Publicaciones científicas de los directivos de investigación de las escuelas de medicina del Perú / Scientific publications by research directors of medical schools in Peru

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High free triiodothyronine and free-triiodothyronine-to-free-thyroxine ratio levels are associated with metabolic syndrome in a euthyroid population.

AIMS: To determine the association between free triiodothyronine (FT3), free thyroxine (FT4) and free-triiodothyronine-to-free-thyroxine ratio (FT3/FT4) levels and Metabolic Syndrome (MetS). MATERIALS AND METHODS: We carried out an analytical cross-sectional study in euthyroid adults of both sexes, who attended the outpatient service of a private clinic in Lima-Peru during the 2014-2016 period. Participants were divided into tertiles (low, intermediate and high) according to their FT3, FT4, and FT3/FT4 ratio values. MetS was defined when three or more metabolic criteria were met by the participants. ROC curves were constructed, and Youden's Index were used to identify the optimal cut-points of each thyroid marker. We elaborated crude/adjusted Poisson regression models to evaluate the association between the thyroid markers and the presence of MetS. The reported association measure was the prevalence ratio (PR) with their respective 95% confidence intervals (95% CI). RESULTS: We analyzed 245 participants, the average age was 38.5 ±â€¯10.3 years, 29.8% were males, and the prevalence of MetS was 31%. In the adjusted Poisson regression models, the prevalence of MetS was higher among the high FT3 tertile compared to the low tertile (aPR = 2.01; 95% CI: 1.22-3.34). The prevalence of MetS was higher among the intermediate FT3/FT4 ratio tertile and the high FT3/FT4 ratio tertile compared to the low tertile, (aPR = 1.78; 95% CI: 1.02-3.10) and (aPR = 2.80; 95% CI: 1.67-4.72); respectively. The highest areas under the curve (AUC) were found for FT3 and FT3/FT4 ratio with areas of 0.654 (95% CI: 0.58-0.73) and 0.649 (95% CI: 0.57-0.72); respectively. CONCLUSION: Elevated levels of FT3 and FT3/FT4 ratio were associated with MetS in a euthyroid population.

Fragilidad y vulnerabilidad como predictores de radiotoxicidad en adultos mayores: un estudio longitudinal en Perú / Frailty and vulnerability as predictors of radiotoxicity in older adults: A longitudinal study in Peru

Fundamento y objetivo: Evaluar la asociación entre fragilidad/vulnerabilidad y el desarrollo de radiotoxicidad en adultos mayores en un hospital de Perú. Material y métodos: Cohorte que incluyó pacientes con diagnóstico de cáncer e indicación de radioterapia que acudieron al servicio ambulatorio de Geriatría del Centro Médico Naval (Lima, Perú) entre 2013 y 2015. Antes de recibir radioterapia se evaluó la fragilidad usando el fenotipo de Fried, y se evaluó la vulnerabilidad usando las escalas VES-13 y G-8. Durante la radioterapia, se determinó el desarrollo de radiotoxicidad. Se elaboraron curvas ROC y modelos de regresión de Cox crudos y ajustados para evaluar la asociación entre las escalas de fragilidad/vulnerabilidad y el desarrollo de radiotoxicidad. Resultados: De un total de 181 pacientes (edad media: 78,1 años, todos del sexo masculino), 33 (18,2%) presentaron algún tipo de radiotoxicidad. La aparición de radiotoxicidad fue mayor en los pacientes con fragilidad o vulnerabilidad en comparación con aquellos sin estas condiciones, según los puntos de corte usuales del fenotipo de Fried (10,9% versus 41,9%), del VES-13 (5,0% versus 63,4%) y del G-8 (5,6% versus 67,6%). El área bajo la curva fue 0,61 (0,55-0,65) para el fenotipo de Fried, 0,79 (0,69-0,86) para el VES-13, y 0,86 (0,58-0,89) para el G-8. Conclusiones: Se encontró una asociación entre fragilidad/vulnerabilidad y el desarrollo de radiotoxicidad. El G-8 y el VES-13 tuvieron mayor área bajo la curva que el fenotipo de Fried, lo que sugiere que podrían ser herramientas útiles al momento de decidir la dosis de radioterapia en pacientes geriátricos (AU)

Background and objective: To assess the association between frailty/vulnerability and the development of radiotoxicity in older adults at a hospital in Peru. Material and methods: Cohort study that included patients with cancer with medical recommendation of radiotherapy, who attended the outpatient department of geriatrics at Naval Medical Center (Lima, Peru) between 2013 and 2015. Before receiving radiation therapy sessions, we measured frailty using Fried phenotype, and vulnerability using VES-13 and G-8 scales. During radiotherapy, we determined the development of radiotoxicity. ROC curves and crude/adjusted Cox regression models were prepared to evaluate the association between the frailty/vulnerability scales and the development of radiotoxicity respectively. Results: From a total of 181 patients (mean age: 78.1 years, all males), 33 (18.2%) developed some type of radiotoxicity. The appearance of radiotoxicity was higher in patients with frailty or vulnerability compared with those without these conditions, according to the usual cutoff points of Fried phenotype (10.9% versus 41.9%), VES-13 (5.0% versus 63.4%) and G-8 (5.6% versus 67.6%). The area under the curve was 0.61 (0.55-0.65) for the Fried phenotype, 0.79 (0.69-0.86) for the VES-13, and 0.86 (0.58-0.89) for the G-8. Conclusions: We found an association between frailty/vulnerability and the development of radiotoxicity. The G-8 and the VES-13 scales had a better area under the curve than Fried phenotype, suggesting that those could be useful tools when deciding the dose of radiotherapy in geriatric patients (AU)

High serum ferritin levels are associated with insulin resistance but not with impaired glucose tolerance in a healthy people population.

AIM: To assess the association between elevated serum ferritin levels and the presence of insulin resistance (IR) or impaired glucose tolerance (IGT) in a population of individuals with no endocrine or metabolic disorders background. METHODS: Analytical cross-sectional study, carried out in adults of both sexes with no medical history of type 2 diabetes mellitus (T2DM) or other metabolic or endocrine disorder, who attended the outpatient service of a private clinic in Lima-Peru during 2012-2014 period. Impaired serum ferritin levels were defined as serum ferritin values >300µg/L in men and >200µg/L in women. IR was defined as a Homeostasis Model Assessment (HOMA-IR) value ≥3.8 and IGT was defined as an oral glucose tolerance test (OGTT) value between 126mg/dL and 199mg/dL. The reported association measure was the prevalence ratio (PR) with their respective 95% confidence intervals (95% CI). RESULTS: We analyzed 213 participants, the average age was 35.8±11.1years and 35.7% were males. The prevalence of impaired serum ferritin levels, IR and IGT in the population was 12.7%, 33.3% and 9.9% respectively. In the adjusted Poisson regression models, the prevalence of IR was higher among the group with impaired serum ferritin levels (PR=1.74; 95%CI:1.18-2.56); however, we found no association between impaired serum ferritin levels and IGT (PR=1.42; 95%CI:0.47-4.30). CONCLUSIONS: Impaired levels of serum ferritin are associated with IR, nevertheless, not with IGT in a metabolically healthy population. Serum ferritin could be considered as an early marker of IR prior to the onset of glycaemia disorders.

Frailty and vulnerability as predictors of radiotoxicity in older adults: A longitudinal study in Peru. / Fragilidad y vulnerabilidad como predictores de radiotoxicidad en adultos mayores: un estudio longitudinal en Perú.

BACKGROUND AND OBJECTIVE: To assess the association between frailty/vulnerability and the development of radiotoxicity in older adults at a hospital in Peru. MATERIAL AND METHODS: Cohort study that included patients with cancer with medical recommendation of radiotherapy, who attended the outpatient department of geriatrics at Naval Medical Center (Lima, Peru) between 2013 and 2015. Before receiving radiation therapy sessions, we measured frailty using Fried phenotype, and vulnerability using VES-13 and G-8 scales. During radiotherapy, we determined the development of radiotoxicity. ROC curves and crude/adjusted Cox regression models were prepared to evaluate the association between the frailty/vulnerability scales and the development of radiotoxicity respectively. RESULTS: From a total of 181 patients (mean age: 78.1 years, all males), 33 (18.2%) developed some type of radiotoxicity. The appearance of radiotoxicity was higher in patients with frailty or vulnerability compared with those without these conditions, according to the usual cutoff points of Fried phenotype (10.9% versus 41.9%), VES-13 (5.0% versus 63.4%) and G-8 (5.6% versus 67.6%). The area under the curve was 0.61 (0.55-0.65) for the Fried phenotype, 0.79 (0.69-0.86) for the VES-13, and 0.86 (0.58-0.89) for the G-8. CONCLUSIONS: We found an association between frailty/vulnerability and the development of radiotoxicity. The G-8 and the VES-13 scales had a better area under the curve than Fried phenotype, suggesting that those could be useful tools when deciding the dose of radiotherapy in geriatric patients.

Consumo de plantas medicinales en usuarios del 'Centro Integral del Adulto Mayor' de la Punta-Callao (Perú) / Consumo de plantas medicinais pelos utentes do 'Centro Integral del Adulto Mayor' de La Punta-Callao (Perú) / Medicinal plant consumption by users of 'Centro Integral del Adulto Mayor' of La Punta-Callao (Peru)

El uso de plantas medicinales ha aumentado durante los últimos años, siendo la población de adultos mayores un importante sector que ha incrementado su consumo. Nuestro objetivo fue conocer el consumo de plantas medicinales en una población de adultos mayores del distrito de la Punta-Callao (Perú). Se realizó una encuesta ad—hoc, semiestructurada y validada en 70 individuos voluntarios. Los resultados reflejan que el 92,9% de los encuestados consumió plantas medicinales. Fueron reportados 50 tipos de plantas medicinales, entre ellos: anís verde (16,6%), manzanilla (16,3%), maíz morado (15%), sábila (6,1%), maca (5,6%), llantén (5%), menta (3,6%), eucalipto (3,6%), linaza (2,8%) y yacón (2,2%). Se obtuvieron datos en relación a la forma de consumo, lugar de compra, frecuencia de uso durante la semana y motivo de uso por cada planta medicinal reportada. Además se observé que un 32,9% de los adultos mayores consume más de 3 fármacos y un 35,9 tiene múltiples patologías (AU)

O consumo de plantas medicinais aumentou durante os últimos anos, sendo a populaçáo idosa um dos sectores em que tal aumento é visível. O objectivo deste trabalho foi o de caracterizar o consumo de plantas medicinais numa populaçáo de idosos do distrito de Punta-Callao (Perú). Realizou-se um inquérito ad hoc, semi-estruturado e validado em 70 individuos voluntários. Os resultados mostram que 92,9% dos entrevistados utilizaram plantas medicinais. Foram identificados 50 tipos de plantas medicinais: anis (16,6%), camomila (16,3%), milho púrpura (15%), aloe (6,1%), maca (5,6%), tanchagem (5%), hortelá-pimenta (3,6%), eucalipto (3,6%), linhaga (2,8%) e yacón (2,2%). Também se obtiveram dados relativos a forma de consumo, lugar de compra, frequóncia de uso durante a semana e motivo de uso por cada planta medicinal relatada. De salientar, ainda, que 32,9% dos idosos consomem mais de 3 fármacos e 35,9 tem múltiplas patologías (AU)

The consumption of medicinal herbs have increase during the last years, being the elderly population an important group who have also increase the consumption. The objective was known the consumption of medicinal herbs of an elderly population from the Punta district, Callao (Peru). An ad-hoc, semi-structured and validated survey was conducted in 70 elderly volunteers. The results reflect that 92.9% of the sample consumed medicinal plants. Fifty types of medicinal plants were reported as: aniseed (16.6%), chamomile (16.3%), purple maize (15%), aloe (61%), maca (56%), llanten (5%), peppermint (36%), eucalyptus (36%), linseed (28%) and yacon (22%). We obtained data on the form of consumption, place of purchase, frequency of use per week and reason for use, for each medicinal herb reported. In addition, 32.9% of the elderly consume more than 3 drugs and 35.9 have multiple pathologies (AU)