Problemas relacionados con la medicación en pacientes con hipertensión arterial, una revisión sistemática

  Introduction: Drug-related problems (DRPs) are associated with treatment ineffectiveness, worsening of the medical condition, development of adverse reactions, and even severe complications that may require hospitalization or additional treatment, causing inconvenience at the global health level due to the hospitalization costs generated. Objective: This research aimed to identify the most common DRPs associated with using antihypertensive drugs and to find the pharmacological groups most commonly prescribed in this treatment. Methodology: A literature review was conducted using the PRISMA and Dader pharmaceutical methods. Based on the inclusion and exclusion criteria, 11 scientific articles were considered. Results: The determination of DRPs was very diverse, with DRP1 being one of the most common, with 44% of the total, followed by DRP5. Among the most prescribed pharmacological groups, Angiotensin-Converting Enzyme Inhibitors (ACEI) and the combination of diuretics with Angiotensin II receptor antagonists (ARA-II) were identified, representing 19.0% and 8.3% of the total cases studied, respectively. Conclusion: It could be evidenced that the most observed DRPs were DRP1 (44%) and DRP5 (25%); similarly, patients treated with ACEI represented by Enalapril (19.0%) were evidenced.Introducción:  Los Problemas Relacionados con la Medicación (PRM) están relacionados a la ineficacia del tratamiento, el empeoramiento de la condición médica, el desarrollo de reacciones adversas, e incluso las complicaciones graves que pueden requerir hospitalización o tratamiento adicional, ocasionando inconvenientes a nivel de la salud mundial, debido a que generan costos por hospitalización. Objetivo: La presente investigación tuvo como objetivo la identificación de los PRM más comunes relacionados al uso de antihipertensivos y encontrar los grupos farmacológicos más prescritos en el tratamiento. Metodología: Se realizó una revisión bibliográfica, usando el método PRISMA y el método farmacéutico DÁDER. Aplicando los criterios de inclusión y exclusión, fueron considerados 11 artículos científicos. Resultados: La determinación de PRM’s fue muy diversa, se evidenció que el PRM1 es uno de los más comunes con un 44% del total, seguido del PRM5. Dentro de los grupos farmacológicos más prescritos se identificaron a los Inhibidores de la Enzima Convertidora de la Angiotensina (IECA) y a la combinación de diuréticos con ARA II, representando el 19.0% y el 8.3% respectivamente del total de casos estudiados. Conclusión: Se pudo evidenciar que los PRM’s más observados fueron: los PRM’s 1 (44%), mientras los PRM’s 5 (25%), de igual manera se evidenció pacientes tratados con IECAS representado por el Enalapril (19.0%). &nbsp

Voluntariado Social Sustentável Aprenda fazendo serviço comunitário

Obetivo principal de este primer proyecto piloto de “ApS Voluntariado Social Sostenible. Aprender haciendo un servicio a la comunidad” (en adelante ApS VSS) ha sido implementar el voluntariado social sostenible en la Facultad de Trabajo Social para desarrollar capacidades y competencias genéricas y específicas, que les permita a las y los participantes reafirmarse socialmente y que les capacite para transmitir la importancia de la Agenda 2030. Se fusionan varias capacidades, para canalizar acciones enmarcadas y ser embajadores/as de los Objetivos de Desarrollo Sostenible (en adelante ODS), teniendo presente el contexto de la COVID-19. A través de la metodología innovadora del Aprendizaje-Servicio se han conseguido los objetivos propuestos ya que se ha buscado promover un encuentro para el trabajo conjunto, desarrollando capacidades humanas a través de la conexión entre la individualidad de las personas, el trabajo grupal y comunitario. Los fundamentos del Trabajo Social han sido necesarios para trabajar un enfoque de derechos, valores y compromiso. Además, se han desarrollado habilidades para la vida desde la educación popular, abordando diversos enfoques y recursos como la educación eco-social, el diseño universal del aprendizaje, los entornos inclusivos, la lectura fácil y los huertos eco-didácticos. En el proyecto ha participado un grupo formado por estudiantes de diferentes cursos del grado y máster de Trabajo Social de la Universidad Complutense de Madrid y por personas externas a la universidad que tienen diversidad intelectual. Además, han participado de forma especial estudiantes de las facultades de Bellas Artes y de Estudios Estadísticos en actividades puntuales del proyecto. Como Servicio a la Comunidad, se propuso a los y las participantes el reto de que fueran embajadores/as de los Objetivos del Desarrollo Sostenible (ODS), compartiendo su mensaje al resto de estudiantado universitario y comunidad, mediante no solo el conocimiento científico, sino también desde el reconocimiento a los demás: cultura, saberes y procesos distintos a los nuestros. Para ello, y mediante el lenguaje de las artes escénicas y de la lectura fácil, los y las participantes, junto con la compañía de Teatro La Tramoya, prepararon una obra de teatro, adaptación de la obra de Miguel de Cervantes y Saavedra, “Quijote cabalga con los ODS” Por último, en la 1ª edición del proyecto de ApS “Voluntariado Social Sostenible. Aprender haciendo un servicio a la comunidad” como se han conseguido los objetivos propuestos e incluso en algunos casos ha superado las expectativas previstas, se puede resumir en las actividades que se presentan en el anexo 1. Además de la formación recibida al estudiantado inscrito/a en la actividad, tal y como se ha citado, se han materializado los ODS en la obra teatral y una actividad pedagógica en relación con los ODS.Depto. de Trabajo Social y Servicios SocialesFac. de Trabajo SocialTRUEOficina Universitaria ApS UCMsubmitte

Perspectivas y desafíos para la competitividad: una mirada global desde los territorios

Este libro de investigación, titulado Perspectivas y desafíos para la competitividad: una mirada global desde los territorios, presenta capítulos de investigación agrupados en cuatro núcleos temáticos. El primero está relacionado con la prospectiva, vigilancia tecnológica, inteligencia de negocios y gestión de proyectos como factores de desarrollo perdurable de los territorios. El segundo aborda los retos del marketing y del capital humano en la sociedad digital. El tercero, el desarrollo humano integral sostenible como apuesta de paz en los territorios. Y, el cuarto, el emprendimiento para el desarrollo humano. Con estas propuestas teóricas se busca brindar algunas pautas para potenciar la incorporación de competencias de gestión y el impacto que el uso de técnicas de prospectiva, vigilancia tecnológica, inteligencia de negocios y gestión de proyectos tienen para el desarrollo armónico y sustentable de los territorios y las organizaciones.

XIV Seminario Internacional de Investigación en Urbanismo. ACTAS

La presente publicación recoge los resúmenes de todas las ponencias presentadas oralmente en la decimocuarta edición del Seminario Internacional de Investigación en Urbanismo (SIIU), celebrada en la Escuela Técnica Superior de Arquitectura de Madrid (Universidad Politécnica de Madrid) y presentadas durante los días 16 y 17 de junio de 2022. El Seminario Internacional de Investigación en Urbanismo tuvo su origen en el año 2007, como iniciativa de un grupo de profesores y doctorandos del Departamento de Urbanismo y Ordenación del Territorio de la Universidad Politécnica de Catalunya. Este seminario, originalmente interno y dirigido a investigadores en formación, pretendía ser un espacio de encuentro anual de los doctorandos del programa para debatir y recibir feedback sobre sus trabajos. Su condición pionera, como espacio de reflexión en torno a temas sobre la ciudad, el territorio y el paisaje en el ámbito hispanoamericano, provocó que muy pronto excediera el ámbito local y se transformara en un espacio de interés internacional. Por esta razón, a partir de la quinta edición, celebrada en 2013, se realiza cada año de manera conjunta entre la sede de Barcelona (Universidad Politécnica de Cataluña) y una sede latinoamericana. Hasta ahora han sido sede del SIIU en América, al otro lado del Atlántico: Buenos Aires, Córdoba (Argentina), Santiago de Chile, Bogotá, São Paulo, Camboriú y Curitiba. Asimismo, a partir del año 2020, el gran interés que estaba generando de este lado del Atlántico impulsa su realización en universidades de la Península Ibérica en conjunto con la UPC. De esta manera, Lisboa fue ese año la sede que, en colaboración con Barcelona, acogió el seminario, con el fin de responder al gran interés que éste tiene en el ámbito lusitano. Y en junio de 2022, Madrid ha sido la sede del seminario en España, con la voluntad de estrechar lazos entre dos de las escuelas de arquitectura más importantes del país, y compartir experiencias y miradas sobre los temas relacionados con el urbanismo. Del otro lado del Atlántico, Curitiba fue la sede latinoamericana que, con gran éxito, celebró la segunda parte del evento en la semana siguiente al evento de Madrid

Efficacy and safety of the CVnCoV SARS-CoV-2 mRNA vaccine candidate in ten countries in Europe and Latin America (HERALD): a randomised, observer-blinded, placebo-controlled, phase 2b/3 trial

Background: Additional safe and efficacious vaccines are needed to control the COVID-19 pandemic. We aimed to analyse the efficacy and safety of the CVnCoV SARS-CoV-2 mRNA vaccine candidate. Methods: HERALD is a randomised, observer-blinded, placebo-controlled, phase 2b/3 clinical trial conducted in 47 centres in ten countries in Europe and Latin America. By use of an interactive web response system and stratification by country and age group (18–60 years and ≥61 years), adults with no history of virologically confirmed COVID-19 were randomly assigned (1:1) to receive intramuscularly either two 0·6 mL doses of CVnCoV containing 12 μg of mRNA or two 0·6 mL doses of 0·9% NaCl (placebo) on days 1 and 29. The primary efficacy endpoint was the occurrence of a first episode of virologically confirmed symptomatic COVID-19 of any severity and caused by any strain from 15 days after the second dose. For the primary endpoint, the trial was considered successful if the lower limit of the CI was greater than 30%. Key secondary endpoints were the occurrence of a first episode of virologically confirmed moderate-to-severe COVID-19, severe COVID-19, and COVID-19 of any severity by age group. Primary safety outcomes were solicited local and systemic adverse events within 7 days after each dose and unsolicited adverse events within 28 days after each dose in phase 2b participants, and serious adverse events and adverse events of special interest up to 1 year after the second dose in phase 2b and phase 3 participants. Here, we report data up to June 18, 2021. The study is registered at ClinicalTrials.gov, NCT04652102, and EudraCT, 2020–003998–22, and is ongoing. Findings: Between Dec 11, 2020, and April 12, 2021, 39 680 participants were enrolled and randomly assigned to receive either CVnCoV (n=19 846) or placebo (n=19 834), of whom 19 783 received at least one dose of CVnCoV and 19 746 received at least one dose of placebo. After a mean observation period of 48·2 days (SE 0·2), 83 cases of COVID-19 occurred in the CVnCoV group (n=12 851) in 1735·29 person-years and 145 cases occurred in the placebo group (n=12 211) in 1569·87 person-years, resulting in an overall vaccine efficacy against symptomatic COVID-19 of 48·2% (95·826% CI 31·0–61·4; p=0·016). Vaccine efficacy against moderate-to-severe COVID-19 was 70·7% (95% CI 42·5–86·1; CVnCoV 12 cases in 1735·29 person-years, placebo 37 cases in 1569·87 person-years). In participants aged 18–60 years, vaccine efficacy against symptomatic disease was 52·5% (95% CI 36·2–64·8; CVnCoV 71 cases in 1591·47 person-years, placebo, 136 cases in 1449·23 person-years). Too few cases occurred in participants aged 61 years or older (CVnCoV 12, placebo nine) to allow meaningful assessment of vaccine efficacy. Solicited adverse events, which were mostly systemic, were more common in CVnCoV recipients (1933 [96·5%] of 2003) than in placebo recipients (1344 [67·9%] of 1978), with 542 (27·1%) CVnCoV recipients and 61 (3·1%) placebo recipients reporting grade 3 solicited adverse events. The most frequently reported local reaction after any dose in the CVnCoV group was injection-site pain (1678 [83·6%] of 2007), with 22 grade 3 reactions, and the most frequently reported systematic reactions were fatigue (1603 [80·0%] of 2003) and headache (1541 [76·9%] of 2003). 82 (0·4%) of 19 783 CVnCoV recipients reported 100 serious adverse events and 66 (0·3%) of 19 746 placebo recipients reported 76 serious adverse events. Eight serious adverse events in five CVnCoV recipients and two serious adverse events in two placebo recipients were considered vaccination-related. None of the fatal serious adverse events reported (eight in the CVnCoV group and six in the placebo group) were considered to be related to study vaccination. Adverse events of special interest were reported for 38 (0·2%) participants in the CVnCoV group and 31 (0·2%) participants in the placebo group. These events were considered to be related to the trial vaccine for 14 (<0·1%) participants in the CVnCoV group and for five (<0·1%) participants in the placebo group. Interpretation: CVnCoV was efficacious in the prevention of COVID-19 of any severity and had an acceptable safety profile. Taking into account the changing environment, including the emergence of SARS-CoV-2 variants, and timelines for further development, the decision has been made to cease activities on the CVnCoV candidate and to focus efforts on the development of next-generation vaccine candidates. Funding: German Federal Ministry of Education and Research and CureVac

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care

Erratum to: Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition) (Autophagy, 12, 1, 1-222, 10.1080/15548627.2015.1100356

non present