[Neurotoxic effect of aqueous extract of boldo (Peumus boldus) in an animal model]. / Efecto neurotóxico del extracto acuoso de boldo (Peumus boldus) en un modelo animal.

OBJECTIVES: To assess the neurotoxic effect of the aqueous extract of boldo (Peumus boldus) in an experimental model. MATERIALS AND METHODS: 20 male Holtzman rats of 250 ± 15 g were randomized into four groups: the negative control received saline solution (SS) orally (PO), the positive control received 6-hydroxydopamine intracranially (IC) and SS by PO. Experimental group 1 received aqueous extract of boldo (AEB) by PO, and experimental group 2 received 6-hydroxydopamine intracranially and AEB by PO. The experiment lasted 21 days. A neurological assessment was performed which had three components: a) clinical, evaluated with the rotarod test, b) biochemical, by measuring serum levels of uric acid, and c) histopathology, by immunohistochemistry for substantia nigra dopaminergic neurons. The Kruskal Wallis test and the Dunn test were used to assess differences between groups. RESULTS: A significant decrease was found in the latency time of the rotarod test between the negative and positive control group (p<0.01), negative control and experimental 1 (p=0.09), negative control and experimental 2 (p<0.01), positive control and experimental 1 (p=0.04), and experimental 1 and 2 (p=0.09). There was no significant intergroup difference in the identification of uric acid. There was a depletion of the total dopaminergic neurons in the neuronal count, without intergroup difference. CONCLUSIONS: A neurotoxic effect of aqueous extract of boldo was recognized at a clinical level in Holtzman male rats.

Factores asociados a la calificación del Examen Nacional de Medicina 2012 en internos de la UNMSM / National Medical Examination 2012 rating-associated factors in UNMSM interns

Introducción: El Examen Nacional de Medicina (ENAM) es una herramienta que mide los conocimientos y el raciocinio clínico del interno como una forma de aproximarse a evaluar la calidad educativa. Objetivo: Determinar los factores asociados a la calificación del ENAM 2012 en internos de la Universidad Nacional Mayor de San Marcos (UNMSM). Diseño: Estudio transversal. Lugar: Facultad de Medicina Humana de la UNMSM, Lima, Perú. Participantes: Internos de Medicina Humana 2012. Intervenciones: Se analizó fuentes secundarias con el método de regresión logística binaria. Se determinó los coeficientes de correlación de Pearson y Spearman, así como la prueba t student. Principales medidas de resultados: Promedios de las calificaciones del ENAM, pertenencia a la promoción ingresante, sede hospitalaria de internado, orden de mérito según promedio ponderado universitario (PPU). Resultados: Los factores asociados a un mejor puntaje en el ENAM fueron pertenecer a la promoción ingresante 2006, realizar internado en EsSalud y ubicarse en el tercio superior y medio. Conclusiones: La pertenencia a la promoción ingresante 2006, la sede hospitalaria de internado y el orden de mérito según el PPU fueron factores asociados a obtener una calificación mayor o igual a trece en el ENAM 2012.

Introduction: The National Medical Examination is a tool that measures knowledge and clinical reasoning as an approach to assess educational quality. Objective: To determine factors associated with qualification of the National Medical Examination (ENAM) 2012 at Universidad Nacional Mayor de San Marcos (UNMSM). Design: Cross-sectional study. Setting: Faculty of Human Medicine, UNMSM, Lima, Peru. Participants: Medical Interns 2012. Interventions: Analysis of secondary sources using the binary logistic regression method. Pearson and Spearman correlation coefficients and Student t test were applied. Main outcome measures: ENAMÆs average scores, belonging to the 2006 class, internship hospital, and merit rank according to weighted university average (PPU). Results: Belonging to the 2006 incoming class, doing internship at EsSalud, and be placed in the academic upper and middle third were factors associated with better score at the national exam of medicine. Conclusions: Belonging to the 2006 class, hospital of internship, and merit rank were factors associated to a score of thirteen or more at the national exam of medicine 2012.

Efecto neurotóxico del extracto acuoso de boldo (Peumus boldus) en un modelo animal / Neurotoxic effect of aqueous extract of boldo (Peumus boldus) in an animal model

Objetivos : Evaluar el efecto neurotóxico del extracto acuoso de boldo (Peumus boldus) en un modelo experimental. Materiales y métodos. Se diseñó un experimento, que incluyó 20 ratas macho Holtzman de 250 ± 15 gr, distribuidas aleatoriamente en cuatro grupos: el control negativo recibió solución salina (SS) por vía oral (VO), el control positivo que recibió 6-hidroxidopamina por vía intracraneal (VIC) y SS por VO, el grupo experimental 1 recibió extracto acuoso de boldo (EAB) por VO y el grupo experimental 2 recibió 6-hidroxidopamina por VIC y EAB por VO, en todos los casos durante 21 días. Se realizó una evaluación neurológica, la cual tuvo tres componentes: a) clínico, evaluado con el test de rotarod, b) bioquímico, mediante la determinación de niveles séricos de ácido úrico, y c) histopatológico, por inmunohistoquímica para neuronas dopaminérgicas de sustancia negra. Se empleó la prueba de Kruskal Wallis y el test de Dunn para evaluar las diferencias entre los grupos. Resultados. Se encontró disminución significativa en el tiempo de latencia del test de rotarod entre los grupos control negativo y control positivo (p<0,01), control negativo y experimental 1 (p=0,09), control negativo y experimental 2 (p<0,01), control positivo y experimental 1 (p=0,04), y experimental 1 y 2 (p=0,09). En la determinación de ácido úrico no hubo diferencia significativa intergrupal. En el conteo neuronal hubo depleción de neuronas dopaminérgicas totales, pero sin diferencia intergrupal. Conclusiones. Se evidencio un efecto neurotóxico del extracto acuoso de boldo en ratas macho de la cepa Holtzman a nivel clínico.

Objectives. To assess the neurotoxic effect of the aqueous extract of boldo (Peumus boldus) in an experimental model. Materials and methods. 20 male Holtzman rats of 250 ± 15 g were randomized into four groups: the negative control received saline solution (SS) orally (PO), the positive control received 6-hydroxydopamine intracranially (IC) and SS by PO. Experimental group 1 received aqueous extract of boldo (AEB) by PO, and experimental group 2 received 6-hydroxydopamine intracranially and AEB by PO. The experiment lasted 21 days. A neurological assessment was performed which had three components: a) clinical, evaluated with the rotarod test, b) biochemical, by measuring serum levels of uric acid, and c) histopathology, by immunohistochemistry for substantia nigra dopaminergic neurons. The Kruskal Wallis test and the Dunn test were used to assess differences between groups. Results. A significant decrease was found in the latency time of the rotarod test between the negative and positive control group (p<0.01), negative control and experimental 1 (p=0.09), negative control and experimental 2 (p<0.01), positive control and experimental 1 (p=0.04), and experimental 1 and 2 (p=0.09). There was no significant intergroup difference in the identification of uric acid. There was a depletion of the total dopaminergic neurons in the neuronal count, without intergroup difference. Conclusions. A neurotoxic effect of aqueous extract of boldo was recognized at a clinical level in Holtzman male rats.

Adherencia terapéutica en pacientes con tratamiento antihipertensivo en el Hospital de Emergencias Grau, 2012 / Therapeutic adherence in patients with antihypertensive treatment at the Hospital Emergency Grau, 2012

La hipertensión arterial (HTA) es una de las enfermedades de mayor incidencia a nivel mundial que produce importante mortalidad y discapacidad, principalmente en el desarrollo de enfermedad cardiovascular y cerebro-vascular consecuencia de un inadecuado control de la presión arterial. La razón principal de estos pobres resultados seria la falta de adherencia al tratamiento. Objetivo: Determinar el nivel de adherencia terapéutica en pacientes con tratamiento antihipertensivo en el Hospital de Emergencias Grau durante el 2012. Material y Métodos: Se realizó un estudio observacional, descriptivo, prospectivo, transversal en el que se entrevistó a pacientes atendidos en consultorios externos de cardiología y medicina interna del Hospital de Emergencias Grau utilizando el Test de Morisky-Green para determinar su adherencia al tratamiento farmacológico y se determinó el nivel de presión arterial. Resultados: 64,1 por ciento eran del sexo masculino; 77,7 por ciento tenían 60 años o más. El 44,7 por ciento tenían educación secundaria; 58,3 por ciento eran casados; 41,7 por ciento tenían su presión arterial controlada. La adherencia al tratamiento farmacológico fue 47,6 por ciento. Se halló asociación entre adherencia y presión arterial controlada (p<0,05). Conclusión: la adherencia al tratamiento farmacológico fue baja y la principal causa de incumplimiento de la medicación antihipertensiva fue el olvido de la toma del medicamento.

Hypertension is one of the diseases with the highest incidence in the world that produces significant mortality and disability, especially in the development of cardiovascular disease and cerebrovascular result of inadequate blood pressure control. The main reason for these poor results would be the lack of adherence to treatment. Objective: Determine the level of adherence in patients with antihypertensive treatment in the Emergency Hospital Grau in 2012. Material and Methods: An observational, descriptive, prospective, cross-sectional study was performed in patients attending to the outpatient clinic of the Hospital Emergency Grau using the Morisky-Green Test to determine their adherence to drug treatment and determine the blood pressure control. Results: 64.1 per cent were men, 77.7 per cent had 60 years or more. 44.7 per cent had secondary education level, 58.3 per cent were married and 41.7 per cent had their blood pressure under control. Adherence to drug treatment was 47.6 per cent. Association between adherence and blood pressure control (p<0.05) were found. Conclusion: Adherence to drug therapy was low and the main cause of failure of antihypertensive medication was the forgetting to take medication.