Análisis de las prescripciones y dispensaciones de psicofármacos en una oficina de farmacia de la provincia de Mendoza, Argentina / Prescriptions and dispensations analysis of psychotropic drugs in a pharmacy office of Mendoza province, Argentina

El Uso Racional de Medicamentos refiere a prácticas adecuadas en cada componente de la cadena de utilización. En este trabajo, nuestro objetivo radicó en determinar el perfil de las prescripciones de psicofármacos recibidas y dispensadas en una oficina de farmacia de la provincia de Mendoza (Argentina), evaluar posibles errores, medir la magnitud del consumo e identificar los psicofármacos de primera elección. Se efectuó un análisis observacional, transversal y retrospectivo de prescripciones dispensadas entre el 1 de enero y el 30 de junio de 2020. Los datos se obtuvieron directamente desde las prescripciones. Los fármacos se codificaron según el sistema de clasificación ATC y los diagnósticos según la Clasificación Internacional de Enfermedades, ambos propuestos por la OMS. La prueba del Chi-cuadrado se utilizó para comparar las variables. Una probabilidad de p<0,05 fue considerada estadísticamente significativa. Se registraron 7.836 prescripciones en 7.041 recetas (media por paciente = 1,11±0,32). Hubo mayor prescripción de psicofármacos a pacientes femeninos (χ2 p<0,001). Las especialidades médicas que más prescribieron los psicofármacos dispensados fueron Clínica, Medicina Familiar y Psiquiatría. Los fármacos psicolépticos fueron los mayormente prescritos, seguido de los antiepilépticos, psicoanalépticos y analgésicos. El 43,76% del total correspondió a benzodiacepinas, principalmente clonazepam, alprazolam y bromazepam. Clonazepam fue el fármaco más prescrito en el período analizado (21,75%), principalmente para diagnósticos de trastornos de ansiedad, hipertensión arterial y depresión. Los registros obtenidos muestran un elevado consumo de ciertos psicofármacos, resultando coincidente con estudios semejantes, hallándose idéntica relación con los fármacos más prescritos, sexo y especialidad del profesional prescriptor. (AU)

The Rational Use of Medicines it refers to adequate practices in each component of the utilization chain. In this work, our objective was to determinate profile of psychotropic drugs prescriptions received and dispensed in a pharmacy office of Mendoza province (Argentina), with evaluation of possible errors, determination of the magnitude consumption and identification of first-choice psychotropic drugs. It was performed an observational, cross-sectional, and retrospective analysis of the prescriptions dispensed between January 1 and June 30, 2020. Data were obtained directly from prescriptions. Drugs were coded according to the ATC classification system and diagnoses according to the International Classification of Diseases, both proposed by the WHO. The Chi-square test was used to compare the variables. A probability of p<0.05 was considered significant statistically. It was registered 7,836 prescriptions in 7,041 prescriptions (mean per patient = 1.11±0.32). There was a greater prescription of psychotropic drugs to female patients (χ2 p<0.001). The clinical medical did result the professional that more prescribed the psychotropic drugs dispensed followed by Family Medicine and Psychiatry specialties. Psycholeptic drugs were the most prescribed, followed by antiepileptic, psychoanaleptic and analgesic drugs. 43.76% of the total corresponded to benzodiazepines, mainly clonazepam, alprazolam and bromazepam. Clonazepam was the most prescribed drug in the analyzed period (21.75%), mainly for diagnosing anxiety disorders, arterial hypertension, and depression. The records obtained show a high consumption of certain psychotropic drugs groups, which coincides with similar studies, finding an identical relationship with the most prescribed drugs, sex, and specialty of the prescribing professional. (AU)

La Farmacoepidemiología como una estrategia útil en diabetes mellitus: experiencia en un Centro Sanitario de Mendoza, Argentina / Pharmacoepidemiology as a useful strategy in diabetes mellitus: experience in a Health Center in Mendoza, Argentina

Introducción: La diabetes mellitus (DM) es de importancia para la salud pública y la Farmacoepidemiología constituye una herramienta útil para controlarla.Objetivo: Determinar frecuencia, comorbilidades, dispensación y consumo de medicamentos en un Centro de Atención Primaria de la Salud de Mendoza, Argentina. Metodología: Se realizó un estudio descriptivo, observacional, transversal, retrospectivo en 700 pacientes adultos, se determinó frecuencia de DM, comorbilidades, dispensación y consumo de medicamentos. Resultados: Se encontró asociación entre sexo masculino y riesgo de DM. La DM tipo 2 fue la más frecuente. La hipertensión arterial fue la comorbilidad asociada a DM. Fármacos más dispensados: insulina y metformina, fármacos más consumidos: metformina luego enalapril. Conclusiones: El análisis farmacoepidemiológico permitió detectar problemas relacionados con la DM, sus comorbilidades y tratamientos. Estos estudios favorecen la prevención y tratamiento de la DM. (AU)

Introduction: Diabetes mellitus (DM) is essential for public health, and Pharmacoepidemiology is a useful tool to control it.Objective: To determine frequency, comorbidities, dispensation, and consumption of medicines in a Primary Health Care Center of Mendoza, Argentina. Methodology: A descriptive, observational, cross-sectional, retrospective study was carried out in 700 adult patients, frequency of DM, comorbidities, dispensation, and consumption of medications was determined. Results: Association between male sex and the risk of DM was found. Type 2 DM was the most frequent. Hypertension was the comorbidity associated with DM. Most dispensed drugs: insulin and metformin, most consumed drugs: metformin then enalapril. Conclusion: The pharmacoepidemiological analysis allowed to detect problems related to DM, its comorbidities, and treatments.These studies favor the prevention and treatment of DM. (AU)

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)

[Comparative evaluation of the indirect enzyme-linked immunosorbant assay in milk for the detection of cattle infected with Brucella abortus, in herds located in the province of Cundinamarca, Colombia]. / Evaluación comparativa del método inmunoenzimático indirecto en leche para la detección de bovinos infectados con Brucella abortus, en hatos del departamento de Cundinamarca, Colombia.

To perform a comparative evaluation of the indirect enzyme-linked immunosorbent assay (iELISA) in milk, for the detection of Brucella abortus in cattle, 1,523 milk samples were taken from individual animals and bulk milk belonging to 200 herds in the province of Cundinamarca, Colombia. All these herds were part of the official programme of monitoring free herds and determining herd prevalence in the province. The samples were submitted simultaneously to the milk ring test and the iELISA. A total of 584 individual and 497 bulk milk samples taken from free herds were considered negative, and served to determine the initial ELISA cut-off point. An optimised determination of the cut-off point involved an operational analysis, using a statistical programme. In the analysis, the total population was considered: 756 individual positive and negative samples, as defined by herd history and previously established serologies. The cut-off point was set at > 0.20 optical density units, which, expressed in percentage positivity, corresponded to 20.5% against the controls, with a sensitivity of 95.3%, a specificity of 95.1%, and a confidence interval of 95%. Indirect confirmation of the state of infection was made with competitive ELISA in the serum of the individual animals considered positive, and an attempt was made to determine bacterial presence by isolation in culture and by reverse transcription-polymerase chain reaction. The results confirm that the indirect ELISA is highly sensitive and specific, provides confirmed results in strict quality-control conditions, and may be used to test a large number of herd or individual samples, thus enhancing the efficiency of surveillance programmes and control campaigns.

Diverse ideas on the growth kinetics of disseminated cancer cells.

Theoretical and empirical arguments are used to support the growth kinetics of disseminated tumors. Employing viable hypotheses, it is established that Gompertzian growth of disseminated cancer cells can be derived from a number of theoretical considerations. Empirical methods are used to validate and confirm the theoretical assertions with the use of available data.

Normal cell decline and inhibition in acute leukemia: a biomathematical modeling approach.

Biomathematical models describing acute leukemia are introduced. These models are used to show some of the possible ways in which the normal cell population declines in the presence of malignant cells in acute leukemia. They also described situations in which normal cell inhibition by the malignant clone contributes to and supports leukemic development. The progression of acute leukemia is quantified both analytically and numerically by considering the steady-state and dynamic properties of the models. The studies and investigations indicate that as long as malignant cells are present in acute leukemia, normal cell growth or regrowth capabilities will be very reduced and diminished. As biomedicine becomes more quantitative, studies that involve the employment and use of various mathematical methods and techniques also become more relevant. In this regard, the models could be useful in predicting the quantitative and qualitative behavior of cell population in certain acute leukemias as the search for more effective therapeutic strategies continues.

Modeling tumor growth.

The meaning and limitations of certain mathematical models of tumor growth are discussed, and some new derivations of the existing models are given. A theoretical justification for Gompertz's law of growth for tumors is presented. An age-dependent Von Bertalanffy's equation and diffusion models are introduced, and existence and uniqueness problems are addressed.

On the classical trapping problem.

We consider the problem of finding the probability density for the location of an untrapped pest satisfying a diffusion equation with the scaled Laplacian. Then by taking the initial data to the diffusion process to be in some Lp spaces, we establish the existence and uniqueness of local solutions in these spaces and the existence and uniqueness of weak global solutions in Lp,q; p,q greater than 3. The interest of this method relies on the fact that it is by successive approximations and hence amenable to numerical treatment.