ABSTRACT
Introduction: Due to their impact on healthcare systems, the sustainability and optimization of high-cost drugs is an issue of concern for several countries. Different strategies have been implemented such as centralized purchasing to optimize budgetary resources. However, there is still a need for a mechanism to optimize these drugs further. Methods: We conducted this prospective multicenter intervention study in five hospitals in the Andalusian Public Health System of Cádiz (Spain) between July 2019 and September 2021. We developed an online website (Farmastock) and implemented it to determine the availability of high-cost, low-use, and near-expiry medicines in each hospital. We used a simple analysis using operational variables to assess the project intervention's savings impact on managing these high-cost drugs. Results: The implementation of Farmastock in Cádiz resulted in savings of 675,757.52 for the Andalusian Public Health System, with 238 medicines transferred out of the 373 available. Of these medicines offered, the most considerable percentage were medicines used for pathologies with high clinical instability and accounted for nearly 80% of the medicines optimized by the tool. Conclusions: Farmastock allowed the Andalusian Public Health System to make substantial financial savings by not making new purchases of high-cost drugs available in other centers of this health network that were not being used. Therefore, this tool is a very efficient measure to contribute to the sustainability of the APHS and could be implemented in more hospitals soon.
ABSTRACT
Intentar la redacción de una historia de la obesidad en veinte folios sería una auténtica temeridad. Sin embargo, para cumplir con el amable encargo de incluir algunos de los aspectos centrales expuestos en el III Curso Avanzado de Obesidad, organizado por la Real Academia Nacional de Farmacia en abril de 2016, no podemos sino trazar un panorama general sobre el estado de la cuestión, dividido en los siguientes cuatro epígrafes. En primer lugar, el establecimiento de un contexto general en el marco de la evolución biológica. En segundo, las bases lógicas o pre científicas -si entendemos por científicas las alcanzadas por la ciencia moderna y contemporánea- establecidas en la Historia para entender el fenómeno de la obesidad. En tercero, los aspectos sociales y estéticos sobre la gordura. Y por último, un pequeño recorrido sobre gordos ilustres (AU)
Try writing in twenty pages about obesity through history would be a genuine recklessness. However, to meet the friendly custom of including some of the central issues exposed in the III Advanced Course of Obesity, organized by the Royal Spanish Academy of Pharmacy, we cannot but draw a general picture about the State of the art, divided into the following four headings: first, the establishment of a general context in the frame of biological evolution. Second, the logics or pre scientific bases - if we mean by scientific those achieved by modern and contemporary science - established in the History to understand the phenomenon of obesity. Third, the social and aesthetic aspects of fatness. And finally, a small visit to illustrious obese people (AU)
Subject(s)
Humans , Obesity/history , Biological Evolution , Anti-Obesity Agents/history , Knowledge Bases , Feeding Behavior , Feeding Behavior , Body ImageABSTRACT
Motivo y objetivos: El rugby es un deporte de contacto de gran popularidad en el mundo donde el jugador sufre impactos que pueden acontecer con traumas músculo-esqueléticos. La sensibilización central es un aumento de respuesta de las neuronas centrales a señales provenientes de los receptores unimodales y polimodales. Por tanto, puede ser generada desde la periferia mediante señales nociceptivas prolongadas en el tiempo. Material y métodos: Muestra de 30 jugadores de rugby (15 mujeres y 15 hombres) con dolor músculo-esquelético sub-agudo o crónico, originado de la práctica deportiva y un grupo control que no presentaban dolor. Se midió bilateralmente el umbral de dolor a la presión en la articulación acromio-clavicular; nervio mediano; nervio cubital; segundo metacarpiano; músculotibial anterior; ligamento peroneo-astragalino anterior; articulación C5/6; músculo infraespinoso y apófisis espinosa de L3. Resultados: El 52% presentaban dolor músculo-esquelético. La duración media del dolor fue de 27,5 ± 11,1 semanas, la intensidad media de dolor en la última semana de 4,1 ± 1,7; la intensidad máxima de 6 ± 1,9; y la intensidad mínima de 1,8 ± 1,2. El ANOVA no encontró diferencias significativas en los umbrales de dolor a la presión en ninguno de los puntos analizados entre jugadores de rugby con y sin dolor (P > 0,05). Discusión: El cuestionario revela que el dolor que padecen se produce durante la práctica deportiva, y no interfiere en actividades de la vida diaria. No se han encontrado signos de sensibilización tanto periférica como central en jugadores con dolor músculo-esquelético. Podría deberse, a la disparidad de lesiones que presentaban los deportistas, o bien, por la dificultad existente para evaluar la percepción de dolor en deportistas
Background and objective: Rugby is a famous contact sport around the world where the player can receive impacts accounting for musculo-skeletal trauma. Central sensitization represents an increased response of the neurons of the central nervous system originated from continuous afferent nociceptive inputs from peripheral tissues. Material and methods: Thirty rugby players (15 men, 15 women) participated in this study. They were divided into those with acute or chronic musculoskeletal pain originated from the sport practice and into a control group formed for those without pain. Pressure pain thresholds (PPT) were bilaterally assessed over the acromio-clavicular joint, median nerve, ulnarnerve, second metacarpal, tibialis anterior muscle, anterior talofibular ligament, C5/C6 joint, infraspinatus muscle and spinous process of L3. Results: Fifty-two percent (n=16) of rugby players exhibited pain. The mean duration of pain was 27.5 ± 11.1 weeks, mean pain intensity experienced the previous week was 4.1 ± 1.7, the worst pain intensity was 6 ±1.9, and the lowest pain intensity was 1.8 ± 1.2). The ANOVA test did not reveal significant differences in pressure pain thresholds in any of the analyzed points between rugby player with and without pain (P > 0.05). Discussion: Our results suggest that rugby players exhibited musculoskeletal pain derived from the sport but the pain does not inferred into daily life activities. The current study did not show the presence of peripheral or central sensitization mechanism in rugby players suffering musculoskeletal pain. Current results can be related to the different lesions and pain areas that the participants included in our study suffered from, and/or also to differences in pain perception in sport players in general
Subject(s)
Humans , Athletic Injuries/epidemiology , Musculoskeletal Pain/epidemiology , Central Nervous System Sensitization , Sports/statistics & numerical data , Activities of Daily LivingABSTRACT
No disponible
Subject(s)
Humans , Male , Female , History, 18th Century , History, 19th Century , Education, Pharmacy/history , Education, Pharmacy/methods , Education, Pharmacy/organization & administration , Faculty/history , Faculty/organization & administration , Education, Pharmacy/standards , Faculty/standards , Faculty , Social ResponsibilityABSTRACT
Los Borbones emplearon a la ciencia como palanca de modernización de España. El modelo ilustrado, basado en el envío de estudiantes al extranjero, la contratación de profesores de excelencia y el establecimiento de nuevas instituciones para fomentar la investigación científica, ha tenido amplio eco en nuestra historia. El programa científico ilustrado varió notablemente a partir de la muerte de Carlos III y, sobre todo, de la Revolución Francesa, pero durante todo el reinado de los primeros Borbones conserva unas características propias, insertadas en la polémica nacional entre «antiguos y modernos». Muy distinta fue la estructura institucional propuesta durante el reinado de José I Bonaparte, inspirada claramente en lo efectuado en Francia, y muy complejas las posturas tomadas por los científicos ante la Guerra de la Independencia. Muchas de sus propuestas, sorprendentemente, fueron llevadas a la práctica durante el reinado absolutista de Fernando VII (AU)
The Borbones used science as a key for the modernization of Spain. The enlightened model, based on sending students outwards, the contracting of excellency professors and the establishment of new institutions to foment the scientific investigation, has had a wide repercution in our history. At the time of Carlos III death and specially because of the French Revolution, the enlightened scientific program changed notoriously; but during the first Borbones kingdom it preserves it´s own properties inserted in the national polemic between «ancients and moderns». Much different was the institutional structure proposed during the Jose I Bonaparte kingdom, clearly inspired in what was done in France, and very complex stands were taken by the scientists about the Independence War. Surprisely many of their proposuals, were used during the absolutist kingdom of Fernando VII (AU)
Subject(s)
Humans , Science/history , Pharmaceutical Services/history , 51708/history , SpainABSTRACT
El proyecto de investigación hace referencia a los medicamentos relacionados con el escolasticismo galenista y con la influencia astrológica, alquímica y mágica, parte fundamental del paradigma científico de la Edad Moderna. A través de los fármacos, se estudian los avances científicos, el pensamiento no sólo científico, las ideas sanitarias y los anhelos de la época referentes a la salud. Se acabará redactando un repertorio de la relación entre plantas y la astrología, un lapidario, un bestiario; los medicamentos contra la peste; la sífilis y las perspectivas de los nuevos medicamentos americanos, el mesmerismo y la homeopatía
The investigation project makes reference to the medicines related with the galenic-scholastic style and with the astrological, alchemical and magical influence, it leaves fundamental of the scientific paradigm of the Modern Age. Through the medicines we study scientific advances, the thought not only scientific, the sanitary ideas and the yearnings of the time referents to the health. At the end we will edit a repertoire of the relationship between plants and the astrology; also a lapidary, a bestiarium (repertoire of animals); the medications against the pest; the syphilis and the perspectives of the American new medicines, the mesmerism and the homeopathy
