Knowledge, perceptions and attitudes of health professionals in pharmacovigilance: a systematic review

La farmacovigilancia se implementó desde hace varias décadas para buscar, notificar y dar seguimiento a las reacciones adversas a los medicamentos, pero su abordaje en el mundo es todavía poco sistemático. Pese a los esfuerzos de la Organización Mundial de la Salud para alentar la notificación de las reacciones adversas a los medicamentos, existen variaciones de país a país, por lo que hace falta uniformar el nivel de capacitación en farmacovigilancia de los profesionales de la salud. En este trabajo se revisan los estudios recientes sobre la evaluación de conocimientos, actitudes y percepción en farmacovigilancia de los profesionales de la salud en treinta y nueve países. Se observó que en todos los casos los encuestados tienen conocimientos deficientes y muestran actitudes de complacencia, ignorancia, indiferencia y lucrativa, entre otras. Palabras clave: farmacovigilancia, reacción adversa a los medicamentos, evaluación de conocimientos y actitudes

Relationship between genotoxicity and oxidative stress induced by mercury on common carp (Cyprinus carpio) tissues

Artículo científicoMercury is one of the most toxic metals in aquatic systems since it is able to induce neurobehavioral disorders as well as renal and gastrointestinal tract damage. The common carp Cyprinus carpio is an important species from both an ecological and economic viewpoint as it is consumed in many countries, the top producers being Mexico, China, India and Japan. The present study aimed to evaluate the relation between Hg-induced oxidative stress and genotoxicity in diverse tissues of C. carpio. Specimens were exposed to 0.01 mg Hg/L (the maximum per- missible limit for aquatic life protection), and lipid peroxidation, protein carbonyl content and the activity of antioxidant enzymes were evaluated at 96 h. Micronuclei frequency and DNA damage by comet assay were determined at 12, 24, 48, 72 and 96 h. Hg induced oxidative stress and genotoxicity on exposed fish, since inhibition of antioxidant enzymes activity and increases in lipid peroxidation, DNA damage and micronuclei frequency occurred. Blood, gill and liver were more susceptible to oxidative stress, while blood were more sensitive to genotoxicity. In conclusion, Hg at concentrations equal to the maximum permissible limit for aquatic life protection induced oxidative stress and genotoxicity on C. carpio, and these two effects prove to be corre- lated.Consejo Nacional de Ciencia y Tecnología (CONACyT, Project 181541) as well as the Secretaría de Investigación y Posgrado of the Instituto Politécnico Nacional, Mexico (SIP-IPN, Projects 20160871 and 20170931)

Amoxicillin in the Aquatic Environment, Its Fate and Environmental Risk

Amoxicillin is a broad-spectrum antibiotic widely used for treating both human and animal diseases, and it belongs to a group that are excreted unchanged within urine and faeces; therefore, it is possible to find traces of this drug or its degradation products in environmental water bodies. In water, it is rapidly degraded by biotic and abiotic factors, yielding different intermediate products; these are suspected of being more resistant to degradation, and potentially more toxic, than the parent compound. In the water bodies, these compounds may produce toxic effects on the aquatic organisms from different trophic levels and produce an ecological imbalance. Amoxicillin may bioaccumulate in fish muscle tissues, with the possibility of the occurrence of these drugs in food, leading to a passive consumption of this antibiotic resulting in undesirable effects on consumer health such as immunoallergic responses. However, the main problem related with the presence of this antimicrobial compounds in fish tissues is the possibility of inducing bacterial resistance genes. At present, the available scientific knowledge is less than what is needed to fully assess the risks that amoxicillin pose to the environment, and it is still necessary to conduct large amount of research works before a thorough understanding of this severe environmental issue

Sublethal effects induced by captopril on Cyprinus carpio as determined by oxidative stress biomarkers

Artículo científicoTo our knowledge, this is the first study to evaluate captopril-induced oxidative stress in fish, and specifically in the common carp Cyprinus carpio. At present, very few studies in the international literature evaluate the suble- thal effects of captopril on aquatic organisms such as fish, and available ones focus on determination of median lethal concentration in crustaceans and algae. Also, studies evaluating these effects do not make reference to the mechanism of action of this pharmaceutical or its toxicokinetics. This limits our knowledge of the character- ization of the sublethal effects of this medication and of its potential ecological impact. The present study aimed to evaluate the sublethal effects induced by three different concentrations of captopril, on C. carpio), by determi- nation of activity of the antioxidant enzymes superoxide dismutase (SOD), catalase (CAT) and glutathione perox- idase (GPx), as well as indicators of cellular oxidation: hydroperoxide content (HPC), lipid peroxidation (LPX) and protein carbonyl content (PCC). Specimens were exposed for 12, 24, 48, 72 and 96 h to three different cap- topril concentrations: 1 μg L− 1, 1 mg L− 1 and 100 mg L− 1 (the first one has been detected environmentally, the other two have been associated with diverse toxic effects in aquatic species), and brain, gill, liver, kidney and blood samples were evaluated. Significant increases in HPC and LPX were observed mainly in kidney and gill, while PCC also increased in brain. Modifications were found in the activity of SOD (mostly in kidney, brain and blood), CAT (all organs) and GPx (kidney and gill). In conclusion, captopril induces oxidative stress in C. carpi

Effects of peppermint extract and chitosan-based edible coating on storage quality of common carp (Cyprinus carpio) fillets

Artículo internacional en revista indizadaEdible coatings have recently been developed and applied to different food matrices, due to their numerous benefits, such as increasing the shelf life of foods, improving their appearance, being vehicles of different compounds, such as extracts or oils of various spices that have antioxidant and antimicrobial activity, as well as being friendly to the environment. The objective of this research was to develop a new edible coating based on chitosan enriched with peppermint extract and to evaluate its effectiveness to inhibit microbial development in vitro and improve both the quality and shelf life of common carp (Cyprinus carpio) during refrigerated storage (4 ± 1 C). Three treatments were used: edible coating (C + EC), edible coating +, 5% chitosan (C + ECCh) and edible coating + 1.5% chitosan + 10% peppermint (C + ECChP). Prior the coating carp fillets; the antibacterial activity and antioxidant capacity were evaluated in the peppermint extract and coating solutions. After coating and during storage, the following were determined on the fillet samples: microbiological properties, observed for ECP, an inhibition halo of 14.3 mm for Staphylococcus aureus, not being the case for Gram-negative species, for ECCh, inhibition halos of 17.6 mm, 17.1 mm and 16.5 mm for S. aureus, Salmonella typhimurium and Escherichia coli, respectively; for the ECChP, inhibition halos for S. aureus, S. typhimurium and E. coli of 20 mm, 17 mm and 16.8 mm, respectively. For the physicochemical characteristics: an increase in solubility was observed for all treatments during storage, reaching 46.7 mg SN protein/mg total protein for the control, and values below 29.1 mg SN protein/mg total protein (p C + ECCh > C + ECChP, respectively at the end of storage. For the pH, maximum values were obtained for the control of 6.4, while for the fillets with EC a maximum of 5.8. For TVB-N, the fillets with different CE treatments obtained values (p C + E C > C + ECCh > C + ECChP respectively). Total phenolic compounds in the aqueous peppermint extract were 505.55 mg GAE/100 g dried leaves, with 98.78% antioxidant capacity in the aqueous extract and 81.88% in the EC. Biomolecule oxidation (hydroperoxide content) had a significant increase (p < 0.05) in all treatments during storage, 1.7 mM CHP/mg protein in the control, to 1.4 in C + EC, 1.27 in C + ECCh and 1.16 in C + ECChP; TBARS assay values increased in the different treatments during refrigerated storage, with final values of 33.44, 31.88, 29.40 and 29.21 mM MDA/mg protein in the control; C + EC; C + ECCh and C + ECChP respectively. In SDS -PAGE a protective effect was observed in the myofibrillar proteins of fillets with ECChP). The results indicate that the C + ECCh and C + ECChP treatments extend the shelf life of 3–5 days with respect to microbiological properties and 4–5 days with respect to physicochemical characteristics. A reduction in lipid and protein oxidation products was also observed during refrigerated storage. With these findings, this is considered a promising method to increase the shelf life of fish fillets combined with refrigeration and we are able to recommend this technology for the fish processing industry.Consejo Nacional de Ciencia y Tecnologí

Impacto de una intervención educativa en los conocimientos en farmacovigilancia y en el reporte de reacciones adversas a los medicamentos de profesionales de la salud en un hospital público de segundo nivel de atención en el Estado de México, México

El objetivo del estudio es evaluar el impacto de una intervención educativa en los conocimientos en farmacovigilancia y en el número y calidad de reportes de reacciones adversas a los medicamentos (RAM) en médicos y enfermeros de un hospital público de segundo nivel de atención del Estado de México. Dicha intervención consistió en un programa piloto de capacitación. Se diseñó y administró un cuestionario de conocimientos antes y después de la intervención y monitorearon los reportes de RAM. Los resultados se analizaron mediante estadística descriptiva, asociación y comparación. Luego de la intervención, los conocimientos en farmacovigilancia mejoraron significativamente, especialmente en los enfermeros; el número de reportes de RAM incrementó 6.2 veces y la calidad aumentó hasta tercer grado. Por tanto, es necesario educar continuamente en farmacovigilancia

Cyto-genotoxicity and oxidative stress in common carp (Cyprinus carpio) exposed to a mixture of ibuprofen and diclofenac

Thirty million people worldwide consume each day nonsteroidal anti-inflammatory drugs (NSAIDs), a heterogeneous group of pharmaceuticals used for its analgesic, antipyretic, and anti- inflammatory properties. Recent studies report high NSAID concentrations in wastewater treat- ment plant effluents, in surface, ground, and drinking water, and in sediments. NSAIDs are also known to induce toxicity on aquatic organisms. However, toxicity in natural ecosystems is not usu- ally the result of exposure to a single substance but to a mixture of toxic agents, yet only a few studies have evaluated the toxicity of mixtures. The aim of this study was to evaluate the toxicity induced by diclofenac (DCF), ibuprofen (IBP), and their mixture on a species of commercial inter- est, the common carp Cyprinus carpio. The median lethal concentration of IBP and DCF was determined, and oxidative stress was evaluated using the following biomarkers: lipid peroxidation and activity of the antioxidant enzymes superoxide dismutase, catalase and glutathione peroxi- dase. Cyto-genotoxicity was evaluated by micronucleus test, comet assay, and the specific activity of caspase-3. Results show that DCF, IBP, and a mixture of these pharmaceuticals induced free radical production, oxidative stress and cyto-genotoxicity in tissues of C. carpio. However, a greater effect was elicited by the mixture than by either pharmaceutical alone in some biomarkers evaluated, particularly in gill.Secretaria de Investigacion y Estudios Avanzados de la UAEM (Project 3722/ 2014CID)

As2O3 Induces Oxidative Stress in Gill, Liver, Brain and Blood of Cyprinus carpio

Artículo científicoArsenic (As) is a toxic trace element for diverse aquatic species. It is present naturally in water in diverse oxidation states and chemical species. During its biotransformation, As induces production of reactive oxygen species, eliciting oxidative stress in diverse organisms. This study aimed to evaluate As-induced toxicity in brain, liver, blood and gill of the common carp Cyprinus carpio.Secretaría de Investigación y Estudios Avanzados of the Universidad Autónoma del Estado de México (SIEA-UAEM, project UAEM 3722/2014/CID)

Optimization of the physic, optical and mechanical properties of a composite edible films of gelatin, whey protein and chitosan

Artículo indizadoThe aim of this work was to evaluate the effect of the concentration of gelatin (G) (3–6 g), whey protein (W) (2.5–7.5 g) and chitosan (C) (0.5–2.5 g) on the physical, optical and mechanical properties of composite edible films (CEFs) using the response surface methodology (RSM), as well as optimizing the formulation for the packaging of foods. The results of the study were evaluated via first‐ and second‐order multiple regression analysis to obtain the determination coefficient val‐ ues with a good fit (R ˃ 0.90) for each of the response variables, except for the values of solubility and b*. The individual linear effect of the independent variables (the concentrations of gelatin, whey protein and chitosan) significantly affected (p ≤ 0.05) the water vapor permeability (WVP), strength and solubility of the edible films. The WVP of the edible films varied from 0.90 to 1.62 × 10−11 g.m/Pa.s.m2, the resistance to traction varied from 0.47 MPa to 3.03 MPa and the solubility varied from 51.06% to 87%. The optimized values indicated that the CEF prepared with a quantity of 4 g, 5 g and 3 g of gelatin, whey protein and chitosan, respectively, provided the CEF with a smooth, continuous and transparent surface, with L values that resulted in a light‐yellow hue, a lower WVP, a maximum strength (resistance to traction) and a lower solubility. The results revealed that the optimized formulation of the CEF of G–W–C allowed a good validation of the prediction model and could be applied, in an effective manner, to the food packaging industry, which could help in miti‐ gating the environmental issues associated with synthetic packaging materials.Consejo Nacional de Ciencia y Tecnologí

Alterations to embryonic development and teratogenic effects induced by a hospital effluent on Cyprinus carpio oocytes

Artículo indizado en revista internacionaland diverse pharmaceuticals are noteworthy that can affect organisms if they are not properly removed from the effluents. The hospital effluent evaluated in the present study came from IMSS (Instituto Mexicano del Seguro So- cial) Clinic 221 in downtown Toluca, State of Mexico, a secondary care facility. The contaminants identified in hospitals have been associated with deleterious effects on aquatic organisms; however, it is necessary to continue with more studies in order to be able to regulate the production of said contaminants which are generally dumped into the city sewage system. The present study had the purpose of evaluating the alterations to embry- onic development and teratogenic effects on oocytes Cyprinus carpio after exposure to different proportions of hospital effluent. For said purpose, the physicochemical properties of the effluent were determined. Concentra- tions of the main microcontaminants were also determined. An embryolethality study out and the determination of the main alterations to embryonic development and teratogenic effects produced, due to exposure of C. carpio at different proportions of the effluent, were carried out. The results showed that the physicochemical properties were within the values permitted by Mexican regulation; however, the presence of contaminants such as NaClO metals, anti-biotics, anti-diabetics, non-steroidal anti-inflammatory drugs, hormones and beta-blockers, was de- tected. Lethal concentration 50 was 5.65% and the effective concentration for malformations was 3.85%, with a teratogenic index of 1.46. The main teratogenic alterations were yolk deformation, scoliosis, modified chorda structure, tail malformation, fin deformity and mouth hyperplasia. A high rate of hatching delay was observed. The results suggest that the hospital effluent under study is capable of inducing embryotoxicity and teratogenic- ity in oocytes of C. carpio.Consejo Nacional de Ciencia y Tecnologí