Introducción. Las enfermedades cardiovasculares son la principal causa de mortalidad.Desde la farmacia comunitaria (FC) es posible ayudar a los pacientes a mejorar los factores de riesgo ...cardiovascular (FRCV) modificables: hipertensión arterial (HTA), dislipemia, diabetes mellitus (DM), tabaquismo y obesidad. Entre los servicios profesionales farmacéuticos relacionados con la salud comunitaria se incluyen este tipo de actuaciones. El objetivo de este estudio ha sido determinar el perfil sociosanitario y farmacoterapéutico de los pacientes con RCV atendidos en la FC española, con el fin de diseñar la intervención más efectiva para ellos.
Método: Se realizó un estudio descriptivo de corte transversal entre enero 2017 y febrero 2018. Utilizando un formulario de recogida de datos se registraron los correspondientes a los pacientes de cuatro FC, dos en Sevilla y dos en Badajoz (España) mediante entrevistas individualizadas.
Resultados: La muestra inicial (n=100) quedó reducida a 98 pacientes, mayores (61,5±10,1 años), 51,0 % varones, con bajo nivel educativo (53,1 %) y la mayoría de ellos viviendo acompañados (87,8 %). El 74,5 % eran pacientes en prevención primaria y su nivel de RCVmoderado (2,51±1,89). HTA (83,7 %), dislipemia (64,39 %), diabetes II (38,8 %) y obesidad (52,0 %) fueron los factores más prevalentes. Casi la mitad de los pacientes (48,5 %) realizaban ejercicio físico regularmente y el 23,5 % eran fumadores. Los fármacos más consumidos fueron los modificadores de lípidos (59,4 %), antidiabéticos orales (37,5 %), antitrombóticos (32,2 %) y betabloqueantes (28,1 %),
Conclusiones: La utilización de formularios encaminados a detectar las necesidades educacionales y farmacoterapéuticas de pacientes con RCV, permitirá establecer diferentes estrategias para mejorar la capacidad de gestionar su enfermedad.
Over the last three decades, urban agriculture has been improving food security in Cuba by providing fresh vegetables within and on the outskirts of cities and villages. However, organic fertilizers ...and substrates that are used in urban agriculture systems can be contaminated by trace elements and accordingly pose risks to human health. This study was carried out to measure the concentrations of cadmium, lead, arsenic, selenium, mercury, nickel, and chromium in composts and substrates used in Cuba’s urban agriculture, as well as in vegetables grown in this cropping system to assess risks to human health. Extraction of trace elements from samples was performed with a mixture of nitric and hydrochloric acid in a microwave oven. Cadmium, lead, nickel, and chromium were determined via optical emission spectrometry, and mercury, selenium, and arsenic were measured using an atomic absorption spectrophotometer coupled with a hydride generation system. We demonstrated that the concentrations of trace elements in organic fertilizers, with the exception of compost from municipal solid waste, were within permissible values and do not pose risks to human health. The compost produced from municipal solid waste and the substrates prepared with this material presented cadmium and lead concentrations above maximum permissible concentrations. This work represents the first national-wide survey of trace elements in Cuban urban agriculture. As a result of this investigation, the use of municipal-solid-waste compost for food production was forbidden in Cuba.
The objective of this work was to evaluate in a model of chronic ulcer the antiulcer effect and the possible mechanisms by which this fruit produces gastroprotection. The pulp of the green fruit was ...sliced, dried at 50 oC, ground and sieved. Ninety Male Wistar rats of 190 ± 10 g were used. The antiulcer effect of pulp was performed with the chronic model of ulcer by acetic acid, used 5 groups of 8 animal, the suspension of the pulp at 125; 250; 500 mg / kg BW were applied 72 hours after inducing the ulcer for 7 days. For the determination of the mechanisms, also 5 groups of 10 animal were used, the banana pulp was supplied in a dose of 125, 250 and 500 mg / kg of BW, for three days, before inducing the ulcers with indomethacin, the activity of the myeloperoxidase, the superoxide dismutase and the levels of prostaglandins in the gastric mucosa were determined. Treatment with the suspensions of the pulp in the chronic ulcer model reduced in a very highly significant way the damaged area in all the treated groups and this reduction was greater than that produced by ranitidine; there was a significant decrease in myeloperoxidase only with the highest dose tested and a significant increase of superoxide dismutase and prostaglandins level with all the doses used. We conclude that the pulp preparations provoked an intense anti-ulcer. The mechanism of gastroprotective action was mediated by an antioxidant effect and mucosal protection.
Background
The concept of Pharmaceutical Care (PC) is being gradually developed, and it’s impact in health care should be measured using a quality tool.
Objective
The aim of this study was to ...describe and assess the psychometric properties of a patient satisfaction questionnaire (PSQ) for PC services in community pharmacies in Seville, Spain. It was based on a previous questionnaire in Spanish.
Methods
The face and content validity were assessed using the items of a validated questionnaire developed by Traverso et al. and adapted to the Seville pharmacy patient population. The PSQ was designed for use in the community pharmacy setting by a panel of seven pharmacists with expertise in both PC and questionnaire design. The result, was a ‘draft PSQ’ which comprised of 27 multidimensional items, with responses recorded on a five-point ‘Likert-type scale’. The validity and reliability of the ‘final PSQ’ was carried out using a cross-sectional and analytical study. Eighteen community pharmacies agreed to participate in the study. The draft PSQ was a self completion questionnaire distributed to patients by pharmacists following selection criteria. The survey response rate was assessed. The validity was determined by establishing the distribution of the PSQ’s items and dimensions of the PSQ through factor analysis, and the reliability was evaluated with Cronbach’s alpha coefficient (α).
Results
Two-hundred and twenty-three patients took part in the study.The factor analysis with varimax rotation established a ‘final PSQ’ with 24 items over two dimensions: Medication Therapy Management (MTM) and General satisfaction with the pharmacy/staff and services (GSP/SS) which extracted 63.5% of the variance. The internal consistency by α was 0.964 for the PSQ and 0.959 and 0.916 for the two dimensions, respectively. The median (mode) score for GSP/SS was 5.0 (5.0) and 4.0 (5.0) for MTM. The Wilcoxon-test indicated that the difference between these scores was statistically significant (
P
< 0.001).
Conclusion
Our results suggest that the PSQ is a two dimensional instrument with psychometric properties able to assess patient satisfaction in community pharmacies. However, its validity and reliability need to be further confirmed in different PC settings and its sensitivity to measure changes in satisfaction over time also needs to be established.
Introducción: en trabajos previos se ha demostrado, de forma experimental, que el fruto verde de la Musa spp ABB, variedad Burro CEMSA, es efectivo como agente gastroprotector. Objetivo: evaluar los ...posibles mecanismos por los cuales la pulpa de este fruto produce gastroprotección. Métodos: se utilizaron ratas Wistar machos de 190 ± 10 g. La pulpa del fruto verde se rebanó, se desecó a 50oC durante 72 horas, se molió y tamizó. Se conformaron seis grupos experimentales: el control negativo, el control positivo y los grupos a los que se les suministró la pulpa de plátano en dosis de 125; 250; 500 y 1000 mg/kg de peso vivo, durante tres días, antes de inducir las úlceras por la indometacina: 40 mg/kg de peso vivo. Se determinó el efecto antiulceroso, la actividad de la mieloperoxidasa, de la superóxido dismutasa y los niveles de prostaglandinas en la mucosa gástrica. Resultados: se obtuvo una disminución altamente significativa de la intensidad de las lesiones con el uso de todas preparaciones del fruto; se produjo una disminución significativa de la mieloperoxidasa solo con la dosis de 1000 mg/kg de peso vivo y un incremento significativo de la superóxido dismutasa y del contenido de las prostaglandinas en la mucosa gástrica con todas las dosis empleadas. Conclusión: las preparaciones de la pulpa provocaron una intensa acción gastroprotectora. El mecanismo de acción está mediado por un efecto antioxidante y por la protección de la mucosa, causada por el incremento de los niveles de prostaglandinas.
Introduction: In previous studies we have demonstrated experimentally that the green fruit of the Musa spp ABB, variety Burro CEMSA, is effective as a gastroprotective agent in a model of induction ...of ulcers by absolute alcohol and indomethacin. Objective: To evaluate in a model of chronic ulcer the antiulcer effect and the possible mechanisms by which the pulp of this fruit produces gastroprotection. Materials and methods: Male Wistar rats of 190 ± 10 g were used. The pulp of the green fruit was sliced, dried at 50 oC for 72 hours, ground and sieved. The antiulcer effect of pulp suspensions was performed with the model of chronic ulcer by acetic acid, used 5 experimental groups of 8 rats each, group 1 negative control, group 2 positive control (ranitidine 50 mg / kg, weight alive), group 3. 4 and 5 that was given the suspension of the pulp at 125; 250; 500 mg / kg live weight. The substances to be tested were applied 72 hours after inducing the ulcer for a period of 7 days. For the determination of the mechanisms, five experimental groups of 10 animals each were formed: the negative control, the positive control and three groups to which the banana pulp was supplied in a dose of 125, 250 and 500 mg / kg of live weight, for three days, before inducing the ulcers with indomethacin: at 40 mg / kg of live weight, the activity of the myeloperoxidase, the superoxide dismutase and the levels of prostaglandins in the gastric mucosa were determined. Results: Treatment with the suspensions of the pulp in the chronic ulcer model reduced in a very highly significant way the damaged area in all the treated groups and this reduction was greater than that produced by ranitidine. A highly significant decrease in lesion intensity was obtained with the use of all preparations of the banana pulp in the indomethacin ulcer induction model; there was a significant decrease in myeloperoxidase only with the highest dose tested and a significant increase of superoxide dismutase and prostaglandins content in the gastric mucosa with all the doses used. Conclusions: We conclude that the pulp preparations provoked an intense anti-ulcer and gastroprotective action. The mechanism of action is mediated by an antioxidant effect and mucosal protection, caused by the increase of prostaglandin levels. The study has been conducted in conformance with the Ethical Principles for the use of animals in research and education.
Observations of binary stars containing an accreting black hole or neutron star often show x-ray emission extending to high energies (>10 kilo–electron volts), which is ascribed to an accretion disk ...corona of energetic particles akin to those seen in the solar corona. Despite their ubiquity, the physical conditions in accretion disk coronae remain poorly constrained. Using simultaneous infrared, optical, x-ray, and radio observations of the Galactic black hole system V404 Cygni, showing a rapid synchrotron cooling event in its 2015 outburst, we present a precise 461 ± 12 gauss magnetic field measurement in the corona. This measurement is substantially lower than previous estimates for such systems, providing constraints on physical models of accretion physics in black hole and neutron star binary systems.
Evaluate the relationship between the presence of polymorphisms in genes involved in the pharmacodynamics of irinotecan (UGT1A, SLCO1B1, ABCB1 and ABCC2) and the safety of irinotecan in the treatment ...of metastatic colorectal cancer (mCRC).
Prospective observational, single-centre study of 30 months duration, which included patients diagnosed with mCRC treated with FOLFIRI was carried out. Toxicity was evaluated in each treatment cycle according to the Common Terminology Criteria for Adverse Events (CTCAE) v.4.0 NCI. Genomic DNA was obtained with a peripheral blood sample from an extraction method based on alkaline lysis. Genetic characterisation was performed using the LigthCycler®480 platform and allele-specific HybProbe® fluorescent probes. Analysed polymorphisms were: UGT1A1*28, UGT1A1*60, UGT1A7*1,*2,*3,*4, UGT1A7*12, UGT1A9*22, SLCO1B1 (rs11045879), ABCC2 (rs717620) and ABCB1 (rs1045642).
Thirty-four patients were included (73.5% were male, mean age 59.9 years 27–81) in the study. Polymorphisms rs8175347, rs17868323, rs3832043, rs11692021 and rs7577677 were associated with a higher incidence of adverse effects. Furthermore, it was observed that those patients with wild-type in UGT family genes analysed have lower rates of toxicity associated with irinotecan treatment than those with certain mutated allele (p=0.010).
These results suggest that the presence of certain polymorphisms in the UGT1A family of genes is related to the development of toxicity during treatment with irinotecan.
Evaluar la relación entre la presencia de polimorfismos en los genes implicados en la farmacodinamia del irinotecán (UGT1A, SLCO1B1, ABCB1 y ABCC2) y la seguridad asociada al mismo en el tratamiento del cáncer colorrectal metastásico (CCRm)
Estudio prospectivo observacional y unicéntrico de 30 meses de duración, en el que se incluyeron los pacientes diagnosticados de CCRm tratados con el esquema FOLFIRI. La toxicidad fue evaluada en cada ciclo de tratamiento según la Common Terminology Criteria for Adverse Events (CTCAE) v.4.0 NCI. La obtención del ADN genómico se realizó mediante una muestra de sangre periférica a partir de un método de extracción basado en lisis alcalina. La caracterización genética se realizó empleando la plataforma LigthCycler®480 y sondas fluorescentes HybProbe® específicas de alelo. Los polimorfismos analizados fueron: UGT1A1*28, UGT1A1*60, UGT1A7*1,*2,*3,*4, UGT1A7*12, UGT1A9*22, SLCO1B1 (rs11045879), ABCC2 (rs717620) y ABCB1 (rs1045642).
Fueron incluidos 34 pacientes (el 73,5% eran hombres, con una edad media de 59,9 años 27-81). Los polimorfismos: rs8175347, rs17868323, rs3832043, rs11692021 y rs7577677 se relacionaron con una mayor incidencia de efectos adversos. Por otro lado, se observó que aquellos pacientes wild-type, en la serie de genes de la familia UGT analizada, presentan unas menores tasas de toxicidad asociada al tratamiento con irinotecán que aquellos que poseen alguno de los polimorfismos analizados (p=0,010).
Estos resultados sugieren que la presencia de determinados polimorfismos en la familia de genes UGT1A se encuentra relacionada con el desarrollo de toxicidad en el tratamiento con irinotecán en dosis para el esquema FOLFIRI.
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