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Abstract The objective of the study was to determine the spatial distribution patterns of Pinus and Quercus species along an altitudinal gradient in a temperate forest in northwestern Mexico. Individual uniformity (W i ), species mixture (M i ), and size dominance (U i ) were analyzed using structural parameters based on the relationships with the four nearest neighbors. Data were obtained from 37 sampling sites at three different altitude levels (Level 1: 2 200-2 600 m, Level 2: 2 600-2 800 m, and Level 3: 2 800-3 200 m), generating a total of 979 structural groups for all species. Pinus contributed 191, 51, and 41 groups at levels 1, 2, and 3, while Quercus contributed 192, one and zero, respectively. Pinus showed a tendency towards randomness, as did the oaks at Level 1; although, in this analysis, it was observed that at higher altitudes, Pinus tends towards a regular distribution. The species mix was medium to high for Pinus, which indicates that its individuals are surrounded by trees of different species, unlike Quercus. Size dominance revealed that Pinus specimens are taller than those of the Quercus genus throughout the gradient, especially at Level I. This approach provides an accurate understanding of the role of species in forest ecosystem dynamics.

Resumen El objetivo del estudio fue determinar los patrones de distribución espacial de las especies de Pinus y Quercus a lo largo de un gradiente altitudinal en un bosque templado del noroeste de México. Se analizó la uniformidad de los individuos (W i ), la mezcla de especies (M i ) y la dominancia dimensional (U i ) mediante parámetros estructurales basados en las relaciones con los cuatro vecinos más cercanos. Los datos se obtuvieron de 37 sitios de muestreo en tres niveles altitudinales (Nivel 1: 2 200-2 600 m, Nivel 2: 2 600-2 800 m y Nivel 3: 2 800-3 200 m), lo que generó un total de 979 grupos estructurales para todas las especies. Pinus contribuyó con 191, 51 y 41 grupos en los niveles 1, 2 y 3; mientras que Quercus aportó 192, uno y cero, respectivamente. Pinus evidenció tendencia hacia la aleatoriedad, y los encinos también en el Nivel 1, aunque en este análisis se observó que a mayor altitud Pinus tiende hacia una distribución regular. La mezcla de especies fue de media a alta para Pinus, lo cual indica que sus individuos están rodeados de árboles de especies diferentes, y con Quercus ocurrió al contrario. La dominancia dimensional reveló que los ejemplares de Pinus tienen mayor altura que los del género Quercus en todo el gradiente, especialmente en el Nivel 1. Este enfoque proporciona una comprensión exacta de la función que cumplen las especies en la dinámica de los ecosistemas forestales.

https://doi.org/10.29298/rmcf.v15i81.1426

Incidence of childhood cancer in Latin America and the Caribbean: coverage, patterns, and time trends
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de Paula Silva, Neimar

; Colombet, Murielle

; Moreno, Florencia

; Erdmann, Friederike

; Dolya, Anastasia

; Piñeros, Marion

; Stiller, Charles A

; Steliarova-Foucher, Eva

; Steliarova-Foucher, E

; Colombet, M

; Gloeckler Ries, LA

; Moreno, F

; Dolya, A

; Shin, HY

; Hesseling, P

; Stiller, CA

; Moreno, F

; Laura, EA

; Duarte, MA

; Alonso, M

; Prince, MA

; Diumenjo, MC

; Arias Ondicol, N

; Lima, CA

; Mundim Pena, GP

; Asturian Laporte, C

; de Oliveira, JC

; Pontes de Aquino, JA

; Vallebuona, C

; Galaz, JC

; Umaña, ME

; Espinoza, C

; Vargas Gallagher, SM

; Uribe, CJ

; Bravo, LE

; Arias Ortiz, NE

; Yepez Chamorro, MC

; Torres Alvarado, G

; Galán Alvarez, YH

; Martinez Reyes, FC

; Tanca Campozano, J

; Castillo Calvas, JC

; Mendoza Alava, M

; Cueva Ayala, P

; Roué, T

; Deloumeaux, J

; Joachim, C

; Duarte Muñoz, F

; Hanchard, B

; Fajardo-Gutiérrez, A

; Payet, E

; Albújar, PF

; Zavala Zegarra, DE

; Barrios, E

Revista Panamericana de Salud Pública

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2024, Volume 48 elocation e11

Abstract: Es En Pt | Text: Es En Pt | PDF: Es | PDF: En | PDF: Pt

resumen está disponible en el texto completo

ABSTRACT Objective. To provide a comprehensive overview of geographical patterns (2001–2010) and time trends (1993–2012) of cancer incidence in children aged 0–19 years in Latin America and the Caribbean (LAC) and interpret the findings in the context of global patterns. Methods. Geographical variations in 2001–2010 and incidence trends over 1993–2012 in the population of LAC younger than 20 years were described using the database of the third volume of the International Incidence of Childhood Cancer study containing comparable data. Age-specific incidence per million person-years (ASR) was calculated for population subgroups and age-standardized (WSR) using the world standard population. Results. Overall, 36 744 unique cases were included in this study. In 2001–2010 the overall WSR in age 0–14 years was 132.6. The most frequent were leukemia (WSR 48.7), central nervous system neoplasms (WSR 23.0), and lymphoma (WSR 16.6). The overall ASR in age group 15–19 years was 152.3 with lymphoma ranking first (ASR 30.2). Incidence was higher in males than in females, and higher in South America than in Central America and the Caribbean. Compared with global data LAC incidence was lower overall, except for leukemia and lymphoma at age 0–14 years and the other and unspecified tumors at any age. Overall incidence at age 0–19 years increased by 1.0% per year (95% CI [0.6, 1.3]) over 1993–2012. The included registries covered 16% of population aged 0–14 years and 10% of population aged 15–19 years. Conclusions. The observed patterns provide a baseline to assess the status and evolution of childhood cancer occurrence in the region. Extended and sustained support of cancer registration is required to improve representativeness and timeliness of data for childhood cancer control in LAC.

RESUMO Objetivo. Apresentar uma visão abrangente dos padrões geográficos (2001 a 2010) e das tendências temporais (1993 a 2012) da incidência de câncer em crianças e jovens de 0 a 19 anos na América Latina e no Caribe (ALC) e interpretar os resultados no contexto de padrões mundiais. Métodos. Foram descritas variações geográficas de 2001 a 2010 e tendências de incidência de 1993 a 2012 na população com menos de 20 anos da ALC usando informações comparáveis da base de dados do terceiro volume do estudo International Incidence of Childhood Cancer. Foram calculadas taxas de incidência específica por idade por milhão de pessoas-ano (ASR, na sigla em inglês) para subgrupos populacionais e taxas padronizadas por idade usando a população padrão mundial (WSR, na sigla em inglês). Resultados. No total, foram incluídos 36 744 casos únicos. No período de 2001 a 2010, a WSR para todos os tumores combinados na faixa etária de 0 a 14 anos foi de 132,6. Os diagnósticos mais frequentes foram leucemia (WSR de 48,7), neoplasias do sistema nervoso central (WSR de 23,0) e linfoma (WSR de 16,6). A ASR para todos os tumores combinados na faixa etária de 15 a 19 anos foi de 152,3, e a maior taxa foi a de linfoma (ASR de 30,2). A incidência foi maior no sexo masculino do que no sexo feminino e maior na América do Sul do que na América Central e no Caribe. De modo geral, em comparação com as estimativas mundiais, a incidência na ALC foi menor, exceto para leucemia e linfoma entre 0 e 14 anos e para outros tumores e tumores não especificados em qualquer idade. A taxa de incidência na faixa etária de 0 a 19 anos aumentou em 1,0% ao ano (IC de 95% [0,6, 1,3]) entre 1993 e 2012. Os registros incluídos cobriam 16% da população de 0 a 14 anos e 10% da população de 15 a 19 anos. Conclusões. Os padrões observados servem de referência para avaliar o status e a evolução da ocorrência de câncer infantil na região. É necessário garantir um apoio ampliado e consistente aos registros de câncer para aprimorar a representatividade e a disponibilidade das informações em tempo adequado para o controle do câncer infantil na ALC.

https://doi.org/10.26633/rpsp.2024.11

Traits of the host trees, not community diversity, drive epiphytes abundance in tropical seasonal forests trees diversity
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Schievenin, Dimitrio Fernandes

; Santos, Camila Alonso

; Lima, Karina de

; Melo, Antônio Carlos Galvão de

; Engel, Vera Lex

; Durigan, Giselda

Biota Neotropica

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2024, Volume 24 N. 1 elocation e20231558

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract Epiphytes are considered indicators of forest ecological integrity, but the factors that explain their abundance are still not well understood. We here evaluated tree colonization by epiphytes in old-growth monospecific reforestation stands of Astronium urundeuva (M.Allemão) Engl. (Anacardiaceae) and Eucalyptus saligna Sm. (Myrtaceae), in comparison to a neighbor seasonal tropical forest fragment under similar environmental conditions. In each forest type, we identified and measured all trees (planted and colonizers) from 5-cm stem diameter in five 200 m² plots and quantified all vascular epiphytes per tree. Tree species were categorized by bark roughness, canopy deciduousness and growth rate. The abundance of epiphytes and the frequency of host trees were higher in the A. urundeuva plantation than in the native forest, with the E. saligna stand in an intermediate position. Also, we found that host traits influenced the abundance of epiphytes in their trunks. Host trees had average stem perimeter and height both higher than non-hosts, which indicates that colonization is more likely to occur in older trees. The average abundance of epiphytes per tree was higher in species with rough bark, but no relationship was found with canopy deciduousness or tree growth rate. We evidenced, therefore, that forest plantations, even if monospecific, can provide habitat for epiphytes. However, at community level, colonization success, either in native or restored forest, depends on the relative abundance of species whose bark type favors epiphytes establishment. integrity understood oldgrowth old M.Allemão MAllemão M Allemão (M.Allemão Engl Anacardiaceae (Anacardiaceae Sm Myrtaceae, Myrtaceae , (Myrtaceae) conditions planted colonizers 5cm cm 5 20 m roughness rate A E position Also trunks nonhosts, nonhosts non hosts, hosts non-hosts evidenced therefore plantations However level success establishment (Myrtaceae 2

Resumo Epífitas são consideradas indicadores de integridade ecológica em florestas, mas os fatores que explicam sua abundância ainda não são bem compreendidos. Neste estudo, avaliamos a colonização por epífitas em antigos talhões monoespecíficos de Astronium urundeuva (M.Allemão) Engl. (Anacardiaceae) e Eucalyptus saligna Sm. (Myrtaceae), em comparação com um fragmento vizinho de floresta estacional semidecidual sob condições ambientais semelhantes. Em cada tipologia florestal, identificamos e medimos todas as árvores (plantadas e que colonizaram os locais) a partir de 5 cm de diâmetro à altura padrão, em cinco parcelas de 200 m². Nelas, também quantificamos todas as epífitas vasculares por árvore. Em busca de uma explicação funcional para as diferenças entre espécies, utilizamos rugosidade da casca, deciduidade da copa e taxa de crescimento como atributos potencialmente relevantes. A abundância das epífitas e a frequência de forófitos foi maior no talhão de A. urundeuva do que na floresta nativa, com o talhão de E. saligna ocupando uma posição intermediária. Encontramos evidências, também, de que os atributos dos forófitos influenciaram a abundância de epífitas em seus troncos. Os forófitos apresentaram maior perímetro médio e altura que as árvores não hospedeiras, o que indica que a colonização é mais provável de ocorrer em árvores mais velhas. A abundância média de epífitas por árvore foi maior em espécies com casca rugosa, mas nem a deciduidade da copa, nem a velocidade de crescimento exerceram efeito neste aspecto. Evidenciamos, portanto que, plantações florestais, ainda que monoespecíficas, podem prover habitat para epífitas. Contudo, em nível de comunidade, o sucesso da colonização, seja em florestas nativas ou restauradas, depende da abundância relativa de espécies cujo tipo de casca favorece o estabelecimento de epífitas. compreendidos estudo M.Allemão MAllemão M Allemão (M.Allemão Engl Anacardiaceae (Anacardiaceae Sm Myrtaceae, Myrtaceae , (Myrtaceae) semelhantes florestal plantadas locais padrão 20 m² m Nelas relevantes nativa E intermediária evidências troncos hospedeiras velhas rugosa aspecto Evidenciamos florestais monoespecíficas Contudo comunidade restauradas (Myrtaceae 2

https://doi.org/10.1590/1676-0611-bn-2023-1558

Fertility and carbon stock in pasture and forest environments in the Southern Amazon
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Silva, Fernando L.

; Silva, Marcus H. M. e

; S. Oliveira-Júnior, Ernandes

; López-Alonso, Marta

; Pierangeli, Maria A. P.

Revista Brasileira de Engenharia Agrícola e Ambiental

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2024, Volume 28 N. 1 elocation e270888

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT Inadequate management of pasture soils in the Amazon has resulted in a predominance of degraded pastures. Considering the natural characteristics of this region can favor more appropriate strategies for sustainability, the objective of this study was to evaluate the differences in the chemical and physical attributes of pasture and forest soils in the Southern Amazon and to identify the most sensitive attributes of their fertility. Additionally, this study suggests appropriate management practices for sustainable pastures. Soil samples from the 0 to 0.20 m layer were analyzed to determine pH, exchangeable bases (calcium, magnesium, and potassium), exchangeable aluminum, potential acidity, phosphorus, organic carbon, bulk density, and texture. Pasture soils had a higher pH, calcium content, and bulk density than forest soils. However, the pasture soils had lower phosphorus and organic matter content. The soil organic carbon stocks were also lower in pasture soils, with levels 0.8 to 12 Mg ha-1 lower than in forest soils. The fertility attributes most sensitive to soil management in these pastures were phosphorus, pH, organic carbon, and bulk density. The lack of nutrients and soil and water conservation practices have contributed to the degradation of these pastures. Therefore, the recommended management for these pastures should aim to improve the organic matter content, reduce compaction, and replenish and cycle nutrients. sustainability Additionally 020 20 0.2 pH calcium, (calcium magnesium potassium, potassium , potassium) aluminum acidity texture content However 08 8 0. 1 ha1 ha ha- Therefore compaction 02 2

RESUMO O manejo inadequado de solos de pastagens na Amazônia resulta em predomínio de pastagens degradadas. Considerando as características naturais dessa região pode favorecer estratégias mais adequadas para sua sustentabilidade, o objetivo desse estudo foi avaliar as diferenças de atributos químicos e físicos de solos de pastagens e florestas no sul da Amazônia e identificar os atributos mais sensíveis de sua fertilidade. Além disso, sugerir práticas de manejo mais adequadas para essas pastagens em direção à sustentabilidade. Amostras de solo da camada de 0 a 0,20 m foram analisadas para determinação de pH, bases trocáveis (cálcio, magnésio e potássio), alumínio trocável, acidez potencial, fósforo, carbono orgânico, densidade aparente e textura. Os solos de pastagem tiveram maior pH, cálcio e densidade aparente do que os solos de floresta. No entanto, os solos de pastagem apresentaram menores teores de fósforo e matéria orgânica. Os estoques de carbono orgânico do solo também foram menores nas pastagens, com teores de 0,8 a 12 Mg ha-1 inferiores aos solos da floresta. Os atributos de fertilidade mais sensíveis ao manejo do solo nessas pastagens foram fósforo, pH, carbono orgânico e densidade aparente. A carência de nutrientes e de práticas de conservação do solo e da água têm contribuído para o estado de degradação dessas pastagens. Portanto, o manejo recomendado para essas pastagens deve visar a melhoria da matéria orgânica, redução da compactação, além da reposição e ciclagem de nutrientes. degradadas sustentabilidade disso 020 20 0,2 pH cálcio, (cálcio potássio, potássio , potássio) trocável potencial textura floresta entanto orgânica 08 8 0, 1 ha1 ha ha- Portanto compactação 02 2

https://doi.org/10.1590/1807-1929/agriambi.v28n1e270888

Effect of cationic surfactant on the physicochemical and antibacterial properties of colloidal systems (emulsions and microemulsions) emulsions microemulsions
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Rambo, M. K. D.

; Lins, R. F.

; Silva, F. L. N

; Alonso, A.

; Rambo, M. C. D.

; Leal, J. E. C

; Sousa-Neto, D. de

Brazilian Journal of Biology

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2024, Volume 84 elocation e278013

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract Colloidal systems have been used to encapsulate, protect and release essential oils in mouthwashes. In this study, we investigated the effect of cetylpyridinium chloride (CPC) on the physicochemical properties and antimicrobial activity of oil-in-water colloidal systems containing tea tree oil (TTO) and the nonionic surfactant polysorbate 80. Our main aim was to evaluate whether CPC could improve the antimicrobial activity of TTO, since this activity is impaired when this essential oil is encapsulated with polysorbate 80. These systems were prepared with different amounts of TTO (0-0.5% w/w) and CPC (0-0.5% w/w), at a final concentration of 2% (w/w) polysorbate 80. Dynamic light scattering (DLS) results revealed the formation of oil-swollen micelles and oil droplets as a function of TTO concentration. Increases in CPC concentrations led to a reduction of around 88% in the mean diameter of oil-swollen micelles. Although this variation was of only 20% for the oil droplets, the samples appearance changed from turbid to transparent. The surface charge of colloidal structures was also markedly affected by the CPC as demonstrated by the transition in zeta potential from slightly negative to highly positive values. Electron paramagnetic resonance (EPR) studies showed that this transition is followed by significant increases in the fluidity of surfactant monolayer of both colloidal structures. The antimicrobial activity of colloidal systems was tested against a Gram-negative (Escherichia coli) and Gram-positive (Staphylococcus aureaus) bacteria. Our results revealed that the inhibition of bacterial growth is observed for the same CPC concentration (0.05% w/w for E. coli and 0.3% w/w for S. aureus) regardless of TTO content. These findings suggest that TTO may not act as an active ingredient in polysorbate 80 containing mouthwashes. encapsulate mouthwashes study (CPC oilinwater water (TTO 00.5% 005 0 0.5% 5 (0-0.5 ww w w/w, , 2 (w/w DLS (DLS oilswollen swollen 88 20 transparent values EPR (EPR Gramnegative Gram Escherichia Grampositive Staphylococcus aureaus bacteria 0.05% 05 (0.05 E 03 3 0.3 S aureus content 8 00 00.5 0.5 (0-0. 0.05 (0.0 0. 00. (0-0 0.0 (0. (0- (0 (

Resumo Sistemas coloidais têm sido usados para encapsular, proteger e liberar óleos essenciais em enxagues bucais. Neste estudo, investigamos o efeito do cloreto de cetilpiridínio (CPC) nas propriedades físico-químicas e na atividade antimicrobiana de sistemas coloidais do tipo óleo-em-água contendo óleo de melaleuca (TTO) e o surfactante não iônico polissorbato 80. Nosso principal objetivo foi avaliar se o CPC poderia melhorar a atividade antimicrobiana do TTO, uma vez que ela é prejudicada quando este óleo essencial é encapsulado com polisorbato 80. Estes sistemas foram preparados com diferentes quantidades de TTO (0-0,5% m/m) e CPC (0-0,5% m/m) para uma concentração final de polissorbato 80 de 2% (m/m). Os resultados de espalhamento de luz dinâmico (DLS) revelaram a formação de micelas e gotículas inchadas de óleo em função da concentração de TTO. Aumentos nas concentrações de CPC resultaram numa redução de cerca de 88% no diâmetro médio das micelas inchadas com óleo. Embora esta variação tenha sido de apenas 20% para as gotículas de óleo, a aparência das amostras mudou de turva para transparente. A carga superficial das estruturas coloidais também foi significativamente afetada pelo CPC, como demonstrado pela transição no potencial zeta de valores levemente negativos para valores muito positivos. Estudos de ressonância paramagnética eletrônica (EPR) mostraram que esta transição é seguida por aumentos significativos na fluidez da monocamada de surfactante em ambas as estruturas coloidais. A atividade antimicrobiana dos sistemas coloidais foi testada contra bactérias Gram-negativas (Escherichia coli) e Gram-positivas (Staphylococcus aureaus). Nossos resultados revelaram que a inibição do crescimento bacteriano é observada para a mesma concentração de CPC (0,05% m/m para E. coli e 0,3% m/m para S. aureus), independentemente do conteúdo de TTO. Estas descobertas sugerem que o TTO não deve atuar como ingrediente ativo em enxagues bucais contendo polissorbato 80. encapsular estudo (CPC físicoquímicas físico químicas óleoemágua água (TTO 00,5% 005 0 0,5% 5 (0-0,5 mm m 8 2 m/m. . (m/m) DLS (DLS 88 20 transparente positivos EPR (EPR Gramnegativas Gram negativas Escherichia Grampositivas positivas Staphylococcus aureaus. aureaus aureaus) 0,05% 05 (0,05 E 03 3 0,3 S aureus, aureus , aureus) 00 00,5 0,5 (0-0, (m/m 0,05 (0,0 0, 00, (0-0 0,0 (0, (0- (0 (

https://doi.org/10.1590/1519-6984.278013

Concordancia entre el Índice de Capacidad Laboral y los Años de Discapacidad Sobrevenida Estimados mediante metodología PoRT-9LSQ
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Soriano-Tarín, Guillermo

; Francisco-García, Juan C

; Alonso-Bosque, José M

; Valle-Robles, Marisa

; Bernabeu-Atanasio, Alba

Archivos de Prevención de Riesgos Laborales

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dec 2023, Volume 26 N. 4 Pages 259 - 274

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Objetivo: Analizar la asociación entre los estilos de vida y factores de riesgo para la salud que pueden suponer un abandono prematuro del trabajo, con los años de discapacidad sobrevenida estimados (ADSE) en población laboral, y calcular la correlación entre el Índice de Capacidad Laboral (ICL) y el Work Ability Score (WAS), y ambos con los ADSE y su coste económico. Métodos: Estudio transversal en una muestra de trabajadores a los que se realizó un examen de salud. La información se recogió mediante los cuestionarios ICL y WAS, y la metodología PoRT-9LSQ. Se realizó un análisis de la asociación entre los factores de riesgo analizados y los ADSE mediante regresión lineal y análisis de la varianza (ANOVA). Se analizó la correlación entre ICL y WAS usando el coeficiente de correlación intraclase (CCI), y con los ADSE y su coste económico mediante regresión lineal ajustada. Resultados: Se incluyeron 590 trabajadores. Los factores que más influyeron en la media de ADSE fueron el sedentarismo, la mala alimentación y el sobrepeso/obesidad, con diferencias estadísticamente significativas según sexo, turno y ocupación (p<0,05). El CCI entre ICL y WAS fue del 93,0% para una valoración excelente/buena. La regresión lineal ajustada entre ICL y los ADSE fue de 7,982-0,136xICL (p<0,05), siendo similar para el WAS. Conclusiones: El ICL se ha mostrado útil para la predictibilidad de los ADSE en población laboral, lo que facilitará la toma de decisiones del personal sanitario para identificar personas vulnerables favoreciendo cambios en los estilos de vida y el autocuidado.

Abstract Objective: To analyze the association between lifestyles and health risk factors that can lead to prematurely leaving work, with the expected Years Lived with Disability (AYLD) in a working population, and to calculate the correlation between the Work Ability Index (WAI) and the Work Ability Score (WAS), and then both of these with the AYLD and its economic cost. Methods: A cross-sectional study in a sample of workers who underwent a health examination. The information was collected using the ICL and WAS questionnaires, applying the PoRT-9LSQ methodology. Linear regression and analysis of variance (ANOVA) were used to analyze the association between the risk factors and AYLD. The correlation between WAI and WAS was analyzed using the intraclass correlation coefficient (ICC), and then between each of these the AYLD and its economic cost using adjusted linear regression. Results: A total of 590 workers were included. Factors that most influenced the average AYLD were a sedentary lifestyle, poor diet, and overweight/obesity, with statistically significant differences according to sex, shift, and occupation (p<0.05). An ICC of 93.0% was found between ICL and WAS, a good/excellent rating. The adjusted linear regression between ICL and ADSE was 7.982-0.136xICL (p<0.05), and was similar for WAS. Conclusions: The WAI is useful for predicting AYLD in the working population. This can facilitate decisionmaking by health personnel to identify vulnerable people, encouraging changes in lifestyle and self-care.

https://doi.org/10.12961/aprl.2023.26.04.02

Efecto de la densidad de población y la fertilización sobre la productividad del agua y rendimientos de híbridos de maíz en el Valle de México
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Alonso-Sánchez, Homero

; Tadeo-Robledo, Margarita

; Espinosa-Calderón, Alejandro

; Zaragoza-Esparza, Job

; López-López, Consuelo

; Zamudio-González, Benjamín

; Monter-Santillán, Alan

; Turrent-Fernández, Antonio

; Arteaga-Escamilla, Israel

; Mora-García, Karina

Terra Latinoamericana

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dec 2023, Volume 41 elocation e1577

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Summary: Food insufficiency in corn and water and fertilizer crisis worldwide demand efficiency in the use of resources, increasing or conserving production. Thus, the objective of this research is to explore the response of four white maize hybrids released for valles Altos in two environments considering two population densities, two doses of fertilization and an unfertilized control group. Hybrids were evaluated in a factorial arrangement in Cuautitlan (FESC-UNAM) and Texcoco (CEVAMEX), Mexico State, at two planting densities (D1 = 75,000; D2 = 90,000 plants ha-1) with three fertilization treatments (F1 = 160-80-00, F2 = 120-40-00, F3 = 00-00-00). The completely randomized block design experiment was made up of the treatments and the combination of the factors 2×4×2×3 established in three repetitions. The means were compared with Tukey’s test (P < 0.05). In FESC-UNAM with less total water, the result of grain yield and water productivity was 5.96 Mg ha-1 and 1.29 kg m-3 in CEVAMEX 4.76 Mg ha-1 and 0.5 kg m-3; the Atziri Puma hybrid stood out with 6.52 Mg ha-1 and 1.09 kg m-3. No significant effect of planting density was observed and D1 resulted with 5.32 Mg ha-1 and 0.9 kg m-3 versus D2 with 5.40 Mg ha-1 and 0.9 kg m-3. In fertilization F1 was statistically higher with 5.64 Mg ha-1 and 0.94 kg m-3. Nevertheless, no difference was observed between F2 (5.24 Mg ha-1 and 0.88 kg m-3) and the control F3 (5.19 Mg ha-1 and 0.87 kg m-3), which showed the interaction of the environments with hybrids, of which Atziri Puma stood out at FESC-UNAM (7.3 Mg ha-1 and 1.58 kg m-3). The FESC-UNAM site has productive potential under rainfed conditions with the Puma and INIFAP hybrids.

Resumen: La insuficiencia alimentaria en maíz, la crisis de agua y fertilizantes a nivel mundial, demandan incrementar la eficiencia en el uso de recursos incrementando o conservando la producción. El objetivo del trabajo fue definir la respuesta de cuatro híbridos de maíz blanco (Tlaoli Puma, Atziri Puma, H-49 AE y H-47 AE) en dos ambientes con dos densidades de población y dos dosis de fertilización y testigo sin fertilizar. Como arreglo factorial, en los ambientes Cuautitlán (FESC-UNAM) y Texcoco (CEVAMEX), Estado de México, se evaluaron los híbridos con dos densidades de siembra (D1=75 000; D2=90 000 plantas ha-1) y tres tratamientos de fertilización (F1=160-80-00, F2=120-40-00, F3=00-00-00). El experimento en bloques completos al azar se conformó con los tratamientos y la combinación de los factores 2×4×2×3 establecidos en tres repeticiones. Las medias se compararon con el método Tukey (P < 0.05). Para el rendimiento de grano y productividad del agua, en la FESC-UNAM con menor agua total, resultaron de 5.96 Mg ha-1 y 1.29 kg m-3 en CEVAMEX 4.76 Mg ha-1 y 0.5 kg m-3; el híbrido Atziri Puma sobresalió con 6.52 Mg ha-1 y 1.09 kg m-3. No se observó efecto significativo de la densidad de siembra y D1 resultó con 5.32 Mg ha-1 y 0.9 kg m-3 contra D2 con 5.4 Mg ha-1 y 0.9 kg m-3. En la fertilización, F1 fue superior estadísticamente con 5.64 Mg ha-1 y 0.94 kg m-3, pero no hubo diferencia entre F2 (5.24 Mg ha-1 y 0.88 kg m-3) y el control F3 (5.19 Mg ha-1 y 0.87 kg m-3). Se presentó interacción de los ambientes con los híbridos y destacó el híbrido Atziri Puma en la FESC-UNAM (7.3 Mg ha-1 y 1.58 kg m-3). El sitio FESC-UNAM tiene potencial productivo en condiciones de temporal con los híbridos Puma e INIFAP.

https://doi.org/10.28940/terra.v41i0.1577

Estudio del switch de adalimumab por su biosimilar en un hospital de tercer nivel
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Sanz-Alonso, V

; Leralta-González, C

; Marín Gorricho, R

; Iturbe-Heras, M

; Hurtado Gómez, MF

; Caso-González, A

Revista de la OFIL

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sep 2023, Volume 33 N. 3 Pages 253 - 257

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Objetivos: Debido al aumento en el consumo de los medicamentos biológicos y al impacto que esto supone en el gasto hospitalario, los objetivos de este estudio son: calcular el ahorro económico anual generado por el switch a adalimumab biosimilar y analizar el porcentaje de pacientes que mantienen dicho tratamiento en un hospital de tercer nivel. Material y métodos: Estudio descriptivo, observacional, longitudinal, retrospectivo en el que se incluyeron un grupo de pacientes a los que se les realizó switch de adalimumab por su biosimilar cuando en la Comisión Asesora Técnica de medicamentos de la comunidad se autorizó dicho cambio. Resultados: De los 218 pacientes, nueve tuvieron que volver al medicamento original (4,13%). La motivación fue: pérdida de eficacia en cinco, reacción alérgica en tres y otro, un paciente pediátrico con dolor tras la inyección del medicamento biosimilar. El coste de adquisición en nuestro hospital de una unidad del medicamento original es de 195,6 €, mientras que del biosimilar es de 75 €. Si consideramos una posología cada dos semanas, ya que es la más frecuente en nuestros pacientes, el coste anual por paciente con el original sería de 5.085 € y con el biosimilar de 1.950 €. Por lo tanto, el ahorro anual que supone el cambio del medicamento original al biosimilar es de 683.560 €. Conclusiones: El switch de adalimumab original al biosimilar supone un importante ahorro económico sin que se reduzca la efectividad en el proceso de su enfermedad. Lo que contribuye a la eficiencia y sostenibilidad del sistema sanitario. En nuestra población, el 4,13% tuvo que volver al medicamento original. Sería conveniente realizar estudios en un número superior de pacientes y continuar su seguimiento a largo plazo para obtener conclusiones más firmes.

Summary Objectives: Due to the increase in the consumption of biologic drugs and the impact this has on hospital spending, the objectives of this study are: to calculate the economic savings generated by switching to biosimilar adalimumab and to analyze the percentage of patients who maintain this treatment in a tertiary level hospital. Material and methods: Descriptive, observational, longitudinal, retrospective study that included a group of patients who were switched from adalimumab to its biosimilar, when the Technical Advisory Committee for Medicines of the community authorized the change. Results: Of the 218 patients, nine had to return to the original drug (4.13%). The motivation was: loss of efficacy in five, allergic reaction in three and the other was a pediatric patient with pain after injection of the biosimilar drug. The acquisition cost in our hospital of an unit of the original drug is €195.6, while that of the biosimilar is €75. If we consider a dosage every two weeks, since this is the most frequent in our patients, the annual cost per patient with the original drug would be €5,085 and with the biosimilar €1,950. Therefore, the annual savings from switching from the original drug to the biosimilar is €683,560. Conclusions: Switching from the original adalimumab to the biosimilar means significant economic savings without reducing the effectiveness of the disease process. This contributes to the efficiency and sustainability of the halthcare system. In our population, 4.13% had to return to the original drug. It would be advisable to carry out the study in a larger number of patients and to continue its long-term follow-up to obtain firmer conclusions.

https://doi.org/10.4321/s1699-714x2023000300006

Atezolizumab in advanced or metastatic urothelial carcinoma after platinum-based chemotherapy: experience in real clinical practice
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García Basas, L

; Sánchez Cuervo, M

; Pérez Anchordoqui, D

; Alonso Gordoa, T

; Álvarez Díaz, A

Revista de la OFIL

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sep 2023, Volume 33 N. 3 Pages 277 - 283

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Introducción: Los resultados de los ensayos clínicos a menudo difieren de la práctica real. Atezolizumab mostró un perfil de eficacia y seguridad favorable en pacientes con carcinoma urotelial avanzado en recaída tras quimioterapia basada en platino en el ensayo IMvigor211. Este estudio compara las características basales de los pacientes tratados con atezolizumab en la práctica clínica real y en el ensayo IMvigor211 y también su eficacia y seguridad. Métodos: Estudio observacional retrospectivo realizado en un hospital terciario. Se incluyeron todos los pacientes que recibieron atezolizumab entre el 10 de enero de 2018 y el 5 de marzo de 2020. Se evaluó la supervivencia libre de progresión, la supervivencia global y el número de discontinuaciones por efectos adversos. Resultados: Se incluyeron 29 pacientes, con un seguimiento de 5,1 meses (rango 0-21,6). La mediana de edad fue 75 años frente a los 67 años de los pacientes del ensayo IMvigor211. La supervivencia libre de progresión fue 2,7 meses (IC95% 1,9-3,5) frente a 2,1 meses (IC95% 2,1-2,2) en el IMvigor211. La supervivencia global fue 5,1 meses (IC95% 1,9-8,3) frente a 8,6 meses (IC95% 7,8-9,6) en el IMvigor211. Hubo un 13,8% de interrupciones por toxicidad frente al 3,5% de pacientes que discontinuaron el tratamiento en el ensayo IMvigor211. Conclusión: En la práctica clínica real, los pacientes tienen peor estado basal que los del ensayo IMvigor211. Los resultados en la práctica real son similares a los del ensayo clínico. Se necesitan estudios con un mayor seguimiento y número de pacientes para confirmar estas hipótesis.

Summary Introduction: Clinical trial results with new cancer therapies often differ from the results observed in daily practice. Atezolizumab showed durable responses and a favorable safety profile for patients with advanced urothelial carcinoma refractory to platinum-based chemotherapy in the IMvigor211 trial. This study was conducted to compare patients treated in real clinical practice and IMvigor211 trial regarding baseline characteristics, effectiveness and safety. Material and methods: Retrospective, observational study of data collection in a tertiary hospital. Patients receiving atezolizumab between January 10, 2018, and March 5, 2020, were included. Primary endpoints were progression free survival, overall survival and the number of discontinuations due to adverse events. Results: Twenty-nine patients were studied with a median follow up of 5.1 months (range 0-21.6). Median age was 75 years in our cohort and 67 years in the IMvigor211 trial. The median progression free survival was 2.7 months (95%CI 1.9-3.5) versus 2.1 months (95%CI 2.1-2.2) in the IMvigor211. The median overall survival was 5.1 months (95% CI 1.9-8.3) versus 8.6 months (95%CI 7.8-9.6) in the IMvigor211. There was a 13.8% of treatment withdrawals due to immune related toxicity compared to 3.5% of patients who discontinued treatment due to the same cause in IMvigor211. Conclusion: Patients treated in real clinical practice have less favorable baseline characteristics than patients in the IMvigor211 trial. Results in real clinical practice are similar to those of the clinical trial. Further studies with a longer median follow up and a more significant number of patients would be warranted to confirm these hypotheses.

https://doi.org/10.4321/s1699-714x2023000300011

10.

Nuevos inhibidores de aminopeptidasa N, aminopeptidasa A y dipeptidil peptidasa IV con potenciales aplicaciones biomédicas en cáncer
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Pascual Alonso, Isel

; Arrebola Sánchez, Yarini

; Charli, Jean Louis

; Sánchez Ramírez, Belinda

; Díaz Guevara, Lisset

; Valdés Tresanco, Mario Ernesto

; Valiente Flores, Pedro A.

; Rivera Méndez, Laura

; García Rodríguez, Gabriela

; Almeida García, Fabiola

; Bergado Baez, Gretchen

; Chávez, María de los Ángeles

; Chappé Pacheco, Mae

; Pedroso Reynaldo, Alejandro

Anales de la Academia de Ciencias de Cuba

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aug 2023, Volume 13 N. 2 elocation e1273

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT Introduction: Cancer is the second leading cause of death in our country and in the world. Within the attractive targets for the design of new anticarcinogenic agents we find aminopeptidases. In particular, within the M1 family, the neutral aminopeptidase (APN, EC 3.4.11.2), the acid aminopeptidase (APA, EC 3.4.11.7) and within the S9 family of serine peptidases, the enzyme dipeptidyl peptidase IV (DPP-IV, EC 3.4.14.5); the before mentioned are targets established for the development of new anticancer agents due to their over-expression in different types of cancer. Considering the biomedical relevance of the inhibition of APN, APA and DPP-IV, the main goal of this paper is to identify new inhibitors of these enzymes with potential biomedical applications. Methods: They were addressed two strategies for the identification of new inhibitors of the enzymes under study: a) identification and biochemical characterization of new low molecular mass inhibitors of APN, APA and DPP-IV, for which virtual screenings were carried out in the base of low molecular mass compounds HitFinder, Maybridge (ThermoFisher), and b) biochemical characterization of the inhibition of APN, APA and DPP-IV by bestatin and bacitracin as new inhibitors of these enzymes. Subsequently, it was carried out the kinetic validation of the new identified inhibitors, they were carried out in silico structure: function relationship studies, it was also evaluated the biodistribution in a rat model as well as their cytotoxic effects on APN+/DPP-IV+ tumor lines. Results: They were identified and kinetically validated five new dual inhibitors of APN, APA and DPP-IV with non-competitive inhibition mechanisms in most cases. In silico studies of Enzyme: inhibitor complexes allowed the identification of non-conserved residues within the corresponding family and this lays the foundations for the rational design of highly selective APN, APA and DPP-IV inhibitors with greater biomedical potential. They were identified for the first time, using a methodology established in this work the presence of APN and DPP-IV in cancer tumor lines with high incidence and mortality in Cuba and the world. The new inhibitors have promising effects on these APN+/DPP-IV+ tumor lines. Conclusions: They are reported for the first-time new inhibitors of APN, APA and DPP-IV, with different inhibition mechanisms, some of them non-competitive, which are more advantageous from the therapeutic point of view than competitive inhibitors, with promising effects on tumor lines related to cancers with high incidence and mortality in Cuba.

RESUMEN Introducción: El cáncer constituye la segunda causa principal de muerte en nuestro país y en el mundo. Dentro de los blancos atractivos para el diseño de nuevos agentes anticancerígenos encontramos las aminopeptidasas. En particular, dentro de la familia M1, la aminopeptidasa neutra (APN, EC 3.4.11.2) y la aminopeptidasa ácida (APA, EC 3.4.11.7) y dentro de la familia S9 de las peptidasas serino, la enzima dipeptidil peptidasa IV (DPP-IV, EC 3.4.14.5) son blancos establecidos para el desarrollo de nuevos anticancerígenos debido a su sobreexpresión en diferentes tipos de cáncer. Teniendo en cuenta la relevancia biomédica de la inhibición de APN, APA y DPP-IV, el presente trabajo tiene como objetivo la identificación de nuevos inhibidores de estas enzimas con potenciales aplicaciones biomédicas. Métodos: Para la identificación de nuevos inhibidores de las enzimas en estudio se abordaron 2 estrategias de trabajo: a) identificación y caracterización bioquímica de nuevos inhibidores de APN, APA y DPP-IV de baja masa molecular para lo cual se realizaron cribados virtuales en la base de compuestos de baja masa molecular HitFinder, Maybrigde (ThermoFisher) y, b) caracterización bioquímica de la inhibición de APA, APA y DPP-IV por bestatina y bacitracina como nuevos inhibidores de estas enzimas. Posteriormente, se procedió a la validación cinética de los nuevos inhibidores identificados, se realizaron estudios de relación estructura: función in silico, se evaluó la biodistribución en modelo de rata así como se evaluaron sus efectos citotóxicos sobre líneas tumorales APN+/DPP-IV+. Resultados: Se identificaron y validaron cinéticamente 5 nuevos inhibidores duales de APN, APA y DPP-IV con mecanismos de inhibición de tipo no competitivo en la mayoría de los casos. Los estudios in silico de los complejos enzima: inhibidor permitieron la identificación de residuos no conservados dentro de la correspondiente familia y que sientan las bases para el diseño racional de inhibidores de APN, APA y DPP-IV altamente selectivos y con mayores potencialidades biomédicas. Se identificaron por primera vez la presencia de APN y DPP-IV en líneas tumorales de cáncer de alta incidencia y mortalidad en Cuba y el mundo, mediante una metodología establecida en el presente trabajo. Los nuevos inhibidores tienen efectos promisorios sobre estas líneas tumorales APN+/DPP-IV+. Como conclusiones, se informan por primera vez nuevos inhibidores de APN, APA y DPP-IV, con diferentes mecanismos de inhibición, algunos de ellos de tipo no competitivos, que resultan más ventajosos desde el punto de vista terapéutico que inhibidores competitivos, con efectos promisorios sobre líneas tumorales relacionadas con canceres de alta incidencia y mortalidad en Cuba.

11.

Articulos
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Coma, E

; Caíala, M

; Méndez Boo, L

; Alonso, S

Archivos argentinos de pediatría

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jun 2023, Volume 121 N. 3 Pages 20 - 20

Abstract: Es | Text: Es | PDF: Es

12.

Indicadores basados en consumo en una Unidad de Cuidados Intensivos sin implantación de PROA
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Plasencia García, I

; Tévar Alfonso, E

; Ferrer Machín, A

; Betancor García, T

; Merino Alonso, J

; Martín Velasco, M

Revista de la OFIL

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mar 2023, Volume 33 N. 1 Pages 27 - 31

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Objetivo: Medir los indicadores del uso hospitalario de antibióticos basados en datos de consumo, comparando datos entre 2018 y 2019 en una Unidad de Medicina Intensiva de un hospital de tercer nivel sin implantación de Programas de Optimización de Antibióticos (PROA). Métodos: Asignar un valor a cada indicador evaluado en base a datos de consumo empleando los datos del programa de gestión del Servicio de Farmacia y las DDD por cada 100 estancias. En base a la diferencia de las medias obtenidas entre 2018 y 2019 se calculó la significación estadística mediante la t-Student de medidas pareadas. Resultados: Se evaluaron 13 indicadores, de los cuales sólo 2 (15%) presentaron diferencias estadísticamente significativas, el consumo de fluorquinolonas y el ratio fluconazol/equinocandinas, mostrando una evolución positiva. Conclusiones: El empleo de estos indicadores deberían estandarizarse para la evaluación de las políticas antibióticas de los centros, lo que serviría para establecer comparaciones entre centros de similares características o bien la evolución temporal para un mismo centro y/o servicio. Esto permitiría detectar puntos críticos y establecer acciones de mejora, entre ellas la creación de equipos PROA, especialmente en unidades de pacientes críticos.

Abstract Objective: The aim of our study is to calculate the indicators of hospital use of antimicrobial agents based on consumption, comparing data from 2018 with data from 2019 in an Intensive Care Unit of a third level hospital without an stewardship program. Methods: Retrospective study in which we assigned a value to each indicator based on consumption using DDD per 100 bed-stays. Data was obtained using the pharmacy management software. Statistical analysis was performed by t-Student test based on the difference of means obtained in 2018 and 2019 respectively. Results: 13 indicators were evaluated, only 2 of them (15%) showed an statistically significant difference between periods, the consumption of fluoroquinolones and the fluconazole/ echinocandin ratio, both showing a positive evolution. Conclusions: The use of these indicators should be standardized in order to evaluate antibiotic policies, which will help establishing comparisons between centers of specific characteristics or studying the temporal evolution for the same center and/or service. This will allow detecting critical points and establishing improvement actions, including the creation of stewardship programs, especially in critical care units.

https://doi.org/10.4321/s1699-714x2023000100006

13.

Experiencia clínica en hipertensión arterial pulmonar en un hospital general de tercer nivel
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Leralta-González, C

; Caso-González, A

; Sanz-Alonso, V

; Iturbe-Heras, M

; Núñez-Rodríguez, J

Revista de la OFIL

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mar 2023, Volume 33 N. 1 Pages 63 - 69

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Introducción: La hipertensión arterial pulmonar es una enfermedad rara. Cursa con aumento progresivo de la resistencia vascular pulmonar e insuficiencia ventricular derecha y muerte precoz. Los tratamientos específicos han mejorado la esperanza de vida aunque el pronóstico a largo plazo sigue siendo desfavorable con una mortalidad del 40% a los tres años. Materiales y métodos: El estudio es descriptivo observacional trasversal y retrospectivo realizado en un hospital general de tercer nivel entre mayo de 2004 y agosto de 2020. Se midió la capacidad funcional (CF), la presión arterial pulmonar media, el test de la marcha de los 6 minutos (PM6M) entre otras variables. Se recogieron variables de tratamiento farmacológico específico y efectos adversos, así como la adherencia farmacológica. Resultados: La población fue de 27 pacientes, la mayoría mujeres con edad media de 62 años. Más del 80% de los pacientes presentaban CF II-III y PM6M de riesgo intermedio. Los tratamientos en primera línea y monoterapia mayoritarios fueron el sildenafilo y bosentán con un grado de recomendación de Ia, seguidos de ambrisentán. Los otros grupos de fármacos fueron minoritarios en los pacientes. No se encontraron diferencias estadísticamente significativas en la variación del PM6M, sí hubo variación de PAPm de forma positiva. Conclusiones: Todos los pacientes llevaban en tratamiento específico más de tres años, aunque sería necesario ampliar el tamaño muestral. En cuanto a la seguridad los efectos adversos fueron de grado leve y la adherencia al tratamiento elevada.

Abstract Introduction: Pulmonary arterial hypertension is a rare disease. It results a progressive increase in pulmonary vascular resistance and in right ventricular failure and early death. Specific treatments have improved the life expectancy of patients but the long-term prognosis remains poor, resulting in a high mortality of 40% at 3 years. Materials and methods: The research conducted is descriptive, cross-sectional and retrospective. It was carried out in a third level general hospital between May 2004 and August 2020. The measured variables were functional capacity (CF), PAPm, 6-minute walk test (PM6M) and other clinical parameters. Variables related to specific pharmacological treatment and adverse effects, as well as pharmacological adherence were also collected. Results: The study population was 27 patients, most of them women, with an average age of 62 years. More than 80% of patients presented CF II-III and PM6M of moderate risk. First-line and monotherapy treatments were mainly sildenafil and bosentan, with an Ia recommendation level. Ambrisentan was also a first-line treatment. The other drug groups were in the minority among patients. On the other hand, no statistically significant differences in PM6M variation were found, although there was positive variation in PAPm. Conclusions: The patients had been on specific treatment for more than three years. In terms of safety, adverse effects were minor and adherence to treatment high.

https://doi.org/10.4321/s1699-714x2023000100012

14.

Perfil de pacientes grandes consumidores de fentanilo de liberación rápida en un área sanitaria de Córdoba
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Sáez-Torres de Vicente, M

; Plata Illescas, JA

; Aguilar Alonso, E

Revista de la OFIL

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mar 2023, Volume 33 N. 1 Pages 53 - 55

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Objetivo: Describir el tipo de pacientes que superan la dosis diaria definida (DDD) de fentanilo de liberación inmediata en un área sanitaria. Material y métodos: Estudio observacional, descriptivo, realizado en un área sanitaria de 256.807 habitantes en el que se incluyeron todos los pacientes que superaban la DDD de fentanilo de liberación inmediata en diciembre de 2019. Resultados: Se detectaron 29 pacientes, 58,6% mujeres, con una mediana de edad de 59 (31-87) años, que superaban una media de 3 (1,1-10) veces la DDD de fentanilo de liberación inmediata, en sus distintas presentaciones, siendo la indicación en el 69% de los casos dolor crónico no oncológico (DCNO). La mayoría de los pacientes tomaba benzodiacepinas (79,3%) y el mayor porcentaje de primeras prescripciones de fentanilo de liberación rápida procedía de atención primaria (38%). Conclusiones: En nuestro estudio el uso inadecuado o posible abuso de fentanilo de liberación inmediata se da en mayor proporción en pacientes con DCNO, y en la mayoría de los casos la primera prescripción se realizó en atención primaria. No observamos relación clara con patología psiquiátrica ni otras adicciones.

Abstract Objective: To describe the type of patients that exceed the defined daily dose (DDD) of immediate-release fentanyl in a health area. Material and methods: Observational, descriptive study, carried out in a health area of 256,807 inhabitants, which included all patients who passed the immediate-release fentanyl DDD in December 2019. Results: 29 patients were detected, 58.6% female, with a median age of 59 (31-87) years, who exceeded an average of 3 (1.1-10) times the immediate-release fentanyl DDD, in its different presentations, being the indication in 69% of cases chronic non-cancer pain (CNCP). The majority of patients took benzodiazepines (79.3%) and the highest percentage of first-prescriptions for inmediate-release fentanyl came from primary care (38%). Conclusions: In our study, the inappropriate use or possible abuse of immediate-release fentanyl occurs in a greater proportion in patients with CNCP, and in most cases the first prescription was made in primary care. We did not observe a clear relationship with psychiatric pathology or other addictions.

https://doi.org/10.4321/s1699-714x2023000100010

15.

Intervenciones para la exploración del pie en pacientes diabéticos, en atención primaria: una revisión sistemática de guías de práctica clínica
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Ballesteros-Álvaro, A

; Cuesta-Rodríguez, R

; Fernández-Antolinez, A

; Soto-Vallejera, M

; López-Alonso, A

; Martín-Suances, J

; García-Moreno, R

; Mata-Gómez, G

; Miguel-Montoya, S

Ene

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2023, Volume 17 N. 1 elocation 1980

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Objetivo principal: Identificar la mejor evidencia disponible sobre intervenciones efectivas para la exploración y estratificación del PD. Metodología: Revisión de Guías de Práctica Clínica con recomendaciones acerca de la exploración y estratificación del PD. Resultados principales: Recopilamos las intervenciones que son más efectivas para diagnosticar precozmente el PD en A.P recogidas de 10 GPC. Incluyen la evaluación visual de los pies, la valoración de la neuropatía diabética periférica mediante monofilamento de Semmes-Weinstein de 10 g, diapasón de 128 Hz y exploración del reflejo aquíleo, y la valoración de la enfermedad arterial periférica mediante la palpación de pulsos periféricos y determinación del índice tobillo brazo. Posteriormente estratificación del riesgo de desarrollar un PD. Conclusión principal: La monitorización de las extremidades inferiores debe formar parte de los planes de cuidados de los pacientes diabéticos. Se deberían establecer unidades especializadas en atención al PD y poder derivar desde AP a estos pacientes.

Abstract: Interventions for foot examination in diabetic patients in Primary Care: A review of Clinical Practice Guidelines Main objective: To identify the best available evidence on effective interventions in the exploration and diagnosis of DF. Methodology: Review of the Clinical Practice Guidelines with recommendations on the exploration and stratification of DF. Main results: We compiled the interventions that are most effective for early diagnosis of DF in P.C collected in 10 CPG. They include visual assessment of their feet, assessment of diabetic peripheral neuropathy using a 10-g Semmes-Weinstein monofilament, 128-Hz tuning fork, and Achilles reflex testing, assessment of peripheral arterial disease by palpation of peripheral pulses, and determination of the ankle arm index Subsequently, risk stratification of developing DF. Main conclusion: Monitoring of the lower extremities should be part of the care plans for diabetic patients. Specialized units should be established for DF care and these patients should be able to be referred from PC.

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