Increasing access to hematopoietic cell transplantation in Latin America: results of the 2018 LABMT activity survey and trends since 2012.

A total of 5642 hematopoietic cell transplants (HCT) in 5445 patients (2196-40% allogeneic and 3249-60% autologous) were reported by 127 teams in 14 Latin American countries that answered the 2018 LABMT/WBMT Global Transplant Activity survey. The transplant rate (defined as the number of first transplants per 10 million inhabitants per year) was 85 (51 autologous and 34 allogeneic) in 2018. The main indications for allogeneic HCT were acute leukemias (60%), while plasma cell disorders and lymphomas were the most common conditions warranting autologous HCT (50 and 36%, respectively). In the allogeneic HCT, HLA-identical siblings were the main type of donor (44%) followed by related mismatched/haploidentical donors (32%). Peripheral blood stem cells were used in 98% of the autologous and in 64% of the allogeneic transplants. From 2012 to 2018, there was a 64% increase of reported HCT (54% in autologous and 80% in allogeneic). In the allogeneic setting, the most pronounced increase in donor type was observed in haploidentical relatives (from 94 procedures in 2012 up to 710 in 2018), surpassing unrelated donors as of 2017. Significant trends detected in Latin America include rising numbers of the procedures reported, a faster increase in allogeneic HCT compared with autologous HCT and a significant increase in family mismatched/haploidentical donors. The LABMT/WBMT activity survey provides useful data to understand the HCT activity and trends in Latin America.

Basic Skills in Higher Education: An Analysis of Attributed Importance.

Today, the skills-based approach is increasingly in demand by companies due, in large part, to the fact that it favors the management of human resources by focusing on individual capabilities; which, finally, improves the job profile of a company. As a result, choosing the right candidates has become increasingly selective. Universities, therefore, need to teach skills to improve the incorporation of graduates into the workplace making it as successful as possible. For this reason, it is of special relevance to know if college students consider that the acquisition of skills is key for their incorporation into the workplace. The main objective of this study was to analyze and compare the importance assigned to the acquisition of basic skills in the university education of 694 students studying four different bachelor degrees: pedagogy, early childhood education, primary education, and psychology. For this purpose, a Likert-type questionnaire on basic skills was distributed with four possible options and the following five dimensions that grouped basic skills: organizational and planning capacity; access to information sources; analysis and synthesis of texts, situations, and people; teamwork; and problem solving. The results show that as a whole all students across different bachelor degrees gave a high score to the acquisition of basic skills, with early childhood education students giving it greater importance compared to the students from other disciplines and, more specifically, differences were observed in some dimensions depending on the bachelor degree that they have started.

Experiencia de trasplante de progenitores hematopoyéticos autólogo en pacientes con esclerodermia sistémica cutánea difusa / Autologous hematopoietic stem cell transplantation experience in patients with diffuse cutaneous systemic scleroderma

Introducción: La progresión y la falta de opciones terapéuticas conlleva a un gran aumento de la morbi-mortalidad en la esclerodermia sistémica cutánea difusa. Caso Clínico: Se presentan tres pacientes con diagnóstico de Esclerodermia sistémica de rápida progresión sin compromiso cardiopulmonar o renal severo con múltiples líneas de tratamiento incluyendo altas dosis de ciclofosfamida, sometidas a trasplante autólogo (2015-2020) con acondicionamiento a base de Ciclofosfamida y Globulina Antitimocitica, como opción terapéutica. Durante el procedimiento no se observaron complicaciones infecciosas severas con un prendimiento medular en el día 10 y una recaída promedio de 9.6 meses. Conclusiones: Ante el buen perfil de toxicidad y la buena tolerancia al procedimiento se debe considerar al Trasplante Autólogo como una opción de tratamiento en pacientes sin altas dosis acumuladas de ciclofosfamida o en estadios precoces de enfermedad.

Introduction: Progression and lack of therapeutic options leads to greatly increased morbi-mortality in diffuse cutaneous systemic scleroderma. Case Report: We present three patients with a diagnosis of rapidly progressive systemic scleroderma without severe cardiopulmonary or renal involvement with multiple lines of treatment including high doses of cyclophosphamide, undergoing autologous transplantation (2015-2020) with Cyclophosphamide and Antithymocyte Globulin based conditioning, as a therapeutic option. No severe infectious complications were observed during the procedure with a medullary attachment on day 10 and a mean relapse of 9.6 months. Conclusions: Given the good toxicity profile and good tolerance to the procedure, Autologous Transplantation should be considered as a treatment option in patients without high accumulated doses of cyclophosphamide or in early stages of disease.

Experiencia de trasplante de progenitores hematopoyéticos autólogo en pacientes con esclerodermia sistémica cutánea difusa / Autologous hematopoietic stem cell transplantation experience in patients with diffuse cutaneous systemic scleroderma

Introducción: La progresión y la falta de opciones terapéuticas conlleva a un gran aumento de la morbi-mortalidad en la esclerodermia sistémica cutánea difusa. Caso Clínico: Se presentan tres pacientes con diagnóstico de Esclerodermia sistémica de rápida progresión sin compromiso cardiopulmonar o renal severo con múltiples líneas de tratamiento incluyendo altas dosis de ciclofosfamida, sometidas a trasplante autólogo(2015-2020) con acondicionamiento a base de Ciclofosfamida y Globulina Antitimocitica, como opción terapéutica. Durante el procedimiento no se observaron complicaciones infecciosas severas con un prendimiento medular en el día 10 y una recaída promedio de 9.6 meses. Conclusiones: Ante el buen perfil de toxicidad y la buena tolerancia al procedimiento se debe considerar al Trasplante Autólogo como una opción de tratamiento en pacientes sin altas dosis acumuladas de ciclofosfamida o en estadios precoces de enfermedad.

Background:The progression and lack of therapeutic options leads to a large increase in morbidity and mortality in diffuse cutaneous systemic scleroderma. Clinical Case: Three patients with a diagnosis of rapidly progressing systemic scleroderma without severe cardiopulmonary or renal involvement with multiple lines of treatment including high doses of cyclophosphamide, submitted to autologous transplant (2015-2020) with conditioning based on Cyclophosphamide and Antithymocyte Globulin are presented as a therapeutic option. During the procedure, no various infectious infections were observed with a medullary seizure on day 10 and an average relapse of 9.6 months. Conclusions: Due to the good toxicity profile and good tolerance to the procedure, Autologous Transplantation should be considered as a treatment option in patients without high accumulated doses of cyclophosphamide or in early stages of disease.

Estudio del lenguaje en las diferentes fases de la enfermedad de Alzheimer a través del Test de Boston / Study of language in the different phases of Alzheimer's disease through the Boston Test

Introducción. El incremento en la esperanza de vida en las sociedades desarrolladas ha provocado un aumento en la aparición de enfermedades que son desconocidas por el mundo médico y científico, y por tanto difíciles de abarcar por la comunidad terapéutica. El objetivo de este trabajo es el análisis exhaustivo del progreso en el deterioro de cada una de las áreas del lenguaje en las diferentes fases de la enfermedad de Alzheimer (EA). De esta forma, se podrá planificar la intervención del logopeda en estos pacientes en función de la fase en que se encuentren. Metodología. Para ello se ha diseñado un estudio para evaluar distintos aspectos del proceso cognitivo del lenguaje mediante la utilización del Test de Boston. Esta investigación se ha llevado a cabo con 32 participantes, de los cuales 8 no estaban diagnosticados de EA, 8 estaban diagnosticados de EA en la fase leve, 8 estaban diagnosticados de EA en la fase moderada y, por último, 8 estaban diagnosticados con EA en la fase grave, con el fin de poder estudiar cómo se van alterando las habilidades lingüísticas en las diferentes fases de la enfermedad. Resultados. Los resultados muestran cómo a medida que progresa la enfermedad, el habla espontánea, la comprensión auditiva y la expresión oral van deteriorándose en los participantes diagnosticados de EA. Sin embargo, no en todas las áreas del lenguaje el deterioro avanza de igual forma; de hecho, en el área de habla espontánea los participantes en fase leve ya comienzan a mostrar un deterioro significativo con respecto al grupo control. Sin embargo, dentro del área de comprensión auditiva, los participantes diagnosticados de EA son capaces de realizar de forma satisfactoria la tarea de discriminación auditiva, incluso en fases avanzadas de la enfermedad. Discusión y conclusiones. En esta investigación se observa cómo el curso de la alteración de las capacidades comunicativas difiere a lo largo del curso de la EA. Por ello, resalta la necesidad de estudiar en profundidad sus áreas del lenguaje para así ayudar a la planificación de la intervención del logopeda en cada momento específico de la enfermedad (AU)

Introduction. The increase in life expectancy in developed societies has led to an rise in the appearance of diseases that are unknown by the medical and scientific world and, therefore, are difficult to cover by the therapeutic community. The Alzheimer's disease (AD) is a neurodegenerative disease that has multiple cognitive disorders, being especially relevant the language impairment displayed by patients diagnosed with the disease. The objective of this research is the exhaustive analysis of the progress in the deterioration of each of the areas of language in the different phases of AD. Thus, the intervention of the speech therapist can be planned in these patients depending on the phase in which they are. Method. We have designed a study to evaluate various aspects of the cognitive process of language using the Boston Test. We have worked with 32 individuals, eight of which were not diagnosed with AD, eight diagnosed with AD in mild stage, eight with AD in moderate stage and finally, eight were diagnosed with AD in advanced stage. We analysed how it is disrupting language abilities at different stages of the disease. Results. The results show how Spontaneous Speech, Listening Comprehension and Oral Expression will be deteriorate in these patients as the disease progresses. However, deterioration does not proceed in the same way in all areas of language. In the Spontaneous Speech area, participants in the mild stage already begin to show a significant deterioration with respect to the control group. On the other hand, within the area of Listening Comprehension, all participants diagnosed with AD successfully perform the auditory discrimination task, even in advanced stages of the disease. Discussion and conclusions. This research shows how the course of the alteration of the communicative capacities differs along the course of AD. Therefore, it highlights the need to study in more depth the language of the AD to help planning a speech therapy intervention in each specific phase of the illness (AU)

Expression of c-Fos protein in medial septum/diagonal band of Broca and CA3 region, associated with the temporary inactivation of the supramammillary area.

The supramammillary (SuM) area is part of the diencephalic nuclei comprising the mammillary bodies, and is a key structure in the memory and spatial learning processes. It is a critical region in the modulation/generation of hippocampal theta rhythm. In addition, many papers have recently shown a clear involvement of this structure in the processes of spatial learning and memory in animal models, although it is still not known how it modulates spatial navigation and response emotional. The aim of the present research was to study the effect of the temporary inactivation of the SuM area on synaptic plasticity of crucial structures in the formation of spatial memory and emotional response. Sprague-Dawley rats were asigned in three groups: a control group where the animals were not subjected to any treatment, and two groups where the rats received microinjections of tetrodotoxin (TTX) in the SuM area (5ng diluted in 0.5µl of saline) or saline (0.5µl). The microinjections were administered 90min before the perfusion. Later, cellular activity in medial septum/diagonal band of Broca (MS/DBB) and CA3 region of the dorsal hippocampus was assessed, by measuring the immediate early gene c-fos. The results show a clear hiperactivity cellular in medial septum/diagonal band of Broca and a clear hypoactivity cellular in the CA3 region of the hippocampus when there was a functional inactivation of the SuM area. It suggests that the SuM area seems to be part of the connection and information input pathways to CA3 region of the hippocampal formation, key for proper functioning in spatial memory and emotional response.

Temporary inactivation of the supramammillary area impairs spatial working memory and spatial reference memory retrieval.

The aim of our study was to examine the supramammillary (SuM) area involvement in spatial memory. Sprague-Dawley rats with chronically implanted cannula in the supramammillary area were trained in two spatial memory tasks with different memory demands: reference and working memory. In the spatial reference memory task, the rats received microinjections in the SuM area of tetrodotoxin (TTX) (0.5 ng diluted in 0.5 microL of saline) or saline (0.5 microL). The microinjections were administered 30 min before the spatial training (day 4) (to assess the effect on acquisition) and on the following two days (days 5 and 6) the training was conducted without microinjections (to study the effect on consolidation). On the last training day (day 7), in order to assess the retrieval of spatial information, the rats received the microinjections 30 min before the spatial training. The spatial working memory used was a delayed-matching-to-position (DMTP) task. Spatial training was performed for seven days. During the first three days of the spatial training, the rats achieved a good spatial knowledge and learnt the working memory rule necessary to solve the spatial task. On days 4 and 6, the rats received microinjections to study involvement of the SuM area in working memory. The results showed that temporary inactivation of SuM area impairs both the rat's ability to solve a spatial working memory task with DMTP demands and the recovery of spatial information in a spatial reference memory task. We suggest that SuM area is involved in the rearrangement of spatial information during spatial working memory tasks with DMTP memory demands.

Supramammillary and adjacent nuclei lesions impair spatial working memory and induce anxiolitic-like behavior.

The present study assesses the involvement of the supramammillary and adjacent nuclei in spatial memory and anxiety-like behaviors. Rats with electrolytic lesions in the supramammillary nucleus were pre- and post-operatively trained in two spatial memory tasks and two anxiety tasks. Spatial memory tasks were performed in an open field with seven different goal positions containing the reward. Anxiety-like behaviors were tested in the elevated T-maze. In the spatial reference memory task, neither lesioned nor sham-lesioned groups were impaired. In the working memory task, lesioned animals were permanently impaired in their ability to solve the delayed-matching-to-position task. This working memory deficit is not related to increased proactive interference. It could be related to impairment of the rats ability to reorganize spatial stimuli. Consequently, rats were not able to achieve an optimal performance level to solve spatial tasks with continuous changes in the place location. In the elevated T-maze, lesioned rats reduced passive avoidance response but no changes in the escape response were observed. These results suggest a clear involvement of the supramammillary nucleus in working memory and behavioral inhibition but not in either spatial reference memory or in escape responses.

Análisis de la disponibilidad de medicamentos en una farmacia comunitaria / Analysis of the availability of medicines in a community pharmacy

Introducción: La legislación vigente en España establece que las oficinas de farmacia deberán prestar entre otros servicios, el de la adquisición, custodia y dispensación de los medicamentos a la población. Objetivos : Evaluar la disponibilidad de medicamentos en una farmacia comunitaria , y analizar los no disponibles y estudiar el tiempo de consecución de estos. Método: Estudio retrospectivo de cuarenta y cinco días de duración de las dispensaciones de medicamentos realizadas en una farmacia comunitaria de Sevilla y de los no disponibles para la dispensación . Se recogen en una aplicación informática los registros de medicamentos dispensados, y en un procedimiento de encargos los medicamentos que no se disponen pero que el cliente accede a que se le posponga su dispensación y se registra el tiempo de consecución. También se anotan los medicamentos no dispensados ni encargados. Resultados: El número total de dispensaciones posibles fue de 4.429 envases de medicamentos, de las que se efectuaron realmente 4.400 (99,0 por ciento), aunque en el acto fueron 4.172 (94,2 por ciento). Los medicamentos encargados tardaron en obtenerse una media de 9 horas y 27 minutos. El 78 por ciento de los 257 medicamentos no disponibles en el acto lo fueron por una rotura del stock de la farmacia en estos. La farmacia poseía un sustituto con la misma composición , dosis y forma farmacéutica en 142 ocasiones, el 55 por ciento de estos 257 medicamentos. Conclusiones: La farmacia comunitaria cumple adecuadamente su papel de accesibilidad del medicamento a la población y goza de un sistema de reaprovisionamiento de gran celeridad (AU)

Introduction: The prevailing legislation in Spain establishes that community pharmacies should give among other services, the acquirement, custody and dispensing of medicines to the population. Objectives: To evaluate the availability of medicines in a community pharmacy, and analyze those not available and study the time in the acquisition of them. Method: A 45 days length retrospective study on the dispensed medicines and those not available for dispensing in a Community pharmacy in Seville. The records of prescribed medicines were gathered on a computer application, and in a process of order the medicines not available but which the customer orders should be put at his or her disposition, and also the time of acquisition was registered. The medicines neither dispensed nor ordered were also noted down. Results: The total number of possible dispensations were 4.429 medicine packages, of which 4.400 were really made (99.0%), although immediately they were 4,127 (94.2%) the medicines ordered took an average of 9 hours and 27 minutes to be obtained. 78% of the 257 medicines not available immediately were due to a lack of stock in the pharmacy. The pharmacy had a substitute with the same composition, doses and pharmaceutical format on 142 occasions, 55% of these 257 medicines. Conclusions: The community pharmacy fulfilled adequately its role of accessibility to medicines for the population and possesses a supply system of great swiftness (AU)

Análisis de la prescripción antibiótica en una farmacia comunitaria / Analysis of the antibiotic prescription in a community pharmacy

Introducción: El problema de los resistencias o antibióticos tiene su origen en unas pautas de utilización inadecuados. Objetivo: evaluar lo prescripción antibiótica a adultas en una farmacia comunitaria. Métodos: Estudio observacional prospectivo sobre los antibióticos prescritos paro tratamientos agudos a los pacientes mayores de 15 años, usuarios de una farmacia comunitaria de lo ciudad de Sevilla. A los que acceden a participar en el estudio se les realiza una encuesta en la que se recogen datos del paciente (edad, sexo, si tiene fiebre y si estaba tomando un antibiótico previamente), localización de la infección, datos del prescriptor (especialidad, si es su médico habitual, financiación de la receta, información sobre posología y duración del tratamiento), datos del medicamento (especialidad, dosis diaria, duración y precio) y datos del cuidador si no era el paciente quien acudía a la farmacia. Resultados: Quedaron incluidos 2 /4 pacientes o los que se les dispensaron 234 envases de antibióticos. Los penicilinas fueron las más prescritas, con 99 prescripciones y dentro de ellas lo amoxicilina, que únicamente no estuvo en 5 de éstos. Los siguientes grupos fueron macrólidos, con 48 y cefalosporinas con 37. La administración oral copó 212 de los 214 tratamientos, el número de tomas diarios fue de 2,5 (DE= 1,1) y fueron 6,2 DÍAS (DE= 2,5) los días de duración del tratamiento. Conclusiones: la utilización de antibióticos está tendiendo a seleccionar antibióticos de amplio espectro y de una mayor comodidad de uso para el paciente en cuanto a posología y duración, en detrimento de una política de uso racional del medicamento (AU)

Introduction: The problem of antibiotic resistances lies in the improper use of the guidelines. Objective: To evaluate antibiotic prescriptions for adults in a community pharmacy. Methods: Prospective observational study on prescribed antibiotics for acute treatment in patients older than fifteen, uses of a community pharmacy in Seville. A survey was carried out on those who agreed to take part in the study in which data of the patient was gathered (age, sex, if the person had a fever, and if he/she had been previously taking an antibiotic) the location of the infection, information about the prescriber (subspecialty, if he/she is the patient's usual physician, the funding of the prescription, information on dosage and length of treatment) data on the drug (brand name, daily doses, duration and price) and information on the person in charged of the prescription if it wasn 't the patient who visited the pharmacy. Results: 214 patients were included, to whom 234 antibiotic packages were dispensed. The most prescribed were penicillins, with 99 prescriptions and among those amoxycillin which was only absent in five cases. The next groups were macrolides with 48 and cephalosporins with 37. Oral administration took up 212 of the 214 treatments, the daily doses was 2.5 (SD= 1.1) and the duration of treatment was 6.2 days (SD=2.5). Conclusions: the use of antibiotics has the tendency of selecting antibiotics of an ample spectrum and a major convenience in use for the patient as far as dosage and duration, to the detriment of a rational drug use policy (AU)