EVALUACIÓN DEL EFECTO HIPOGLICEMIANTE DE EXTRACTOS DE ALLIUM CEPA (CÁSCARA DE CEBOLLA) EN RATONES

Objetivo: Determinar el efecto hipoglicemiante de las catáfilas de cebolla (Allium cepa). Material y Métodos: Estudio experimental de tipo aleatorizado. Los extractos fueron obtenidos de catáfilas de muestras provenientes de tres fincas agrícolas -Tacna, Arequipa y Lima-, en alcohol de 70º GL por 7 días, con movimiento del macerado en oscuridad; filtrada y deshidratada en una estufa a no más de 40º C; luego se diluyó 1.4 g de cada muestra con 7.6 ml de agua destilada y 1 ml de twin 80. En el ensayo se utilizó cinco grupos de ratones de la cepa balb C 53 con seis unidades experimentales cada uno. A cuatro de estos grupos se les indujo un estado hiperglicemiante con glucosa administrada por vía intraperitoneal a una dosis de 3 g de glucosa/kg de peso corpóreo. A tres de estos grupos se les administró el extracto correspondiente de muestras de cada finca, mientras que el grupo de control fue utilizado para monitorear el nivel de glicemia alcanzado por el estado hiperglicemiante inducido. El grupo restante (basal) no recibió extracto ni se le indujo estado diabético y sus niveles de glucemia normales sirvieron para la comparación con los resultados de los otros grupos. Se administró 1 ml/100 g de cada extracto a cada grupo respectivo, a una dosis de 0.4 g/100 g de peso corpóreo. Finalmente, se tomaron muestras de glucemia a los 45 y 90 minutos después de la administración de glucosa. Resultados: El grupo control tuvo medias de glucemia de 264 mg/dl y 147,6667 mg/dl a los 45 y 90 minutos mientras que el grupo basal tuvo medias de 115,6666 mg/dl y 101,8333 mg/dl. Los grupos Arequipa, Orgánica (Lima) e Ilabaya (Tacna) presentaron medias de 123,8333, 184 y 202 mg/dl respectivamente a los 45 minutos, mientras que a los 90 minutos las medias fueron de 100,6667, 126,8333 y 107,6667 mg/dl. Conclusión: Los extractos elaborados a base de cascara de cebolla tienen efectos hipoglicemiantes en ratones. El extracto de catafilas arequipeñas demostró posees el mayor efecto hipoglicemiante. Palabras Claves: catáfilas de cebolla, efecto hipoglicemiante

Perfil epidemiológico y molecular de pacientes con cáncer de pulmón en un centro oncológico referencial de Lima, Perú.

Background: According to GLOBOCAN estimates, in 2020, lung cancer was the second most frequent cancer and epidemiological information is needed in Latin American countries. The objective was to describe the epidemiological and molecular characteristics of lung cancer patients from a referral clinic in Lima, Peru. Material and methods: A retrospective cohort study was conducted to characterize the epidemiological and molecular profile of lung cancer patients attended at a referral cancer center in Peru during 2018 to 2021. Variables such as age, sex, histology, staging and mutation were reported. In the descriptive analysis, frequencies and percentages were shown for categorical variables. For numerical variables, the best measure of central tendency and dispersion was reported. Results: A total of 225 patients with a diagnosis of lung cancer were observed. EGFR gene mutation was the most frequently detected (45.3%); and within them exon 19 deletion (55.7%). The most frequent histological type was adenocarcinoma with 180 patients (85.7%). Of the total number of patients with EGFR mutation, 77.8% received treatment with a tyrosine kinase inhibitor (osimertinib, erlotinib, afatinib) and 15.9% received immunotherapy (pembrolizumab, atezolizumab, nivolumab). Conclusions: The predominant mutation was EGFR, the most frequent histologic type was adenocarcinoma and most patients received treatment with a tyrosine kinase inhibitor.Introducción: Según estimaciones del GLOBOCAN, en 2020, el cáncer de pulmón fue el segundo más frecuente y se necesita información epidemiológica en países latinoamericanos. El objetivo fue describir las características epidemiológicas y moleculares de pacientes con cáncer de pulmón de una clínica referencial de Lima, Perú. Material y métodos: Se realizó un estudio cohorte retrospectiva para caracterizar el perfil epidemiológico y molecular de los pacientes con cáncer pulmón atendidos en un centro oncológico referencial del Perú durante 2018 al 2021. Se reportaron variables como edad, sexo, histología, estadiaje y mutación. En el análisis descriptivo, se mostraron frecuencias y porcentajes para las variables categóricas. En el caso de las variables numéricas, se reportó la mejor medida de tendencia central y de dispersión. Resultados: Se observó un total de 225 pacientes con diagnóstico de cáncer de pulmón. La mutación del gen EGFR fue la más frecuentemente detectada (45.3%); y dentro de ellas la deleción del exón 19 (55.7%). El tipo histológico más frecuente fue de Adenocarcinoma con 180 pacientes (85.7%). Del total de paciente con mutación en el EGFR, el 77.8% recibió tratamiento con algún inhibidor de tirosin kinasa (osimertinib, erlotinib, afatinib) y un 15.9% recibieron inmunoterapia (pembrolizumab, atezolizumab, nivolumab). Conclusiones: La mutación predominante fue el EGFR, el tipo histológico más frecuente fue el adenocarcinoma y la mayoría de pacientes recibió tratamiento con un inhibidor de tirosin kinasa

Effectiveness and safety of the bevacizumab and erlotinib combination versus erlotinib alone in EGFR mutant metastatic non-small-cell lung cancer: systematic review and meta-analysis

BackgroundThe EGFR gene encodes a protein that stimulates molecular pathways that allow the growth and development of the tumor microenvironment. The current preferred tyrosine kinase inhibitor (TKI) for the first-line treatment of EGFRm metastatic non-small cell lung cancer (NSCLC) is osimertinib. However, the combination of angiogenesis inhibitors and TKI has produced discordant results. We aimed to assess the effects of the bevacizumab and erlotinib combination in EGFRm metastatic NSCLC.MethodsUsing eligibility criteria focused on patients with EGFRm metastatic NSCLC treated with bevacizumab and erlotinib, we searched databases including clinical trial randomized studies and reviews published until April 15, 2023 in Medline (PubMed), Scopus, and Embase. Eight clinical trials (1,052 patients) were selected from 1,343 articles for quantitative and qualitative assessment. The risk of bias was assessed using the Cochrane Risk of Bias tool. Data were synthesized through random-effects meta-analysis.ResultsThe bevacizumab and erlotinib combination significantly improved the progression-free survival (PFS) (log(HR) = 0.63; 95% CI: 0.54–0.73, p < 0.001) and overall response ratio (ORR) (RR = 0.79; 95% CI, 0.64–0.97, p = 0.03). However, it did not improve the overall survival (log(HR) = 0.93; 95% CI, 0.78–1.10, p = 0.38) and was associated with higher serious adverse events (SAEs) (OR = 3.48; 95% CI, 1.76–6.88, p = 0.005). A subgroup analysis suggested similar benefits in different mutation subtypes and brain metastasis condition. The evidence is limited by a moderate risk of bias across studies and heterogeneity in the reporting of SAEs.ConclusionsThe bevacizumab and erlotinib combination significantly improved PFS and ORR in EGFRm metastatic NSCLC but were also associated with higher-grade (≥3) adverse events. These results suggest that while the combination therapy may enhance progression-free survival and overall response, it does not improve the overall survival and is associated with higher toxicity. Thus, the treatment should be personalized based on individual patient comorbidities. Further prospective trials are needed to validate these results.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/#searchadvanced, identifier CDR 42022364692

Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.Peer reviewe

Search for new particles in events with energetic jets and large missing transverse momentum in proton-proton collisions at root s=13 TeV

A search is presented for new particles produced at the LHC in proton-proton collisions at root s = 13 TeV, using events with energetic jets and large missing transverse momentum. The analysis is based on a data sample corresponding to an integrated luminosity of 101 fb(-1), collected in 2017-2018 with the CMS detector. Machine learning techniques are used to define separate categories for events with narrow jets from initial-state radiation and events with large-radius jets consistent with a hadronic decay of a W or Z boson. A statistical combination is made with an earlier search based on a data sample of 36 fb(-1), collected in 2016. No significant excess of events is observed with respect to the standard model background expectation determined from control samples in data. The results are interpreted in terms of limits on the branching fraction of an invisible decay of the Higgs boson, as well as constraints on simplified models of dark matter, on first-generation scalar leptoquarks decaying to quarks and neutrinos, and on models with large extra dimensions. Several of the new limits, specifically for spin-1 dark matter mediators, pseudoscalar mediators, colored mediators, and leptoquarks, are the most restrictive to date.Peer reviewe

Combined searches for the production of supersymmetric top quark partners in proton-proton collisions at root s=13 TeV

A combination of searches for top squark pair production using proton-proton collision data at a center-of-mass energy of 13 TeV at the CERN LHC, corresponding to an integrated luminosity of 137 fb(-1) collected by the CMS experiment, is presented. Signatures with at least 2 jets and large missing transverse momentum are categorized into events with 0, 1, or 2 leptons. New results for regions of parameter space where the kinematical properties of top squark pair production and top quark pair production are very similar are presented. Depending on themodel, the combined result excludes a top squarkmass up to 1325 GeV for amassless neutralino, and a neutralinomass up to 700 GeV for a top squarkmass of 1150 GeV. Top squarks with masses from 145 to 295 GeV, for neutralino masses from 0 to 100 GeV, with a mass difference between the top squark and the neutralino in a window of 30 GeV around the mass of the top quark, are excluded for the first time with CMS data. The results of theses searches are also interpreted in an alternative signal model of dark matter production via a spin-0 mediator in association with a top quark pair. Upper limits are set on the cross section for mediator particle masses of up to 420 GeV