Implementación del Programa de Farmacovigilancia como Factor Principal de la Droguería “Su Salud”

NO APLICAPara la realización de esta actividad se analizará la farmacovigilancia, su importancia en el sector salud y el quehacer del regente de farmacia en el control del riesgo, la seguridad del paciente y la prevención de reacciones adversas/eventos adversos por el mal uso de medicamentos y el reporte de los mismos a las entidades nacionales, departamentales y municipales encargadas de ejercer la vigilancia; de esta manera se pretende dar soluciones a través de la implementación de un programa de farmacovigilancia y de capacitación periódica al personal que labora dentro de este establecimiento. En este trabajo se analiza la problemática que se genera en un establecimiento farmacéutico donde se evidencian errores de dispensación por la falta de inducción a un auxiliar nuevo y su desconocimiento del establecimiento y de medicamentos LASA, faltantes frecuentes de medicamentos, retrasos en la recepción de pedidos y en el almacenamiento; esto genero problemas en la disponibilidad de los productos en la estantería.To carry out this activity, pharmacovigilance will be analyzed, its importance in the health sector and the work of the pharmacy manager in risk control, patient safety and the prevention of adverse reactions / adverse events due to the misuse of medicines and their reporting to the national, departmental and municipal entities in charge of exercising surveillance; In this way, it is intended to provide solutions through the implementation of a pharmacovigilance program and periodic training for the personnel who work within this establishment. This paper analyzes the problems that arise in a pharmaceutical establishment where dispensing errors are evident due to the lack of induction of a new assistant and their ignorance of the establishment and of LASA medications, frequent shortages of medications, delays in receiving orders and in storage; This generated problems in the availability of the products on the shelf

A Review Study on the Postharvest Decay Control of Fruit by <em>Trichoderma</em>

This chapter consists of an overview with the most relevant results about the efficacy of Trichoderma on postharvest disease control. The results of investigations demonstrate that this fungus can control several phytopathogens in different fruits. Postharvest losses represent a major problem in several countries. The constant application of fungicides not only at field but also at postharvest stage has led to microbial resistance cases, which make the control of these pathogens difficult. Biological control is a promising alternative to chemical fungicide applications. In this sense, an eco-friendly alternative and effective approach for controlling diseases is the use of microbial antagonists like Trichoderma, which have several mechanisms of action to stop disease development. A crucial treat in biological control is related to the maintenance of microbial viability and efficacy, that is why other technologies like their incorporation into edible films and coatings, nanotechnology, microbial mixtures, among others have been applied in combination with Trichoderma successfully. An enhancement in biocontrol activity is achieved when alternative systems are combined like GRAS substances, biopolymers, and other antagonists. Thus, Trichoderma is an eco-friendly alternative to threat postharvest diseases as an alternative to chemical treatments

Second-growth and small forest clearings have little effect on the temporal activity patterns of Amazonian phyllostomid bats

Secondary forests and human-made forest gaps are conspicuous features of tropical landscapes. Yet, behavioural responses to these aspects of anthropogenically-modified forests remain poorly investigated. Here, we analyse the effects of small human-made clearings and secondary forests on tropical bats by examining the guild- and species-level activity patterns of phyllostomids sampled in the Central Amazon, Brazil. Specifically, we contrast the temporal activity patterns and degree of temporal overlap of six frugivorous and four gleaning animalivorous species in old-growth forest and second-growth forest and of four frugivores in old-growth forest and forest clearings. The activity patterns of frugivores and gleaning animalivores did not change between old-growth forest and second-growth, nor did the activity patterns of frugivores between old-growth forest and clearings. However, at the species level we detected significant differences for Artibeus obscurus (old-growth forest vs. second-growth) and Artibeus concolor (old-growth forest vs.clearings). The degree of temporal overlap was greater than random in all sampled habitats. However, whereas for frugivorous species the degree of temporal overlap was similar between old-growth forest and second-growth, for gleaning animalivores it was lower in second-growth than in old-growth forest. On the other hand, forest clearings were characterized by increased temporal overlap between frugivores. Changes in activity patterns and temporal overlap may result from differential foraging opportunities and dissimilar predation risks. Yet, our analyses suggest that activity patterns of bats in second-growth and small forest clearings, two of the most prominent habitats in humanized tropical landscapes, varies little from the activity patterns in old-growth forest

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Prospects for observing and localizing gravitational-wave transients with Advanced LIGO, Advanced Virgo and KAGRA

Abstract: We present our current best estimate of the plausible observing scenarios for the Advanced LIGO, Advanced Virgo and KAGRA gravitational-wave detectors over the next several years, with the intention of providing information to facilitate planning for multi-messenger astronomy with gravitational waves. We estimate the sensitivity of the network to transient gravitational-wave signals for the third (O3), fourth (O4) and fifth observing (O5) runs, including the planned upgrades of the Advanced LIGO and Advanced Virgo detectors. We study the capability of the network to determine the sky location of the source for gravitational-wave signals from the inspiral of binary systems of compact objects, that is binary neutron star, neutron star–black hole, and binary black hole systems. The ability to localize the sources is given as a sky-area probability, luminosity distance, and comoving volume. The median sky localization area (90% credible region) is expected to be a few hundreds of square degrees for all types of binary systems during O3 with the Advanced LIGO and Virgo (HLV) network. The median sky localization area will improve to a few tens of square degrees during O4 with the Advanced LIGO, Virgo, and KAGRA (HLVK) network. During O3, the median localization volume (90% credible region) is expected to be on the order of 105, 106, 107Mpc3 for binary neutron star, neutron star–black hole, and binary black hole systems, respectively. The localization volume in O4 is expected to be about a factor two smaller than in O3. We predict a detection count of 1-1+12(10-10+52) for binary neutron star mergers, of 0-0+19(1-1+91) for neutron star–black hole mergers, and 17-11+22(79-44+89) for binary black hole mergers in a one-calendar-year observing run of the HLV network during O3 (HLVK network during O4). We evaluate sensitivity and localization expectations for unmodeled signal searches, including the search for intermediate mass black hole binary mergers

Postharvest evaluation of Goldfinger banana (FHIA-01) at different storage temperatures followed by an acclimation time

Introduction. Banana fruit is one of the major staple crops grown in the humid tropical areas of Mexico. In spite of the adequate preharvest performance of Goldfinger banana (FHIA-01) in the field, little information about its postharvest behavior has been generated. We decided to study the ripening behavior and quality of fruit during controlled storage and acclimation time. Materials and methods. Banana fruit of the hybrid Musa acuminata X balbisiana ’FHIA-01 Goldfinger’ were stored at 11, 13, 15 and 20 °C for 21 days and then transferred to 25 ± 2°C for acclimation. Fruit sampling under controlled temperatures was performed after 1, 3 and 5 days and the samples were analyzed for CO2 and ethylene production, weight loss, acidity, pH, firmness, and total soluble solids (TSS). Results and discussion. The physiological response and quality of cv. FHIA-01 were affected by the temperature and period of storage and acclimation. During the storage period at 20 °C banana fruit showed total loss of firmness, high TSS (23 °Brix) and full color development (yellow) after 15 days. Fruit at 11 °C and then transferred to 25 °C had delayed maturity with alteration of the ripening process. Conclusion. In general, the optimum storage temperatures for this banana cultivar were 13 °C and 15 °C for 7 to 14 days