Evaluación de la eficacia de un programa integral de prevención secundaria de la enfermedad cardiovascular en atención primaria: estudio PREseAP

ObjetivosEvaluar la eficacia de un programa integral de prevención secundaria para reducir la morbimortalidad en los pacientes que han tenido una enfermedad cardiovascular, controlar los factores de riesgo y el cumplimiento de la medicación profiláctica para prevenir recurrencias y mejorar la calidad de vida de los pacientes con enfermedad cardiovascular.DiseñoEnsayo clínico aleatorizado por clusters, abierto, pragmático, en atención primaria.EmplazamientoUn total de 42 centros de salud de 8 comunidades autónomas del Estado español.ParticipantesVarones y mujeres hasta 85 años de edad, diagnosticados de enfermedad coronaria y/o accidente cerebrovascular y/o enfermedad vascular periférica en el último año, y que no presenten una enfermedad grave o terminal.IntervenciónSe aleatorizarán los centros de salud para seguir la atención habitual en los pacientes diagnosticados de enfermedad cardiovascular (grupo control) o para implantar un programa integral de prevención secundaria (grupo intervención).Mediciones principalesAcontecimientos letales atribuibles a enfermedad cardiovascular, acontecimientos no letales atribuibles a enfermedad cardiovascular, acontecimientos letales por cualquier causa y calidad de vida relacionada con la salud (SF-36).ObjectivesTo assess the efficacy of a comprehensive secondary prevention programme to reduce morbidity and mortality in patients who have suffered a cardiovascular (CV) event; to control CV risk factors and prophylactic treatment in order to prevent recurrence; and to improve the quality of life of patients with cardiovascular disease.DesignRandomised, pragmatic, open clinical trial in primary care.SettingA total of 42 primary care centres of 8 different areas in Spain.ParticipantsMen and women below 86 years old, diagnosed with coronary disease and/or stroke and/or peripheral vascular disease in the preceding year, and who have no serious or terminal disease.InterventionPrimary care centres will be randomised to following usual care (control group), or to following a comprehensive programme of secondary prevention (intervention group).Main measurementsCardiovascular fatal events, cardiovascular non-fatal events, total mortality and health-related quality of life (SF-36)

Implementation of "wiki" philosophy to the update of teaching material in the area of pharmacy and pharmaceutical technology

La Directiva 2005/36/CE del Parlamento Europeo y del Consejo, relativa al reconocimiento de cualificaciones profesionales, en su artículo 44, referente a la formación del farmacéutico, y la Orden CIN/2137/2008, por la que se establecen los requisitos para la verificación de los títulos universitarios oficiales que habiliten para el ejercicio de esta profesión, recogen conocimientos y competencias que deben contemplarse en su formación académica. Muchos de ellos están directamente relacionados con los fármacos y con los medicamentos y, por tanto, estrechamente vinculados con el Área de Conocimiento de “Farmacia y Tecnología Farmacéutica”. Como profesores de esta Área desde hace muchos años, hemos apreciado la dificultad existente en la preparación del material docente. Este hecho es debido a diversas razones. Entre ellas destacan: a) limitación de las fuentes documentales existentes sobre las propiedades físico-químicas y biofarmacéuticas de muchos principios activos; b) escasez de textos concernientes a la fabricación concreta de medicamentos; c) irrupción continua en el mercado de nuevos medicamentos, que implica que muchos textos se queden desfasados; d) dispersión de los contenidos. Para intentar soslayar esta problemática, se han venido realizando diversas actividades docentes. Una de ellas, objeto de la presente comunicación, fue implantada en el curso 2009-10, para los alumnos de 5º curso y se seguirá incluyendo en la programación docente para el próximo 2010-11. Está basada en el concepto “wiki”. Consiste en la elaboración, por parte de alumnos y profesores, de un espacio común, convenientemente organizado, donde todos aportan información para elaborar una gran enciclopedia virtual sobre el medicamento.Directive 2005/36/EC of the European Parliament and Council on the recognition of professional qualifications, section 44, concerning the formation of pharmacists, and the Order CIN/2137/2008, laying down the requirements for verification of official university degrees that prepare students to work in this profession, gather knowledge and skills to be covered in their education. Many of them are directly related to drugs and medicines and, therefore, closely linked to the Knowledge Area "Pharmacy and Pharmaceutical Technology”. As teachers of this area for many years, we have appreciated the difficulty in preparing the teaching material. This is due to various reasons. These include: a) limitation of existing documentary sources on the physico-chemical and biopharmaceutical characteristics of many active ingredients. b) a shortage of texts concerning the specific manufacture of medicaments. c) continuous irruption in the market for new drugs and dosage forms, which means that many texts become outdated. d) information dispersion. To circumvent this problem, various educational activities have being conducted. One of this, object of the present communication, was introduced in 2009-10 for students in the 5th grade and still be included in the course program for the next 2010-11. It is based on the concept of "wiki". It consists of establishing, by students and teachers, a common area, conveniently organized in which all provide information to develop a virtual encyclopedia of medicaments

Bactericidal effect of magnesium ions over planktonic and sessile Staphylococcus epidermidis and Escherichia coli

Magnesium and its alloys are in focus to produce implants due to their excellent mechanical properties, facility to decompose in the body, enhancement of new bone formation and antibacterial properties. However, there is still a lack of consensus about the origin of such antibacterial effect. Up to date, most antibacterial studies were performed over newly synthesized MgO particles, nanotubes or nanowires in the form of slurries, integrated within polymeric matrixes or as coatings of other bulk materials whereas the effect of pure Mg2+ions over bacteria viability, in the absence of secondary processes, has not been assessed yet. Hence, in this study, we have characterized the bactericidal effect of Mg2+ions over two different bacteria strains, Staphylococcus epidermidis (Gram-positive) and Escherichia coli (Gram-negative) controlling both pH and ion concentration. Also, we have considered the ion effect on dissimilar planktonic and sessile cells on surfaces with different hydrophobicity

Cystic Fibrosis: actual treatment and future perspectives with nanotechnology

Introducción: Actualmente, los tratamientos existentes para tratar la fibrosis quística (FQ) están diseñados para controlar sus síntomas, consistentes principalmente en retención de moco e infección crónica. Se propone la vía pulmonar como alternativa para la administración de los fármacos, principalmente antimicrobianos. Sin embargo, su rápido aclaramiento, que conduce a niveles bajos de fármaco e incremento de los regímenes posológicos, así como la aparición de efectos adversos, hacen de la nanotecnología una estrategia interesante para esta enfermedad. Objetivo: estudiar y analizar los diferentes sistemas nanoparticulares existentes para su uso por vía pulmonar, concretando en el uso de sistemas lipídicos para el tratamiento de la FQ. Método: se realizó una búsqueda no sistemática de artículos en diferentes bases de datos, en los últimos 10 años principalmente, siguiendo pautas establecidas de palabras clave. Resultados: Los progresos que se han conseguido en los últimos años hacen que la FQ pase a ser una enfermedad de adultos. Los tratamientos que se están usando en la actualidad están siendo cada vez más desplazados por otras alternativas, como los sistemas nanoparticulares, siendo idóneos para la administración pulmonar debido a su pequeño tamaño, su liberación sostenida y su elevada biocompatibilidad. Entre éstos, destacan los liposomas por su similitud estructural con el surfactante pulmonar, así como por su capacidad de destruir las biopelículas bacterianas. La mayoría de las formulaciones encontradas contenían un solo fármaco. Conclusión: Existen evidencias científicas que indican que la investigación debe dirigirse hacia el desarrollo de formulaciones que sean capaces de destruir la biopelícula.Introduction: Currently, the management of treatments in cystic fibrosis (CF) is mainly focused to control symptoms, which consist of mucus retention and chronic infection. The pulmonary route is proposed as an interesting alternative for administering drugs, especially antimicrobials. However, the rapid clearance of these, which leads to low drug levels and increased dosage regimens, as well as the appearance of adverse effects, make nanotechnology an interesting strategy for this disease. Objective: to study and analyze the different nanoparticulate systems available for use via the lung, specifying the use of lipid systems for the treatment of CF. Method: a non-systematic search of articles in different databases was carried out, mainly in the last 10 years, following established guidelines for selecting keywords. Results: The progress in recent years makes CF become an adult disease. Current treatments are increasingly being displaced by other alternatives, such as nanoparticular systems, being suitable for pulmonary administration due to their small size, sustained release and high biocompatibility. Among these, liposomes stand out for their structural similarity to lung surfactant, as well as for their ability to destroy bacterial biofilms. Most of the formulations contained a single drug. Conclusion: Scientific literature evidenced that research studies should be directed towards the development of formulations that are intended to destroy the biofilm

Aircraft icing: in-cloud measurements and sensitivity to physical parameterizations

The prediction of supercooled cloud drops in the atmosphere is a basic tool for aviation safety, owing to their contact with and instant freezing on sensitive locations of the aircraft. One of the main disadvantages for predicting atmospheric icing conditions is the acquisition of observational data. In this study, we used in‐cloud microphysics measurements taken during 10 flights of a C‐212 research aircraft under winter conditions, during which we encountered 37 regions containing supercooled liquid water. To investigate the capability of the Weather Research and Forecasting model to detect regions containing supercooled cloud drops, we propose a multiphysics ensemble approach. We used four microphysics and two planetary boundary layer schemes. The Morrison parameterization yielded superior results, whereas the planetary boundary layer schemes were essential in evaluating the presence of liquid water content. The Goddard microphysics scheme best detected the presence of ice water content but tended to underestimate liquid water content

Mutación infrecuente en el síndrome renal-coloboma: A propósito de un caso y revisión

El síndrome renal-coloboma es una enfermedad autosómica dominante caracterizada por hipodisplasia renal y coloboma. Se presenta el caso de una niña de 12 años afecta de enfermedad renal crónica, colobomas papilares bilaterales y mutación excepcional del gen PAX-2 . Con diagnóstico prenatal de hipoplasia renal bilateral, a los 5 días de vida, presentó clínica y datos analíticos compatibles con enfermedad renal crónica. En los controles posteriores, se apreció reflujo vesicoureteral grado ii bilateral, que se resolvió espontáneamente, proteinuria mantenida en rango no nefrótico controlada con enalapril y colobomas bilaterales con atrofia macular izquierda. La función renal se mantuvo estable. El estudio genético demostró mutación p.R104X de novo sin sentido en heterocigosis. Globalmente, existen documentados 80 casos de síndrome renal- coloboma asociado a mutaciones de este gen. Las evaluaciones oftalmológicas y genéticas son fundamentales en los casos de hipodisplasia renal. La función renal determinará el pronóstico. Se realizó una revisión bibliográfica de la etiopatogenia de la enfermedad. Renal-coloboma syndrome is an autosomal dominant disease characterized by renal hypodysplasia and coloboma. A case of a 12-year-old girl with chronic kidney disease, bilateral optic nerve colobomas and an exceptional PAX-2 gene mutation is presented. Diagnosed in prenatal scans with bilateral renal hypoplasia, she presented clinical and laboratory findings of chronic kidney disease at 5 days of life. Following tests Mutación infrecuente en el síndrome renal-coloboma: A propósito de un caso y revisión Infrequent mutation in renal-coloboma syndrome: Case report and review showed grade II bilateral vesicoureteral reflux spontaneously solved, maintained non nephrotic proteinuria controlled with enalapril and bilateral colobomas with left macular atrophy. Renal function remained stable. Genetic study showed de novo and non sense mutation p.R104X in heterocygosis. Currently there are 80 published cases of renal-coloboma syndrome associated with this gene mutations. Ophthalmologic and genetic evaluations are crucial in cases affected by renal hypodysplasia. Renal function will establish prognosis. We review the etiopathogenesis of this disease

Efficacy of direct current generated by multiple-electrode arrays on F3II mammary carcinoma: experiment and mathematical modeling

BACKGROUND: The modified Gompertz equation has been proposed to fit experimental data for direct current treated tumors when multiple-straight needle electrodes are individually inserted into the base perpendicular to the tumor long axis. The aim of this work is to evaluate the efficacy of direct current generated by multiple-electrode arrays on F3II mammary carcinoma that grow in the male and female BALB/c/Cenp mice, when multiple-straight needle electrodes and multiple-pairs of electrodes are inserted in the tumor. METHODS: A longitudinal and retrospective preclinical study was carried out. Male and female BALB/c/Cenp mice, the modified Gompertz equation, intensities (2, 6 and 10 mA) and exposure times (10 and 20 min) of direct current, and three geometries of multiple-electrodes (one formed by collinear electrodes and two by pair-electrodes) were used. Tumor volume and mice weight were measured. In addition, the mean tumor doubling time, tumor regression percentage, tumor growth delay, direct current overall effectiveness and mice survival were calculated. RESULTS: The greatest growth retardation, mean doubling time, regression percentage and growth delay of the primary F3II mammary carcinoma in male and female mice were observed when the geometry of multiple-pairs of electrodes was arranged in the tumor at 45, 135, 225 and 325o and the longest exposure time. In addition, highest direct current overall effectiveness (above 66%) was observed for this EChT scheme. CONCLUSIONS: It is concluded that electrochemical therapy may be potentially addressed to highly aggressive and metastic primary F3II murine mammary carcinoma and the modified Gompertz equation may be used to fit data of this direct current treated carcinoma. Additionally, electrochemical therapy effectiveness depends on the exposure time, geometry of multiple-electrodes and ratio between the direct current intensity applied and the polarization current induced in the tumor

Robustness testing in the determination of seven drugs in animal muscle by liquid chromatography–tandem mass spectrometry

In this work, the robustness of the sample preparation procedure for the determination of six tranquilizers (xylazine, azaperone, propionylpromazine, chlorpromazine, haloperidol, and azaperol) and a beta-blocker (carazolol) in animal muscle by LC/MS–MS was assessed through the experimental design methodology. A 2III7 − 4 fractional factorial design was performed to evaluate the influence of seven variables on the final concentration of the seven drugs in the samples, in accordance with what is laid down in Commission Decision No 2002/657/EC. The variation considered for each of those seven factors is likely to happen when preparing the samples, being the values chosen as level − 1, the nominal operating conditions. The results of the experimentation were evaluated from different statistical strategies, such as hypothesis testing using an external variance previously estimated, Lenth's method, and Bayesian analysis. Both Lenth's and Bayes' approaches enabled to determine the effect of every variable even though no degrees of freedom were left to estimate the residual error. The same conclusion about the robustness of the extraction step was reached from the three methodologies, namely, none of the seven factors examined influenced on the method performance significantly, so the sample preparation procedure was considered to be robust.Ministerio de Ciencia e Innovación (CTQ2011-26022) and MINECO (CTQ2014- 53157-R)