Using a single tablet daily to treat latent tuberculosis infection in Brazil: bioequivalence of two different isoniazid formulations (300 mg and 100 mg) demonstrated by a sensitive and rapid high-performance liquid chromatography-tandem mass spectrometry method in a randomised, crossover study

The recommended treatment for latent tuberculosis (TB) infection in adults is a daily dose of isoniazid (INH) 300 mg for six months. In Brazil, INH was formulated as 100 mg tablets. The treatment duration and the high pill burden compromised patient adherence to the treatment. The Brazilian National Programme for Tuberculosis requested a new 300 mg INH formulation. The aim of our study was to compare the bioavailability of the new INH 300 mg formulation and three 100 mg tablets of the reference formulation. We conducted a randomised, single dose, open label, two-phase crossover bioequivalence study in 28 healthy human volunteers. The 90% confidence interval for the INH maximum concentration of drug observed in plasma and area under the plasma concentration vs. time curve from time zero to the last measurable concentration “time t” was 89.61-115.92 and 94.82-119.44, respectively. The main limitation of our study was that neither adherence nor the safety profile of multiple doses was evaluated. To determine the level of INH in human plasma, we developed and validated a sensitive, simple and rapid high-performance liquid chromatography-tandem mass spectrometry method. Our results showed that the new formulation was bioequivalent to the 100 mg reference product. This finding supports the use of a single 300 mg tablet daily strategy to treat latent TB. This new formulation may increase patients’ adherence to the treatment and quality of life.

Propósitos para 2015: más salud y bienestar

Boletín semanal para profesionales sanitarios de la Secretaría General de Calidad, Innovación y Salud Pública de la Consejería de Igualdad, Salud y Políticas Sociales

Tractament d'aigües residuals mitjançant un sistema híbrid d'aiguamolls artificials: cap a una depuració més verda

Les aigües residuals són aquelles derivades de les activitats humanes, ja sigui involuntàriament o de forma intencionada. Aquest és el punt de partida del present projecte. És inqüestionable que aquestes aigües no es poden tornar a abocar al medi natural d’on s’han extret sense ser tractades prèviament, ja que contenen diferents tipus de contaminants que perjudiquen greument el nostre entorn. Des de que l’ésser humà va adonar-se d’aquesta evidència han aparegut sistemes de depuració d’aquestes aigües. L’objectiu principal d’aquest projecte és la posada en marxa d’un sistema híbrid d’aiguamolls artificials que pugui realitzar aquesta funció tan necessària per a la nostra societat, en aquest cas depurant les aigües residuals provinents d’un centre tecnològic (en què es combinen aigües sanitàries i aigües provinents dels laboratoris de recerca), de forma que compleixin els requisits marcats a la llei per al seu abocament al medi natural. El desenvolupament del present projecte segueix les bases del mètode científic, és a dir unes hipòtesis que hem formulat als objectius. Col·laboració en el disseny i construcció de l’experiment, el sistema híbrid d’aiguamolls. La recollida de mostres i posterior anàlisi de diferents paràmetres d’aquestes aigües abans i després de ser tractades. En aquest cas també s’ha fet un seguiment i evolució, tant del sistema com de la vegetació planta. I finalment l’anàlisi dels resultats i posterior discussió per veure si s’han complert els objectius. De forma general, els resultats han estat bastant positius, tant en la configuració amb l’AFSSV inundat i buit. No obstant això, s’observa que amb l’AFSSV s’observen clar avantatges en l’eliminació de força contaminants. Les aigües compleixen pràcticament tots els límits de contaminats establerts per la llei, menys l’amoni per algun tipus d’error humà o interferències i algun dia la DBO5. Durant la durada de l’experimentació han sorgit alguns problemes amb el sistema, els quals es recomana solucionar per a posteriors projecte. Els més destacats són les característiques del tanc d’homogeneïtzació i l’eutrofització a l’AFS. Per tant, podem concloure que s’ha confirmat el que apuntava la bibliografia, en què aquests sistemes híbrids d’aiguamolls poden ser un substitut als tractaments convencionals de depuració de les aigües residuals. Tanmateix amb algunes limitacions i un llarg recorregut que encara s’ha de seguir en aquest camp de la investigació. Projectes com aquest, que suposen l’inici d’un projecte més gran, poden ajudar a l’objectiu final que ha de ser crear un món més sostenible.

La Competencia jurisdiccional en materia de sucesiones transfronterizas en el Reglamento (UE) Nº 650/2012

Aquest estudi està orientat a presentar la manera com configura la competència jurisdiccional en matèria de successions transnacionals en el Reglament (UE) n º 650/2012. S'analitza la complexitat de determinar la jurisdicció aplicable a partir de l'estudi comparatiu amb la primera configuració que es va fer de la competència en el text de la Proposta de Reglament de la Comissió Europea i també de les diferents legislacions vigents dins de la UE abans de l'entrada en vigor del Reglament Europeu de Successions. Així mateix s'observa, més detalladament la determinació de la jurisdicció i el seu abast en l'ordenament jurídic espanyol

Lactococcus garvieae endocarditis in a native valve identified by MALDI-TOF MS and PCR-based 16s rRNA in Spain: A case report.

Lactococcus garvieae is a Gram-positive, catalase negative coccus arranged in pairs or short chains, well-known as a fish pathogen. We report a case of Infective Endocarditis (IE) by L. garvieae in a native valve from a 68-year-old male with unknown history of contact with raw fish and an extensive history of heart disease. This case highlights the reliability of MALDI-TOF MS compared to conventional methods in the identification of rare microorganisms like this.

Assessment of myocardial edema and area-at-risk in acute myocardial infarction by CMR: Evaluation of a novel T2-mapping method

Objectives. The goal of this study is to evaluate a T2-mapping sequence by: (i) measuring the reproducibility intra- and inter-observer variability in healthy volunteers in two separate scanning session with a T2 reference phantom; (2) measuring the mean T2 relaxation times by T2-mapping in infarcted myocardium in patients with subacute MI and compare it with patient's the gold standard X-ray coronary angiography and healthy volunteers results. Background. Myocardial edema is a consequence of an inflammation of the tissue, as seen in myocardial infarct (MI). It can be visualized by cardiovascular magnetic resonance (CMR) imaging using the T2 relaxation time. T2-mapping is a quantitative methodology that has the potential to address the limitation of the conventional T2-weighted (T2W) imaging. Methods. The T2-mapping protocol used for all MRI scans consisted in a radial gradient echo acquisition with a lung-liver navigator for free-breathing acquisition and affine image registration. Mid-basal short axis slices were acquired.T2-maps analyses: 2 observers semi- automatically segmented the left ventricle in 6 segments accordingly to the AHA standards. 8 healthy volunteers (age: 27 ± 4 years; 62.5% male) were scanned in 2 separate sessions. 17 patients (age : 61.9 ± 13.9 years; 82.4% male) with subacute STEMI (70.6%) and NSTEMI underwent a T2-mapping scanning session. Results. In healthy volunteers, the mean inter- and intra-observer variability over the entire short axis slice (segment 1 to 6) was 0.1 ms (95% confidence interval (CI): -0.4 to 0.5, p = 0.62) and 0.2 ms (95% CI: -2.8 to 3.2, p = 0.94, respectively. T2 relaxation time measurements with and without the correction of the phantom yielded an average difference of 3.0 ± 1.1 % and 3.1 ± 2.1 % (p = 0.828), respectively. In patients, the inter-observer variability in the entire short axis slice (S1-S6), was 0.3 ms (95% CI: -1.8 to 2.4, p = 0.85). Edema location as determined through the T2-mapping and the coronary artery occlusion as determined on X-ray coronary angiography correlated in 78.6%, but only in 60% in apical infarcts. All except one of the maximal T2 values in infarct patients were greater than the upper limit of the 95% confidence interval for normal myocardium. Conclusions. The T2-mapping methodology is accurate in detecting infarcted, i.e. edematous tissue in patients with subacute infarcts. This study further demonstrated that this T2-mapping technique is reproducible and robust enough to be used on a segmental basis for edema detection without the need of a phantom to yield a T2 correction factor. This new quantitative T2-mapping technique is promising and is likely to allow for serial follow-up studies in patients to improve our knowledge on infarct pathophysiology, on infarct healing, and for the assessment of novel treatment strategies for acute infarctions.

El blog y otras herramientas comunicativas de la biblioteca del Área de Gestión Sanitaria Este de Málaga - Axarquía

In 2006 the Library of the Andalusian Public Health System (BVSSPA) is constituted as a Virtual Library which provides Resources and Services that are accessed through inter-hospital local area network (corporate intranet) and Internet. On the other hand, the Hospital de la Axarquia still did not have any institutional or self-presence on the Internet and the librarian ask the need to create a space for communication with the "digital users" of the Library of the area through a website. MATERIALS AND METHODS. The reasons why we opted for a blog were: -It was necessary to make no financial outlay for its establishment. It allowed for great versatility, both in its administration and in its management by users. -The ability to compile on the same platform different Web 2.0 communication tools. Between different options available we chose Blogger Google Inc. The blog allowed entry to the 2.0 services or Social Web in the library. The benefits offered were many, especially the visibility of the service and communication with the user. 2.0 tools that have been incorporated into the library are: content syndication (RSS) which allowed users to stay informed about updates to the blog. Share documents and other multimedia as presentations through SlideShare, images through Flickr or Picasa, or videos (YouTube). And the presence on social network like Facebook and Twitter. RESULTS. The analysis of the activity we has been traking by Google Analytics tool, helping to determine the number of blog visits. Since its stablishment, on November 17th 2006, until November 29th 2010 the blog has received 15,787 visitors, 38,422 page views were consulted, at each visit on average 2.4 pages were consulted and each visit has an average stay at the site of 4'31''. DISCUSSION. The blog has served as a communication and information tool with the user. Since the creation of the blog we have incorporated technologies and tools to interact with the user. With all the tools used we have applied the concept of "open source" and the contents were generated from the activities organized in the Knowledge Management Unit from the anatomo-clinical sessions, the training activities, dissemination events, etc. The result has been the customization of library services, contextualized in the Knowledge Management Unit - Axarquia. In social networks we have shared information and files with the professionals and the community. CONCLUSIONS. The blog has allowed us to explore technologies that allow us to communicate with the user and the community, disseminate information and documents with the participation of users and become the "Interactive Library" we aspire to be.

La Unión Europea frente a Darfur una vez más: EUFOR Chad/RCA

Los estados europeos se han mostrado impotentes ante el conflicto que asola Sudán, ejemplificado por la catástrofe humanitaria de Darfur. La creciente presión para “hacer algo” llegó a los despachos de los ministros de exteriores europeos hace cuatro años y desde entonces, tanto a nivel unilateral como europeo se han desarrollado diferentes (y fracasadas) iniciativas. A nivel de la PESD, por ejemplo, la Unión puso en marcha en coordinación con la OTAN, la operación de apoyo a la misión de la Unión Africana en Darfur, la operación AMIS II, pero pronto se vio desbordada por las dimensiones del conflicto. Este fracaso ha obligado a la Unión a ocupar un lugar protagonista en este conflicto imposible de desligar del enfrentamiento de Sudán con Chad, a través de la operación EUFOR Chad/RCA. Sin embargo, esta nueva operación se está convirtiendo en la última pesadilla europea en el terreno de la PESD. El complejo contexto bélico a escala regional así como las dificultades para construir una operación europea a gran escala han puesto en evidencia las diferencias entre socios europeos sobre el deber de intervenir en el conflicto de Darfur, así como las lagunas en la estrategia europea hacia un conflicto tan grave como el que asola el triángulo formado por Sudán, Chad y la República Centroafricana (RCA).

Ser catalans : una visió dels visitants de Barcelona... més enllà dels tòpics

Es tracta d'un treball en què s'analitzen les dades obtingudes de quatre entrevistes a estudiants estrangers que viuen a Barcelona sobre la seva visió de la catalanitat. També hi ha reflexions sobre quina visibilitat té la llengua catalana en aquest concepte d'identitat catalana.

Natalizumab-related anaphylactoid reactions in MS patients are associated with HLA class II alleles.

OBJECTIVES We aimed to investigate potential associations between human leukocyte antigen (HLA) class I and class II alleles and the development of anaphylactic/anaphylactoid reactions in patients with multiple sclerosis (MS) treated with natalizumab. METHODS HLA class I and II genotyping was performed in patients with MS who experienced anaphylactic/anaphylactoid reactions and in patients who did not develop infusion-related allergic reactions following natalizumab administration. RESULTS A total of 119 patients with MS from 3 different cohorts were included in the study: 54 with natalizumab-related anaphylactic/anaphylactoid reactions and 65 without allergic reactions. HLA-DRB1*13 and HLA-DRB1*14 alleles were significantly increased in patients who developed anaphylactic/anaphylactoid reactions (p M-H = 3 × 10(-7); odds ratio [OR]M-H = 8.96, 95% confidence interval [CI] = 3.40-23.64), with a positive predictive value (PPV) of 82%. In contrast, the HLA-DRB1*15 allele was significantly more represented in patients who did not develop anaphylactic/anaphylactoid reactions to natalizumab (p M-H = 6 × 10(-4); ORM-H = 0.2, 95% CI = 0.08-0.50), with a PPV of 81%. CONCLUSIONS HLA-DRB1 genotyping before natalizumab treatment may help neurologists to identify patients with MS at risk for developing serious systemic hypersensitivity reactions associated with natalizumab administration.

La Biblioteca Virtual del Sistema Sanitario Público de Andalucía: 10 años de servicio y un futuro viable

Presentado en la mesa redonda "Innovar en gestión de información: plataformas tecnológicas para creación de contenidos compartidos" de las XIII Jornadas Bibliotecarias de Andalucía (Granada, 5 y 6 Noviembre 2015).

Las voluntades anticipadas y su utilización en la toma de decisiones

Enfrentar la muerte como final inevitable de todo ser humano es una cuestión que ha preocupado a la humanidad desde sus orígenes y ha motivado innumerable literatura en todos los tiempos. Quizás por esta razón, la actuación del profesional sanitario en el tramo final de la vida de sus pacientes se ha enmarcado tradicionalmente en la toma de decisiones individuales o bien de forma conjunta con la familia del enfermo, debatiéndose entre su máxima aspiración de salvar esa vida y la aceptación del desenlace inevitable como consecuencia de la enfermedad. Poco a poco se va interiorizando la obligación ética y deontológica de saber ver el momento en el que hay que decir basta y limitarse a acompañar al paciente en su proceso de muerte, haciéndolo lo más indoloro y apacible que se pueda.

L'ensenyament universitari del segle XXI : més enllà del paper

La Universitat Oberta de Catalunya (UOC) és un exemple de la tendència de futur de l'ensenyament universitari, en què l'estudiant pren les regnes de l'aprenenetatge i les institucions educatives s'adapten a les noves necessitats de l'usuari afavorint la flexibilitat, la mobilitat i les eines tecnològiques imprescindibles per a aquest nou model d'enseyament.

Les habilitats Informacionals a la Biblioteca de la Universitat Oberta de Catalunya

In this paper the initiatives carried out by the Biblioteca Virtual UOC in relation to the information skills, in the UOC curricula as well as in the context of new European higher education area, are presented. Looking forward the catalogue of generic skills to be defined by the UOC, in relation to which the Virtual Library has submitted a proposal to introduce a course on information skills to be offered during the first semester, the Library has chosen to develop and carry out two complementary initiatives. On the one hand, to offer a course of information skills for teachers within the program of training courses for teachers organized by the Teaching Action Management Area. On the other, the Library participates in the presential meetings organized by the University by means of workshops to guide students in finding information.