Manual de calidad en Farmacia de Atención Primaria / Quality management system in Primary Care Pharmacy

La gestión de calidad mediante ISO9001:2008 permite controlar y mejorar los procesos de las organizaciones. Nuestro servicio de farmacia del hospital de referencia del sector sanitario dispone de un manual de calidad; la incorporación de un farmacéutico de Atención Primaria (FAP) a la plantilla supuso el desarrollo e implantación de los procedimientos referidos a la gestión de la farmacoterapia en el área ambulatoria por parte de los FAP y su incorporación al manual de calidad, estableciendo los documentos e indicadores necesarios. El Sistema Integrado de Gestión del hospital (SIG: calidad, medio ambiente y prevención) y, en concreto, el sistema de gestión de calidad, permite ir más allá de la simple realización de tareas, puesto que se busca la mejora continua de los procedimientos y actividades (AU)

Quality management by ISO9001: 2008 lets control and improve of processes in organizations. Our hospital pharmacy department of the health area has a manual of quality; the fact that a primary health care pharmacist (FAP) was included in the staff, meant the development and implementation of the quality procedures about their work in drug therapy management in the ambulatory care area, establishing documents and indicators as needed. The Integrated Management System of the hospital (SIG: quality, environment and prevention) and, in particular, the quality management system, allows us to go beyond the simple tasks, as it seeks the continuous improvement of procedures and activities (AU)

Suministro de medicamentos desde hospitales a centros de Atención Primaria y gestión de la calidad / Drug supply and distribution from hospitals to Primary Care centres and total quality management

El presente trabajo consiste en el estudio descriptivo del desarrollo de un procedimiento de suministro de medicamentos desde los servicios de farmacia hospitalaria a los botiquines de los centros de Atención Primaria y, cuando el servicio de farmacia del hospital de referencia tiene implantado un sistema integral de gestión de la calidad, su inclusión en el manual de calidad. Con este fin se han desarrollado los documentos normativos correspondientes, así como los indicadores de actividad (muestran el volumen de trabajo realizado) y de calidad (identifican los puntos de mejora), que permiten una monitorización y mejora continua del proceso. El suministro a los centros de Atención Primaria desde el hospital de referencia del Sector Sanitario permite una mejor racionalización del uso de medicamentos en los mismos y el sistema integral de gestión de la calidad va un paso más allá, permitiendo asegurar una óptima prestación del servicio (AU)

The objective of this paper is to describe the development of a procedure of drug distribution from hospital pharmacy service to primary care centres and, when the reference hospital pharmacy service has a quality management total system, their incorporation into the quality management total system. For this purpose, we have developed normative documents, activity indicators (they show the amount of work done) and quality indicators (they allow to identify items to improve) in order to monitor the correct performance of activities. Distribution from health area hospitals to ambulatory care allows a better rational use of drugs in primary care centres and the quality management total system allows to guarantee the best service (AU)

Structural and kinetic characterization of NADP-dependent, non-phosphorylating glyceraldehyde-3-phosphate dehydrogenase from celery leaves.

NADP-dependent, non-phosphorylating glyceraldehyde-3-phosphate dehydrogenase (EC 1.2.1.9) from celery leaves was purified over 1200-fold to a specific activity of 35 units/mg protein, and its kinetic, regulatory and structural properties were characterized. The purified enzyme exhibited a homotetrameric structure with a subunit molecular mass of 54 kDa. A high specificity of the enzyme for the substrates NADP(+) (K(m)=7 µM) and D-glyceraldehyde-3-phosphate (K(m)=127 µM) was observed. Maximal activity was determined at pH 8.5. The purified enzyme was highly unstable, requiring the addition of NADP(+) or conditions of high ionic strength in the medium. A hysteretic behavior, with a lag phase of minutes, was observed during activity measurement of the enzyme preincubated in the absence of substrates. The lag was inversely proportional to the protein concentration during preincubation. The hysteretic parameters were affected by the substrates, KCl and mannitol among other compounds. Distinctively, incubation with NADP(+) produced a near twofold activation of the enzyme. Results suggest that in alditol producing plants the enzyme plays a key role in the synthesis and partitioning of photoassimilates.

Effects of stress on cellular infrastructure and metabolic organization in plant cells

Ample evidence shows the role of cytoskeleton mainly in cell division, cell form, and general orientation by the perception of physical forces such as gravity and mechanical ones in plant cells. However, the problem of how cytoskeleton organization and its dynamics at the cellular level in turn affects main metabolic pathways of gene expression and cellular energetics is yet unsolved. The response given by cells to environmental challenges such as stress responses is crucially dependent on the organization of their architecture. Drought, high salinity, and low temperature are sensed by plants as a water stress condition. The latter is known to entrain a series of physiological and metabolic changes at the cellular level. This review hypothesizes that the cytoskeletal network of plant cells and tissues may transduce environmental stress into changes in the organization and dynamics of metabolism and gene expression. Accordingly, experimental evidence concerning the current models of cytoplasmic architecture that have emerged in recent years and the effects of stress on the cytostructure are analyzed.