Reacciones adversas a fármacos : nivel de conocimiento

Las reacciones adversas a fármacos (RAF) pueden afectar gravemente la salud y son motivo de consulta frecuente. Incluso pueden pasar desapercibidas si no se las piensa. Evaluar el conocimiento y valor que el equipo de salud otorga al tema, es fundamental para evitar la morbimortalidad de las RAF. Objetivos: Determinar el nivel de conocimiento de las reacciones adversas a fármacos (RAF) en el equipo de salud. Reflexionar sobre la propia práctica en relación a las RAF. Materiales y Métodos: Estudio descriptivo transversal a través de encuesta autoadministrada, anónima y validada, con preguntas cerradas de respuesta verdadero/falso sobre RAF de amiodarona, acenocumarol, enalapril, furosemida, salbutamol, clonazepam y ácido acetil salicílico. La encuesta constó de 51 opciones para las drogas citadas. Se consultó sobre la formación académica en farmacología, lectura y pensamiento en RAF previo a la prescripción así como experiencias sobre el tema. Se incluyeron médicos de planta (MP) médicos residentes (MR) y estudiantes (E) del 6º año de medicina. Análisis estadístico: medidas de tendencia central, medidas de dispersión y test exacto de Fisher. Se consideró significativa p<0.05. Resultados: Se encuestaron a 107 personas; 85% eran médicos (60.4% MR, 39.6% MP) y 15% E. El 58.9% fueron mujeres; edad promedio: 31.3 años. Cursaron farmacología como actividad curricular durante su formación el 96%. En los 6 meses previos, 81.3% refieren lecturas sobre farmacología y 16% realizó algún curso sobre el tema. Al momento de prescribir, 54% refieren que SIEMPRE pensaron en RAF. El 6.54% refiere que NUNCA lee previamente RAF antes de prescribir fármacos y 27.1% lo hacen SIEMPRE. El 32% contestó que NUNCA ha tenido pacientes con RAF graves; 43%, de 1 a 3 VECES y 25% MÁS DE 3 VECES. En relación a RAF habituales en drogas de uso frecuente los MP y MR respondieron correctamente el 74% cada uno. Conclusiones: El 54% refieren que SIEMPRE pensó en RAF al momento de prescribir y sólo el 27% refirió leer SIEMPRE sobre el tema antes de una indicación. El fármaco en que se demostró menos conocimiento fue acenocumarol y el mejor conocido fue el enalapril. El nivel de instrucción farmacológico, aún en drogas elementales en la salud pública/privada, es relativamente bajo por lo que se debiera implementar mayor fármacovigilancia para prevenir las RAF, como así también concientizar al equipo de salud sobre la importancia de esta problemática.Introduction: Adverse Drugs Reactions (ADR) can seriously affect health and are a frequent medical consultation cause. Sometimes can even go unnoticed if you do not take account of them. To evaluate knowledge and value that the medical team gives to the issue is fundamental in avoid morbidity and mortality of the ADR. Objectives: To determine the level of knowledge of ADR in the medical team. Reflect on the practice about the ADR. Material and methods: Descriptive cross-sectional study through a selfadministered, anonymous and validated survey with closed true / false answer questions on ADR of amiodarone, acenocoumarol, enalapril, furosemide, salbutamol, clonazepam and acetylsalicylic acid. The survey had 51 options for the drugs mentioned. It was consulted about pharmacological training, reading and thinking in ADR prior to prescription, as well as, experiences on the subject. Staff doctors (SD), resident doctors (RD) and 6th year medicine students (S) were included. Statistical analysis: measures of central tendency, scatter measures and Fisher's exact test. It was considered significant p <0.05. Outcomes: 107 people were surveyed; 85% were medical doctors (60.4% RD, 39.6% SD) and 15% S. 58.9% were women; average age: 31.3 years. 96% studied pharmacology as a curricular activity during their training. In the previous 6 months, 81.3% had read pharmacology and 16% had done some course about it. At prescribing, 54% thought ALWAYS about ADR, 6.54% report that NEVER read ADR before prescribing and 27.1% made it ALWAYS. 32% answered that they have NEVER had patients with serious ADR; 43% 1 to 3 TIMES and 25% MORE THAN 3 TIMES. About ADR in frequently used drugs, SD and RD answered correctly in 74% each one. Students answered correctly at 64%. About drugs, surveyed people responded correctly at enalapril n 60 (56.07%), acetylsalicylic acid n 57 (53.21%), prednisone n 54 (50.46), amiodarone n 21 (19.62%), salbutamol n 13 (12.14%), piperacillin tazobactam n 12 (11.21%), clonazepam n 12 (11.21%), furosemide n 3 (2.8%), and acenocoumarol n 1 (0.93%). From the comparative analysis between SD and RD, the ALWAYS response in ADR was more frequent in the first ones with SL (p = 0.08). We did not find differences in training or reading on ADR before prescribing between both groups. Conclusion: 54% ALWAYS thought about ADR at prescribing and only 27 referred to read ALWAYS this topic before an indication. The drug that showed less knowledge about was acenocoumarol and the one that showed best knowledge about was enalapril. The level of pharmacological instruction, even in elementary drugs, in public or private medical care system, is low. That is why is more pharmacovigilance is to be implemented in order to prevent ADR, as well as to make the health team aware of the importance of this problem.Fil: Valli Caparroz, Diego. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de Clínica MédicaFil: Salomón, Susana. Universidad Nacional de Cuyo. Facultad de Ciencias MédicasFil: Carena, José. Universidad Nacional de Cuyo. Facultad de Ciencias MédicasFil: Anci, Cynthia. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de Clínica MédicaFil: García Castellanos, Nicolás. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de Clínica MédicaFil: Morea, Gastón. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de Clínica Médic

Thyroid status modulates T lymphoma growth via cell cycle regulatory proteins and angiogenesis

We have shown in vitro that thyroid hormones (THs) regulate the balance between proliferation and apoptosis of T lymphoma cells. The effects of THs on tumor development have been studied, but the results are still controversial. Herein, we show the modulatory action of thyroid status on the in vivo growth of T lymphoma cells. For this purpose, euthyroid, hypothyroid, and hyperthyroid mice received inoculations of EL4 cells to allow the development of solid tumors. Tumors in the hyperthyroid animals exhibited a higher growth rate, as evidenced by the early appearance of palpable solid tumors and the increased tumor volume. These results are consistent with the rate of cell division determined by staining tumor cells with carboxyfluorescein succinimidyl ester. Additionally, hyperthyroid mice exhibited reduced survival. Hypothyroid mice did not differ significantly from the euthyroid controls with respect to these parameters. Additionally, only tumors from hyperthyroid animals had increased expression levels of proliferating cell nuclear antigen and active caspase 3. Differential expression of cell cycle regulatory proteins was also observed. The levels of cyclins D1 and D3 were augmented in the tumors of the hyperthyroid animals, whereas the cell cycle inhibitors p16/INK4A (CDKN2A) and p27/Kip1 (CDKN1B) and the tumor suppressor p53 (TRP53) were increased in hypothyroid mice. Intratumoral and peritumoral vasculogenesis was increased only in hyperthyroid mice. Therefore, we propose that the thyroid status modulates the in vivo growth of EL4 T lymphoma through the regulation of cyclin, cyclin-dependent kinase inhibitor, and tumor suppressor gene expression, as well as the stimulation of angiogenesis.Fil: Sterle, Helena Andrea. Pontificia Universidad Católica Argentina ; ArgentinaFil: Valli, Eduardo. Pontificia Universidad Católica Argentina ; ArgentinaFil: Cayrol, Maria Florencia. Pontificia Universidad Católica Argentina ; ArgentinaFil: Paulazo, Maria Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos. Universidad de Buenos Aires. Facultad de Medicina. Centro de Estudios Farmacológicos y Botánicos; ArgentinaFil: Martinel Lamas, Diego José. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Díaz Flaqué, María Celeste. Pontificia Universidad Católica Argentina ; ArgentinaFil: Klecha, Alicia Juana. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; ArgentinaFil: Colombo, L.. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Oncología ; ArgentinaFil: Medina, Vanina Araceli. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Cremaschi, Graciela Alicia. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina. Pontificia Universidad Católica Argentina ; ArgentinaFil: Barreiro Arcos, María Laura. Pontificia Universidad Católica Argentina ; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Química Biológica; Argentin

Virus de la Hepatitis E en Mendoza : presentación de 3 casos

La Hepatitis "E" es una enfermedad de distribución global, con morbilidad y mortalidad significativa, cuya incidencia ha aumentado en los últimos años. Con el propósito de potenciar la sospecha diagnostica de esta patología, se realiza una reactualización a partir de la presentación de 3 casos ocurridos en el Hospital Lagomaggiore de la Ciudad de Mendoza, Argentina.Hepatitis "E" is a disease of global distribution, with significantly morbidity and mortality, whose incidence keep growing as time goes by. In order to increase diagnostic suspicion of this illness, we perform a review based in three cases that take place in Lagomaggiore´s Hospital in Mendoza city, Argentina. Key words: Hepatitis, HEV.Fil: Miranda, Jimena. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de Clínica MédicaFil: Gisbert, Patricia. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de Clínica MédicaFil: Mastronardi, Valentina. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de Clínica MédicaFil: Clausen Karzovnik, Gabriela. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de Clínica MédicaFil: Lascano, Soledad. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de Clínica MédicaFil: Valli, Diego. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de Clínica MédicaFil: Salomón, Susana Elsa. Universidad Nacional de Cuyo. Facultad de Ciencias MédicasFil: Carena, José Alberto. Universidad Nacional de Cuyo. Facultad de Ciencias Médica

Multianalyte analysis of volatile compounds in virgin olive oils using SPME-GC with FID or MS detection: results of an international interlaboratory validation

The organoleptic assessment (Panel test) is the only procedure within the official methods for determining the quality of virgin olive oils that involves an expert panel. There is an urgent need for analytical methodology that can reliably measure volatile compounds in virgin olive oils that is capable of supporting and anticipating the official Panel test. For this reason, a new method based on solid-phase microextraction–gas chromatography with the choice of two possible detectors (FID or MS) was subjected to a large international interlaboratory validation study. The study involved a two-stage process: first, a pretrial phase in which 7 participants were exposed to the method for the first time to identify any initial problems with the methodology; then, a formal validation stage (trial proper), which involved 20 laboratories from Europe, USA, Japan and China. The performance of the different detectors was investigated. While both methods have advantages, the method using FID provided better results for 11 compounds, in terms of reproducibility, compared to MS. This information will allow to implement the method with accurate information of the method performance depending on the detector used. Practical applications: This study provides information from an interlaboratory validation of a method for measuring volatile compounds in virgin olive oils conducted with laboratories (from industry and academia) working in the olive oil sector. The information on the expected analytical errors in the determination of each volatile compound is necessary to apply this method for supporting the official Panel test (sensory analysis). The SPME-GC-MS/FID methods proposed in this work can be used for the internal quality control of a company/distributor/quality control laboratory and could also be used in cases of difficult/contradictory organoleptic assessment, or to confirm results from sensory panels in cases of disputes/disagreement (Reg. EU 2022/2105).European Commission 63569

El profesional de la salud y la telemedicina : ¿una relación con futuro?

Objetivo: Establecer el uso, interés y aceptación de la Telemedicina (Tm) en el ámbito de profesionales de salud en pandemia COVID 19. Material y métodos: Estudio descriptivo y transversal, a través de una encuesta estructurada, autoadministrada, anónima, realizada a personal de salud. Análisis comparativo entre médicos clínicos y otros profesionales médicos. Análisis estadístico: realizado con Epi Info, medidas tendencia central y test exacto Fisher. Criterio significación p<0.05. Resultados: Se incluyeron 105 profesionales de la salud, 50.5% de género masculino, edad media 48.8 años; 97% eran médicos. El 46% revisa el celular de manera inmediata al despertarse, 10.5% a la media hora y 6% al llegar al trabajo; 55% piensan que la Tm traía beneficios antes de la pandemia y 30% no se lo había planteado; 55% usaba tecnología en la relación médico paciente. Motivos de no usarla: despersonalización 37%, falta de experiencia 28% y 25% por características de los pacientes; 78% cambió de idea respecto a Tm en la asistencia cotidiana durante la pandemia. Motivos: utilidad 52%, obligación para no quedar fuera del sistema 14%. Al 26% le preocupa el uso por lo legal. Mejor aplicación para Tm: 61.5% consultas, 55% interconsultas, 19% diagnósticos. Preferencia para comunicación virtual con pacientes: Whatsapp 81%, teléfono 38.5%, videollamada 19%. El 72% no recibe remuneración; 60% continuará usando Tm luego de la pandemia, 24% prefiere la consulta presencial. Tienen dos teléfonos (personal y Tm) 21%. Siente que Tm suma 55%, soluciona problemas 30%, resulta esclavizante 11.5%. El 87.5% piensa que no se dejará de usar. Análisis comparativo: los médicos clínicos no consideraban a la Tm como beneficiosa antes de la pandemia y expresaron un cambio de perspectiva a favor luego de la misma (p<0.05). Conclusión: La Tm en pandemia ha impregnado el ejercicio profesional, superando barreras y promoviendo la accesibilidad. Sin embargo, no existe una adecuada regulación. A pesar de esto, se deja vislumbrar que la Tm llegó para quedarse.Objective: To stablish use, interest and acceptance of telemedicine (Tm) in the field of health professionals in the COVID 19 pandemic. Materials and methods: Descriptive cross-sectional study, developed through a structured, self-administered, anonymous survey, carried out to health personnel. Comparative analysis between clinicians and other professionals. Statistical analysis: made with Epi Info, central tendency measures and Fisher exact test. Criterion significance p<0.05. Results: 105 health professionals were included, 50.5% male, mean age 48.8 years; 97% were doctors. 46% check cell phone immediately upon waking up, 10.5% within half an hour and 6% upon arrival at work; 55% think that Tm brought benefits before pandemic and 30% had not considered it; 55% used technology in doctor-patient relationship. Reasons for not using Tm: 37% despersonalization, 28% lack of experience and 25% due to patient characteristics; 78% change their minds regarding Tm in daily care during the pandemic. Reasons: utility 52%, not to be left out of the system 14%; 26% are concerned about legal use. Best application for Tm: 61.5% consults, 55% interconsultations with other specialists, 19% diagnosis. Preference for virtual communication with patients: Whatsapp 81%, telephone 38.5%, videocall 19%; 72% do not receive remuneration; 60% will continue to use Tm after the pandemic, 24% prefer face-to-face consults. Have two telephones (personal and Tm) 21%. Feels that Tm adds up 55%, solves problems 30%, is enslaving 11.5%; 87.5% think that it will not be discontinued. Comparative analysis: clinicians use Tm in pandemic because they have no other alternative and after this, they have decided not to use it on daily routine (p<0.05). Conclusion: Tm in pandemic has impregnate profesional practice, overcoming barriers and promoting accessibility. Nevertheless, there is no adequate regulation. However, Tm is here to stay.Fil: Solavallone, Vanina . Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de Clínica MédicaFil: Anci, Cynthia . Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de Clínica MédicaFil: Elaskar, María . Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de Clínica MédicaFil: Valli Caparroz, Diego . Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de Clínica MédicaFil: Salomón, Susana Elsa. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de Clínica MédicaFil: Carena, José. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de Clínica Médic

Olive oil quality and authenticity: A review of current EU legislation, standards, relevant methods of analyses, their drawbacks and recommendations for the future

Background: The physical, chemical and organoleptic characteristics of olive oil (OO) are regulated by the European Union (EU) by Reg. (EEC) 2568/91 as amended, which also establishes methods for their analysis. Despite the fact that the OO sector is highly regulated, it is acknowledged that there are still problems; fats and oils, including OOs, are ranked third, after meat and meat products and fish and fish products, in the 2016 EU Food Fraud report on non-compliances per product category. For this reason, EU legislation, among the most advanced in the field, continuously chases after the emerging frauds. The process of proposing new methods or reviewing those current is constantly in progress, to ensure the robustness and the clarity required by official standardised procedures. Scope and approach: This review will identify current gaps in EU legislation and discuss drawbacks of existing analytical methods with respect to OO. Suggestions for replacement of specific steps within the present EU methods with more efficient analytical solutions to reduce time and/or solvent consumption will be proposed. Key findings and conclusions: This review critiques existing regulatory methods and standards, highlights weaknesses and proposes possible solutions to safeguard the consumer and protect the OO market

Peer inter-laboratory validation study of a harmonized SPME-GC-FID method for the analysis of selected volatile compounds in virgin olive oils

In the context of supporting the panel test in the classification of virgin olive oils, the qualitative and quantitative analysis of a number of volatile compounds responsible for their aroma is of great importance. Herein, the data obtained from three laboratories that analyzed the same samples are presented with the view to develop an inter-laboratory validation study of a harmonized solid-phase micro-extraction coupled with gas-chromatography with flame ionized detector (SPME-GC-FID) method for determination of selected volatile compounds. In particular, quantification of the minimum number of key markers responsible for positive attributes (e.g. fruity) and sensory defects was investigated. Three quantification strategies were considered since they can have a notable impact on the effectiveness of the use of markers as well as on the robustness and simplicity of the method that is designed for control laboratories. A peer-validation study indicated repeatability with a mean relative standard deviation (RSD%) lower than 14% except for ethyl propanoate, 3-methyl-1-butanol, 1-octen-3-ol, and (E)-2-decenal. Linearity was satisfactory (R2 > 0.90) for all compounds when the calibration curves were corrected by the internal standard. Several critical issues were identified, such as high RSD% (>50%) in terms of reproducibility for ethyl propanoate, (E)-2-decenal, and possible improvements of the limits of detection (LODs) and quantitation (LOQs) of (E)-2-heptenal, (E,E)-2,4-hexadienal, and (E)-2-decenal. In particular, some compounds (ethyl propanoate, (E)-2-heptenal, 1-octen-3-ol, (E,E)-2,4-hexadienal, (E)-2-decenal and pentanoic acid) showed LOQs that were higher than the concentrations found in some samples. The discussion permitted improvement of the protocol towards the final version for an upcoming full validation process

Maf/ham1-like pyrophosphatases of noncanonical nucleotides are host-specific partners of viral RNA-dependent RNA polymerases.

Cassava brown streak disease (CBSD), dubbed the “Ebola of plants”, is a serious threat to food security in Africa caused by two viruses of the family Potyviridae: cassava brown streak virus (CBSV) and Ugandan (U)CBSV. Intriguingly, U/CBSV, along with another member of this family and one secoviridae, are the only known RNA viruses encoding a protein of the Maf/ham1-like family, a group of widespread pyrophosphatase of non-canonical nucleotides (ITPase) expressed by all living organisms. Despite the socio-economic impact of CDSD, the relevance and role of this atypical viral factor has not been yet established. Here, using an infectious cDNA clone and reverse genetics, we demonstrate that UCBSV requires the ITPase activity for infectivity in cassava, but not in the model plant Nicotiana benthamiana. HPLC-MS/MS experiments showed that, quite likely, this host-specific constraint is due to an unexpected high concentration of non-canonical nucleotides in cassava. Finally, protein analyses and experimental evolution of mutant viruses indicated that keeping a fraction of the yielded UCBSV ITPase covalently bound to the viral RNA-dependent RNA polymerase (RdRP) optimizes viral fitness, and this seems to be a feature shared by the other members of the Potyviridae family expressing Maf/ham1-like proteins. All in all, our work (i) reveals that the over-accumulation of non-canonical nucleotides in the host might have a key role in antiviral defense, and (ii) provides the first example of an RdRP-ITPase partnership, reinforcing the idea that RNA viruses are incredibly versatile at adaptation to different host setups.post-print2435 K