Phytochemical Profiling by UHPLC-Q-TOF/MS and Chemopreventive Effect of Aqueous Extract of Moringa oleifera Leaves and Benzyl Isothiocyanate on Murine Mammary Carcinogenesis.

Moringa oleifera Lam, commonly known as moringa, is a plant widely used both as a human food and for medicinal purposes around the world. This research aimed to evaluate the efficacy of the aqueous extract of Moringa oleifera leaves (MoAE) and benzyl isothiocyanate (BIT) in rats with induced breast cancer. Cancer was induced with 7,12-dimethylbenz[a]anthracene (DMBA) at a dose of 60 mg/kg by orogastric gavage once only. Forty-eight rats were randomly assigned to eight groups, each consisting of six individuals. The control group (healthy) was called Group I. Group II received DMBA plus saline. In addition to DMBA, Groups III, IV, and V received MoAE at 100, 250, and 500 mg/kg/day, respectively, while Groups VI, VII, and VIII received BIT at 5, 10, and 20 mg/kg/day, respectively. Treatment was carried out for 13 weeks. Secondary metabolite analysis results identified predominantly quercetin, caffeoylquinic acid, neochlorogenic acid, vitexin, and kaempferol, as well as tropone, betaine, loliolide, and vitexin. The administration of MoAE at a dose of 500 mg/kg and BIT at 20 mg/kg exhibited a notable decrease in both the total tumor count and the cumulative tumor weight, along with a delay in their onset. Furthermore, they improved the histological grade. A significant decrease in serum levels of VEGF and IL-1ß levels was observed (p < 0.001) with a better effect demonstrated with MoAE at 500 mg/kg and BIT at 20 mg/kg. In conclusion, this study suggests that both the aqueous extract of Moringa oleifera leaves and the benzyl isothiocyanate possess antitumor properties against mammary carcinogenesis, and this effect could be due, at least in part, to the flavonoids and isothiocyanates present in the extract.

Antiulcer Effect of Senna multiglandulosa via Increased Secretion of Mucus and Nonprotein Sulfhydryl Groups in an Experimental Murine Model.

Peptic ulcer is a universal condition that is a public health problem due to its prevalence, risk of complications and socioeconomic impact. This study aimed to determine the antiulcer effect of the hydroalcoholic extract from Senna multiglandulosa leaves against ethanol-induced gastric ulcer in rats. Thirty-six male albino Holtzman rats were assigned to six groups. Group I received physiological saline (PS) at doses of 10 mL/kg; group II: ethanol (PS + ethanol 5 mL/kg); group III; omeprazole 100 mg/kg/day (gold standard); groups IV, V and VI received doses of 100, 250 and 500 mg/kg/day of S. multiglandulosa extract, respectively. The stomach was removed to determine the ulcerative lesions and two sections of the glandular zone to carry out the analysis of the gastric mucus and sulfhydryl groups content. As result, S. multiglandulosa at doses of 250 and 500 mg/kg produced a significant decrease of the injured area, with values of 46.28 ± 7.95 mm2 and 6.91 ± 2.48 mm2, respectively (P < 0.001). The protective effect was showed at dose of 500 mg/kg (92.27%) and a significant increase in the production of mucus with a value of 83.13 ± 13.09 mg/mL/g of tissue (61.14%). The production of nonprotein sulfhydryl groups (NP-SG) also increased significantly at the three evaluated doses, being 250.34 ± 21.16 µg/g tissue at dose of 500 mg/kg (119.94%). It is concluded that S. multiglandulosa extract protected against ethanol-induced gastric ulcer due to increased gastric mucus secretion and its antioxidant activity due to the generation of nonprotein sulfhydryl groups.

Phytochemical Constituents and Ameliorative Effect of the Essential Oil from Annona muricata L. Leaves in a Murine Model of Breast Cancer.

Annona muricata leaves are traditionally used as an anticancer plant in the world. The aim of this study was to evaluate the ameliorative effect of the essential oil from Annona muricata leaves (EOAm) in an experimental model of breast cancer and to determine the volatile constituents with gas chromatography-mass spectrometry (GC-MS). Thirty female rats were assigned to five groups: the control group; the DMBA (7,12-dimethylbenz[α]anthracene) group; and three groups received daily EOAm doses of 50, 100, and 200 mg/kg/day, plus DMBA, respectively. After 13 weeks of treatment, tumors were analyzed pathologically and biochemical markers in serum were noted. As a result, in GC-MS analysis, 40 compounds were identified and 4 of them were abundant: Z-caryophyllene (40.22%), followed by α-selinene (9.94%), ß-pinene (8.92%), and ß-elemene (7.48%). Furthermore, EOAm in a dose-dependent form produced a reduction in tumor frequency and the accumulated tumor volume was reduced by 50% and 71% with doses of 100 and 200 mg/kg, respectively. Serum levels of reduced glutathione (GSH) increased and malondialdehyde (MDA) decreased significantly compared to the DMBA group. Serum levels of vascular endothelial growth factor (VEGF) decreased significantly from 70.75 ± 7.15 pg/mL in the DMBA group to 46.50 ± 9.00 and 34.13 ± 11.50 pg/mL in groups treated with doses of 100 and 200 mg/kg, respectively. This study concludes that the EOAm leaves showed an ameliorative effect in a murine model of breast cancer.

Corrigendum to "Potential Toxicity of the Essential Oil from Minthostachys mollis: A Medicinal Plant Commonly Used in the Traditional Andean Medicine in Peru".

[This corrects the article DOI: 10.1155/2019/1987935.].

Carvacrol: An In Silico Approach of a Candidate Drug on HER2, PI3Kα, mTOR, hER-α, PR, and EGFR Receptors in the Breast Cancer.

Carvacrol is a phenol monoterpene found in aromatic plants specially in Lamiaceae family, which has been evaluated in an experimental model of breast cancer. However, any proposed mechanism based on its antitumor effect has not been reported. In our previous study, carvacrol showed a protective effect on 7,12-dimethylbenz[α]anthracene- (DMBA-) induced breast cancer in female rats. The main objective in this research was to evaluate by using in silico study the carvacrol on HER2, PI3Kα, mTOR, hER-α, PR, and EGFR receptors involved in breast cancer progression by docking analysis, molecular dynamic, and drug-likeness evaluation. A multilevel computational study to evaluate the antitumor potential of carvacrol focusing on the main targets involved in the breast cancer was carried out. The in silico study starts with protein-ligand docking of carvacrol followed by ligand pathway calculations, molecular dynamic simulations, and molecular mechanics energies combined with the Poisson-Boltzmann (MM/PBSA) calculation of the free energy of binding for carvacrol. As result, the in silico study led to the identification of carvacrol with strong binding affinity on mTOR receptor. Additionally, in silico drug-likeness index for carvacrol showed a good predicted therapeutic profile of druggability. Our findings suggest that mTOR signaling pathway could be responsible for its preventive effect in the breast cancer.

The Essential Oil of Cymbopogon citratus Stapt and Carvacrol: An Approach of the Antitumor Effect on 7,12-Dimethylbenz-[α]-anthracene (DMBA)-Induced Breast Cancer in Female Rats.

C. citratus essential oil and carvacrol have shown an antitumor effect on breast tumor cell lines; the main objective of this research was to evaluate the antitumor effect of the essential oil of Cymbopogon citratus (EOCc) and carvacrol on 7,12-dimethylbenz [a] anthracene (DMBA)-induced breast cancer in female rats. Cancer was induced by a single administration of DMBA at dose of 80 mg/kg body weight (BW). A total of 54 female Holtzman rats were randomly assigned into 9 groups (n = 6). Group I: PS (Physiological saline); Group II: DMBA; Groups III, IV, and V: DMBA + EOCc at doses of 50, 100 and 200 mg/kg/day BW, respectively; Groups VI, VII, and VIII: DMBA + carvacrol at doses of 50, 100 and 200 mg/kg/day BW, respectively; and group IX: DMBA + EOCc + carvacrol at doses of 100 mg/kg/day BW. The treatment lasted 14 weeks. As results, EOCc showed a reduction in tumors as well as necrosis and mitosis. Animals treated with carvacrol did not show necrosis, mitosis, or infiltration. Carvacrol at dose of 100 mg/kg/day BW revealed a significant decrease in the cumulative tumor volume down to 0.11 ± 0.05 cm3 compared to 0.38 ± 0.04 cm3 of the DMBA group (p < 0.01). It is concluded that EOCc and carvacrol had an antitumor effect on DMBA-induced breast cancer in female rats.

Cordia lutea L. Flowers: A Promising Medicinal Plant as Chemopreventive in Induced Prostate Carcinogenesis in Rats.

The objective of this study was to evaluate the chemopreventive effect of the ethanolic extract of Cordia lutea flowers (EECL) on N-methyl-N-nitrosourea- (MNU), cyproterone-, and testosterone-induced prostate cancer in rats. 40 Holtzman male rats were used and assigned to 5 groups (n = 8). In Group I, rats received normal saline (10 mL/Kg); Group II: rats were induced for prostate cancer with cyproterone, testosterone, and NMU; Groups III, IV, and V: rats received EECL daily, at doses of 50, 250, and 500 mg/kg body weight, respectively. After the period of treatment, animals were sacrificed by an overdose of pentobarbital and blood samples were collected for determination of prostate-specific antigen (PSA). The prostate was dissected and weighed accurately. The ventral lobe of the prostate was processed for histopathology analysis. The somatic prostate index decreased with EECL at dependent dose, from 0.34 ± 0.04 to 0.23 ± 0.05 (P < 0.05). The PSA levels also decreased significantly at doses of 250 and 500 mg/kg. Histopathological analysis showed a decrease in the number of prostatic layers with high-grade prostatic intraepithelial neoplasia (HG-PIN) and low-grade prostatic intraepithelial neoplasia (LG-PIN) at the dose of 500 mg/kg. The ethanolic extract of Cordia lutea flowers had a chemopreventive effect on induced prostate cancer in rats.

Manejo de paciente adulto con mordida abierta anterior por deglución atípica. Reporte de caso / Adult patient treatment with previous open bite by atypical deglution. Case report / Gestão de pacientes adultos com mordida aberta anterior por deglução atípica. Relato de caso

La mordida abierta anterior es una maloclusión en que uno o más dientes no alcanzan el plano oclusal y no se establece contacto con sus antagonistas. Su tratamiento es difícil y existe controversia en la necesidad de un abordaje quirúrgico. El presente caso relata el manejo de un paciente femenino de 61 años de edad, atendido en la clínica del Instituto Mexicano de Ortodoncia, que acudió por "separación de sus dientes". La evaluación clínica y radiográfica presentó una clase I esquelética, biprotrusiva, con overbite de -30% con sonrisa baja y no consonante, deglución atípica como factor etiológico que permitió el diagnóstico de mordida abierta ante-rior. El tratamiento consistió en la colocación de brackets prescripción Roth slot .022 con tubos hasta terceros molares superiores e inferiores, colocando brackets más hacia gingival con respecto al centro de la corona anatómica de ambas arcadas para lograr la extrusión y cierre de la mordida abierta y arco de sonrisa; en cen-trales a 1.5mm, laterales a 1mm y caninos a 0.5mm. Fue fundamental el uso de topes oclusales posteriores y también de elásticos anteriores cortos y ligeros desde el primer día del tratamiento. Se consiguió la corrección de la posición de los dientes en un tiempo de 18 meses, que además se indujo un cambio en el patrón de deglución. Mediante el plan de tratamiento propuesto se demostró que se puede dar estabilidad a la oclusión y que no todo paciente con mordida abierta es candidato a tratamiento quirúrgico para la corrección de esta maloclusión.

The previous open bite is a malocclusion in which one or more teeth do not get the occlusal plane and no con-tact is made with their antagonists. Its treatment is difficult and there is controversy in the need for a surgical approach. The present case relates to the management of a 61-year-old female patient, treated at the clinic of the Mexican Institute of Orthodontics, who came for "separation of her teeth." The clinical and radiographic evaluation presented a skeletal class I, biprotrusive, with overbite of -30% with low and non-consonant smile, atypical swallowing as an etiological factor that allowed the diagnosis of anterior open bite. The treatment con-sisted of the placement of Roth slot .022 prescription brackets with tubes up to upper and lower third molars, placing more gingival braces with respect to the center of the anatomical crown of both arches to achieve extrusion and closure of the open bite and arch of smile; in centrals at 1.5mm, laterals at 1mm and canines at 0.5mm. The use of posterior occlusal bumpers and also of short and light anterior elastics from the first day of treatment was essential. Correction of the position of the teeth was achieved in a period of 18 months, which also induced a change in the swallowing pattern. Through the proposed treatment plan it was shown that oc-clusion stability can be given and that not every patient with an open bite is a candidate for surgical treatment for the correction of this malocclusion.

A mordida aberta anterior é uma má oclusão na qual um ou mais dentes não atingem o plano oclusal e não é feito contato com seus antagonistas. Seu tratamento é difícil e há controvérsia na necessidade de uma abord-agem cirúrgica. O presente caso refere-se ao tratamento de uma paciente de 61 anos de idade, atendida na clínica do Instituto Mexicano de Ortodontia, que veio pela "separação dos seus dentes". A avaliação clínica e radiográfica apresentou classe esquelética biprotrusiva I, com sobremordida de -30% com sorriso baixo e não consoante, deglutição atípica como fator etiológico que permitiu o diagnóstico de mordida aberta anterior. O tratamento consistiu na colocação de suportes de prescrição Roth .022 com tubos até os terceiros molares superiores e inferiores, colocando os suportes mais voltados para a gengiva em relação ao centro da coroa anatômica de ambos os arcos para obter extrusão e fechamento da mordida e arco aberto de sorriso; nas centrais a 1,5 mm, laterais a 1 mm e caninos a 0,5 mm. O uso de topes oclusais posteriores e também de elásticos anteriores curtos e leves desde o primeiro dia de tratamento foi essencial. A correção da posição dos dentes foi realizada em um período de 18 meses, o que também induziu uma alteração no padrão da deglutição. Através do plano de tratamento proposto, demonstrou-se que a estabilidade da oclusão pode ser dada e que nem todo paciente com mordida aberta é candidato ao tratamento cirúrgico para correção dessa má oclusão.

Potential Toxicity of the Essential Oil from Minthostachys mollis: A Medicinal Plant Commonly Used in the Traditional Andean Medicine in Peru.

Medicinal plants are used throughout the world and the World Health Organization supports its use by recommending quality, safety and efficacy. Minthostachys mollis is distributed in the Andes of South America and is used by the population for various diseases. While studies have shown their pharmacological properties, the information about their safety is very limited. Then, the goal of this research was to determine the acute oral toxicity and in repeated doses during 28 days of Minthostachys mollis essential oil (Mm-EO) in rats. For the acute toxicity test two groups of rats, of three animals each, were used. Each group received Mm-EO in a single dose of 2000 or 300 mg/kg of body weight. For the repeated dose toxicity test, four groups of 10 rats each were used. Doses of 100, 250 and 500 mg/kg/day were used, one group was control. With the single dose of Mm-EO of 2000 mg/kg of body weight, the three rats in the group showed immediate signs of toxicity and died between 36 and 72 hours. In the lung, inflammatory infiltrate was observed, predominantly lymphocytic with severe hemorrhage and presence of macrophages with hemosiderin. In the repeated dose study, male rats (5/5) and female rats (2/5) died at the dose of 500 mg/kg/day. The body weight of both male and female rats decreased significantly with doses of 250 and 500 mg/kg/day. The serum levels of AST and ALT increased significantly and the histopathological study revealed chronic and acute inflammatory infiltrate in the lung; while in the liver was observed in 80% of the cases (24/30) mild chronic inflammatory infiltrate and in some of those cases there was vascular congestion and in one case cytoplasmic vacuolization. The Mm-EO presented moderate acute oral toxicity, while with repeated doses for 28 days; there was evidence of toxicity, in a dose-dependent manner, mainly at the hepatic level.

Aceite esencial de Thymus vulgaris L (tomillo), su combinación con EDTA contra Cándida albicans y formulación de una crema / Thymus vulgaris L (thyme) essential oil and its combination with EDTA against Candida albicans; formulation of a cream

El patógeno Cándida albicans puede causar infecciones invasivas graves y frecuentes lesiones superficiales. Los fármacos usados en el tratamiento presentan inconvenientes y es necesario buscar alternativas. Objetivos. Determinar la actividad del aceite esencial (AE) de Thymus vulgaris y de su combinación con EDTA sobre Cándida albicans, y formular una crema con el AE suplementado con derivados terpénicos naturales. Diseño. Estudio experimental in vitro y toxicidad in vivo. Lugar. Facultad de Medicina y Facultad de Farmacia y Bioquímica, Universidad Nacional Mayor de San Marcos, Lima, Perú. Material biológico. Cepa de Cándida albicans para las pruebas in vitro y conejos para la toxicidad dérmica. Métodos. La actividad antifúngica se determinó por el método de difusión en pozo de agar; la concentración inhibitoria mínima (CIM), por el método de microdilución en caldo. La crema se formuló con el AE al 1 por ciento y otra suplementada con carvacrol, timol, citral y EDTA. La toxicidad dérmica se determinó en conejos. Principales medidas de resultados. Halos de inhibición, CIM, signos de toxicidad. Resultados. El AE a 100 mg/mL inhibió el crecimiento de Cándida albicans con halos de inhibición de 30,33 ± 0,58 mm, mientras que la adición de EDTA produjo halos de 35,33 ± 0,58 mm. La CIM para el AE y AE + EDTA fue de 8 mg/mL y 0,5 mg/mL, respectivamente. La crema con AE 1 por ciento produjo halos de inhibición de 13,33 ± 0,58 mm, mientras que la adición de EDTA, timol, carvacrol y citral aumentó el halo hasta 24,33 ± 0,58 mm. No se evidenció signos de toxicidad dérmica en conejos. Conclusiones. El AE de Thymus vulgaris presentó actividad inhibitoria sobre Cándida albicans y el EDTA incrementó dicha actividad; asimismo, el aceite esencial, EDTA, carvacrol, timol y citral formulados en una crema mostraron efecto sinérgico y sin signos de toxicidad dérmica...

Candida albicans may cause severe invasive infections and frequently superficial lesions. Drugs used in treatment present drawbacks and search of alternatives becomes necessary. Objectives: To determine the activity of Thymus vulgaris essential oil (EO) alone and combined with EDTA on Candida albicans, and formulate a cream with EO supplemented with natural terpenes. Design: In vitro experimental and in vivo toxicity study. Setting: Faculty of Medicine and Faculty of Pharmacy, Universidad Nacional Mayor de San Marcos, Lima, Peru. Biological material:Candida albicans strain for in vitro study and rabbits for dermal toxicity tests. Methods:Antifungal activity was determined by agar well diffusion method, and minimum inhibitory concentration (MIC) by broth microdilution method. A cream was formulated with EO 1 per cent and another supplemented with carvacrol, thymol, citral and EDTA. Dermal toxicity in rabbits was determined. Main outcome measures: Inhibition halos, MIC, signs of toxicity. Results: EO at 100 mg/mL inhibited Candida albicans growth with 30.33 ± 0.58 mm inhibition halos; adding EDTA produced 35.33 ± 0.58 mm halos. MIC for EO and EO + EDTA was respectively 8 mg/mL and 0.5 mg/mL. EO 1 per cent cream originated 13.33 ± 0.58 mm inhibition halos, and addition of EDTA, thymol, carvacrol and citral increased halos to 24.33 ± 0.58 mm. No signs of dermal toxicity in rabbits were observed. Conclusions:Thymus vulgaris EO showed inhibitory activity against Candida albicans and EDTA increased this activity; essential oil, EDTA, carvacrol, thymol and citral formulated in cream also showed synergistic effect without evidence of dermal toxicity...

Evaluación de la toxicidad del aceite esencial de Aloysia triphylla Britton (cedrón) y de la actividad anti-Trypanosoma cruzi del citral, in vivo / In vivo evaluation of Aloysia triphylla britton (lemon verbena) essential oil toxicity and citral anti-Trypanosma cruzi activity

Existe escasa investigación en enfermedades olvidadas. Las plantas medicinales son una potencial fuente de compuestos antimicrobianos. Objetivos: Determinar la toxicidad del aceite esencial de Aloysia triphylla y la actividad del citral contra Trypanosoma cruzi en ratones. Diseño: Estudio experimental preclínico in vivo. Institución: Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú. Material: Ratones albinos. Intervenciones: La toxicidad aguda oral a dosis única fue evaluada en ratas albinas. Para la actividad tripanocida se utilizaron ratones asignados a los siguientes grupos: infectados y no tratados (G1), infectados y tratados con citral en dosis de 50, 150 y 300 mg/kg/día (G2, G3 y G4, respectivamente), infectados y tratados con benznidazol 100 mg/kg (G5) y no infectados y no tratados (G6). La parasitemia fue determinada individualmente cada 2 días por microscopia directa. En los días 14, 21 y 28 post infección, cinco ratones de cada grupo fueron sacrificados y los corazones procesados para análisis histopatológico. Principales medidas de resultados: Signos de toxicidad y mortalidad, y parasitemia. Resultados: La dosis límite de 2 000 mg/kg no provocó signos ni síntomas de toxicidad y los estudios anatomopatológicos macroscópicos y microscópicos no mostraron alteración de los órganos estudiados. La parasitemia fue reducida significativamente con la dosis de 300 mg/kg en los días 16, 18, y 20 post infección (p<0,05). El número de nidos de amastigotes y de infiltrados inflamatorios en corazón fueron reducidos en 67,7 por ciento y 51,7 por ciento, respectivamente, con 300 mg/kg en el día 28. Conclusiones: El aceite esencial de Aloysia triphylla es calificado como no tóxico y el citral en dosis de 300 mg/kg tuvo actividad contra Trypanosoma cruzi en ratones...

There is limited research on neglected diseases. Medicinal plants are potential sources of antimicrobial compounds. Objectives: To determine the toxicity of Aloysia triphylla essential oil and citral activity against Trypanosoma cruzi in mice. Design: Experimental study in vivo, preclinical. Setting: Faculty of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru. Biological material: Albino mice. Main outcome measures: Signs of toxicity and mortality and parasitemia. Interventions: Acute oral toxicity at single dose was evaluated in albino rats. For trypanocidal activity mice were assigned to the following groups: untreated infected (G1), infected and treated with citral at doses 50, 150 and 300 mg/kg/day (G2, G3 and G4 respectively), infected and treated with benznidazole 100 mg/kg (G5), and uninfected and untreated (G6). Parasitemia was determined individually every 2 days by direct microscopy. In days 14, 21 and 28 post infection five mice from each group were sacrificed and their hearts processed for histopathology. Results: The limit dose of 2 000 mg/kg did not cause signs or symptoms of toxicity and macro and microscopic anatomopathology did not show alterations in the organs studied. Parasitemia was significantly reduced at dose of 300 mg/kg at days 16, 18, and 20 post infection (p<0.05); the number of amastigote nests and inflammatory infiltrates in heart were reduced on day 28 by 67.7 per cent and 51.7 per cent respectively with 300 mg/kg. Conclusions: Aloysia triphylla essential oil is qualified as nontoxic and citral at 300 mg/kg dose had activity against Trypanosoma cruzi in mice...

La eficiencia del índice de PSA libre en el diagnóstico de cáncer de próstata / The efficiency of free PSA index in the diagnosis of prostate cancer

Determinar la eficiencia de la prueba de índice de PSA libre en la práctica clínica hospitalaria. Diseño: Estudio retrospectivo de evaluación de la prueba de índice de PSA libre. Lugar: Hospital Nacional Edgardo Rebagliati Martins. Participantes: 371 casos de pacientes sometidos a biopsia prostática, 104 casos de cáncer de Próstata y 267 casos de Hiperplasia Benigna de Próstata. Intervenciones: Recolección de datos mediante la revisión de registros médicos hospitalarios y revisión de estudios anatomopatológicos. Principales medidas de resultados: Sensibilidad, especificidad, valor predictivo positivo, valor predictivo negativo, curva ROC (Receiver Operating Characteristic) y el área bajo la curva ROC (ABC). Resultados: El índice de PSA libre con un punto de corte de 0,20 demostró una sensibilidad de 0,85, especificidad de 0,51, valor predictivo positivo de 0,41, Valor Predictivo Negativo 0,90. El Area bajo la curva ROC fue de 0,78. Conclusiones: El incremento de la especificidad del PSA total es insuficiente para que la prueba sea considerada como optima para discriminar a los pacientes tributarios de biopsia de próstata y evitar las biopsias innecesarias. Sería recomendable elevar el punto de corte para aumentar la sensibilidad de la prueba a 95 por ciento a fin de evitar la pérdida de casos detectados de cáncer de próstata...

To determine the effectiveness of the PSA test free index in Clinical Practice. Design: Retrospective evaluation of the test free PSA index. Location: Hospital National Edgardo Rebagliati Martins Participants: 371 cases of patients undergoing prostate biopsy, 104 cases of prostate cancer and 267 cases of benign prostatic hyperplasia. Interventions: Data collection through review of hospital medical records and review of pathological diagnosis. Main outcome measures: Sensitivity, specificity, positive predictive value, negative predictive value, ROC curve (Receiver Operating Characteristic) and the area under the ROC curve (AUC). Results: The index of free PSA with a cutoff of 0.20 showed a sensitivity of 0.85, specificity of 0.51, positive predictive value of 0.41, negative predictive value of 0.90. The area under the ROC curve was 0.78. Conclusions: The increased specificity of total PSA is insufficient for the test is considered optimal to discriminate against patients for prostate biopsy and avoid unnecessary biopsies. It would be advisable to raise the set point to increase the sensitivity of the test to 95 per cent in order to avoid loss of detected cases of prostate cancer...