María José Faus

The antioxidant effect of β-caryophyllene protects rat liver from carbon tetrachloride-induced fibrosis by inhibiting hepatic stellate cell activation.

Plant-based whole foods provide thousands of bioactive metabolites to the human diet that reduce the risk of developing chronic diseases. β-Caryophyllene (CAR) is a common constituent of the essential oil of numerous plants, vegetables, fruits and medicinal herbs, and has been used as a flavouring agent since the 1930 s. Here, we report the antioxidant activity of CAR, its protective effect on liver fibrosis and its inhibitory capacity on hepatic stellate cell (HSC) activation. CAR was tested for the inhibition of lipid peroxidation and as a free radical scavenger. CAR had higher inhibitory capacity on lipid peroxidation than probucol, α-humulene and α-tocopherol. Also, CAR showed high scavenging activities against hydroxyl radical and superoxide anion. The activity of 5-lipoxygenase, an enzyme that actively participates in fibrogenesis, was significantly inhibited by CAR. Carbon tetrachloride-treated rats received CAR at 2, 20 and 200 mg/kg. CAR significantly improved liver structure, and reduced fibrosis and the expression of Col1a1, Tgfb1 and Timp1 genes. Oxidative stress was used to establish a model of HSC activation with overproduction of extracellular matrix proteins. CAR (1 and 10 μm) increased cell viability and significantly reduced the expression of fibrotic marker genes. CAR, a sesquiterpene present in numerous plants and foods, is as a natural antioxidant that reduces carbon tetrachloride-mediated liver fibrosis and inhibits hepatic cell activation.

Effects of dietary nucleotides on the fatty acid composition of erythrocyte membrane lipids in term infants

Human milk contains relatively high amounts of acid-soluble nucleotides, mainly CMP, AMP, UMP, IMP, and UDP sugars, and lacks orotate. On the contrary, cows milk and adapted formulas contain high amounts of orotate and very low amounts of CMP and AMP. Nucleotides may be modulators of metabolic functions in gut and liver. To evaluate the possible role of dietary nucleotides in newborn fatty acid metabolism, we studied the polyunsaturated fatty acid (PUFA) composition of erythrocyte membrane phospholipids in 58 term infants at 30 days of age. Twenty of them were fed human milk (HM), 19 an adapted formula (MF), and 19 with the same formula supplemented with nucleotides (NMF) in an amount similar to that present in HM. Relative content of omega 6 and 3 PUFA greater than 18 carbon atoms was significantly reduced especially in phosphatidylethanolamine and phosphatidylserine for infants fed regular MF compared with those fed HM or NMF. Unsaturation index of red blood cell phospholipids showed a similar effect. These results suggest that dietary nucleotides play a role in the in vivo desaturation and elongation of essential fatty acids to long chain PUFA during early life for the human newborn.

Revisión de tests de medición del cumplimiento terapéutico utilizados en la práctica clínica

El incumplimiento farmacoterapéutico constituye un importante problema asistencial que puede afectar a la salud de los pacientes, y es una de las posibles causas del fracaso de los tratamientos. Cada fármaco que se comercializa ha necesitado un gran esfuerzo e inversión, que puede resultar en vano si el enfermo no lo utiliza como debe1,2. La falta de cumplimiento de la pauta terapéutica es un fenómeno común, sobre todo en procesos crónicos, y en ocasiones las razones que conducen a esta conducta son complejas y se basan en el complicado proceso del comportamiento humano3. Actualmente, el incumplimiento del tratamiento farmacológico es la causa del fracaso de muchos tratamientos y conlleva serios problemas en calidad de vida, costes para el sistema de salud y, sobre todo, contribuye a que no se consigan resultados clínicos positivos4. La Organización Mundial de la Salud (OMS) considera la falta de cumplimiento de los tratamientos crónicos y sus consecuencias negativas clínicas y económicas un tema prioritario de la salud pública5. Para facilitar la valoración del cumplimiento, se dispone de una serie de métodos apoyados en la entrevista clínica, en los que, de forma directa, se le pregunta al enfermo sobre su cumplimiento. Estos procedimientos son métodos muy fiables si el paciente se confiesa mal cumplidor y, por tanto, poseen un alto valor predictivo positivo. No obstante, al comparar este método con otros más exactos, se observa que hay un número importante de enfermos que mienten cuando dicen que toman toda la medicación (bajo valor predictivo negativo)6. Es evidente que la identificación de los pacientes incumplidores resulta fundamental; por ello, los profesionales de la salud deben aplicar estos métodos, incorporándolos a la práctica asistencial diaria7. Se plantea una revisión para identificar qué tests se utilizan en la valoración del incumplimiento terapéutico, que sean aplicables, sencillos y que no requieran de un gran esfuerzo y tiempo en la práctica clínica por los profesionales de la salud.También se plantea sugerir qué método o combinación de métodos serían más prácticos, ágiles e idóneos para valorar el cumplimiento terapéutico en atención primaria. Se ha realizado una revisión bibliográfica durante el mes de mayo de 2007 en las bases de datos Medline (PubMed), y en las referencias de los artículos considerados relevantes, para obtener estudios publicados sobre incumplimiento de la medicación. En la estrategia de búsqueda se utilizaron los términos «compliance and drug» y «adherence and drug», en títulos o resúmenes, publicados entre enero de 1990 y mayo de 2007, en artículos en los que la medición del cumplimiento se realizó mediante entrevista clínica (test de incumplimiento). Además, se llevó a cabo una búsqueda en distintas fuentes primarias y en tesis doctorales publicadas en ese mismo período. Los tests encontrados que presentan posibilidades para su aplicación en la práctica clínica se describen a continuación.

Terms used in patient safety related to medication: a literature review

There is a lack of homogeneity in the terminology used in the context of patient safety related to medication. The aim of this review was to identify the terms and definitions used in patient safety related to medication within the scientific literature.

Effect of stress on liver and muscle glycogen phosphorylase in rainbow trout (salmo gairdneri)

Abstract 1. 1. In rainbow trout ( Salmo gairdneri ), liver and muscle glycogen concentrations decreased in response to severe physical disturbance, liver glycogen recovered 30 min after the treatment, probably due to an increase in gluconeogenesis. 2. 2. The activity of glycogen phosphorylase in muscle and liver was increased during disturbance, the former being affected by AMP, the latter not. 3. 3. Lactate and glucose concentrations in blood increased in the early stages of the treatment. Lactate was probably converted into glucose to be used as the source of energy during the disturbance.

Barreras para la implantación de servicios cognitivos en la farmacia comunitaria española

Objetivo Identificar y analizar los elementos que dificultan la diseminacion, la implantacion y la sostenibilidad de distintos servicios cognitivos orientados a los pacientes en la farmacia comunitaria espanola. Diseno Estudio cualitativo en el que se han utilizado entrevistas semiestructuradas, con el fin de realizar un analisis descriptivo. Metodos Se eligieron dos conjuntos de expertos relacionados con la farmacia comunitaria espanola. El primero estaba compuesto de 15 farmaceuticos comunitarios que se habian destacado por sus actividades profesionales y el segundo, por 18 estrategas de la farmacia. Resultados La falta de orientacion clinica de la formacion universitaria, la falta de actitud ante el cambio y la incertidumbre sobre su futuro profesional se identificaron como barreras del farmaceutico individual. Para la farmacia como empresa, se identificaron como barreras la falta de pago por los servicios, la ausencia de mensajes claros y el reducido volumen de la farmacia espanola. En la categoria profesion farmaceutica, el actual sistema de remuneracion, la falta de formacion universitaria clinica y la falta de liderazgo de las instituciones representantes fueron las barreras encontradas. En cuanto a los otros colectivos, se encontro que la falta de apoyo real de las administraciones sanitarias, el desconocimiento de los medicos de los objetivos de los servicios cognitivos farmaceuticos, y la falta de demanda de estos servicios por los pacientes fueron las barreras identificadas. Conclusiones Se han encontrado 12 barreras que se han agrupado en 6 categorias. Estas barreras coinciden con las comunicadas en otros paises.

Interacciones medicamentosas: aproximación para establecer y evaluar su relevancia clínica

La identificacion, prevencion y tratamiento de las interacciones medicamentosas clinicamente relevantes son aspectos fundamentales en la farmacoterapia. En este trabajo se ha pretendido sistematizar la informacion y desarrollar una propuesta para establecer y evaluar la relevancia clinica de las interacciones medicamentosas. Se realizo una revision bibliografica en Medline y PubMed, y en las referencias de los articulos considerados relevantes. En los titulos y resumenes de los articulos se busco el termino «interacciones medicamentosas» combinado con «relevante clinicamente», «relevancia clinica» o «relevante significativamente». Se incluyeron las publicaciones realizadas en humanos, en ingles o espanol, entre enero de 1996 y junio de 2006. Se presentan el tipo y mecanismo de las interacciones medicamentosas, especialmente las asociadas a cambios en el aclaramiento sistemico y en la biodisponibilidad; se propone una secuencia de pasos a seguir para establecer la relevancia clinica de las interacciones y una clasificacion basada en la gravedad y probabilidad de aparicion.

Providing Patient Care in Community Pharmacies in Spain

OBJECTIVE To review the current status of Spanish community pharmacy, both in practice and research terms, and analyze its future trends. FINDINGS Spain has a social security system where all citizens receive health care, social services, and pensions. All medical care and surgery are free for citizens; however, community pharmacies in Spain are privately owned. There are geographic and population standards for the establishment of new pharmacies, resulting in an average of 1 pharmacy per 2000 residents. Almost all pharmacies offer the same services: compounding, weight and blood pressure measurement, and cholesterol and glucose testing. There are also other, less-implemented services, such as methadone supply or directed observed treatments. Most of these services are freely provided, except compounding (fee for service), methadone, and directed observed treatments. University pharmacy practice departments do not exist in Spain, which leads to scarce research in this area. DISCUSSION Efforts have been made to describe and measure the prevalence of negative clinical outcomes produced by pharmacotherapy and create an operational procedure to provide pharmacotherapy follow-up. CONCLUSIONS Spain has many community pharmacies, but there is little pharmacy practice research. Some advanced cognitive services exist, but few are being remunerated.

Characterization of SPf(66)n: a chimeric molecule used as a malaria vaccine

SPf66 is a chemically synthesized 45 amino acid peptide derived from fractions of four different proteins of Plasmodium falciparum (83, 55 and 35 kDa and CS, the circumsporozoite protein) that elicits a protective immune response against malaria. In this paper we show the characterization of the SPf(66)n in batch 9 to be used in a field trial in young children at Ifakara in Tanzania. The analysis of SPf(66)n indicates that it is highly soluble in water and that the amino acid composition and sequence corresponds to that designed for the synthesis of the polypeptide. The packed product has a molecular weight ranging from 10 to 25 kDa. It is pure, free of metallic contaminants, atoxic and stable at 4 degrees C. The antibodies raised against this product in rabbits recognize the individual antigenic determinants of the molecule and the native epitopes of merozoites.

Influences of Diet and Postnatal Age on the Lipid Composition of Red Blood Cell Membrane in Newborn Infants

The fatty acid and cholesterol contents of tissue membranes are determinants of their stability and functionality. This study was designed to evaluate the influences of diet and postnatal age on the polyunsaturated fatty acid (PUFA) composition of erythrocyte membrane phospholipid fractions and on the red blood cell membrane cholesterol and phosphorus contents in newborn infants during the 1st month of life. A group of infants was fed on human milk and another group on adapted milk formula. Blood samples were obtained at birth, from cord blood, and at 7 and 30 days of age. Long-chain w6 PUFA declined with advancing age in all membrane phosphoglycerides and sphingomyelin (SM) in those infants fed formula. w6 PUFA also decreased in phosphatidylcholine (PC) and phosphatidylserine (PS) in infants fed human milk and were maintained constant in phosphatidylethanolamine (PE) and SM. w3 PUFA were less affected by postnatal age. PE and SM showed significantly higher percentages of w6 and w3 long-chain PUFA in infants fed human milk than in those fed formula. Membrane cholesterol content increased in all infants from birth to 1 month of life but phosphorus levels were unaffected by diet and postnatal age. These results suggest that diets with a low content of long-chain PUFA, such as adapted cows milk formulas, may induce changes in membrane functionality and that incorporation of PUFA to the diet in amounts similar to those found in human milk should be considered at least in early life.