrenia episodes might help to shorten hospital stay.

La adherencia predice la remisión sintomática y psicosocial en esquizofrenia: estudio naturalístico de la integración de los pacientes en la comunidad / Adherence predicts symptomatic and psychosocial remission in schizophrenia: naturalistic study of patient integration in the community

Introducción. El funcionamiento psicosocial en pacientes con esquizofrenia que son atendidos en la práctica diaria es un aspecto que no está suficientemente estudiado. El objetivo de este estudio fue evaluar la relación entre la remisión sintomática y psicosocial y la adherencia al tratamiento en esquizofrenia. Métodos. Este estudio transversal, no intervencionista y multicéntrico evaluó la remisión sintomática y psicosocial y la integración comunitaria de 1.787 pacientes ambulatorios con esquizofrenia atendidos en servicios de salud mental españoles. La adherencia a la medicación antipsicótica en el año anterior se dividió en las categorías ≥ 80% y < 80%. Resultados. La remisión sintomática se alcanzó en el 28,5% de los pacientes, y la remisión psicosocial en el 26,2%. En total, el 60,5% de los pacientes se clasificaron dentro de la categoría de pacientes con adherencia al tratamiento antipsicótico y el 41% dentro de la de pacientes con adherencia al tratamiento no farmacológico. Durante la visita de estudio, se cambió el tratamiento al 28,4% de los pacientes, en el 31,1% debido a la baja adherencia (8,8% de la población total). Los pacientes con adherencia al tratamiento presentaron mayores porcentajes de remisión sintomática y psicosocial que aquellos sin adherencia (30,5 frente al 25,4%, p<0,05; y 32 frente al 17%, p<0,001, respectivamente). Solo el 3,5% de los pacientes presentaron un nivel adecuado de integración comunitaria, que también fue más alta entre los pacientes adherentes (73,0 frente al 60,1%, p<0,05). Conclusiones. La adherencia al tratamiento antipsicótico se asoció con la remisión sintomática y psicosocial, así como con la integración comunitaria (AU)

Introduction. Psychosocial functioning in patients with schizophrenia attended in daily practice is an understudied aspect. The aim of this study was to assess the relationship between symptomatic and psychosocial remission and adherence to treatment in schizophrenia. Methods. This cross-sectional, non-interventional, and multicenter study assessed symptomatic and psychosocial remission and community integration of 1,787 outpatients with schizophrenia attended in Spanish mental health services. Adherence to antipsychotic medication in the previous year was categorized as ≥ 80% vs. < 80%. Results. Symptomatic remission was achieved in 28.5% of patients, and psychosocial remission in 26.1%. A total of 60.5% of patients were classified as adherent to antipsychotic treatment and 41% as adherent to non-pharmacological treatment. During the index visit, treatment was changed in 28.4% of patients, in 31.1% of them because of low adherence (8.8% of the total population). Adherent patients showed higher percentages of symptomatic and psychosocial remission than non-adherent patients (30.5 vs. 25.4%, P<.05; and 32 vs. 17%, P<.001, respectively). Only 3.5% of the patients showed an adequate level of community integration, which was also higher among adherent patients (73.0 vs. 60.1%, P<.05). Conclusions. Adherence to antipsychotic medication was associated with symptomatic and psychosocial remission as well as with community integration (AU)

Cribado fitoquímico del Baccharis latifolia (R&P.) Pers. (chilca) / Phytochemical screening of Baccharis latifolia (R&P.) Pers. (chilca)

Introducción: Baccharis latifolia (R.&P.) Pers. (chilca), es una especie espontánea que crece en las riberas de los ríos. En el Perú abunda y habita entre 1000 y 4000 m. Es una planta dioica arbustiva de 1 a 2 m de altura. Presenta tallo cilíndrico, estriado longitudinalmente; hojas simples, alternas, pecioladas; limbo aovado-lanceolado; capítulo en cimas corimbosas y aquenio cilíndrico.mObjetivo: identificar metabolitos secundarios de interés medicinal en las hojas de B. latifolia. Métodos: para la colección del material botánico se emplearon los métodos de Cerrate y Ramagosa et al. El cribado fitoquímico se realizó por el método de Olga Lock. Por colorimetría, se catalogó cualitativamente la presencia del metabolito en "+++" (abundante), "++" (moderado), "+" (leve) y "-" (ausencia). Se evaluó la presencia de los siguientes metabolitos: alcaloides, fenoles, flavonoides, carbohidratos, aminoácidos y lípidos. Resultados: los metabolitos detectados con alta presencia fueron los fenoles (+++) en todos los extractos, excepto en el extracto con solvente n-hexano. Asimismo, se evidenció la presencia de flavonoides (+++) y alcaloides (+++) en el extracto acidulado. Igualmente, se comprobó la existencia carbohidratos en todos los extractos excepto en el extracto con n-Hexano. No se detectaron aminoácidos ni lípidos. Conclusiones: las hojas de B. latifolia contienen abundantes compuestos fenólicos, en los extractos etanólico, clorofórmico y acidulado y se evidenció ausencia de estos en el extracto en n-hexano. Asimismo, se observó alta presencia de alcaloides en el extracto acidulado de B. latifolia. Los extractos de las hojas de B. latifolia no presentan aminoácidos ni lípidos(AU)

Introduction: Baccharis latifolia (R.&P.) Pers. (chilca) is a wild species that grows on riverbanks. The species is abundant in Peru, where it grows between 1 000 and 4 000 m. It is a shrubby dioicous plant 1 to 2 m in height. The stem is cylindrical and longitudinally striated; the leaves are simple, alternate and petiolated, with ovate-lanceolate blades; capitula in corymbous tips and cylindrical achenes. Objective: Identify secondary metabolites of medicinal interest in leaves of B. latifolia. Methods: Collection of the botanical material was based on the Cerrate and Ramagosa et al methods. Phytochemical screening followed Olga Lock's method. For colorimetry, presence of the metabolite was qualitatively classed as "+++" (abundant), "++" (moderate), "+" (mild) or "-" (absent). Presence of the following metabolites was evaluated: alkaloids, phenols, flavonoids, carbohydrates, amino acids and lipids. Results: Phenols were found to be abundant (+++) in all extracts, except for the extract with n-hexane solvent. Flavonoids (+++) and alkaloids (+++) were present in the acidulated extract. Carbohydrates were found in all extracts except for the extract with n-hexane. Amino acids and lipids were not found. Conclusions: Leaves of B. latifolia contain abundant phenolic compounds in the ethanolic, chloroformic and acidulated extracts, but they are absent in the n-hexane extract. Alkaloids were abundant in the acidulated extract of B. latifolia. Extracts of leaves of B. latifolia do not contain amino acids or lipids(AU)

Adherence predicts symptomatic and psychosocial remission in schizophrenia: Naturalistic study of patient integration in the community. / La adherencia predice la remisión sintomática y psicosocial en esquizofrenia: estudio naturalístico de la integración de los pacientes en la comunidad.

INTRODUCTION: Psychosocial functioning in patients with schizophrenia attended in daily practice is an understudied aspect. The aim of this study was to assess the relationship between symptomatic and psychosocial remission and adherence to treatment in schizophrenia. METHODS: This cross-sectional, non-interventional, and multicenter study assessed symptomatic and psychosocial remission and community integration of 1,787 outpatients with schizophrenia attended in Spanish mental health services. Adherence to antipsychotic medication in the previous year was categorized as≥80% vs.<80%. RESULTS: Symptomatic remission was achieved in 28.5% of patients, and psychosocial remission in 26.1%. A total of 60.5% of patients were classified as adherent to antipsychotic treatment and 41% as adherent to non-pharmacological treatment. During the index visit, treatment was changed in 28.4% of patients, in 31.1% of them because of low adherence (8.8% of the total population). Adherent patients showed higher percentages of symptomatic and psychosocial remission than non-adherent patients (30.5 vs. 25.4%, P<.05; and 32 vs. 17%, P<.001, respectively). Only 3.5% of the patients showed an adequate level of community integration, which was also higher among adherent patients (73.0 vs. 60.1%, P<.05). CONCLUSIONS: Adherence to antipsychotic medication was associated with symptomatic and psychosocial remission as well as with community integration.

Efecto sobre el sistema de la coagulación del zumo de frutas y hortalizas peruanas / Effect on the clotting system of Peruvian fruit and vegetable juice

OBJETIVO: Comprobar el efecto anticoagulante in vitro e in vivo de frutas y hortalizas peruanas e identificar la vía de la coagulación sobre la que actúa. MATERIAL Y MÉTODOS: Se extrajo los zumos de Ananascomosus (L.) Merr, Citrus limonun Risso, Carica papaya L., Alliumsativum L., Allium cepa L. y Zingiber officinale L. Roscoe. Se realizó un estudio in vitro con plasma humano e in vivo administrando el zumo vía oral a ratas por catorce días. La actividad anticoagulante fue evaluada midiendo el tiempo de protrombina (TP) y el tiempo de tromboplastina parcial activado (TTPa), además se determinó el fibrinógeno. RESULTADOS: In vitro los zumos de Ananas y Zingiber prolongaron el TP, Carica el TTPa y los de Citrus, Alliumsativumy cepa ambas pruebas. In vivo los zumos de Allium cepa y Carica prolongaron el TP, Citrus el TTPa, Ananas ambas pruebas. Los zumos de Ananas, Citrus, Allium sativum y Zingiber disminuyeron el fibrinógeno. CONCLUSIÓN: In vitro e in vivo los zumos de Ananascomosus, Citrus limonun, Carica papaya y Allium cepa tienen efecto anticoagulante. Los zumos de Allium sativum y Zingiber officinale,tienen este efecto solo in vitro.

OBJECTIVE: Verify the anticoagulant effect in vitro and in vivo of Peruvian fruit and vegetable juice and identify the coagulation pathway on which it acts. MATERIAL AND METHODS: Extracted juices of Ananascomosus (L.) Merr, Citrus limonunRisso, Carica papaya L., Allium sativum L., Allium cepa L. and Zingiber officinale L. Roscoe. An in vitro study with human plasma and in vivo administering juice orally to rats for 14 days. Anticoagulant activity was evaluated by measuring the prothrombin time (PT) and partial activated thromboplastin time (APTT), the Fibrinogen was also determined. RESULTS: In vitro juices of Ananas and Zingiber prolonged PT, Carica prolonged APTT and Citrus, Allium sativum and cepa prolonged both tests. In vivo, juices of Allium cepa and Carica prolonged PT, citrus prolonged APTT, and Anannas both tests. The juices of Anannas, Citrus, Allium sativum and Zingiber decreased Fibrinogen. CONCLUSION: In vitro and in vivo Ananascomosus, Citrus limonun, Carica papaya and Allium cepa juices have anticoagulant effect. The juices of Allium sativum and Zingiber officinale, have this effect only in vitro.

Efecto hipoglicemiante de los extractos acuoso y etanólico de psidium guajava L. (Guayaba) en ratas diabéticas inducidas por aloxano / Hypoglycemic effect of aqueous and ethanol extracts of psidium guajava L. (guajava) in alloxan-induced diabetic rats

OBJETIVO: Evaluar la actividad antidiabética de los extractos acuoso y etanólico obtenidos a partir de las hojas de Psidium guajava L. en ratas diabéticas inducidas por aloxano. MAZTERIAL y METODOS: La hiperglicemia se indujo en ratas albinas mediante la administración de aloxano monohidrato (100 mg/kg ip). El extracto acuoso fue administrado en una sola dosis de 250 mg/kg, mientras que el extracto etanólico a las dosis de 250 y 500 mg/kg también a dosis única. La glucosa en sangre se determinó a las dos, cuatro y veinticuatro horas, después de la administración del aloxano. RESULTADOS: La administración de los extractos acuoso y etanólico de Psidium guajava L. tendieron a disminuir la concentración de glucosa en sangre. El extracto acuoso con una concentración de 250 mg/kg se encontró que era más potente que los extractos etanólicos, con la concentración de glucosa media más baja de 86,67 mg/dL, dos horas después de que se administró. El efecto del extracto etanólico sólo se observó en la concentración de 500 mg/kg con una ligera disminución de la glucosa en sangre. CONCLUSIÓN: Este estudio indicó una actividad antidiabética significativa del extracto acuoso de Psidium guajava L. en ratas diabéticas inducidas por aloxano.

OBJECTIVE: To evaluate antidiabetic activity of water and ethanol extracts from Psidium guajava L. leaves in alloxan-induced diabetic rats. MATERIAL and METHODS: Hyperglycemia was induced in albino rats by administering alloxan monohydrate (100 mg/kg i.p.). Water extract at a dose of 250 mg/kg was administered at a single dose, while ethanol extracts at doses of 250 and 500 mg/kg were also administered at a single dose. Blood glucose was determined two hours after administering the extracts. RESULTS: The addition of water and ethanol extracts of Psidium guajava L. tended to decrease the blood glucose concentration. The water extract at a concentration of 250 mg/kg was found to be more potent than ethanol extracts with the lowest mean glucose concentration of 86.67 mg/dL two hours after it was administered. The effect of ethanol extract was only observed at the concentration of 500 mg/kg with a slight decrease in blood glucose. CONCLUSION: This study indicated a significant antidiabetic activity of water extract of Psidium guajava L. in alloxan induced diabetic rats.

Efecto sobre la motilidad intestinal del extracto de alcaloides de semilla de Jatropha curcas L. / Effect of the alkaloid extract from Jatropha curcas L. seeds on the intestinal motility

Introducción: estudios preclínicos del extracto total de la raíz de Jatropha curcas L. (piñón blanco) demostraron su efecto antidiarreico, en contraste, ensayos de toxicidad crónica del extracto total de la semilla muestran efecto diarreico. Objetivo: determinar el efecto sobre la motilidad intestinal del extracto de alcaloides de semilla de Jatropha curcas L. Métodos: se utilizaron 50 ratones albinos con pesos medios de 25 g, se empleó el método de Arbós y otros; se administró carbón activado al 5 % vía oral, dosis de 0,1 mL/10 g, como marcador intestinal. Los grupos experimentales fueron: agua destilada 0,1 mL/10 g, atropina 1 mg/kg, extracto de alcaloides de semilla de Jatropha curcas 500 y 1 000 mg/kg, respectivamente, y neostigmina 1 g/kg. Para la validación estadística se usó la prueba de Kruskal-Wallis, ANOVA, Tukey, y Newman-Keuls. Resultados: el porcentaje de recorrido del carbón activado fue de 69,21; 36,37; 58,96; 49,65 y 74,17, respectivamente. La prueba de ANOVA demostró diferencias estadísticas (p< 0,05; IC 95 %), y la prueba de Tukey y Newman-Keuls, demostraron diferencias significativas entre el grupo que recibió agua destilada y la planta a 1 000 mg/kg. Conclusiones: se comprobó efecto de disminución de la motilidad intestinal por acción del extracto de alcaloides de Jatropha curcas, en dosis de 1 000 mg/kg.

Introduction: preclinical research studies of Jatropha curcas L. (piñón blanco) root extract proved its antidiarrheal activity; however the chronic toxicity test of the total seed extract demonstrated diarrheal effect. Objectives: to determine the effect of the alkaloid extract from Jatropha curcas L. seeds on the gastrointestinal motility. Methods: fifty albino mice with average weight of 25 g were used. The Arbos et al.´s method was applied. The intestinal marker was 5 % activated charcoal administered at a dose of 0.1 mL/10 g. The experimental groups included 0.1 mL/10 g of distilled water, 1.5 mg/kg of atropine, alkaloid extract of Jatropha curcas L. seeds at doses of 500 and 1 000 mg/kg respectively, and 1 g/kg of neostigmine The statistical validation was based on Kruskal-Wallis test, ANOVA, and Tukey and Newman-Keuls test. Results: the percentages of the charcoal run were 69.21, 36.37, 58.96, 49.65, and 74.17 respectively. The ANOVA test demonstrated statistical significance (p< 0.05, IC 95 %). Comparative Tukey and Newman-Keuls test showed statistical significance between distilled water and Jatropha curcas at a dose of 1 000 mg/kg. Conclusions: the decrease on the gastrointestinal motility resulting from the effect of the alkaloid extract of Jatropha curcas seeds was proved at a dose of 1 000 mg/kg.

Evaluación de la Cyclantera pedata L. (caigua) en la prevención de la dislipidemia y la formación de ateromas aórtico en Oryctolagus cuniculus (conejos) / Evaluation of Cyclantera pedata L. (caigua) in the prevention of dyslipidemia and aortic atheroma formation on Oryctolagus cuniculus (rabbits)

Determinar la acción de la caigua (Cyclanthera pedata L.) en la prevención de la dislipidemia y la formación de ateromas aórticos, en conejos. Se utilizaron 25 conejos distribuidos en seis grupos; grupo I, sin hipercolesterolemia (control negativo); los cinco restantes, con hipercolesterolemia inducida por consumo de colesterol mezclado con aceite vegetal, vía oral durante 30 días: un control positivo (solo colesterol); un grupo con Colesterol+Atorvastatina y tres con caigua a las dosis de 250, 500 y 1000 mg/kg, respectivamente. A los 30, 60 y 90 días se determinó los niveles séricos de colesterol total, triglicéridos, así como TGO, TGP y ALP. Se comparó las diferencias de medidas con ANOVA y test de Tukey. El colesterol y los triglicéridos séricos, se incrementaron en los animales que recibieron colesterol. La Atorvastatina y la caigua, en las diferentes dosis, impidieron el incremento, producido por la dieta hipergrasa; en nunguno de los grupos apreciamos la formación de ateromas en las arterias; tampoco observamos cambios importantes en las enzimas hepáticas. El consumo crónico del extracto hidroalcohólico de Cyclanthera pedata, evitó la hipercolesterolemia y redujo la hipertricliceridemia producida por el consumo crónico de una dieta hipergrasa en conejos. En ninguno de los grupos apreciamos ateoremas aórticos.

To determinate the action of Cyclanthera pedata L. (caigua) in the prevention of dyslipidemia and aortic atheroma formation on rabbits. We used 25 rabbits distributed in six groups: Group I Negative control (without hypercholesterolemia); G II: positive control (hyperlipemic diet); G III: hyperlipemic diet plus atorvastatine; G IV: Hyperlipemic diet plus caigua (100 mg/k); G V: hyperlipemic diet plus caigua (250 mg/k); G VI: hyperlipemic diet plus caigua (500 mg/k). After 30, 60 and 90 days we determine the serum of total cholesterol, tryglycerides, TGO, TGP and ALP. We observe an increase of cholesterol and triglycerides serum of rabbits fed with hyperlipemic diet. Atorvastatine and caigua, at the used doses, avoided the increase of cholesterol and triglycerides level caused by hyperlipemic diet; any group present some atheroma in the orta artery, and we neither observe important changes on serums of hepatic enzymes as well. The chronic consumption of Cyclanthera pedata, avoided or reduced the hypercholesterolemia and the hypertriclyceridemia in rabbits fed with hyperlipidic diet. In none of the groups, we appreciate aortic atheromas.

Efectos sobre la temperatura, frecuencia respiratoria, frecuencia cardiaca y electrocardiograma de Maytenus macrocarpa (Ruiz & Pav.) Briq. (chuchuhuasi) / Effects of Maytenus macrocarpa (Ruiz & Pav.) Briq. (chuchuhuasi) in temperature, respiratory rate, heart rate, and electrocardiogram

Introducción: estudios de árboles del género Maytenus, especies forsskaoliana, ilicifolia y krukovii revelan efectos depresores a nivel cardiovascular sobre la presión arterial y frecuencia cardiaca. Objetivos: analizar experimentalmente los efectos de las hojas de Maytenus macrocarpa "chuchuhuasi" sobre la frecuencia cardiaca, patrones electrocardiográficos, frecuencia respiratoria, y temperatura. Métodos: investigación de tipo exploratorio, analítico y experimental. Se utilizaron ratas albinas en 9 grupos de 8 ratas. Grupo 1 (control: Halatal), grupo 2 (placebo: agua destilada), grupo 3 (adrenalina), grupo 4 (atropina), grupo 5 (acetilcolina), grupo 6 (propranolol), grupo 7 (chuchuhuasi 500 mg/kg), grupo 8 (chuchuhuasi 1 000 mg/kg) y grupo 9 (chuchuhuasi 1 500 mg/kg). La temperatura rectal se midió con termómetro de mercurio, la frecuencia respiratoria, por conteo directo; el electrocardiograma y la frecuencia cardiaca, mediante el uso de polígrafo. El programa MATLAB se utilizó para analizar los datos obtenidos en el electrocardiograma. Para la validación estadística se usó la prueba de ANOVA, pruebas de Tuckey, Wilconxon y Shapiro-Wilk. Resultados: Maytenus macrocarpa mostró mayor actividad depresora sobre la frecuencia cardiaca (promedio 308,6 ppm), mayor efecto inotrópico negativo (promedio onda P: 0,08300 mv, promedio onda R: 0,1539 mv), marcada bradipnea (promedio 51,6 rpm) e hipotermia (promedio: 31,84 °C) a dosis de 1 500 mg/kg. Conclusiones: Maytenus macrocarpa demostró efecto bradicardizante, depresor de la frecuencia respiratoria y la temperatura corporal.

Introduction: studies on Maytenus trees comprising forsskaoliana, krukovii, and ilicifolia species showed depressing effects on the blood pressure and the heart rate. Objectives: to experimentally analyze the effects of Maytenus macrocarpa leaves on the heart rate, the electrocardiographic patterns, the respiratory rate, and the temperature. Method: this study was exploratory, analytical, and experimental. Albino rats were grouped in 9 groups of 8 rats each. Group 1 (control: Halatal), group 2 (placebo: distillated water), group 3 (adrenaline), group 4 (atropine), group 5 (acetylcholine), group 6 (propranolol), group 7 (500 mg/kg chuchuhuasi), group 8 (1 000 mg/kg chuchuhuasi), and group 9 (1 500 mg/kg chuchuhuasi). The rectal temperature was measured with a mercury thermometer, whereas the direct count allowed measuring the respiratory frequency. The polygraph registered electrocardiogram and heart rate as well. The MATLAB program analyzed data from the electrocardiogram. The statistic validation was performed with ANOVA, Tuckey, Wilcoxon, and Shapiro-Wilk tests. Results: Maytenus macrocarpa showed depressing effects on the cardiac frequency, being more effective at 1 500 mg/kg doses (average 308.6 ppm), higher negative inotropic effect at 1 500 mg/kg doses (average P wave 0.08300 mv, average R wave 0.1539 mV). Severe bradypnea was shown at 1 500 mg/kg doses (average RF 51.6 rpm), as well as hypothermia (average T° 31.84 °C). Conclusion: Maytenus macrocarpa demonstrated bradycardic as well as depressing effects on respiratory frequency and body temperature.