Primary health care pharmacists and vision for community pharmacy and pharmacists in Chile

The Chilean healthcare system is composed of public and private sectors, with most of the higher-income population being covered privately. Primary healthcare in the public system is provided in more than 2,500 public primary care centers of different sizes with assigned populations within territories. Private insurance companies have their own healthcare networks or buy services from individual health providers. Patients from the public system receive most medications free of charge in primary care pharmacies embedded in each care center. Private patients must purchase their medicines from community pharmacies. Some government policies subsidize part of the cost of medications, but original medicines remain as the most expensive of Latin America. Three chain pharmacies have more than 90% of the market share, and these pharmacies have negative public perception because of price collusion court sentences. A non-profit, municipal pharmacy model was developed but has limited implementation. Most privately owned independent and chain community pharmacies do not provide pharmaceutical services as there is no remuneration or cover by insurers. The limited number of publicly owned Municipal pharmacies could implement pharmaceutical services in community settings as they are non-profit establishments and have full-time pharmacists but are not resourced for these services. A limited number of pharmaceutical services are almost exclusively provided in public primary care, including medication reviews, pharmaceutical education, home visits and pharmacovigilance services, but several barriers to their implementation remain. A risk-based multimorbidity care model was implemented in 2020 for public primary care with additional employment of part-time pharmacists to provide services. We believe that this model will help pharmacists to optimize their time by prioritizing the much-needed clinical tasks. We propose within this multimorbidity care model that the more time-consuming services are provided to higher risk patients. Pharmacy prescribing i.e. amending or approving changes in medications in primary care for chronic conditions could also be useful for the health system, but pharmacists would require additional training. The landscape for pharmaceutical services for primary care in Chile is promising, but the integration with community pharmacies will not be possible until they are funded by public and private insurance, and the public perception of these establishments is improved.</jats:p

Filtration–UV irradiation as an option for mitigating the risk of microbiologically influenced corrosion of subsea construction alloys in seawater

The effect of filtration-UV irradiation of seawater on the biofilm activity on several offshore structural alloys was evaluated in a continuous flow system over 90 days. Biofilms ennobled the electrode potential by +400–500 mV within a few days of exposure to raw untreated seawater. Filtration-UV irradiation of the seawater delayed the ennoblement of the steels for up to 40 days and lowered localized corrosion rates in susceptible alloys. Ennobling biofilms were composed of microbial cells, diatoms and extracellular polymeric substances and the bacterial community in biofilms was affected by both the alloy composition and seawater treatment

Duration of Treatment for Pseudomonas aeruginosa Bacteremia : a Retrospective Study

Introduction: There is no consensus regarding optimal duration of antibiotic therapy for Pseudomonas aeruginosa bacteremia. We aimed to evaluate the impact of short antibiotic course. Methods: We present a retrospective multicenter study including patients with P. aeruginosa bacteremia during 2009-2015. We evaluated outcomes of patients treated with short (6-10 days) versus long (11-15 days) antibiotic courses. The primary outcome was a composite of 30-day mortality or bacteremia recurrence and/or persistence. Univariate and inverse probability treatment-weighted (IPTW) adjusted multivariate analysis for the primary outcome was performed. To avoid immortal time bias, the landmark method was used. Results: We included 657 patients; 273 received a short antibiotic course and 384 a long course. There was no significant difference in baseline characteristics of patients. The composite primary outcome occurred in 61/384 patients in the long-treatment group (16%) versus 32/273 in the short-treatment group (12%) (p = 0.131). Mortality accounted for 41/384 (11%) versus 25/273 (9%) of cases, respectively. Length of hospital stay was significantly shorter in the short group [median 13 days, interquartile range (IQR) 9-21 days, versus median 15 days, IQR 11-26 days, p = 0.002]. Ten patients in the long group discontinued antibiotic therapy owing to adverse events, compared with none in the short group. On univariate and multivariate analyses, duration of therapy was not associated with the primary outcome. Conclusions: In this retrospective study, 6-10 days of antibiotic course for P. aeruginosa bacteremia were as effective as longer courses in terms of survival and recurrence. Shorter therapy was associated with reduced length of stay and less drug discontinuation

Application of HPM to Solve Unsteady Squeezing Flow of a Second-Grade Fluid between Circular Plates

In this article, Homotopy Perturbation Method (HPM) is used to provide two approximate solutions to the nonlinear differential equation that describes the behaviour for the unsteady squeezing flow of a second grade fluid between circular plates. Comparing results between approximate and numerical solutions shows that our results are capable to provide an accurate solution and are extremely efficient

Classical Perturbation Method for the Solution of a Model of Diffusion and Reaction

In this paper, we employ perturbation method (PM) to solve nonlinear problems. As case study PM is employed to obtain approximate solutions for the nonlinear differential equation that models the diffusion and reaction in porous catalysts. We find that the square residual error (S.R.E) of our solutions is in the range and this requires only the third order approximation of PM, which shows the effectiveness of the method

HPM Approximations for Trajectories: From a Golf Ball Path to Mercury’s Orbit

In this work, we propose the approximated analytical solutions for two highly nonlinear problems using the homotopy perturbation method (HPM). We obtained approximations for a golf ball trajectory model and a Mercury orbit’s model. In addition, to enlarge the domain of convergence of the first case study, we apply the Laplace-Padé resummation method to the HPM series solution. For both case studies, we were able to obtain approximations in good agreement with numerical methods, depicting the basic nature of the trajectories of the phenomena

Factores precosecha, cosecha y poscosecha inherentes al cultivo de jamaica (Hibiscus sabdariffa L.): Una revisión

Hibiscus sabdariffa L. is cultivated to obtain fiber from the stems, oil from the seeds, and to harvest its calyces. Currently, there is a growing interest for the calyces due to studies that have proven their functional feature as the antioxidant effect, alluded to its anthocyanin content, and other benefits that expand their use to the pharmaceutical sector. However, there are no studies focused on relating all the factors involved in the process, from sowing and preharvesting management, to harvest, postharvesting management, distribution and the sale of dried calyces. The aim of this review is to highlight the factors involved in Roselle management such as variety, crop nutrition, sowing date, irrigation, plagues and diseases incidence and use of phytohormones. To establish the optimal time of calyces harvest, studies have been focused on determining aspects such as size, pH, dry matter content and anthocyanins at different times after blooming. As for the postharvest, the trend marked by studies is to implement improvements in the drying process of calyces and to let producers, distributors and sellers know the quality standards because much of the damage during postharvesting is associated with deficiencies in the way calyces are handled.Hibiscus sabdariffa L. se cultiva para obtener fibra de sus tallos, aceite de sus semillas y cosechar sus cálices. Actualmente hay un creciente interés por los cálices debido a estudios que han probado su característica funcional como lo es el efecto antioxidante, aludido a su contenido en antocianinas y otros beneficios que expanden su uso al sector farmacéutico. Sin embargo, no hay estudios enfocados en relacionar todos los factores involucrados en el proceso desde la siembra y manejo precosecha hasta la cosecha, el manejo poscosecha, y la distribución y venta de los cálices secos. El objetivo de esta revisión es destacar los factores involucrados en el manejo de la jamaica, tales como la variedad, nutrición del cultivo, fecha de siembra, irrigación, incidencia de plagas y enfermedades y el uso de fitohormonas. Para establecer el tiempo óptimo de cosecha de los cálices, los estudios se han enfocado en determinar aspectos tales como el tamaño, pH, contenido de materia seca y de antocianinas en distintos tiempos a partir de la floración. En cuanto a la poscosecha, la tendencia que marcan los estudios es implementar mejoras en el proceso de secado de los cálices y hacer saber a los productores, distribuidores y vendedores los estándares de calidad debido a que gran parte del daño durante la poscosecha está asociado con las deficiencias en la forma de manejo los cálices

Microglia Transcriptome Changes in a Model of Depressive Behavior after Immune Challenge.

Depression symptoms following immune response to a challenge have been reported after the recovery from sickness. A RNA-Seq study of the dysregulation of the microglia transcriptome in a model of inflammation-associated depressive behavior was undertaken. The transcriptome of microglia from mice at day 7 after Bacille Calmette Guérin (BCG) challenge was compared to that from unchallenged Control mice and to the transcriptome from peripheral macrophages from the same mice. Among the 562 and 3,851 genes differentially expressed between BCG-challenged and Control mice in microglia and macrophages respectively, 353 genes overlapped between these cells types. Among the most differentially expressed genes in the microglia, serum amyloid A3 (Saa3) and cell adhesion molecule 3 (Cadm3) were over-expressed and coiled-coil domain containing 162 (Ccdc162) and titin-cap (Tcap) were under-expressed in BCG-challenged relative to Control. Many of the differentially expressed genes between BCG-challenged and Control mice were associated with neurological disorders encompassing depression symptoms. Across cell types, S100 calcium binding protein A9 (S100A9), interleukin 1 beta (Il1b) and kynurenine 3-monooxygenase (Kmo) were differentially expressed between challenged and control mice. Immune response, chemotaxis, and chemokine activity were among the functional categories enriched by the differentially expressed genes. Functional categories enriched among the 9,117 genes differentially expressed between cell types included leukocyte regulation and activation, chemokine and cytokine activities, MAP kinase activity, and apoptosis. More than 200 genes exhibited alternative splicing events between cell types including WNK lysine deficient protein kinase 1 (Wnk1) and microtubule-actin crosslinking factor 1(Macf1). Network visualization revealed the capability of microglia to exhibit transcriptome dysregulation in response to immune challenge still after resolution of sickness symptoms, albeit lower than that observed in macrophages. The persistent transcriptome dysregulation in the microglia shared patterns with neurological disorders indicating that the associated persistent depressive symptoms share a common transcriptome basis

Number of genes and transcript isoforms analyzed and differentially expressed between BCG-challenged (BCG) and Control mice within cell type and between microglia and macrophages within challenge group and overlapping counts.

<p>Number of genes and transcript isoforms analyzed and differentially expressed between BCG-challenged (BCG) and Control mice within cell type and between microglia and macrophages within challenge group and overlapping counts.</p