Registration system of professional performances defendants in Community Pharmacy.

INTRODUCCION El diseño de una herramienta o sistema de registro de todas las actuaciones profesionales (AP) que demanda el usuario en la farmacia comunitaria, en el mostrador, donde el farmacéutico realiza la mayor parte de su labor, es imprescindible para entender la barrera de falta de “tiempo” para implantar o desarrollar servicios cognitivos en la farmacia comunitaria. MATERIAL Y METODO El equipo investigador del estudio diseñó la herramienta de registro utilizando como soporte informático el sistema de gestión disponible en las farmacias participantes en el estudio (FARMATCR). Después de un pilotaje de 15 días y de los ajustes necesarios se creó la herramienta definitiva. Los requisitos básicos que se persiguieron para el diseño de la herramienta, fueron: Registrar todas las AP demandadas en el mostrador de la farmacia comunitaria. Recopilar la máxima información para cada una de las AP. Mantener la agilidad en la resolución de las mismas. Se decide hacer un control de calidad de la herramienta para saber si satisface las necesidades para lo que se ha diseñado. RESULTADO: herramienta FINAL La herramienta consiste en la introducción en el sistema informático (FARMATCR,) de una serie de códigos de trabajo nuevos (artículos, aportaciones y desplegables). DISCUSION Es difícil encontrar un equilibrio entre agilidad y rigor del registro. La herramienta es capaz de cuantificar las AP que se realizan en el mostrador, pero con limitaciones.INTRODUCTION Designing a tool or registration system for all professional activities requested by all user over the counter in the community pharmacy, where the pharmacist conducts most of its work, is essential to enable the understanding of the barrier of “lack of time” in order to establish or develop cognitive services in the community pharmacy . METHOD The research team working on this survey, designed the registered tool using the management system available in all pharmacies participants in the survey, as a computerized record (FARMATICR) The ultimate tool was created after 15 days of pile work and needed adjustments. The basic requirements pursued for the design of the tool were: The recording of all professional activities requested at the counter in pharmacies. The compiling of all information for each of the professional activities To maintain the flexibility in the resolutions of these. It was decided to have constant feedback of the quality of the tool to see if it met the requirements for its designed purpose. RESULTS The tool is the introduction into the computer system (FARMATICR,) of a series of new labor codes (articles, transfers and leaflets). DISCUSSION. It is difficult to find a balance between the speed and the inflexibility of the record. The tool is able to quantify the professional activities carried out in the pharmacy counter, but with its limitations

Effect of pores on the mechanical and durability properties on high strength recycled fine aggregate mortar

[EN] Larger consumption of natural fine aggregates (NFA) leads to an increase in cost, energy, and negative environmental impact. On the contrary, the larger production of construction waste results in the generation of recycled fine aggregate (RFA), which requires safe disposal. The aim of study, is to the hunt for such alternatives, compares the mortar mechanical and durability properties with and without RFA. High strength mortar specimens were produced with mix proportion as 1:3 using RFA as partial replacement for NFA as 0%, 25%, 50% and 100%. The mechanical and durability performance of all specimens was assessed in the terms of compressive strength, flexural strength, water absorption and mercury intrusion porosimetry. Mechanical performance is confirmed by microscopic studies. The main results display that the mortar with 25% of RFA, performed better, which are related to pore structures and their distribution. It is noted that the, pores also increase with the increase in RFA content. The effect of pores on the strength and their relationships are assessed.SIAuthor wish to thank for the supports and guidance given by faculties from University of Leon, Leon, Spain and Coimbatore Institute of Technology, Coimbatore, Indi

Actuaciones profesionales realizadas en la farmacia comunitaria

Objetivo: Describir todas las actuaciones profesionales (AP) que se llevan a cabo como respuesta a las demandas realizadas por los usuarios en la farmacia comunitaria (FC). Material y métodos: Estudio observacional, descriptivo y transversal, realizado durante 6 meses en dos farmacias comunitarias de Denia (Alicante). La población de estudio fueron todas las demandas de servicio que realizaron los usuarios de ambas farmacias. La variable de estudio fue la AP, es decir, cada uno de los servicios demandados por el usuario en la FC: dispensación, indicación, automedicación, consultas y ventas, clasificándose cada uno en sus resoluciones e incidencias. Resultados: En el estudio se realizaron 30.617 AP, correspondiendo un 42% a la dispensación con receta, y se registró casi un 23% de incidencias. Las indicaciones farmacéuticas supusieron un 9% del total, resolviéndose en la mayoría de casos con la recomendación de un medicamento. Un 33% fueron demandas de automedicación, cursando con casi un 20% de incidencias. Un 7% fueron consultas y un 10% ventas de productos sanitarios. Conclusiones: Del total de AP realizadas, el 90% se consideran farmacéuticas. El 83% fueron dispensaciones de medicamentos, más de la mitad de éstas sin prescripción médica, lo que revela la importancia del asesoramiento farmacéutico en las dispensaciones sin receta. El hecho de que 9 de cada 10 incidencias que se producen en la dispensación con receta y en la automedicación sean por la falta de información del paciente nos pone en alerta sobre la necesidad de implementar medidas que mejoren esta carencia

Actuaciones profesionales realizadas en la farmacia comunitaria

Objetivo: Describir todas las actuaciones profesionales (AP) que se llevan a cabo como respuesta a las demandas realizadas por los usuarios en la farmacia comunitaria (FC). Material y métodos: Estudio observacional, descriptivo y transversal, realizado durante 6 meses en dos farmacias comunitarias de Denia (Alicante). La población de estudio fueron todas las demandas de servicio que realizaron los usuarios de ambas farmacias. La variable de estudio fue la AP, es decir, cada uno de los servicios demandados por el usuario en la FC: dispensación, indicación, automedicación, consultas y ventas, clasificándose cada uno en sus resoluciones e incidencias. Resultados: En el estudio se realizaron 30.617 AP, correspondiendo un 42% a la dispensación con receta, y se registró casi un 23% de incidencias. Las indicaciones farmacéuticas supusieron un 9% del total, resolviéndose en la mayoría de casos con la recomendación de un medicamento. Un 33% fueron demandas de automedicación, cursando con casi un 20% de incidencias. Un 7% fueron consultas y un 10% ventas de productos sanitarios. Conclusiones: Del total de AP realizadas, el 90% se consideran farmacéuticas. El 83% fueron dispensaciones de medicamentos, más de la mitad de éstas sin prescripción médica, lo que revela la importancia del asesoramiento farmacéutico en las dispensaciones sin receta. El hecho de que 9 de cada 10 incidencias que se producen en la dispensación con receta y en la automedicación sean por la falta de información del paciente nos pone en alerta sobre la necesidad de implementar medidas que mejoren esta carencia

Effect of dried distillers grains (DDGS) on diet digestibility, growth performance, and carcass characteristics in Creole wool lambs fed finishing diets

Dried corn distillers grains with solubles (DDGS) can partially replace grains and forages in diets for ruminants. The objective of this research was to evaluate the effect of replacing grains and soybean meal with DDGS (0%, 15%, 30% and 45%) in the diet of lambs. Thirty-two native lambs were used (initial bodyweight = 28.6 ± 2.19 kg) in a completely randomized design. Initial body weight was a co-variable, and the means were compared with the Tukey test. The dry matter intake was significantly higher in DDGS containing diet than in the control treatment. The daily weight gain was higher in the diets with 15% of DDGS compared with the control. Dry matter digestibility was lower by 7% with 45% of DDGS. The hot and cold carcass weights were significantly higher by 8% in DDGS treatments compared to the control. The inclusion of increasing levels of DDGS in the diet of fattening lambs increased their dry matter intake, improved carcass weight, and did not adversely affect carcass characteristics.Keywords: Carcass, by-products, animal production, ruminant nutritio

High-Flow Oxygen with Capping or Suctioning for Tracheostomy Decannulation

9 p.BACKGROUND When patients with a tracheostomy tube reach a stage in their care at which decannulation appears to be possible, it is common practice to cap the tracheostomy tube for 24 hours to see whether they can breathe on their own. Whether this approach to establishing patient readiness for decannulation leads to better outcomes than one based on the frequency of airway suctioning is unclear. METHODS In five intensive care units (ICUs), we enrolled conscious, critically ill adults who had a tracheostomy tube; patients were eligible after weaning from mechanical ventilation. In this unblinded trial, patients were randomly assigned either to undergo a 24-hour capping trial plus intermittent high-flow oxygen therapy (control group) or to receive continuous high-flow oxygen therapy with frequency of suctioning being the indicator of readiness for decannulation (intervention group). The primary outcome was the time to decannulation, compared by means of the log-rank test. Secondary outcomes included decannulation failure, weaning failure, respiratory infections, sepsis, multiorgan failure, durations of stay in the ICU and hospital, and deaths in the ICU and hospital. RESULTS The trial included 330 patients; the mean (±SD) age of the patients was 58.3±15.1 years, and 68.2% of the patients were men. A total of 161 patients were assigned to the control group and 169 to the intervention group. The time to decannulation was shorter in the intervention group than in the control group (median, 6 days [interquartile range, 5 to 7] vs. 13 days [interquartile range, 11 to 14]; absolute difference, 7 days [95% confidence interval, 5 to 9]). The incidence of pneumonia and tracheobronchitis was lower, and the duration of stay in the hospital shorter, in the intervention group than in the control group. Other secondary outcomes were similar in the two groups. CONCLUSIONS Basing the decision to decannulate on suctioning frequency plus continuous highflow oxygen therapy rather than on 24-hour capping trials plus intermittent highflow oxygen therapy reduced the time to decannulation, with no evidence of a between-group difference in the incidence of decannulation failure. (REDECAP ClinicalTrials.gov number, NCT02512744.

Predictive factors and early biomarkers of response in multiple sclerosis patients treated with natalizumab

There are an increasing number of treatments available for multiple sclerosis (MS). The early identification of optimal responders to individual treatments is important to achieve individualized therapy. With this aim, we performed a multicenter retrospective longitudinal study including 186 MS patients treated with natalizumab who were followed for 2 years. We analyzed the following variables at recruitment: sex, current age, age at disease onset, disease duration, EDSS, number of T2 and Gd + lesions, IgG and IgM oligoclonal bands, HLA class II (DR, DRB, DQA, DQB, and DRB1*15:01), IgG and IgM antibody titers against human herpesvirus 6 (HHV-6) and the antibody response to Epstein–Barr virus (EBV) through the measurement of the anti-EBNA-1 and anti-VCA IgG titers, in relation to clinical response (no relapses or disability progression), and to NEDA-3 (no evidence of disease activity in terms of clinical response and no changes in MRI scans either) after 2-years follow-up. Baseline EDSS score, baseline EBNA-1 IgG titers and percentage change of HHV6 IgG titers between baseline and 6 month visits were significantly different in clinical responders and in NEDA-3 status (all of them remained significant in the multivariate analysis). We identified three variables for the early identification of natalizumab optimal responders in a rapid and cost-effective approach

On the origins of American Criollo pigs: A common genetic background with a lasting Iberian signature

American Criollo pigs are thought to descend mainly from those imported from the Iberian Peninsula starting in the late 15th century. Criollo pigs subsequently expanded throughout the Americas, adapting to very diverse environments, and possibly receiving influences from other origins. With the intensification of agriculture in the mid-20th century, cosmopolitan breeds largely replaced Criollo pigs, and the few remaining are mostly maintained by rural communities in marginal areas where they still play an important socio-economic and cultural role. In this study, we used 24 microsatellite markers in samples from 1715 pigs representing 46 breeds with worldwide distribution, including 17 American Criollo breeds, with the major focus of investigating their genetic diversity, structure and breed relationships. We also included representatives of the Iberian, Local British, Hungarian, Chinese and Commercial breeds, as well as Wild Boar, in order to investigate their possible influence in the genetic composition of Criollos. Our results show that, when compared with the other breeds, Criollo pigs present higher levels of genetic diversity, both in terms of allelic diversity and expected heterozygosity. The various analyses indicate that breed differentiation overall explains nearly 21% of the total genetic diversity. Criollo breeds showed their own identity and shared a common genetic background, tending to cluster together in various analyses, even though they differ from each other. A close relationship of Criollos with Iberian breeds was revealed by all the different analyses, and the contribution of Iberian breeds, particularly of the Celtic breeds, is still present in various Criollo breeds. No influence of Chinese breeds was detected on Criollos, but a few were influenced by Commercial breeds or by wild pigs. Our results confirm the uniqueness of American Criollo pigs and the role that Iberian breeds have played in their development. © 2021 Revidatti 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

La obesidad es una enfermedad crónica. Posicionamiento del grupo de trabajo de Diabetes, Obesidad y Nutrición de la Sociedad Española de Medicina Interna (SEMI) por un abordaje centrado en la persona con obesidad

Introducción: La obesidad es una enfermedad metabólica crónica, compleja y multifactorial, implicada en el desarrollo de enfermedades crónicas no transmisibles como la diabetes mellitus tipo 2, las enfermedades cardiovasculares y el cáncer. Es necesario que la atención a las personas con obesidad sea una parte esencial de la visión integral que la medicina interna aporta a la persona enferma. Material y métodos: Entre septiembre de 2019 y enero de 2020 se difundió una encuesta en línea a los socios de la Sociedad Espanola ˜ de Medicina Interna; se elaboró un análisis DAFO con las respuestas y, mediante la técnica de Grupo Nominal, se elaboraron las recomendaciones. Resultados: Obtuvimos 599 respuestas. Edad media 44,4 ± 11 anos; ˜ 52,1% mujeres. El 91,8% de los internistas evalúa a los pacientes para descartar las comorbilidades asociadas a la obesidad, principalmente la diabetes mellitus tipo 2 (96,2%), la enfermedad cardiovascular (88,9%) o el síndrome de hipoventilación asociada a obesidad (73%), entre otros. El 79,9% proporciona indicaciones sobre modificación del estilo de vida. El 64,1% y el 74,9% conocen las indicaciones de los fármacos y de la cirugía bariátrica, respectivamente. El 93,8% y el 83% consideran la obesidad y el sobrepeso una enfermedad crónica y el 88,7% una patología propia del internista, debiendo tener un papel activo y protagonista en su tratamiento (85,3%). Conclusiones: El objetivo del presente documento es dar a conocer el grado de conocimiento y de sensibilidad de los internistas frente al manejo de la obesidad y elaborar un consenso de recomendaciones de la Sociedad Espanola ˜ de Medicina Interna basadas en la evidencia científica y en la opinión de sus miembros