Effectiveness of the Dader Method for pharmaceutical care in patients with bipolar I disorder: EMDADER-TAB: study protocol for a randomized controlled trial

Background Bipolar I disorder (BD-I) is a chronic mental illness characterized by the presence of one or more manic episodes, or both depressive and manic episodes, usually separated by asymptomatic intervals. Pharmacists can contribute to the management of BD-I, mainly with the use of effective and safe drugs, and improve the patient’s life quality through pharmaceutical care. Some studies have shown the effect of pharmaceutical care in the achievement of therapeutic goals in different illnesses; however, to our knowledge, there is a lack of randomized controlled trials designed to assess the effect of pharmacist intervention in patients with BD. The aim of this study is to assess the effectiveness of the Dader Method for pharmaceutical care in patients with BD-I.Methods/design Randomized, controlled, prospective, single-center clinical trial with duration of 12 months will be performed to compare the effect of Dader Method of pharmaceutical care with the usual care process of patients in a psychiatric clinic. Patients diagnosed with BD-I aged between 18 and 65 years who have been discharged or referred from outpatients service of the San Juan de Dios Clinic (Antioquia, Colombia) will be included. Patients will be randomized into the intervention group who will receive pharmaceutical care provided by pharmacists working in collaboration with psychiatrists, or into the control group who will receive usual care and verbal-written counseling regarding BD. Study outcomes will be assessed at baseline and at 3, 6, 9, and 12 months after randomization. The primary outcome will be to measure the number of hospitalizations, emergency service consultations, and unscheduled outpatient visits. Effectiveness, safety, adherence, and quality of life will be assessed as secondary outcomes. Statistical analyses will be performed using two-tailed McNemar tests, Pearson chi-square tests, and Student’s t-tests; a P value <0.05 will be considered as statistically significant.Discussion As far as we know, this is the first randomized controlled trial to assess the effect of the Dader Method for pharmaceutical care in patients with BD-I and it could generate valuable information and recommendations about the role of pharmacists in the improvement of therapeutic goals, solution of drug-related problems, and adherence.Trial registration Registration number NCT01750255 on August 6, 2012. First patient randomized on 24 November 2011.The Pharmaceutical Promotion and Prevention Group received financial support from the Committee for Development Research, (CODI), and sustainability program (2013-2014), Universidad de Antioquia

Diuretic Activity of the Flavonoid Pinostrobin Previously Identified from the Species Renealmia alpinia: Diuretic Activity of Pinostrobin

Renealmia alpinia is a plant traditionally employed as antiophidic, pain reliever, antipyretic, and antiemetic. Its main metabolites are flavonoids, with pinostrobin as the most abundant compound of this plant species. In this study, we determined the diuretic activity of pinostrobin, previously identified from the species Renealmia alpinia in normal mice. The evaluation of the diuretic activity of the flavonoid pinostrobin was carried out at doses of 5, 10, and 20 mg/kg of body weight. The diuretic activity was evaluated using the Kau et al. (1984) method with modifications made by Benjumea et al. (2005), using mice instead of rats. Metabolic cages equipped with graduated cylinders were used to measure the volume of urine excretion at 2, 4, and 6 hours. At 6 hours, pH and conductivity were measured, and the concentration of excreted sodium, potassium, magnesium, and calcium ions was estimated by ion chromatography. Creatinine, albumin, blood urea nitrogen, and urea of mice blood were analyzed. There was an increase of 32% and 38% at a dose of 10 and 20 mg/kg, respectively, in the urinary excretion of water by pinostrobin, an elimination of sodium concentration similar to furosemide at 5 and 10 mg/kg, An increase in potassium concentration of 52% at 10 mg/kg and a higher magnesium excretion of 85% at 5 mg/kg, were statistically significant compared to furosemide. Pinostrobin showed a diuretic effect increasing the volume of urinary excretion in mice and excretion of sodium, potassium, magnesium, and calcium ions, with a possible mechanism in the loop of Henle

Neuropharmacological effects of the ethanolic extract of Sida acuta

ABSTRACT Sida acuta Burm. f., Malvaceae, is regarded as astringent, tonic and useful in treating urinary diseases and blood disorders, bile, liver and as treatment for nervous diseases. Different methods were developed: sodium pentobarbital-induced sleeping time, anxiolytic activity, test for muscle-effects, pentylenetetrazole (PTZ)-induced seizures, effect on normal body temperature. All experiments were performed in an isolated room with 12/12 h light/dark cycles at 22 ± 1 ºC. The effects described in this work for Sida acuta are according to what is known in traditional medicine, where is used as sedative agent. At the higher doses used in this work (500 and 1000 mg/kg), the Sida acuta extract reduced the latency time (T1) and increased the sleeping time (T2) induced by pentobarbital, indicating a sedative and hypnotic effect of the plant's extract. The extract of Sida acuta shows an increase in open arm exploration (anxiolytic activity). Results obtained in the rota-rod test showed that only the elevated dose (750 mg/kg) of Sida acuta extract, acutely administered, promotes significant changes, at 60 and 120 min post-administration, in the time of permanence in the rod. The ethanolic extract from the leaves and stems of Sida acuta, causes effects on the central nervous system in experimental animals

Circunferencia de la cintura en niños y escolares manizaleños de 1 a 16 años Waist circumference in children aged 1 to 16 years from Manizales

Introducción: en adultos y en niños, la circunferencia de la cintura como indicador de masa grasa intra-abdominal, se correlaciona de manera más directa con el riesgo de enfermedad cardiovascular y con un perfil lipídico aterogénico, que la obesidad, determinada por el índice de masa corporal. Objetivo: caracterizar la circunferencia de la cintura en los niños y escolares del Programa de Nutrición de Manizales. Materiales y métodos: estudio descriptivo. Población de estudio: 10.720 niños y escolares de ambos géneros, de instituciones públicas urbanas y rurales de Manizales. Variables y análisis: edad, género, estatura, peso y circunferencia de la cintura. En cada género se compararon medianas de la cintura con diferente clasificación de la estatura (U de Mann Whitney), proporciones de bajo y alto índice de masa corporal (chi²) y promedios de la circunferencia de la cintura en niños con índice de masa corporal bajo y normal (U de Mann Whitney). La correlación con la cintura se estimó separada por género. Se aceptó como significativo todo valor de pP90) fue significativamente más alta en ambos géneros (p=0,020 niños; p=0,0450 niñas), que con el índice de masa corporal (>P95).INTRODUCTION: waist circumference in adults and children as intra-abdominal fat mass indicator is correlated in a more direct way with the risk of cardiovascular disease and with an atherogenic lipid profile than obesity, determined by the body mass index. OBJECTIVE: characterize waist circumference in school children from the Manizales Nutrition Program. MATERIALS AND METHODS: descriptive study. COHORT STUDY: 10720 children from both genders of Manizales public urban and rural institutions. VARIABLES AND ANALYSIS: age, gender, height, weight and waist circumference. Mean waist measures were compared in each gender with different classification of height (Mann Whitney U), low and high body mass index proportions and mean waist circumference in children with low body mass index and normal (Mann Whitney U). Correlation with waist was estimated separate by gender. All value of pP90) was significant higher in both genders (p=0.020 boys; p=0.045 girls) than with body mass index (>P95)

Transcriptomic Analysis of the Venom Gland and Enzymatic Characterization of the Venom of <i>Phoneutria depilata</i> (Ctenidae) from Colombia

The transcriptome of the venom glands of the Phoneutria depilata spider was analyzed using RNA-seq with an Illumina protocol, which yielded 86,424 assembled transcripts. A total of 682 transcripts were identified as potentially coding for venom components. Most of the transcripts found were neurotoxins (156) that commonly act on sodium and calcium channels. Nevertheless, transcripts coding for some enzymes (239), growth factors (48), clotting factors (6), and a diuretic hormone (1) were found, which have not been described in this spider genus. Furthermore, an enzymatic characterization of the venom of P. depilata was performed, and the proteomic analysis showed a correlation between active protein bands and protein sequences found in the transcriptome. The transcriptomic analysis of P. depilata venom glands show a deeper description of its protein components, allowing the identification of novel molecules that could lead to the treatment of human diseases, or could be models for developing bioinsecticides