Microbiological quality control of non-sterile compounded medicines prepared in a Portuguese hospital centre.

OBJECTIVES: This work aimed to evaluate the quality of non-sterile formulations compounded at Centro Hospitalar Cova da Beira (Covilhã, Portugal) immediately after preparation and up to the defined 'beyond-use date'. METHODS: Microbiological quality control tests were performed in accordance with monograph 5.1.4 of the European Pharmacopoeia 8.0. Samples of compounded products were collected from January to December 2014 after preparation and were analysed immediately and reanalysed after storage under the established conditions, for each preparation. RESULTS: In the test period, 392 preparations were analysed, corresponding to 24 different formulations (8 intermediate preparations, 11 oral solutions/suspensions and 5 topical preparations). All preparations were in accordance with the pharmacopoeia specifications immediately after preparation. However, for the formulations 'prednisolone oral solution (5 mg/mL)' and 'nitroglycerine and cinchocaine ointment (0.25%/0.5%)', the microbial counts of some batches exceeded the defined limits after storage up to the beyond-use date. CONCLUSIONS: These results show that the compounding practices implemented at this pharmacy department are able to ensure the microbiological quality of compounded products. This microbiological quality control methodology also allowed identification of the need to replace formulations shown not to be stable throughout the storage period. On the basis of these results, a monthly routine of microbiological control of a random sample of compounded medicines was established in order to ensure their quality and safety for use.

Risk behaviors and STI prevalence among people with HIV in El Salvador.

To date, there are no studies from El Salvador among people with HIV to inform prevention programs. We conducted a study in El Salvador in 2008 among people with HIV using audio computer-assisted interviews on risk behaviors and access to health care. Blood was tested for syphilis and herpes simplex type 2 (HSV-2). Active syphilis was defined as RPR titer ≥1:8. Genital specimens were tested for other sexually transmitted infections (STI) by PCR. We evaluated factors associated with unprotected sex with last stable partner of HIV-negative or unknown status among those reporting a stable partner. A total of 811 HIV-positive individuals participated: 413 men and 398 women. Prevalence of Chlamydia and gonorrhea was low (≤1%), while prevalence of other STI was high: Mycoplasma genitalium (14%), syphilis (15% seropositivity, active syphilis 3%) and HSV-2 (85%). In multivariate analysis, disclosing HIV status to partner (OR 0.2, 95% CI: 0.1-0.3, p<0.001), participation in HIV support groups (OR 0.3, 95% CI: 0.1-0.8, p=0.01), easy access to condoms (OR 0.4, 95% CI: 0.2-0.9, p=0.04) were protective factors for unprotected sex. Reporting a casual partner in the last 12 months (OR 3.6, 95% CI: 1.5-8.5, p=0.004). and having an STI (OR 2.6, 95% CI:1.3-5.5, p=0.02) were associated with an increased odds of unprotected sex. Prevention interventions among HIV-positives in El Salvador should focus on increasing condom access, promoting HIV disclosure and couples testing and reducing the number of partners. The positive role of support groups should be used to enhance behavioral change.

How many men who have sex with men and female sex workers live in El Salvador? Using respondent-driven sampling and capture-recapture to estimate population sizes.

OBJECTIVE: To estimate the numbers of female sex workers (FSW) and men who have sex with men (MSM) in San Salvador, El Salvador. DESIGN AND METHODS: A capture-recapture exercise was conducted among MSM and FSW in San Salvador in 2008. The first capture was done by distributing key chains to both MSM and FSW populations through local non-governmental organizations (NGO) that work with these groups. The second capture was done during the course of an integrated behavioural and biological survey (IBBS) using respondent-driven sampling (RDS). The proportion receiving a key chain estimated from the IBBS study was adjusted by RDS-derived weights. RESULTS: The first capture included 400 FSW and 400 MSM. Of the 624 MSM interviewed in the IBBS, 36 (5.8% crude; 3.2% adjusted RDS) had received the key chain. The estimated population size of MSM in San Salvador was 12 480 (95% CI 7235 to 17 725). Of the 663 FSW interviewed in the IBBS, 39 (5.9% crude; 6.9% adjusted RDS) had received the key chain. The estimated number of FSW was 5765 (95% CI 4253 to 7277). CONCLUSIONS: The capture-recapture exercise was successfully linked to an IBBS to obtain city-level population sizes for MSM and FSW, providing valuable information at a low cost. Size estimates are crucial for programme planning for national AIDS programmes, NGOs and stakeholders working with these populations and for HIV projection models.

Assessing the relative quality of anesthesiology and critical care medicine Internet mailing lists.

UNLABELLED: We studied the relative quality of a subset of anesthesiology and critical care medicine Internet mailing lists regarding the publishing capacity of their members to compare them with the major journals and conferences regarding these specialties. Using systematic searches on MEDLINE and according to the Science Citation Index 1995, we investigated the impact factor of mailing list subscribers, of the first authors of the selected articles, and of the first authors of published abstracts from conferences. We studied six mailing lists, seven journals, and four conferences. Journals and conferences showed a higher percentage of published authors and higher average impact factor among their first authors than the mailing lists did per subscriber. However, when only the subset of publishing authors from the three media was considered, no significant differences were found. We conclude that qualified authors may be found among the subscribers of Internet medical mailing lists on anesthesiology and critical care medicine. These professional discussion groups could complement peer-reviewed publications and conferences in professional information exchange and continuing medical education. IMPLICATIONS: Internet publishing is not governed by rules that assure certain basic quality standards. Methods for assessing these standards are needed. We compared discussion groups with medical journals and conferences on anesthesiology and critical care medicine by calculating the impact factor of their members and first authors, respectively. Our study shows that qualified authors may be found in all three media.

Can examination of WWW usage statistics and other indirect quality indicators distinguish the relative quality of medical web sites?

BACKGROUND: The Internet offers a great amount of health related websites, but concern has been raised about their reliability. Several subjective evaluation criteria and websites rating systems have been proposed as a help for the Internet users to distinguish among web resources with different quality, but their efficacy has not been proven. OBJECTIVES: To evaluate the agreement of a subset of Internet rating systems editorial boards regarding their evaluations of a sample of pediatric websites. To evaluate certain websites characteristics as possible quality indicators for pediatric websites. METHODS: Comparative survey of the Results of systematic evaluations of the contents and formal aspects of a sample of pediatric websites, with the number of daily visits to those websites, the time since their last update, the impact factor of their authors or editors, and the number of websites linked to them. RESULTS: 363 websites were compiled from eight rating systems. Only 25 were indexed and evaluated by at least two rating systems. This subset included more updated and more linked websites. There was no correlation among the Results of the evaluation of these 25 websites by the rating systems. The number of inbound links to the websites significantly correlated with their updating frequency (p<.001), with the number of daily visits (p=.005), and with the Results of their evaluation by the largest rating system, HealthAtoZ (p<.001). The websites updating frequency also significantly correlated with the RESULTS of the websites evaluation by HealthAtoZ, both about their contents (p=.001) and their total values (p<.05). The number of daily visits significantly correlated (p<.05) with the Results of the evaluations by Medical Matrix. CONCLUSIONS: Some websites characteristics as the number of daily visits, their updating frequency and, overall, the number of websites linked to them, correlate with their evaluation by some of the largest rating systems on the Internet, what means that certain indexes obtained from the usage analysis of pediatric websites could be used as quality indicators. On the other hand, the citation analysis on the Web by the quantification of inbound links to medical websites could be an objective and feasible tool in rating great amounts of websites.

Temperature dependence on the passive and dynamic electrical parameters of muscle cells.

Measurements of the temperature dependence in the range from 10 C to 30 C on the passive and dynamic electrical properties of single frog muscle cell following Arrhenius relation have been made. The propagated responses (V-t) and conduction velocity theta were analyzed following the H-H propagated cable equation. The ionic current-membrane potential relationship (I-t) was calculated from the phase-plane trajectory analysis (V-V) of the action potential curve (V-t). All the rate and time constants of the excitation and propagation processes kr, kNa, kK, tau Na, tau K, the negative conductance (-gNa) and the ionic conductances gNa, gK, influencing the evolution of the curves (V-t), (V-V) and (I-V) are correlated. The magnitudes of the resting (Vr) and action potential amplitude (Vs), the excitation potential (V*), the negative after potential (Vn), and the sodium equilibrium potential (VNa); the magnitudes of the maximum rate of rise and fall of the spike (V+) and (V-) and those corresponding to the inward INa and outward IK ionic currents, were analyzed. Two general classes of findings were obtained. One group of action potential parameters theta, V+, V-, Vn, kr, kNa, kK, tau Na, tau K, -gNa, gNa, gK, INa and IK is strongly temperature dependent with Q 10 S approximately 2 and energy of activation E approximately 10 kcal/mole. The other group of parameters, Gm (passive conductance), Cm (capacitance), tau, Vr, V*, Vs, and VNa are slightly temperature dependent, with Q10's lower than 1.4. This study contributes deeply to the analysis of temperature effects on the electrical cell responses to adequate stimuli. This temperature dependence analysis was designed to detect possible "masked" actions of microwave radiation on cell membrane functions.

Quantitation of chronic microwave radiation effects on muscle cell electrical excitable properties: a temperature dependence analysis of the H-H cable and membrane current parameters of irradiated cells.

Frogs Rana pipiens maintained under constant laboratory environmental conditions were subjected daily to chronic microwave exposure with pulsed microwave (2.88 GHZ) at a power density of 10 mW/cm2, during 0.1 hour, for periods up to 100 days. The whole body Specific Absorption Rate (SAR) was of 1.5 mW/g per 1 mW/cm2. The passive and dynamic electrical parameters of sartorius muscle cells from control and irradiated frogs as a function of temperature in the range from 10 C to 30 C, have been analyzed. This temperature dependence analysis, presented in another work, was planned to be used in this paper for detecting those possible "masked" chronic microwave effects in complex membrane mechanisms highly temperature sensitive, and tightly related to the excitation and propagation of bioelectrical responses. The temperature dependence of the passive (Vr, Gm, Cm, and tau) and the active cell electrical parameters (theta, V*, Vs, VNa, Vn, V+, V-, kr, kNa, kK, tau Na, tau K, -gNa, gNa, gK, INa, and IK) was not altered by chronic microwave exposure. The striking observation reported in another work, about the presence of two groups of cell electrical parameters, characterized by their dependence with temperature, was reproduced on the irradiated muscle cells. Results have indicated that there was not muscle cell cumulative bioeffects resulting from microwave exposure to 10 mW/cm2, over a 0.1 hour period.

Quantitation of chronic microwave radiation effects on muscle cell electrical excitable properties: a temperature dependence analysis of the H-H cable and membrane current parameters of irradiated cells

Frogs Rana pipiens maintained under constant laboratory environmental conditions were subjected daily to chronic microwave exposure with pulsed microwave (2.88 GHZ) at a power density of 10 mW/cm2, during 0.1 hour, for periods up to 100 days. The whole body Specific Absorption Rate (SAR) was of 1.5 mW/g per 1 mW/cm2. The passive and dynamic electrical parameters of sartorius muscle cells from control and irradiated frogs as a function of temperature in the range from 10 C to 30 C, have been analyzed. This temperature dependence analysis, presented in another work, was planned to be used in this paper for detecting those possible [quot ]masked[quot ] chronic microwave effects in complex membrane mechanisms highly temperature sensitive, and tightly related to the excitation and propagation of bioelectrical responses. The temperature dependence of the passive (Vr, Gm, Cm, and tau) and the active cell electrical parameters (theta, V*, Vs, VNa, Vn, V+, V-, kr, kNa, kK, tau Na, tau K, -gNa, gNa, gK, INa, and IK) was not altered by chronic microwave exposure. The striking observation reported in another work, about the presence of two groups of cell electrical parameters, characterized by their dependence with temperature, was reproduced on the irradiated muscle cells. Results have indicated that there was not muscle cell cumulative bioeffects resulting from microwave exposure to 10 mW/cm2, over a 0.1 hour period.

Temperature dependence on the passive and dynamic electrical parameters of muscle cells

Measurements of the temperature dependence in the range from 10 C to 30 C on the passive and dynamic electrical properties of single frog muscle cell following Arrhenius relation have been made. The propagated responses (V-t) and conduction velocity theta were analyzed following the H-H propagated cable equation. The ionic current-membrane potential relationship (I-t) was calculated from the phase-plane trajectory analysis (V-V) of the action potential curve (V-t). All the rate and time constants of the excitation and propagation processes kr, kNa, kK, tau Na, tau K, the negative conductance (-gNa) and the ionic conductances gNa, gK, influencing the evolution of the curves (V-t), (V-V) and (I-V) are correlated. The magnitudes of the resting (Vr) and action potential amplitude (Vs), the excitation potential (V*), the negative after potential (Vn), and the sodium equilibrium potential (VNa); the magnitudes of the maximum rate of rise and fall of the spike (V+) and (V-) and those corresponding to the inward INa and outward IK ionic currents, were analyzed. Two general classes of findings were obtained. One group of action potential parameters theta, V+, V-, Vn, kr, kNa, kK, tau Na, tau K, -gNa, gNa, gK, INa and IK is strongly temperature dependent with Q 10 S approximately 2 and energy of activation E approximately 10 kcal/mole. The other group of parameters, Gm (passive conductance), Cm (capacitance), tau, Vr, V*, Vs, and VNa are slightly temperature dependent, with Q10’s lower than 1.4. This study contributes deeply to the analysis of temperature effects on the electrical cell responses to adequate stimuli. This temperature dependence analysis was designed to detect possible [quot ]masked[quot ] actions of microwave radiation on cell membrane functions.

Temperature dependence on the passive and dynamic electrical parameters of muscle cells.

Measurements of the temperature dependence in the range from 10 C to 30 C on the passive and dynamic electrical properties of single frog muscle cell following Arrhenius relation have been made. The propagated responses (V-t) and conduction velocity theta were analyzed following the H-H propagated cable equation. The ionic current-membrane potential relationship (I-t) was calculated from the phase-plane trajectory analysis (V-V) of the action potential curve (V-t). All the rate and time constants of the excitation and propagation processes kr, kNa, kK, tau Na, tau K, the negative conductance (-gNa) and the ionic conductances gNa, gK, influencing the evolution of the curves (V-t), (V-V) and (I-V) are correlated. The magnitudes of the resting (Vr) and action potential amplitude (Vs), the excitation potential (V*), the negative after potential (Vn), and the sodium equilibrium potential (VNa); the magnitudes of the maximum rate of rise and fall of the spike (V+) and (V-) and those corresponding to the inward INa and outward IK ionic currents, were analyzed. Two general classes of findings were obtained. One group of action potential parameters theta, V+, V-, Vn, kr, kNa, kK, tau Na, tau K, -gNa, gNa, gK, INa and IK is strongly temperature dependent with Q 10 S approximately 2 and energy of activation E approximately 10 kcal/mole. The other group of parameters, Gm (passive conductance), Cm (capacitance), tau, Vr, V*, Vs, and VNa are slightly temperature dependent, with Q10s lower than 1.4. This study contributes deeply to the analysis of temperature effects on the electrical cell responses to adequate stimuli. This temperature dependence analysis was designed to detect possible [quot ]masked[quot ] actions of microwave radiation on cell membrane functions.

Quantitation of chronic microwave radiation effects on muscle cell electrical excitable properties: a temperature dependence analysis of the H-H cable and membrane current parameters of irradiated cells.

Frogs Rana pipiens maintained under constant laboratory environmental conditions were subjected daily to chronic microwave exposure with pulsed microwave (2.88 GHZ) at a power density of 10 mW/cm2, during 0.1 hour, for periods up to 100 days. The whole body Specific Absorption Rate (SAR) was of 1.5 mW/g per 1 mW/cm2. The passive and dynamic electrical parameters of sartorius muscle cells from control and irradiated frogs as a function of temperature in the range from 10 C to 30 C, have been analyzed. This temperature dependence analysis, presented in another work, was planned to be used in this paper for detecting those possible [quot ]masked[quot ] chronic microwave effects in complex membrane mechanisms highly temperature sensitive, and tightly related to the excitation and propagation of bioelectrical responses. The temperature dependence of the passive (Vr, Gm, Cm, and tau) and the active cell electrical parameters (theta, V*, Vs, VNa, Vn, V+, V-, kr, kNa, kK, tau Na, tau K, -gNa, gNa, gK, INa, and IK) was not altered by chronic microwave exposure. The striking observation reported in another work, about the presence of two groups of cell electrical parameters, characterized by their dependence with temperature, was reproduced on the irradiated muscle cells. Results have indicated that there was not muscle cell cumulative bioeffects resulting from microwave exposure to 10 mW/cm2, over a 0.1 hour period.

Digital interface for bioelectrical data acquisition system.

The action potential digitalized and stored by means of a fast solid state electronic waveform recording system (Digitalizer) can be directly read out on a printer or in a computer for further processing. It has been designed a digital interface allowing the automatization of these bioelectrical data acquisition and printing process.

Digitalizer system and memory for electric transients.

It was designed a fast solid state electronic waveform recording system (Digitalizer), which can record, store and display action potentials or any type of event, either single pulse or repetitive, as a function of time. Above all, its capacity to record fast transients and to give the output in analog and digital form, makes this electronic device more convenient that conventional recorders or single trace oscilloscope systems.

Temperature effects on the properties of the Hodgkin-Huxley propagated action potential model determined by computed solutions and phase-plane analysis.

The equation for membrane potential (V) of the squid giant axon or some muscle cells, which is the heart of the Hodgkin-Huxley model for the action potential, can be written in three ways: first, as a partial differential equation in time and space; second, as an ordinary differential equation in time, assuming uniform wave propagation for the action potential, and third, as an even simpler ordinary differential equation for the potential at a point, so-called "space clamp" conditions. Solutions were computed for the first two of these equations, at three different temperatures, and the results compared. Temperature dependence of the appropriate parameters was calculated from a simple exponential relationship. Significant changes in the quantitative predictions of the model were found as the temperature was changed from 6.3 C to 18.5 C. Phase-plane (V v V, I v V) analysis has been used to examine the nature of these differences.

Digitalizer system and memory for electric transients

It was designed a fast solid state electronic waveform recording system (Digitalizer), which can record, store and display action potentials or any type of event, either single pulse or repetitive, as a function of time. Above all, its capacity to record fast transients and to give the output in analog and digital form, makes this electronic device more convenient that conventional recorders or single trace oscilloscope systems.

Digital interface for bioelectrical data acquisition system

The action potential digitalized and stored by means of a fast solid state electronic waveform recording system (Digitalizer) can be directly read out on a printer or in a computer for further processing. It has been designed a digital interface allowing the automatization of these bioelectrical data acquisition and printing process.

Temperature effects on the properties of the Hodgkin-Huxley propagated action potential model determined by computed solutions and phase-plane analysis

The equation for membrane potential (V) of the squid giant axon or some muscle cells, which is the heart of the Hodgkin-Huxley model for the action potential, can be written in three ways: first, as a partial differential equation in time and space; second, as an ordinary differential equation in time, assuming uniform wave propagation for the action potential, and third, as an even simpler ordinary differential equation for the potential at a point, so-called [quot ]space clamp[quot ] conditions. Solutions were computed for the first two of these equations, at three different temperatures, and the results compared. Temperature dependence of the appropriate parameters was calculated from a simple exponential relationship. Significant changes in the quantitative predictions of the model were found as the temperature was changed from 6.3 C to 18.5 C. Phase-plane (V v V, I v V) analysis has been used to examine the nature of these differences.

Digital interface for bioelectrical data acquisition system.

The action potential digitalized and stored by means of a fast solid state electronic waveform recording system (Digitalizer) can be directly read out on a printer or in a computer for further processing. It has been designed a digital interface allowing the automatization of these bioelectrical data acquisition and printing process.

Digitalizer system and memory for electric transients.

It was designed a fast solid state electronic waveform recording system (Digitalizer), which can record, store and display action potentials or any type of event, either single pulse or repetitive, as a function of time. Above all, its capacity to record fast transients and to give the output in analog and digital form, makes this electronic device more convenient that conventional recorders or single trace oscilloscope systems.

Temperature effects on the properties of the Hodgkin-Huxley propagated action potential model determined by computed solutions and phase-plane analysis.

The equation for membrane potential (V) of the squid giant axon or some muscle cells, which is the heart of the Hodgkin-Huxley model for the action potential, can be written in three ways: first, as a partial differential equation in time and space; second, as an ordinary differential equation in time, assuming uniform wave propagation for the action potential, and third, as an even simpler ordinary differential equation for the potential at a point, so-called [quot ]space clamp[quot ] conditions. Solutions were computed for the first two of these equations, at three different temperatures, and the results compared. Temperature dependence of the appropriate parameters was calculated from a simple exponential relationship. Significant changes in the quantitative predictions of the model were found as the temperature was changed from 6.3 C to 18.5 C. Phase-plane (V v V, I v V) analysis has been used to examine the nature of these differences.