Summary Objective: To analyze the new prescriptions at discharge from the Emergency Department: utilization profile, degree of adaptation to the Pharmacotherapeutic Guide, quality of the prescription and cost estimation. Method: Cross-sectional descriptive study. The variables included the number of prescribed medications, if it was done according to the Spanish Official Denomination, financing by the National Health System, adaptation to the Pharmacotherapeutic Guide and the existence of a cheaper alternative. The completion of basic data and cost of prescriptions was also checked. Results: A total of 1,252 episodes received 2,152 prescriptions with a mean of 2.1 per episode. Out of them 78% were adapted to the hospital pharmacotherapeutic guide and 88.9% financed drugs. Most common drugs were: acetaminophen, metamizole, ibuprofen, desketoprofen and omeprazole. The deficit filling of the prescription compromised the dispensation in 231 prescriptions (10.7%). In 20 drugs, 57.5% of spending and 73.0% of saving were concentrated. Extrapolating the results to the prescriptions of one year, it is obtained that the expense would be €1,161,008.8, expecting for a reduction in €370,846.2 after adaptation to the guide or € 571,323.3 by adding the medication delivery strategy. Conclusions: New prescriptions at discharge are concentrated in a low number of medications. Acting on them allows a wide margin of economic improvement and increases security. Avoiding the prescription of non-financed medicines and guaranteeing the delivery of the medication upon discharge from the Emergency Department are another of the points of improvement identified.

Resumen Objetivo: Analizar las prescripciones nuevas al alta del Servicio de Urgencias Hospitalario: perfil de utilización, grado de adecuación a la Guía Farmacoterapéutica del hospital (GFT), calidad de la prescripción y estimación de costes. Método: Estudio descriptivo transversal. Las variables incluyeron número de medicamentos prescritos, si se hizo según Denominación Oficial Española, financiación por el Sistema Nacional de Salud, adecuación a la GFT y existencia de alternativa más económica. También se comprobó la cumplimentación de datos básicos y coste de las prescripciones. Resultados: En un total de 1.252 episodios hubo 2.152 prescripciones nuevas al alta. Del total de prescripciones, se adecuaron a la Guía Farmacoterapéutica del hospital el 78,0% y estaban financiadas el 88,9%. Los fármacos más comunes fueron: paracetamol metamizol, ibuprofeno, dexketoprofeno y omeprazol. La cumplimentación deficitaria de la prescripción comprometió la dispensación en 231 prescripciones (10,7%). En 20 presentaciones se concentra el 57,5% del gasto y el 73% del ahorro. Extrapolando los resultados a las prescripciones de un año se obtiene que el gasto farmacéutico sería de 1.161.608,8€, esperándose una reducción en 370.846,2€ tras la adecuación a la guía o de 571.323,3€ añadiendo la entrega de medicación. Conclusiones: Las prescripciones nuevas al alta se concentran en un número bajo de medicamentos. Actuar sobre los mismos permite un amplio margen de mejora económico y aumenta la seguridad. Evitar la prescripción de medicamentos no financiados y garantizar la entrega de la medicación al alta en el Servicio de Urgencias, son otro de las puntos de mejora identificados.

In vivo proton magnetic resonance spectroscopy (¹H-MRS) is a technique capable of assessing biochemical content and pathways in normal and pathological tissue. In the brain, ¹H-MRS complements the information given by magnetic resonance images. The main goal of the present study was to assess the accuracy of ¹H-MRS for the classification of brain tumors in a pilot study comparing results obtained by manual and semi-automatic quantification of metabolites. In vivo single-voxel ¹H-MRS was performed in 24 control subjects and 26 patients with brain neoplasms that included meningiomas, high-grade neuroglial tumors and pilocytic astrocytomas. Seven metabolite groups (lactate, lipids, N-acetyl-aspartate, glutamate and glutamine group, total creatine, total choline, myo-inositol) were evaluated in all spectra by two methods: a manual one consisting of integration of manually defined peak areas, and the advanced method for accurate, robust and efficient spectral fitting (AMARES), a semi-automatic quantification method implemented in the jMRUI software. Statistical methods included discriminant analysis and the leave-one-out cross-validation method. Both manual and semi-automatic analyses detected differences in metabolite content between tumor groups and controls (P < 0.005). The classification accuracy obtained with the manual method was 75% for high-grade neuroglial tumors, 55% for meningiomas and 56% for pilocytic astrocytomas, while for the semi-automatic method it was 78, 70, and 98%, respectively. Both methods classified all control subjects correctly. The study demonstrated that ¹H-MRS accurately differentiated normal from tumoral brain tissue and confirmed the superiority of the semi-automatic quantification method.

We studied the peptide-degrading anaerobic communities of methanogenic reactors from two mesophilic full-scale modified upflow anaerobic sludge blanket (UASB) reactors treating brewery wastewater in Colombia. Most probable number (MPN) counts varied between 7.1 x 10(8) and 6.6 x 10(9) bacteria/g volatile suspended solids VSS (Methanogenic Reactor 1) and 7.2 x 10(6) and 6.4 x 10(7) bacteria/g (VSS) (Methanogenic Reactor 2). Metabolites detected in the highest positive MPN dilutions in both reactors were mostly acetate, propionate, isovalerate and, in some cases, negligible concentrations of butyrate. Using the highest positive dilutions of MPN counts, 50 dominant strains were isolated from both reactors, and 12 strains were selected for sequencing their 16S rRNA gene based on their phenotypic characteristics. The small-subunit rRNA gene sequences indicated that these strains were affiliated to the families Propionibacteriaceae, Clostridiaceae and Syntrophomonadaceae in the low G + C gram-positive group and Desulfovibrio spp. in the class d-Proteobacteria. The main metabolites detected in the highest positive dilutions of MPN and the presence of Syntrophomonadaceae indicate the effect of the syntrophic associations on the bioconversion of these substrates in methanogenic reactors. Additionally, the potential utilization of external electron acceptors for the complete degradation of amino acids by Clostridium strains confirms the relevance of these acceptors in the transformation of peptides and amino acids in these systems.

Modern imaging methods, such as radiological CT/MRI scanning provides real, full 3D data of the body surface and internal structures. This information is stored in DICOM files (a standard protocol in radiology image acquisition). Many image-analysis procedures, such as interactive visualization, morphometry, densitometry, three dimensional reconstruction, etc., can be carried-out on these files. These tasks are performed in a non-invasive and non-destructive manner, and the results can be stored in order to document the case. The present paper describes the basis of image-analysis procedures on DICOM files directed to forensic purposes (socalled "virtopsy"), emphasizing the utility of the method in Pathology, Forensic Traumatology and other fields. The virtopsy must be considered not only as a post-mortem procedure (complementing but not substituting the traditional autopsy), but a way to examine body parts in an interactive manner, whatever the subject is dead or alive. That spreads its utility and makes the method appropriate whenever an accurate, real-time, interactive and reproducible forensic anatomic examination is required.

Los modernos métodos de imagen, como la CT y la RNM proporcionan datos reales y tridimensionales de la superficie y las estructuras internas corporales. Esta información se almacena en ficheros DICOM (un protocolo estándar en adquisición de imagen radiológica). Sobre esos ficheros pueden realizarse muchos procedimientos de análisis de imagen, tales como visualización interactiva, morfometría, reconstrucciones tridimensionales, etc. Estas tareas son realizadas de una manera no invasiva y no destructiva, pudiéndose almacenar los resultados para documentación del caso. El presente trabajo describe las bases de los procedimientos de análisis de imagen sobre ficheros DICOM dirigidos a propósitos forenses (la llamada "virtopsia"), enfatizando la utilidad del método en Patología, Traumatología Forense y otros campos. La "virtopsia" debe ser considerada no sólo como un procedimientos post-mortem (complementando pero no sustituyendo a la autopsia tradicional), sino como un modo de examinar partes corporales de una manera interactiva, sea en el fallecido o en el sujeto vivo. Ello amplia su utilidad y hace apropiado el procedimiento siempre que se requiera un examen anatómico forense reproducible, preciso, interactivo y en tiempo real.