¿Toman los pacientes deprimidos el tratamiento prescrito? Estudio descriptivo sobre el cumplimiento del tratamiento antidepresivo / Do depressed patients comply with treatments prescribed? A cross-sectional study of adherence to the antidepressant treatment

Introducción. El cumplimiento del tratamiento antidepresivo es un aspecto importante en la evolución de los trastornos depresivos. El mal cumplimiento se ha asociado a una peor evolución, a un mayor número de recaídas y mayor coste económico. El objetivo de este estudio es describir el cumplimiento del tratamiento antidepresivo en una muestra de pacientes de atención primaria (AP) con diagnóstico de depresión durante el año 2007. Método. Se realizó un muestreo aleatorio de pacientes con diagnóstico de depresión y tratamiento con antidepresivos atendidos en dos equipos de (AP) y se revisaron las historias clínicas. En ellas consta el número de recetas prescritas y el número de recetas recogidas en la farmacia. Se calculó la diferencia entre recetas prescritas y recogidas. Una diferencia de + 2 se consideró un buen cumplimiento. Se mostraron los resultados en porcentajes y se realizaron comparaciones Ji cuadrado, t-student y ANOVA cuando procedía. Resultados. La muestra estaba compuesta de 212 pacientes. La edad media era de 63,2 años (DE =15,27). El 66,5% estaba en tratamiento con un antidepresivo y el 24,1% con dos. El porcentaje de pacientes no cumplidores era del 33,96% [IC 95% (27,35-40,57)]. Los pacientes cumplidores presentaban un menor porcentaje de tratamiento con otros fármacos crónicos. En los cumplidores el porcentaje de mujeres era superior que en el de no cumplidores (p = 0,015). No había diferencias en el cumplimiento en los pacientes atendidos en el centro de salud mental. Conclusiones. Un tercio de los pacientes en tratamiento farmacológico antidepresivo no eran cumplidores puesto que no lo retiraban de forma adecuada de las farmacias. Es necesario desarrollar estrategias de mejora de la adherencia terapéutica de los pacientes (AU)

Introduction. Compliance with antidepressant treatment is a very relevant factor in the outcome of depressive disorders. Poor compliance has been associated with worse outcome, increased rate of relapses and greater cost. This study has aimed to describe adherence to antidepressant treatment in a sample of primary care patients with a diagnosis of depression in 2007. Methods. Randomized sampling was made of patients with depression and antidepressant treatment attended in two primary care teams. Their medical records were reviewed to obtain the total number of prescriptions given to patients and the total number of prescriptions dispensed in the pharmacies. The difference between prescriptions written and collected was calculated. A difference of ± 2 was considered as good compliance. Results are shown as percentages. Comparisons were made with the chi-square, Student’s T and ANOVA tests, where appropriate. Results. The simple was made up of 212 patients. Mean age was 63.2 years (SD 15.27). In the sample, 66.5% were treated with only one antidepressant and 24.1% with two. The percentage of non-compliance was 33.96% (95% CI: 25.35–40.57). Treatment-adherent patients have a lower percentage of long-term treatment with other drugs. The percentage of treatment-adherent women was higher than non-adherent (p=0.015). No differences were found in compliance among patients treated in the mental health center. Conclusions. One third of patients on antidepressant drug treatment were non-compliers because the drugs were not picked up properly from the pharmacies. We need to develop strategies to improve the therapeutic adherence of patients (AU)

[Do depressed patients comply with treatments prescribed?: a cross-sectional study of adherence to the antidepressant treatment]. / ¿Toman los pacientes deprimidosel tratamiento prescrito? Estudiodescriptivo sobre el cumplimientodel tratamiento antidepresivo.

INTRODUCTION. Compliance with antidepressant treatment is a very relevant factor in the outcome of depressive disorders. Poor compliance has been associated with worse outcome, increased rate of relapses and greater cost. This study has aimed to describe adherence to antidepressant treatment in a sample of primary care patients with a diagnosis of depression in 2007. METHODS. Randomized sampling was made of patients with depression and antidepressant treatment attended in two primary care teams. Their medical records were reviewed to obtain the total number of prescriptions given to patients and the total number of prescriptions dispensed in the pharmacies. The difference between prescriptions written and collected was calculated. A difference of ± 2 was considered as good compliance. Results are shown as percentages. Comparisons were made with the chi-square, Student's T and ANOVA tests, where appropriate. RESULTS. The simple was made up of 212 patients. Mean age was 63.2 years (SD 15.27). In the sample, 66.5% were treated with only one antidepressant and 24.1% with two. The percentage of non-compliance was 33.96% (95% CI: 25.35­40.57). Treatment-adherent patients have a lower percentage of long-term treatment with other drugs. The percentage of treatment-adherent women was higher than non-adherent (p=0.015). No differences were found in compliance among patients treated in the mental health center. CONCLUSIONS. One third of patients on antidepressant drug treatment were non-compliers because the drugs were not picked up properly from the pharmacies. We need to develop strategies to improve the therapeutic adherence of patients.

Assessment and management of infants with apparent life-threatening events in the paediatric emergency department.

OBJECTIVE: To report our experience with a guideline approach for the assessment of apparent life-threatening events (ALTE) at our paediatric emergency department (PED). METHODS: Prospective observational case series study of a guideline approach for infants under the age of 12 months who suffered an ALTE between 1 April 2005 and 31 June 2006. RESULTS: A total of 66 infants with ALTE were included. Fourteen had perinatal risk factors and 16 previous ALTE. Only 14 presented significant abnormalities at examination at the PED. Eight had recurrent ALTE at the PED. Laboratory investigations were abnormal in 35 infants. A total of 45 infants were admitted. Associated conditions (secondary ALTE) were reported in 24 infants (36%), mostly respiratory infections and gastroesophageal reflux. Laboratory investigations contributed to a related diagnosis in nine cases. Compared with idiopathic group, the secondary ALTE sufferers had more perinatal risk factors, more abnormal examination findings, higher risk of recurrence and more frequent need for intervention in the PED. CONCLUSION: Most infants with a first episode of ALTE have normal physical examination. The absence of data suggesting underlying disease, after detailed history and examination, identifies a pool of infants who may be handled conservatively. This group may be monitored as outpatients after keeping them under watch for a short time at the emergency unit, thus avoiding unnecessary admissions. The low yield of laboratory tests in this group suggests that they could be safely omitted in most ALTE and restricted to cases with risk factors and/or whose progress at the observation unit is not satisfactory.

Actividad proteolítica de extractos enzimáticos obtenidos de plantas de la familia Bromeliaceae / Proteolytic activity of enzymatic extracts from plants of the Bromeliaceae family

Las enzimas proteolíticas aisladas de plantas de la familia Bromeliaceae se utilizan ampliamente en la industria médica, biotecnológica y alimenticia. Los estudios realizados en los últimos años sobre la actividad contra metástasis y tumores de las cisteíno-proteasas hacen que se incremente el interés por explorar nuevas fuentes naturales de obtención de fitoproteasas. En el presente trabajo se evaluó la actividad proteolítica de extractos enzimáticos obtenidos a partir de diferentes órganos de plantas de la familia Bromeliaceae. Se colectaron y clasificaron cinco grupos. Las plantas que se colectaron pertenecen a 3 géneros de la mencionada familia: 3 grupos son del género Tillandsia, 1 es del género Guzmania y otro del género Hohenbergia. Los mayores índices de actividad específica (3,3 U/mg de proteínas) se obtuvieron en los preparados obtenidos a partir de diferentes órganos de Hohenbergia penduliflora Mez, de cuyos extractos obtenidos se evaluó la influencia del pH de extracción y la actividad específica fue superior al realizarla a pH 3 a partir de sus tallos.

The proteolytic enzymes isolated from the Bromeliaceae family are widely used in the medical, biotechnological, and food industries. The studies conducted in recent years on the activity against metastasis and cysteine-proteases, increase the interest in screening new natural sources of obtention of phytoproteases. In the present paper, the authors assessed the proteolytic activity of enzymatic extracts obtained from different organs of the Bromeliaceae family plants. Five groups were collected and classified. Plants obtained belong to three genuses of the above mentioned family: 3 groups are of genus Tillandsia , one of genus Guzmania , and the other of genus Hohenbergia . The highest rates of specific activity (3.3 U/mg of proteins) were attained in preparations obtained from different organs of Hohenbergia penduliflora Mez. from whose extracts the influence of extraction pH was assessed. The specific activity was greater on carrying it out at pH3, starting from their stalks.

Actividad proteolítica de extractos enzimáticos obtenidos de plantas de la familia Bromeliaceae / Proteolytic activity of enzymatic extracts from plants of the Bromeliaceae family

Las enzimas proteolíticas aisladas de plantas de la familia Bromeliaceae se utilizan ampliamente en la industria médica, biotecnológica y alimenticia. Los estudios realizados en los últimos años sobre la actividad contra metástasis y tumores de las cisteíno-proteasas hacen que se incremente el interés por explorar nuevas fuentes naturales de obtención de fitoproteasas. En el presente trabajo se evaluó la actividad proteolítica de extractos enzimáticos obtenidos a partir de diferentes órganos de plantas de la familia Bromeliaceae. Se colectaron y clasificaron cinco grupos. Las plantas que se colectaron pertenecen a 3 géneros de la mencionada familia: 3 grupos son del género Tillandsia, 1 es del género Guzmania y otro del género Hohenbergia. Los mayores índices de actividad específica (3,3 U/mg de proteínas) se obtuvieron en los preparados obtenidos a partir de diferentes órganos de Hohenbergia penduliflora Mez, de cuyos extractos obtenidos se evaluó la influencia del pH de extracción y la actividad específica fue superior al realizarla a pH 3 a partir de sus tallos(AU)

Quantitative trait loci analysis of leaf and plant longevity in Arabidopsis thaliana.

The natural variation in leaf and plant longevity in Arabidopsis thaliana was analysed in a set of 45 ecotypes and 155 recombinant inbred lines derived from a Cape Verde Islands (Cvi) x Landsberg erecta (Ler) cross. Post-bolting longevity was inversely related to time to flowering and rosette leaf number in the set of 45 ecotypes, with Cvi having the longest and Ler the shortest post-bolting longevity. The recombinant inbred line population was tested under low or high soil nutrient levels (LN or HN, respectively). Three quantitative trait loci (QTL), one in chromosome 3 and two in chromosomes 1 and 5, were associated with longevity of the 6th rosette leaf under LN and HN, respectively. Four QTL for post-bolting longevity were found in chromosomes 1, 3, 4, and 5, and two in chromosomes 1 and 5 under LN and HN, respectively. An epistatic interaction affecting post-bolting longevity under LN, but not HN, was detected. Ler and Cvi carry a mix of increasing and decreasing alleles for the QTL affecting longevity of the 6th leaf and post-bolting longevity. Longevity of the 6th rosette leaf was associated with different QTL than post-bolting longevity, and it was affected by different QTL depending on nutrient availability. By contrast, the major QTL affecting post-bolting longevity exerted significant effects irrespective of soil nutrient availability.