Prescripciones de inhibidores de bomba de protones. Análisis de su ajuste a las recomendaciones y evidencias científicas publicadas. / Prescription of proton pump inhibitors. Analysis of their compliance with published recommendations and scientific evidence

JUSTIFICACIÓN: dado elevado consumo de IBP en España, y publicaciones que sugieren una sobreprescripción, es posible revisar desde la farmacia qué medicamentos acompañan al IBP en las recetas, para conocer si su indicación para prevenir gastrolesividad estaría justificada. OBJETIVOS: analizar una muestra de recetas de IBP indicados para prevención de gastrolesividad, averiguando qué porcentaje no se ajustaría a las guías de práctica clínica. MATERIAL Y MÉTODOS: se incluyen en el estudio recetas electrónicas canarias de IBP, de pacientes que retiran su medicación en la farmacia. Se excluyen las recetas de otras Comunidades, recetas en papel y privadas, porque no consta el plan de tratamiento completo. En el acto de dispensación, el paciente firma un consentimiento informado, aunque no se recogen datos de carácter personal. Las variables estudiadas son:- Código Individual del Paciente (CIP), cuyo formato no permite identificarle.- Edad y sexo (extraídos del CIP).- Fecha de la receta.- Fecha de inicio del tratamiento con IBP.- Medicamentos incluidos en la receta. Se descartan los IBP prescritos por primera vez hace menos de tres meses, para descartar posibles tratamientos agudos de patología gástrica. Se considera indicado el IBP para la prevención de gastrolesividad producida por medicamentos cuando se inició hace más de 3 meses. Se elabora un listado de medicamentos gastrolesivos, según las evidencias científicas publicadas. Cuando alguno de ellos aparece en la receta, se considera que el uso de IBP está justificado. RESULTADOS Y DISCUSIÓN: se ha analizado 116 recetas. En 34 (29.3 %) no se halló ningún medicamento gastrolesivo, mientras en 83 (70.7 %) sí se encontraron medicamentos gastrolesivos. De las 67 recetas de mujeres, 17 (25,4 %) no se ajustarían a las evidencias publicadas. (AU)

Prescripciones de inhibidores de bomba de protones. Análisis de su ajuste a las recomendaciones y evidencias científicas publicadas / Proton pump inhibitor prescriptions. Analysis of their compliance with published recommendations and scientific evidence

JUSTIFICACIÓN: dado elevado consumo de IBP en España, y publicaciones que sugieren una sobreprescripción, es posible revisar desde la farmacia qué medicamentos acompañan al IBP en las recetas, para conocer si su indicación para prevenir gastrolesividad estaría justificada.OBJETIVOS: analizar una muestra de recetas de IBP indicados para prevención de gastrolesividad, averiguando qué porcentaje no se ajustaría a las guías de práctica clínica.MATERIAL Y MÉTODOS: se incluyen en el estudio recetas electrónicas canarias de IBP, de pacientes que retiran su medicación en la farmacia. Se excluyen las recetas de otras Comunidades, recetas en papel y privadas, porque no consta el plan de tratamiento completo. En el acto de dispensación, el paciente firma un consentimiento informado, aunque no se recogen datos de carácter personal. Las variables estudiadas son:- Código Individual del Paciente (CIP), cuyo formato no permite identificarle.- Edad y sexo (extraídos del CIP).- Fecha de la receta.- Fecha de inicio del tratamiento con IBP.- Medicamentos incluidos en la receta. Se descartan los IBP prescritos por primera vez hace menos de tres meses, para descartar posibles tratamientos agudos de patología gástrica. Se considera indicado el IBP para la prevención de gastrolesividad producida por medicamentos cuando se inició hace más de 3 meses. Se elabora un listado de medicamentos gastrolesivos, según las evidencias científicas publicadas. Cuando alguno de ellos aparece en la receta, se considera que el uso de IBP está justificado.RESULTADOS Y DISCUSIÓN: se ha analizado 116 recetas. En 34 (29.3 %) no se halló ningún medicamento gastrolesivo, mientras en 83 (70.7 %) sí se encontraron medicamentos gastrolesivos. De las 67 recetas de mujeres, 17 (25,4 %) no se ajustarían a las evidencias publicadas. En hombres, este resultado apareció en 17 recetas de un total de 49 (14, 3%). No se halló diferencia significativa entre sexos (Χ2 = 0,01, p =0,05). (AU)

Femtogram Resolution of Iron Content on a Per Cell Basis: Ex Vivo Storage of Human Red Blood Cells Leads to Loss of Hemoglobin.

The magnetic characteristics of hemoglobin (Hb) changes with the binding of dioxygen (O2) to the heme prosthetic groups of the globin chains: from paramagnetic ferrous Hb to diamagnetic ferrous oxyhemoglobin (oxyHb) with reversibly bound O2, or paramagnetic ferric methemoglobin (metHb). When multiplied over the number of Hb molecules in a red blood cell (RBC), the effect is detectable through motion analysis of RBCs in a high magnetic field and gradient. This motion is referred to as magnetophoretic mobility, which can be conveniently expressed as a fraction of the cell sedimentation velocity. In this Article, using a previously developed and reported instrument, cell tracking velocimetry (CTV), we are able to detect difference in Hb concentration in two RBC populations to a resolution of 1 × 107 Hb molecules per cell (4 × 107 atoms of Fe per cell or 4-5 femtograms of Fe). Similar resolution achieved with inductively coupled plasma-mass spectrometry requires on the order of 105-106 cells and provides an average, whereas CTV provides a measurement for each cell. CTV analysis revealed that RBCs lose, on average, 17% of their Hb after 42 days of storage, the maximum FDA-approved length of time for the cold storage of RBCs in additive solution. This difference in Hb concentration was the result of routine RBC storage; clinical implications are discussed.

Muscular activity during isometric incisal biting.

This study attempted to estimate TMJ loading during incisal loading using a custom load-cell device and surface electromyographic (sEMG) recordings of the main jaw closers to assess the outcome correlation. Study participants were 23 healthy volunteers. The incisal loads having submaximal and mean intensity were recorded using a calibrated electronic load cell; simultaneously, surface electromyography (sEMG) of the right and left masseter and temporalis muscles was recorded. Readings of the resting, clenching in maximal and submaximal intercuspal positions and mean (50%) incisal loads were recorded. Clenching sEMG activity was used as a reference for normalization. The mean (SD) submaximal incisal load recorded was 498 (305.78)N, and the mean at 50% of the submaximal load was 268.93 (147.37)N. Mean (SD) sEMG activity during submaximal clenching was 141.23 (87.76)µV, with no significant differences between the four muscles. During submaximal voluntary incisal loading, the normalized mean sEMG activity was 49.99 (34.54)µV %, and 27.17(15.29)µV % during mean (50%) effort. The incisal load was generated mainly by the masseter muscles, as these showed a positive correlation during mean but not during submaximal effort. In the edge-to-edge jaw position, the mean incisal load effort seems to be physiological, but excessive TMJ loads can be expected from chronic or excessive incisal loading. In conclusion, incisal loads require the activity of the masseter muscles, which show a positive correlation between sEMG activity and effective incisal loads during mean, but not during submaximal, effort, and the masseter muscles are dominant over the temporalis muscles during submaximal incisal biting.

Dynamic loading of immature epiphyseal cartilage pumps nutrients out of vascular canals.

The potential influence of mechanical loading on transvascular transport in vascularized soft tissues has not been explored extensively. This experimental investigation introduced and explored the hypothesis that dynamic mechanical loading can pump solutes out of blood vessels and into the surrounding tissue, leading to faster uptake and higher solute concentrations than could otherwise be achieved under unloaded conditions. Immature epiphyseal cartilage was used as a model tissue system, with fluorescein (332 Da), dextran (3, 10, and 70 kDa) and transferrin (80 kDa) as model solutes. Cartilage disks were either dynamically loaded (± 10% compression over a 10% static offset strain, at 0.2 Hz) or maintained unloaded in solution for up to 20 h. Results demonstrated statistically significant solute uptake in dynamically loaded (DL) explants relative to passive diffusion (PD) controls for all solutes except unbound fluorescein, as evidenced by the DL:PD concentration ratios after 20 h (1.0 ± 0.2, 2.4 ± 1.1, 6.1 ± 3.3, 9.0 ± 4.0, and 5.5 ± 1.6 for fluorescein, 3, 10, and 70 kDa dextran, and transferrin). Significant uptake enhancements were also observed within the first 30s of loading. Termination of dynamic loading produced dissipation of enhanced solute uptake back to PD control values. Confocal images confirmed that solute uptake occurred from cartilage canals into their surrounding extracellular matrix. The incidence of this loading-induced transvascular solute pumping mechanism may significantly alter our understanding of the interaction of mechanical loading and tissue metabolism.

Factores sociales en las conductas alimentarias de estudiantes universitarios / Social factors in feeding behavior of university students

The feeding behavior has a direct influence on the nutritional status of individuals belonging to diverse age groups, among them, higher education students. The aim of this research was to interpret the perception of the influence exerted by the family environment, university peers and educational staff on the dietary behavior of university students belonging to the Universidad Católica de la Santísima Concepción. In order to achieve this aim, qualitative methodology through a phenomenological design was used. As a strategy to gather information, a semi-structured interview was applied to eight students, going into some of the results in depth with focus group composed by nine students of the university. Our results showed that the family, friends and university staff influenced the feeding behavior of the interviewed students. Moreover, these influences were found to be favourable regarding healthy feeding behavior in the case of student's family; and unfavourable in the case of friends and university staff.

Las conductas alimentarias influyen directamente en el estado nutricional de los individuos pertenecientes a diversos grupos etarios, entre ellos, los estudiantes de educación superior. El objetivo de esta investigación fue interpretar la percepción de los estudiantes universitarios pertenecientes a la Universidad Católica de la Santísima Concepción, de las condicionantes que el entorno familiar, social y plantel educacional ejercen en sus conductas alimentarias. Para el logro de este fin se utilizó la metodología cualitativa, a través de un diseño fenomenológico. Como estrategia de recolección de información se realizó una entrevista semi-estructurada a 8 estudiantes, profundizando algunos resultados con un grupo focal integrado por 9 alumnos de la Universidad. Por los resultados y en conclusión del estudio, la familia, amigos y plantel universitario condicionan las conductas alimentarias de los estudiantes entrevistados, interpretando estas influencias como favorables en el caso de la familia y desfavorables por parte del plantel universitario y los amigos de aulas para mantener conductas alimentarias saludables.

Apnea severa: signo precoz de neumonía por pneumocystis carinnii en un lactante VIH negativo / Apnea as an early sign of pneumocystis carinii pneumonia in an HIV negative infant

A few reports in the medical literature suggest an association between Pneumocystis caring and apnea in small infants. This patient, a 1 month 20 days old, HIV negative, infant girl weighing 2,000 grams was admitted to hospital after presenting a severe episode of apnea with cyanosis and bradicardia. She progressively developed bronchopneumonia by P. carinii that required prolonged mechanical ventilation with high ventilatory parameters. The clinical course of this patient illustrates that apnea can be an early sign of P. carinii infection in small infants. Early diagnosis and specific therapy might prevent morbidity and mortality and also decrease the length of hospitalization

Lues congenita en recien nacidos y lactantes del servicio de neonatologia y pediatria Hosp. Viedma

En un estudio prospectivo realizado en el Servicio de Pediatria y Neonatologia del hospital F. Viedma (Cochabamba, Bolivia) se busco determinar el comportamiento clinico y epidemiologico de la lues congenita precoz, (LCP) en recien nacidos (RN) y lactantes. En lapso de casi dos anos detectaron 22 casos con un predominio de LCP florida. Existio una correlacion entre la enfermedad, peso bajo al nacer y partos prematuros , las manifestaciones clinicas reflejan lo descrito en la literatura.

Brain monoamine oxidase activity after in vivo-chronic iprindole treatment.

The effects of chronic administration of three different doses of iprindole on the monoamine oxidase activity and neurotransmitter content were studied in the cerebral cortex, the mesencephalon and the cerebellum of mouse brain. The treatment inhibited mitochondrial monoamine oxidase activity of all three brain regions studied, although a dose-response inhibitory effect was found only in the mesencephalon. Brain regional serotonin contents were markedly increased after iprindole treatment. The 5-hydroxyindoleacetic acid contents showed a significant decrease only in the cerebral cortex. Neither dopamine nor norepinephrine brain regional contents were significantly altered. On the basis of these results it is suggested that a substrate-specific inhibition of monoamine oxidase is involved in the mechanism of action of this tricyclic antidepressant.