Vitamin D status, proinflammatory cytokines and bone mineral density in Mexican people with multiple sclerosis.

BACKGROUND: Vitamin D (VD) has been classically associated with calcium homeostasis and bone mineral density since it has a key role on mineralization and resorption. Immunomodulatory effects have been attributable to VD; low concentrations of VD have been associated with elevation of inflammatory markers. Inflammatory autoimmune diseases, such as multiple sclerosis (MS), a chronic neurodegenerative suffering, whose etiology is still unknown, is directly related to an increase in pro-inflammatory cytokines such as interleukin 17 and interleukin 1ß who play an important role in this physiopathology. Nowadays, even though additional studies have linked MS's clinical signs with low VD concentration, there is scarce information of this association in people from regions with sufficient sun exposure. The aim of this study was to evaluate serum VD and cytokine concentrations, and bone density, in Mexican people with MS. METHODS: Vitamin D (25OHD), interleukin 1ß, interleukin 6 and interleukin 17 concentrations of twenty-five volunteers with MS were determined by enzyme-linked immunosorbent assay. Bone mineral density and body composition assessment was performed by dual energy X-Ray absorptiometry. RESULTS: A mean concentration of 17.3 ± 4.6 ng/ml of 25OHD was obtained, in a range of 5.15 to 25.71 ng/ml; when international advisory bodies thresholds were applied 76% of the participants exhibited some degree of VD inadequacy. Pro-inflammatory markers were detectable among the participants: interleukin 1ß in 100%, interleukin 6 in 64%, whereas interleukin 17 was found in 24% of the volunteers. Bone mineral density below the expected for the age was found in 8% of the participants, with lumbar spine as the most affected anatomic region. Non-significant correlations were found between VD and bone mineral density (Z-score) or pro-inflammatory markers. CONCLUSION: Although non-significant correlations were found between VD and bone mineral density or cytokines, it is important to highlight that an important percentage of our participants exhibited some degree of VD inadequacy, an unknown fact for them, since these are not included in routine clinical evaluations. The low concentrations of VD among this sample regardless of annual UVB sun exposure may suggest the involvement of endogenous and not environmental factors. Further works are needed in order to deepen the physiological causes and effects of VD deficiency in people with MS.

Derrame paraneumónico complicado: análisis de 2 cohortes consecutivas tratadas con distinto criterio / Complicated pleural infection: Analysis of 2 consecutive cohorts managed with a different policy

INTRODUCCIÓN: El tratamiento del derrame pleural paraneumónico complicado (DPC) es controvertido. Las principales guías recomiendan el drenaje, pero con el menor nivel de evidencia. Recientes trabajos han observado buenos resultados solo con antibióticos. Hemos comparado retrospectivamente nuestros resultados en 2 cohortes consecutivas de pacientes tratados con distinto criterio: en el grupo 1 (2005-2009, actitud intervencionista) el drenaje se decidía en función de las características del líquido pleural, de acuerdo con las principales guías; en el grupo 2 (2010-2013, actitud conservadora) el drenaje se decidía en función de la evolución clínica del paciente. MÉTODOS: Se revisaron las historias clínicas de los pacientes tratados por DPC entre 2005 y 2013. Las principales variables analizadas fueron la proporción de pacientes drenados y la duración de la estancia hospitalaria. RESULTADOS: Se analizó a 109 pacientes (64 grupo 1 y 45 grupo 2). Se colocó un tubo de drenaje en el 83% de los pacientes del grupo 1 y en el 47% de los del grupo 2 (p < 0,001). La duración media de la estancia hospitalaria fue de 11,4 días en el grupo 1 y 12,3 días en el grupo 2 (p = 0,45). No se observaron otras diferencias destacables. CONCLUSIÓN: Nuestros resultados coinciden con los de otros estudios recientes que han observado una buena evolución en niños tratados solo con antibióticos y cuestionan la necesidad del drenaje en muchos de los niños que presentan un DPC. Son necesarios ensayos clínicos para identificar las circunstancias en las que se puede obtener un beneficio del drenaje en el DPC

INTRODUCTION: The treatment of complicated pleural infection (CPI) is controversial. Clinical guidelines recommend drainage, but with the lowest grade of evidence. Recent reports have observed good outcomes with antibiotics alone. We retrospectively compared the outcomes in two consecutive cohorts treated with different policies: the first treated according to pleural fluid charactersitics (2005-2009, interventional-prone, group 1) and the second according to clinical assessment (2010-2013, conservative-prone, group 2). METHODS: The clinical records of all children treated for CPI in our hospital between 2005 and 2013 were thoroughly reviewed. Primary outcomes were the proportion of children drained and the length of hospital stay (LHS). RESULTS: One hundred and nine patients (64 group 1 and 45 group 2) were analyzed. A chest tube was placed in 83% of patients in group 1 and 47% in group 2 (P<0.001). The mean LHS was 11.4 days for patients in group 1 and 12.3 for patients in group 2 (P=0.45); no differences were observed in other outcomes. CONCLUSION: Our results add to few recent observations reporting good outcomes in many children treated with antibiotics alone and challenge the need to drain most children with CPI. Clinical trials are now needed to identify when a drainage procedure would be useful

Development of a new sorptive extraction method based on simultaneous direct and headspace sampling modes for the screening of polycyclic aromatic hydrocarbons in water samples.

A new straightforward and inexpensive sample screening method for both EPA and EU priority polycyclic aromatic hydrocarbons (PAHs) in water has been developed. The method is based on combined direct immersion and headspace (DIHS) sorptive extraction, using low-cost disposable material, coupled to ultraperformance liquid chromatography with fluorescence and UV detection (UPLC-FD-UV). Extraction parameters, such as the sampling mode, extraction time and ionic strength were investigated in detail and optimized. Under optimized conditions, water samples (16 mL) were concentrated in silicone disks by headspace (HS) and direct immersion (DI) modes simultaneously, at room temperature for 9h for the majority of the 24 studied compounds. Ultrasound-assisted desorption of extracted analytes in acetonitrile was carried out also at room temperature. The optimized chromatographic method provided a good linearity (R≥0.9991) and a broad linear range for all studied PAHs. The proposed analytical procedure exhibited a good precision level with relative standard deviations below 15% for all analytes. Quantification limits between 0.7 and 2.3 µg L(-1) and 0.16 and 3.90 ng L(-1) were obtained for compounds analyzed by UV (acenaphtylene, cyclopenta[c,d]pyrene and benzo[j]fluoranthene) and fluorescence, respectively. Finally, the proposed method was applied to the determination of PAHs in different real tap, river and wastewater samples.

Awareness and confidence of family physicians in recognition and treatment of psychiatric disorders

OBJECTIVES: This paper aims to evaluate the competence and confidence of the primary care practitioner in the recognition, diagnosis and treatment of mental disorders.METHODOLOGY: A validated 13 point questionnaire which incorporated items from the DSM IV was given to the participants of the annual convention of the Philippine Academy of Family Physician held in Davao City Sept 8-10, 2000.RESULTS: Four hundred eighty five family physicians returned the self administered questionnaire. Fifty one percent (248/ 485) claimed they would immediately refer patients to the psychiatrist while 28% (137/ 485) would initiate treatment on their own. Fourteen percent (68/ 485) and 10.9% (53/ 485) of the respondents indicated that they were familiar with the DSM IV criteria for schizophrenia and depression respectively; however only 11.3 % (55/485)were confident in using the criteria for diagnosis. Fortytwo percent (204/485) described schizophrenic patients as being irritable and aggressive, 30% (146/485) believed that hallucinations were the hallmark symptom, while 18% (88/485) considered bizarre behavior as the most significant indicator of schizophrenia. For depression the subjective feeling of sadness and worthlessness was most indicative of depression for the respondents (63% or 305), while 21% or 102 considered low self esteem or unstable self image as one of the criteria for depression and 16% or 78 thought of diminished interest or pleasure in all activities as the more important symptom to look for when diagnosing depression. Tricyclic antidepressants were still the preferred drug by most family physicians in treating depression (72% or 340) while 62% (301/ 485) prescribed benzodiazepines and 51% (248/ 485) also used the newer selective serotonin reuptake inhibitors. Patients with schizophrenia would be given typical psychotropic drugs like chlorpromazine or haloperidol more commonly (88% or 427), while 46% (224/ 485) had begun to prescribe atypical antipsychotic medications.CONCLUSION:The family physician seems to be hesitant or unsure with their diagnosing or treating psychiatric patients though willing to administer psychotropic medications.

Identifying undetected cases of chronic kidney disease in Mexico. Targeting high-risk populations.

BACKGROUND AND AIMS: Chronic kidney disease (CKD) is a major public health problem in Mexico. Current guidelines recommend routine CKD testing in patients at increased risk for CKD. We undertook this study to examine the diagnostic yield of targeted screening (case-finding) for CKD in high-risk populations in rural and urban communities in Jalisco, Mexico. METHODS: In a cross-sectional study, we did laboratory tests searching for CKD and its risk factors and compared the characteristics of participants with those reported by the National Health and Nutrition Survey 2006 (NHNS). Individuals who were aware that they had CKD and those <18 years of age were excluded. RESULTS: There were 9,169 participants assessed: 28.7% were men and mean age was 55.6 ± 13.7 years. They were predominantly female (71.3 vs. 55.6%, p = 0.0001) and older (55.59 ± 0.1 vs. 42.5 ± 0.3 years, p = 0.0001) than the NHNS population. Self-reported diabetes (41.9 vs. 7.3%, p = 0001) and fasting blood sugar >126 mg/dl (56.1 vs. 14.4%, p = 0.0001) were more prevalent among the participants; self-reported hypertension (41.9 vs. 7.3%, p = 0.0001), systolic blood pressure ≥ 140 mm Hg or diastolic blood pressure ≥ 90 mm Hg (52.5 vs. 43.2%, p = 0.0001), and obesity (42.8. vs. 29.3%, p = 0.0001) were also more frequent among participants. There were 19.7% with proteinuria; CKD was more prevalent among the high risk participants in our study (31.3 vs. 8.0%, p = 0.0001) than in the general population. CONCLUSIONS: CKD was detected frequently in high-risk Mexican populations. Trials of case-finding and intervention are feasible and warranted in Mexico.

Asthma and paracetamol: Could we really know what happens between them?

An association between paracetamol use or exposure in different times of life, including gestation and childhood, and asthma has been observed in recent years. Causality cannot be established from observational studies because of the arguable presence of many confounding factors and biases. Randomised trials are needed to disclose the nature of the association, but are difficult to carry out because of ethic, economic and logistical issues as large patient samples should be involved for a long time in such studies. Pragmatic trials may be the best option to shed some light on this issue. Questions regarding the problems and difficulties of conducting such trials and the way to overcome them are discussed (AU)

Sobrecarga y dolor percibido en cuidadoras de ancianos dependientes / Overload and pain in perceived caregivers of dependent elder

Objetivos: Evaluar la sobrecarga subjetiva y el dolor percibido en cuidadoras de ancianos dependientes y determinar si la intensidad del dolor percibido está asociado a la sobrecarga de la cuidadora. Material y métodos: Estudio observacional, descriptivo transversal. Variables:edad, sexo, parentesco familiar, convivencia con el paciente, nivel educativo, tiempo como cuidador, trabajo remunerado, Índice de Esfuerzo del Cuidador (IEC) e intensidad del dolor (EVA). Análisis estadístico descriptivo e inferencial: Test T de Student, r de Pearson y ANOVA, según los casos. Resultados: IEC 6,58 ± 1,21, EVA 6,60 ± 1,21 ; correlación EVA y IEC r= 0,571, p<0,0001; EVA y tiempo como cuidadora r=0,340, p<0,026. Conclusiones: Las cuidadoras de ancianos dependientes presentan elevados índices de sobrecarga y percepción del dolor provocada por propias características de los cuidados que requieren los ancianos dependientes. Existe una relación directa entre la intensidad del dolor y el grado de sobrecarga de las cuidadoras (AU)

Objectives: To assess the subjective stress and perceived pain in carers of dependent elders, and whether the perceived pain intensity is associated with the caregiver overload or not. Material and methods: This is an observational, descriptive, transversal study. Variables: age, sex, family relationship, living together with the patient, educational level, time as a caregiver, paid work, the Caregiver Stress Index (IEC) and pain intensity (VAS). Descriptive and inferential statistical analysis: Student's T test, Pearson r and ANOVA, as appropriate. Results: IEC 6.58 ± 1.21, 6.60 ± 1.21 EVA, EVA and IEC correlation r = 0.571, p <0.0001, EVA and time as caregivers r = 0.340, p <0.026. Conclusions: The caregivers of dependent elders have high overhead rates and perception of pain caused by own characteristics of care required by dependent elders. There is a direct relationship between pain intensity and the degree of overload of the caregivers (AU)

Optimization of a dispersive liquid-liquid microextraction method for the analysis of benzotriazoles and benzothiazoles in water samples.

A simple and rapid dispersive liquid-liquid microextraction method has been developed for the determination of 11 benzotriazoles and benzothiazoles in water samples. Tri-n-butylphosphate (TBP) was used as extractant, thus avoiding the use of toxic water-immiscible chlorinated solvents. The influence of several variables (e.g., type and volume of dispersant and extraction solvents, sample pH, ionic strength, etc.) on the performance of the sample preparation step was systematically evaluated. Analytical determinations were carried out by high-performance liquid chromatography with fluorescence and UV detection and liquid chromatography-electrospray ionization-tandem mass spectrometry. The optimized method exhibited a good precision level with relative standard deviation values between 3.7% and 8.4%. Extraction yields ranging from 67% to 97% were obtained for all of these considered compounds. Finally, the proposed method was successfully applied to the analysis of benzotriazoles and benzothiazoles in real water samples (tap, river, industrial waters, and treated and raw wastewaters).

Predicción de la solubilidad del Alopurinol en mezclas disolventes / Solubility prediction of Allopurinol in solvent mixtures

La predicción de solubilidad de los principios activos en sistemas codisolventes se estudia para optimizar los procesos tecnológicos de preformulación y resulta clave en procesos de desarrollo e investigación en el diseño farmacéutico racional de medicamentos seguros y eficaces. En este trabajo, algunos métodos de estimación, desarrollados en los últimos años, se han probado con el alopurinol. El alopurinol es un compuesto químico empleado como medicamento frente a la hiperuricemia y sus complicaciones, como la gota. Se obtuvieron excelentes correlaciones entre las solubilidades experimentales y calculadas a 25ºC. Los resultados demuestran la utilidad de estos modelos en preformulación de medicamentos con el fin de reducir el número de experimentaciones, que a menudo consumen tiempo y recursos económicos(AU)

The prediction of solubility of the drugs in co-solvents systems is studied to optimize technological processes of preformulación and it is key in processes of development and research on rational pharmaceutical design of safe and effective medicines. In this work, some methods of estimation, developed in recent years, have been tested with allopurinol. Allopurinol is a drug used primarily to treat hyperuricemia and its complications, including chronic gout. We have obtained excellent correlations between the calculated and experimental solubility at 25 ºC. The results show the usefulness of these models in preformulación from medicines to reduce the number of experiments, which often consume time and resources(AU)

Predicción de la solubilidad del mebendazol en mezclas disolventes / Solubility prediction of mebendazole in solvent mixtures

Los estudios de solubilidad proporcionan una valiosa información que puede emplearse en optimizar el proceso en las fases previas en el desarrollo de medicamentos. En los últimos años, se han desarrollado diferentes métodos de predicción de la solubilidad. En esta investigación se han probado dos modelos de Jouyban con el mebendazol (MB) a 298,15 K en mezclas binarias formadas por etanol y agua y etanol-acetato de etilo. Estos modelos son sencillos de aplicar y resultan muy útiles puesto que sólo se requiere un número pequeño de resultados experimentales. El primer modelo utilizado fue el siguiente: lnXm, = f1 lnX1 + f2 lnX2 + f3 lnX3, B1 (f12f2) + B2 (f1f2) + B3 (f32f2) + B4 (f3f2) (ec.1) en la que, X1, X2, y X3 son las solubilidades del soluto en los disolventes puros 1-3, respectivamente, B1-4 son constantes del modelo. El otro modelo semiempírico de predicción fue: lnXm,T = f1 lnX1,T +(1-f1) lnX2,T +f1 (1-f1) [T T85,254 735,662 (1 ) 1 1 F - - F+ ] (ec. 2)en la que f1 es la fracción de volumen de la mezcla agua-etanol, y T, la temperatura experimental. El tercer término es el factor de exceso de Jouyban-Acree (Factor JA). Los dos modelos semiempíricos de predicción empleados proporcionan una excelente reproducibilidad del perfil de solubilidad. Se concluye que los modelos propuestos, pueden ser útiles en preformulación para predecir el incremento de solubilidad en mezclas disolventes, ahorrando determinaciones experimentales, que consumen tiempo y un importante gasto económico en el diseño de formulaciones líquidas(AU)

Solubility studies provide valuable information that can be used to optimize the process in the previous stages in development of drugs. In recent years, different methods of prediction of solubility have been developed. In this research, two models of Jouyban was tested with mebendazole (MB) to 298,15 K in binary mixtures of water- ethanol and ethanol-ethylacetate. These models are very easy to apply and useful since only a small number of experimental results is required. The first model used was the following: lnXm, = f1 lnX1 + f2 lnX2 + f3 lnX3, B1 (f12f2) + B2 (f1f2) + B3 (f32f2) + B4 (f3f2) (ec.1) where X1, X2 and X3 are the solubility of the solute in the pure solvents, respectively, B1-4 are constant model. The other semiempirical prediction model tested was: lnXm,T = f1 lnX1,T +(1-f1) lnX2,T +f1 (1-f1) [T T85,254 735,662( (1 ) 1 1 F - - F+ ] (ec.2) where f1 is the fraction of the volume of the mixture ethanol-water, and T, the experimental temperature. The third term is the factor of excess Jouyban-Acree (Factor JA). The two semiempirical prediction models employed offer an excellent reproducibility of the profile of solubility. It is concluded that the proposed models may be useful in preformulación to predict increased solubility in mixing solvents, saving experimental determinations, which consume time and economic effort in the design of liquid formulations(AU)

Development of a matrix solid-phase dispersion method for the determination of polycyclic aromatic hydrocarbons in sewage sludge samples.

A new, single-step extraction and purification method based on matrix solid-phase dispersion (MSPD) was developed to determine 17 polycyclic aromatic hydrocarbons (PAHs) in sewage sludge samples. The MSPD method consists of sample homogenisation, exhaustive extraction and clean-up by a single process. The different operational parameters of the method, such as the type of dispersant, type and amount of additives, clean-up co-sorbent and extractive solvent were evaluated. Reversed-phase (C18) and polymeric (Oasis HLB and Oasis MAX) materials, as well as normal phase sorbents (Florisil, silica, neutral alumina) and an inert support (sand) were tested to assess the sorbents effect on the yield and selectivity of the MSPD process. Analysis of extracts was performed by high performance liquid chromatography (HPLC) coupled with fluorescence detection. Quantification limits obtained for all of these considered compounds (between 0.0001 and 0.005mugg(-1) dry mass) were well below of the limits recommended in the EU. The extraction yields for the different compounds obtained by MSPD ranged from 76.3% to 103.6%. On the other hand, the extraction efficiency of the optimised method is compared with that achieved by microwave-assisted extraction and the method was applied to the analysis of real sewage sludge samples. A certified reference material (sewage sludge (BCR 088)) and a reference material (sewage sludge (RTC-CNS312-04)) were used to validate the proposed method.

Prevalencia de micosis superficiales en las Fuerzas Armadas Españolas: estudio PREMIEM / Prevalence of superficial mycosis in the Spanish Armed Forces: PREMIEM study

Objetivos: El motivo del presente trabajo se basa en el estudio en la población militar de la prevalencia de micosis (onicomicosis, tinea pedis y pitiriasis versicolor) en los diferentes medios en los que se desenvuelve el contingente militar con el objetivo final de prevenir los factores de riesgo específicos. Material y métodos: Mediante una autoevaluación coordinada con los médicos de las unidades y el servicio de microbiología del Hospital Militar Central Gómez Ulla, se evaluaron 3.712 sujetos. Resultados: En 41 de ellos se obtuvieron resultados positivos, con prevalencia real (confirmación microbiológica de 1.1%). El dermatofito con mayor incidencia fue el Trycophyton rubrum. Conclusiones: El calzado en la ducha es un factor protector, así como la antigüedad en las FAS (AU)

AIMS: The reason for this study was founded on the study of the prevalence of mycosis (onicomycosis, tinea pedis, pitiriasis versicolor) in the in the military population, considering the different environments in which their military activities are developed, with the final objective of the specific risk factors prevention. METHODS: By a coordinated selfevaluation with the medical officers at the units and the Clinical Microbiology Service of the Hospital Militar Central Gómez Ulla, 3,712 individuals were evaluated. RESULTS: Positive results were obtained in 41 of them, with a real prevalence (1.1 % microbiologicaly confirmed). The main incidence of dermatophytes was for Trycophyton rubrum. CONCLUSIONS: The use of shoes in the shower as much as the seniority in the AF,s are protective factors (AU)

Approaches to spirit aroma: contribution of some aromatic compounds to the primary aroma in samples of orujo spirits.

Terpenes and C(13) norisoprenoids are among the most important aromatic compounds found in a volatile and nonvolatile form in grapes. Aromatic typicity of a spirit could be attributed to these compounds despite the very important presence of volatile compounds produced during alcoholic fermentation. In this study, following a solid phase extraction stage, the determination of the varietal aromatic compounds by gas chromatography was performed on 15 samples of Galician orujo spirits. The results show that significant differences (p < 0.05) exist in the concentrations of varietal aromatic compounds in Galician spirits obtained from different varieties of grapes. alpha-Ionona is the varietal aromatic compound that is most likely to contribute to the aroma of all of the spirits studied. The spirits from Catalan Roxo are the most aromatic, with floral and fruity nuances, while the spirits from Godello were the less aromatic group as far as the varietal compounds studied are concerned. Spirits from Mencia and Treixadura show a similar profile, but the former has a more intensive aroma due to beta-pinene, citronellol, and alpha-ionone. Albariño spirits stand out because of their profile that is marked by the contributions of eugenol and linalool.

Apoptosis in human granulosa cells after induction of ovulation in women participating in an intracytoplasmic sperm injection program.

OBJECTIVES: To investigate whether analysis of granulosa cell apoptosis can be useful in assessing follicular and oocyte maturation and the regulation of granulosa cell apoptosis by follicular fluid steroids in preovulatory follicles of stimulated women. STUDY DESIGN: Apoptosis in aspirated granulosa cells (n=64) was measured using the Annexin V-affinity assay by flow cytometry. Follicular fluid steroids were determined by ELISA and RIA. Statistics were evaluated using the Levenne test, Student t-test and simple linear regression analysis. RESULTS: No significant differences in the number and percentage of apoptotic granulosa cells per follicle were observed according to the maturity and fertilizability of the oocytes by intracytoplasmic sperm injection within these follicles. No correlations were found between levels of steroid hormones in follicular fluid and the number and proportion of granulosa cells undergoing apoptosis. CONCLUSIONS: The percentage of apoptosis in granulosa cells is not related to oocyte maturity and fertilizability by ICSI or to follicular quality in stimulated cycles of normal women. However, the possibility cannot be discarded that this parameter may be of importance at other phases of follicular development or in natural cycles when no treatment that influences follicular physiology is being applied.

Exclusión de paternidad con 14 STR en provincia de Buenos Aires. Argentina / Paternity eclusions with 14 STRs in Buenos Aires province

Sobre un total de 546 estudios de filiación analizados por electroforesis capilar utilizando los kits PowerPlex 16 o Identifiler, se registraron exclusiones en 103 casos (18,9 por ciento). De estos, se analizaron en forma detallada 69 informes. El número promedio de marcadores que excluyeron el vínculo fue de 8. En el 50 por ciento de los casos se detectaron de 6 a 8 exclusiones. En un único análisis el número de exclusiones fue de 3. El marcador que puso en evidencia el mayor número de incompatibilidades fue el FGA y el locus que resultó menos informativo el TPOX (AU)

Inclusión de paternidad con 14 STR en provincia de Buenos Aires, Argentina / Paternity inclusions with 14 STRs in Buenos Aires province

Se realizaron 546 estudios de filiación por electroforesis capilar utilizando los kits PowerPlex e Identifiler; con un promedio de 14 marcadores STR analizados. El 75,5 por ciento de los casos fueron inclusiones, el 18,9 por ciento fueron exclusiones y el 1,6 por ciento resultó no informativo. El 4 por ciento restante correspondió a impugnaciones y reconocimiento de paternidad (dos padres alegados).Sobre 211 inclusiones (madre, hijo, padre alegado) el 95,3 por ciento resultó con índice de paternidad superiores a 104. En 40 inclusiones hijo/padre o madre alegados el 80 por ciento de los índices estimados resultó mayor de 104. En 9 casos se consideró la presencia de una mutación en el hijo (AU)

Consumo de medicamentos en ancianos / Drug consumption in the aged people

Se realizó una estudio observacional, descriptivo, retrospectivo, en un área de salud del Consejo Popular Luyanó, perteneciente al Policlínico ô14 de junioö; para caracterizar el consumo de medicamentos en una muestra de ancianos. El estudio fue realizado durante los meses de noviembre y diciembre de 1999, y enero y febrero de 2000. Fueron entrevistados 132 ancianos que representan del 89 por ciento del total de ancianos en 2 consultorios. El promedio de edad fue de 71,23 años. Encontramos que el 81 por ciento de los ancianos consumen algún fármaco (exceptuando vitaminas), y el motivo principal de prescripción son las afecciones cardiovasculares y los dolores articulares. La familia de fármacos más utilizada fue la de los analgésicos, los antiinflamatorios, los antipiréticos, y dentro de estos, la aspirina. Las vitaminas fueron utilizadas por 49 pacientes y la medicina verde por 21, el 40 por ciento de las prescripciones fueron hechas por el Médico de Familia, el 41 por ciento por otros especialistas y el 19 por ciento correspondió a la automedicación. En general, fue reportada la incidencia de pocos efectos secundarios y sobresalieron los malestares digestivos. En la muestra estudiada el consumo de fármacos fue elevado y en muchos aspectos se corresponde con el tratamiento de las afecciones más frecuentes en este grupo etáreo

Consumo de medicamentos en ancianos / Drug consumption in the aged people

Se realizó una estudio observacional, descriptivo, retrospectivo, en un área de salud del Consejo Popular Luyanó, perteneciente al Policlínico “14 de junio”; para caracterizar el consumo de medicamentos en una muestra de ancianos. El estudio fue realizado durante los meses de noviembre y diciembre de 1999, y enero y febrero de 2000. Fueron entrevistados 132 ancianos que representan del 89 por ciento del total de ancianos en 2 consultorios. El promedio de edad fue de 71,23 años. Encontramos que el 81 por ciento de los ancianos consumen algún fármaco (exceptuando vitaminas), y el motivo principal de prescripción son las afecciones cardiovasculares y los dolores articulares. La familia de fármacos más utilizada fue la de los analgésicos, los antiinflamatorios, los antipiréticos, y dentro de estos, la aspirina. Las vitaminas fueron utilizadas por 49 pacientes y la medicina verde por 21, el 40 por ciento de las prescripciones fueron hechas por el Médico de Familia, el 41 por ciento por otros especialistas y el 19 por ciento correspondió a la automedicación. En general, fue reportada la incidencia de pocos efectos secundarios y sobresalieron los malestares digestivos. En la muestra estudiada el consumo de fármacos fue elevado y en muchos aspectos se corresponde con el tratamiento de las afecciones más frecuentes en este grupo etáreo(AU)

Awareness and confidence of family physicians in recognition and treatment of psychiatric illness

The family practitioner plays an important role in the detection and treatment of mental disorders. It is said that over half of all persons affected with mental illness are initially seen and treated by the non-psychiatrist in the outpatient setting rather than in the specialty mental health clinic. Objective: This paper aims to evaluate perceived level of confidence and competence of the primary care practitioner in the recognition, diagnosis, and management of mental disorders. Methods: A survey of family physicians and general practitioners using a thirteen (13)-point questionnaire during an annual convention of the Philippine Academy of Family Physicians (PAFP) was conducted. The questionnaire included items that attempted to quantify: exposure to psychiatry during residency and current medical practice; proportion of mental illness cases among total patient load; signs and symptoms that would be associated with mental illness; familiarity with standardized criteria for diagnosing mental illness i.e. schizophrenia and depression; familiarity with therapeutic medications; and perceived level of confidence in treating psychiatric cases. Results and Conclusion: The study implies that the family physician, although aware of the general signs and symptoms indicative of mental illness, is still hesitant in formulating a definitive diagnosis. Possible reasons for this attitude may be inadequate training in psychiatry as well as unfamiliarity and perceived difficulty with the DSM-IV.