Complejidad en el diagnóstico y tratamiento del dolor neuropático / Complexity of diagnosis and treatment of neuropathic pain

Mujer de 56 años que arrastra problemas de salud neurológicos desde 2017 tras sufrir un accidente de tráfico. Le diagnostican un parkinsonismo. En noviembre de 2021 acude a consultar información sobre los cribados de deterioro cognitivo desde la farmacia comunitaria al presentar queja de olvidos frecuentes. Finalmente, en junio de 2022 se lleva a cabo una evaluación farmacoterapéutica del tratamiento siguiendo la metodología Dáder y se estudia la carga anticolinérgica (CA) que presenta la medicación. Según la escala CALS, la paciente presentó una CA de 3,25 que se puede relacionar con aparición de efectos adversos como alteraciones de la cognición. Al no tener controlado el dolor, se le sugiere volver a consultar con su médico para intentar lograr un tratamiento efectivo. Con la nueva visita se diagnostica un trastorno neurológico funcional y trastorno depresivo mayor. Con el cambio de tratamiento, la CA disminuyó hasta 1. El tratamiento del dolor neuropático es complejo y el diagnóstico certero es importante para instaurar el tratamiento efectivo. Aunque muchas veces la sintomatología conlleva a confundir el diagnóstico y tratar con fármacos no eficaces para solucionar el problema que causan reacciones adversas como es el caso. En estas situaciones es necesario una reevaluación periódica del tratamiento y del estado cognitivo del paciente (AU)

Treatment of COVID-19 pneumonia with low-dose radiotherapy plus standard of care versus standard of care alone in frail patients : The SEOR-GICOR IPACOVID comparative cohort trial.

PURPOSE: To assess the efficacy of lung low-dose radiotherapy (LD-RT) in the treatment of patients with COVID-19 pneumonia. MATERIALS AND METHODS: Ambispective study with two cohorts to compare treatment with standard of care (SoC) plus a single dose of 0.5 Gy to the whole thorax (experimental prospective cohort) with SoC alone (control retrospective cohort) for patients with COVID-19 pneumonia not candidates for admission to the intensive care unit (ICU) for mechanical ventilation. RESULTS: Fifty patients treated with LD-RT were compared with 50 matched controls. Mean age was 85 years in both groups. An increase in arterial oxygen partial pressure (PaO2)/fraction of inspired oxygen (PAFI) in the experimental LD-RT-treated group compared to the control group could not be found at 48 h after LD-RT, which was the primary endpoint of the study. However, PAFI values significantly improved after 1 month (473 vs. 302 mm Hg; p < 0.0001). Pulse oxymetric saturation/fraction of inspired oxygen (SAFI) values were also significantly higher in LD-RT-treated patients than in control patients at 1 week (405 vs. 334 mm Hg; p = 0.0157) and 1 month after LD-RT (462 vs. 326 mm Hg; p < 0.0001). All other timepoint measurements of the respiratory parameters were similar across groups. Patients in the experimental group were discharged from the hospital significantly earlier (23 vs. 31 days; p = 0.047). Fifteen and 26 patients died due to COVID-19 pneumonia in the experimental and control cohorts, respectively (30% vs. 48%; p = 0.1). LD-RT was associated with a decreased odds ratio (OR) for 1­month COVID-19 mortality (OR = 0.302 [0.106-0.859]; p = 0.025) when adjusted for potentially confounding factors. Overall survival was significantly prolonged in the LD-RT group compared to the control group (log-rank p = 0.027). No adverse events related to radiation treatment were observed. CONCLUSION: Treatment of frail patients with COVID-19 pneumonia with SoC plus single-dose LD-RT of 0.5 Gy improved respiratory parameters, reduced the period of hospitalization, decreased the rate of 1­month mortality, and prolonged actuarial overall survival compared to SoC alone.

Could pulmonary low-dose radiation therapy be an alternative treatment for patients with COVID-19 pneumonia? Preliminary results of a multicenter SEOR-GICOR nonrandomized prospective trial (IPACOVID trial).

PURPOSE: To evaluate the efficacy and safety of lung low-dose radiation therapy (LD-RT) for pneumonia in patients with coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS: Inclusion criteria comprised patients with COVID-19-related moderate-severe pneumonia warranting hospitalization with supplemental O2 and not candidates for admission to the intensive care unit because of comorbidities or general status. All patients received single lung dose of 0.5 Gy. Respiratory and systemic inflammatory parameters were evaluated before irradiation, at 24 h and 1 week after LD-RT. Primary endpoint was increased in the ratio of arterial oxygen partial pressure (PaO2) or the pulse oximetry saturation (SpO2) to fractional inspired oxygen (FiO2) ratio of at least 20% at 24 h with respect to the preirradiation value. RESULTS: Between June and November 2020, 36 patients with COVID-19 pneumonia and a mean age of 84 years were enrolled. Seventeen were women and 19 were men and all of them had comorbidities. All patients had bilateral pulmonary infiltrates on chest X­ray. All patients received dexamethasone treatment. Mean SpO2 pretreatment value was 94.28% and the SpO2/FiO2 ratio varied from 255 mm Hg to 283 mm Hg at 24 h and to 381 mm Hg at 1 week, respectively. In those who survived (23/36, 64%), a significant improvement was observed in the percentage of lung involvement in the CT scan at 1 week after LD-RT. No adverse effects related to radiation treatment have been reported. CONCLUSIONS: LD-RT appears to be a feasible and safe option in a population with COVID-19 bilateral interstitial pneumonia in the presence of significant comorbidities.

Waist-to-height ratio and skipping breakfast are predictive factors for high blood pressure in adolescents.

The purpose of this study was to estimate the prevalence of high blood pressure (HBP) in adolescents of the Valencian Autonomous Community (VC) in Spain. Besides, its association with other risk factors related to cardiovascular disease (CVD) or arterial hypertension (AHT) in order to increase our knowledge of public health and to provide advice about healthy diets. We conducted a multicentre, observational, cross-sectional, epidemiological study in a sample of 4402 adolescents from 15 schools during the 2015-2016 school year. The participants were aged between 11 and 18 years, and any individuals already diagnosed with AHT were excluded. In addition to the Physical Activity Questionnaire for Adolescents (PAQ-A), Evaluation of the Mediterranean Diet Quality Index (KIDMED), a lifestyle habits survey, the waist-to-height ratio (WtHR), and body mass index (BMI) were calculated for each participant. Informed Consent was obtained from Parents of the adolescents involved in the current study. The study received approval from the University ethics committee and all procedures were conducted in accordance with the tenets of the Declaration of Helsinki. Chi-squared, Student t-tests, and ANOVA statistical analyses showed that 653 (14.8%) adolescents had previously undiagnosed HBP and that was significantly associated with male sex (p < 0.001), age over 15 years (p < 0.05), and height, weight, waist circumference, WtHR, BMI, and skipping breakfast. Based on the data we obtained in this study, the modifiable factors that influence HBP in adolescents were WtHR, BMI, and skipping breakfast.

Vaccination against Louping Ill Virus Protects Goats from Experimental Challenge with Spanish Goat Encephalitis Virus.

Spanish goat encephalitis virus (SGEV) is a recently described member of the genus Flavivirus belonging to the tick-borne encephalitis group of viruses, and is closely related to louping ill virus (LIV). Naturally acquired disease in goats results in severe, acute encephalitis and 100% mortality. Eighteen goats were challenged subcutaneously with SGEV; nine were vaccinated previously against LIV and nine were not. None of the vaccinated goats showed any clinical signs of disease or histological lesions, but all of the non-vaccinated goats developed pyrexia and 5/9 developed neurological clinical signs, primarily tremors in the neck and ataxia. All non-vaccinated animals developed histological lesions restricted to the central nervous system and consistent with a lymphocytic meningomyeloencephalitis. Vaccinated goats had significantly (P <0.003) greater concentrations of serum IgG and lower levels of IgM (P <0.0001) compared with unvaccinated animals. SGEV RNA levels were below detectable limits in the vaccinated goats throughout the experiment, but increased rapidly and were significantly (P <0.0001) greater 2-10 days post challenge in the non-vaccinated group. In conclusion, vaccination of goats against LIV confers highly effective protection against SGEV; this is probably mediated by IgG and prevents an increase in viral RNA load in serum such that vaccinated animals would not be an effective reservoir of the virus.

Lambs are Susceptible to Experimental Challenge with Spanish Goat Encephalitis Virus.

Spanish goat encephalitis virus (SGEV) is a member of the genus Flavivirus, family Flaviviridae, and causes encephalomyelitis in goats. The aim of this study was to determine whether sheep are susceptible to experimental challenge with SGEV by two different routes. The results show that SGEV can infect sheep by both the subcutaneous and intravenous routes, resulting in neurological clinical disease with extensive and severe histological lesions in the central nervous system. Lambs challenged subcutaneously developed more severe lesions on the ipsilateral side of the brain, but the lesion morphology was similar irrespective of the route of challenge. The clinical presentation, pathogenesis, lesion morphology and distribution shows that SGEV is very similar to louping ill virus (LIV) and therefore any disease control plan must take into account any host species and SGEV vectors as potential reservoirs. Furthermore, discriminatory diagnostics need to be applied to any sheep or goat suspected of disease due to any flavivirus in areas where SGEV and LIV co-exist.

Identification of a new Y chromosome haplogroup in Spanish native cattle.

The aim of this work was to perform a thorough analysis of the diversity of Y-haplotypes in Spanish cattle. A total of 207 Bos taurus males were sampled across 25 European breeds, with a special focus on rare, local Spanish populations. Animals were genotyped with five Y-specific microsatellites (INRA189, UMN0103, UMN0307, BM861 and BYM1), two indels (ZFY10 and USP9Y) and one SNP (UTY19). A new haplogroup, distinct from those described by Götherström et al. (2005), was identified and named Y1.2. Samples representing the three B. taurus Y-haplogroups were genotyped for four additional Y chromosome SNPs (rs121919254, rs121919281, rs121919323 and rs137049553). Among these SNPs, only rs121919281 was informative in B. taurus and helped to confirm the new Y1.2 haplogroup. Analysis of a larger dataset of standardized haplotypes for 1507 individuals from 57 populations from Spain, other European countries and Africa showed the new Y1.2 haplogroup to be found exclusively in Spanish breeds. This finding reinforces the importance of local Spanish cattle as reservoirs of genetic diversity as well as the importance of the Iberian Peninsula in the history of cattle.

Contribution of Lidia cattle breed historical castes to the paternal genetic stock of Spain.

The main objective of this work was to determine whether the five founding castes defined in the Lidia cattle breed actually have an important contribution to the Spanish paternal genetic stock as well as to the paternal genetic origin support. A total of 1300 Bos taurus male individuals were genotyped for five microsatellites (INRA189, UMN0103, UMN0307, BM861 and BYM1) and one indel (ZFY10). Microsatellite and indel alleles were combined into haplotypes, identifying a total of 38 haplotypes, 11 of them belonging to haplogroup Y1 and 27 to haplogroup Y2. Ten different haplotypes were found in the Lidia cattle breed, with five being exclusive to this breed. Our results agree with different male genetic stocks in the Lidia breed: one hypothetically representing the ancient Iberian bovine genetic stock (Gallardo, Navarra and Cabrera castes and some encastes from Vistahermosa) and a second one that is the result of the more recent breeding strategy of choosing the most aggressive individuals from traditional herds (including some Vistahermosa encastes and the Vazqueña caste). In terms of conservation, it would be better to not consider this breed as a unit but to consider the caste, or even better the encaste, as the target of putative conservation efforts.

First Confirmation of Schmallenberg Virus in Cattle in Spain: Tissue Distribution and Pathology.

Between January and June 2013, nine stillborn bovine foetuses with congenital malformations from nine cattle herds located in Salamanca (central Spain) were detected. Necropsy was performed on two calves. Pathological lesions together with molecular genetics and serological results allowed a definitive diagnosis: first confirmation of Schmallenberg virus (SBV) infection in cattle in Spain. SBV was detected in different tissues and organic fluids in both animals including blood, suggesting a possible viraemia. The umbilical cord was also positive for the presence of SBV in both animals. The former tissue provides an easy to obtain sample and might be a sample of choice when necropsy is carried out in the field.

Opinión de los farmacéuticos comunitarios de la provincia de Valencia sobre la atención y resolución de consultas farmacoterapéuticas de información de medicamentos / Opinion of the community pharmacists of the province of Valencia about consultation and resolution of pharmacotherapeutics consultations of drug information

Objetivos: Caracterizar y describir la consulta farmacoterapéutica de información de medicamentos (CFTIM) con el fin de aumentar el conocimiento sobre esta actividad en la farmacia comunitaria. Métodos: Estudio observacional, descriptivo, transversal mediante un cuestionario ad hoc anónimo autocumplimentado por los farmacéuticos voluntarios de las farmacias comunitarias de la provincia de Valencia. Resultados: Un total de 222 farmacéuticos comunitarios (18,4%) respondieron al cuestionario. El 3,5% de los usuarios que acuden a la farmacia lo hace sólo para realizar las CFTIM, cuya frecuencia diaria se estima entre 4 y 9. La mayoría de las CFTIM se atienden y resuelven por el farmacéutico, en el mismo lugar de la farmacia, sin establecer un horario determinado y sin cobrarlas. Su duración media es de 4 minutos, y el motivo de consulta más frecuente son las instrucciones de uso de los medicamentos. El 74,5% de los farmacéuticos cree que resuelve correctamente la mayoría de CFTIM, aunque sólo el 6,4% las registra. Casi todos están de acuerdo en la importancia del valor que tiene esta actividad para el sistema sanitario y la salud del paciente, así como en que se debe prestar como un servicio diferenciado en la farmacia comunitaria. Prácticamente todos están de acuerdo que resolviéndolas se previenen, detectan y/o resuelven problemas relacionados con los medicamentos y resultados negativos asociados a la medicación. Conclusiones: El estudio confirma la realización habitual de esta actividad en la farmacia comunitaria valenciana y aporta datos inéditos, cualitativos y cuantitativos, relevantes para su conocimiento, que permite contrastarlos con los obtenidos en estudios observacionales de campo

Aims: To characterize and to describe the pharmacotherapeutic consultations drug of information (PCDI) in order to increase awareness of this activity in the community pharmacy. Methods: Observational, descriptive, cross-sectional study by means of an administered anonymous questionnaire to volunteer pharmacists of community pharmacies in the province of Valencia. Results: 222 community pharmacists (18.4%) responded to the questionnaire. The 3.5% of users who visit the pharmacy, do it just for the PCDI. The estimated daily frequency is between 4-9 consultations. Most PCDI are attended and resolved by the pharmacist in the same place of the pharmacy, without setting a specific time and without collectability. The average duration is 4 minutes and the most frequent reason for consultation is instructions for use of drugs. 74.5% of the pharmacists believes that they solve correctly the majority of consultations, but they only registers the 6.4% of them. Practically they all agree in the importance of the value that has this activity for the sanitary system and for the health of the patient, as well as that this activity is provided in the community pharmacy as a differentiated service. Practically they all agree that resolving the consultations get ready, detect and/or solve drug related problems and negative results associated with the medication. Conclusions: The study confirms the common realization of this activity in the Valencian community pharmacy and provides qualitative and quantitative relevant unpublished data to your knowledge, allowing to compare them with those obtained in field observational studies

Mitochondrial DNA and Y-chromosome diversity in East Adriatic sheep.

Variation in mitochondrial DNA (mtDNA) and Y-chromosome haplotypes was analysed in nine domestic sheep breeds (159 rams) and 21 mouflon (Ovis musimon) sampled in the East Adriatic. Mitochondrial DNA analyses revealed a high frequency of type B haplotypes, predominantly in European breeds, and a very low frequency of type A haplotypes, which are more frequent in some Asian breeds. Mitochondrial haplotype Hmt-3 was the most frequent (26.4%), and 37.1%, 20.8% and 7.6% of rams had haplotypes one, two and three mutations remote from Hmt-3 respectively. In contrast, Y-chromosome analyses revealed extraordinary paternal allelic richness: HY-6, 89.3%; HY-8, 5.0%; HY-18, 3.1%; HY-7, 1.3%; and HY-5, 1.3%. In fact, the number of haplotypes observed is comparable to the number found in Turkish breeds and greater than the number found in European breeds so far. Haplotype HY-18 (A-oY1/135-SRYM18), identified here for the first time, provides a link between the haplotype HY-12 (A-oY1/139-SRYM18) found in a few rams in Turkey and haplotype HY-9 (A-oY1/131-SRYM18) found in one ram in Ethiopia. All mouflons had type B mtDNA haplotypes, including the private haplotype (Hmt-55), and all were paternally monomorphic for haplotype HY-6. Our data support a quite homogeneous maternal origin of East Adriatic sheep, which is a characteristic of European breeds. At the same time, the high number of haplotypes found was surprising and intriguing, and it begs for further analysis. Simultaneous analysis of mtDNA and Y-chromosome information allowed us to detect a large discrepancy between maternal and paternal lineages in some populations. This is most likely the result of breeder efforts to 'upgrade' local populations using rams with different paternal origins.

Se puede mejorar el uso de las benzodiacepinas desde la farmacia / Pharmacist can improve the use of benzodiazepines

Introducción: Las benzodiacepinas (BZD) son medicamentos generalmente indicados para el insomnio y la ansiedad, que se utilizan mucho más tiempo del aconsejado por la Agencia Española del Medicamento y pueden producir, entre otras reacciones adversas, deterioro cognitivo, pérdida de memoria, sedación y, en uso continuado, tolerancia y dependencia. Objetivo: Mejorar desde la farmacia el uso de las BZD en mayores de 65 años y, con ello, el estado de salud del paciente. Material y métodos: Estudio controlado a simple ciego, realizado en 12 farmacias desde febrero de 2006 hasta febrero de 2008. Los pacientes forman parte del grupo control o de intervención según el orden de una lista aleatoria. Se utilizan hojas de registro del uso de BZD, fi chas de registro farmacoterapéutico y los cuestionarios de Siu-Reuben, Pfeiffer y de Reacciones Adversas. Se considera un resultado satisfactorio si al final del estudio el paciente disminuye la dosis de BZD, pasa a uso esporádico, la elimina o cambia por lorazepam. Resultados: Se incluyen 164 pacientes en el grupo control y 173 en el de intervención. El 85% de los pacientes utiliza las BZD más tiempo del aconsejado. La intervención farmacéutico-médico-paciente consigue un mejor resultado (84%) que la del farmacéuticopaciente (41%). Obtienen resultados satisfactorios el 29% de los pacientes del grupo de intervención, frente al 10,8% del grupo control, y ello supone una mejora del test de Pfeiffer y de Reacciones Adversas. Conclusiones: Las BZD son fármacos mal utilizados. La intervención del farmacéutico mejora su uso y conlleva una mejora en el estado de salud del paciente. Se debe mejorar la relación farmacéutico-médico(AU)

Introduction: Benzodiazepines (BZD) are generally indicated for insomnia and anxiety. They are used much longer than recommended by the Spanish Drug Agency and can produce, among other adverse reactions, cognitive impairment, memory loss, sedation and tolerance in continuous use and dependence. Aim: Improve the rational use of BZD in patients older than 65 years old and thus the health of the patient from the pharmacy. Methods: Single-blind controlled study conducted in 12 pharmacies since February 2006 to February 2008. Patients divided into control or intervention group in the order of a random list. We recorded BZD used, pharmacotherapy and results of tests: Siu-Reuben, Pfeiffer and Adverse Reactions. It is considered satisfactory if at the end of the study the patient reduces the dose of BZD, change to occasional use, eliminate the use of BZD or change to lorazepam. Results: 164 patients were included in the control group and 173 in the intervention group. 85% BZD were used longer than recom mended. Intervention pharmacist-physician-patient gets better results (84%) than pharmacist-patient (41%). Satisfactory results were obtained by 29% patients in the intervention group compared with 10.8% patients in the control group with an improvement of Pfeiffer and adverse reactions tests. Conclusions: BZD are misused. The pharmaceutical intervention leads to better use and improved health status of the patient. It should improve pharmacist-physician relationship(AU)

Sordera súbita: estudio retrospectivo sobre 40 casos ingresados en nuestro hospital / Sudden deafness: a retrospective study of 40 cases admitted to our hospital

Introducción: La sordera brusca es una pérdida súbita de audición a nivel neuro-sensorial, por causas desconocidas, y con mal pronóstico funcional. Las causas son desconocidas, lo que genera múltiples hipótesis y discusiones sobre esta patología. Objetivo: Evaluar los factores asociados al pronóstico y determinar los aspectos terapéuticos que influyen en el pronóstico de estos pacientes. Material y método: Revisamos las historias clínicas de los pacientes diagnosticados de sordera brusca durante un período de estudio de 4 años, y calculamos las frecuencias de las diferentes variables consideradas como relevantes; realizamos análisis bivariante y una comparación de las distribuciones mediante test de ANOVA y un análisis multivariante con regresión logística y lineal múltiple. Resultados: Analizamos 40 casos. Consideramos factores como el oído afectado, antecedentes cardiovasculares, HTA, diabetes, dislipemia, tabaco, hemoglobina, hematocrito, las circunstancias temporales y geográficas, de las que ninguna de ellas resultaron significativas para la recuperación. Tras el análisis de otros factores, encontramos un predominio de casos en verano y otoño (90 por ciento) frente a invierno y primavera (10 por ciento). El uso del famciclovir estuvo asociado a mayor probabilidad de recuperación completa OR 21,164 [1,265-374,47]. Por el contrario, estuvieron ligados a una menor probabilidad de recuperación completa: el tratamiento con medicina hiperbárica OR 0,013 [0,001-0,433], la curva audiométrica descendente OR 0,164 [0,032-0,533], y la presencia de vértigo asociada a acúfenos OR 0,158 [0,08-1,015]. La aspirina mejoró la recuperación de decibelios media 24,3 db IC 95 por ciento [1,00-47,61]. Conclusiones: El estudio es una serie retrospectiva cuyo análisis multivariante muestra que el famciclovir y el AAS tienen un efecto estadísticamente beneficioso en el tratamiento de la sordera súbita...

Introduction: The sudden deafness is a sudden loss of hearing at the neuro-senso-rial, for unknown reasons, and bad functional prognosis. The cause is unknown, generating multiple hypotheses and discussions on this topic. Aim: To evaluate the factors associated with prognosis and determine therapeutic aspects that influence the prognosis of these patients. Matherial and method: We reviewed the medical records ofpatients diagnosed with sudden hearing loss during a study period of 4 years, and calculate the frequencies of the different variables considered relevant; performed bivariate analysis and a comparison of the distributions byANOVA and a multivariate analysis with logistic regression and multiple lineal. Results: We analyzed 40 cases. We consider factors like the affected ear, cardiovascular history, hypertension, diabetes, dyslipidemia, snuff, hemoglobin, hematocrit, temporal and geographical, of which none were significant for recovery. After analysis of other factors, we found a predominance of cases in summer and autumn (90 percent) compared to winter and spring (10 percent). Use of famciclovir was associated with greater likelihood of complete recovery OR 21.164 [1.265 to 374.47]. On the contrary, were linked to a lower linked to a lower likelihood of full recovery: treatment with hyperbaric OR 0.013 [0.0010.0433] OR descending audiometric curve [0.164 0.032 to 0.533] and the presence of vertigo associated with tinnitus OR o.158 [0.08 to 1.015]. Aspirin improved recovery of 24.3 db decibel half 95 percent CI [1.00 to 47.61]. Conclusions: The study is a retrospective multivariate analysis which shows that famciclovir and aspirin have a statisfically beneficial in the treatment of sudden deafness, which in our sample is more frequent in summer and autumn. Biased studies are needed on these results may provide new hypotheses for treatment.

Adolescente con obesidad: ¿presenta síndrome metabólico? / Obese adolescents: do they have metabolic syndrome?

La obesidad es una condición cada vez más presente en niños y jóvenes, en especial en países industrializados. El problema de la obesidad infantil es su alta probabilidad de persistir en la vida adulta y la posibilidad de acompañarse de comorbilidad, siendo lo más destacable el aumento del riesgo cardiovascular y otras complicaciones metabólicas, como es el síndrome metabólico (AU)

Obesity is a growing condition in children and adolescents, especially in industrialized countries. It has a high probability of persisting in adulthood and of becoming a comorbid condition, most frequently with a higher cardiovascular risk and other metabolic complications, such as metabolic syndrome (AU)

Optimización de la farmacoterapia en un hospital de Traumatología / Optimisation of pharmacotherapy in a trauma centre

Objetivo Evaluar los resultados de la implantación de un programa de atención farmacéutica dirigido a optimizar el tratamiento farmacoterapéutico individualizado en un hospital de Traumatología con historia clínica informatizada (HCI) y sistema integral de dispensación individualizada de medicamentos (SIDIM).Métodos Estudio retrospectivo observacional de 3 años de duración (2007-2009). Se realizó un seguimiento diario del tratamiento farmacoterapéutico de los pacientes ingresados en unidades de hospitalización con SIDIM. Mediante el registro en un documento normalizado, se clasificaron los problemas relacionados con los medicamentos (PRM) y/o errores de medicación (EM) identificados, así como las intervenciones farmacéuticas realizadas de acuerdo con la idoneidad y el grado de aceptación de las mismas. Para la identificación de pacientes con oportunidades de mejora en su farmacoterapia (PRM y/o EM) se empleó el método IASER®.Resultados Se realizaron 1.971 intervenciones farmacéuticas (IF) tras revisar 124.336 líneas de tratamiento correspondientes a 12 IF por cada 100 pacientes. La prevalencia de pacientes con PRM fue del 12% distribuidos de la siguiente manera: 50,66% categorizados en seguridad, 22,98% en indicación, 12,23% en efectividad y 14,13% en adherencia. Los grupos fármacológicos principalmente implicados fueron: antiinfecciosos (29%), fármacos para el aparato locomotor (..) (AU)

Objective To evaluate the results for implementing a pharmaceutical care programme aimed at optimising personalised pharmacotherapeutic treatment in a Trauma Centre with electronic medical records (EMR) and an integral system for personalised medication dispensing (ISPMD).Method A three-year observational, retrospective study (2007-2009). On a daily basis, we checked the pharmaceutical treatment of patients admitted to hospital units with ISPMD. The medication-related problems (MRP) and medication errors (ME) were identified and classified by recording them on a standardised document. We also recorded data on the Pharmaceutical Interventions performed in accordance with fitness and level of acceptance. We used the laser® method to identify patients with pharmacotherapy improvement opportunities (MRP and/or ME).Results One thousand nine-hundred and seventy-one pharmaceutical interventions (PI) were found after having reviewed 124 336 treatment lines, resulting in 12 PI for every 100 patients. The prevalence of patients with MRP was 12%, distributed as such: 50.66% were safety-related, 22.98% indication-related, 12.23% effectiveness-related and 14.13% adherence-related. The main drug groups involved were: anti-infectious agents (29%), drugs for the musculoskeletal system (21%), drugs for blood and haematopoietic organs (12%), and drugs for the nervous system (11%). The active ingredient that required most PI in 2007 was dexketoprofen (15.6%), followed by ketorolac (12.4%). In 2008, it was dexketoprofen (22.0%) followed by gentamicin (7.3%), and in 2009 enoxaparin (19.0%) followed by dexketoprofen (14.3%). The origin of MRP was due to ME in 91% of cases in 2007and 81% in 2008, decreasing (..) (AU)

[Optimisation of pharmacotherapy in a trauma centre]. / Optimización de la farmacoterapia en un hospital de Traumatología.

OBJECTIVE: To evaluate the results for implementing a pharmaceutical care programme aimed at optimising personalised pharmacotherapeutic treatment in a Trauma Centre with electronic medical records (EMR) and an integral system for personalised medication dispensing (ISPMD). METHOD: A three-year observational, retrospective study (2007-2009). On a daily basis, we checked the pharmaceutical treatment of patients admitted to hospital units with ISPMD. The medication-related problems (MRP) and medication errors (ME) were identified and classified by recording them on a standardised document. We also recorded data on the Pharmaceutical Interventions performed in accordance with fitness and level of acceptance. We used the laser method to identify patients with pharmacotherapy improvement opportunities (MRP and/or ME). RESULTS: One thousand nine-hundred and seventy-one pharmaceutical interventions (PI) were found after having reviewed 124 336 treatment lines, resulting in 12 PI for every 100 patients. The prevalence of patients with MRP was 12%, distributed as such: 50.66% were safety-related, 22.98% indication-related, 12.23% effectiveness-related and 14.13% adherence-related. The main drug groups involved were: anti-infectious agents (29%), drugs for the musculoskeletal system (21%), drugs for blood and haematopoietic organs (12%), and drugs for the nervous system (11%). The active ingredient that required most PI in 2007 was dexketoprofen (15.6%), followed by ketorolac (12.4%). In 2008, it was dexketoprofen (22.0%) followed by gentamicin (7.3%), and in 2009 enoxaparin (19.0%) followed by dexketoprofen (14.3%). The origin of MRP was due to ME in 91% of cases in 2007 and 81% in 2008, decreasing to 53% in 2009. PI fitness, as percentages (CI 95%) were considered: Important PI [30.29 (10.19-49.95)]; Very important PI [38.36 (35.45-73)]; Acceptable PI [82.10 (52.28-111.10)]. CONCLUSIONS: Optimising personalised pharmacotherapeutic treatment by implementing an interdisciplinary Pharmaceutical Care programme promotes team work, and as a result improves rational and safe medication dispensing.

Usefulness of molecular-based methods for estimating effective population size in livestock assessed using data from the endangered black-coated Asturcón pony.

Empirical evidence of the usefulness of different molecular-based methods to estimate the effective population size (N(e)) for conservation purposes in endangered livestock populations is reported. The black-coated Asturcón pony pedigree (1,981 individuals) was available. Additionally, a total of 267 Asturcón individuals born in 1998, 2002, and 2008 were typed for 15 microsatellites. These yearly cohorts (cohort(1998, 2002, 2008)) included almost all individuals kept for reproduction at the end of the corresponding foaling season. The genealogical realized N(e) was estimated for each cohort by using the individual increase in inbreeding. Molecular N(e) was computed by using 1) linkage disequilibrium [N(e)(()(D)())], 2) a temporal method based on F-statistics [N(e)(()(T)())], 3) an unbiased temporal method [N(e)(()(JR)())], and 4) a Bayesian temporal method [N(e)(()(B)())]. Estimates of increased from cohort(1998) (18.8 ± 5.1) to cohort(2008) (24.9 ± 5.2), illustrating the history of the population and its breeding policy of avoiding matings between close relatives. The estimates of N(e)(()(D)()) were highly biased upward, with the maximum N(e)(()(D)()) value obtained for cohort(2002) (137.0). The estimates of N(e)(()(T)()), N(e)(()(JR)()), and N(e)(()(B)()) showed similar performance. However, N(e)(()(JR)()) estimates were very consistent across cohorts, varying from 14.9 to 15.5 after correcting for the effect of overlapping generations. When the drift signal was not strong (pair cohort(1998)-cohort(2002)), estimates of N(e)(()(T)()) and N(e)(()(B)()) were not realistic. Estimates of N(e)(()(B)()) tended to be biased downward (being 9.0 or below for the sampling pairs including cohort(2008)). Results of N(e)(()(D)()) are more likely to be estimates of the effective number of breeders producing the sample, rather than the effective size for a generation. The temporal methods were strongly affected by a weak drift signal, particularly when samplings were not spaced a sufficient number of generations or a sufficient time apart. The use of molecular-based estimates of N(e) is not straightforward, and their use in livestock conservation programs should be carried out with caution. Sampling strategies (including sampling sizes, sampling periods, and the age structure of the sampled individuals) must be carefully planned to ensure that robust estimates of N(e) are obtained.

Implementación de un aula de la Farmacia en la Facultad de Ciencias de la Salud de la Universidad CEU - Cardenal Herrera / Implementation of Classroom of Pharmacy at the Faculty of Health Sciences

El Espacio Europeo de Educación Superior (EEES) supone un cambio en nuestras metodologíasdocentes, que deben orientarse hacia una mayor participación del alumno en el proceso de enseñanzaaprendizaje,así como a satisfacer la necesidad de formación del mundo laboral. Por ello, y en base a lanecesidad de nuestra Universidad de adaptar la docencia de Farmacia al Espacio Europeo deEducación Superior, la Facultad de Ciencias de la Salud de la Universidad CEU Cardenal Herrera, hadesarrollado un proyecto para implantar un aula que simule una Oficina de Farmacia.Entre los perfiles laborales del farmacéutico, el de Oficina de Farmacia es el más frecuente, por seresta la ocupación laboral mayoritaria. La labor en las farmacias comunitarias consiste básicamente enla conservación, dispensación, asesoramiento y elaboración de medicamentos. Todo ello, unido alejercicio de la atención farmacéutica, conlleva una gran carga de responsabilidad, un conocimiento yvigilancia de la legislación establecida al respecto y una base científica y técnica importante. Lafarmacia es, a su vez, un centro de educación y prevención sanitaria, dietética y cosmética.Con el objetivo de que nuestros alumnos desarrollen todas las competencias necesarias para elfarmacéutico en la Facultad de Salud se implantó el Aula de la Farmacia(AU)

The European Higher Education Area (EHEA) represents a shift in our teaching methodology, whichshould now be steered towards a greater participation of students in the teaching-learning process andshould satisfy the employment market’s need for trained professionals. In this context, our universityhas sought to adapt its pharmacy teaching programme to the EHEA, and so the Faculty of HealthSciences of the CEU Cardenal Herrera University has developed a project to create a space thatsimulates a working pharmacy.Among the different professional profiles within the discipline of pharmacy, a position in achemist’s/drugstore is the most common, as the majority of pharmacists are employed as such. Thework of community pharmacies basically consists of the storing, dispensing and preparation ofmedication. These tasks, combined with the pharmaceutical care provided to patients and customers,involve a great deal of responsibility that depends on knowledge and safeguarding of the currentlegislation and a solid scientific and technical training. A pharmacy is, at the same time, a centre ofeducation and prevention in health, diet and cosmetics(AU)

Multiple paternal origins of domestic cattle revealed by Y-specific interspersed multilocus microsatellites.

In this study, we show how Y-specific interspersed multilocus microsatellites, which are loci that yield several amplified bands differing in size from the same male individual and PCR reaction, are a powerful source of information for tracing the history of cattle. Our results confirm the existence of three main groups of sires, which are separated by evolutionary time and clearly predate domestication. These three groups are consistent with the haplogroups previously identified by Götherström et al. (2005) using five Y-specific segregating sites: Y1 and Y2 in taurine (Bos taurus) cattle and Y3 in zebu (Bos indicus) cattle. The zebu cattle cluster clearly originates from a domestication process that was geographically and temporally separated from that of taurine clusters. Our analyses further suggest that: (i) introgression of wild sire genetic material into domesticated herds may have a significant role in the formation of modern cattle, including the formation of the Y1 haplogroup; (ii) a putative domestication event in Africa probably included local Y2-like wild sires; (iii) the West African zebu cattle Y-chromosome may have partially originated from an ancient introgression of humped cattle into Africa; and (iv) the high genetic similarity among Asian zebu sires is consistent with a single domestication process.