EVALUACIÓN DE LA EFICACIA DE LA ATENCIÓN FARMACÉUTICA EN PACIENTES CON DERMATITIS ATÓPICA

RESUMEN Introducción: La dermatitis atópica es una enfermedad inflamatoria y crónica de la piel que afecta en gran medida a la calidad de vida de los pacientes de la padecen. Objetivo: Evaluar la eficacia de la atención farmacéutica en pacientes con dermatitis atópica diagnosticada, valorando su impacto sobre la sintomatología y la adherencia al tratamiento. Métodos: Se realizó un estudio experimental longitudinal prospectivo en 50 pacientes con dermatitis atópica no controlada, llevando a cabo una actuación farmacéutica individualizada basada en tres estrategias: educación sanitaria, seguimiento farmacoterapéutico, e intervención sobre el cuidado dermocosmético. Se evaluó la sintomatología y la adherencia al tratamiento farmacológico de cada paciente, y su evolución tras la intervención. Resultados: Los datos obtenidos se analizaron mediante el test estadístico de McNemar, confirmando que el 79,17% de los pacientes graves y el 92,30% de los casos moderados mejoraron significativamente tras la intervención. El valor obtenido del estadístico (Z=3,49) indicó que las variables intervención farmacéutica y mejora del paciente no eran independientes, siendo la primera la causa de la segunda. Al inicio del estudio, el 42% de los pacientes eran incumplidores, mientras que al final del mismo sólo el 23,81% lo eran. Conclusión: Este estudio demuestra que la atención farmacéutica, y más concretamente el seguimiento farmacoterapéutico, son herramientas útiles y necesarias para reducir la sintomatología y mejorar la calidad de vida de los pacientes con dermatitis atópica. PALABRAS CLAVE: dermatitis atópica; atención farmacéutica; intervención farmacéutica; eficacia.   ABSTRACT Introduction: Atopic dermatitis is an inflammatory and chronic skin disease that greatly affects the quality of life of patients suffering from it. Objective: To evaluate the efficacy of pharmaceutical care in patients with diagnosed atopic dermatitis, assessing its impact on symptomatology and adherence to treatment. Methods: A prospective longitudinal experimental study was conducted in 50 patients with uncontrolled atopic dermatitis, and an individualized pharmaceutical action was carried out based on three strategies: health education, pharmacotherapeutic follow-up, and intervention on the dermocosmetic routine. The symptomatology and adherence to the pharmacological treatment of each patient, and their evolution after the intervention were evaluated. Results: The data obtained were analyzed by means of the McNemar statistical test, confirming that 79.17% of the serious patients and 92.30% of the moderate cases improved significantly after the intervention. The value obtained from the statistic (Z = 3.49) indicated that the variables pharmaceutical intervention and patient improvement were not independent, the former being the cause of the latter. At the beginning of the study, 42% of the patients were noncompliant, while at the end of the study only 23.81% were noncompliant. Conclusion: This study demonstrates that pharmaceutical care, and more specifically pharmacotherapy follow-up, are useful and necessary tools to reduce symptomatology and improve the quality of life of patients with atopic dermatitis. KEY WORDS: atopic dermatitis; pharmaceutical care; pharmaceutical intervention; effectiveness

EVALUACIÓN DE LA EFICACIA DE LA ATENCIÓN FARMACÉUTICA EN PACIENTES CON DERMATITIS ATÓPICA

RESUMEN Introducción: La dermatitis atópica es una enfermedad inflamatoria y crónica de la piel que afecta en gran medida a la calidad de vida de los pacientes de la padecen. Objetivo: Evaluar la eficacia de la atención farmacéutica en pacientes con dermatitis atópica diagnosticada, valorando su impacto sobre la sintomatología y la adherencia al tratamiento. Métodos: Se realizó un estudio experimental longitudinal prospectivo en 50 pacientes con dermatitis atópica no controlada, llevando a cabo una actuación farmacéutica individualizada basada en tres estrategias: educación sanitaria, seguimiento farmacoterapéutico, e intervención sobre el cuidado dermocosmético. Se evaluó la sintomatología y la adherencia al tratamiento farmacológico de cada paciente, y su evolución tras la intervención. Resultados: Los datos obtenidos se analizaron mediante el test estadístico de McNemar, confirmando que el 79,17% de los pacientes graves y el 92,30% de los casos moderados mejoraron significativamente tras la intervención. El valor obtenido del estadístico (Z=3,49) indicó que las variables intervención farmacéutica y mejora del paciente no eran independientes, siendo la primera la causa de la segunda. Al inicio del estudio, el 42% de los pacientes eran incumplidores, mientras que al final del mismo sólo el 23,81% lo eran. Conclusión: Este estudio demuestra que la atención farmacéutica, y más concretamente el seguimiento farmacoterapéutico, son herramientas útiles y necesarias para reducir la sintomatología y mejorar la calidad de vida de los pacientes con dermatitis atópica. PALABRAS CLAVE: dermatitis atópica; atención farmacéutica; intervención farmacéutica; eficacia.   ABSTRACT Introduction: Atopic dermatitis is an inflammatory and chronic skin disease that greatly affects the quality of life of patients suffering from it. Objective: To evaluate the efficacy of pharmaceutical care in patients with diagnosed atopic dermatitis, assessing its impact on symptomatology and adherence to treatment. Methods: A prospective longitudinal experimental study was conducted in 50 patients with uncontrolled atopic dermatitis, and an individualized pharmaceutical action was carried out based on three strategies: health education, pharmacotherapeutic follow-up, and intervention on the dermocosmetic routine. The symptomatology and adherence to the pharmacological treatment of each patient, and their evolution after the intervention were evaluated. Results: The data obtained were analyzed by means of the McNemar statistical test, confirming that 79.17% of the serious patients and 92.30% of the moderate cases improved significantly after the intervention. The value obtained from the statistic (Z = 3.49) indicated that the variables pharmaceutical intervention and patient improvement were not independent, the former being the cause of the latter. At the beginning of the study, 42% of the patients were noncompliant, while at the end of the study only 23.81% were noncompliant. Conclusion: This study demonstrates that pharmaceutical care, and more specifically pharmacotherapy follow-up, are useful and necessary tools to reduce symptomatology and improve the quality of life of patients with atopic dermatitis. KEY WORDS: atopic dermatitis; pharmaceutical care; pharmaceutical intervention; effectiveness

Higher COVID-19 pneumonia risk associated with anti-IFN-α than with anti-IFN-ω auto-Abs in children

We found that 19 (10.4%) of 183 unvaccinated children hospitalized for COVID-19 pneumonia had autoantibodies (auto-Abs) neutralizing type I IFNs (IFN-alpha 2 in 10 patients: IFN-alpha 2 only in three, IFN-alpha 2 plus IFN-omega in five, and IFN-alpha 2, IFN-omega plus IFN-beta in two; IFN-omega only in nine patients). Seven children (3.8%) had Abs neutralizing at least 10 ng/ml of one IFN, whereas the other 12 (6.6%) had Abs neutralizing only 100 pg/ml. The auto-Abs neutralized both unglycosylated and glycosylated IFNs. We also detected auto-Abs neutralizing 100 pg/ml IFN-alpha 2 in 4 of 2,267 uninfected children (0.2%) and auto-Abs neutralizing IFN-omega in 45 children (2%). The odds ratios (ORs) for life-threatening COVID-19 pneumonia were, therefore, higher for auto-Abs neutralizing IFN-alpha 2 only (OR [95% CI] = 67.6 [5.7-9,196.6]) than for auto-Abs neutralizing IFN-. only (OR [95% CI] = 2.6 [1.2-5.3]). ORs were also higher for auto-Abs neutralizing high concentrations (OR [95% CI] = 12.9 [4.6-35.9]) than for those neutralizing low concentrations (OR [95% CI] = 5.5 [3.1-9.6]) of IFN-omega and/or IFN-alpha 2

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Mise au point d'une méthode d'évaluation de la lipolyse in vitro et application aux formulations lipidiques

MONTPELLIER-BU Pharmacie (341722105) / SudocSudocFranceF

Fomento del sector agroindustrial de la piña en pequeñas y medianas inversiones

El estudio es desarrollar un modelo agroindustrial de piña en 30 hectáreas con ventas hacia el mercado de exportación de esta fruta, tomando en cuenta el comportamiento de nuestro mercado interno con sus riesgos de producción y comercialización, tomando en cuenta los productos sustitutos y competidores, planteando la manera óptima de producción y venta del producto, cumpliendo los estándares de calidad establecidos a nivel mundial; y analizando la situación actual del mercado en cuanto a las importaciones y exportaciones del producto. Siendo un modelo a seguir la ubicación del proyecto no se especifica, y se lo puede llevar a cabo en distintos sitios del país. Pero para efectos de costos del modelo, se tomó en cuenta los costos actuales en la provincia del Guayas. La producción esperada es de 3,177,500 kilos promedio anual, con un ingreso promedio de $730,825.0 desde el cuarto año de operación. La producción es cíclica debido que un año se cosecha 30 hetáreas y el siguiente 20, debido a la propuesta técnica de siembra escalonada durante el año. La inversion inicial es de$ 746,872.5, siendo financiada el 60% con crédito a siete años con tres años de período de gracia y el restate 40% con capital de los accionistas. El período de reuperaión del total de la inversión es de 4 años. La tasa intera de retorno finaciera (TIRF) para el proyecto es de 34.18% y el Valor Actual Neto es $ 620,283.35 . El proyecto se ha evaluado en un horizonte de 10 años. El número de empleos permanentes generados es de 23 puestos de trabajo y 10 ocasionales en época de cosecha

p38 Mitogen-Activated Protein Kinase- and HuR-Dependent Stabilization of p21Cip1 mRNA Mediates the G1/S Checkpoint▿

Activation of p38 mitogen-activated protein kinase (MAPK) plays an important role in the G2/M cell cycle arrest induced by DNA damage, but little is known about the role of this signaling pathway in the G1/S transition. Upregulation of the cyclin-dependent kinase inhibitor p21Cip1 is thought to make a major contribution to the G1/S cell cycle arrest induced by γ radiation. We show here that inhibition of p38 MAPK impairs p21Cip1 accumulation and, as a result, the ability of cells to arrest in G1 in response to γ radiation. We found that p38 MAPK induces p21Cip1 mRNA stabilization, without affecting its transcription or the stability of the protein. In particular, p38 MAPK phosphorylates the mRNA binding protein HuR on Thr118, which results in cytoplasmic accumulation of HuR and its enhanced binding to the p21Cip1 mRNA. Our findings help to understand the emerging role of p38 MAPK in the cellular responses to DNA damage and reveal the existence of p53-independent networks that cooperate in modulating p21Cip1 levels at the G1/S checkpoint