Rendimiento del ASAS Health Index en pacientes con Espondiloartritis de la vida real / Performance of ASAS Health Index in real life spondyloarthritis patients

Introducción: El cuestionario "Assessment of Spondyloarthritis International Society Health Index" (ASAS-HI) fue desarrollado para medir de manera global la funcionalidad y el estado de salud en pacientes con espondiloartritis (EspA). Se han propuesto puntos de corte para determinar diferentes estados de salud que fueron poco evaluados en pacientes de la vida real. Objetivos: Describir el estado de salud medido por ASAS-HI en pacientes argentinos con EspA axial (EspAax) y periférica (EspAp) en la práctica diaria y evaluar los factores asociados al pobre estado de salud. Materiales y métodos: Estudio de corte transversal, analítico y multicéntrico. Se incluyeron consecutivamente pacientes con EspAax y EspAp según criterios ASAS, de 15 centros argentinos. Análisis estadístico: Se realizó estadística descriptiva, análisis bivariado y multivariado (regresión logística múltiple) para evaluar los factores asociados al pobre estado de salud (ASAS-HI ≥12). Para analizar la validez de constructo de la herramienta se realizó correlación de Spearman entre el ASAS-HI y otros parámetros de evaluación de la enfermedad. Resultados: Se incluyeron 274 pacientes con EspA, con una edad media de 49 (±14) años y una duración mediana de la enfermedad de 62 meses (p25-75: 24-135), 155 (56,6%) de los pacientes eran de sexo masculino, 129 pacientes (47%) con EspAax y 145 (52,9%) EspAp. Según el ASAS-HI 119 pacientes (43,4%) presentaban buen estado de salud, 117 (42,7%) tenían estado de salud moderado y 38 (13.9%) pobre estado de salud. En los pacientes con EspAp el valor de ASAS-HI mediano fue de 7 (p25-75: 3-10). El ASAS-HI correlacionó positivamente con: DAS28: rho: 0.5 (p<0.001) y HAQ: rho: 0.54 (p<0.001). La variable asociada de manera independiente con pobre estado de salud fue el DAS28 (OR: 1.9, IC95% 1.1-3.4, p: 0.029). En los pacientes con EspAax el valor de ASAS-HI mediano fue de 6 (p25-75: 2.75-10). El ASAS-HI mostró correlación con: BASDAI: rho: 0.7 (p<0.001), ASDAS-ERS: rho: 0.7 (p<0,001), ASQoL: rho: 0.8 (p<0.001), BASFI rho: 0.75 (p<0.001). La variable que se asoció de manera independiente a pobre estado de salud fue el ASDAS-ERS (OR 6.6, IC95% 2-22, p 0.002). Conclusión: Un pobre estado de salud se asoció independientemente a mayor actividad de la enfermedad en pacientes con EspAax y EspAp. El ASAS-HI correlacionó con otros parámetros de la enfermedad, lo que refuerza la validez de constructo de esta nueva herramienta.

Introduction: The "Assessment of Spondyloarthritis International Society Health Index" (ASAS-HI) questionnaire was developed to globally measure function and health status in patients with spondyloarthritis (SpA). Cut-off points have been proposed to determine different health states that were poorly evaluated in real-life patients. Objectives: To describe the health status measured by ASAS-HI in Argentine patients with axial SpA (AxSpA) and peripheral SpA (SpAp) in daily practice and to evaluate the factors associated with poor health. Materials and methods: Cross-sectional, analytical and multicenter study. Patients with SpAax and SpAp were consecutively included according to ASAS criteria, from 15 Argentine centers. Statistical analysis: Descriptive statistics, bivariate and multivariate analysis (multiple logistic regression) were performed to evaluate the factors associated with poor health status (ASAS-HI ≥12). To analyze the construct validity of the tool, Spearman correlation was performed between the ASAS-HI and other disease evaluation parameters. Results: 274 patients with SpA were included, with a mean age of 49 (± 14) years and a median duration of the disease of 62 months (p25-75: 24-135), 155 (56.6%) were male, 129 patients (47%) with AxSpA and 145 (52.9%) SpAp. According to the ASAS-HI, 119 patients (43.4%) had good health, 117 (42.7%) had moderate health and 38 (13.9%) had poor health. In patients with SpAp, the mean ASAS-HI value was 7 (p25-75: 3-10). The ASAS-HI positively correlated with: DAS28: rho: 0.5 (p <0.001) and HAQ: rho: 0.54 (p <0.001). The variable independently associated with poor health status was DAS28 (OR: 1.9, 95% CI 1.1-3.4, p: 0.029). In patients with AxSpA, the mean ASAS-HI value was 6 (p25-75: 2.75-10). The ASAS-HI showed correlation with: BASDAI: rho: 0.7 (p <0.001), ASDAS-ERS: rho: 0.7 (p <0.001), ASQoL: rho: 0.8 (p <0.001), BASFI rho: 0.75 (p <0.001). The variable that was independently associated with poor health was the ASDAS-ERS (OR 6.6, 95% CI 2-22, p 0.002). Conclusion: Poor health status was independently associated with higher disease activity in patients with AxSpA and SpAp. The ASAS-HI correlated with other parameters of the disease, which reinforces the construct validity of this new tool.

Hacia una alimentación sostenible: un esfuerzo multidisciplinario / Towards sustainable diets: a multidisciplinary approach

Nuestro planeta se enfrenta a un reto sin precedentes. En 2050, las predicciones indican que la población crecerá hasta los nueve billones de personas, que deberán nutrirse en un planeta con recursos limitados. El sistema global de alimentación debe transformarse, pasando de una producción no sostenible a una producción sostenible, y de una alimentación insuficiente o excesiva a una alimentación sana para todo el mundo. Es muy importante definir qué es una dieta sostenible y hay un consenso científico razonable en cómo deben ser las dietas con un impacto ambiental bajo y saludables a la vez. Los detalles varían de todos modos en función del contexto. Así pues, para entender el impacto de los cambios en la dieta en un contexto más amplio y global se precisan estudios de países y regiones con distintos hábitos, culturas y condiciones. Las guías de alimentación se utilizan básicamente para promover una alimentación que tenga en cuenta la prevención de enfermedades crónicas, pero solo pocos países han incluido aspectos medioambientales en sus guías. Estas sugieren un estilo de cocina y alimentación basado en el mundo vegetal (plant-forward), que enfatiza y celebra pero no está exclusivamente limitado a los alimentos vegetales. Las empresas deberían promover una alimentación basada en el mundo vegetal (plant-forward), ya que satisface el concepto de dietas sostenibles y, a la vez, una demanda creciente por parte de los consumidores. Hay muchas maneras de hacerlo, no solo con los productos que venden sino también con propuestas de recetas y todo tipo de comunicación dirigida a los consumidores. Es una necesidad real y urgente para la salud de las personas y del planeta

Our world is facing an unprecedented challenge. By 2050, the global population is predicted to increase to nine billion people, whom we must nourish on a planet with limited resources. A transformation of the global food system is needed, from an unsustainable to a sustainable food production, and from low-fat quality diets or too much food to healthy diets for everybody. It is very important to define what sustainable diets are, and there is reasonable scientific consensus on what lower environmental impact diets that are consistent with food health should look like. The details though vary according to the context, and to understand the impact of dietary change in a broader and global perspective studies are required in countries/regions with different habits, culture and conditions. Dietary guidelines are mainly used to promote healthy eating to prevent chronic disease, but only few countries have included environmental aspects in their food-based dietary guidelines so far. These suggest "plant-forward", a style of cooking and eating that emphasizes and celebrates but is not limited to only plant-based foods. Companies should promote plant-forward eating, since it fits both with sustainable diets and increasing consumer demands. There are several ways to do so, not only with the products they sell, but also with proposed meals and recipes, and all types of communication towards consumers. It is a real and urgent need for the health of the people and the planet

Enfermedad por anticuerpos antimembrana basal glomerular: una causa infrecuente de fallo renal / Anti-glomerular basement membrane antibody disease: An uncommon cause of renal failure

No disponible

Resolución de casos prácticos en pequeños grupos en la enseñanza de la asignatura “química general y analítica” del grado en farmacia / Resolution of practical cases in small groups in the teaching of “general and analytical chemistry” subject of degree in pharmacy

El Proyecto realizado por el equipo docente del Departamento de Química Analítica de la Facultad deFarmacia de Sevilla, ha utilizado la técnica de enseñanza en pequeños grupos (EPG) que constituyeuna faceta esencial en la renovación de las metodologías docentes para la incorporación y adaptaciónde las enseñanzas universitarias al Espacio Europeo de Educación Superior. La actividad propuesta seha llevado a cabo en la asignatura “Química General y Analítica” del Grado en Farmacia. Con elobjetivo de mejorar el aprendizaje del alumno y fomentar el trabajo en equipo del mismo, se hasubdividido en tres cada uno de los seis grupos asignados a “Clases Prácticas en el aula”, logrando unnúmero de alumnos presentes en la misma (20 alumnos) que permite la impartición de la docencia conuna dinámica distinta a la lección magistral. La actividad desarrollada ha tenido una gran acogida porparte de los alumnos donde un alto porcentaje de los mismos consigue superar sin grandes dificultadesel apartado del examen destinado a casos prácticos(AU)

The Project developed by the Educational Team of the Department of Analytical Chemistry (Facultyof Pharmacy, Seville), has used the technique of Small Groups Learning (SGL) that constitutes anessential facet in the renovation of the educational methodologies for the incorporation and adaptationof the university lessons to the European Space for Higher Education. The proposed activity has beencarried out in the “General and Analytical Chemistry” subject of the Degree in Pharmacy. With theaim of improving the learning of the student and fomenting the work in equipment of the same, it hasbeen subdivided in three each one of the six assigned groups to “Practical exercises in the classroom”,obtaining a number of present students in the same (20 students) that allows the imparting of teachingwith a dynamic different from the magisterial lesson. The developed activity has presented a greatreception by the students and a high percentage of the same is able to surpass without great difficultiesthe section of the examination destined to practical cases(AU)

Management of returned anti-neoplastic treatments and their reuse in oncology patients.

OBJECTIVE: Analyse the profile of parenteral preparation and treatment (anti-neoplastic and supplementary) that were dispensed and returned to the Pharmacy Department, the reasons why they were not administered, their reuse and the associated direct costs. METHOD: Longitudinal study over eight months (October 2004-May 2005) in a tertiary hospital with centre for preparing anti-neoplastic agents (including supplementary treatment) in its Pharmacy Department. The variables studied, downloaded from the Oncofarm® application, are as follows: (a) patients and diagnostics; (b) returned treatments, classified by reason returned, pharmaco-therapeutic scheme, cycle and day; (c) returned preparations (anti-neoplastic and supplementary) that were reused; and (d) direct costs. Data is presented with its absolute and relative frequencies and confidence intervals of 95% normalised at 1000 patients/day. RESULTS: 84 treatments were returned by 66 patients for a total of 139 preparations corresponding to 3,429 patients/day. This figure represents 24.5 (CI 95%, 19.6 to 30.2) treatments that were prepared and not administered per 1,000 patients/day, mainly due to clinical causes (n = 47). Colon neoplasia and treatment with 5-fluorouracil and levofolinic acid presented the highest number of returns. The returned preparations made up 1.45 % (CI 95%, 1.2 to 1.7) of those produced. The percentage of reuse is 98%, which results in savings of euro 10,432.55 (90% of the cost of the treatments that are returned). CONCLUSIONS: The application of quality, effectiveness and safety criteria to anti-neoplastic treatments that are prepared and returned to the Pharmacy Department allows a more efficient preparation process.

Gestión de la devolución de tratamientos antineoplásicos y de su reutilización en pacientes oncológicos / Management of returned anti-neoplastic treatments and their reuse in oncology patients

Objetivo: Analizar el perfil de tratamientos y preparaciones parenterales (antineoplásicas y de soporte) dispensados y devueltos al servicio de farmacia, las causas de no administración, su reutilización y los costes directos asociados. Método: Estudio longitudinal, prospectivo, durante 8 meses (octubre 2004-mayo 2005) en un hospital terciario con centralización de la preparación de esquemas antineoplásicos (incluye tratamiento de soporte) en el servicio de farmacia. Las variables estudiadas, descargadas del aplicativo Oncofarm®, fueron: a) pacientes y diagnósticos; b) tratamientos devueltos, diferenciando por causa, esquema farmacoterapéutico, ciclo y día; c) preparaciones devueltas (antineoplásicos y soporte) y reutilizadas, y d) costes directos. Los datos se presentan con sus frecuencias absolutas, relativas e intervalos de confianza (IC) del 95 %, normalizado a 1.000 pacientes/día. Resultados: 84 tratamientos devueltos de 66 pacientes con un total de 139 preparaciones correspondientes a 3.429 pacientes/día. Este dato representa 24,5 (IC del 95 %, 19,6 a 30,2) de tratamientos preparados y no administrados por 1.000 pacientes/día, debido, mayoritariamente, a causas clínicas (n = 47). La neoplasia de colon y el esquema de 5-fluorouracilo y ácido levofolínico presentan el mayor número de devoluciones. Las preparaciones devueltas suponen el 1,45 % (IC del 95 %, 1,2 a 1,7) de las elaboradas. El porcentaje de reutilización es del 98 %, con un coste ahorrado que asciende a 10.432,55 (90 % del coste de los tratamientos devueltos).Conclusiones: La aplicación de criterios de calidad, eficacia y seguridad a los tratamientos antineoplásicos preparados y devueltos al servicio de farmacia permite incrementar la eficiencia en el proceso de preparación (AU)

Objective: Analyse the profile of parenteral preparation and treatment (anti-neoplastic and supplementary) that were dispensed and returned to the Pharmacy Department, the reasons why they were not administered, their reuse and the associated direct costs. Method: Longitudinal study over eight months (October 2004-May 2005) in a tertiary hospital with centre for preparing anti-neoplastic agents (including supplementary treatment) in its Pharmacy Department. The variables studied, downloaded from the Oncofarm® application, are as follows: a) patients and diagnostics; b) returned treatments, classified by reason returned, pharmaco-therapeutic scheme, cycle and day; c) returned preparations (anti-neoplastic and supplementary) that were reused; and d) direct costs. Data is presented with its absolute and relative frequencies and confidence intervals of 95 % normalised at 1000 patients/day. Results: 84 treatments were returned by 66 patients for a total of 139 preparations corresponding to 3,429 patients/day. This figure represents 24.5 (CI 95 %, 19.6 to 30.2) treatments that were prepared and not administered per 1,000 patients/day, mainly due to clinical causes (n = 47). Colon neoplasia and treatment with 5-fluorouracil and levofolinic acid presented the highest number of returns. The returned preparations made up 1.45 % (CI 95 %, 1.2 to 1.7) of those produced. The percentage of reuse is 98 %, which results in savings of € 10,432.55 (90 % of the cost of the treatments that are returned).Conclusions: The application of quality, effectiveness and safety criteria to anti-neoplastic treatments that are prepared and returned to the Pharmacy Department allows a more efficient preparation process (AU)

[Screening for congenital hypothyroidism, phenylketonuria, galactosemia and biotinidase deficiency in a sample of mentally retarded patients in the city of Havana]. / Cribado de hipotiroidismo congénito, fenilcetonuria, galactosemia y deficiencia de biotinidasa en una muestra de retrasados mentales de Ciudad de La Habana.

INTRODUCTION: Congenital hypothyroidism (CH), phenylketonuria (PKU), galactosemia (GAL) and biotinidase deficiency (BD) are innate errors in metabolism that share varying degrees of mental retardation (MR) as a common characteristic. AIMS. The aim of our study was to screen individuals with MR of unknown origin for CH, PKU, GAL and BD. PATIENTS AND METHODS: Venous blood samples were collected on SS 903 specimen collection paper from 55 individuals with MR of unspecific origin born within the period 1977 1997. CH diagnosis was performed through determination of total thyroxine (T4) and thyroid stimulating hormone (TSH), using the UMELISA T4 and neonatal TSH reagent kits, respectively, and the detection of PKU, GAL and BD was conducted by determining phenylalanine (Phe), total galactose (Gal) and biotinidase enzyme activity (Biot) using UMTEST PKU, GAL and BIOTINIDASA. RESULTS: The mean values obtained for the analytes that were evaluated were: 0.8 mUI of TSH/L of total blood (EEM: 0.2), 113.1 nmol of T4/L of serum (EEM: 5.4), 67.7 mol of Phe/L of total blood (EEM: 0.1), 0.1 mmol of Gal/L of total blood (EEM: 0.01), and Biot activity was normal in all cases. CONCLUSIONS: This study enabled us to determine the T4, TSH, Phe and Gal levels in a sample from the Cuban population with MR of unknown causation. In addition, slightly higher levels of T4 were found in children who had hyperkinesis

Cribado de hipotiroidismo congénito, fenilcetonuria, galactosemia y deficiencia de biotinidasa en una muestra de retrasados mentales de Ciudad de La Habana / Screening for congenital hypothyroidism, phenylketonuria, galactosemia and biotinidase deficiency in a sample of mentaly retarded patients in the city of Havana

Introducción.El hipotiroidismo congénito (HC), la fenilcetonuria (FCU), la galactosemia (GAL) y la deficiencia de biotinidasa (DB) son errores innatos del metabolismo que tienen como característica común el retraso mental (RM) de diferentes gradaciones. Objetivo. Realizar el cribado de HC, FCU, GAL y DB en individuos con RM de etiología desconocida. Pacientes y métodos. Se recolectaron muestras de sangre venosa en tarjetas de papel de filtro S&S 903 de 55 individuos con RM sin etiología específica, nacidos en el período de 1977-1997. El diagnóstico de HC se realizó mediante las determinaciones de tiroxina total (T4) y hormona estimulante del tiroides (TSH), con los estuches de reactivos UMELISA T4 y TSH neonatal, respectivamente, y la detección de FCU, GAL y DB mediante las determinaciones de fenilalanina (Phe), galactosa total (Gal) y la actividad de la enzima biotinidasa (Biot), con los UMTEST PKU, GAL y BIOTINIDASA. Resultados. Los valores medios obtenidos para los análitos evaluados fueron: 0,8 mUI de TSH/L de sangre total (EEM: ñ0,2), 113,1 nmol de T4/L de suero (EEM: ñ5,4), 67,7 µmol de Phe/L de sangre total (EEM: ñ0,1), 0,1 mmol de Gal/L de sangre total (EEM:ñ0,01) y la actividad de Biot fue normal en todos los casos. Conclusiones. Este estudio permitió conocer los niveles de T4, TSH, Phe y Gal en una muestra de población cubana con RM de etiología desconocida. Además, se encontraron niveles ligeramente elevados de T4 en niños que tenían hipercinesia (AU)

[Nimesulide - a non-steroidal anti-inflammatory drug, a preferential cyclooxygenase-2 inhibitor]. / Nimezulid - nesteroidno protivov'zpalitelno lekarstveno sredstvo, preimyshestestven inkhibitor COX-2]

Nimesulide (Aulin) refers to the class of sulphonanilides, which is unique among the non-steroidal antiinflammatory drugs (NSAIDs), being also the first drug on the market of pharmaceuticals, which preferentially inhibits the enzyme cyclooxygenase-2 (COX-2). This enzyme takes part in the synthesis of prostaglandin, which is produced in the course of the cascade of the inflammation process and has relation to the pathogenesis of pain, inflammation and fever, while the COX-1 enzyme forms prostaglandin, which projects the gastro-intestinal mucosis. Many newly found factors, together with the preferential inhibition of COX-2, are also contributing to the therapeutic effects of Nimesulide. The therapeutic concentration of non-combined active substance in blood-circulation reduces the following indicators: the activity of the myeloperoxidase; the release of cytokines; the histamine effects; the synthesis of stromelysin and collagenase, which pull down the proteoglicans and collagen. It is also characteristic of Nimesulide its antioxidant activity and suppression of: the synthesis of superoxidic ions from the neutrophils; also, the synthesis of platelet activating factor. Nimesulide shows good tolerability and is safe with patients having respiratory problems due to treatment with other NSAIDs.

Optimization of an extraction method of aroma compounds in white wine using ultrasound.

A simple and rapid method is described for the extraction of wine volatile compounds. The procedure was based on the ultrasonic-assisted extraction using a mixing of n-pentane-diethylether (1:2) as solvent. Factorial designs have been used to optimize the sonication process. Factors such as sample volume, extraction time and solvent volume were considered. A statistical approach was used to find suitable conditions for the ultrasound extraction of aroma compounds of wine. A factorial design at two-level revealed that lower sample volume (100 ml instead of 125 ml) and solvent volume of 50 ml instead of 60 ml contributed to improve extraction efficiency. Performance of the method was evaluated, and the procedure applied to the analysis of aroma compound in white wines from 'Condado de Huelva' (Spain).

[Cryptococcosis with exclusive cutaneous presentation in a patient with AIDS]. / Criptococosis de presentación exclusivamente cutánea en un paciente con SIDA.

We report an exclusively cutaneous case of cryptococcosis, which is exceptional. He was a 33 years old patient with the acquired immunodeficiency syndrome who presented with an ulcer-necrotic lesion at the nasal wings with a long and torpid evolution. Finally, culture and biopsy were diagnostic of cryptococcosis. We ruled out affection of other organs and the cryptococcal antigen was negative in serum and cerebrospinal fluid. The patient was treated with fluconazole and had a good clinical course. Its emphasized the scarcity of this form of presentation as well as the lack of specificity of its lesions and the necessity of ruling out other locations once the fungus is isolated in the skin. Diagnosis is simple through skin biopsy and culture. Its important to determine the cryptococcal antigen. We comment on the current approaches to treatment during acute and maintenance phases, after the appearance of the new imidazolic compounds such as fluconazole.