The Role of Physiotherapy in Peripheral Artery Disease in Patients With Diabetes Mellitus: A Narrative Review.

Diabetes mellitus (DM) comprises a spectrum of metabolic disorders distinguished by the persistent elevation of glucose levels in the bloodstream. It stands as a primary risk factor for peripheral arterial disease (PAD), denoted by atherosclerosis affecting the lower extremities. One clinical manifestation of symptomatic PAD is intermittent claudication alleviated by rest but also capable of presenting as atypical leg pain. Confirmatory diagnostic measures, including the ankle-brachial index (ABI), toe-brachial index (TBI), or Doppler waveform analysis, are imperative in the verification of PAD. For management, the recommendation is to incorporate physiotherapy alongside concurrent medical interventions, such as anticoagulants, antiplatelet agents, statins, or, in certain cases, surgical procedures. This narrative review seeks to elucidate the advantages of physiotherapy in diabetic patients with PAD, contributing to the deceleration of disease progression and improving symptoms. Although supervised exercise therapy is strongly supported by empirical evidence as more beneficial, the absence of supervised environments is a common issue. Consequently, the preference lies in the combination of supervised exercise with home-based regimens. The objective is that each patient exercises for more than three days per week, progressively extending their duration weekly. This approach has demonstrated a noteworthy enhancement in walking functionality, exercise tolerance, pain alleviation, and an overall improvement in the quality of life for patients.

Papel de la ciclooxigenasa (COX) en las alteraciones motoras gastrointestinales y la fiebre inducidas por el lipopolisacárido (LPS) en la oveja / No disponible

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Aplicabilidad y efectividad de un protocolo de indicación farmacéutica en farmacias comunitarias de Sevilla capital / Applicability and effectiveness of a protocol for pharmacist prescribing in community pharmacies in the city of Seville

Introducción: La indicación farmacéutica puede entenderse erróneamente como equivalente al consejo farmacéutico, aunque en realidad se trata de un autocuidado asistido en que el paciente acude al farmacéutico solicitando la elección de un fármaco que no requiere receta médica, haciéndole partícipe de un compromiso y responsabilidad profesional. Si existiera una metodología de documentación y evaluación de intervenciones unificada y validada, los datos serían comparables y extrapolables a otros ámbitos y dispondríamos de un instrumento de medición de actividad, calidad y un posible sistema de acreditación de la indicación farmacéutica. Objetivo: Evaluar la aplicabilidad y efectividad de un protocolo de indicación farmacéutica mediante la aplicación de un protocolo y considerando la percepción del estado de salud de los pacientes atendidos. Metodología: Estudio multicéntrico cuasiexperimental, postest, sin grupo control, con entrevistador externo, realizado con 107 pacientes que acuden a 7 farmacias elegidas al azar para solicitar al farmacéutico que le recomiende un medicamento para tratar un problema de salud. Resultados: El protocolo se ha aplicado en el 95,33% de los casos sin desviarse del protocolo; se identificó el problema de salud menor en un 94,8% de los pacientes, se seleccionaron fármacos en el 96,26% de los casos y, tras aplicarlo, el resultado fue positivo en 97 pacientes. Los pacientes manifestaron que se habían recuperado de sus síntomas con una puntuación de 8,59 sobre 10, y la consulta se resolvió en un 89,6% de los casos. Conclusión: La aplicabilidad del protocolo y efectividad de la indicación farmacéutica a las consultas incluidas en el estudio de diversas farmacias elegidas al azar ha sido posible (AU)

Introduction: Pharmacist prescribing can be wrongly understood as the equivalent of pharmaceutical advice, when in reality it is assisted self-care in which the patient approaches the pharmacist requesting the choice of a drug that does not require a doctor’s prescription, making the pharmacist make a commitment and take professional responsibility. If there were a valid and standardised intervention assessment and documentation methodology, the details could be compared and extrapolated to other areas and we would have an instrument to measure activity and quality, and a possible system for the accreditation of pharmacist prescribing. Objective: To assess the applicability and effectiveness of a protocol for pharmacist prescribing through the application of a protocol and by considering the perception of the state of health of the patients being attended. Methodology: Quasi-experimental, multicentric study, posttest, without a control group, with an external interviewer, carried out on 107 patients attending 7 random pharmacies to request the pharmacist to recommend a drug to them to treat a health problem. Results: The protocol was applied in 95.33% of the cases without straying from the protocol; the minor health problem was identified in 94.8% of the patients, drugs were chosen in 96.26% of the cases and, after being applied, the result was positive in 97 patients. The patients stated that they recovered from their symptoms with a score of 8.59, and the consultation was resolved in 89.6% of the cases. Conclusion: In the cases of the consultations included in the study of several random pharmacies it was possible to apply the protocol and effectiveness of pharmacist prescribing (AU)

K+ channels involved in contractility of rabbit small intestine

Most excitable cells, including gastrointestinal smooth muscle cells, express several types of K+channels. The aim of this study was to examine the types of K+ channels involved in the contractility of longitudinal smooth muscle of rabbit small intestinein vitro. Spontaneous contractions and KCl-stimulated contractions were reduced by atropine, phentolamine, propranolol, suramin, tetrodotoxin and indomethacin. The amplitude and tone of spontaneous contractions were increased by apamin, charybdotoxin, iberiotoxin, E4031, tetraetylammonium (TEA) and BaCl2. The frequency of contractions was reduced in the presence of apamin and TEA and increased by charybdotoxin. It was found that 4-aminopyridine increased the tone of spontaneous contractions and reduced the amplitude and frequency of contractions. Glibenclamide did not modify the amplitude, frequency or tone of contractions. KCl-stimulated contractions were increased by E4031, were not modified by apamin, glibenclamide, NS1619 or diazoxide, and were reduced by charybdotoxin, TEA, 4-aminopyridine or BaCl2. These results suggest that both Ca2+-activated K+ channels of small and high conductance, and HERG K+ channels and inward rectifier K+ channels participate in spontaneous contractions of small intestine. On the other hand, voltage-dependent K+ channels, HERG K+ channels, inward rectifier K+ channels and high conductance Ca2+-activated K+ channels are involved in KCl-stimulated contractions (AU)

La mayoría de las células excitables, incluyendo las células lisas gastrointestinales, expresan varios tipos de canales de K+. El objetivo de este estudio es examinar los tipos de canales de K+que están involucrados en la contractilidad del músculo liso longitudinal del intestino delgado de conejoin vitro. Las contracciones espontáneas y las producidas por KCl se redujeron por atropina, fentolamina, propranolol, suramina, tetrodotoxina e indometacina. La amplitud y tono de las contracciones espontáneas aumentaron por apamin, charybdotoxina, iberiotoxina, E4031, tetraetilamonio (TEA) y BaCl2, mientras que la frecuencia de las contracciones se redujo en presencia de apamin, charybdotoxina y TEA. La 4-aminopiridina aumentó el tono de las contracciones espontáneas y redujo la amplitud y frecuencia de las contracciones. La glibenclamida no modificó la amplitud, frecuencia y tono de las contracciones. Las contracciones producidas por el KCl aumentaron en presencia de E4031, no fueron modificadas por el apamin, glibenclamida, NS1619 o diazóxida y disminuyeron en presencia de la charybdotoxina, TEA, 4-aminopiridina o BaCl2. Estos resultados sugieren que los canales de K+ activados por Ca2+ de pequeña y gran conductancia, canales de K+ HERG canales de K+ rectificadores de entrada participan en las contracciones espontáneas del intestino delgado. Por otra parte, los canales de K+ voltaje-dependientes, canales de K+ HERG, canales de K+ rectificadores de entrada y canales de K+activados por Ca2+ de gran conductancia están implicados en las contracciones producidas por el KCl (AU)