Reference intervals of the sex hormonal profile in healthy women: A retrospective single-center study in Peru

The female hormonal profile is of utmost importance for the assessment of the endocrinological functional status and the diagnosis of diseases. The analysis must delimit their normality intervals based on the manufacturer's cut-off points. Due to not all intervals can be evaluated before use, it is imperative to verify the reference intervals to achieve uniformity in the interpretation of results in the female population. We determine the reference intervals of five female sex hormones [Follicle Stimulating hormone (FSH), Estradiol, Luteinizing Hormone (LH), Prolactin, and progesterone] using electrochemiluminescence in the Cobas e411 (Roche). We included female patients >18 years old, between the 3rd and 15th day of the menstrual cycle (follicular phase) and had no previous medical history or recent medication. For reference intervals analysis, we followed the recommendations of the CLSI C28-A3 guideline. The average concentration for FSH, progesterone, LH, prolactin and estradiol were 11.48 ± 21.10 mIU/ml, 8.19 ± 11.90 ng/ml, 10.98 ± 11.55 ng/ml, 25.05 ± 32.74 ng/mL, and 147.08 ± 473.8 pmol/mL, respectively. Eighty per cent of parameters showed a satisfactory transfer for the manufacturer's reference intervals, except for estradiol, which had 85.5% of transferred values. Our results suggest that 4/5 sex hormones were found within the manufacturer's reference intervals and can be quantified in Peruvian women, ensuring the quality of their results. However, it is necessary to determine the estradiol with other reagents and assays since we show errors in the transfer of intervals

Six‑sigma and quality planning of TORCH tests in the Peruvian population: a single‑center cross‑sectional study

"Objective: To ensure the health of newborns, it is necessary to perform high-quality diagnostic tests. The TORCH panel is a set of tests that identifes infectious pathogens such as Toxoplasma (Toxo) and Cytomegalovirus (CMV) that are common in low-setting populations. We performed TORCH panel quality planning using six sigma in a reference laboratory at Peru. Results: This was a cross-sectional study. TORCH tests include Toxo, Rubella, CMV, and Herpes. We processed all samples by fourth-generation ELISA on the GEMINI XCR200 analyzer (Diatron, Budapest, Hungary). We obtained the imprecision from the annual data of the external quality assessment plan and we used the CLSI EP12-A3 guideline. In a total of 44,788 analyses, the average imprecision was 3.69±1.47%, and CMV had lower imprecision (2.3 and 2.6% for IgM and IgG, respectively). Quality planning of the TORCH panel allowed estimating the sigma value that ranged from 4 to 10 (average 7±2 sigma), where rubella had the highest values (10 for IgM and 8 for IgG) while HSV2 had the lowest values (4 for IgM and 5 for IgG). Our results suggest the optimal performance of half of the markers including Toxoplasma, Rubella, and CMV in the Peruvian population.

The current context of a cannabis regulatory change: Analysis of a Peruvian course

This article presents an analysis of the technical opinions expressed during the update course "Medicinal use of cannabis: An informed perspective for adequate regulation" held from June to July 2022. The course was organized by the National Center for Intercultural Health of the National Institute of Health of Peru with the objective of gathering specialized information and thus developing an institutional technical opinion on the proposal of modifications to the cannabis regulation issued by the General Directorate of Medicines and Drugs Supplies. The new regulation must include the artisanal production of cannabis and derivatives through patient associations according to the mandate of Law 31312, which modifies Law 30681, thus including this activity. During the event, various topics related to the use of cannabis were discussed, including traditional and therapeutic uses, scientific evidence, history of prohibition, botany, biochemistry, pharmacology, toxicological risks, national regulation, regulatory experience in Uruguay, public health and access. As well as criminal effects, situation of access to cannabis to the patient, quality control, productive experience of patients associations in Brazil

Validación de la escala de miedo a la COVID-19 en una muestra de estudiantes universitarios

Introducción: El miedo a la COVID-19 se distribuye por todo el mundo y afecta a todas las comunidades, incluidos los estudiantes universitarios. Es necesario tener herramientas para medir este miedo. Objetivo: Validar la traducción al español del cuestionario FCV-19S (Fear of COVID-19 Scale). Métodos: Estudio transversal basado en cuestionarios online, realizado en universitarios peruanos de pregrado, durante el primer brote de la COVID-19. Se incluyeron estudiantes con idioma español nativo, acceso a internet y se excluyeron sujetos con problemas de compresión del lenguaje. La traducción del cuestionario se realizó bajo un protocolo estandarizado y se aplicó una evaluación observacional para valorar la validez y confiabilidad de FCV-S19 con α de Cronbach, correlación de Pearson y análisis factorial. Resultados: Se encuestaron 208 estudiantes universitarios, con edad promedio de 25,9 ± 5,9 años (IC95 %: 25,1 a 26,7); más de la mitad fueron mujeres (58,7 %) y aproximadamente 57 % vivía con sus padres. El α de Cronbach fue ≥ 0,8 entre los dominios, con buena consistencia interna del cuestionario (α de Cronbach= 0,832). La validez del instrumento entre los 7 ítems y las 5 categorías demostró una correlación adecuada (p< 0,05); el test de Bartlett (p= 0,0001) y el Kaiser-Meyer-Olkin (0,818) definieron por análisis factorial una dimensión que explicó el 52,3 % de la varianza total. Conclusiones: La traducción al español del cuestionario FCV-19S tiene una validez y confiabilidad óptima, es capaz de medir el miedo por la COVID-19 en una muestra de estudiantes universitarios de Perú.Campus Lima Centr

Acute hepatic and renal toxicity assessment of Euphorbia huanchahana (Klotzsch & Garcke) Boissier (Huachangana) in Holtzman rats

Background: Euphorbia huachahana (Klotzch & Garcke) Boissier (Huachangana) (EhKGBh) has been used for over a century for medicinal purposes in the Peruvian population; however, its safety and possible toxic effects of use have not been reported. The purpose of this study was to determine the acute hepatic and renal toxicity of EhKGBh in Holtzman rats. Methods: Analytical and experimental study. The population consisted of 52 rats of both sexes weighing between 300 and 350 g divided into four groups: G1 and G2 EhKGBh groups (26 rats each) and two control groups (10 rats each). The experimental group was administered EhKGBh at a single dose of 2000 mg/kg P.O. to demonstrate toxicity during the 14-day follow-up. A daily assessment of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), total bilirubin (TBIL), and conjugated bilirubin (CBIL) was performed. Results: Evaluation of the liver tissue showed mild changes in inflammation, predominantly vascular, with small clots. Kidney tissue did not show inflammatory or necrotic changes. However, we showed differences in the weight of the rats between both groups (p < 0.004) and significant increases in TBIL (0.98–1.07 mg/dL), CBIL (0.43–0.45 mg/dL), AST (126.4–141.8 U/L), and ALP (254–298 U/L) but not ALT (39.7–41.1 U/L) (p < 0.05). Conclusion: The single dose of EhKGBh extract at 2000 mg/kg has no toxicity, and there is no change in tissue toxicity during the 14-day follow-up.Campus Lima Centr

"What is the perception of medical students about eLearning during the COVID-19 pandemic? A multicenter study in Peru"

"Introduction: As face-to-face medical education was restricted during the pandemic; digital tools have been deployed to continue education showing a good educational impact in most countries. However, the perception of medical students in Peru on eLearning has not yet been investigated. This study assessed the perception of 440 medical students from two national universities in Peru on the characteristics and limitations of eLearning during 2021. Materials and methods: We conducted a cross-sectional study using the self-administered survey Encuesta Virtual en Tiempos de COVID-19 (EVI-CV19) on students between the second and sixth medical year of the Universidad Nacional Mayor de San Marcos (UNMSM) and the Universidad Nacional San Luis Gonzaga (UNSLG, n=325). Results: The majority of students were under 30 years of age (93.9% vs. 97.2%, p=0.084), and female (67% vs. 64%, p=0.107). Of the total, 63.9% and 81.5% UNMSM and UNSLG students considered the virtual platform effective in favouring feedback with recorded lectures (85.2% vs. 85.5%) and the organization of documents (61.7% vs. 80.9%), respectively (p>0.05). Seventy per cent and 46.8% of UNMSM and UNSLG students perceived that teachers were nottrained (p=0.063), and 26.1% and17.2% of students perceived thatthe virtual modality affected their academic performance a lot, respectively (p=0.003). About 38% of students from both universities perceived the virtual platforms as very secure. We found differences between UNMSM and UNSLG students on whether the virtual exams were fair (28.7% vs. 52.3%, p<0.001). Conclusions: This study reported a favorable perception of medical eLearning with clear differences in the limitations of the virtual environment.

Changes in high-density lipoprotein (HDL), low-density lipoprotein (LDL) and cholesterol concentration in heavy cannabis users: A single-centre study in Cusco, Peru

Background: The effect of cannabis on cholesterol and lipid balance has been reported for decades. However, there are conflicting reports on the reduction of low-density lipoprotein (LDL-C) and total cholesterol. The purpose of this study was to determine the immediate changes of Cannabis spp. consumption by pyrolytic route in heavy users. Methods: A cross-sectional study on 20 Peruvian heavy cannabis users (mean age: 31 ± 9.5 years). The inclusion criteria were males with an average weight of 50–70 kg, normal BMI, and having used cannabis, without association with other drugs, for at least one year with a high frequency per week (use: 4–7 days/week). High-density lipoprotein (HDL-C), LDL-C, and total cholesterol were evaluated 30 and 120 min after the administration of Cannabis spp. (~0.2 g by inhalation). Results: Of the total 12 (60%), 10 (50%), and 11 (55%) had desirable total cholesterol, fairly good HDL-C (40–60 mg/dL) and fairly good LDL-C (100–129 mg/dL) values, respectively. The mean basal concentration of total cholesterol, HDL-cholesterol, and LDL-cholesterol was 193.37 ± 20.18 mg/dL, 60.05 ± 6.36 mg/dL, and 129.65 ± 14.50 mg/dL, respectively. HDL-cholesterol showed progressive increases in participants with desirable HDL-C > 60 mg/dL at 30 min (10 vs. 14 participants, p < 0.001) and at 120 min (10 vs. 16 participants, p < 0.001), while LDL-C peaked in participants with concentrations < 100 mg/dL at 30 min (desirable cholesterol: 0 vs. 2, p = 0.001). HDL-C concentration showed differences after cannabis consumption, showing increases at 30 (63.25 ± 7.68 mg/dL) and 120 min (69.15 ± 18.67 mg/dL) and total cholesterol concentration changed to 180.95 ± 19.3 mg/dL (95%CI 172.5 to 189.4) at 120 min (p = 0.007). Conclusions: HDL-C cholesterol increased 30 and 120 min after Cannabis spp. ingestion, while LDL-C and total cholesterol showed partial reductions in heavy-users from Cusco, PeruCampus Lima Centr

Cuentos de nunca acabar. Aproximaciones desde la interculturalidad

Cuentos de nunca acabar. Aproximaciones desde la interculturalidad, surge después de la pandemia y su imposibilidad de socializar “en persona” con los compañeros de eventuales encuentros, porque la Comprensión Lectora tenía que reinventarse para su nueva reflexión cognitiva, adaptación contextual y reconstrucción del conocimiento. Este renovado enfoque de la realidad postpandemia, concebido en el marco de la educación intercultural comunitaria, busca potencializar los entornos naturales, sociales y culturales como recursos de aprendizaje multidisciplinario a través del lenguaje animado de los cuentos. En este marco, había que dinamizar la asignatura de Comunicación Oral y Escrita, que se dicta en los Primeros Niveles de los Centros de Apoyo de Otavalo, Cayambe, Latacunga y Riobamba, mediante un eje transversal donde los estudiantes escriban fundamentados en valores de la cosmovisión andina, considerando que provienen de varios lugares de la sierra y amazonía ecuatoriana. Todo surgió del encuentro presencial de un sábado cualquiera donde los estudiantes realizaban ejercicios narrativos, logrando una apreciable respuesta de imaginación, más emotiva que la clásica tarea de las Unidades, tanto así que, pasados unos días, seguían llegando sus escritos a mi correo. Entonces nos pusimos manos a la obra, cada estudiante tendría dos opciones como Actividad Integradora, la primera consistía en escribir un cuento de su propia inspiración, y la segunda analizar un clásico para comentar sus valores y antivalores. La mayor parte de estudiantes decidió escribir su propio cuento, de donde se escogieron algunas participaciones que podrían considerarse originales, para una edición que, respetando la transcripción de la tradición oral que prima en los sectores comunitarios, nos concretamos en revisar la puntuación y ortografía para publicarlos. Con esto buscamos innovar la Actividad Integradora, por algo más práctico y operativo para configurar los Objetos de Aprendizaje que buscamos. Así nació, en medio del camino, este libro de Cuentos de nunca acabar. Aproximaciones desde la interculturalidad, que ponemos en sus manos. Hernán Hermosa Mantilla Quito, junio de 202

Qualitative determination of cannabinoids (cannabidiol) in twenty commercial medicinal oils obtained from patients during medical consultation in Lima, Peru 2021

Este proyecto de investigación tuvo como objetivo: determinar cualitativamente la presencia de cannabinoides (cannabidiol) en 20 aceites medicinales comerciales obtenidos de pacientes durante consulta médica en Lima, Perú 2021. Materiales y métodos: Se diseñó un estudio observacional con enfoque cualitativo y muestreo no probabilístico en el Centro Médico Especializado en Cannabis Medicinal CANNAVITAL en Lima (Perú). Los criterios de inclusión fueron aceites de cannabis procedentes de pacientes con diferentes matrices de aceites, precios, frascos, y con/sin registro sanitario. Se utilizó Fast blue B y el reactivo colorimétrico Reaja para determinar los cannabinoides y cannabidiol (CBD), respectivamente. Resultados: Del total de aceites, 14 (70%) aceites presentaron cannabinoides y que 4 (20%) presentaron concentraciones débiles de cannabinoides. Los aceites con 15 a 20 ml fueron los que tuvieron mayor frecuencia de cannabinoides (n=5, 25%). Además, 9 (45%) aceites presentaron CBD y 1 (5%) aceite tuvo concentraciones débiles. Los aceites con 5 a 10 ml de aceite tuvieron mayores concentraciones de CBD (n=9, 45%). Todos los aceites con matriz de aceite de olivo tuvieron cannabinoides. Conclusiones: la determinación cualitativa de cannabinoides en veinte aceites medicinales comerciales obtenidos de pacientes durante consulta médica en Lima, Perú durante el 2021, demostró que 7/10 aceites contenían cannabinoides en sus diferentes presentaciones comerciales

Therapeutic Potential of Cannabinoid Profiles Identified in <i>Cannabis</i> L. Crops in Peru

Cannabis is a plant that is cultivated worldwide, and its use is internationally regulated, but some countries have been regulating its medicinal, social, and industrial uses. This plant must have arrived in Peru during the Spanish conquest and remains widely cultivated illicitly or informally to this day. However, new regulations are currently being proposed to allow its legal commercialization for medicinal purposes. Cannabis contains specific metabolites known as cannabinoids, some of which have clinically demonstrated therapeutic effects. It is now possible to quantitatively measure the presence of these cannabinoids in dried inflorescences, thus allowing for description of the chemical profile or “chemotype” of cannabinoids in each sample. This study analyzed the chemotypes of eight samples of dried inflorescences from cannabis cultivars in four different regions of Peru, and based on the significant variation in the cannabinoid profiles, we suggest their therapeutic potential. The most important medical areas in which they could be used include the following: they can help manage chronic pain, they have antiemetic, anti-inflammatory, and antipruritic properties, are beneficial in treating duodenal ulcers, can be used in bronchodilators, in muscle relaxants, and in treating refractory epilepsy, have anxiolytic properties, reduce sebum, are effective on Methicillin-resistant Staphylococcus aureus, are proapoptotic in breast cancer, can be used to treat addiction and psychosis, and are effective on MRSA, in controlling psoriasis, and in treating glioblastoma, according to the properties of their concentrations of cannabidiol, cannabigerol, and Δ9-tetrahydrocannabinol, as reviewed in the literature. On the other hand, having obtained concentrations of THC, we were able to suggest the psychotropic capacity of said samples, one of which even fits within the legal category of “non-psychoactive cannabis” according to Peruvian regulations