Decisiones razonables y razonadas sobre medicamentos convencionales y de uso tradicional. El Seguimiento Farmacoterapéutico, integrador de la perspectiva del paciente.

Se presenta un caso de una paciente con síndrome metabólico y comorbilidades asociadas que acude a un consultorio farmacéutico del nivel primario de Atención en Salud en Bogotá (Colombia), donde recibe seguimiento farmacoterapéutico. La paciente usa tratamientos prescritos por sus médicos y se automedica con productos naturales, como son el extracto de balsamina para regular niveles de glucosa, el extracto de arándano azul europeo para problemas oculares y el uso de lecitina de soja para control de triglicéridos. Para la evaluación de la farmacoterapia, se localizó evidencia científica sobre el uso y conveniencia de cada producto en el tratamiento de sus problemas de salud, realizándose las siguientes intervenciones: continuar con la toma de la balsamina, el Bilberry y la lecitina de soja, ya que existen reportes de su utilidad como coadyuvantes en el control de las enfermedades que presenta y la elaboración de un plan de medicación para reforzar la adherencia a los tratamientos. Cuando se evalúan las intervenciones, encontramos que las cifras de glicemia, presión arterial y función hepática se encuentran dentro de objetivos terapéuticos. En este caso, el químico farmacéutico tiene una labor integradora de las terapias de los pacientes, basados en la valoración del riesgo-beneficio y a través del seguimiento farmacoterapéutico obtiene información clínica que permite tomar decisiones sustentadas para el futuro, más aún en el contexto de Latinoamérica, donde los productos naturales son ampliamente usados en la población

Decisiones razonables y razonadas sobre medicamentos convencionales y de uso tradicional. El Seguimiento Farmacoterapéutico, integrador de la perspectiva del paciente.

Se presenta un caso de una paciente con síndrome metabólico y comorbilidades asociadas que acude a un consultorio farmacéutico del nivel primario de Atención en Salud en Bogotá (Colombia), donde recibe seguimiento farmacoterapéutico. La paciente usa tratamientos prescritos por sus médicos y se automedica con productos naturales, como son el extracto de balsamina para regular niveles de glucosa, el extracto de arándano azul europeo para problemas oculares y el uso de lecitina de soja para control de triglicéridos. Para la evaluación de la farmacoterapia, se localizó evidencia científica sobre el uso y conveniencia de cada producto en el tratamiento de sus problemas de salud, realizándose las siguientes intervenciones: continuar con la toma de la balsamina, el Bilberry y la lecitina de soja, ya que existen reportes de su utilidad como coadyuvantes en el control de las enfermedades que presenta y la elaboración de un plan de medicación para reforzar la adherencia a los tratamientos. Cuando se evalúan las intervenciones, encontramos que las cifras de glicemia, presión arterial y función hepática se encuentran dentro de objetivos terapéuticos. En este caso, el químico farmacéutico tiene una labor integradora de las terapias de los pacientes, basados en la valoración del riesgo-beneficio y a través del seguimiento farmacoterapéutico obtiene información clínica que permite tomar decisiones sustentadas para el futuro, más aún en el contexto de Latinoamérica, donde los productos naturales son ampliamente usados en la población

Role of the employment status and education of mothers in the prevalence of intestinal parasitic infections in Mexican rural schoolchildren

<p><b>Background:</b> Intestinal parasitic infections are a public health problem in developing countries such as Mexico. As a result, two governmental programmes have been implemented: a) "National Deworming Campaign" and b) "Opportunities" aimed at maternal care. However, both programmes are developed separately and their impact is still unknown. We independently investigated whether a variety of socio-economic factors, including maternal education and employment levels, were associated with intestinal parasite infection in rural school children.</p> <p><b>Methods:</b> This cross-sectional study was conducted in 12 rural communities in two Mexican states. The study sites and populations were selected on the basis of the following traits: a) presence of activities by the national administration of albendazole, b) high rates of intestinal parasitism, c) little access to medical examination, and d) a population having less than 2,500 inhabitants. A total of 507 schoolchildren (mean age 8.2 years) were recruited and 1,521 stool samples collected (3 per child). Socio-economic information was obtained by an oral questionnaire. Regression modelling was used to determine the association of socio-economic indicators and intestinal parasitism.</p> <p><b>Results:</b> More than half of the schoolchildren showed poliparasitism (52%) and protozoan infections (65%). The prevalence of helminth infections was higher in children from Oaxaca (53%) than in those from Sinaloa (33%) (p < 0.0001). Giardia duodenalis and Hymenolepis nana showed a high prevalence in both states. Ascaris lumbricoides, Trichuris trichiura and Entamoeba hystolitica/dispar showed low prevalence. Children from lower-income families and with unemployed and less educated mothers showed higher risk of intestinal parasitism (odds ratio (OR) 6.0, 95% confidence interval (CI) 1.6–22.6; OR 4.5, 95% CI 2.5–8.2; OR 3.3, 95% CI 1.5–7.4 respectively). Defecation in open areas was also a high risk factor for infection (OR 2.4, 95% CI 2.0–3.0).</p> <p><b>Conclusion:</b> Intestinal parasitism remains an important public health problem in Sinaloa (north-western Mexico) and Oaxaca (south-eastern Mexico). Lower income, defecation in open areas, employment status and a lower education level of mothers were the significant factors related to these infections. We conclude that mothers should be involved in health initiatives to control intestinal parasitism in Mexico.</p&gt

Pharmacoeconomic analysis of adjuvant oral capecitabine vs intravenous 5-FU/LV in Dukes' C colon cancer: the X-ACT trial

Oral capecitabine (Xeloda<sup>®</sup>) is an effective drug with favourable safety in adjuvant and metastatic colorectal cancer. Oxaliplatin-based therapy is becoming standard for Dukes' C colon cancer in patients suitable for combination therapy, but is not yet approved by the UK National Institute for Health and Clinical Excellence (NICE) in the adjuvant setting. Adjuvant capecitabine is at least as effective as 5-fluorouracil/leucovorin (5-FU/LV), with significant superiority in relapse-free survival and a trend towards improved disease-free and overall survival. We assessed the cost-effectiveness of adjuvant capecitabine from payer (UK National Health Service (NHS)) and societal perspectives. We used clinical trial data and published sources to estimate incremental direct and societal costs and gains in quality-adjusted life months (QALMs). Acquisition costs were higher for capecitabine than 5-FU/LV, but higher 5-FU/LV administration costs resulted in 57% lower chemotherapy costs for capecitabine. Capecitabine vs 5-FU/LV-associated adverse events required fewer medications and hospitalisations (cost savings £3653). Societal costs, including patient travel/time costs, were reduced by >75% with capecitabine vs 5-FU/LV (cost savings £1318), with lifetime gain in QALMs of 9 months. Medical resource utilisation is significantly decreased with capecitabine vs 5-FU/LV, with cost savings to the NHS and society. Capecitabine is also projected to increase life expectancy vs 5-FU/LV. Cost savings and better outcomes make capecitabine a preferred adjuvant therapy for Dukes' C colon cancer. This pharmacoeconomic analysis strongly supports replacing 5-FU/LV with capecitabine in the adjuvant treatment of colon cancer in the UK

Unusual magneto-optical behavior induced by local dielectric variations under localized surface plasmon excitations

We study the effect of global and local dielectric variations on the polarization conversion rps response of ordered nickel nanowires embedded in an alumina matrix. When considering local changes, we observe a non-monotonous behavior of the rps, its intensity unusually modified far beyond to what it is expected for a monotonous change of the whole refractive index of the embedding medium. This is related to the local redistribution of the electromagnetic field when a localized surface plasmon is excited. This finding may be employed to develop and improve new biosensing magnetoplasmonic devices

Expression of a barley cystatin gene in maize enhances resistance against phytophagous mites by altering their cysteine-proteases

Phytocystatins are inhibitors of cysteine-proteases from plants putatively involved in plant defence based on their capability of inhibit heterologous enzymes. We have previously characterised the whole cystatin gene family members from barley (HvCPI-1 to HvCPI-13). The aim of this study was to assess the effects of barley cystatins on two phytophagous spider mites, Tetranychus urticae and Brevipalpus chilensis. The determination of proteolytic activity profile in both mite species showed the presence of the cysteine-proteases, putative targets of cystatins, among other enzymatic activities. All barley cystatins, except HvCPI-1 and HvCPI-7, inhibited in vitro mite cathepsin L- and/or cathepsin B-like activities, HvCPI-6 being the strongest inhibitor for both mite species. Transgenic maize plants expressing HvCPI-6 protein were generated and the functional integrity of the cystatin transgene was confirmed by in vitro inhibitory effect observed against T. urticae and B. chilensis protein extracts. Feeding experiments impaired on transgenic lines performed with T. urticae impaired mite development and reproductive performance. Besides, a significant reduction of cathepsin L-like and/or cathepsin B-like activities was observed when the spider mite fed on maize plants expressing HvCPI-6 cystatin. These findings reveal the potential of barley cystatins as acaricide proteins to protect plants against two important mite pests

Imprisonment and internment: Comparing penal facilities North and South

Recent references to the ‘warehouse prison’ in the United States and the prisión-depósito in Latin America seem to indicate that penal confinement in the western hemisphere has converged on a similar model. However, this article suggests otherwise. It contrasts penal facilities in North America and Latin America in terms of six interrelated aspects: regimentation; surveillance; isolation; supervision; accountability; and formalization. Quantitatively, control in North American penal facilities is assiduous (unceasing, persistent and intrusive), while in Latin America it is perfunctory (sporadic, indifferent and cursory). Qualitatively, North American penal facilities produce imprisonment (which enacts penal intervention through confinement), while in Latin America they produce internment (which enacts penal intervention through release). Closely entwined with this qualitative difference are distinct practices of judicial involvement in sentencing and penal supervision. Those practices, and the cultural and political factors that underpin them, represent an interesting starting point for the explanation of the contrasting nature of imprisonment and internment