RESUMEN

OBJECTIVE: to evaluate the relationship between 25(OH)D3 levels and fatal outcome in patients over 60 years of age undergoing surgical repair of hip fractures. METHODS: prospective cohort of patients undergoing surgical repair of hip fractures. At admission, 25(OH)D3 levels were measured, among other parameters. Patients were followed for at least 1 year, and incident mortality was recorded. RESULTS: 209 patients were included in the study, with a mean age of 79.5 ± 7.6 years among survivors and 80.7 ± 8.2 years among those who died in the first postoperative year (p=0.346). The 25(OH)D3 levels of survivors were significantly higher than those of patients who died (p=0.003). After adjusting for confounding variables, 25(OH)D3 levels below 12.5ng/mL were significant risk factors regardless of mortality (adjusted OR: 7.6; 95% CI: 2.35 to 24.56). CONCLUSIONS: our data show that serum 25(OH)D3 levels below 12.5ng/mL significantly and independently increased the risk of mortality in the first year after surgical repair of low-energy hip fracture in patients over 60 years of age in the geographic region where this study was conducted. Low albumin also showed a significant association with mortality in these patients. All other factors had no significant associations.

Asunto(s)

RESUMEN

ABSTRACT Objective: to evaluate the relationship between 25(OH)D3 levels and fatal outcome in patients over 60 years of age undergoing surgical repair of hip fractures. Methods: prospective cohort of patients undergoing surgical repair of hip fractures. At admission, 25(OH)D3 levels were measured, among other parameters. Patients were followed for at least 1 year, and incident mortality was recorded. Results: 209 patients were included in the study, with a mean age of 79.5 ± 7.6 years among survivors and 80.7 ± 8.2 years among those who died in the first postoperative year (p=0.346). The 25(OH)D3 levels of survivors were significantly higher than those of patients who died (p=0.003). After adjusting for confounding variables, 25(OH)D3 levels below 12.5ng/mL were significant risk factors regardless of mortality (adjusted OR: 7.6; 95% CI: 2.35 to 24.56). Conclusions: our data show that serum 25(OH)D3 levels below 12.5ng/mL significantly and independently increased the risk of mortality in the first year after surgical repair of low-energy hip fracture in patients over 60 years of age in the geographic region where this study was conducted. Low albumin also showed a significant association with mortality in these patients. All other factors had no significant associations.

RESUMO Objetivo: avaliar a relação entre os níveis de 25(OH)D3 e o desfecho fatal em pacientes acima de 60 anos submetidos a correção cirúrgica de fratura de quadril. Métodos: coorte prospectiva de pacientes submetidos a correção cirúrgica de fraturas de quadril. À admissão, foram medidos os níveis de 25(OH)D3, entre outros parâmetros. Os pacientes foram acompanhados por, pelo menos, um ano e a mortalidade foi registrada. Resultados: foram incluídos 209 pacientes no estudo, com média de idade de 79,5 ± 7,6 anos entre os sobreviventes e 80,7 ± 8,2 anos entre os que morreram no primeiro ano de pós-operatório (p=0,346). Os níveis de 25(OH)D3 dos sobreviventes foram significativamente maiores do que os dos pacientes que morreram (p=0,003). Após o ajuste para variáveis de confusão, níveis de 25(OH)D3 abaixo de 12,5ng/mL foram fator de risco significativo, independentemente da mortalidade (OR ajustado 7,6; IC 95% 2,35 24,56). Conclusões: níveis séricos de 25(OH)D3 abaixo de 12,5ng/mL aumentaram significativa e independentemente o risco de morte no primeiro ano após o reparo cirúrgico de fratura de quadril de baixa energia em pacientes com mais de 60 anos de idade na região geográfica onde este estudo foi realizado. A albumina baixa também teve associação significativa com a mortalidade nesses pacientes. Todos os outros fatores não tiveram associações significativas.

Asunto(s)

RESUMEN

OBJECTIVE: To analyze the mortality rate at one-year follow-up of patients with hip fracture who underwent surgery at the university hospital of this institution. METHOD: The authors reviewed 213 medical records of hospitalized patients aged 65 years or older, following to the order they were admitted to the orthopedics and traumatology service from January 2012 to August 2013. RESULTS: One-year mortality rate was 23.6%. Mortality was higher among women, with a 3:1 ratio. Anemia (p = 0.000) and dementia (p = 0.041) were significantly associated with the death group. Patients who remained hospitalized for less than 15 days and who were discharged within seven days after surgery showed increased survival. CONCLUSION: In the present sample of patients with hip fracture who underwent surgery, one-year mortality rate was 23.6%, and the main comorbidities associated with this outcome were anemia and dementia.

OBJETIVO: Analisar a mortalidade, em um ano de seguimento, de pacientes com fratura da extremidade proximal do fêmur submetidos a procedimento cirúrgico no hospital universitário da nossa instituição. MÉTODO: Foram revisados 213 prontuários de pacientes internados com 65 anos ou mais, conforme a ordem de admissão no Serviço de Ortopedia e Traumatologia de janeiro de 2012 a agosto de 2013. RESULTADOS: A taxa de mortalidade em um ano foi de 23,6%. A mortalidade foi maior em mulheres, numa proporção 3:1. Anemia (p = 0,000) e demência (p = 0,041) estiveram significativamente associadas ao grupo óbito. Pacientes que permaneceram internados por até 15 dias e os que tiveram alta hospitalar em até sete dias após a cirurgia apresentaram um aumento na sobrevida. CONCLUSÃO: Em nossa amostra de pacientes com fratura de fêmur submetidos a procedimento cirúrgico, a taxa de mortalidade foi de 23,6%; as principais comorbidades associadas a esse desfecho foram anemia e demência.

RESUMEN

ABSTRACT OBJECTIVE: To analyze the mortality rate at one-year follow-up of patients with hip fracture who underwent surgery at the university hospital of this institution. METHOD: The authors reviewed 213 medical records of hospitalized patients aged 65 years or older, following to the order they were admitted to the orthopedics and traumatology service from January 2012 to August 2013. RESULTS: One-year mortality rate was 23.6%. Mortality was higher among women, with a 3:1 ratio. Anemia (p = 0.000) and dementia (p = 0.041) were significantly associated with the death group. Patients who remained hospitalized for less than 15 days and who were discharged within seven days after surgery showed increased survival. CONCLUSION: In the present sample of patients with hip fracture who underwent surgery, one-year mortality rate was 23.6%, and the main comorbidities associated with this outcome were anemia and dementia.

RESUMO OBJETIVO: Analisar a mortalidade, em um ano de seguimento, de pacientes com fratura da extremidade proximal do fêmur submetidos a procedimento cirúrgico no hospital universitário da nossa instituição. MÉTODO: Foram revisados 213 prontuários de pacientes internados com 65 anos ou mais, conforme a ordem de admissão no Serviço de Ortopedia e Traumatologia de janeiro de 2012 a agosto de 2013. RESULTADOS: A taxa de mortalidade em um ano foi de 23,6%. A mortalidade foi maior em mulheres, numa proporção 3:1. Anemia (p = 0,000) e demência (p = 0,041) estiveram significativamente associadas ao grupo óbito. Pacientes que permaneceram internados por até 15 dias e os que tiveram alta hospitalar em até sete dias após a cirurgia apresentaram um aumento na sobrevida. CONCLUSÃO: Em nossa amostra de pacientes com fratura de fêmur submetidos a procedimento cirúrgico, a taxa de mortalidade foi de 23,6%; as principais comorbidades associadas a esse desfecho foram anemia e demência.

Asunto(s)

RESUMEN

El amplio desarrollo de los medicamentos gen‚ricos, y la demostración de fallas en la biodisponibilidad a partir de la d‚cada de los 70 condujo a la introducci¢n de requerimientos de bioequivalencia en pa¡ses del hemisferio norte, los que se han incorporado progresivamente en las regulaciones propuestas por la Organización Mundial de la Salud, la FDA y la EMEA, y luego entre la legislación de diferentes paises a diferente velocidad. Dos medicamentos son terap‚uticamente equivalentes si ellos son equivalentes farmac‚uticos o alternativas farmacéuticas y después de la administración en la misma dosis molar, sus efectos, con respecto a eficacia y seguridad, ser n esencialmente los mismos cuando sean administrados a pacientes por la misma v¡a de administración bajo las condiciones especificadas en el inserto. La decisión de intercambiabilidad es una inferencia luego de la demostración de equivalencia terapéutica, que supone que un medicamento puede ser reemplazado por otro que contenga lamisma dosis molar del medicamento en la misma forma farmacéutica y adminstrado en la misma v¡a e intervalo, esper ndose que los efectos farmacodin micos sean los mismos. En este trabajo se revisan los tipos de estudios utilizados para evaluar la equivalencia terapéutica, sus requisitos principales as¡ como los criterios de aceptabilidad y rechazo de los estudios. Se revisa la exigencia de estudios de equivalencia e intercambiabilidad se¤alados a la ley de medicamentos peruana aprobada en 2009.

The extensive development of generic drugs, and bioavailability failures from the 70s led to introduce bioequivalence requeriments in north region of the world, which progressively incorporated into regulations of WHO, FDA and EMEA, and then between different countries laws. Two drugs are therapeutically equivalent if they are pharmaceutical equivalents or pharmaceutical alternatives and after administration in the same molar dose, their efficacy effects and safety, will be essentially the same when administered to patients by the same route of administration under the conditions specified in the insert. The decision of interchangeability is an inference after show the therapeutic equivalence, which means that a drug can be replaced by another containing the same molar dose in the same dosage form and in the same via e interval, expected that pharmacodynamic effects are the same. In this article we review the types of studies used to evaluate the therapeutic equivalence, the requirement and criteria of acceptability and rejection of the studies. Likewise review the requirement for equivalence and interchangeability studies appointed in the Peruvian Drug Act in 2009.

Asunto(s)

RESUMEN

We assessed the association of erythrocyte indices on mean blood glucose-independent racial disparity in hemoglobin A1c (HbA1c) in youth with type 1 diabetes. Blacks still had higher HbA1c after adjustment for mean blood glucose, red blood cell indices, age, and sex. Such differences need to be taken into account when interpreting HbA1c in Black patients.

Asunto(s)

RESUMEN

El desarrollo de los medicamentos químicos de los últimos 50 años ha permitido la obtención de notables mejoras en la salud humana. La calidad, seguridad y eficacia así como las Buenas Prácticas de Manufactura (BPM), y las Buenas Prácticas de Laboratorio (BPL), son exigencias implantadas en la industria farmacéutica en la mayoría de los países. La aparición y desarrollo de las especialidades farmacéuticas genéricas en los últimos 35 años ha acompañado al desarrollo de los estudios de Biodisponibilidad y Bioequivalencia in vivo e in vitro (Bioexención). Se revisa los avances en estudios de Bioequivalencia en el Perú y los requisitos de la Ley de medicamentos aprobada en 2009. Los estudios de Bioequivalencia principalmente farmacocinéticos constituyen el estándar para que los organismos regulatorios en materia farmacéutica asuman la equivalencia terapéutica. Esta a su vez es un criterio aceptado para asumir intercambiabilidad del medicamento. En este artículo se revisan las definiciones, los diferentes tipos de diseños empleados en los estudios de Bioequivalencia, sus requisitos principales así como los criterios de aceptabilidad y rechazo de los resultados de los estudios de Bioequivalencia. Se hace especial mención a la posición de la OMS, la FDA y EMEA en los últimos años. Se describe la Clasificación Biofarmacéutica (SCB), que considera cuatro grupos y su aplicación para la bioexencin, bajo los criterios de la FDA y de la OMS.

In the last 50 years the development of the chemical medicines has allowed to achieve remarkable improvements in human health care. In many countries the pharmaceutical industry regulations on quality, safety and effectiveness as well as Good Manufacturing Practices (GMP) and Good Laboratory Practices (GLP) are mandatory requirements. Generic pharmaceutical products have been developed in the last 35 years, along with studies of bioavailability, bioequivalence in vivo and in vitro (Biowaiver). In this article the progress in Bioequivalence studies in Peru will be reviewed as well as the requirements of the Medicines Act adopted in 2009. The pharmacokinetic Bioequivalence is the standard for pharmaceutical regulatory agencies; in this way they are able to establish pharmaceutical therapeutic equivalence and this is an accepted criteria for the medication interchangeability. The most important requirements of acceptability and rejection of the results of the studies of Bioequivalence are reviewed in this article, as well as the criteria and the definitions related to them and the different programs designed for these studies. In this article we review definition, different study designs used bioequivalence, their requirements and the criteria of acceptability and rejection of the results bioequivalence studies. The position of the WHO, the FDA and EMEA in the last few years has a special reference in the article. The Biopharmaceutics Classification System (BCS), that consider four groups and their application to biowaiver, under the criteria of FDA and WHO is reviewed.

Asunto(s)

RESUMEN

Los servicios asistenciales revelan interés por establecer protocolos de rehabilitación con sobredentaduras mandibulares retenidas a implantes, pero necesitan respaldo científico evaluado con instrumentos confiables. Objetivo: El objetivo de este estudio fue evaluar un modelo-protocolo de rehabilitación con sobredentaduras implanto retenidas para servicios públicos, por medio de test de rendimiento masticatorio, valores de retención y valoración de la satisfacción terapéutica obtenidos con las prótesis mandibulares implanto-retenidas. Materiales y métodos: Este trabajo fue realizado entre la Facultad de Odontología Universidad de Concepción (FAO-UDEC) y el Servicio de Salud Bío Bío (SS-BÍO-BÍO). Catorce pacientes fueron seleccionados, usuarios del SS-BÍO-BÍO, y recibieron sobredentaduras implanto-retenidas confeccionadas con protocolo del programa Rehabilitación Oral mención Prótesis (ROMPE. FAO-UDEC). Dos Implantes Neodent (3,75 × 11 y 13 mm) por paciente fueron instalados y conectados con carga temprana. Antes y después de instalar y conectar los implantes se evaluó: la satisfacción terapéutica con encuesta Programa ROMPE.FAO-UDEC, la retención con dinamómetro Force Gauge y el rendimiento masticatorio con test tamizado de maní. Los datos fueron procesados con programa SPSS 16.0 con test Kolmogorov-Smirnov, t-test para muestras relacionadas. Significación estadística p < 0,05. Resultados: La eficiencia masticatoria aumenta de forma significativa después de la conexión de los implantes. La satisfacción terapéutica con las prótesis y la resistencia a la tracción son altamente significativas posterior a la conexión de ellas. Conclusiones: Estos resultados son coincidentes con la gran mayoría de estudios publicados, y permiten sostener científicamente que el protocolo de confección de sobredentaduras ROMPE FAO-UDEC y SS-BÍO-BÍO es una alternativa confiable.

Health care services show interest in establishing rehabilitation protocols with mandibular overdentures retained on two implants, but they require scientific evidence evaluated with reliable instruments. Objective: To evaluate masticatory performance, retention and therapeutic satisfaction of patientswith a model rehabilitation protocol for implant-retained overdentures. Materials and methods: This study was conducted between the Faculty of Dentistry, University of Concepción (FAO UDEC) and Bío Bío Health Service(SS-Bío Bio). Fourteen patients, selected users of Bío Bío Health Service, Los Angeles, received implant-overdentures using a protocol of the Oral Rehabilitation Prosthesis Program (ROMPE FAO UDEC). Two Neodent™ implants (3.75 × 11 and 13 mm) were installed in each patient and connected with early loading. Before and after installing and connecting the implants, (0, 30 and 60 days), therapeutic satisfaction was assessed using the ROMPE FAO UDEC graduate program questionnaire. Retention was measured with a Force Gauge Dynamometer, and masticatory performance was quantified with a peanut screening test. Data were processed with SPSS 16.0 program and Kolmogorov-Smirnov test and t- test were used. Significance was set at P < .05. Results: Masticatory efficiency significantly increases after connectingthe implants. Therapeutic satisfaction with the prosthesis and the tensile strength are highly significant. Conclusions: These results coincide with the vast majority of published studies. It can be scientifically argued that the ROMPE FAO UDEC, SS Bío Bío overdenture protocol is a reliable alternative.

Asunto(s)

RESUMEN

The protein composition of the soluble venom from the South American fish-eating coral snake Micrurus surinamensis surinamensis, here abbreviated M. surinamensis, was separated by RP-HPLC and 2-DE, and their components were analyzed by automatic Edman degradation, MALDI-TOF and ESI-MS/MS. Approximately 100 different molecules were identified. Sixty-two components possess molecular masses between 6 and 8 kDa, are basically charged molecules, among which are cytotoxins and neurotoxins lethal to fish (Brachidanios rerio). Six new toxins (abbreviated Ms1-Ms5 and Ms11) were fully sequenced. Amino acid sequences similar to the enzymes phospholipase A2 and amino acid oxidase were identified. Over 20 additional peptides were identified by sequencing minor components of the HPLC separation and from 2-DE gels. A functional assessment of the physiological activity of the six toxins was also performed by patch clamp using muscular nicotinic acetylcholine receptor assays. Variable degrees of blockade were observed, most of them reversible. The structural and functional data obtained were used for phylogenetic analysis, providing information on some evolutionary aspects of the venom components of this snake. This contribution increases by a factor of two the total number of alpha-neurotoxins sequenced from the Micrurus genus in currently available literature.

Asunto(s)

RESUMEN

Autonomic dysfunction is frequent in patients with fibromyalgia (FM). Heart rate variability analyses have demonstrated signs of ongoing sympathetic hyperactivity. Catecholamines are sympathetic neurotransmitters. Catechol-O-methyltransferase (COMT), an enzyme, is the major catecholamine-clearing pathway. There are several single-nucleotide polymorphisms (SNPs) in the COMT gene associated with the different catecholamine-clearing abilities of the COMT enzyme. These SNPs are in linkage disequilibrium and segregate as 'haplotypes'. Healthy females with a particular COMT gene haplotype (ACCG) producing a defective enzyme are more sensitive to painful stimuli. The objective of our study was to define whether women with FM, from two different countries (Mexico and Spain), have the COMT gene haplotypes that have been previously associated with greater sensitivity to pain. All the individuals in the study were female. Fifty-seven Mexican patients and 78 Spanish patients were compared with their respective healthy control groups. All participants filled out the Fibromyalgia Impact Questionnaire (FIQ). Six COMT SNPs (rs2097903, rs6269, rs4633, rs4818, rs4680, and rs165599) were genotyped from peripheral blood DNA. In Spanish patients, there was a significant association between three SNPs (rs6269, rs4818, and rs4680) and the presence of FM when compared with healthy controls. Moreover, in Spanish patients with the 'high pain sensitivity' haplotype (ACCG), the disease, as assessed by the FIQ, was more severe. By contrast, Mexican patients displayed only a weak association between rs6269 and rs165599, and some FIQ subscales. In our group of Spanish patients, there was an association between FM and the COMT haplotype previously associated with high pain sensitivity. This association was not observed in Mexican patients. Studies with a larger sample size are needed in order to verify or amend these preliminary results.

Asunto(s)

Asunto(s)

RESUMEN

BACKGROUND: One of the 2 classification criteria for fibromyalgia (FM) is the presence of tender points on specific anatomic sites. It has been established that these tender points reflect a state of generalized allodynia (defined as pain resulting from a stimulus that does not normally provoke pain). Patients with FM often describe pain elicitation during blood pressure testing (sphygmomanometry). OBJECTIVE: The objective of this study was to define if a universally used clinical test, sphygmomanometry, is helpful in the identification of patients with FM. METHODS: The authors conducted a prospective multicenter study in 3 different public rheumatology outpatient services. Each center studied 20 patients with FM, 20 with rheumatoid arthritis, 20 with osteoarthritis, and 20 healthy individuals. The following question was asked of each participant: "When I take your blood pressure, tell me if the cuff's pressure brings forth pain." The blood pressure cuff was inflated at an approximate rate of 10 mm Hg per second up to 180 mm Hg or to the point when pain was elicited. RESULTS: Sixty-nine percent of patients with FM had sphygmomanometry-evoked allodynia in contrast to 10% of patients with osteoarthritis, 5% with rheumatoid arthritis, and 2% of healthy individuals (P < 0.001). The mean blood pressure value at which allodynia was elicited was lower in patients with FM (143 +/- 40 mm Hg) when compared with the other 3 groups (176 +/- 11 mm Hg) or higher (P < 0.001). In patients with FM, there was a significant negative correlation between the blood pressure value at which allodynia developed and total Fibromyalgia Impact Questionnaire (FIQ) score, number of tender points, and the FIQ visual analog scales for pain intensity and fatigue (P < 0.05). The test yields a diagnostic sensitivity for FM of 0.7, specificity 0.96, positive predictive value 0.86, and negative predictive value 0.91. CONCLUSIONS: In this developmental study of patients attending rheumatology clinics, the generation of pain during blood pressure testing was strongly associated with the diagnosis of FM. This robust linkage probably reflects a tautologic phenomenon. A sine qua nonelement for FM diagnosis is the presence of tender points in discrete anatomic sites. These tender points in turn reflect a state of generalized mechanical allodynia that can be locally elicited by the cuff pressure during blood pressure testing. Sphygmomanometry is a simple bedside test that may be useful in the recognition of patients with FM. Blood pressure testing is a universal procedure in all clinical environments. Based on our results, we suggest searching for FM features in any person who has sphygmomanometry-evoked allodynia.

Asunto(s)

RESUMEN

Objetivo: El carcinoma de células en anillos de sello primario del colon y recto, es una neoplasia poco frecuente, variedad del adenocarcinoma del intestino grueso. El propósito de este estudio fue establecer su incidencia, historia natural y relación con el cáncer de colon no polipoide hereditario (HNPCC). Métodos: Se revisaron las historias clínicas e histología de 28 pacientes con diagnóstico de carcinoma de células en anillo de sello primario del colón y recto, en el Instituto Nacional de Enfermedades Neoplásicas (INEN), entre los años 1991 al 2002. Resultados: La incidencia del carcinoma de células de sello fue del 5.09 por ciento en relación con los casos de adenocarcinoma primario del colon y recto. Los pacientes fueron diagnosticados en estadios avanzados de enfermedad (C y D de Dukes). En la mayoría de casos la neoplasia comprometió todo el espesor de la pared intestinal (tipo Bormann IV). La relación Hombre - Mujer fue 1.1.5. La edad media de presentación 55.5 años y la mediana 57 años (rango de 11 a 83 años). Conclusiones.- La comparación de nuestros datos con lo reportado en la literatura, muestra algunas diferencias, que pueden estar relacionadas con características biológicas propias de nuestra población y con la aplicación de diferentes criterios de selección de los casos. No es posible establcer en nuestra serie la relación entre HNPCC y carcinoma de células en anillo de sello primario del colon y recto.

Asunto(s)

Asunto(s)

RESUMEN

El presente estudio de investigación, prospectivo transversal tuvo como objetivo establecer los valores referenciales de homocisteína en hombres y mujeres de 17 1 60 años aparentemente sanos en la ciudad de Lima-Perú. El dosaje de homocisteína plasmática se realizó , en una muestra no probabilística de 229 donantes voluntarios provenientes de Bancos de Sangre de los Hospitales Nacionales Guillermo Almenara Irigoyen (HNGAI) y Edgardo Rebagliati Martins (HNERM) EsSalud, clínicas San Pablo, Laboratorios Odalab s. R. L., alumnos de la Universidad Mayor de San Marcos y Universidad Cristiana María Inmaculada en el período de julio a noviembre de 1999. Para el dosaje de homocisteína plasmática se utilizó el método de Inmunoensayo de polarización fluorescente (FPIA). Se evaluó la influencia de la edad sobre la homocisteína plasmática en las sub-poblaciones: de 17 a 31 años (X=8.34ñ2.53 µmol/L) y de 32 a 60 años (X=8.39ñ2.34 µmol/L). No se encontraron diferencias significativas en cuanto a la homocisteína entre estos dos grupos de edad. Los valores medios de homocisteína plasmática fueron mayores en varones (X=8.97ñ2.35µmol/L) que en mujeres (X=7.76ñ2.39 µmol/L y no siguen una distribución normal para ambos sexos. Los límites de referencia para homocisteína plasmática en el grupo de donantes estudiados se estimaron mediante método no paramétrico, fueron para el sexo masculino 4.79 y 14.74 µmol/L y para el sexo femenino 4.72 y 13.87 µmol/L.

Asunto(s)

RESUMEN

Estudio sobre tabaco en las escuelas que toma como referencia a alumnos de 13 a 15 años. Su propósito es medir las actitudes, conocimientos y comportamientos de estudiantes relacionados al uso del tabaco, la cesación, la exposición medioambiental al humo del tabaco y también al acercamiento de los estudiantes a la curricula preventiva de la escuela, los programas comunitarios y a los mensajes de los medios de comunicación masiva

Asunto(s)

RESUMEN

El presente estudio, constituye el Tercer Estudio de opinión de Líderes acerca de las drogas. En el se analizan los diversos componentes relacionados a la oferta, demanda y comercialización de las drogas en el país, la opinión sobre su impacto en la economía y el desarrollo del país, los esfuerzos que desarrollan las instituciones gubernamentales y la sociedad civil, así como factores relativos al cultivo de la hoja de coca, el narcotráfico y la importancia de las fuentes de información social en el problema de las drogas, bajo la óptica del líder. En el presente estudio participaron 700 líderes peruanos seleccionados aleatoriamente, distribuídos 400 en Lima y 300 en seis ciudades de provincias (Costa: Trujillo y Tacna; Sierra: Arequipa y Ayacucho; Selva: Iquitos y Tarapoto)

Asunto(s)

RESUMEN

La presente investigación de CEDRO realizada en las ciudades de Lima, Trujillo, Huancayo y Tarapoto entre 5268 alumnos de segundo, tercer y cuarto año de secundaria revela que el consumo de drogas ilegales (marihuana, pasta básica de cocaína y clorhidrato de cocaína) ha aumentado con relación a los indicadores de estudios anteriores. Se presentan gráficos indicando la prevalencia de vida de las drogas ilícitas o ilegales; gráficos indicando el nivel de conocimiento acerca de las drogas en los escolares de segundo a cuarto año de educación secundaria

Asunto(s)

RESUMEN

Se revisan la bioquímica, el metabolismo y las alteraciones genéticas del metabolismo de la metionina y homocisteína. Se discute el rol de la elevación de la homocisteína plamática como factor de riesgo an las enfermedades cardiovasculares, infarto de miocardio, enfermedad trombótica, arteriosclerosis, enfermedades vasculares cerebrales e infarto cerebral, así como el rol de las vitaminas B6, B12 y el ácido fólico en el metabolismo de la homocisteína, y la génesis de la hiperhomocisteinemia por déficit de estas vitaminas. Se revisan los valores referenciales peruanos en relación con los valores plasmáticos referenciales internacionales para homocisteína plasmática en población normal, y se analizan las ventajas y desventajas de los métodos analíticos disponibles para la medición de la homocisteína plasmática.

Asunto(s)

RESUMEN

La necesidad para este estudio, que examina la naturaleza del mercado de drogas ilícitas desde una perspectiva multidisciplinaria, internacional, se basa en la expansión de estos mercados por todo el mundo, así como en el creciente reconocimiento que la dinámica subyacente de tales mercados y los problemas relacionados, debería ser tratado tanto a nivel nacional como a nivel internacional. El proyecto estudia veinte mercados de droga urbanos alrededor del mundo, cada uno en diferente fase de madurez y con características diferentes. El presente estudio da énfasis en las tendencias económicas, sociales y políticas que convierten a la economías urbano-rurales en puntos vulnerables para el tráfico de drogas. El negocio de las drogas en Lima, básicamente se realiza a nivel de individuos o familias para los cuales la venta de sustancias es una actividad cotidiana. El estudio está referido a la situación del mercado de drogas ilícitas en la ciudad de Lima, capital del Perú, y ha sido elaborado por un equipo multidisciplinario de CEDRO, sobre la base de informaciones recogidas de encuestas efectuadas, del análisis de informaciones periodísticas, de la experiencia personal de altos jefes de la Policía que trabajan en la lucha contra las drogas, a consumidores con problemas y a personas involucradas directamente en el narcotráfico

Asunto(s)