Generalidades de la Farmacovigilancia

La vigilancia de los fármacos es una actividad de la salud encargada de la detención, valoración entendimiento y prevención de los efectos adversos o de cualquier problema relacionado con los medicamentos. Hay muchos factores que hacen difícil detectar las reacciones adversas de los medicamentos, por esto se creó la farmacovigilancia, con el fin de desarrollar sistemas para la prevención de riesgos y evaluaciones de reacciones adversas, pues es muy importante dentro de las funciones de los farmacéuticos tener un amplio conocimiento al respecto puesto que sus funciones principales son elaborar, comercializar y distribuir medicamentos y su participación es muy importante de la calidad de vida de un paciente mediante su servicio; favoreciendo a los diferentes sistemas de farmacovigilancia para la evaluación de seguridad y su efectividad de los tratamientos y así mejorar la calidad de atención en los problemas de salud.Drug monitoring is a Health activity in charge of the detection, assesment, understanding and prevention of adverse effects or any problem related to drugs. There are many factors that make it difficult to detect adverse drug reactions, which is why pharmacovigilance was created, in order to develop systems for the prevention of risks and evaluations of adverse reactions, as it is very important within the functions of pharmacists to have extensive knowledge in this regard since their main functions are to develop, market and distribute drugs and their participation is very important in improving quality of life of a patient through their service; favoring the different pharmacovigilance systems to evaluate the safety and effectiveness of the treatments and thus improve the quality of care in Health problem

Evaluación de las características fisicoquímicas y sensoriales del pan de molde enriquecido con Kiwicha (Amaranthus caudatus L.) y Cañihua (Chenopodium pallidicaule Aellen)

Bread is a widely consumed food, which has wheat as its basic ingredient; there are various formulations that include flour from different cereal sources. The objective of the research was to evaluate the effect of including Kiwicha (Amaranthus caudatus L.) and Cañihua (Chenopodium pallidicaule Aellen) on the physicochemical and sensory characteristics of bread leaf. The preparation of ​​bread leaf was developed with the direct dough method; the mixture was carried out with a simple mixture design and only the three formulations with the highest protein contents were selected., F1(trigo, Kiwicha, Cañihua: 73 %, 17 %, 10 %); F2 (wheat, Kiwicha, Cañihua: 73 %, 20 %, 7 %) and F3 (wheat, Kiwicha, Cañihua: 70%, 20%, 10%); F0 was considered as control: bread leaf made with 100% wheat flour. The physicochemical characteristics were analyzed using a complete randomized design (RCD), with Tukey's test (p ≤ 0,05) and sensory properties with Friedman's test (p ≤ 0,05). The results showed that the physicochemical characteristics were different (p ≤ 0,05) except for pH and titratable acids. The F3 formulation reported lower alanine content and higher leucine content with 0,10 to 1,79 g of amino acid (AA) per 100 g of protein pure, determined in (g/100 g of original sample and factor 6,25), respectively. In the bread crust, the L* color analysis was higher in formulation F3 (50,0) (p ≤ 0,05) while the other formulations F1 and F2 varied. Sensorily, the F0 treatment had greater acceptability, however, in the prepared breads (F1, F2 and F3) the content of iron, amino acids and macronutrients stands out. It is concluded that breads made with the addition of Kiwicha and Cañihua to the flour formulation are a good source of proteins, iron, and amino acids.El pan es un alimento de consumo masivo, que tiene como ingrediente básico al trigo; existen diversas formulaciones en la que incluyen harina de distintas fuentes de cereales. El objetivo de la investigación fue evaluar el efecto de la inclusión de Kiwicha (Amaranthus caudatus L.) y Cañihua (Chenopodium pallidicaule Aellen) en las características fisicoquímicas y sensoriales del pan de molde. La elaboración del pan de molde se desarrolló con el método de masa directa; la mezcla se realizó con diseño de mezclas simples y se seleccionaron solo las tres formulaciones con los contenidos más altos de proteínas, F1 (trigo, Kiwicha, Cañihua: 73 %, 17 %, 10 %); F2 (trigo, Kiwicha, Cañihua: 73 %, 20 %, 7 %) y F3 (trigo, Kiwicha, Cañihua: 70 %, 20 %, 10 %); se consideró como control F0: pan de molde elaborado con 100 % de harina de trigo. Las características fisicoquímicas se analizaron mediante diseño completo al azar (DCA), con prueba de Tukey (p ≤ 0,05) y las propiedades sensoriales se analizaron con la prueba de Friedman (p ≤ 0,05). Los resultados mostraron que las características fisicoquímicas fueron diferentes (p ≤ 0,05), a excepción del pH y acidez titulable. La formulación F3, reportó menor contenido de alanina y mayor cantidad leucina con 0,10 a 1,79 g de aminoácido (AA) por 100 g de proteína pura, determinada en (g/100 g de muestra original y factor 6,25), respectivamente. En la corteza de pan, el análisis de color L* fue mayor en la formulación F3 (50,0) (p ≤ 0,05) mientras que las otras formulaciones variaron F1 y F2. Sensorialmente, el tratamiento F0 tuvo mayor aceptabilidad, sin embargo, en los panes elaborados (F1, F2 y F3) se destaca el contenido de hierro, aminoácidos y macronutrientes. Se concluye que los panes elaborados con adición de Kiwicha y Cañihua a la formulación de la harina son una buena fuente de proteínas, hierro y aminoácidos

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Anchuelo. Propuestas bioclimáticas en el espacio público

Anchuelo. Propuestas bioclimáticas en el espacio público. Publicación digital de los trabajos elaborados por los estudiantes del curso 2021/22 de la asignatura La Ciudad y el Medio de la Escuela Técnica Superior de Arquitectura de Madrid de la Universidad Politécnica de Madrid. Muestra una serie de propuestas elaboradas en la asignatura para mejorar bioclimáticamente diferentes espacios públicos municipales en el marco del acuerdo realizado entre el Departamento de Urbanística y Ordenación del Territorio y el Excmo. Ayuntamiento de Anchuelo (Madrid)

Harmonized D-dimer levels upon admission for prognosis of COVID-19 severity: Results from a Spanish multicenter registry (BIOCOVID-Spain study).

Coagulopathy is a key feature of COVID-19 and D-dimer has been reported as a predictor of severity. However, because D-dimer test results vary considerably among assays, resolving harmonization issues is fundamental to translate findings into clinical practice. In this retrospective multicenter study (BIOCOVID study), we aimed to analyze the value of harmonized D-dimer levels upon admission for the prediction of in-hospital mortality in COVID-19 patients. All-cause in-hospital mortality was defined as endpoint. For harmonization of D-dimer levels, we designed a model based on the transformation of method-specific regression lines to a reference regression line. The ability of D-dimer for prediction of death was explored by receiver operating characteristic curves analysis and the association with the endpoint by Cox regression analysis. Study population included 2663 patients. In-hospital mortality rate was 14.3%. Harmonized D-dimer upon admission yielded an area under the curve of 0.66, with an optimal cut-off value of 0.945 mg/L FEU. Patients with harmonized D-dimer ≥ 0.945 mg/L FEU had a higher mortality rate (22.4% vs. 9.2%; p

Characteristics and laboratory findings on admission to the emergency department among 2873 hospitalized patients with COVID-19: the impact of adjusted laboratory tests in multicenter studies. A multicenter study in Spain (BIOCOVID-Spain study).

Identification of predictors for severe disease progression is key for risk stratification in COVID-19 patients. We aimed to describe the main characteristics and identify the early predictors for severe outcomes among hospitalized patients with COVID-19 in Spain. This was an observational, retrospective cohort study (BIOCOVID-Spain study) including COVID-19 patients admitted to 32 Spanish hospitals. Demographics, comorbidities and laboratory tests were collected. Outcome was in-hospital mortality. For analysis, laboratory tests values were previously adjusted to assure the comparability of results among participants. Cox regression was performed to identify predictors. Study population included 2873 hospitalized COVID-19 patients. Nine variables were independent predictors for in-hospital mortality, including creatinine (Hazard ratio [HR]:1.327; 95% Confidence Interval [CI]: 1.040-1.695, p = .023), troponin (HR: 2.150; 95% CI: 1.155-4.001; p = .016), platelet count (HR: 0.994; 95% CI: 0.989-0.998; p = .004) and C-reactive protein (HR: 1.037; 95% CI: 1.006-1.068; p = .019). This is the first multicenter study in which an effort was carried out to adjust the results of laboratory tests measured with different methodologies to guarantee their comparability. We reported a comprehensive information about characteristics in a large cohort of hospitalized COVID-19 patients, focusing on the analytical features. Our findings may help to identify patients early at a higher risk for an adverse outcome

Cardiac troponin and COVID-19 severity: Results from BIOCOVID study.

Myocardial injury is a common finding in COVID-19 strongly associated with severity. We analysed the prevalence and prognostic utility of myocardial injury, characterized by elevated cardiac troponin, in a large population of COVID-19 patients, and further evaluated separately the role of troponin T and I. This is a multicentre, retrospective observational study enrolling patients with laboratory-confirmed COVID-19 who were hospitalized in 32 Spanish hospitals. Elevated troponin levels were defined as values above the sex-specific 99th percentile upper reference limit, as recommended by international guidelines. Thirty-day mortality was defined as endpoint. A total of 1280 COVID-19 patients were included in this study, of whom 187 (14.6%) died during the hospitalization. Using a nonspecific sex cut-off, elevated troponin levels were found in 344 patients (26.9%), increasing to 384 (30.0%) when a sex-specific cut-off was used. This prevalence was significantly higher (42.9% vs 21.9%; P  In this multicentre study, myocardial injury was a common finding in COVID-19 patients. Its prevalence increased when a sex-specific cut-off and cardiac troponin T were used. Elevated troponin was an independent predictor of 30-day mortality, irrespective of cardiac troponin assay and cut-offs to detect myocardial injury. Hence, the early measurement of cardiac troponin may be useful for risk stratification in COVID-19

Safety and Outcome of Revascularization Treatment in Patients With Acute Ischemic Stroke and COVID-19: The Global COVID-19 Stroke Registry.

BACKGROUND AND OBJECTIVES COVID-19 related inflammation, endothelial dysfunction and coagulopathy may increase the bleeding risk and lower efficacy of revascularization treatments in patients with acute ischemic stroke. We aimed to evaluate the safety and outcomes of revascularization treatments in patients with acute ischemic stroke and COVID-19. METHODS Retrospective multicenter cohort study of consecutive patients with acute ischemic stroke receiving intravenous thrombolysis (IVT) and/or endovascular treatment (EVT) between March 2020 and June 2021, tested for SARS-CoV-2 infection. With a doubly-robust model combining propensity score weighting and multivariate regression, we studied the association of COVID-19 with intracranial bleeding complications and clinical outcomes. Subgroup analyses were performed according to treatment groups (IVT-only and EVT). RESULTS Of a total of 15128 included patients from 105 centers, 853 (5.6%) were diagnosed with COVID-19. 5848 (38.7%) patients received IVT-only, and 9280 (61.3%) EVT (with or without IVT). Patients with COVID-19 had a higher rate of symptomatic intracerebral hemorrhage (SICH) (adjusted odds ratio [OR] 1.53; 95% CI 1.16-2.01), symptomatic subarachnoid hemorrhage (SSAH) (OR 1.80; 95% CI 1.20-2.69), SICH and/or SSAH combined (OR 1.56; 95% CI 1.23-1.99), 24-hour (OR 2.47; 95% CI 1.58-3.86) and 3-month mortality (OR 1.88; 95% CI 1.52-2.33).COVID-19 patients also had an unfavorable shift in the distribution of the modified Rankin score at 3 months (OR 1.42; 95% CI 1.26-1.60). DISCUSSION Patients with acute ischemic stroke and COVID-19 showed higher rates of intracranial bleeding complications and worse clinical outcomes after revascularization treatments than contemporaneous non-COVID-19 treated patients. Current available data does not allow direct conclusions to be drawn on the effectiveness of revascularization treatments in COVID-19 patients, or to establish different treatment recommendations in this subgroup of patients with ischemic stroke. Our findings can be taken into consideration for treatment decisions, patient monitoring and establishing prognosis