Integración del farmacéutico comunitario en un equipo de atención domiciliaria: estudio de costes de una experiencia piloto.

Objetivo: Estimar la carga económica que suponen los pacientes adscritos al servicio de atención domiciliaria de atención primaria y el coste que supondría incluir un farmacéutico en este equipo. Método: Estudio descriptivo prospectivo de evaluación de la carga económica del programa de atención domiciliaria. Emplazamiento: CAP Montnegre de una ABS urbana de la ciudad de Barcelona. Participantes: Pacientes adscritos al servicio de atención domiciliaria que fueron atendidos entre enero y junio de 2014 por la enfermera gestora de casos del centro. Las farmacéuticas revisaron la medicación de los pacientes para identificar problemas relacionados con la medicación y proponer intervenciones al equipo de atención domiciliaria. Mediciones principales: Revisando los historiales clínicos de los pacientes, se recogieron los costes en atención primaria, especializada, urgencias, ingresos y pruebas en 6 meses. Se estimó necesaria una visita del farmacéutico cada 6 meses para evaluar el plan de actuación. Se calcularon los costes medios para cada nivel asistencial. Resultados: Participaron 50 pacientes que generaron un coste medio total en 6 meses de 3174,5¿, siendo el 29% la atención primaria y el 66% la atención secundaria. El coste medio por paciente de la intervención farmacéutica fue de 116,4¿ (lo que supondría un incremento del 3,7% de los costes generados por estos pacientes)

Integración del farmacéutico comunitario en un equipo de Atención Domiciliaria: Estudio de costes de una experiencia piloto

Objetivo: Estimar la carga económica que suponen los pacientes adscritos al servicio de atención domiciliaria de atención primaria y el coste que supondría incluir un farmacéutico en este equipo. Método: Estudio descriptivo prospectivo de evaluación de la carga económica del programa de atención domiciliaria. Emplazamiento: CAP Montnegre de una ABS urbana de la ciudad de Barcelona. Participantes: Pacientes adscritos al servicio de atención domiciliaria que fueron atendidos entre enero y junio de 2014 por la enfermera gestora de casos del centro. Las farmacéuticas revisaron la medicación de los pacientes para identificar problemas relacionados con la medicación y proponer intervenciones al equipo de atención domiciliaria. Mediciones principales: Revisando los historiales clínicos de los pacientes, se recogieron los costes en atención primaria, especializada, urgencias, ingresos y pruebas en 6 meses. Se estimó necesaria una visita del farmacéutico cada 6 meses para evaluar el plan de actuación. Se calcularon los costes medios para cada nivel asistencial. Resultados: Participaron 50 pacientes que generaron un coste medio total en 6 meses de 3174,5€, siendo el 29% la atención primaria y el 66% la atención secundaria. El coste medio por paciente de la intervención farmacéutica fue de 116,4€ (lo que supondría un incremento del 3,7% de los costes generados por estos pacientes). Conclusión: El estudio muestra que el coste generado por los pacientes en atención domiciliaria es elevado y que la inclusión de un farmacéutico en el equipo supondría un coste relativamente bajo. Será necesario realizar estudios de coste-efectividad de intervenciones multidisciplinares con farmacéutico para evaluar el impacto clínico y la eficiencia de estas intervenciones

Integración del farmacéutico comunitario en un equipo de Atención Domiciliaria: Estudio de costes de una experiencia piloto

Objetivo: Estimar la carga económica que suponen los pacientes adscritos al servicio de atención domiciliaria de atención primaria y el coste que supondría incluir un farmacéutico en este equipo. Método: Estudio descriptivo prospectivo de evaluación de la carga económica del programa de atención domiciliaria. Emplazamiento: CAP Montnegre de una ABS urbana de la ciudad de Barcelona. Participantes: Pacientes adscritos al servicio de atención domiciliaria que fueron atendidos entre enero y junio de 2014 por la enfermera gestora de casos del centro. Las farmacéuticas revisaron la medicación de los pacientes para identificar problemas relacionados con la medicación y proponer intervenciones al equipo de atención domiciliaria. Mediciones principales: Revisando los historiales clínicos de los pacientes, se recogieron los costes en atención primaria, especializada, urgencias, ingresos y pruebas en 6 meses. Se estimó necesaria una visita del farmacéutico cada 6 meses para evaluar el plan de actuación. Se calcularon los costes medios para cada nivel asistencial. Resultados: Participaron 50 pacientes que generaron un coste medio total en 6 meses de 3174,5€, siendo el 29% la atención primaria y el 66% la atención secundaria. El coste medio por paciente de la intervención farmacéutica fue de 116,4€ (lo que supondría un incremento del 3,7% de los costes generados por estos pacientes). Conclusión: El estudio muestra que el coste generado por los pacientes en atención domiciliaria es elevado y que la inclusión de un farmacéutico en el equipo supondría un coste relativamente bajo. Será necesario realizar estudios de coste-efectividad de intervenciones multidisciplinares con farmacéutico para evaluar el impacto clínico y la eficiencia de estas intervenciones

Ezrin interacts with the SARS coronavirus spike protein and restrains infection at the entry stage

© 2012 Millet et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Background: Entry of Severe Acute Respiratory Syndrome coronavirus (SARS-CoV) and its envelope fusion with host cell membrane are controlled by a series of complex molecular mechanisms, largely dependent on the viral envelope glycoprotein Spike (S). There are still many unknowns on the implication of cellular factors that regulate the entry process. Methodology/Principal Findings: We performed a yeast two-hybrid screen using as bait the carboxy-terminal endodomain of S, which faces the cytosol during and after opening of the fusion pore at early stages of the virus life cycle. Here we show that the ezrin membrane-actin linker interacts with S endodomain through the F1 lobe of its FERM domain and that both the eight carboxy-terminal amino-acids and a membrane-proximal cysteine cluster of S endodomain are important for this interaction in vitro. Interestingly, we found that ezrin is present at the site of entry of S-pseudotyped lentiviral particles in Vero E6 cells. Targeting ezrin function by small interfering RNA increased S-mediated entry of pseudotyped particles in epithelial cells. Furthermore, deletion of the eight carboxy-terminal amino acids of S enhanced S-pseudotyped particles infection. Expression of the ezrin dominant negative FERM domain enhanced cell susceptibility to infection by SARS-CoV and S pseudotyped particles and potentiated S-dependent membrane fusion. Conclusions/Significance: Ezrin interacts with SARS-CoV S endodomain and limits virus entry and fusion. Our data present a novel mechanism involving a cellular factor in the regulation of S-dependent early events of infection.This work was supported by the Research Grant Council of Hong Kong (RGC#760208)and the RESPARI project of the International Network of Pasteur Institutes

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015

SummaryBackground The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6–58·8) of global deaths and 41·2% (39·8–42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding Bill & Melinda Gates Foundation

Antimicrobial activity of sesquiterpene lactones isolated from traditional medicinal plant, Costus speciosus (Koen ex.Retz.) Sm

<p>Abstract</p> <p>Background</p> <p><it>Costus speciosus </it>(Koen ex.Retz.) Sm (Costaceae) is an Indian ornamental plant which has long been used medicinally in traditional systems of medicine. The plant has been found to possess diverse pharmacological activities. Rhizomes are used to treat pneumonia, rheumatism, dropsy, urinary diseases, jaundice, skin diseases and leaves are used<b/>to treat mental disorders.</p> <p>Method</p> <p>Antibacterial and antifungal activities were tested using Disc diffusion method and Minimum Inhibitory <b>Concentration </b>(MIC). Column chromatography was used to isolate compounds from hexane extract. X-ray crystallography technique and GC-MS analysis were used to identify the compounds</p> <p>Results</p> <p>Antibacterial and antifungal activities were observed in hexane, chloroform, ethyl acetate and methanol extracts. Hexane extract of <it>C.speciosus </it>showed good activity against tested fungi also. Two sesquiterpenoid compounds were isolated (costunolide and eremanthin) from the hexane extract. Both the compounds did not inhibit the growth of tested bacteria. But, both the compounds inhibited the tested fungi. The compound costunolide showed significant antifungal activity. The MIC values of costunolide were; 62.5 μg/ml against <it>Trichophyton mentagrophytes</it>, 62. μg/ml against <it>T. simii</it>, 31.25 μg/ml against <it>T. rubrum </it>296, 62.5 μg/ml against <it>T. rubrum </it>57, 125 μg/ml against <it>Epidermophyton floccosum</it>, 250 μg/ml against <it>Scopulariopsis </it>sp, 250 μg/ml against <it>Aspergillus niger</it>, 125 μg/ml against <it>Curvulari lunata</it>, 250 μg/ml against <it>Magnaporthe grisea</it>.</p> <p>Conclusion</p> <p>Hexane extract showed promising antibacterial and antifungal activity. The isolated compound costunolide showed good antifungal activity.</p

A chloroplast retrograde signal, 3’phosphoadenosine 5’-phosphate, acts as a secondary messenger in abscisic acid signaling in stomatal closure and germination

Organelle-nuclear retrograde signaling regulates gene expression, but its roles in specialized cells and integration with hormonal signaling remain enigmatic. Here we show that the SAL1-PAP (3'-phosphoadenosine 5'- phosphate) retrograde pathway interacts with abscisic acid (ABA) signaling to regulate stomatal closure and seed germination in Arabidopsis. Genetically or exogenously manipulating PAP bypasses the canonical signaling components ABA Insensitive 1 (ABI1) and Open Stomata 1 (OST1); priming an alternative pathway that restores ABA-responsive gene expression, ROS bursts, ion channel function, stomatal closure and drought tolerance in ost1-2. PAP also inhibits wild type and abi1-1 seed germination by enhancing ABA sensitivity. PAP-XRN signaling interacts with ABA, ROS and Ca2+; up-regulating multiple ABA signaling components, including lowly-expressed Calcium Dependent Protein Kinases (CDPKs) capable of activating the anion channel SLAC1. Thus, PAP exhibits many secondary messenger attributes and exemplifies how retrograde signals can have broader roles in hormone signaling, allowing chloroplasts to fine-tune physiological responses.Wannarat Pornsiriwong, Gonzalo M Estavillo, Kai Xun Chan, Estee E Tee, Diep Ganguly, Peter A Crisp, Su Yin Phua, Chenchen Zhao, Jiaen Qiu, Jiyoung Park, Miing Tiem Yong, Nazia Nisar, Arun Kumar Yadav, Benjamin Schwessinger, John Rathjen, Christopher I Cazzonelli, Philippa B Wilson, Matthew Gilliham, Zhong-Hua Chen, Barry J Pogso

A roadmap for gene functional characterisation in crops with large genomes: Lessons from polyploid wheat

Understanding the function of genes within staple crops will accelerate crop improvement by allowing targeted breeding approaches. Despite their importance, a lack of genomic information and resources has hindered the functional characterisation of major crop genes. The recent release of high-quality reference sequences for these crops underpins a suite of genetic and genomic resources that support basic research and breeding. For wheat, these include gene model annotations, expression atlases and gene networks that provide information about putative function. Sequenced mutant populations, improved transformation protocols and structured natural populations provide rapid methods to study gene function directly. We highlight a case study exemplifying how to integrate these resources. This review provides a helpful guide for plant scientists, especially those expanding into crop research, to capitalise on the discoveries made in Arabidopsis and other plants. This will accelerate the improvement of crops of vital importance for food and nutrition security