Diseño y validación de un Cuestionario para evaluar los Conocimientos sobre Infecciones del Tracto Genital Inferior en farmacia comunitaria / Design and validation of a Questionnaire to evaluate the knowledge about Lower Genital Tract Infections in Community Pharmacy

Objetivos: Diseñar y validar un cuestionario de conocimientos sobre infecciones del tracto genital inferior, de no transmisión sexual, destinado a las pacientes que acuden a las farmacias comunitarias y han sufrido infecciones vaginales al menos una vez. Material y métodos: Validación y diseño del cuestionario de conocimientos se basó en la revisión bibliográfica, valoración por el panel de expertos (método Delphi) y el análisis estadístico correspondiente. Se determinó la fiabilidad de la escala mediante el índice de consistencia interna (alfa de Cronbach), se realizó un análisis factorial de componentes principales con rotación Varimax y se verificó la sensibilidad del cuestionario al cambio a través del Test de Wilcoxon y McNemar. El cuestionario se autoadministró dentro de las oficinas de farmacia antes de la intervención educativa mediante folletos especialmente elaborados y se volvió a aplicar pasados 6 meses. Resultados: La valoración por 30 expertos fue superior a 4 sobre 5 en escala Likert. En el estudio participaron 105 mujeres entre 18 y 65 años de 11 farmacias comunitarias de Madrid. La consistencia interna antes y después de depuración de ítems fue 0,713 y 0,738 respectivamente. El análisis factorial confirmó la multidimensionalidad del cuestionario. Mediante el Test de Wilcoxon se demostró la sensibilidad del cuestionario a la intervención educativa. El 28,6% de las pacientes contestó correctamente a más del 75% de los ítems. Conclusiones. Los conocimientos sobre infecciones vaginales se consideran insatisfactorios por lo tanto se ve necesaria la implementación de educación sanitaria en las oficinas de farmacia. Gracias a la fiabilidad de la escala y la óptima validez del contenido, el cuestionario diseñado puede ser considerado una buena base para futuras investigaciones y una herramienta recomendable en la práctica profesional

Objectives: To design and validate a questionnaire of knowledge about infections of the lower genital tract, of non-sexual transmission, intended for patients who visit community pharmacies and have suffered vaginal infections at least once. Material and methods: The validation and design of the knowledge questionnaire was based on bibliographic review, evaluation by the panel of experts (Delphi method) and the corresponding statistical analysis. The reliability of the scale was determined using the internal consistency index (Cronbach's alpha). Besides, a factorial analysis of the main components with Varimax rotation was carried out and the questionnaire sensitivity to change was verified through the Wilcoxon and McNemar test. The questionnaire was self-administered among the pharmacies before the educational intervention through specially prepared brochures and was re-applied after 6 months. Results: The evaluation by 30 experts was superior to 4 out of 5 on the Likert scale. The study involved 105 women between 18 and 65 years old from 11 community pharmacies in Madrid. The internal consistency before and after the item screening was 0,713 and 0,738 respectively. The factorial analysis confirmed the multidimensionality of the questionnaire. The Wilcoxon test demonstrated the sensitivity of the questionnaire to the educational intervention. Only 28.6% of the patients correctly answered more than 75% of the items. Conclusions: The knowledge about vaginal infections is considered unsatisfactory; therefore, it is necessary to implement health education in the community pharmacies. Thanks to the reliability of the scale and the optimal validity of the content, the designed questionnaire can be considered a good basis for future research and a recommended tool in professional practice

Reactive Oxygen Species Contribute to the Bactericidal Effects of the Fluoroquinolone Moxifloxacin in Streptococcus pneumoniae.

We studied the transcriptomic response of Streptococcus pneumoniae to the fluoroquinolone moxifloxacin at a concentration that inhibits DNA gyrase. Treatment of the wild-type strain R6, at a concentration of 10× the MIC, triggered a response involving 132 genes after 30 min of treatment. Genes from several metabolic pathways involved in the production of pyruvate were upregulated. These included 3 glycolytic enzymes, which ultimately convert fructose 6-phosphate to pyruvate, and 2 enzymes that funnel phosphate sugars into the glycolytic pathway. In addition, acetyl coenzyme A (acetyl-CoA) carboxylase was downregulated, likely leading to an increase in acetyl-CoA. When coupled with an upregulation in formate acetyltransferase, an increase in acetyl-CoA would raise the production of pyruvate. Since pyruvate is converted by pyruvate oxidase (SpxB) into hydrogen peroxide (H2O2), an increase in pyruvate would augment intracellular H2O2. Here, we confirm a 21-fold increase in the production of H2O2 and a 55-fold increase in the amount of hydroxyl radical in cultures treated during 4 h with moxifloxacin. This increase in hydroxyl radical through the Fenton reaction would damage DNA, lipids, and proteins. These reactive oxygen species contributed to the lethality of the drug, a conclusion supported by the observed protective effects of an SpxB deletion. These results support the model whereby fluoroquinolones cause redox alterations. The transcriptional response of S. pneumoniae to moxifloxacin is compared with the response to levofloxacin, an inhibitor of topoisomerase IV. Levofloxacin triggers the transcriptional activation of iron transport genes and also enhances the Fenton reaction.