ABSTRACT
Objetivos: analizar la mejora de la adherencia en pacientes no adherentes con HTA no controlada, polimedicados y mayores de 55 años tras el empleo de sistemas personalizados de reacondicionamiento (SPD). Diseño: estudio longitudinal (6 meses). Se analizaron los niveles de adherencia al tratamiento mediante una adaptación del test de Morisky-Green, contaje de medicación devuelta (en el grupo SPD) y valores de presión arterial. Emplazamiento: estudio multicéntrico en 35 farmacias comunitarias de toda España. Participantes: 195 participantes (88 grupo SPD y 107 grupo control) mayores de 55 años, polimedicados, no adherentes a la medicación, con HTA no controlada y que empleaban receta médica electrónica. Intervenciones: el grupo SPD recibió su medicación en SPD mientras el grupo control recibía su medicación de manera rutinaria. Mediciones principales: a ambos grupos se les realizaron tomas periódicas de sus valores de PAS/PAD mediante tensiómetro digital.Resultados: el grupo SPD obtuvo un descenso significativo de los valores de PA frente al grupo control (la PAS disminuyó en 18,3 mmHg en el grupo SPD vs. 9,9 mmHg en el grupo control y la PAD en 9,9 mmHg vs. 8,9 mmHg). Ambos grupos aumentaron su adherencia hasta superar el 90 %.Conclusiones: el empleo de SPD permitió controlar los niveles de PA a casi un 50 % de los pacientes por lo que se postula como una buena herramienta (costo-efectiva, bien tolerada por los usuarios, de fácil uso ) para mejorar la adherencia de los pacientes y controlar la HTA de estos, aunque son necesarios más estudios. (AU)
Subject(s)
Humans , Male , Female , Aged , Treatment Adherence and Compliance , Polypharmacy , Hypertension/drug therapy , Antihypertensive Agents/economics , Pharmaceutical Services , Blood Pressure Determination , Drug CostsABSTRACT
The coronavirus pandemic (COVID-19) is currently the biggest threat to human lives due to its rapid transmission rate causing severe damage to human health and economy. The transmission of viral diseases can be minimized at its early stages with proper planning and preventive practices. The use of facemask has proved to be most effective measure to curb the spread of virus along with social distancing and good hygiene practices. This necessitates more research on facemask technology to increase its filtration efficiencies and proper disposal, which can be accelerated with knowledge of the current manufacturing process and recent research in this field. This review article provides an overview of the importance of facemask, fundamentals of nonwoven fabrics, and its manufacturing process. It also covers topics related to recent research reported for improved facemask efficiencies and testing methods to evaluate the performance of facemask. The plastic waste associated with the facemask and measures to minimize its effect are also briefly described. A systematic understanding is given in order to trigger future research in this field to ensure that we are well equipped for any future pandemic.
ABSTRACT
Combination therapy with everolimus and an aromatase inhibitor such as exemestane is an effective treatment option for advanced or recurrent breast cancer. However, the therapy is often limited because of the occurrence of severe adverse events (AEs), including oral mucositis, interstitial lung disease, diarrhea, and rash. Therefore, early management of AEs is extremely important to obtain maximum treatment outcome. We investigated here the effects of comprehensive pharmaceutical care for prevention of severe AEs on patient's quality-of-life (QOL) and continuation of therapy. QOL was assessed every month based on the five-level version of EuroQol-5-Dimension (EQ-5D-5L). AEs were graded according to the Common Terminology Criteria for Adverse Events (ver 4.0). Implementation of comprehensive pharmaceutical care remarkably reduced the incidence of severe oral mucositis as compared with those without such interventions. EQ-5D-5L health states were almost constant during 6 months after intervention, ranging from 0.850 to 0.889. Median time to treatment failure (TTF) was significantly longer after intervention than before [224.0 days, 95% confidence interval (CI): 117-331 days versus 34 days, 21-47 days, hazard ratio (HR): 0.027, 95% CI: 0.005 - 0.154, p<0.001]. These findings suggest that our comprehensive pharmaceutical care is highly effective for enhancing treatment outcome by maintaining patient's QOL.
Subject(s)
Androstadienes/therapeutic use , Antineoplastic Agents/therapeutic use , Aromatase Inhibitors/therapeutic use , Breast Neoplasms/drug therapy , Everolimus/therapeutic use , Pharmaceutical Services , Adult , Aged , Androstadienes/adverse effects , Antineoplastic Agents/adverse effects , Breast Neoplasms/psychology , Disease-Free Survival , Female , Humans , Kaplan-Meier Estimate , Middle Aged , Patient Compliance , Postmenopause , Quality of Life , Stomatitis/chemically induced , Stomatitis/therapy , Treatment FailureABSTRACT
The role of p38 mitogen-activated protein kinase (MAPK) in IL-1-induced growth inhibition was investigated using IL-1-sensitive human melanoma A375-C2-1 cells and IL-1-resistant A375-R8 cells. In both cells, p38 MAPK was activated by IL-1. A selective inhibitor for p38 MAPK, SB203580, almost completely recovered the IL-1-induced growth inhibition in A375-C2-1 cells. IL-1-induced IL-6 production was also suppressed by SB203580. However, the reversal effect of SB203580 was not due to the suppression of IL-6 production because the SB203580 effect was still observed in the presence of exogenous IL-6. Down-regulation of ornithine decarboxylase (ODC) activity as well as its protein level has been shown to be essential for IL-1-induced growth inhibition. SB203580 also reversed the IL-1-induced down-regulation of ODC activity and intracellular polyamine levels without affecting ODC mRNA levels in A375-C2-1 cells. In IL-1-resistant R8 cells, however, IL-1 only slightly suppressed ODC activity. In A375-C2-1 cells, the mRNA expression level of antizyme (AZ), a regulatory factor of ODC activity, has been shown to be up-regulated by IL-1. IL-1-induced up-regulation of AZ mRNA level was not affected by SB203580. These findings demonstrate that p38 MAPK plays an important role in IL-1-induced growth inhibition in A375 cells through down-regulating ODC activity without affecting the level of ODC mRNA and AZ mRNA. In IL-1-resistant A375-R8 cells, IL-1 signaling pathway is deficient between p38 MAPK activation and down-regulation of ODC activity.
Subject(s)
Calcium-Calmodulin-Dependent Protein Kinases/physiology , Growth Inhibitors/physiology , Interleukin-1/physiology , Melanoma/pathology , Melanoma/prevention & control , Mitogen-Activated Protein Kinases , Calcium-Calmodulin-Dependent Protein Kinases/metabolism , Cell Division/immunology , Down-Regulation/immunology , Enzyme Activation/immunology , Enzyme Inhibitors/pharmacology , Humans , Imidazoles/pharmacology , Interleukin-1/antagonists & inhibitors , Interleukin-6/antagonists & inhibitors , Interleukin-6/biosynthesis , Interleukin-6/physiology , Intracellular Fluid/metabolism , Melanoma/enzymology , Ornithine Decarboxylase/genetics , Ornithine Decarboxylase/metabolism , Ornithine Decarboxylase Inhibitors , Polyamines/metabolism , Proteins/genetics , Proteins/metabolism , Pyridines/pharmacology , RNA, Messenger/metabolism , Tumor Cells, Cultured , p38 Mitogen-Activated Protein KinasesABSTRACT
A simple 2 X 2 factorial analysis provides separation of drive and learning aspects in a bar press escape learning. In addition, attentional measure is given considering the dispersion of results. This experimental design has been proved with Diazepam, a drug of rather well known effects, to assert the validity of the method.
