Review. From the Factory to the Metropolis

Negri, A. (2020). De la fábrica a la metrópolis. (F. Venturi, trad.). Cactus. 256 pp.Negri, A. (2020). De la fábrica a la metrópolis. (F. Venturi, trad.). Cactus. 256 pp

Pharmacist‑led antimicrobial stewardship programme in a small hospital without infectious diseases physicians

Pharmacists may be tasked to lead antibiotic stewardship programmes (ASP) implementation in small hospitals in absence of infectious diseases (ID) physicians. The objectives are to evaluate the effectiveness of a pharmacist-led ASP in a hospital without ID physician support, with special focus on indicators of the hospital use of antimicrobial agents based on consumption and asess the potential clinical and economic impact of pharmacist interventions (PIs) through the CLEO tool. A prospective quasi-experimental study to implement an ASP in a 194-bed hospital. We evaluated changes in antimicrobial use measured as mean defined daily doses per 1000 patient-days (AUD) for intervention versus preintervention period. A total of 847 antimicrobial PIs were proposed, being 88.3% accepted. Discontinuation due to excessive duration was the most frequently performed PI (23.4%). Most of PIs was classified as major or moderate clinical impact, 41.7% and 37.8% respectively. The global consumption of antimicrobial was reduced from 907.1 to 693.8 AUD, with a signifcant drop in carbapenems and quinolones. Direct expenditure of antibiotics decreased significantly. Pharmacistled ASP has being effective in reducing consumption of antibiotics. In the absence of ID physician´s support and oversight, pharmacists could lead the improvement of the use of antimicrobials

Desde CoOs hasta .NetFramework: comunicación hardware/software mediante VCP

En este artículo se describe una práctica de laboratorio para la docencia de sistemas operativos en tiempo real (RTOS) para microcontroladores de 32bits en el ámbito de los grados en Ingeniería de Computadores, mediante una metodología de aprendizaje basado en proyectos (ABP) [1]. En concreto esta práctica abarca la comunicación Hardware/ Software entre un RTOS en un microcontrolador con un núcleo vectorial Cortex-M4 y una aplicación software escrita en C# usando Visual Studio 2010 a través de puertos series virtuales (VCP). Esta práctica está enfocada como un proyecto que los alumnos han de ir realizando desde cero, avanzando mediante la consecución de hitos, hasta conseguir obtener un sistema final. El sistema a desarrollar se divide en dos partes, por un lado tenemos un microcontrolador de la familia STM32 ejecutando un RTOS completamente libre, CoOs, el cual recibe comandos para mover un motor y un servo, y simultáneamente envía la información de sensores de distancia y contacto usando el puerto serie. Por otro lado tenemos un PC con un sistema operativo de la familia Windows, en el que se construye una aplicación visual, la cual muestra el valor de los sensores y permite enviar comandos de movimiento y posición al microcontrolador. El desarrollo de este tipo de proyectos se añade a la necesidad del uso de diferentes herramientas para el desarrollo del firmware y del software en paralelo, de manera incremental, y enfocadas para ámbitos de uso muy distintos. Esta práctica ha tenido una gran acogida por parte de los alumnos, ya que les ha servido de ejemplo del desarrollo de periféricos empotrados y tiempo real, con una aplicación directa en el campo de la robótica, instrumentación o control automático.SUMMARY -- In this article a practical laboratory session for teaching operating systems in real time (RTOS) with 32-bit microcontrollers is described. This session is thought to be imparted in the Computer Engineering degree, through a methodology of project-based learning (PBL) [1]. Specifically, this practice session encompasses Hardware/Software RTOS communication between a microcontroller with Cortex- M4 core vector and a software application written in C # using Visual Studio 2010 via virtual serial ports (VCP). This practice is focused as a project that students must be making from scratch, by achieving several milestones, to obtain a final system. The system to develop is divided into two parts. First, we have a STM32 microcontroller family running a completely free RTOS, CoOS, which receives commands to move motors, and simultaneously sends information about distance sensors and using the serial port. On the other hand we have a PC with a Windows system operating family, where a visual application, which shows the value of the sensors and allows to send commands to the microcontroller motion and position is constructed. The development of this type of project is added to the need to use different development tools for firmware and software in parallel, incrementally, and focused to very different fields of use. This practice has been well received by the students, because it has served as an example of the development of a real-time system with embedded peripherals; and it has a direct application in the field of robotics, instrumentation and automatic control

Planificación del proyecto de adoquinado en calles del casco urbano del municipio de Quezalguaque, departamento de León

El presente estudio se realizó con la finalidad de hacer la planificación de un proyecto de adoquinado, enfocándose en el cálculo de volúmenes de obra, costos unitarios y programación de obras en el municipio de Quezalguaque, departamento de León

Impact of Functional Polymorphisms on Drug Survival of Biological Therapies in Patients with Moderate-to-Severe Psoriasis

Biological therapies (BTs) indicated for psoriasis are highly effective; however, not all patients obtain good results, and loss of effectiveness is the main reason for switching. Genetic factors may be involved. The objective of this study was to evaluate the influence of single-nucleotide polymorphisms (SNPs) on the drug survival of tumor necrosis factor inhibitors (anti-TNF) medications and ustekinumab (UTK) in patients diagnosed with moderate-to-severe psoriasis. We conducted an ambispective observational cohort study that included 379 lines of treatment with anti-TNF (n = 247) and UTK (132) in 206 white patients from southern Spain and Italy. The genotyping of the 29 functional SNPs was carried out using real-time polymerase chain reaction (PCR) with TaqMan probes. Drug survival was evaluated with Cox regression and Kaplan-Meier curves. The multivariate analysis showed that the HLA-C rs12191877-T (hazard ratio [HR] = 0.560; 95% CI = 0.40-0.78; p = 0.0006) and TNF-1031 (rs1799964-C) (HR = 0.707; 95% CI = 0.50-0.99; p = 0.048) polymorphisms are associated with anti-TNF drug survival, while TLR5 rs5744174-G (HR = 0.589; 95% CI = 0.37-0.92; p = 0.02), CD84 rs6427528-GG (HR = 0.557; 95% CI = 0.35-0.88; p = 0.013) and PDE3A rs11045392-T together with SLCO1C1 rs3794271-T (HR = 0.508; 95% CI = 0.32-0.79; p = 0.002) are related to UTK survival. The limitations are the sample size and the clustering of anti-TNF drugs; we used a homogeneous cohort of patients from 2 hospitals only. In conclusion, SNPs in the HLA-C, TNF, TLR5, CD84, PDE3A, and SLCO1C1 genes may be useful as biomarkers of drug survival of BTs indicated for psoriasis, making it possible to implement personalized medicine that will reduce financial healthcare costs, facilitate medical decision-making and improve patient quality of life. However, further pharmacogenetic studies need to be conducted to confirm these associations.University of Granada and the Fundación de Investigación Biosanitaria de Andalucía Oriental (FIBAO)Virgen de las Nieves University Hospital Biobank was supported by grants co-funded by ERDF funds (EU) from the Instituto de Salud Carlos III (PT13/0010/0039)

Medication Review with Follow-Up for End-Stage Renal Disease: Drug-Related Problems and Negative Outcomes Associated with Medication—A Systematic Review

Financial support received as a Doctoral Grant [reference number OAICE-143-2020] from the Office of International Affairs and External Cooperation, University of Costa Rica.Background: This article reviews the available scientific literature on drug-related problems and negative outcomes associated with medications identified by medication review with follow-up for end-stage renal disease and discussed with the physicians. Methods: A systematic review was conducted of the scientific literature retrieved from the following databases: MEDLINE (via PubMed), Web of Science, SCOPUS, Cochrane Library: The Cochrane Central Register and Control Trials (CENTRAL) and Literatura Latinoamericana y del Caribe (LILACS), Medicina en Español (MEDES), and the SciELO bibliographic database (a collection of scientific journals). The following terms were used as descriptors and searched in free text: “end-stage renal disease”, “medication review”, “drug-related problems”, and “negative outcomes associated with medication”. The following limits were applied: “humans” and “adults (more than 18 years)”. Results: A total of 59 references were recovered and, after applying inclusion/exclusion criteria, 16 articles were selected. Of these selected articles, 15 provided information on drug-related problems and only 1 on negative outcomes associated with medications. Conclusions: It can be concluded that drug-related problems and negative outcomes associated with medications affect patients with end-stage renal disease, mainly those receiving renal replacement therapy. More evidence is needed, especially on negative outcomes associated with medication.Office of International Affairs and External Cooperation, University of Costa Rica OAICE-143-202

Patrones de comportamiento de la malaria en el departamento de Risaralda, Colombia, 2007-2009

Introducción: La malaria es la enfermedad parasitaria de mayor morbimortalidad en Latinoamérica, especialmente en países de la cuenca amazónica, incluido Colombia. Risaralda, uno de sus departamentos con baja carga, requiere vigilancia y evaluación periódicas con el fin de contribuir a mayor control. Materiales y métodos: Estudio epidemiológico de evaluación de incidencia, etiología, distribución geográfica y mortalidad por malaria en el período 2007-2009, en Risaralda, Colombia. Resultados: Durante el período se registraron 2640 casos (promedio 880±290/año). La incidencia osciló entre 60,01 (2008) a 122,87 (2011) casos/100.000 hab (IPA, 0,6-1,23 casos/1.000 hab). Del total de casos, 93,4% correspondieron a P. vivax, 3,7% a P. falciparum y 2,9% a P. vivax/P. falciparum, siendo 68,9% de los casos del municipio Pueblo Rico, 14,0% Mistrató y 3,1% Pereira, adicionalmente 13% fueron importados de otros departamentos. La mortalidad fue constante, 0,1 muertes/100.000 hab/año. Discusión: La carga de la malaria en Risaralda se explica en parte por las condiciones sociales de los municipios así como ambientales, los cuales se han visto reflejados en ésta y otras enfermedades transmitidas por vectores en Colombia, Latinoamérica y el Mundo. Por ello deben hacerse mayores esfuerzos en investigación operativa que permitan profundizar actividades orientadas al mayor control y reducción de la enfermedad en el departamento.http://revistas.utp.edu.co/index.php/revistamedic

Hypoxia-Inducible Factor-1 Alpha Expression Is Predictive of Pathological Complete Response in Patients with Breast Cancer Receiving Neoadjuvant Chemotherapy

Supplementary Materials The following supporting information can be downloaded at: https://www.mdpi.com/article/10.3390/cancers14215393/s1, Table S1: Relation between HIF-1α expression and pAKT and pMAPK; Table S2: Logistic regression model as a predictive factor of response to treatment.To demonstrate the value of hypoxia-inducible factor-1α (HIF-1α) in predicting response in patients with breast cancer receiving standard neoadjuvant chemotherapy (NAC). Methods: Ninety-five women enrolled in two prospective studies underwent biopsies for the histopathological diagnosis of breast carcinoma before receiving NAC, based on anthracyclines and taxanes. For expression of HIF-1α, EGFR, pAKT and pMAPK, tumor samples were analyzed by immunohistochemistry in tissues microarrays. Standard statistical methods (Pearson chi-square test, Fisher exact test, Kruskal–Wallis test, Mann–Whitney test and Kaplan–Meier method) were used to study the association of HIF-1α with tumor response, survival and other clinicopathologic variables/biomarkers. Results: HIF-1α expression was positive in 35 (39.7%) cases and was significantly associated to complete pathological response (pCR) (p = 0.014). HIF-1α expression was correlated positively with tumor grade (p = 0.015) and Ki-67 expression (p = 0.001) and negativity with progesterone receptors (PR) (p = 0.04) and luminal A phenotype expression (p = 0.005). No correlation was found between HIF-1α expression and EGFR, pAKT and pMAPK. In terms of survival, HIF-1α expression was associated with a significantly shorter disease-free survival (p = 0.013), being identified as an independent prognostic factor in multivariate analysis. Conclusions: Overexpression of HIF-1α is a predictor of pCR and shorter DFS; it would be valuable to confirm these results in prospective studies

Influence of Genetic Polymorphisms on Response to Biologics in Moderate-to-Severe Psoriasis

This work was partly supported by a contract for Cristina Membrive Jimenez from the University of Granada and the Fundacion de Investigacion Biosanitaria de Andalucia Oriental (FIBAO). The Virgen de las Nieves University Hospital Biobank was supported by grants co-funded by ERDF funds (EU) from the Instituto de Salud Carlos III (PT13/0010/0039).The results of this research are part of the doctoral thesis that will be presented by Cristina Membrive Jiménez at the University of Granada as part of the doctoral studies in “Pharmacy”.Psoriasis is a chronic inflammatory skin pathology of autoimmune origin and unknown etiology. There are various therapies for treating it, including a wide range of biopharmaceuticals indicated in moderate-to-severe psoriasis. Depending on their therapeutic target, they are classified as tumor necrosis factor inhibitors (anti-TNF) or cytokine inhibitors (interleukin-12, 23, and 17 antagonists). Although they have proved effective and safe, in clinical practice, many patients show a short- and long-term suboptimal response and even varying degrees of toxicity. This variability in response may be influenced by genetic factors, such as polymorphisms in the genes involved in the pathological environment, metabolism or mechanism of action of the drug that could affect the effectiveness and toxicity of biological therapies. This review assesses pharmacogenetic studies of the impact of genetic factors on response to biopharmaceuticals and toxicity in patients diagnosed with moderate-to-severe psoriasis. The results suggest that polymorphisms detected in the HLA genes, in genes that encode cytokines (TNF, IL genes, TNFAIP3), transporters (PDE3A-SLCO1C1, SLC12A8), receptors (TNFRSF1B, CD84, FCGR2A and FCGR3A, IL17RA, IL23R, TLR genes, PGLYRP4) and associated proteins (TNFAIP3, LY96, TIRAP, FBXL19), as well as other genes implicated in the pathogenesis of psoriasis (CDKAL1, CARD14, PTTG1, MAP3K1, ZNF816A, GBP6, CTNNA2, HTR2A, CTLA4, TAP1) can be used in the future as predictive markers of treatment response and/or toxicity with biological therapies in patients diagnosed with moderate-to-severe psoriasis, tailoring treatment to the individual patient.University of GranadaFundacion de Investigacion Biosanitaria de Andalucia Oriental (FIBAO)ERDF funds (EU) from the Instituto de Salud Carlos III PT13/0010/003