Preliminary Perceptual Findings of Singing After Flow Phonation Voice Exercises for Singers in Training.

INTRODUCTION: Goals of voice therapy and vocal pedagogy share similar principles and therefore, therapy approaches designed to improve the disordered voice may be equally effective when used to enhance healthy voice and vice versa. The purpose of this study was to investigate the effects of flow phonation voice exercises on vocal characteristics of students in undergraduate vocal music training programs and examine their potential use in vocal pedagogy. METHODS: A total of 10 cis females were recruited and were randomized into two groups: an experimental group (group 1, n = 6) receiving five sessions of flow phonation intervention across 5 weeks; and a control group (group 2, n = 4) that did not receive any direct intervention other than vocal hygiene education. Participants provided data pertaining to auditory perception, subjective respiratory measures, voice-related quality of life, and vocal fatigue before and after 5 weeks. Flow phonation exercises consisted of cup bubble blowing, gargling, and stretch and flow. Wilcoxon signed ranks test was administered to compare outcomes across time points and between groups. RESULTS: Data indicate statistically significant changes in auditory perception of the singing voice, and voice-related quality of life for the group that received flow phonation exercises alone. No other measures showed statistical significance. DISCUSSION AND CONCLUSION: Overall, this study indicates that the use of flow phonation voice exercises has the potential to improve voice instruction within the voice studio. While our target enrollments were not met to achieve optimal statistical power, our hypotheses were at least partially supported. In particular, positive intervention-related changes were observed in self-perceived voice handicap, and auditory perception of singing which were not observed in the control group.

Potential present and future distributions of the genus Atta of Mexico.

Temperature and precipitation influence insect distribution locally and drive large-scale biogeographical patterns. We used current and future climate data from the CHELSA database to create ensemble species distribution models for three Atta leaf-cutting ant species (Atta cephalotes, A. mexicana, and A. texana) found in Mexico. These models were used to estimate the potential impact of climate change on the distribution of these species in the future. Our results show that bioclimatic variables influence the distribution of each Atta species occupying a unique climatic niche: A. cephalotes is affected by temperature seasonality, A. mexicana by isothermality, and A. texana by the minimum temperature of the coldest month. Atta texana and A. mexicana are expected to decline their range by 80% and 60%, respectively, due to rising temperatures, decreased rainfall, and increased drought. Due to rising temperatures and increased humidity, Atta cephalotes is expected to expand its range by 30%. Since Atta species are important pests, our coexistence with them requires knowledge of their ecological functions and potential future distribution changes. In addition, these insects serve as bioindicators of habitat quality, and they can contribute to the local economy in rural areas since they are eaten as food for the nutritional value of the queens. In this sense, presenting a future perspective of these species' distribution is important for forest and crop management. Education programs also are necessary to raise awareness of the importance of these ants and the challenges they face because of climate change. Our results offer a perspective of climate change studies to define conservation and adaptation strategies for protecting vulnerable areas such as high-elevation remnant forests.

New patch-based strategy for COVID-19 automatic identification using chest x-ray images.

Purpose: The development of a robust model for automatic identification of COVID-19 based on chest x-rays has been a widely addressed topic over the last couple of years; however, the scarcity of good quality images sets, and their limited size, have proven to be an important obstacle to obtain reliable models. In fact, models proposed so far have suffered from over-fitting erroneous features instead of learning lung features, a phenomenon known as shortcut learning. In this research, a new image classification methodology is proposed that attempts to mitigate this problem. Methods: To this end, annotation by expert radiologists of a set of images was performed. The lung region was then segmented and a new classification strategy based on a patch partitioning that improves the resolution of the convolution neural network is proposed. In addition, a set of native images, used as an external evaluation set, is released. Results: The best results were obtained for the 6-patch splitting variant with 0.887 accuracy, 0.85 recall and 0.848 F1score on the external validation set. Conclusion: The results show that the proposed new strategy maintains similar values between internal and external validation, which gives our model generalization power, making it available for use in hospital settings. Supplementary Information: The online version contains supplementary material available at 10.1007/s12553-022-00704-4.

Pre-operative embolization for staged treatment of infantile choroid plexus papilloma.

Choroid plexus papillomas (CPPs) are benign but rare neuroepithelial neoplasms of the choroid plexus that represent the non-malignant form of a spectrum of tumors of the choroid plexus. The vast majority of CPPs present in children under 5 years of age. Some CPPs are diagnosed prenatally, but many of them reach a large size before diagnosis. CPPs typically present with signs and symptoms of hydrocephalus. Treatment of these tumors has traditionally been with surgical resection. Large CPPs in young children present a challenge due to risk of high blood loss during resection. Here, the authors describe the case of a 3-month-old presenting with hydrocephalus and a large CPP of the third ventricle that was managed with a staged strategy of embolization followed by a delayed resection, allowing the tumor to involute prior to surgery.

Pharmacokinetics and Pharmacodynamics of Cefepime in Adults with Hematological Malignancies and Febrile Neutropenia after Chemotherapy.

Patients with chemotherapy-induced febrile neutropenia (CIFN) may have changes in the pharmacokinetics (PK) compared to patients without malignancies or neutropenia. Those changes in antibiotic PK could lead to negative outcomes for patients if the therapy is not adequately adjusted to this. In this, open-label, non-randomized, prospective, observational, and descriptive study, a PK model of cefepime was developed for patients with hematological neoplasms and post-chemotherapy febrile neutropenia. This study was conducted at a cancer referral center, and study participants were receiving 2 g IV doses of cefepime every 8 h as 30-min infusions. Cefepime PK was well described by a two compartment model with a clearance dependent on a serum creatinine level. Using Monte Carlo simulations, it was shown that continuous infusions of 6g q24h could have a good achievement of PK/PD targets for MIC levels below the resistance cut-off point of Enterobacteriaceae. According to the simulations, it is unnecessary to increase the daily dose of cefepime (above 6 g daily) to increase the probability of target attainment (PTA). Cumulative fraction of response (CFR) using interment dosing was suboptimal for empirical therapy regimens against K. pneumoniae and P. aeruginosa, and continuous infusions could be used in this setting to maximize exposure. Patients with high serum creatinine levels were more likely to achieve predefined PK/PD targets than patients with low levels.

Enhanced Mathematical Model for Producing Highly Dense Metallic Components through Selective Laser Melting.

In this work, a previously developed mathematical model to predict bulk density of SLMed (produced via Selective Laser Melting) component is enhanced by taking laser power, scanning speed, hatch spacing, powder's thermal conductivity and specific heat capacity as independent variables. Experimental data and manufacturing conditions for the selective laser melting (SLM) of metallic materials (which include aluminum, steel, titanium, copper, tungsten and nickel alloys) are adapted from the literature and used to evaluate the validity of the proposed enhanced model. A strong relation between dependent and independent dimensionless products is observed throughout the studied materials. The proposed enhanced mathematical model shows to be highly accurate since the computed root-mean-square-error values (RMSE) does not exceed 5 × 10-7. Furthermore, an analytical expression for the prediction of bulk density of SLMed components was developed. From this, an expression for determining the needed scanning speed, with respect to laser power, to achieve highly dense components produced via SLM, is derived.

A Mathematical Dimensional Model for Predicting Bulk Density of Inconel 718 Parts Produced by Selective Laser Melting.

In this work, dimensional analysis is used to develop a general mathematical model to predict bulk density of SLMed components taking volumetric energy density, scanning speed, powder's thermal conductivity, specific heat capacity, and average grain diameter as independent variables. Strong relation between dependent and independent dimensionless products is observed. Inconel 718 samples were additively manufactured and a particular expression, in the form of a power-law polynomial, for its bulk density, in the working domain of the independent dimensionless product, was obtained. It is found that with longer laser exposure time, and lower scanning speed, better densification is attained. Likewise, volumetric energy density has a positive influence on bulk density. The negative effect of laser power in bulk density is attributed to improper process conditions leading to powder particle sublimation and ejection. A maximum error percentage between experimental and predicted bulk density of 3.7119% is achieved, which corroborates the accuracy of our proposed model. A general expression for determining the scanning speed, with respect to laser power, needed to achieve highly dense components, was derived. The model's applicability was further validated considering SLMed samples produced by AlSi10Mg and Ti6Al4V alloys. This article elucidates how to tune relevant manufacturing parameters to produce highly dense SLM parts using mathematical expressions derived from Buckingham's π- theorem.

Safety and efficacy of brainstem biopsy in children and young adults.

OBJECTIVE: Biopsies of brainstem lesions are performed to establish a diagnosis in the setting of an atypical clinical or radiological presentation, or to facilitate molecular studies. A better understanding of the safety and diagnostic yield of brainstem biopsies would help guide appropriate patient selection. METHODS: All patients who underwent biopsy of a brainstem lesion during the period from January 2011 to June 2019 were reviewed. Demographic, radiological, surgical, and outcome data were collected. RESULTS: A total of 58 patients underwent 65 brainstem biopsies during the study period. Overall, the median age was 7.6 years (IQR 3.9-14.2 years). Twenty-two of the 65 biopsies (34%) were open, 42 (65%) were stereotactic, and 1 was endoscopic. In 3 cases (5%), a ventriculoperitoneal shunt was placed, and in 9 cases (14%), a posterior fossa decompression was performed during the same operative session as the biopsy. An intraoperative MRI (iMRI) was performed in 28 cases (43%). In 3 of these cases (11%), the biopsy was off target and additional samples were obtained during the same procedure. New neurological deficits were noted in 5 cases (8%), including sensory deficits, ophthalmoparesis/nystagmus, facial weakness, and hearing loss; these deficits persisted in 2 cases and were transient in 3 cases. A pseudomeningocele occurred in 1 patient; no patients developed a CSF leak or infection. In 8 cases (13%) an additional procedure was needed to obtain a diagnosis. CONCLUSIONS: Brainstem biopsies are safe and effective. Target selection and approach should be a collaborative effort. iMRI can be used to assess biopsy accuracy in real time, thereby allowing any adjustment if necessary.

The necessary gender perspective for the analysis of health problems.

This work begins with the difference between sex and gender, then show that the contrasts in the field of health between men and women can be explained: by the construction of gender of consultants and health service providers, by the structure of the services themselves of health (which also reflects gender constructions), and by the reproduction of gender patterns through education and research. The work shows the need to include a gender perspective in health research.

Este trabajo inicia con la diferencia entre sexo y género, para mostrar que los contrastes en el campo de la salud entre hombres y mujeres pueden explicarse por la construcción de género de consultantes y de proveedores de servicios de salud, por la estructura de los propios servicios de salud (que refleja también construcciones de género) y por la reproducción de patrones de género a través de la educación y la investigación. El trabajo muestra la necesidad de incluir la perspectiva de género en la investigación en salud.

Best practices for high data-rate macromolecular crystallography (HDRMX).

In macromolecular crystallography, higher flux, smaller beams, and faster detectors open the door to experiments with very large numbers of very small samples that can reveal polymorphs and dynamics but require re-engineering of approaches to the clustering of images both at synchrotrons and XFELs (X-ray free electron lasers). The need for the management of orders of magnitude more images and limitations of file systems favor a transition from simple one-file-per-image systems such as CBF to image container systems such as HDF5. This further increases the load on computers and networks and requires a re-examination of the presentation of metadata. In this paper, we discuss three important components of this problem-improved approaches to the clustering of images to better support experiments on polymorphs and dynamics, recent and upcoming changes in metadata for Eiger images, and software to rapidly validate images in the revised Eiger format.

Evaluation and treatment of children with radiation-induced cerebral vasculopathy.

OBJECTIVE: Stenoocclusive cerebral vasculopathy is an infrequent delayed complication of ionizing radiation. It has been well described with photon-based radiation therapy but less so following proton-beam radiotherapy. The authors report their recent institutional experience in evaluating and treating children with radiation-induced cerebral vasculopathy. METHODS: Eligible patients were age 21 years or younger who had a history of cranial radiation and subsequently developed vascular narrowing detected by MR arteriography that was significant enough to warrant cerebral angiography, with or without ischemic symptoms. The study period was January 2011 to March 2019. RESULTS: Thirty-one patients met the study inclusion criteria. Their median age was 12 years, and 18 (58%) were male. Proton-beam radiation therapy was used in 20 patients (64.5%) and photon-based radiation therapy was used in 11 patients (35.5%). Patients were most commonly referred for workup as a result of incidental findings on surveillance tumor imaging (n = 23; 74.2%). Proton-beam patients had a shorter median time from radiotherapy to catheter angiography (24.1 months [IQR 16.8-35.4 months]) than patients who underwent photon-based radiation therapy (48.2 months [IQR 26.6-61.1 months]; p = 0.04). Eighteen hemispheres were revascularized in 15 patients. One surgical patient suffered a contralateral hemispheric infarct 2 weeks after revascularization; no child treated medically (aspirin) has had a stroke to date. The median follow-up duration was 29.2 months (IQR 21.8-54.0 months) from the date of the first catheter angiogram to last clinic visit. CONCLUSIONS: All children who receive cranial radiation therapy from any source, particularly if the parasellar region was involved and the child was young at the time of treatment, require close surveillance for the development of vasculopathy. A structured and detailed evaluation is necessary to determine optimal treatment.

Ozonesonde Quality Assurance: The JOSIE-SHADOZ (2017) Experience.

The ozonesonde is a small balloon-borne instrument that is attached to a standard radiosonde to measure profiles of ozone from the surface to 35 km with ~100-m vertical resolution. Ozonesonde data constitute a mainstay of satellite calibration and are used for climatologies and analysis of trends, especially in the lower stratosphere where satellites are most uncertain. The electrochemical-concentration cell (ECC) ozonesonde has been deployed at ~100 stations worldwide since the 1960s, with changes over time in manufacture and procedures, including details of the cell chemical solution and data processing. As a consequence, there are biases among different stations and discontinuities in profile time-series from individual site records. For 22 years the Jülich [Germany] Ozone Sonde Intercomparison Experiment (JOSIE) has periodically tested ozonesondes in a simulation chamber designated the World Calibration Centre for Ozonesondes (WCCOS) by WMO. In October-November 2017 a JOSIE campaign evaluated the sondes and procedures used in SHADOZ (Southern Hemisphere Additional Ozonesondes), a 14-station sonde network operating in the tropics and subtropics. A distinctive feature of the 2017 JOSIE was that the tests were conducted by operators from eight SHADOZ stations. Experimental protocols for the SHADOZ sonde configurations, which represent most of those in use today, are described, along with preliminary results. SHADOZ stations that follow WMO-recommended protocols record total ozone within 3% of the JOSIE reference instrument. These results and prior JOSIEs demonstrate that regular testing is essential to maintain best practices in ozonesonde operations and to ensure high-quality data for the satellite and ozone assessment communities.

Neuroética del trasplante de cuerpo / Neuroethics of body transplantation

Introducción. Existe bibliografía reciente en revistas especializadas acerca del trasplante de cuerpo, generada fundamentalmente por Sergio Canavero y un grupo chino. Desde hace un par de años vienen anunciando que realizarán el procedimiento, pero aún no ha ocurrido. Objetivo. Realizar un análisis neuroético sobre el trasplante de cuerpo, proponiendo la metodología de Diego Gracia en ética y bioética analizando hechos, valores y deberes. Se propone además que, con el conocimiento actual, el trasplante de cuerpo debe tratarse desde la ética de la investigación. Desarrollo. Aunque desde hace casi un siglo hay antecedentes de intentar conseguir un trasplante de cuerpo, existen numerosas limitaciones para poder realizarlo con el conocimiento actual porque no hay investigación preclínica seria y rigurosa (se encuentran a lo sumo datos anecdóticos). Con los datos disponibles, ni siquiera parece que pueda pensarse en el diseño de un protocolo de inclusión de seres humanos para el trasplante de cuerpo. En cuanto a valores, atendiendo al modelo de Emanuel, quien propone ocho requisitos para cumplir con la ética de la investigación clínica, no es posible siquiera cumplir uno cabalmente. Lo más prudente es recomendar que no debe realizarse un procedimiento así en seres humanos. Conclusiones. Considerando el conocimiento científico disponible y los valores de la ética de la investigación, no debe realizarse un trasplante de cuerpo en seres humanos, ni como investigación clínica ni mucho menos como práctica clínica

Introduction. Recent contributions to the specialised literature address the topic of body transplantation, mostly produced by Sergio Canavero and a group of researchers from China. For several years they have been announcing that they will carry out the procedure, but it has still not been performed. Aims. The aim of this study is to perform a neuroethical analysis of body transplantation, based on the methodology of Diego Gracia on ethics and bioethics and an analysis of facts, values and duties. Furthermore, we also propose that, with the knowledge available today, body transplantation must be addressed from the perspective of research ethics. Development. As regards the facts, it can be said that, although the history of attempts to perform a body transplant dates back almost a century, there are many limitations preventing it from being performed with our current knowledge. This is due to the fact that no serious and rigorous preclinical research has been conducted (at most some anecdotal data can be found). With the data that is available, it does not even seem possible to think of designing a protocol to include human beings for body transplantation. In terms of values, according to the model developed by Emanuel, who proposes eight requirements that must be met to comply with the ethics of clinical research, it is not even possible to comply with one of them. Regarding duties, it would be wise to recommend that such a procedure should not be carried out on humans. Conclusions. Considering the scientific knowledge currently available and the values of research ethics, a body transplantation should not be performed in human beings either as clinical research or as clinical practice

Evaluación de la prescripción profiláctica de omeprazol y ranitidina mediante la identificación de factores de riesgo de sangrado gastrointestinal / Evaluation of prophylactic prescription of omeprazole and ranitidine by identifying risk factors for gastrointestinal bleeding

RESUMEN La información actual sobre el uso de inhibidores de la producción de ácido clorhídrico (inhibidores de bomba de protones y antagonistas de los receptores de histamina H2), en pacientes no críticos hospitalizados para la profilaxis de úlceras por estrés es controversial. Con el fin de evaluar la pertinencia de este grupo de medicamentos en conformidad con el riesgo de sangrado gastrointestinal medido por la escala de Herzig et al. {Risk factors for nosocomial gastrointestinal bleeding and use of acid-suppres-sive medication in non-critically ill patients, J. Gen. Intern. Med, 28(5), 683-690 (2013)}, se realizó un estudio observacional descriptivo longitudinal con recolección retrospectiva de la información, el cual incluyó todos los pacientes mayores de 18 años sin sangrado gastrointestinal y con más de tres días de hospitalización, en el servicio de medicina interna de un hospital de tercer nivel de Bogotá. Según esta escala, el 64% de los pacientes se clasificó en bajo riesgo, el 22,3% en medio-bajo, el 6,7% en medio-alto, y el 6,7% en alto. La prescripción profiláctica de inhibidores de la secreción ácida se realizó en el 67% de los pacientes de bajo riesgo, en el 57% de los de medio-bajo y en el 100% de los pacientes de riesgo medio-alto y alto. Cerca de la mitad (55,35%) de los pacientes recibieron un antiulceroso sin requerirlo; por lo tanto, se recomienda realizar actividades educativas dirigidas al personal prescriptor, con el fin de hacer un uso adecuado de este grupo de medicamentos.

SUMMARY Current information on the use of inhibitors of the production of hydrochloric acid (proton-pump inhibitor (PPI) ATC A02BC and histamine H2 receptor antagonists (Anti H2) ATC A02BC) in non-critical patients for the prophylaxis of stress ulcers is controversial. A descriptive longitudinal observational study with a retrospective collection of information, that included patients over 18 years with more than three days of hospitalization in internal medicine, without active gastrointestinal bleeding using the scale of Herzig et al. {Risk factors for nosocomial gastrointestinal bleeding and use of acid-suppressive medication in non-critically ill patients, J. Gen. Intern. Med., 28(5), 683-690 (2013)}, to assess the risk gastrointestinal bleeding was carried out. According to the risk score, patients were classified 64% as low risk, 22.3% medium-low risk, 6.7% medium-high risk and 6.7% high risk. Prophylactic prescription inhibiting acid secretion was performed in 67% of patients at low risk, 57% in medium-low risk and 100% for patients with medium-high and high risk. More than half (55.33%) of the patients received a PPI/anti H2 without requiring it. Educational activities are recommended to the prescribing staff in order to make proper use of this group of drugs.

Phase II Trial on Extending the Maintenance Flushing Interval of Implanted Ports.

PURPOSE: Retrospective studies suggest that it may be safe to extend the maintenance flushing interval of implanted ports from once every month, as recommended by the manufacturer, to once every 3 months, but no prospective cohort studies have been done specifically assessing the safety and feasibility of this intervention. METHODS: This was a phase II study in oncologic patients who retained a functional port after completion of systemic chemotherapy. Patients enrolled in the study had their port flushed once every 3 months and were observed until completion of five scheduled flushes (one on enrollment and four additional flushes, one every 3 months) or development of any port-related complication, including infections, thrombosis, and occlusions. The primary end points were frequency of port-related complications and port failure requiring removal. RESULTS: A total of 87 patients were enrolled in the study. The median follow-up time was 308 days, accounting for a total of 24,202 catheter-days. There were 10 port-related complications (11.49%; 95% CI, 4.85% to 18.14%). No infection or symptomatic thrombosis occurred. The mean time to port-related complication was 184 days. No patients developed port failure while on protocol, but on subsequent medical record review, four patients developed a complication that required port removal or port revision within 30 days of being removed from the trial (4.6%; 95% CI, 0.4% to 8.8%; 0.17/1,000 catheter-days). CONCLUSION: Extending the maintenance flushes of implanted ports in adult oncologic patients to once every 3 months is safe, effective, and likely to increase patient adherence and satisfaction while decreasing the associated cost.

Attraction by repulsion: compounds with like charges undergo self-assembly in water that improves in high salt and persists in real biological fluids.

We report a family of highly anionic calixarenes that form discrete homo-dimeric assemblies in pure water, that get stronger in high salt solutions, and that remain assembled in complex, denaturing solutions like real urine. The results reveal the potential of like-charged subunits for self-assembly in high-salt solutions and biological fluids.

Costos directos e impacto sobre la morbimortalidad hospitalariade eventos adversos prevenibles a medicamentosen una institución de tercer nivel de Bogotá / Direct costs and impact on hospital morbidity and mortality of preventable adverse drug events in a tertiary institution in Bogota

Introducción. La implementación de actividades de farmacovigilancia permite supervisar y evaluar aspectos relacionados con la atención médica. Es necesario que la información recolectada permita identificar oportunidades para mejorar la calidad de la atención en salud. Se propone un análisis de los eventos adversos a medicamentos desde la óptica preventiva y económica, estableciendo su impacto local.Objetivo. Determinar el porcentaje de eventos adversos prevenibles a medicamentos, reportados en una institución de tercer nivel, para establecer su impacto sobre la morbimortalidad y el económico desde la óptica del pagador y mostrando la relevancia de usar un método que permita identificarlos y evitar o disminuir su presentación. Materiales y métodos. A partir de los reportes generados durante actividades de farmacovigilancia en el año 2007 en un hospital de tercer nivel de Bogotá, se revisaron las historias clínicas de los pacientes involucrados y se evaluó la relación de causalidad, la gravedad y el carácter prevenible de los eventos adversos a medicamentos. Se calcularon los costos directos generados, agrupándolos en pruebas diagnósticas, tiempo de estancia adicional, procedimientos y medicamentos adicionales. Resultados. Se revisaron 448 reportes de eventos adversos a medicamentos en 283 pacientes y se encontró que 24,8 % de los eventos reportados eran prevenibles, con mortalidad de 1,1 % y costos totales asociados con su atención entre $ 33´620.346 (US$ 16.687) y $ 37´754.856 (US$ 18.739). Los factores más frecuentemente asociados con la prevención fueron las interacciones farmacológicas y las dosis o frecuencias inadecuadas de administración.Conclusiones. Es importante tomar medidas tendientes a disminuir la presentación de eventos adversos prevenibles a medicamentos, ya que repercuten negativamente tanto sobre la salud de los pacientes, como en el consumo de recursos.

Introduction. Implementing pharmacovigilance activities consists of monitoring and assessment of activities related to medical attention. However, additional data are necessary to identify conditions where care quality can be improved. Therefore, a focus on adverse drug events analysis from a prevention and economic perspective is needed, with emphasis on its local impact.Objective. Preventable adverse drug events were summarized to establishing their impact on morbidity and mortality, as well as to estimate the ensuing economic burden. Materials and methods. The data were gathered from a level 3 hospital (high complexity), located in Bogotá, Colombia, where specific pharmacovigilance activities were recorded in 2007. Patient charts were reviewed to characterize adverse drug events according to their causality, severity and preventability. Direct costs were estimated by grouping diagnostic tests, length of hospitalization, procedures and additional drugs required. Results. The charts of 283 patients and 448 reports were analyzed. These data indicated that 24.8% of adverse drug events were preventable and that an associated mortality of 1.1% had occurred. The associated direct costs were between USD $16,687 and $18,739. Factors more commonly associated with preventability were drug-drug interactions, as well as inappropriate doses and unsuitable frequencies at which the drugs were administrated. Conclusions. The data recommended that actions be taken to decrease preventable adverse drug events, because of negative impact on patient’s health, and unnecessary consumption of healthcare resources.

Comparative in vitro study of the antimicrobial activities of different commercial antibiotic products of vancomycin.

BACKGROUND: One of the most critical problems about antimicrobial therapy is the increasing resistance to antibiotics. Previous studies have shown that there is a direct relation between erroneous prescription, dosage, route, duration of the therapy and the antibiotics resistance. Other important point is the uncertainty about the quality of the prescribed medicines. Some physicians believe that generic drugs are not as effective as innovator ones, so it is very important to have evidence that shows that all commercialized drugs are suitable for therapeutic use. METHODS: Microbial assays were used to establish the potency, the Minimal Inhibitory Concentrations (MICs), the Minimal Bactericidal Concentration (MBCs), the critical concentrations, and the production of spontaneous mutants that are resistant to vancomycin. RESULTS: The microbial assay was validated in order to determine the Vancomycin potency of the tasted samples. All the products showed that have potency values between 90 - 115% (USP requirement). The products behave similarly because the MICs, The MBCs, the critical concentrations, the critical concentrations ratios between standard and samples, and the production of spontaneous mutants don't have significant differences. CONCLUSIONS: All products analyzed by microbiological tests, show that both trademarks and generics do not have statistical variability and the answer of antimicrobial activity Show also that they are pharmaceutical equivalents.