Comparación de efectos y costos de anestésicos inhalados

Los costos generados por la prestación de los servicios de salud aumentan a una tasa insostenible debido a factores como la aparición de nuevos y más costosos fármacos, la falta de control de precios de los medicamentos y a su uso inadecuado, por lo que se ha planteado como objetivo disminuir los gastos derivados de la atención para garantizar la sostenibilidad de los sistemas sanitarios. En la actualidad, el mayor desafío que enfrentan los hospitales y profesionales de la salud es la optimización de los resultados clínicos mientras se reducen los costos, lo cual se ha logrado utilizando la mejor evidencia científica y la adopción de modelos farmacoeconómicos que ayudan a determinar cuáles tecnologías en salud tienen una mejor relación de costo-efectividad

Profile of antiretroviral agents use in Colombia

Introduction: Since the beginning of the epidemic, human immunodeficiency virus (HIV) has taken more than 36 million lives. Objective: To determine the antiretroviral drug prescription patterns in a population of individuals with HIV infection in Colombia. Materials and methods: Cross-sectional study analyzing the profiles of patients treated with antiretroviral drugs between April 1st and September 30th, 2015. The sociodemographic, pharmacological, and comorbidity variables were identified. Individuals with a positive diagnosis of HIV of all ages and both genders were included. Results: We found 641 patients with a mean age of 39.0±17 years who were predominantly male (60.2%). The most used medications were lamivudine-zidovudine (51.6%), lopinavir-ritonavir (36%) and efavirenz (24.5%). The combination of lamivudine-zidovudine plus lopinavir-ritonavir was the most prescribed regimen (29.5%), but a total of 80 different regimens was identified. Being an adult between the ages of 45-64 years (OR=2.25; 95%CI 1.367-3.713) was associated with a greater probability of receiving 4 or more antiretrovirals. A total of 267 (41.6%) patients used at least one comedication (range: 1-18 drugs), especially anti-ulcer (57.3%), lipid-lowering (28.8%) and anti-hypertensive (28.5%) drugs. Conclusions: Patients undergoing antiretroviral treatment are receiving medications with elevated intrinsic values at the recommended doses and present comorbidities associated with chronic agerelated conditions. However, these patients receive a great variety of regimens that are not included in the clinical practice guidelines

Isospin transport in 84Kr + 112,124Sn collisions at Fermi energies

Isotopically resolved fragments with Z<=20 have been studied with high resolution telescopes in a test run for the FAZIA collaboration. The fragments were produced by the collision of a 84Kr beam at 35 MeV/nucleon with a n-rich (124Sn) and a n-poor (112Sn) target. The fragments, detected close to the grazing angle, are mainly emitted from the phase-space region of the projectile. The fragment isotopic content clearly depends on the n-richness of the target and it is a direct evidence of isospin diffusion between projectile and target. The observed enhanced neutron richness of light fragments emitted from the phase-space region close to the center of mass of the system can be interpreted as an effect of isospin drift in the diluted neck region.Comment: 8 pages, 7 figure

In situ monitoring of latex film formation by small-angle neutron scattering: Evolving distributions of hydrophilic stabilizers in drying colloidal films

The distribution of hydrophilic species, such as surfactants, in latex films is of critical importance for the performance of adhesives, coatings and inks, among others. However, the evolution of this distribution during the film formation process and in the resulting dried films remains insufficiently elucidated. Here, we present in situ (wet) and ex situ (dry) SANS experiments that follow the film formation of two types of latex particles, which differ in their stabilizer: either a covalently bonded poly(methacrylic acid) (PMAA) segment or a physically adsorbed surfactant (sodium dodecyl sulfate, SDS). By fitting the experimental SANS data and combining with gravimetry experiments, we have ascertained the hydrophilic species distribution within the drying film and followed its evolution by correlating the size and shape of stabilizer clusters with the drying time. The evolution of the SDS distribution over drying time is being driven by a reduction in the interfacial free energy. However, the PMAA-based stabilizer macromolecules are restricted by their covalent bonding to core polymer chains and hence form high surface-area disc-like phases at the common boundary between particles and PMAA micelles. Contrary to an idealized view of film formation, the PMAA does not remain in the walls of a continuous honeycomb structure. The results presented here shed new light on the nanoscale distribution of hydrophilic species in drying and ageing latex films. We provide valuable insights into the influence of the stabilizer mobility on the final structure of latex films

Identification of a critical binding site for local anaesthetics in the side pockets of Kv1 channels

© 2021 The Authors.[Background and Purpose]: Local anaesthetics block sodium and a variety of potassium channels. Although previous studies identified a residue in the pore signature sequence together with three residues in the S6 segment as a putative binding site, the precise molecular basis of inhibition of Kv channels by local anaesthetics remained unknown. Crystal structures of Kv channels predict that some of these residues point away from the central cavity and face into a drug binding site called side pockets. Thus, the question arises whether the binding site of local anaesthetics is exclusively located in the central cavity or also involves the side pockets. [Experimental Approach]: A systematic functional alanine mutagenesis approach, scanning 58 mutants, together with in silico docking experiments and molecular dynamics simulations was utilized to elucidate the binding site of bupivacaine and ropivacaine. [Key Results]: Inhibition of Kv1.5 channels by local anaesthetics requires binding to the central cavity and the side pockets, and the latter requires interactions with residues of the S5 and the back of the S6 segments. Mutations in the side pockets remove stereoselectivity of inhibition of Kv1.5 channels by bupivacaine. Although binding to the side pockets is conserved for different local anaesthetics, the binding mode in the central cavity and the side pockets shows considerable variations. [Conclusion and Implications]: Local anaesthetics bind to the central cavity and the side pockets, which provide a crucial key to the molecular understanding of their Kv channel affinity and stereoselectivity, as well as their spectrum of side effects.The study was supported by the Ministerio de Ciencia e Innovación (MICINN, Spain) Grants SAF2016-75021-R and PID2019-104366RB-C21 (to C.V. and T.G.); the European Regional Development Fund (Fondo Europeo de Desarrollo Regional [FEDER]) and the Instituto de Salud Carlos III CIBERCV programme CB/11/00222 (to C.V. and T.G.); the Consejo Superior de Investigaciones Científicas (CSIC) Grants PIE201820E104 and 2019AEP148 (to C.V.); the Fondo Nacional de Desarrollo Científico y Tecnológico (FONDECYT) 1191133 and the Fondo de Equipamiento Científico y Tecnológico (FONDEQUIP) 160063 grants from ANID (to W.G.); and the Deutsche Forschungsgemeinschaft (DFG) Grant DE1482-4/1 to N.D

FAZIA applications

International audienceThe present status and the perspectives of the FAZIA project are presented. The main achievements in terms of identification thresholds and isotopic resolution are discussed, together with the adopted technical solutions. The detector is particularly well suited for the investigation of isospin transport phenomena at intermediate beam energies; perspectives to reduce the identification thresholds to cope with lower energy ISOL beams are briefly introduced. Some experimental results concerning isospin transport effects obtained with a test telescope are presented. The study of isospin transport phenomena can give information on the symmetry energy term of the nuclear equation of state by comparing the experimental results on isospin related observables with the predictions of transport codes

A cloud-based enhanced differential evolution algorithm for parameter estimation problems in computational systems biology

This is a post-peer-review, pre-copyedit version of an article published in Cluster Computing. The final authenticated version is available online at: https://doi.org/10.1007/s10586-017-0860-1[Abstract] Metaheuristics are gaining increasing recognition in many research areas, computational systems biology among them. Recent advances in metaheuristics can be helpful in locating the vicinity of the global solution in reasonable computation times, with Differential Evolution (DE) being one of the most popular methods. However, for most realistic applications, DE still requires excessive computation times. With the advent of Cloud Computing effortless access to large number of distributed resources has become more feasible, and new distributed frameworks, like Spark, have been developed to deal with large scale computations on commodity clusters and cloud resources. In this paper we propose a parallel implementation of an enhanced DE using Spark. The proposal drastically reduces the execution time, by means of including a selected local search and exploiting the available distributed resources. The performance of the proposal has been thoroughly assessed using challenging parameter estimation problems from the domain of computational systems biology. Two different platforms have been used for the evaluation, a local cluster and the Microsoft Azure public cloud. Additionally, it has been also compared with other parallel approaches, another cloud-based solution (a MapReduce implementation) and a traditional HPC solution (a MPI implementation)Ministerio de Economía y Competitividad; DPI2014-55276-C5-2-RMinisterio de Economía y Competitividad; TIN2013-42148-PMinisterio de Economía y Competitividad; TIN2016-75845-PXunta de Galicia ; R2016/045Xunta de Galicia; GRC2013/05

Architecture and performance of the KM3NeT front-end firmware

The KM3NeT infrastructure consists of two deep-sea neutrino telescopes being deployed in the Mediterranean Sea. The telescopes will detect extraterrestrial and atmospheric neutrinos by means of the incident photons induced by the passage of relativistic charged particles through the seawater as a consequence of a neutrino interaction. The telescopes are configured in a three-dimensional grid of digital optical modules, each hosting 31 photomultipliers. The photomultiplier signals produced by the incident Cherenkov photons are converted into digital information consisting of the integrated pulse duration and the time at which it surpasses a chosen threshold. The digitization is done by means of time to digital converters (TDCs) embedded in the field programmable gate array of the central logic board. Subsequently, a state machine formats the acquired data for its transmission to shore. We present the architecture and performance of the front-end firmware consisting of the TDCs and the state machine