Colonization by Streptococcus pneumoniae among children in Porto Velho, Rondônia, Western Brazilian Amazon.

Streptococcus pneumoniae is one of the primary pathogens that are associated with acute respiratory infections (ARI) that cause high rates of morbidity and mortality among children under five years of age in developed and developing countries. This study aimed to determine the prevalence of nasopharyngeal colonization, the antimicrobial resistance profile, and the capacity for biofilm formation by S. pneumoniae isolated from children aged 0-6 years with ARI throughout the Porto Velho-RO. A total of 660 swabs were collected from children with ARI. Molecular and biochemical tests were performed to characterize the isolates. The disk-difusion method and the E-test were used for antimicrobial sensitivity testing (TSA). Biofilm formation capacity was assessed using microtiter plate assays, and serotype detection was acheived using polymerase chain reaction (PCR) analyses. The colonization rate for S. pneumoniae was 8.9% (59/660) and exhibited a high prevalence in children under 23 months of age 64.4% (38/59). The observed serotypes were 9V and 19F with frequencies of 1.7% (1/59) and 13.6% (8/59), respectively. The antimicrobial susceptibility test revealed 100% (59/59) sensitivity to vancomycin. In contrast, trimethoprim and oxacillin exhibited high resistance rates of 76.3% (45/59) and 52.5% (31/59), respectively. Of the biofilm-forming isolates, 54.8% (23/42) possessed resistance to some antimicrobials. In this study, S. pneumoniae showed high rates of antimicrobial resistance and the ability to form biofilms, as these are factors that favor bacterial persistence and can cause serious damage to the host.

Comprende el medicamento/descubre al farmacéutico. Resultados preliminares 2021 y 2022 en Extremadura. Diferencias en las aulas / Understand the medicine/discover the pharmacist. Preliminary results 2021 and 2022 in Extremadura. Differences in the classroom

INTRODUCCIÓN: en esta edición el proyecto CONÓCEME: comprende el medicamento/descubre al farmacéutico, va dirigido también a estudiantes de 4º o 3º Educación Secundaria Obligatoria (ESO) con el fin de llegar a todos los adolescentes.OBJETIVOS: evaluar la diferencia de aprendizaje de las nociones básicas del uso adecuado del medicamento entre los estudiantes de los cursos 1º bachillerato, 4º y 3º ESO. _Evaluar el grado de satisfacción con la actividad educativa de los estudiantes.MATERIAL Y MÉTODOS: estudio observacional descriptivo, transversal, prospectivo, multicéntrico, centrado en una muestra de estudiantes de 1º bachillerato, 4º y 3º ESO de las dos provincias extremeñas durante 2021 y 2022. Se realizaron formaciones específicas a los farmacéuticos comunitarios (FC) que impartieron las intervenciones educativas (IE) informándoles sobre el proyecto, y proporcionándoles la documentación asociada, con la finalidad de conseguir IE lo más homogéneas posibles en todas las provincias. La actividad educativa fue impartida por uno o dos FC, en dos sesiones. Después de cada IE, los estudiantes resolvieron cinco ejercicios en la plataforma del proyecto. En la segunda, tras los ejercicios rellenaron una encuesta de satisfacción. Para completar la actividad se envió al centro el ebook “Guía práctica para el uso adecuado de los medicamentos” para su difusión entre alumnos y profesores. RESULTADOS: Badajoz fue la provincia de Extremadura que participó en el estudio CONÓCEME, Cáceres se incorporó al proyecto en esta edición 2021. A fecha 11/03/2022, participaron 10 centros educativos, 8 en Cáceres y 2 en Badajoz. Ubicados 7 en población urbana y 3 en rural (<10.000 habitantes); siendo 6 de los centros de titularidad pública. (AU)

Estudio de brote COVID en centro residencial de mayores (CRM) de Alconchel: comparativa entre pacientes antes y después de la COVID / Study of the COVID outbreak in the elderly residential centre (CRM) of Alconchel: comparison between patients before and after COVID

JUSTIFICACIÓN: el 4,1 % de la población mayor en España vive en residencias; allí son más vulnerables a infecciones graves por COVID sufriendo altas tasas de mortalidad. En octubre del 2020 aparece un brote en el CRM de Alconchel Desde la farmacia ofrecemos el servicio de SPD y SFT. (AU)

Implantación del servicio de SPD y seguimiento farmacoterapéutico en centro residencial de mayores de Alconchel durante un brote por COVID-19 / Implementation of the SPD service and pharmacotherapeutic monitoring in a residential centre for the elderly in Alconchel during an outbreak of COVID-19

JUSTIFICACIÓN: el 4,1 % de la población mayor vive en residencias. Las personas que viven en estos centros son más vulnerables a las infecciones graves por SARS-CoV-2 y tienen altas tasas de mortalidad. El 31 de octubre de 2020 se detecta un brote en el centro residencial de mayores (CRM) de Alconchel. Desde la farmacia les ofrecemos el servicio de SPD y SFT.OBJETIVOS:• Ayudar a trabajadores y residentes del CRM con la organización de la medicación durante el brote de COVID.•Realizar RUM a residentes.•Caracterización de pacientes durante el brote y tras él.•Demostrar la utilidad del SPD en CRM.MATERIAL Y MÉTODOS: contactamos con el CRM para ofrecer el servicio de SPD y AF similar al que prestamos en la AFD. Realizamos un RUM. Contactamos telefónicamente con el MAP para subsanar PRM detectados. Elaboramos SPD según PNT de la guía de SEFAC-SEMERGEN. Análisis de datos con LibreOffice Calc.RESULTADOS: detectamos problemas de conservación e identificación en los medicamentos comprimidos cortados dentro de envase sin lotes y sin caducidad, envases caducados y PRM: pautas incorrectas, interacciones y duplicidades en 5 de 15 usuarios. Durante el brote hay 16 residentes (9 mujeres y 7 hombres), con 85,31 años de media. Dan positivo por COVID mas del 71 % de auxiliares y el 100 % de residentes; el 56 % ingresa en el hospital. El 25 % fallece. De los que superan la enfermedad el 1 7 % tiene secuelas. Tras el brote de COVID instauramos el servicio SPD en CRM. Actualmente hay 12 residentes con 85 años de media.CONCLUSIONES•Reducimos la carga de trabajo al personal auxiliar.•Se subsanan problemas de conservación e identificación de medicamentos y 7 PRM a nivel individual•El 71 % de las auxiliares y el 100 % de los residentes dieron positivo. Más del 56 % de los residentes ingresa en el hospital, el 25 % fallece. El 17 % de los que superan el COVID tienen secuelas. (AU)

Adaptación del tratamiento farmacológico de paciente con SPD tras sufrir accidente cardiovascular (ACV) / Adaptation of the pharmacological treatment of patients with SPD after suffering a cardiovascular accident (CVA)

PRESENTACIÓN: mujer de 87 años vive junto con su marido. Desde 2019 se encuentra en el programa de AFD del ayuntamiento de Alconchel. Presenta 11 problemas de salud (PS), toma 14 medicamentos, uno de ellos de uso hospitalario y tratamiento dietoterápico. El 6 de febrero de 2022, sufre un ACV, recibiendo el alta el 25 de febrero.EVALUACIÓN: se realiza conciliación del tratamiento con el informe de alta; suspenden triflusal e indapamida y prescriben insulina glargina; resto tratamiento sin cambios. Se recomienda dieta triturada y toma de líquido con espesantes.INTERVENCIÓN: realizamos RUM tras alta hospitalaria; comprobando con fichas técnicas (FT) y departamentos técnicos (DT) de los laboratorios la posibilidad de triturar los comprimidos porque presenta problemas de deglución:• Bisoprolol , alprazolam , simvastatina, sertralina y torasemida: están adaptados.• Vivace y tesavel: según FT no adaptado, tras consultar con el DT dan su aprobación.Todos podemos pulverizarlos y dispersarlos en 10 ml de agua.• Omeprazol: adaptado; recomendamos abrir la cápsula suspender gránulos en medio vaso de liquidos o alimentos blandos. Los gránulos no deben masticarse ni triturarse. Administrarlo inmediatamente, preferiblemente en ayunas.• Tramadol/paracetamol: no adaptado; sugerimos cambiarlo a bucodispersable.• Cinacalcet: No adaptado; tras consultar con el DT, no se pueden partir ni triturar. La cubierta es entérica. Su uso partido, triturado o reformulado sólo se ha descrito para derivar dosis atípicas y se han informado principalmente en pediatría.RESULTADOS: tras hablar con el MAP:• Seguir utilizando el tramadol/paracetamol comprimidos; triturarlos ya que los tolerará mejor que el bucodispersable. (AU)

Análisis del taller “intervención farmacéutica en la dispensación de análogos de GLP-1 inyectables”. JORNADAS SEFAC 2021 / Analysis of the workshop "Pharmaceutical intervention in the dispensing of injectable GLP-1 analogues". SEFAC 2021 CONFERENCE

JUSTIFICACIÓN: los agonistas del receptor del GLP-1 (aGLP-1) son un grupo de fármacos que reducen significativamente la hemoglobina glicosilada sin riesgo de hipoglucemias. Este grupo terapéutico tiene efectos multifactoriales más allá del control de la glucemia: disminuye el vaciamiento gástrico, aumenta la cardioprotección, etc. Una dispensación adecuada ayuda a mejorar la adherencia al tratamiento.OBJETIVOS: analizar el impacto del taller de intervención en la dispensación de los análogos de GLP-1 inyectables a través de unas preguntas de evaluación.MATERIAL Y MÉTODOS: se realizó el taller “Intervención en la dispensación de análogos de GLP-1 inyectables” en las diferentes sedes de SEFAC desde septiembre a diciembre del 2021. Para la elaboración del taller se siguió el siguiente procedimiento: Se seleccionaron 4 farmacéuticos expertos en el tema y miembros del grupo de diabetes de SEFAC para la creación del taller. La estructura a seguir fue: 10 minutos teoría, 20 minutos rol play y 10 minutos preguntas. Creación del taller y preguntas de evaluación, revisión por pares del material por comité científico de SEFAC y el comité médico del laboratorio patrocinador. Formación de los ponentes de las diferentes sedes de SEFAC a través de una sesión formativa de 2 horas vía zoom.Desarrollo del taller, realizando las MISMAS preguntas de evaluación antes y después del taller.RESULTADOS: 773 encuestas realizadas en las 15 sedes de SEFAC: 407 encuestas antes del taller y 366 después. El porcentaje de respuestas correctas fue de 50,0% antes y 64,3% después. (AU)

[Focal epileptic seizures mimicking a stroke: neuroimaging and electroencephalographic correlations]. / Crisis epilépticas focales que imitan un ictus: neuroimagen y correlaciones electroencefalográficas.

TITLE: Crisis epilépticas focales que imitan un ictus: neuroimagen y correlaciones electroencefalográficas.

Peripheral and central antinociceptive effects of the butanolic fraction of Byrsonima verbascifolia leaves on nociception-induced models in mice.

Byrsonima verbascifolia (Malpighiaceae), commonly known as 'murici', is used in folk medicine, for example, in the treatment of inflammation. The anti-inflammatory activity of the butanolic fraction of B. verbascifolia leaves (BvBF) was previously reported by our group, and the present study was designed to evaluate their antinociceptive effects. BvBF (25, 50, and 100 mg/kg) administered intraperitoneally (i.p.) inhibited acetic acid induced abdominal writhing. In the formalin test, BvBF (10, 30 and 100 mg/kg, i.p.) caused a reduction in licking time in both the neurogenic and inflammatory phases. Moreover, we demonstrated that BvBF (30 and 100 mg/kg, i.p.) caused an increase in the latency to response in the hot-plate test. These results demonstrate that BvBF possesses marked peripheral and central antinociceptive activities. Pre-treatment with the non-selective receptor antagonist naloxone (5 mg/kg, i.p.) abolished the antinociceptive effects of BvBF (100 mg/kg, i.p.) in the neurogenic phase of the formalin and hot-plate tests. The anti-inflammatory activity of BvBF (previously reported) as well as the participation of the opioidergic system seems to be responsible, at least in part, for these antinociceptive effects. Finally, BvBF at the doses investigated (25, 50 and 100 mg/Kg) did not cause any toxicity signals, showing that the antinociceptive activity is devoid of sedative and hypomotility effects.

Controle de qualidade e análise sensorial em voluntários de xampu esfoliante com extrato hidroalcoólico de Capsicum frutescens L. (Solanaceae) / Quality control and sensory acceptability of exfoliating shampoo containing hydroethanolic extract of Capsicum frutescens L. (Solanaceae) peppers.

A fitocosmética é um setor em nítido crescimento por se ter verificado reais vantagens na incorporação de produtos vegetais em relação a certos produtos sintéticos em produtos cosméticos. O proposto trabalho foi desenvolvido enfocando-se o uso de xampu com a utilização de microesferas de biopolímero e extrato hidroalcoólico de Capsicum frutescens L., mais popularmente conhecida como pimenta-malagueta, para o tratamento de queda capilar simples (alopecia androgênica). As análises físico-químicas envolveram determinação de cinzas totais, pH, identificação de capsaicina e densidade do xampu, entre outros. Considerando-se os diversos aspectos exigidos para a garantia da qualidade do material botânico, que englobam não somente os aspectos físico-químicos, mas também o microbiológico, realizou-se, tanto no extrato quanto no produto final, a contagem total de micro-organismos, pesquisa de Salmonella sp e Escherichia coli, Staphylococcus aureus e Pseudomonas aeruginosa. Foram realizadas análises sensoriais em voluntários, visando avaliar a qualidade sensorial do produto. Os voluntários avaliaram a amostra segundo questionário aplicado. Para as propriedades avaliadas, as microesferas esfoliantes incorporadas ao xampu mostraram-se ser bem aceitas pelos voluntários, principalmente devido à sensação transmitida pela esfoliação, fazendo com que o extrato hidroalcoólico promova uma maior oxigenação local.

Phytocosmetics is a sector of the market in rapid growth, since real advantages have been demonstrated in the incorporation of plant products in cosmetics, in place of certain synthetic products. The focus of this study was on the use of shampoo containing microspheres of biopolymer and a hydroalcoholic extract of the fruit of Capsicum frutescens L., more commonly known as chili pepper, for the treatment of hair loss (androgenic alopecia). The physical and chemical analysis included the determination of total ash, pH and density of the shampoo and the identification of capsaicin. Considering the various requirements for quality assurance of the plant material, encompassing not only physicochemical but also microbiological criteria, both the extract and the final product were subjected to a total count of microorganisms and tests for Salmonella sp, Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa. The sensory quality of the product was assessed by a panel of volunteers, who rated the sample of shampoo in response to a questionnaire. For the properties assessed, the exfoliating microspheres incorporated into the shampoo proved to be well tolerated by the volunteers, mainly on account of the feeling conveyed by exfoliation, causing the hydroalcoholic extract to promote greater local oxygenation.

Diffuse cutaneous leishmaniasis responds to miltefosine but then relapses.

BACKGROUND: Diffuse cutaneous leishmaniasis (DCL), although rare, is profoundly incapacitating. At present there is no successful treatment for this progressive protozoan infection, which is associated with the absence of specific cell-mediated immunity (CMI) to Leishmania. This disease shares features with visceral leishmaniasis (VL), including specific CMI inactivity during active disease and a heavy parasitic burden, but VL responds well to treatment. Miltefosine is the first orally administered drug which has shown efficacy in the treatment of VL; it has not been adequately evaluated in the treatment of DCL. OBJECTIVES: To evaluate the efficacy of miltefosine in the treatment of DCL, using clinical, parasitological, histopathological and immunological criteria. METHODS: Sixteen patients with DCL were treated with miltefosine, 2.0-2.5 mg kg(-1) daily, for variable periods of time (75-218 days). Patients were hospitalized for the first month and evaluated every 2 weeks until the termination of treatment with routine laboratory chemistry, percentage clinical improvement, presence of parasites in skin smears, growth of parasites in culture medium and in hamsters, histopathological characteristics of the granulomas, adverse side-effects, and reactivity to leishmanin skin test antigen. Further cycles of treatment were given in some of these patients, particularly after suspension of treatment was followed by relapse. RESULTS: Patients showed dramatic clinical improvement and reduction in the parasite burden by day 15 after the initiation of treatment, which continued while treatment was maintained. By day 45, 15 patients showed 80-90% clinical improvement. Nevertheless, suspension of treatment was followed by the development of new lesions in all but one patient. Inoculation in hamsters was observed to be the most sensitive technique to detect persisting parasites. Adverse events were very mild. CONCLUSIONS: Miltefosine produced a dramatic clinical and parasitological response in patients with DCL and improvement continued during drug administration, but with a single exception all patients presented new lesions after suspension of treatment. There was no histological or skin test evidence to suggest the development of CMI during treatment, which may be an indispensable criterion for the evaluation of potentially effective drugs against DCL.

La literatura bibliológico-informativa en Cuba: parte II: análisis de dominio del siglo XX / The bibliological-informative literature in Cuba: Part II. XX century domain analysis

Se presentan las etapas que se identifican en el desarrollo de la literatura bibliológico-informativa cubana, así como sus peculiaridades y una descripción de las condiciones económicas, políticas, históricas y culturales que las sustentan.

The stages identified in the development of the Cuban bibliological-informative literature, as well as their peculiarities and a description of the economic, political, historical, and cultural conditions supporting them are presented.

Etiology of diarrheal infections in children of Porto Velho (Rondonia, Western Amazon region, Brazil).

In the present study, 470 children less than 72 months of age and presenting acute diarrhea were examined to identify associated enteropathogenic agents. Viruses were the pathogens most frequently found in stools of infants with diarrhea, including 111 cases of rotavirus (23.6% of the total diarrhea cases) and 30 cases of adenovirus (6.3%). The second group was diarrheogenic Escherichia coli (86 cases, 18.2%), followed by Salmonella sp (44 cases, 9.3%) and Shigella sp (24 cases, 5.1%). Using the PCR technique to differentiate the pathogenic categories of E. coli, it was possible to identify 29 cases (6.1%) of enteropathogenic E. coli (EPEC). Of these, 10 (2.1%) were typical EPEC and 19 (4.0%) atypical EPEC. In addition, there were 26 cases (5.5%) of enteroaggregative E. coli, 21 cases (4.4%) of enterotoxigenic E. coli, 7 cases (1.4%) of enteroinvasive E. coli (EIEC), and 3 cases (0.6%) of enterohemorrhagic E. coli. When comparing the frequencies of diarrheogenic E. coli, EPEC was the only category for which significant differences were found between diarrhea and control groups. A low frequency of EIEC was found, thus EIEC cannot be considered to be a potential etiology agent of diarrhea. Simultaneous infections with two pathogens were found in 39 diarrhea cases but not in controls, suggesting associations among potential enteropathogens in the etiology of diarrhea. The frequent association of diarrheogenic E. coli strains was significantly higher than the probability of their random association, suggesting the presence of facilitating factor(s).

Etiology of diarrheal infections in children of Porto Velho (Rondonia, Western Amazon region, Brazil)

In the present study, 470 children less than 72 months of age and presenting acute diarrhea were examined to identify associated enteropathogenic agents. Viruses were the pathogens most frequently found in stools of infants with diarrhea, including 111 cases of rotavirus (23.6 percent of the total diarrhea cases) and 30 cases of adenovirus (6.3 percent). The second group was diarrheogenic Escherichia coli (86 cases, 18.2 percent), followed by Salmonella sp (44 cases, 9.3 percent) and Shigella sp (24 cases, 5.1 percent). Using the PCR technique to differentiate the pathogenic categories of E. coli, it was possible to identify 29 cases (6.1 percent) of enteropathogenic E. coli (EPEC). Of these, 10 (2.1 percent) were typical EPEC and 19 (4.0 percent) atypical EPEC. In addition, there were 26 cases (5.5 percent) of enteroaggregative E. coli, 21 cases (4.4 percent) of enterotoxigenic E. coli, 7 cases (1.4 percent) of enteroinvasive E. coli (EIEC), and 3 cases (0.6 percent) of enterohemorrhagic E. coli. When comparing the frequencies of diarrheogenic E. coli, EPEC was the only category for which significant differences were found between diarrhea and control groups. A low frequency of EIEC was found, thus EIEC cannot be considered to be a potential etiology agent of diarrhea. Simultaneous infections with two pathogens were found in 39 diarrhea cases but not in controls, suggesting associations among potential enteropathogens in the etiology of diarrhea. The frequent association of diarrheogenic E. coli strains was significantly higher than the probability of their random association, suggesting the presence of facilitating factor(s).

Human immunodeficiency virus infection in children with tuberculosis in Santo Domingo, Dominican Republic: prevalence, clinical findings, and response to antituberculosis treatment.

We studied human immunodeficiency virus (HIV)-seroprevalence among children with clinically diagnosed tuberculosis (TB) and compared the clinical features and response to short-term anti-TB therapy of children with and without HIV infection in Santo Domingo, Dominican Republic. Children aged 18-59 months with new-onset, clinically diagnosed TB were tested for HIV antibodies, their clinical features were recorded and their response to a standard 6-month regimen of daily isoniazid and rifampicin with daily streptomycin and pyrazinamide for the first 2 months was assessed. To increase the number of HIV-infected children with TB available for study, we also included children previously known to be HIV infected who developed new-onset TB. Eleven (5.8%) of 189 consecutively enrolled children with clinically diagnosed TB were HIV infected. Fifteen other children with previously documented HIV infection and new-onset TB were available for study, yielding 26 HIV-positive and 178 HIV-negative children with TB. Of these 204 children with clinically diagnosed TB, 25 HIV-positive and 156 HIV-negative children were successfully followed for 6 months or until death. The proportion of HIV-positive children who failed treatment was 6 (29%) of 21 as compared with only 5 (3%) of 156 HIV-negative children [relative risk = 8.9; 95% confidence interval (CI) 2.9, 26.6; p = 0.0004]. HIV-infected children with clinically diagnosed TB are substantially more likely to fail standard treatment for TB than are HIV-uninfected children. If standard treatment regimens are used in such children, response to treatment must be monitored very closely and appropriate changes in the regimen must be made expeditiously.