Pedro Gutiérrez Bueno (1743-1822) y las relaciones entre la química y la farmacia durante el último tercio del siglo XVIII

El presente trabajo se enmarca en un proyecto de investigación sobre la farmacología en la sociedad española del siglo XIX, en particular, acerca del papel de las prácticas y los conocimientos químicos en la transición de la materia médica a la farmacología experimental. Dentro de ese esquema general, el objeto principal de este trabajo es uno de los principales autores españoles de libros de texto de química del último tercio del siglo XVIII: Pedro Gutiérrez Bueno (1745-1822). En un trabajo anterior se ha estudiado el público destinatario de la primera edición de su libro de texto así como las principales características de esta obra. En este artículo abordaremos el análisis del contexto en el que se produjo la aparición de la segunda edición, lo que conducirá a estudiar las ideas de Gutiérrez Bueno sobre las relaciones entre la química y la farmacia. Estas ideas estuvieron fuertemente influidas por los puntos de vista defendidos por Antoine Fourcroy en Francia.

Acorn consumption improves the immune response of the dung beetle Thorectes lusitanicus

Thorectes lusitanicus, a typically coprophagous species is also actively attracted to oak acorns, consuming, burying them, and conferring ecophysiological and reproductive advantages to both the beetle and the tree. In this study, we explored the possible relation between diet shift and the health status of T. lusitanicus using a generalist entomopathogenic fungus (Metarhizium anisopliae) as a natural pathogen. To measure the health condition and immune response of beetles, we analysed the protein content in the haemolymph, prophenoloxidase (proPO) content, phenoloxidase (PO) activity and mortality of beetles with diets based on either acorns or cow dung. Protein content, proPO levels and PO levels in the haemolymph of T. lusitanicus were found to be dependent on the type of diet. Furthermore, the beetles fed with acorns developed a more effective proPO-PO system than the beetles fed with cow dung. Furthermore, a significant decrease in mortality was observed when infected individuals were submitted to an acorn-based diet. In addition to enhancing an understanding of the relevance of dietary change to the evolutionary biology of dung beetles, these results provide a more general understanding of the ecophysiological implications of differential dietary selection in the context of fitness.

From community approaches to single-cell genomics: the discovery of ubiquitous hyperhalophilic Bacteroidetes generalists

The microbiota of multi-pond solar salterns around the world has been analyzed using a variety of culture-dependent and molecular techniques. However, studies addressing the dynamic nature of these systems are very scarce. Here we have characterized the temporal variation during 1 year of the microbiota of five ponds with increasing salinity (from 18% to >40%), by means of CARD-FISH and DGGE. Microbial community structure was statistically correlated with several environmental parameters, including ionic composition and meteorological factors, indicating that the microbial community was dynamic as specific phylotypes appeared only at certain times of the year. In addition to total salinity, microbial composition was strongly influenced by temperature and specific ionic composition. Remarkably, DGGE analyses unveiled the presence of most phylotypes previously detected in hypersaline systems using metagenomics and other molecular techniques, such as the very abundant Haloquadratum and Salinibacter representatives or the recently described low GC Actinobacteria and Nanohaloarchaeota. In addition, an uncultured group of Bacteroidetes was present along the whole range of salinity. Database searches indicated a previously unrecognized widespread distribution of this phylotype. Single-cell genome analysis of five members of this group suggested a set of metabolic characteristics that could provide competitive advantages in hypersaline environments, such as polymer degradation capabilities, the presence of retinal-binding light-activated proton pumps and arsenate reduction potential. In addition, the fairly high metagenomic fragment recruitment obtained for these single cells in both the intermediate and hypersaline ponds further confirm the DGGE data and point to the generalist lifestyle of this new Bacteroidetes group.

Suplementos alimentares para gestão de peso corporal:

Os suplementos alimentares para emagrecer são um apelo irresistível para quem procura uma forma de perder peso “sem sacrifícios” e “sem esforço”. Com efeito, estamos perante um mercado sazonal em expansão em que a menção “natural” parece tranquilizar os consumidores esquecendo que a eficácia e segurança destes produtos necessita ser avaliada. Nesse contexto, o presente estudo teve como objetivo efetuar a caraterização dos consumidores de suplementos alimentares para emagrecer, da zona centro de Portugal, avaliar o seu grau de satisfação com os produtos e ainda o possível risco que envolve o consumo destes produtos sobretudo quando ingeridos concomitantemente com medicamentos. Recorreu-se a um questionário anónimo, confidencial e de preenchimento voluntário, distribuído em farmácias, parafarmácias e dietéticas e/ou ervanárias maioritariamente do concelho de Viseu e Figueira da Foz. A recolha dos dados decorreu entre os meses de abril e julho de 2014. E tinha como critérios de inclusão ser maior de 18 anos, ambos os sexos e saber ler e escrever. Acorreram 304 indivíduos. A análise dos dados foi feita recorrendo a testes estatísticos adequados a cada caso. O presente estudo ao caracterizar o perfil de consumidores de suplementos alimentares encontrou uma população, maioritariamente feminina (88,5%) com grau de instrução elevado, secundário e superior, nas faixas etária dos 25-44 anos (59,4%), casados ou em união de facto. Apresentavam excesso de peso e obesidade (54%), sem hábitos de prática de exercício físico e com alimentação desequilibrada. Estes preferem adquirir os suplementos alimentares para emagrecer nas farmácias embora a decisão de consumir estes produtos seja pessoal (32,7%). Para aconselhamento preferem o farmacêutico (17,6%) e apenas 4,2% recorrem ao médico. Revelaram ainda consumir estes produtos por um período de tempo limitado, entre 1-3 meses e estarem satisfeitos com os resultados obtidos após o consumo de suplementos alimentares (63,1%). Constituindo os efeitos secundários dos suplementos alimentares uma preocupação legítima verificamos que a maioria dos inquiridos (93,3%) não refere qualquer efeito indesejável, os restantes indivíduos que revelaram aparecimento de ações indesejáveis disseram ter-se dirigido ao farmacêutico para reportar a situação. As patologias com maior prevalência entre os consumidores foram doenças endócrinas, nutricionais e metabólicas, seguida das perturbações mentais e comportamentais e por fim as doenças cardiovasculares a que correspondem os principais grupos terapêuticos encontrados: psicofármacos, medicamentos usados em patologias do sistema endócrino e antihipertensores. Cerca de 25,8% dos inquiridos que consumiam suplementos alimentares para emagrecer utilizavam concomitantemente estes fármacos. A análise dos cinco suplementos alimentares para emagrecer maioritariamente consumidos pela amostra (57,8%) evidenciou a existência de possíveis interações com os grupos de fármacos mais utilizados. Os resultados obtidos mostram por um lado, a necessidade de esclarecer o conceito de que nem tudo o que é natural é inócuo e por outro lado, ressaltam a importância no ato de venda do aconselhamento individual, adaptado a cada consumidor (com ou sem medicação), por um profissional de saúde com conhecimentos no âmbito da gestão e fisiologia de peso corporal e conhecimento sólido sobre a eficácia e segurança destes suplementos.

Birth and mortality statistics of the Virgin Islands of the United States. 1901-1919.

On t.-p., seal of Department of the navy, Bureau of medicine & surgery.

Documents pertaining to the medicinal supplies within the North American colonies from 1643 to 1780,

Contains a reissue of four numbers (April 1937, June-Dec. 1938, Feb. 1939 and Dec. 1940) of the author's journal, the Badger pharmacist. Each number includes a reprint of the document discussed.

Manpower for the human services /

A work progress report submitted to and prepared under a contract with the Manpower Administration, U.S. Department of Labor, under the authority of the Manpower Development and Training Act.

Asthma management by New Zealand pharmacists: a pharmaceutical care demonstration project

Background: Pharmaceutical care services became recognized in New Zealand in the mid-1990s, albeit with limited evidence of the acceptability and effectiveness of the model. An asthma-specific pharmaceutical care service was trialled in southern New Zealand, based on a 'problem-action-outcome' method, with pharmacists adopting a patient-centred, outcome-focused approach with multidisciplinary consultation. Objective: To report on the implementation and outcomes of a specialist asthma service offered by community pharmacists. Design: Pharmacists in five pharmacies, servicing predominantly rural, established clientele, received training in the asthma service and research documentation. Ten patients per pharmacy were recruited in each year (years 1 and 2) of the study. The patients were entered into the study in cohorts of five per pharmacy twice yearly, with year 2 mirroring year 1. The phase-in design minimized the impact on the pharmacists. The patients acted as their own controls. All patients received individualized care and had approximately monthly consultations with the pharmacist, with clinical and quality of life (QoL) monitoring. Results: A total of 100 patients were recruited. On average, 4.3 medication-related problems were identified per patient; two-thirds of them were compliance-related. The most common interventions were revision of patients' asthma action plans, referral and medication counselling. Clinical outcomes included reduced bronchodilator use and improved symptom control in around two-thirds of patients. Asthma-specific QoL changes were more positive and correlated well with clinical indicators. Conclusion: Further research is warranted to integrate this service into daily practice. Clinical outcomes were generally positive and supported by QoL indicators. Characteristics of New Zealand practice and this sample of pharmacies may limit the generalizability of these findings.

Developing New Tourism Services: Dinosaurs a New Drive Tourism Resource for Remote Areas

This paper examines issues encountered when developing new tourism services generally, and specific aspects relating to the development of remote area dinosaur fossil fields for tourism. It studies two sites, one in the USA and one in Australia. Access to both sites is by minor roads, and both sites are characterised by long drives separating the sites from small communities that offer limited infrastructure and few other attractions for visitors. In both areas, however, tourism is seen as one of the few possible ways to sustain existing communities in the face of declining primary-industry-based employment. In general, tourists visiting these areas are on touring holidays of two weeks’ duration or more where the attraction is the general attributes of the region as well as to a lesser extent their interest in dinosaur fossils. These provide a potential resource for remote-region economic development through commodification as a new tourism attraction. Development of dinosaur fossil finds as a tourism resource is conceptualised here as new service development. Developing new tourism services, especially in remote regions, is challenging and has not been well examined in the tourism literature. The new service development process used in this case study first examines the characteristics of the existing tourists travelling through the region. The characteristics of a number of potential market segments currently interested in dinosaur fossils were then examined and contrasted with the existing market. This is conceptualised on a specialist-generalist spectrum of interest in fossils. A study of the tourist service features associated with dinosaur fossil tourism in remote regions of the USA was conducted, leading to the identification of a number of possible incremental development opportunities. The paper then takes a strategic approach to examining potential new tourism service development related to dinosaur fossils in remote regions of Queensland, Australia. In particular, it describes use of information about existing services in similar regions as the basis for ideas about development as well as comparison between existing and potential markets.

An Australian comparison of specialist care of acute myocardial infarction

Objective. To determine whether patients hospitalized with acute myocardial infarction (AMI) in an Australian setting receive better pharmacological care if managed by cardiologists than by non-cardiologists. Design. Retrospective chart review of patients hospitalized between 1 January 1997 and 30 June 1998, undertaken by abstractors blind to study objectives. Setting. One tertiary and two community hospitals in south-east Queensland, Australia, in which all patients admitted with AMI were cared for by cardiologists and general physicians, respectively. Study participants. Two cohorts of consecutive patients satisfying diagnostic criteria for AMI: 184 in the tertiary hospital and 207 in the community hospitals. Main outcome measures. Frequency of use, in highly eligible patients, of thrombolysis, P-blockers, aspirin, angiotensin-converting enzyme (ACE) inhibitors, lipid-lowering agents, nitrates, and calcium antagonists. Cohorts were compared for differences in prognostic factors or illness severity. Results. In community hospital patients, there was greater use of thrombolysis [100% versus 83% in the tertiary hospital; difference 17%, 95% confidence interval (CI) 11-26%; P < 0.001] and of ACE inhibitors (84% versus 66%; difference 18%, 95% CI 3-34%; P = 0.02), and lower median length of stay (6.0 days versus 7.0 days; P = 0.001) compared with tertiary hospital patients. Frequency of use of other drugs, and adjusted rates of death and re-infarction were the same for both cohorts. Conclusions. With respect to pharmacological management of patients hospitalized with AMI, cardiologists and general physicians appear to provide care of similar quality and achieve equivalent outcomes. Further studies are required to confirm the generalizability of these results to Australian practice as a whole.

Locomotor performance of closely related Tropidurus species: relationships with physiological parameters and ecological divergence

Tropidurid lizards have colonized a variety of Brazilian open environments without remarkable morphological variation, despite ecological and structural differences among habitats used. This study focuses on two Tropidurus sister-species that, despite systematic proximity and similar morphology, exhibit great ecological divergence and a third ecologically generalist congeneric species providing an outgroup comparison. We quantified jumping capacity and sprint speed of each species on sand and rock to test whether ecological divergence was also accompanied by differences in locomotor performance. Relevant physiological traits possibly associated with locomotor performance metabolic scopes and fiber type composition, power output and activity of the enzymes citrate synthase, pyruvate kinase and lactate dehydrogenase of the iliofibularis muscle - were also compared among the three Tropidurus species. We found that the two sister-species exhibited remarkable differences in jumping performance, while Tropidurus oreadicus, the more distantly related species, exhibited intermediate values. Tropidurus psamonastes, a species endemic to sand dunes, exhibited high absolute sprint speeds on sand, jumped rarely and possessed a high proportion of glycolytic fibers and low activity of citrate synthase. The sister-species Tropidurus itambere, endemic to rocky outcrops, performed a large number of jumps and achieved lower absolute sprint speed than T. psamonastes. This study provides evidence of rapid divergence of locomotor parameters between sister-species that use different substrates, which is only partially explained by variation in physiological parameters of the iliofibularis muscle.

Achieving better in-hospital and after-hospital care of patients with acute cardiac disease

In patients hospitalised with acute coronary syndromes (ACS) and congestive heart failure (CHF), evidence suggests opportunities for improving in-hospital and after hospital care, patient self-care, and hospital-community integration. A multidisciplinary quality improvement program was designed and instigated in Brisbane in October 2000 involving 250 clinicians at three teaching hospitals, 1080 general practitioners (GPs) from five Divisions of General Practice, 1594 patients with ACS and 904 patients with CHF. Quality improvement interventions were implemented over 17 months after a 6-month baseline period and included: clinical decision support (clinical practice guidelines, reminders, checklists, clinical pathways); educational interventions (seminars, academic detailing); regular performance feedback; patient self-management strategies; and hospital-community integration (discharge referral summaries; community pharmacist liaison; patient prompts to attend GPs). Using a before-after study design to assess program impact, significantly more program patients compared with historical controls received: ACS: Angiotensin-converting enzyme (ACE) inhibitors and lipid-lowering agents at discharge, aspirin and beta-blockers at 3 months after discharge, inpatient cardiac counselling, and referral to outpatient cardiac rehabilitation. CHF. Assessment for reversible precipitants, use of prophylaxis for deep-venous thrombosis, beta-blockers at discharge, ACE inhibitors at 6 months after discharge, imaging of left ventricular function, and optimal management of blood pressure levels. Risk-adjusted mortality rates at 6 and 12 months decreased, respectively, from 9.8% to 7.4% (P=0.06) and from 13.4% to 10.1% (P= 0.06) for patients with ACS and from 22.8% to 15.2% (P < 0.001) and from 32.8% to 22.4% (P= 0.005) for patients with CHF. Quality improvement programs that feature multifaceted interventions across the continuum of care can change clinical culture, optimise care and improve clinical outcomes.

Optimising care of acute coronary syndromes in three Australian hospitals

Objective. To improve quality of in-hospital care of patients with acute coronary syndromes using a multifaceted quality improvement program. Design. Prospective, before and after study of the effects of quality improvement interventions between October 2000 and August 2002. Quality of care of patients admitted between 1 October 2000 and 16 April 2001 (baseline) was compared with that of those admitted between 15 February 2002 and 31 August 2002 (post-intervention). Setting. Three teaching hospitals in Brisbane, Australia. Study participants. Consecutive patients (n = 1594) admitted to hospital with acute coronary syndrome [mean age 68 years (SD 14 years); 65% males]. Interventions. Clinical guidelines, reminder tools, and educational interventions; 6-monthly performance feedback; pharmacist-mediated patient education program; and facilitation of multidisciplinary review of work practices. Main outcome measures. Changes in key quality indicators relating to timing of electrocardiogram (ECG) and thrombolysis in emergency departments, serum lipid measurement, prescription of adjunctive drugs, and secondary prevention. Results. Comparing post-intervention with baseline patients, increases occurred in the proportions of eligible patients: (i) undergoing timely ECG (70% versus 61%; P = 0.04); (ii) prescribed angiotensin-converting enzyme inhibitors (70% versus 60%; P = 0.002) and lipid-lowering agents (77% versus 68%; P = 0.005); (iii) receiving cardiac counselling in hospital (57% versus 48%; P = 0.009); and (iv) referred to cardiac rehabilitation (17% versus 8%; P < 0.001). Conclusions. Multifaceted approaches can improve care processes for patients hospitalized with acute coronary syndromes. Care processes under direct clinician control changed more quickly than those reliant on complex system factors. Identifying and overcoming organizational impediments to quality improvement deserves greater attention.

General practitioners with special interests: risk of a good thing becoming bad?

There is a long tradition of some general practitioners developing areas of special interest within their mainstream generalist practice. General practice is now becoming increasingly fragmented, with core components being delivered as separate and standalone services (eg, travel medicine, skin cancer, women's health). Although this fragmentation seems to meet a need for some patients and doctors, potential problems need careful consideration and response. These include loss of generalist skills among GPs, fewer practitioners working in less well-remunerated areas, such as nursing home visits, and issues related to standards of care and training.