Impacto de la intervención farmacéutica en pacientes hemodializados.

Tesis (Químico Farmacéutico)La Insuficiencia Renal Terminal (IRT) es un problema de salud mundial, así por ejemplo, el año 2002, la incidencia global de IRT era de 242 casos por millón de habitantes/año. La prevalencia de IRT en USA en el año 2005, era de 1.131 pacientes por millón de población (pmp) y actualmente en nuestro país existen 12.523 pacientes en hemodiálisis con una tasa de 754pmp. La mayoría de los pacientes IRT padecen de diversas complicaciones, que los lleva a tener un fuerte sostén farmacológico y los costos del tratamiento pueden superar el medio millón de pesos mensuales. Datos internacionales estiman que el alrededor del 50% de los pacientes en hemodiálisis (HD) no se adhieren a sus terapias, por lo tanto, el objetivo de este trabajo fue aumentar el cumplimiento farmacoterapéutico en este tipo de pacientes. El estudio fue de tipo prospectivo y se desarrolló a través de un programa de intervenciones farmacéuticas, durante un periodo de 3 meses entre Abril y Junio del 2008. Se realizó en el establecimiento Centro Médico y de Diálisis Ltda., ubicado en la comuna de San Miguel, Santiago de Chile. Participaron 45 pacientes, de los cuales 26 eran hombres (58 ±13 años) y 19 mujeres (58 ±12 años). El plan de trabajo se desarrolló en 8 sesiones, educando a los pacientes sobre las características de su enfermedad y la importancia de seguir correctamente su farmacoterapia. Para medir el cumplimiento se utilizaron los test de Haynes-Sackett y Morinsky.,.Green y para clasificar los PRM encontrados se utilizó la clasificación propuesta por el Proyecto Minnesota de esa misma Universidad. Se encontraron 71 Problemas relacionados a medicamentos (PRM), de los cuales 42 fueron solucionados, utilizando como instrumento un calendario de medicamentos. La mayoría de los PRM estaban relacionados a la adherencia (59%), seguridad (24%) y efectividad (17%). Las intervenciones farmacéuticas realizadas en este estudio, lograron mejorar el cumplimiento farmacoterapéutico en los pacientes hemodializados. Se observó que el 43% de los pacientes tuvo una mejoría en su cumplimiento, 40% 10 mantuvo y 17% lo disminuyó (n =30). No se encontró relación directa entre el cumplimiento, ni grado de conocimiento con las características sociodemográficas de los pacientes

Validasi Metode Identifikasi Sildenafil Sitrat, Tadalafil dan Fenilbutazon dalam Jamu Obat Kuat Secara Kromatografi Lapis Tipis – Densitometri

Jamu/Herbal Medicine that contain chemical compounds/Pharmaceutical compounds has been banned by The National Agency of Drug and Food Control in Indonesia, but in December 2017, BPOM released a public warning about aphrodisiac herbal medicine that contain chemical compound like sildenafil citrate and phenylbutazone in the market. The aim of this study was to find out the valid method for identification of sildenafil citrate and phenylbutazone in aphrodisiac herbal medicine. In this study, the developed method was applied to 22 brands of aphrodisiac herbal medicine sample. Sample was extracted with methanol, then 5 µl of sample spotted on silica gel plate 60 F 254 and eluated by chloroform : methanol : amonia (70 : 3 : 1.5, v/v/v). The spots were analyzed by TLC scanner at λ 286 nm. Sildenafil citrate was appeared at Rf 0.76; tadalafil at 0.6 and phenylbutazone at Rf 0.12 with resolution (Rs) value of sildenafil and tadalafil was 1.1 meanwhile tadalafil and phenylbutazone was 5.4. Limit of detection of sildenafil citrate was 8.552 µg/ml (2.053 mg/600 mg capsul), tadalafil was 1.629 µg/ml (0.391 mg/600 mg capsul), and phenylbutazone was 7.877 µg/ml (1.890 mg/600 mg capsul). This study found 14 brands that gave a positive result containing sildenafil citrate and no sample contain tadalafil and phenylbutazone

Implementation Science and Fidelity Measurement: A Test of the 3-5-7 Model™

Children and youths engaged with the child welfare system can experience grief and loss as a result of trauma, broken relationships, and inadequate attachments. Interventionists are often challenged to implement effective strategies that help youths to reestablish trusting relationships and to promote overall psychological well-being. A 5-year federal demonstration project funded by the U.S. Department of Health and Human Services, Children’s Bureau, guided by an implementation science model, sought to increase well-being in youths age 12–21 who were involved in the child welfare system. The 3-5-7 Model™, a strengths-based approach that empowers children, youths, and families to engage in grieving and integrating significant relationships, was studied. A fidelity system was created in order to test the model. Important lessons about implementation science guided the work of the demonstration project. Although definitive conclusions could not be reached, several indicators of psychological well-being were found to be associated with high levels of fidelity to the 3-5-7 ModelTM. Suggestions for future research are offered

HEADACHE PROFILE OF BRAIN TUMOR PATIENTS IN MOHAMMAD HOESIN HOSPITAL PALEMBANG

Background: Headache is one of the most common complaint in population while a serious causative of underlying disease is very rare. Although headaches are rarely the result of a brain tumor, brain tumors are frequently associated with headaches. The challenges to the physician are to determine the specific feature of headache related to brain tumor.Methods: This is cross sectional study involved primary and metastatic brain tumor patient admitted in neurology ward of Mohammad Hoesin hospital from April 2018 to June 2019. The inclusion criteria including age > 18 years old and there was symptom of headache based on anamnesis. All were interviewed about their personal details (age, gender). The characteristic of headache was obtained based on questionnaire designed in our department. Various neurological symptoms related to the tumor were also recorded. Information of the tumor was obtained from the patient’s chart (histopathology of the tumor) and from characteristic of neuroradiological finding (magnetic resonance imaging or computed tomography). Headache and tumor characteristics were compared between primary and metastatic tumor by contrasting frequencies. We also analysed the correlation between tumor characteristics (location, hidrocephalus, vasogenic edema and tumor type) with headache intensity.Results: A total of 95 of 199 patients (48%) with headache symptom were studied in this series. Most patients were complained of chronic headache. Headache was mostly throbbing in both primary and metastatic brain tumors.  Progressively headache was dominant in this study and more than half patients report the quality of headache as moderate at the onset. In 35,8% patients, headache was the patient’s first complaint.  Headache as the isolated symptom of brain tumor was found in only 3,2% and only 28,4% of patients ful?lled the three ‘classic criteria’ of the brain tumor headache. A great localizing value of the headache was found in 63 cases of 95 patients. Of the 61 patients with single tumor and unilateral side, the unilateral headache was on 48 cases (78,8%). Of the 26 patients with strictly bilateral headache, 10 cases (38,5%) had bilateral sided tumors. Conclusion: The incidence of brain tumor headache in this study is similar to previous reports although the classic brain tumor headache features was found in a small portion of the patients.

PAIN CHARACTERISTICS OF CENTRAL NERVOUS SYSTEM TUMOR IN MOHAMMAD HOESIN GENERAL HOSPITAL

Pain is one of the cardinal symptom in tumor patient, especially in Central Nervous System (CNS) tumor. It often impacts patient’s quality of life. The incidence and characteristic of pain have rarely been reported in Palembang, Indonesia. This observational study was planned to investigate the clinical presentation and epidemiology of CNS tumor firstly diagnosed in ward throughout July to December 2018. 99 patients recently diagnosed with CNS tumor were enrolled. From 99 patients, we found 34 patients with tumor associated pain. We further evaluated the information of pain linked with brain tumors via questionnaire and medical record. Of all 34 subjects, the age ranged from 43 to 79 years old with female : male ratio 3:1. Pain was present 100% in spinal tumor and 54% in brain tumor. Clinical characteristics of pain found in brain tumor were typically in ipsilateral lesion (92%), pulsating (76%), moderate intensity (60%), recurrent (84%), not radiating (80%), with frequency of 3-4 times in a week (48%). On the other hand, pain in spinal tumor was generally felt on the site of the lesion (100%), radiating (77.8%), electrical type of pain (44.4%), high intensity (77.8), and constant (88.9%). From this study we conclude that tumor locations can show some different pain characteristics. Therefore careful pain assessment is compulsory to have better understanding and more appropriate management

Adolescents: Orphaned and Vulnerable in the Time of HIV/AIDS

This paper calls for greater attention to orphaned and vulnerable adolescents by agencies working in this field

Prevalence of the E321G MYH1 variant for immune-mediated myositis and nonexertional rhabdomyolysis in performance subgroups of American Quarter Horses.

BackgroundImmune-mediated myositis (IMM) in American Quarter Horses (QHs) causes acute muscle atrophy and lymphocytic infiltration of myofibers. Recently, an E321G mutation in a highly conserved region of the myosin heavy chain 1 (MYH1) gene was associated with susceptibility to IMM and nonexertional rhabdomyolysis.ObjectivesTo estimate prevalence of the E321G MYH1 variant in the QH breed and performance subgroups.AnimalsThree-hundred seven elite performance QHs and 146 random registered QH controls.MethodsProspective genetic survey. Elite QHs from barrel racing, cutting, halter, racing, reining, Western Pleasure, and working cow disciplines and randomly selected registered QHs were genotyped for the E321G MYH1 variant and allele frequencies were calculated.ResultsThe E321G MYH1 variant allele frequency was 0.034 ± 0.011 in the general QH population (6.8% of individuals in the breed) and the highest among the reining (0.135 ± 0.040; 24.3% of reiners), working cow (0.085 ± 0.031), and halter (0.080 ± 0.027) performance subgroups. The E321G MYH1 variant was present in cutting (0.044 ± 0.022) and Western Pleasure (0.021 ± 0.015) QHs at lower frequency and was not observed in barrel racing or racing QHs.Conclusions and clinical importanceKnowing that reining and working cow QHs have the highest prevalence of the E321G MYH1 variant and that the variant is more prevalent than the alleles for hereditary equine regional dermal asthenia and hyperkalemic periodic paralysis in the general QH population will guide the use of genetic testing for diagnostic and breeding purposes

Indoor Air Quality Analysis in Oakridge Oregon

Single page posterClimate change and intense fire seasons in Oregon have worsened air quality, posing health risks to residents. Low cost PM2.5 sensors monitor indoor air quality in Oakridge, Oregon. Many homes received interventions to improve indoor air quality. This study evaluates these interventions' effectiveness and examines the relationship between outdoor and indoor air quality before and after the interventions. We used statistical methods to analyze the data and present preliminary results of this air quality analysis.This research is supported by the Ecosystem Workforce Program at the University of Oregon through a grant from the Lane Regional Protection Agency as part of the Environmental Protection Agency 2021 Targeted Airshed Program (TAG2), under intergovernmental agreement number LRAPA 22-05-01 TAG2

Teachers’ Social Media Use and Its Legal Implications

As society becomes increasingly dependent on technology, school leaders must navigate the evolution of websites, resources, and platforms, including social media, as part of their responsibility to facilitate a safe and productive learning environment for students. This article reviews both constitutional and case law as a means of informing educational leaders of their rights and duties, as well as providing a foundation upon which effective K-12 social media policies and practices for educators can be built. Specifically, we offer an analysis of landmark cases involving the First Amendment and free speech, the delicacy around teachers’s roles as both public employees and private citizens, and recent court cases involving social media use. Additionally, we propose guidelines around social media use, compiled from both practitioners in the field and relevant literature