Consumo de psicofármacos en pacientes ambulatorios en un Hospital de Mendoza, Argentina / Consumption of psychopharms in ambulatory patients in a Hospital de Mendoza, Argentina

Introducción: La aparición de nuevos psicofármacos y diagnósticos psiquiátricos ha conducido a una mayor medicación en psiquiatría, convirtiéndose en uno de los grupos demedicamentos más utilizados.Objetivo: Determinar el consumo de psicofármacos en elServicio de Farmacia de un Hospital de Mendoza en pacientes ambulatorios.Metodología: Se realizó un estudio observacional, descriptivo,transversal, de tipo indicación-prescripción. Se analizaron 1.620prescripciones, provenientes de 509 recetas de pacientes ambulatorios, con al menos un psicofármaco, sobre un total de11.082 medicamentos, durante 17 días (junio 2018). Datos recolectados: socio-demográficos, diagnósticos y medicamentosprescriptos. Los medicamentos y los diagnósticos se clasificaronsegún las clasificaciones Anatómica Terapéutica Química e Internacional de Enfermedades, respectivamente.Resultados (%): Sexo: F (60), M (39). Edad (años): 0-15 (6,4),16-65 (85), mayor de 65 (6). Los grupos farmacológicos másprescriptos fueron: benzodiacepinas (18,9), antipsicóticos(9,2) y antidepresivos (8). Diagnósticos: trastornos mentalesy del comportamiento (63); enfermedades del sistema nervioso (12); enfermedades del sistema osteomuscular y deltejido conectivo (8); síntomas, signos y hallazgos clínicos yde laboratorio, no clasificados en otra parte (4,5). Fármacos:tracto alimentario y metabolismo (10); sangre y órganos formadores de sangre (2); estimulantes cardíacos (10) y sistemanervioso (63).Conclusión: Diagnósticos más frecuentes: depresión, epilepsia y dolor. Se encuentra asociación significativa entre ansiedad y el sexo femenino. Los antiepilépticos y psicolépticosfueron los fármacos más dispensados. El rol del farmacéutico es fundamental en la monitorización de conductas prescriptivas y cuidado de herramientas terapéuticas. (AU)

Introduction: Emergence of new psychopharms and psychiatric diagnoses hasled to greater medication in psychiatry,becoming one of the most used drugsgroups.Objective: To determine the consumption of psychotropic drugs in the Pharmacy Service of a Mendoza Hospital inoutpatients.Methodology: An observational, descriptive, cross-sectional study, of the indication-prescription type was performed.1,620 prescribed drugs were analyzed,corresponding to from 509 prescriptionsin outpatients, with at least one psychoactive drug, on a total of 11,082 medications, for 17 days (June 2018). Datacollected: socio-demographic data, diagnostics and prescribed medications. Medications and diagnoses were classifiedaccording to the anatomical TherapeuticChemical and International Disease classifications, respectively.Results (%): Sex: F (60), M (39). Age(years): 0-15 (6.4), 16-65 (85), over 65(6). The most prescribed pharmacological groups were: benzodiazepines(18.9), antipsychotics (9.2) and antidepressants (8). Diagnoses: mental andbehavioral disorders (63); nervous systemdiseases (12); diseases of the musculoskeletal system and connective tissue (8);symptoms, signs and clinical and laboratory findings, not classified elsewhere(4,5). Drugs: food tract and metabolism(10); blood and blood forming organs(2); cardiac stimulants (10) and nervoussystem (63).Conclusion: Most frequent diagnoses:depression, epilepsy and pain. There isa significant association between anxiety and female sex. Antiepilepticsand psycholeptics were the most dispensed drugs. The pharmacist's role isfundamental in the monitoring of prescriptive behaviors and care of therapeutic tools. (AU)

Liver transplantation for aHUS: still needed in the eculizumab era?

BACKGROUND: The risk of disease recurrence after a kidney transplant is high in patients with atypical hemolytic uremic syndrome (aHUS) and mutations in the complement factor H (FH) gene (CFH). Since FH is mostly produced by the liver, a kidney transplant does not correct the genetic defect. The anti-C5 antibody eculizumab prevents post-transplant aHUS recurrence, but it does not cure the disease. Combined liver-kidney transplantation has been performed in few patients with CFH mutations based on the rationale that liver replacement provides a source of normal FH. METHODS: We report the 9-year follow-up of a child with aHUS and a CFH mutation, including clinical data, extensive genetic characterization, and complement profile in the circulation and at endothelial level. The outcome of kidney and liver transplants performed separately 3 years apart are reported. RESULTS: The patient showed incomplete response to plasma, with relapsing episodes, progression to end-stage renal disease, and endothelial-restricted complement dysregulation. Eculizumab prophylaxis post-kidney transplant did not achieve sustained remission, leaving the child at risk of disease recurrence. A liver graft given 3 years after the kidney transplant completely abrogated endothelial complement activation and allowed eculizumab withdrawal. CONCLUSIONS: Liver transplant may definitely cure aHUS and represents an option for patients with suboptimal response to eculizumab.

Effect of fluorinated groups on photooxidative stability of polymeric protectives applied on marble.

Some new protective copolymers and a commercial one have been tested on Candoglia marble, a very low porosity stone. Two of the polymers contained a partially fluorinated methacrylic monomer, 2,2,2 trifluoro ethyl methacrylate (TFEMA), in combination with either an acrylic, methyl acrylate (MA) or a vinyl ether, n-butyl vinyl ether (n-BVE) unit. Two copolymers, ethyl methacrylate/n-butyl vinyl ether and ethyl methacrylate (EMA)/methyl acrylate (Paraloid B72), were non-fluorinated and similar in compositions and molar ratio. The aim of the work is to test the copolymers and compare the performances of fluorinated new polymers with the non fluorinated one and with the largely used commercial product. The results obtained demonstrate that the introduction, even in limited amounts, of fluorine atoms in the side ester groups of methacrylic type polymers really improves their protective effect and the durability of the stone treatments. The best results were obtained with the copolymer TFEM/MA which is the fluorinated homologous of Paraloid B72.