Objectives: To assess the psychometric properties of the Peruvian version of the Rowland Universal Dementia Assessment Scale (RUDAS-PE) to discriminate controls from patients with mild cognitive impairment (MCI) and early dementia (ED) in a population with a mid-level education. Methods: A total of 133 patients from a memory clinic were administered the RUDAS-PE, INECO Frontal Screening, Addenbrooke’s Cognitive Examination, and Mini-Mental State Examination. Results were compared against a neuropsychological evaluation (gold standard). Validity measures, internal consistency, and concurrent validity were calculated. Results: Cronbach’s α was 0.68; Pearson’s ratio was 0.79 ( P < .01). The area under the receiver–operating characteristics curve of the RUDAS to discriminate between ED and MCI was 89.0% (optimal cutoff at <21), whereas between MCI and controls, it was 99.0% (optimal cutoff at <24). Conclusions: The RUDAS-PE has acceptable psychometric properties performing well in its ability to discriminate controls from patients with MCI and ED.

IntroductionAlthough the worldwide incidence of tuberculosis (TB) is slowly decreasing, annual infection rates in Peru remain among the highest in the Americas. Pharmacies could play an important role in facilitating early detection of TB. However, the awareness, expertise and cooperation of pharmacy workers is fundamental. This study explored the TB-related knowledge, attitudes and practices of pharmacy workers in a district with one of the highest incidences of TB in Peru.MethodsThis cross-sectional study applied a questionnaire that was administered face to face using smartphones with one pharmacy worker at each of 45 randomly selected pharmacies in the El Agustino district of Lima, Peru.ResultsParticipants were primarily female (78%) and had an average age of 31.3 years old (range 18–57 years old). Only 11% of participants were pharmacists with complete university training. The pharmacy workers’ knowledge was adequate; however, workers had important knowledge gaps and myths regarding prevention of TB transmission. Most pharmacy workers (77%) reported they would send a client with a history of cough for more than two weeks to a healthcare center, while 23% reported they would offer them antitussive medication or antibiotics. Almost all workers reported talking with clients about diseases and reported respiratory symptoms as one of the most common causes for consultation (60%). Most participants expressed interest in learning more about TB and expanding their involvement in the fight against TB in their community.ConclusionPharmacy workers have adequate knowledge about TB. However, we identified gaps in knowledge with respect to prevention of TB transmission. Pharmacy workers commonly see patients with respiratory symptoms and some offer recommendations, including for treatment. Pharmacy workers are willing to learn more and contribute to TB control and could be a valuable asset in the control and prevention of TB in Peru. To achieve this integration of pharmacy workers into TB control and prevention, more research is needed.

RESUMENCon el fin de determinar la frecuencia de empleo de plantas medicinales y describir las características de su uso en pacientes de dos hospitales referenciales de la ciudad de Cusco, se realizó un estudio transversal entre agosto y septiembre de 2011. Para el recojo de datos se construyó un instrumento, validado por juicio de expertos. El tamaño de la muestra fue de 250 personas seleccionadas no probabilísticamente. El 83,2 y 75,3% informaron haber empleado plantas medicinales alguna vez en su vida y en el último mes, respectivamente; además, el 85,7 señaló que desearía que su médico le recete plantas medicinales. Sus usos más frecuentes son para problemas digestivos (62,4%); urinarios (42,4%), y respiratorios (40,4%). Se concluye que el empleo de plantas medicinales se encuentra bastante difundido entre los usuarios de dos hospitales referenciales de la ciudad de Cusco. Los patrones de empleo revelan que los pacientes desean que los médicos del sistema de salud prescriban plantas medicinales en su acto médico. Palabras clave: Plantas medicinales; Medicina tradicional; Hospitales; Perú (fuente: DeCS BIREME). USE OF MEDICINAL PLANTS AMONG PEOPLE ATTENDING TWO REFERENCE HOSPITALS IN CUSCO, PERU ABSTRACTIn order to determine the frequency and characteristics of the use of medicinal plants in patients from two third-level hospitals in the city of Cusco, a cross-sectional study was conducted between August and September 2011. For data collection, an instrument was built and validated through experts' judgment. INTRODUCCIÓNSegún la Organización Mundial de Salud, la medicina tradicional comprende a las prácticas, los enfoques, los conocimientos y las creencias sanitarias diversas que incorporan medicinas basadas en plantas; en animales o minerales; en terapias espirituales; en técnicas manuales, y en ejercicios aplicados de forma individual, o en combinación, para mantener el bienestar, además de tratar, diagnosticar y prevenir las enfermedades (1) .En países en vías de desarrollo se ha descrito que hasta el 90% de la población usa la medicina tradicional (1) .Estudios en Latinoamérica reportan diferentes frecuencias de uso de plantas medicinales. En una zona rural de Córdova (Argentina) se ha descrito que el 100% de la población conocía sobre el uso de plantas medicinales, y el 78% conocía al menos cinco especies (2) . En Brasil, dependiendo de la región, la frecuencia de uso de plantas medicinales puede variar entre 70 y 98% de pobladores que la usan (3,4) . En tanto que en Panamá el 84% de adultos que acuden a una unidad de atención primaria, usan también plantas medicinales (5) .El año 2007 se realizó una cumbre internacional organizada por el Colegio Médico del Perú, conocida

Cough is a characteristic symptom of tuberculosis, is the main cause of transmission, and is used to assess treatment response. We aimed to identify the best measure of cough severity and characterize changes during initial tuberculosis therapy. We conducted a prospective cohort of recently diagnosed ambulatory adult patients with pulmonary tuberculosis in two tertiary hospitals in Lima, Peru. Pre-treatment and five times during the first two months of treatment, a vibrometer was used to capture 4-hour recordings of involuntary cough. A total of 358 recordings from 69 participants were analyzed using a computer algorithm. Total time spent coughing (seconds per hour) was a better predictor of microbiologic indicators of disease severity and treatment response than the frequency of cough episodes or cough power. Patients with prior tuberculosis tended to cough more than patients without prior tuberculosis, and patients with tuberculosis and diabetes coughed more than patients without diabetes comorbidity. Cough characteristics were similar regardless of HIV co-infection and for drug-susceptible versus drug-resistant tuberculosis. Tuberculosis treatment response may be meaningfully assessed by objectively monitoring the time spent coughing. This measure demonstrated that cough was increased in patients with TB recurrence or co-morbid diabetes, but not because of drug resistance or HIV co-infection.

Cough frequency during treatment is greater and lasts longer in patients with larger cavities, especially those closer to the airway.