El papel del farmacéutico en el seguimiento farmacoterapéutico del paciente diabético tipo II

Desde hace unas décadas, la figura del farmacéutico ha sufrido una transformación desde especialista del medicamento hacia acompañante del paciente a lo largo de su tratamiento. Esto ha surgido como necesidad social, y debido a esta nueva línea profesional el farmacéutico debe enriquecer su formación en Atención Farmacéutica para así satisfacer las necesidades de los pacientes. Concretamente, el paciente diabético tipo II requiere de un exhaustivo seguimiento farmacoterapéutico (SFT) por parte del farmacéutico ya que presenta una patología crónica con una serie de complicaciones que pueden derivar en graves. Estos antecedentes, nos han instado a analizar la eficacia de los estudios de SFT de la última década realizados al paciente diabético tipo II en las farmacias comunitarias de Sevilla, a través de fuentes bibliográficas procedentes de los archivos del centro de información del medicamento (CIM) del Real e Ilustre Colegio Oficial de Farmacéuticos de Sevilla (RICOFSE). En consecuencia, a nivel provincial, el RICOFSE se ha movilizado en el SFT del paciente diabético tipo II, surgiendo así Triana, Triana I como toma de contacto en la temática de la diabetes tipo II (DM2) y finalmente Triana II, el verdadero proyecto de investigación con consideración de análisis clínico. De esta manera, se evidenció, con mayor o menor calidad, la necesidad del farmacéutico en el SFT y en la educación sanitaria del paciente con DM2. En base a esto, se llevó a cabo un servicio remunerado destinado al paciente con DM2 denominado “Cuida tu Corazón Diabetes”, en el cual se llevaba a la práctica las dos funciones clave del farmacéutico: SFT y educación sanitaria. Sin embargo, debido a los fallos de Triana II: proyecto ambicioso y demasiada aleatorización, se ha abierto un debate hacia la posibilidad de la elaboración de un futuro Triana III en el que se eviten los fallos cometidos en Triana II para así evidenciar, con una mayor calidad en los resultados, el farmacéutico como figura imprescindible para la mejora del paciente diabético tipo II.Universidad de Sevilla. Grado en Farmaci

EL IMPACTO ECONÓMICO, A TRAVÉS DEL DISEÑO DE CIRCUITOS TURÍSTICOS ALTERNATIVOS, DENTRO DE LA CABECERA MUNICIPAL DE OCOSINGO; CHIAPAS

The county seat of Ocosingo, Chiapas has the distinction of being the largest municipality in the State, besides having a unique tourism potential, however has not reached the boom that needs to position itself as one of the tourist destination at the State and national level, so that there is a need to locate to the municipality, as a permanent tourism offering unique experiences to tourists and visitors contributing to economic and social development of the region. In this sense, it is necessary to have with demand enough tourist, who feels attracted by the tourist product, also seeks to design marketing strategies, through the design of an alternative tourist circuit, which allows to offer a diverse range of activities such as; gastronomic tourism, rural tourism and nature tourism, achieving diversification of the offer tourism in the municipality of Ocosingo, Chiapas.La cabecera municipal de Ocosingo, Chiapas se distingue por ser el municipio más extenso del estado, además de poseer un potencial turístico inigualable, sin embargo no ha alcanzado el auge que necesita para posicionarse como uno de los destino turístico a nivel estatal y nacional, es por ello que surge la necesidad de situar al municipio, como un turismo permanente que ofrezca experiencias únicas a los turistas y visitantes, contribuyendo al desarrollo económico y social de la región. En este sentido, es necesario contar con la demanda turistica suficiente, que se sienta atraída por el producto turístico, así mismo, se busca diseñar estrategias de comercialización, a través del diseño de un circuito turístico alternativo, que permita ofertar una gama diversa de actividades tales como; turismo gastronómico, turismo rural y turismo de naturaleza, logrando la diversificación de la oferta turistica dentro del municipio de Ocosingo, Chiapas

Fatores prognósticos da infeção respiratória aguda baixa grave em crianças menores de 5 años na Colômbia

Introduction: Acute lower respiratory infection (alri: community acquired and/or bronchiolitis) is one of the main public health issues for children under five years of age. The main purpose of this research was to describe the epidemiological profile, associated factors, and prognosis of alri in two hospitals in Popayan, Colombia. Materials and Methods: This was a cohort study. We included children from 2 months to 5 years of age with diagnoses of severe alri. Sociodemographic profiles, clinical features, and prognostic factors were collected. The main outcomes under study were mortality, admission to icu, and length of stay. Multivariable analyses were performed to establish the independent contributions of prognostic factors. Results: 121 patients were included. Incidence of alri was 4% ci95% [3,3-4,7] during 6 months of follow-up. Mortality during follow-up was 0,8% (ci95% 0,l-4,4) (one patient). Thirty three percent of children required admission to icu. Median length of stay was 5 days and length of stay in icu was 4 days. Preterm birth was independently associated with icu admission (or=5,1 ci95% [l,3-20] p=0,0l9). Discussion: The incidence of severe alri was 4%. Mortality was low and length of stay was short. Factors related to the diagnosis of alri in this cohort are consistent with those reported in the national and international literature, and the only independent prognostic factor for admission to icu was preterm birth

Forest Restoration in a Fog Oasis: Evidence Indicates Need for Cultural Awareness in Constructing the Reference

Background: In the Peruvian Coastal Desert, an archipelago of fog oases, locally called lomas, are centers of biodiversity and of past human activity. Fog interception by a tree canopy, dominated by the legume tree tara (Caesalpinia spinosa), enables the occurrence in the Atiquipa lomas (southern Peru) of an environmental island with a diverse flora and high productivity. Although this forest provides essential services to the local population, it has suffered 90% anthropogenic reduction in area. Restoration efforts are now getting under way, including discussion as to the most appropriate reference ecosystem to use. Methodology/Principal Findings: Genetic diversity of tara was studied in the Atiquipa population and over a wide geographical and ecological range. Neither exclusive plastid haplotypes to loma formations nor clear geographical structuring of the genetic diversity was found. Photosynthetic performance and growth of seedlings naturally recruited in remnant patches of loma forest were compared with those of seedlings recruited or planted in the adjacent deforested area. Despite the greater water and nitrogen availability under tree canopy, growth of forest seedlings did not differ from that of those recruited into the deforested area, and was lower than that of planted seedlings. Tara seedlings exhibited tight stomatal control of photosynthesis, and a structural photoprotection by leaflet closure. These drought-avoiding mechanisms did not optimize seedling performance under the conditions produced by forest interception of fog moisture. Conclusions/Significance: Both weak geographic partitioning of genetic variation and lack of physiological specialization of seedlings to the forest water regime strongly suggest that tara was introduced to lomas by humans. Therefore, the most diverse fragment of lomas is the result of landscape management and resource use by pre-Columbian cultures. We argue that an appropriate reference ecosystem for ecological restoration of lomas should include sustainable agroforestry practices that emulate the outcomes of ancient uses

The CARBA-MAP study: national mapping of carbapenemases in Spain (2014–2018)

Introduction:Infections caused by carbapenem-resistant Enterobacterales (CRE) and carbapenem-resistant Pseudomonas aeruginosa, including isolates producing acquired carbapenemases, constitute a prevalent health problem worldwide. The primary objective of this study was to determine the distribution of the different carbapenemases among carbapenemase-producing Enterobacterales (CPE, specifically Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae complex, and Klebsiella aerogenes) and carbapenemase-producing P. aeruginosa (CPPA) in Spain from January 2014 to December 2018.Methods: A national, retrospective, cross-sectional multicenter study was performed. The study included the first isolate per patient and year obtained from clinical samples and obtained for diagnosis of infection in hospitalized patients. A structured questionnaire was completed by the participating centers using the REDCap platform, and results were analyzed using IBM SPSS Statistics 29.0.0.Results: A total of 2,704 carbapenemase-producing microorganisms were included, for which the type of carbapenemase was determined in 2692 cases: 2280 CPE (84.7%) and 412 CPPA (15.3%), most often using molecular methods and immunochromatographic assays. Globally, the most frequent types of carbapenemase in Enterobacterales and P. aeruginosa were OXA-48-like, alone or in combination with other enzymes (1,523 cases, 66.8%) and VIM (365 cases, 88.6%), respectively. Among Enterobacterales, carbapenemase-producing K. pneumoniae was reported in 1821 cases (79.9%), followed by E. cloacae complex in 334 cases (14.6%). In Enterobacterales, KPC is mainly present in the South and South-East regions of Spain and OXA-48-like in the rest of the country. Regarding P. aeruginosa, VIM is widely distributed all over the country. Globally, an increasing percentage of OXA-48-like enzymes was observed from 2014 to 2017. KPC enzymes were more frequent in 2017–2018 compared to 2014–2016.Discussion: Data from this study help to understand the situation and evolution of the main species of CPE and CPPA in Spain, with practical implications for control and optimal treatment of infections caused by these multi-drug resistant organisms

Derecho ex cathedra. 1847-1936 Diccionario de catedráticos españoles

Edición revisada 2020.Publicación de las entradas biográficas del Diccionario de catedráticos españoles de Derecho, accesible en http://www.uc3m.es/diccionariodecatedraticos. Al dar forma de libro al material hemos prescindido de algunos elementos informativos, que se mantienen en la página electrónica indicada. Se recogen ahora solamente a los ingresados en el cuerpo con anterioridad a la guerra civil.Publication of the biographical entries of the Diccionario de catedráticos españoles de Derecho, accessible at http://www.uc3m.es/diccionariodecatedraticos. By giving those material book form, we have dispensed with some informative elements, however kept on the web page. Only professors apointed prior to the Civil War are now included.Esta publicación forma parte del proyecto “La memoria del jurista español: génesis y desarrollo de las disciplinas jurídicas” (ref. DER2014-55035-C2-1-P/DER2014-55035-C2-2-P), financiado por el Ministerio de Economía, Industria y Competitividad (España)

Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

Aim To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW). Methods Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality. Results As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067-0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001). Conclusions Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality

Natural History of MYH7-Related Dilated Cardiomyopathy

BACKGROUND Variants in myosin heavy chain 7 (MYH7) are responsible for disease in 1% to 5% of patients with dilated cardiomyopathy (DCM); however, the clinical characteristics and natural history of MYH7-related DCM are poorly described. OBJECTIVES We sought to determine the phenotype and prognosis of MYH7-related DCM. We also evaluated the influence of variant location on phenotypic expression. METHODS We studied clinical data from 147 individuals with DCM-causing MYH7 variants (47.6% female; 35.6 +/- 19.2 years) recruited from 29 international centers. RESULTS At initial evaluation, 106 (72.1%) patients had DCM (left ventricular ejection fraction: 34.5% +/- 11.7%). Median follow-up was 4.5 years (IQR: 1.7-8.0 years), and 23.7% of carriers who were initially phenotype-negative developed DCM. Phenotypic expression by 40 and 60 years was 46% and 88%, respectively, with 18 patients (16%) first diagnosed at <18 years of age. Thirty-six percent of patients with DCM met imaging criteria for LV noncompaction. During follow-up, 28% showed left ventricular reverse remodeling. Incidence of adverse cardiac events among patients with DCM at 5 years was 11.6%, with 5 (4.6%) deaths caused by end-stage heart failure (ESHF) and 5 patients (4.6%) requiring heart transplantation. The major ventricular arrhythmia rate was low (1.0% and 2.1% at 5 years in patients with DCM and in those with LVEF of <= 35%, respectively). ESHF and major ventricular arrhythmia were significantly lower compared with LMNA-related DCM and similar to DCM caused by TTN truncating variants. CONCLUSIONS MYH7-related DCM is characterized by early age of onset, high phenotypic expression, low left ventricular reverse remodeling, and frequent progression to ESHF. Heart failure complications predominate over ventricular arrhythmias, which are rare. (C) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation

Línea de investigación en Helicobacter pylori para la formación de recurso humano en ciencia, tecnología e innovación en el programa de microbiología

Este libro nace de la unión de un maestro altamente calificado y alumnos dedicados con unas creatividades activas y dispuestas a trabajar por resolver los problemas que trae una bacteria a la humanidad. Las investigaciones aquí consignadas son producto de los trabajos de grado de los estudiantes del programa de Microbiología, quienes además fueron miembros del semillero de investigación, MICROORGANISMOS DE IMPORTANCIA EN SALUD HUMANA Y ANIMAL “OBVIO-MICROBIO”. Apoyados y dirigidos por la doctora Adalucy Alvarez-Aldana, quien gracias a su amplio conocimiento en el microorganismo supo sembrar curiosidad sobre el mismo durante las sesiones del semillero, incentivando a muchos de sus alumnos a dedicar su trabajo de grado a resolver alguna pregunta que les surgiera en torno a este microorganismo. Aunque diferentes son las investigaciones, todas fueron trazadas con un fin común, entregarle a la humanidad un poco más de conocimiento sobre Helicobacter pylori, por esto la unión de estas investigaciones en una sola consigna, son importantes para entender más sobre todo lo que rodea esta bacteria y pretenden resolver muchos misterios que aún aquejan la epidemiología detrás de la misma. Estos trabajos son fruto de muchos esfuerzos, materiales y académicos, de personas grandiosas, de la unión de universidades, doctores y docentes de diferentes disciplinas, razón que demuestra una vez más que la unión hace la fuerza, porque solo llegarás más rápido, pero en compañía llegarás más lejos. Además, contamos con la fortuna de tener un capitulo invitado, cuyo tema no es sobre Helicobacter pylori, pero si un sobre un tópico de gran interes en la actualidad como es la resistencia bacteriana. Capitulo titulado: “Caracterización epidemiológica y microbiológica de las bacteriemias y su perfil de resistencia durante el periodo junio 2011 a junio 2015”