Global morbidity and mortality of central nervous system tuberculosis: a systematic review and meta-analysis.

BACKGROUND: Tuberculosis (TB) is the second most common cause of death due to a single infectious agent worldwide after COVID-19. Up to 15% of the cases are extrapulmonary, and if it is located in the central nervous system (CNS-TB), it presents high morbidity and mortality. Still, the global epidemiology of CNS-TB remains unknown. AIM: To estimate the global prevalence and incidence of CNS-TB based on the available literature. METHODS: We systematically searched in MEDLINE, Cochrane Central, Scopus, and LILACS databases (April 2020) and included observational studies evaluating the epidemiology of CNS-TB. Two independent researchers selected and assessed the quality of the studies and extracted relevant data. We performed random-effects model meta-analysis of proportions to estimate the pooled prevalence. The protocol of this study was registered in PROSPERO (CRD 42018103946). RESULTS: We included 53 studies from 28 countries, representing 12,621 patients with CNS-TB. The prevalence of CNS-TB was 2 per 100,000 inhabitants. According to the clinical setting, the prevalence of CNS-TB represented the 13.91% of all cases of meningitis and 4.55% of all cases of TB. The mortality was calculated by tuberculous meningitis due to the lack of data of other presentation, and it rose up to 42.12% in hospitalized patients. The burden of countries' TB, Human Development Index (HDI), and the prevalence of HIV were the most important prevalence moderators, especially in patients with TB. No data on incidence were found. CONCLUSION: The prevalence and mortality of CNS-TB remain high, and TB meningitis is the most frequent presentation. The highest prevalence was reported in developing countries, and its main moderators were the countries' HDI and HIV infection. Our study was limited by high heterogeneity, risk of bias, and potential data under registration from developing countries. The integration of CNS-TB early detection and management into national TB programs and population-based studies from developing countries are needed for better global estimation and response.

Peri-abortion contraceptive counseling: A systematic review of randomized controlled trials.

OBJECTIVE: To assess the effects of peri-abortion contraceptive counseling interventions. METHODS: We performed a systematic review of randomized controlled trials (RCTs) that compared the effect of different types of peri-abortion contraceptive counseling interventions and were published as original papers in scientific journals. The literature search was performed in June 2021 in PubMed, Central Cochrane Library (CENTRAL), Scopus, and Google Scholar; without restrictions in language or publication date. Two independent authors identified studies that met the inclusion and exclusion criteria and extracted the data. The risk of bias was assessed using the Cochrane tool, and evidence certainty was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. Whenever possible, meta-analyses were performed. The protocol was registered at PROSPERO (CRD42020187354). RESULTS: Eleven RCTs were eligible for inclusion (published from 2004 to 2017), from which nine compared enhanced versus standard counseling. Pooled estimates showed that, compared to standard counseling, enhanced counseling was associated with a higher incidence of effective contraceptive use (>3 months) (relative risk [RR], 1.12; 95% confidence interval [CI], 1.09-1.16), although no significant difference was found in the incidence of long-acting reversible contraceptive use (RR, 1.25; 95% CI, 0.68-2.29), contraceptive uptake (RR, 1.06; 95% CI, 0.98-1.15), and obstetric event occurrence (RR, 0.91; 95% CI, 0.57-1.47). Certainty of evidence was very low for all outcomes. In addition, two studies compared contraceptive counseling provided by physicians versus that provided by non-physicians, which did not show significant differences. CONCLUSIONS: Enhanced contraceptive counseling may favor effective contraceptive use but may not affect the rate of obstetric event occurrence. Also, the studies did not find a difference in the effects of counseling interventions given by different providers. Since evidence certainty was very low, future well-designed RCTs are needed to make informed decisions. REGISTRATION: The study protocol was registered at PROSPERO (CRD42020187354).

Producción de las sociedades científicas de estudiantes de medicina en Perú / Production of the scientific societies of medical students in Peru

Introducción: Las escuelas de medicina en Perú tienen un papel importante en la producción científica y el desarrollo en salud del país. Las Sociedades Científicas de Estudiantes de Medicina promueven la investigación entre sus miembros. Sin embargo, no se conocen la evolución y el impacto de su producción científica en sus respectivas universidades. Objetivo: Describir la producción científica de las Sociedades Científicas de Estudiantes de Medicina en Perú durante el período 2002-2018. Métodos: Estudio descriptivo, que analizó los artículos científicos publicados durante 2002-2018 por alguna de las Sociedades Científicas de Estudiantes de Medicina que estuvieron afiliadas a la Sociedad Científica Médico Estudiantil Peruana. Estos artículos se recolectaron mediante una búsqueda sistemática y por autorreporte de los miembros de las sociedades. Además, en cada caso se calculó el aporte a la producción científica en Scopus de las universidades de origen. Resultados: La Sociedad Científica Médico Estudiantil Peruana registró 39 Sociedades Científicas de Estudiantes de Medicina afiliadas, las cuales publicaron 856 artículos científicos entre 2002 y 2018. Existió una tendencia creciente del número de artículos. Del total de estos, 407 (47,6 por ciento) fueron originales, 390 (45,6 por ciento) estaban indizados a Scopus y 580 (67,8 por ciento) tenían como primer autor a un miembro de alguna sociedad. La mediana de artículos por Sociedades Científicas de Estudiantes de Medicina resultó de 11 (rango: 1 a 154). Durante el período 2015-2018, en 9/34 universidades, las Sociedades Científicas de Estudiantes de Medicina aportaron más de la cuarta parte de la producción científica de su universidad a Scopus. Conclusiones: Las Sociedades Científicas de Estudiantes de Medicina presentaron variable producción científica y en varios casos aportaron significativamente a la producción de artículos científicos de sus universidades(AU)

Introduction: Medical schools in Peru play an important role in scientific production and health development nationwide. The Scientific Societies of Medical Students promote research among their members. However, the evolution and impact of their scientific production in their respective universities are not known. Objective: To describe the scientific production of the Scientific Societies of Medical Students in Peru during the period 2002-2018. Methods: Descriptive study that analyzed the scientific articles published during 2002-2018 by any of the Scientific Societies of Medical Students affiliated with the Peruvian Student Medical Scientific Society. These articles were collected through systematic search and self-report by the members of the societies. Also, in each case, the contribution of the universities of origin to Scopus scientific production was calculated. Results: The Peruvian Student Medical Scientific Society registered 39 affiliated Scientific Societies of Medical Students, which published 856 scientific articles between 2002 and 2018. There was an increasing trend in the number of articles. Of that total, 407 (47.6 percent) were original articles, 390 (45.6 percent) were indexed in Scopus and 580 (67.8 percent) had a member of a Society as their first author. The median number of articles by Scientific Societies of Medical Students was 11 (range: 1 to 154). During the 2015-2018 period, in 9 of 34 universities, the Scientific Societies of Medical Students contributed to Scopus more than a quarter of the scientific production of their university. Conclusions: The Scientific Societies of Medical Students presented a diverse scientific production and, in several cases, contributed significantly to the production of scientific articles at their universities(AU)

Diagnostic accuracy of urine dipstick testing for albumin-to-creatinine ratio and albuminuria: A systematic review and meta-analysis.

BACKGROUND: The accuracy of urine dipsticks to detect increased albuminuria is uncertain. We aimed to assess the diagnostic accuracy of urine dipsticks for detecting albuminuria. METHODS: A systematic review of studies that assessed the diagnostic accuracy of urine dipstick testing for detecting albuminuria has been conducted (using as reference standard the albuminuria in a 24-hour sample or the albumin-to-creatinine ratio) in Scopus, PubMed, and Google Scholar. The risk of bias of the included studies has been assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Whenever possible, we performed meta-analyses for sensitivity and specificity. The certainty of the evidence has also been assessed using the Grading of Recommendations Assessment, Development, and Evaluation methodology. RESULTS: A total of 14 studies have been included in this review, having assessed all albumin-to-creatinine ratio (ACR) as assessed standard. Each study used different dipstick types. The resulting pooled sensitivity and specificity for each cutoff point were as follows: for ACR >30 mg/g (13 studies): 0.82 (95% confidence interval: 0.76-0.87) and 0.88 (0.83-0.91); for ACR 30-300 mg/g (7 studies): 0.72 (0.68-0.77) and 0.82 (0.76-0.89); and for ACR >300 mg/g (7 studies): 0.84 (0.71-0.90) and 0.97 (0.95-0.99), respectively. An overall high risk of bias, an important heterogeneity in all pooled analysis, and a very low certainty of the evidence have been found. CONCLUSIONS: Pooled sensitivity and specificity of urine dipsticks have been calculated for different ACR cutoff points. However, the dipstick types differed across studies, and the certainty of the evidence was very low. Thus, further well-designed studies are needed to reach more confident estimates and to assess accuracy differences across dipstick types. REGISTRATION: PROSPERO (CRD42019124637).

Acupuncture for major depressive disorder: A review of the recommendations stated at clinical practice guidelines.

BACKGROUND: The use of acupuncture to treat depression is not uncommon. However, recommendations regarding acupuncture issued by clinical practice guidelines (CPG) vary widely. OBJECTIVE: To describe the recommendations regarding acupuncture in CPGs for depression in adults, and to assess the methodology used to reach them. METHODS: We conducted a scoping review of CPGs for depression management in adults, which performed systematic reviews (SRs) to answer their review questions, were published between January 2014 and May 2018, and assessed the use of acupuncture as a review question. We limited out search to articles published in English/Spanish. We assessed the SRs quality using the "A MeaSurement Tool to Assess Systematic Reviews-2" (AMSTAR-2), and described how the recommendation regarding acupuncture was reached. FINDINGS: We found five CPGs that fulfilled our inclusion criteria: three from the US, one from Canada, and one from China. Four CPGs fulfilled between two and three items of AMSTAR-2, and one CPG fulfilled seven items. The methodology used to formulate the recommendations varied between CPGs. Regarding acupuncture use recommendations: three CPGs did not issue any recommendation (although one mentions that it should not be used), whilst two were in favor. DISCUSSIONS: The lack of a clearly stated review question presented in the majority of CPGs prevents the reader from understanding what the CPG developing group was trying to answer. Moreover, the arguments presented to support a decision are usually not detailed enough. Therefore, the assessment of the recommendations was extremely difficult. CLINICAL IMPLICATIONS: Given that the formulation of recommendations is not always reliable, clinicians should carefully read and assess the recommendations presented in CPGs before implementing them.

Clinical practice guideline for the evaluation and management of patients with severe aortic stenosis for the Peruvian Social Security.

Introduction: This article summarizes the clinical practice guide (CPG) for the evaluation and management of patients with severe aortic stenosis in the Social Security of Peru (EsSalud). Objective: To provide clinical evidence-based recommendations for the evaluation and management of patients with severe aortic stenosis in the EsSalud. Methods: A local guideline development group (local GDG) was established, including medical specialists and methodologists. The local GDG formulated 7 clinical questions to be answered by this CPG. Systematic searches of systematic reviews and, when it was considered pertinent, primary studies, were conducted in PubMed during 2018. The evidence to answer each of the posed clinical questions was selected. The quality of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic work meetings, the local GDG used the GRADE methodology to review the evidence and formulate the recommendations, points of good clinical practice, and the flowchart of evaluation and management. Finally, the CPG was approved with Resolution N.° 47 - IETSI - ESSALUD - 2018. Results: This CPG addressed 7 clinical questions regarding two issues: the initial evaluation and the management of severe aortic stenosis. Based on these questions, 9 recommendations (1 strong recommendation and 8 weak recommendations), 16 points of good clinical practice, and 1 flowchart were formulated. Conclusion: This article summarizes the methodology and evidence-based conclusions from the CPG for the evaluation and management of patients with severe aortic stenosis in the EsSalud.

Introducción: El presente artículo resume la guía de práctica clínica (GPC) para la evaluación y el tratamiento de pacientes con estenosis aórtica severa en el Seguro Social del Perú (EsSalud). Objetivo: Proveer recomendaciones para la evaluación y el tratamiento de pacientes con estenosis aórtica severa en el EsSalud basadas en evidencia científica. Métodos: Se conformó un grupo elaborador local (GEG-Local) que incluyó médicos especialistas y metodólogos. El GEG-Local formuló siete preguntas clínicas que ser respondidas en la presente GPC. Se realizaron búsquedas sistemáticas de revisiones sistemáticas y, cuando fue considerado pertinente, estudios primarios en PubMed durante el 2018. Se seleccionó la evidencia para responder cada una de las preguntas clínicas planteadas. La calidad de la evidencia fue evaluada usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones de trabajo periódicas, el GEG-Local usó la metodología GRADE para revisar la evidencia y formular las recomendaciones, los puntos de buenas prácticas clínicas y el flujograma de evaluación y tratamiento. Finalmente, la GPC fue aprobada con Resolución N.° 47 ­ IETSI ­ ESSALUD ­ 2018. Resultados: La presente GPC abordó siete preguntas clínicas, respecto a dos temas: la evaluación inicial y el tratamiento de la estenosis aórtica severa. Con base en dichas preguntas se formularon nueve recomendaciones (una recomendación fuerte y ocho recomendaciones débiles), 16 puntos de buena práctica clínica y un flujograma. Conclusión: El presente artículo resume la metodología y las conclusiones de la GPC para la evaluación y el tratamiento de pacientes con estenosis aórtica severa en el EsSalud.

Clinical practice guideline for the evaluation and management of patients with severe aortic stenosis for the Peruvian Social Security.

Introduction: This article summarizes the clinical practice guide (CPG) for the evaluation and management of patients with severe aortic stenosis in the Social Security of Peru (EsSalud). Objective: To provide clinical evidence-based recommendations for the evaluation and management of patients with severe aortic stenosis in the EsSalud. Methods: A local guideline development group (local GDG) was established, including medical specialists and methodologists. The local GDG formulated 7 clinical questions to be answered by this CPG. Systematic searches of systematic reviews and, when it was considered pertinent, primary studies, were conducted in PubMed during 2018. The evidence to answer each of the posed clinical questions was selected. The quality of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic work meetings, the local GDG used the GRADE methodology to review the evidence and formulate the recommendations, points of good clinical practice, and the flowchart of evaluation and management. Finally, the CPG was approved with Resolution N.° 47 - IETSI - ESSALUD - 2018. Results: This CPG addressed 7 clinical questions regarding two issues: the initial evaluation and the management of severe aortic stenosis. Based on these questions, 9 recommendations (1 strong recommendation and 8 weak recommendations), 16 points of good clinical practice, and 1 flowchart were formulated. Conclusion: This article summarizes the methodology and evidence-based conclusions from the CPG for the evaluation and management of patients with severe aortic stenosis in the EsSalud.

Introducción: El presente artículo resume la guía de práctica clínica (GPC) para la evaluación y el tratamiento de pacientes con estenosis aórtica severa en el Seguro Social del Perú (EsSalud). Objetivo: Proveer recomendaciones para la evaluación y el tratamiento de pacientes con estenosis aórtica severa en el EsSalud basadas en evidencia científica. Métodos: Se conformó un grupo elaborador local (GEG-Local) que incluyó médicos especialistas y metodólogos. El GEG-Local formuló siete preguntas clínicas que ser respondidas en la presente GPC. Se realizaron búsquedas sistemáticas de revisiones sistemáticas y, cuando fue considerado pertinente, estudios primarios en PubMed durante el 2018. Se seleccionó la evidencia para responder cada una de las preguntas clínicas planteadas. La calidad de la evidencia fue evaluada usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones de trabajo periódicas, el GEG-Local usó la metodología GRADE para revisar la evidencia y formular las recomendaciones, los puntos de buenas prácticas clínicas y el flujograma de evaluación y tratamiento. Finalmente, la GPC fue aprobada con Resolución N.° 47 ­ IETSI ­ ESSALUD ­ 2018. Resultados: La presente GPC abordó siete preguntas clínicas, respecto a dos temas: la evaluación inicial y el tratamiento de la estenosis aórtica severa. Con base en dichas preguntas se formularon nueve recomendaciones (una recomendación fuerte y ocho recomendaciones débiles), 16 puntos de buena práctica clínica y un flujograma. Conclusión: El presente artículo resume la metodología y las conclusiones de la GPC para la evaluación y el tratamiento de pacientes con estenosis aórtica severa en el EsSalud.

¿Cómo impulsar una sociedad científica de estudiantes de medicina? / How to promote a medical students scientific society?

En las últimas décadas las iniciativas estudiantiles de investigación en pregrado han aumentado, por lo que las sociedades científicas de estudiantes de medicina tienen un rol cada vez más importante en el desarrollo de la investigación en América Latina. El crecimiento y la consolidación de estas organizaciones dependerán del fortalecimiento de sus capacidades técnicas, de organización y de liderazgo. Las estrategias básicas que permitirán mejorar la organización son: establecer programas de entrenamiento permanente de conocimientos en investigación; implementar clubes de lectura crítica; fomentar el autoaprendizaje y el uso de los diversos recursos que ofrece la web 2.0; capacitarse en gestión y administración; estandarizar procesos y procedimientos; establecer convenios con otras instituciones, y fomentar el intercambio de experiencias con organizaciones semejantes

In recent decades the student undergraduate research initiatives have increased; so the scientific societies of medical students have an increasingly important role in the development of research in Latin America. The growth and consolidation of these organizations depends on strengthening its technical capabilities, organizational skills and leadership. The basic strategies to improve the organization are: Establish permanent training programs in research knowledge; implement journal clubs; encourage self-learning and use of the various resources offered by web 2.0; training in management and administration; standardize processes and procedures; establish partnerships with other institutions; promote the exchange of experiences with similar organizations

Guía de práctica clínica para la evaluación y el tratamiento de pacientes con estenosis aórtica severa en el Seguro Social del Perú / Clinical practice guideline for the evaluation and management of patients with severe aortic stenosis for the Peruvian Social Security

Resumen Introducción: El presente artículo resume la guía de práctica clínica (GPC) para la evaluación y el tratamiento de pacientes con estenosis aórtica severa en el Seguro Social del Perú (EsSalud). Objetivo: Proveer recomendaciones para la evaluación y el tratamiento de pacientes con estenosis aórtica severa en el EsSalud basadas en evidencia científica. Métodos: Se conformó un grupo elaborador local (GEG-Local) que incluyó médicos especialistas y metodólogos. El GEG-Local formuló siete preguntas clínicas que ser respondidas en la presente GPC. Se realizaron búsquedas sistemáticas de revisiones sistemáticas y, cuando fue considerado pertinente, estudios primarios en PubMed durante el 2018. Se seleccionó la evidencia para responder cada una de las preguntas clínicas planteadas. La calidad de la evidencia fue evaluada usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones de trabajo periódicas, el GEG-Local usó la metodología GRADE para revisar la evidencia y formular las recomendaciones, los puntos de buenas prácticas clínicas y el flujograma de evaluación y tratamiento. Finalmente, la GPC fue aprobada con Resolución N.° 47 — IETSI — ESSALUD — 2018. Resultados: La presente GPC abordó siete preguntas clínicas, respecto a dos temas: la evaluación inicial y el tratamiento de la estenosis aórtica severa. Con base en dichas preguntas se formularon nueve recomendaciones (una recomendación fuerte y ocho recomendaciones débiles), 16 puntos de buena práctica clínica y un flujograma. Conclusión: El presente artículo resume la metodología y las conclusiones de la GPC para la evaluación y el tratamiento de pacientes con estenosis aórtica severa en el EsSalud.

Abstract Introduction: This article summarizes the clinical practice guide (CPG) for the evaluation and management of patients with severe aortic stenosis in the Social Security of Peru (EsSalud). Objective: To provide clinical evidence-based recommendations for the evaluation and management of patients with severe aortic stenosis in the EsSalud. Methods: A local guideline development group (local GDG) was established, including medical specialists and methodologists. The local GDG formulated 7 clinical questions to be answered by this CPG. Systematic searches of systematic reviews and, when it was considered pertinent, primary studies, were conducted in PubMed during 2018. The evidence to answer each of the posed clinical questions was selected. The quality of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic work meetings, the local GDG used the GRADE methodology to review the evidence and formulate the recommendations, points of good clinical practice, and the flowchart of evaluation and management. Finally, the CPG was approved with Resolution N.° 47 — IETSI — ESSALUD — 2018. Results: This CPG addressed 7 clinical questions regarding two issues: the initial evaluation and the management of severe aortic stenosis. Based on these questions, 9 recommendations (1 strong recommendation and 8 weak recommendations), 16 points of good clinical practice, and 1 flowchart were formulated. Conclusion: This article summarizes the methodology and evidence-based conclusions from the CPG for the evaluation and management of patients with severe aortic stenosis in the EsSalud.

Respuesta a los comentarios al artículo "Factores asociados a la deserción en estudiantes de Medicina en una universidad peruana" / Replying the comments to the article

Sr. Editor: Recibimos muy atentos los comentarios respecto a nuestro artículo factores asociados a la deserción en estudiantes de medicina en una universidad peruana,1 en el cual describe que la deserción universitaria es multifactorial; además, contribuye con la identificación de esa problemática para plantear estrategias para la mejora de la permanencia estudiantil. Concordamos que la deserción universitaria se le atribuye múltiples factores que de manera principal se originan por la insuficiencia de integración personal con el entorno intelectual y social de la comunidad institucional, y la pobre interacción con el docente y demás estudiantes fuera de las aulas universitarias durante los primeros años.2 Partiéndose de la observación de fenómenos que ocurren en el contexto donde se realizó el estudio, se identificó que los ingresantes a la universidad son estudiantes de distinto nivel socioeconómico y con distinta motivación para continuar su carrera profesional....

Mr. Publisher: We receive very attentive the comments with regard to our article factors associated with the desertion in students of medicine in a Peruvian university, 1 in which it describes that the university desertion is multifactorial; also, he contributes with the identification of this problems to raise strategies for the progress of the student permanence. We reconcile that the university desertion assumes to him multiple factors that in a main way originate for the insufficiency of personal integration with the intellectual and social environment of the institutional community, and the poor interaction with the teacher and other students out of the university classrooms during the first ones años.2 Breaking of the observation of phenomena that happen in the context where the study was realized, it was identified that the ingresantes to the university are students of different socioeconomic level and with different motivation to continue its career....

Respuesta a los comentarios al artículo "Factores asociados a la deserción en estudiantes de Medicina en una universidad peruana" / Replying the comments to the article "Associated Factors With Medical Students Dropout In Peruvian University"i:en

Sr. Editor: Recibimos muy atentos los comentarios respecto a nuestro artículo factores asociados a la deserción en estudiantes de medicina en una universidad peruana,1 en el cual describe que la deserción universitaria es multifactorial; además, contribuye con la identificación de esa problemática para plantear estrategias para la mejora de la permanencia estudiantil. Concordamos que la deserción universitaria se le atribuye múltiples factores que de manera principal se originan por la insuficiencia de integración personal con el entorno intelectual y social de la comunidad institucional, y la pobre interacción con el docente y demás estudiantes fuera de las aulas universitarias durante los primeros años.2 Partiéndose de la observación de fenómenos que ocurren en el contexto donde se realizó el estudio, se identificó que los ingresantes a la universidad son estudiantes de distinto nivel socioeconómico y con distinta motivación para continuar su carrera profesional....

Mr. Publisher: We receive very attentive the comments with regard to our article factors associated with the desertion in students of medicine in a Peruvian university, 1 in which it describes that the university desertion is multifactorial; also, he contributes with the identification of this problems to raise strategies for the progress of the student permanence. We reconcile that the university desertion assumes to him multiple factors that in a main way originate for the insufficiency of personal integration with the intellectual and social environment of the institutional community, and the poor interaction with the teacher and other students out of the university classrooms during the first ones años.2 Breaking of the observation of phenomena that happen in the context where the study was realized, it was identified that the ingresantes to the university are students of different socioeconomic level and with different motivation to continue its career....

Factores asociados a la deserción en estudiantes de Medicina en una universidad peruana / Associated Factors With Medical Students Dropout In Peruvian University

Objetivo: identificar los factores asociados a la deserción de estudiantes de la facultad de Medicina Humana de una universidad peruana durante el periodo 2010-2013. Métodos: en el estudio se utilizó un diseño no experimental, analítico-casos y controles. El tamaño de la muestra se obtuvo a partir de un antecedente considerando la proporción de casos y controles expuestos según vocación, este fue de 46 personas en ambos grupos, los cuales fueron escogidos a partir de un muestreo probabilístico aleatorio simple sin reemplazo. Se utilizaron los instrumentos que evalúan el nivel socioeconómico y el que mide la fuerza de motivación para la escuela de medicina (SMMS), además de una encuesta conformada por preguntas cerradas y abiertas dirigidas a indagar los aspectos individuales y académicos. Resultados: en ambos grupos, la fuerza de motivación indicó ser frecuentemente "muy baja", además, en su mayoría refirieron haber desaprobado al menos un curso durante los primeros años de la carrera; los cursos de Química médica, Filosofía y Embriología humana y Genética básica fueron las materias más frecuentes en su desaprobación. Los estudiantes de género femenino resultaron ser las más frecuentes en deserción. Conclusiones: la edad de inicio de estudios, la desaprobación de las asignaturas de filosofía, asignatura de bioestadística, horas de estudio por semana y puntaje de fuerza de motivación son factores asociados a la deserción médico estudiantil(AU)

Objective: To identify factors associated with dropout in students of the College of Human Medicine in a Peruvian university during the period 2010 ­ 2013. Methods: Anon-experimental, analytical design was used in the study - Cases and controls. The sample size was obtained from an antecedent considering the proportion of cases and controls exposed as vocation; it was 46 people in both groups; which were selected from a simple random probabilistic sampling without replacement. Instruments that assess the socioeconomic status and measures the strength of motivation for medical school (SMMS), and a survey with closed and open questions to explore individual and academics aspects were used. Results: In both groups, the strength of motivation was often "very low"; also, most reported having at least one course disapproved during the first years of the career; being the most frequent disapproved courses "Medical Chemistry, "Philosophy" and "Basic Human Embryology and Genetics". the female students were the most frequent in dropout. Conclusions: The age at onset of study, disapproval of the subjects of philosophy, the subjects of biostatistics, study hours per week and strength of motivation score are factors associated with medical student dropout(AU)