Three new diterpenoids from the leaves of Salvia lachnostachys.

Three new diterpenoids, demethylfruticuline B (1), 20-hydroxyfruticuline B (2), and 6-hydroxyisofruticuline A (3) were isolated from the leaves of Salvia lachnostachys Benth, together with five known compounds: fruticuline B (4), fruticuline A (5), demethylfruticuline A (6), heterobetulinic acid (7), and maslinic acid (8). The known compounds 7-8 are being reported for the first time in this species. Compounds 1 and 4-6 were tested for antioxidant activity using the ORAC-FL method, and the antioxidant capacity was measured as relative trolox equivalent. All compounds were active, with values of relative trolox equivalent varying between 1.20-2.42. The most active compound was demethylfruticuline B (1).

Antibacterial and antifungal properties of crude extracts and isolated compounds from Lychnophora markgravii.

Antimicrobial activity of dichloromethane and ethanol extracts and five compounds: pinostrobin (I), pinocembrin (II), tectochrysin (III), galangin 3-methyl ether (IV) and tiliroside (V) isolated from Lychnophora markgravii aerial parts against fifteen microorganisms was determined. The structures of these compounds were elucidated based on ESI-MS and NMR spectroscopic data. Both extracts showed antimicrobial activity against several tested microorganisms. Pinostrobin, tectochrysin and galangin 3-methyl ether showed the strongest antibacterial and antifungal effects.

Cost-Effectiveness of Fixed-Dose Combinations Therapies for Chronic Obstructive Pulmonary Disease Treatment.

BACKGROUND AND OBJECTIVE: Chronic obstructive pulmonary disease (COPD), a progressive lung disorder associated with decline of respiratory function, affects 10.2% of Spanish adults (40-80 years of age). This study aimed to assess the cost-effectiveness of two fixed-dose combinations of long-acting muscarinic antagonist and long-acting ß2-agonist therapies for COPD, with Spanish National Health System perspective. METHODS: A Markov model with five health states based on severity levels defined by GOLD 2010 criteria was used to simulate in monthly cycles the evolution along a 5-year period of a cohort of moderate-to-severe COPD patients, treated with aclidinium-formoterol (ACL/FF) 400/12 µg or tiotropium-olodaterol (TIO/OLO) 5/5 µg fixed-dose combinations. Clinical data on lung-function improvement were obtained from a network meta-analysis and applied to mean baseline forced-expiratory-volume in 1 s (FEV1) for the first 24-weeks period. Natural history for lung-function decline (41 ml/year) was applied until the end of simulation. Risk of exacerbation and pneumonia occurrence were considered. Pharmaceutical costs were calculated with dosages according to indication and public ex-factory prices. The health state-specific disease management and event costs, and utilities were derived from the literature. Total costs (€ 2016) and benefits [life-year-gained (LYG) and quality-adjusted-life-year (QALY)] were discounted (3.0% yearly). Sensitivity analyses were performed. RESULTS: Both therapies provided the same outcomes (4.073 LYG and 2.928 QALY) at 5-year period. ACL/FF 400/12 µg provided marginally lower costs (€ - 332) compared to TIO/OLO 5/5 µg. CONCLUSION: ACL/FF 400/12 µg was a cost-saving therapy in patients with moderate-to-severe COPD in Spain, and provided equivalent effects compared to TIO/OLO 5/5 µg.

Auditoria clínica de los pacientes hospitalizados por exacerbación de EPOC en España (estudio AUDIPOC): método y organización del trabajo / Clinical Audit of Patients Admitted to Hospital in Spain due to Exacerbation of COPD (AUDIPOC Study): Method and Organisation

AntecedentesExiste poca información sobre el manejo clínico de pacientes ingresados en hospitales públicos españoles con un diagnóstico de exacerbación de enfermedad pulmonar obstructiva crónica. AUDIPOC es una auditoría clínica sobre el manejo de exacerbación de EPOC en España.ObjetivosValidar la adecuación y validez de los instrumentos de medición de las variables propuestas en AUDIPOC España (estudio preliminar) y verificar su viabilidad en un medio complejo con hospitales de tamaño, recursos y organización diferentes (estudio piloto).Material y métodosEl estudio preliminar se realizó en 4 hospitales y 213 casos. El estudio piloto en 30 hospitales de 6 comunidades autónomas y 1.203 casos.ResultadosLos resultados de ambos estudios contribuyeron a mejorar el diseño y los métodos y organización del estudio AUDIPOC, incluyendo un mejor entrenamiento de los responsables hospitalarios, una nueva clasificación de hospitales, la incorporación de nuevas variables y la creación de una oficina de coordinación y gestión del proyecto.ConclusionesEl estudio AUDIPOC es viable y prevé reclutar 10.000 pacientes en 142 hospitales de todas las Comunidades Autónomas(AU)

BackgroundThere is little information regarding the clinical management of hospital inpatients diagnosed with exacerbation of Chronic Obstructive Pulmonary Disease (COPD). AUDIPOC is a clinical audit dealing with the clinical management of COPD in Spain.ObjectivesTo examine the adequacy and validity of the instruments used to measure the variables proposed by AUDIPOC Spain (Preliminary Study) and to verify the viability of AUDIPOC in a complex environment with hospitals of different sizes, resources, and organizational layout (Pilot Study).Materials and methodsThe Preliminary Study took place in 4 hospitals and studied 213 cases. The Pilot Study took place in 30 hospitals of 6 Autonomous Communities (i.e. Regions) and studied 1203 cases.ResultsThe results of both studies contributed to the improvement of the design, methods and organization of the AUDIPOC work. Some of the improvements include better training of those responsible at a hospital level, a new classification of hospitals, the incorporation of new variables and the creation of a Bureau for the Coordination and Management of the Project.ConclusionsThe AUDIPOC study is viable. It aims to recruit 10000 patients across 142 hospitals from all the Regions of Spain(AU)

[Clinical audit of patients admitted to hospital in Spain due to exacerbation of COPD (AUDIPOC study): method and organisation]. / Auditoria clínica de los pacientes hospitalizados por exacerbación de EPOC en España (estudio AUDIPOC): método y organización del trabajo.

BACKGROUND: There is little information regarding the clinical management of hospital inpatients diagnosed with exacerbation of Chronic Obstructive Pulmonary Disease (COPD). AUDIPOC is a clinical audit dealing with the clinical management of COPD in Spain. OBJECTIVES: To examine the adequacy and validity of the instruments used to measure the variables proposed by AUDIPOC Spain (Preliminary Study) and to verify the viability of AUDIPOC in a complex environment with hospitals of different sizes, resources, and organizational layout (Pilot Study). MATERIALS AND METHODS: The Preliminary Study took place in 4 hospitals and studied 213 cases. The Pilot Study took place in 30 hospitals of 6 Autonomous Communities (i.e. Regions) and studied 1203 cases. RESULTS: The results of both studies contributed to the improvement of the design, methods and organization of the AUDIPOC work. Some of the improvements include better training of those responsible at a hospital level, a new classification of hospitals, the incorporation of new variables and the creation of a Bureau for the Coordination and Management of the Project. CONCLUSIONS: The AUDIPOC study is viable. It aims to recruit 10000 patients across 142 hospitals from all the Regions of Spain.