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El estudio pretende analizar y comparar el grado de fidelización entre pacientes con uno o más factores de riesgo cardiovascular a los que se les realizarán únicamente educación sanitaria y pacientes con uno o más factores de riesgo cardiovascular a los que se les realizará seguimiento farmacoterapéutico. Cada farmacia participante en el proyecto instaurará un "servicio de control de los factores de riesgo cardiovascular" en el que se determinará de forma gratuita a cada paciente los niveles de presión arterial, colesterol total, triglicéridos, glucosa basal, peso, índice de masa corporal y riesgo cardiovascular. Todos estos parámetros se medirán a los cero, tres y seis meses. A los pacientes del grupo control se les realizará educación sanitaria y a los pacientes del grupo intervención se les realizará seguimiento farmacoterapéutico. Además, el estudio incluirá una "campaña antitabaco" para pacientes fumadores. En cada paciente se medirán y tratarán de forma individualizada todos los factores de riesgo cardiovascular con el objetivo de disminuir el riesgo cardiovascular de cada paciente. Para medir el grado de fidelización de los pacientes se realizará un registro mensual de todos los medicamentos y productos sanitarios que el paciente adquiera cada vez que visite la farmacia. En la visita cero y en la visita de los seis meses, se pasará a los pacientes un cuestionario anónimo para poder analizar el grado de satisfacción de los pacientes con la farmacia y con el servicio de seguimiento farmacoterapéutico, tras seis meses de educación sanitaria o seguimiento fármaco terapéutico

Background: Long-term efficacy of heart retransplantation (RTx) for end-stage cardiac allograft failure remains unclear given the limited worldwide experience and is an important question to elucidate given the shortage of donor organs. The aim of this systematic review was to examine the outcomes of RTx in patients with cardiac allograft failure., Methods: Electronic search was performed to identify all studies in the English literature assessing RTx for cardiac allograft failure. All identified articles were systematically assessed for inclusion and exclusion criteria., Results: Eleven studies were included for analysis, with a total of 7,791 patients. A total of 7,446 patients underwent primary heart transplantation (HTx) whereas 345 patients underwent RTx with average time from primary HTx to RTx interval of 5.03 years (95% CI: 3.13-6.94 years). There were 35.2% of patients received RTx within 30 days of primary transplant. Early mortality was significantly higher among RTx patients (RTx 28.2% vs. HTx 11.2%, P<0.001) whereas survival was significantly higher among HTx patients when compared to RTx patients at 1 year (HTx 81.8% vs. RTx 59.1%, P<0.001), 2 years (HTx 77.9% vs. RTx 53.6%, P<0.001), 3 years (HTx 76.1% vs. RTx 49.8%, P<0.001), 5 years (HTx 68.8% vs. RTx 41.4%, P<0.001) and 10 years (HTx 53.9% vs. RTx 31.7%, P<0.001). There were no significant differences between HTx and RTx in terms of freedom from rejection at 1 year (HTx 61.0% vs. RTx 53.7%, P=0.43), 2 years (HTx 63.8% vs. RTx 53.7%, P=0.26), 3 years (HTx 62.9% vs. RTx 51.9%, P=0.30) and 5 years (HTx 61.0% vs. RTx 51.9%, P=0.36)., Conclusions: Patients who underwent heart RTx had a significant lower survival when compared to those who only underwent primary HTx. There were no significant differences in post-transplantation freedom from rejection. Careful patient selection and perioperative care can make heart RTx a viable option for selected recipients., Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.

Background: Transplant coronary artery vasculopathy (TCAV) is the major cause of late allograft failure and death in heart transplant recipients. The aim of this systematic review was to examine the outcomes of percutaneous coronary interventions (PCIs) as compared to coronary artery bypass grafting (CABG) surgery in the management of TCAV. Our secondary objective was to compare the use and outcomes of drug eluting stents (DES) as compared to bare metal stents (BMS) in this patient population., Methods: Electronic search was performed to identify all studies in the English literature examining PCI as compared to CABG for TCAV in heart transplant recipients. All identified articles were systematically assessed for inclusion and exclusion criteria., Results: Of the 4,989 studies identified, 29 studies were included. Among 1,520 patients who developed TCAV, 1,470 patients underwent PCI and 50 patients underwent CABG. There were no significant differences in baseline demographics and comorbidities among the PCI and CABG cohorts. Compared to the PCI cohort, patients who underwent CABG had a higher early mortality (CABG 36.4% vs . PCI 4.3%, P<0.001) and overall mortality (CABG 42.3% vs . PCI 21.4%, P=0.049). When comparing DES versus BMS cohorts, there were no significant differences in the rate of in-stent stenosis (DES 14.5% vs . BMS 24.4%, P=0.476), overall mortality (DES 17.4% vs . BMS 30.8%, P=0.302) or cardiac related mortality (DES 7.7% vs . BMS 21.8%, P=0.415)., Conclusions: CABG and PCI are both feasible modalities for revascularization in patients with TCAV where PCI is associated with lower mortality. There were no differences in outcomes among patients who underwent PCI with DES as compared to BMS. Potential bias may exist due to heterogeneity in available data. Further studies are needed to delineate evidence-based guidelines to tailor the appropriate therapy, CABG or PCI, to the appropriate patient., Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.

The first example of a triple formato/hydroxido/sulfato (FHS) bridge for any metal is reported in compound [Cu2(bpym)(OH)(HCO2)(SO4)(H2O)2]·3H2O (1). Its structure shows the presence of alternating triple FHS bridges and 2,2'-bipyrimidine (bpym) ones. Although in the initial synthesis the sulfate anions were introduced accidentally, here we report the rational synthesis and the magnetic properties of this compound. The magnetic properties show that 1 is an alternating ferro/antiferromagnetic (F/AF) chain compound with predominant antiferromagnetic interactions and were fit to an alternating F/AF S = (1)/2 chain with g = 2.103, JAF = -139 cm(-1), and JF = 116 cm(-1) (α = JF/|JAF| = 0.83). The JAF value found corresponds very well to those previously reported for Cu-bpym-Cu bridges (average value of ca. -150 cm(-1)). The JF value is also very close to the estimated one (ca. 100 cm(-1)) from magneto-structural correlations in triply Cu-Cu bridged compounds with both hydroxido and carboxylato bridges in equatorial positions.

It is estimated that at least one out of three children with recurrent wheezing is atopic. Reliable diagnostic tools are needed in primary care that allow for adequate identification of these children. The purpose of this study was to assess the value of ImmunoCAP Rapid (ICR) Wheeze-Rhinitis Child in the identification of atopy with the use of 10 selected allergens in children with recurrent episodes of wheezing. A multicenter population study is based on primary care. It included children managed consecutively at the health center, who had three or more episodes of wheezing, at least one of them in the last 12 months. Each child completed a physical examination, an epidemiological survey, one capillary blood sampling (110 microl) for ICR, and one venous blood sampling for determination of Phadiatop Infant, total IgE and 10 specific IgE measurements. The children were identified as atopic, based on their clinical signs and symptoms and at least one positive specific IgE (0.35 kU(A)/l or higher), before knowing the results of ICR, Phadiatop Infant and total IgE. ICR was read by two independent observers. Six classes were evaluated, negative without any color and five positive degrees of pink-red color. Two hundred and fifteen children aged between 1 and 14 years were studied (138 boys); 50.7% were identified as atopic, 39.1% were sensitized only to inhalant allergens, 6.5% to food allergens and 5.1% to both. The predominant allergen was the dust mite (39.3%). For ICR, there were 2134 valid double observations. The Kappa index, comparing the negative results vs. any positive result, was 0.91 (95% CI: 0.88-0.94). The intraclass correlation coefficient was 0.98 (95% CI: 0.98-0.99). In the identification of a child as atopic, the positive post-test probability of ICR depended on the color degrees considered: 88.4% for any positive and 97.6% for the most intense tones. The positive post-test probability of Phadiatop Infant and total IgE was 95.6% and 68.2% respectively. ICR showed good reliability for the most prevalent allergen, the dust mite, with a sensitivity of 90.5% (95% CI: 82.1-95.8) and specificity of 88.5% (95% CI: 81.7-93.4). The analysis of the other allergens was limited by the small number of sensitized children. The analysis of receiver operating characteristic curves revealed an area under the curve of 0.84 (95% CI 0.80-0.88) for the cut-off point of specific IgE of 0.35 kU(A)/l and of 0.94(CI 0.91-0.97) for 2 kU(A)/l. A greater intensity of color of the lines of ICR was related to higher levels of specific IgE in blood. ICR is a reliable test for the identification of atopy in children, which identifies most children as atopic, and shows a good correlation in allergen-by-allergen identification. This suggests that it should be regarded as a first-rate tool, in the primary care clinic, for the evaluation of children with recurrent wheezing.

This paper reports the synthesis, structure solution, and magnetic characterization of four new DIMMAL-containing compounds (H2DIMMAL = 2-di1H-2-imidazolylmethylmalonic acid), H2DIMMAL x H2O (1), Na2(DIMMAL) x 5H2O (2), [Cu(HDIMMAL)2] (3), and [Cu2(DIMMAL)2(H2O)2] x 2H2O (4). Compound 1, containing two carboxylates and two protonated imidazole rings, adopts the dizwitterion configuration. These monohydrate MBBs pack together into a 3D array driven, as in the other three cases herein reported, by a combination of multiple-path H-bonds and aromatic-aromatic interactions. Compound 2 consists of centrosymmetric Na+ tetramers in which four NaO6 distorted octahedra are interconnected by carboxylate and water bridges. Compound 3 consists of mononuclear [Cu(HDIMMAL)2] units in which HDIMMAL- acts as a tridentate ligand through two imidazole N atoms and the deprotonated O from a carboxylate. Compound 4 consists of centrosymmetric cyclic dinuclear [Cu2(DIMMAL)2(H2O)2] x 2H2O units involving propionate-arm bridges. The building-block units described above, in each case, are interconnected into 3D networks by multiple H-bonding paths and aromatic-aromatic interactions. The EPR spectra are indicative of an essentially d(x2-y2) ground state for the copper(II) ions in 3 and 4 (CuN4O2 and CuN2O2O' chromophores, respectively). Magnetic susceptibility measurements in the range of 1.8-200 K for compound 4 show weak antiferromagnetic exchange between the copper(II) ions (2J = -1.6(1) cm(-1)). The effectiveness of the propionate-arm bridges, involving C-C sigma bonds, in propagating magnetic exchange between the copper(II) ions is discussed.

A novel mu-pyrazolato-mu-hydroxo-dibridged copper(II) complex has been synthesized and structurally characterized: [(Cu(mepirizole)Br)2(mu-OH)(mu-pz)] (mepirizole=4-methoxy-2-(5-methoxy-3-methyl-1H-pyrazol-1-yl)-6-methylpyrimidine; pz=pyrazolate). The title compound crystallizes in the monoclinic system, space group P2(1)/c, with a=15.618(2) A, b=15.369(3) A, c=16.071(3) A, and beta=112.250(1) degrees. The structure is built up of dinuclear [(Cu(mepirizole)Br)2(mu-OH)(mu-pz)] units with five-coordinated copper(II) ions (CuBrN3O chromophores) linked by mu2-OH and mu2-pyrazolato bridges that are well separated from each others. The intramolecular copper-copper distance is 3.378(3) A. Magnetic susceptibility data show that the copper atoms are strongly antiferromagnetically coupled with J=-770 cm(-1). The obtained triplet-singlet energy gap is compared with those reported for a series of related dimers. The strong antiferromagnetic coupling arising from the complementarity of the hydroxo and pyrazolato bridges has been discussed on the basis of DFT calculations.