Search

Purpose Evaluate the type and severity of potential drug-drug interactions and identify risk factors involved, in pediatric patients admitted in a hospital setting. Methods Transversal retrospective analytical study was carried out with hospitalized pediatric patients from a Hospital in the West of Mexico, second and third level. The patients included were ≤18 years old hospitalized in the children wards; those admitted at the emergency room, neonatal intermediate and intensive therapy units were not included. Medical prescriptions were reviewed taking into consideration anthropometric characteristics, diagnosis and number of drugs prescribed to identify potential drug–drug interactions using Micromedex 2.0 database. Results 88 patients were included, an average of 4.6 ± 2.8 of drugs were prescribed per patient. 37 subjects (42%) presented some degree of potential drug-drug interactions of which 25.5% were major and 27.7% moderate according to the software. Identified risk factors were: age ≥ 4 years (OR 1.917; 95% CI 1.081-3.399), BSA ≥ 0.8m2(OR 1.825; 95% CI 1.021–3.263), height ≥ 1 m (OR 2.556;95% CI 1.322 - 4.941), and number of prescribed medications ≥ 4 (OR 2.106;95% CI 1.248 - 3.556). Conclusion Some of the interactions found were for the benefit of the patient, but others were considered undesirable because they altered the pharmacokinetics of some of the medications administered. Detecting in time the harmful interactions for a patient may favor the patient's safety.

Abelardo Contreras-Vergara,1,* Sonia Sifuentes-Franco,2,3,* Sally Haack,4 Omar Graciano-Machuca,2 Adolfo Daniel Rodriguez-Carrizalez,5 Ana Karen López-Contreras,1 Itzel Viridiana Reyes-Pérez,6 Selene G Huerta-Olvera1,7 1PhD in Pharmacology, Health Sciences University Center (CUCS), University of Guadalajara, Guadalajara, Jalisco, Mexico; 2Department of Health Sciences, Los Valles Campus (Cuvalles), University of Guadalajara, Ameca, Jalisco, Mexico; 3Department of Health Sciences - Disease as an Individual Process, Tonalá Campus, University of Guadalajara, Tonalá, Jalisco, Mexico; 4Drake University College of Pharmacy and Health Sciences, Des Moines, IA, USA; 5Department of Physiology, Health Sciences University Center, Institute of Clinical and Experimental Therapeutics, University of Guadalajara, Guadalajara, Jalisco, Mexico; 6Department of Molecular Biology and Genomics, Health Sciences University Center, University of Guadalajara, Guadalajara, Jalisco, Mexico; 7Medical and Life Sciences Department, La Ciénega University Center (CUCI), University of Guadalajara, Ocotlán, Jalisco, Mexico*These authors contributed equally to this workCorrespondence: Selene G Huerta-Olvera, Medical and Life Sciences Department, La Ciénega University Center, University of Guadalajara, Ocotlán, Jalisco, 47810, Mexico, Tel +52 392 9259400, Email selene.huerta@academicos.udg.mxPurpose: To evaluate the impact of pharmaceutical education on medication adherence in patients with Type 2 Diabetes and Systemic Arterial Hypertension.Patients and Methods: This randomized clinical trial enrolled patients with a diagnosis of Type 2 Diabetes Mellitus and Systemic Arterial Hypertension treated in an internal medicine outpatient clinic of a teaching hospital. One hundred and three patients were randomly assigned to the study groups; 51 to the control group and 52 to the intervention group with a 6 months follow-up. Medication adherence was assessed using the Morisky 8-item medication adherence scale. To improve patient adherence to treatment, a wallet card was provided with an up-to-date list of prescribed medications along with recommendations for follow-up care.Results: One hundred and seventy-nine patients were screened for eligibility, of which 103 (57.5%) participated in the study. The intervention group showed a statistically significant decrease in capillary glucose levels, glycated hemoglobin, systolic and diastolic blood pressure, total cholesterol and triglycerides compared to the control group. The frequencies on medication adherence levels at 3 and 6 months in the control group remained similar to baseline, while in the intervention group the frequency of high adherence increased significantly at 6 months (8.7% to 43.5%).Conclusion: A high percentage of patients are not achieving optimal control of their diabetes. Medication adherence rates were between 45– 50% in patients at the baseline of the study, but after receiving education and support from a pharmacist, the intervened group showed a significant increase in their adherence.Keywords: adherence to treatment, chronic disease, health education, morisky medication adherence scale

Psoriasis (Ps) is a chronic dermatosis characterized by erythematous-squamous plaques derived from an inflammatory response. The effect of polymorphisms in the genes that encode the members of the IL-17 family and their receptors has been studied to find an association with the susceptibility to Ps. However, the findings have not been conclusive. To describe the association between IL-17A, IL-17F and IL-17RA gene polymorphisms and susceptibility to Ps. A systematic review was conducted using the PubMed and Scopus databases to identify studies that evaluated the association between IL-17A, IL-17F, and IL-17RA gene polymorphisms and Ps susceptibility. This meta-analysis included reports published until June 2021. Heterogeneity was assessed using Cochran’s Q-statistic test and I2 statistics. The associations between polymorphisms and Ps susceptibility were determined by pooled OR with a 95% CI. Fifteen studies were included. The frequency of the T allele of the IL-17F rs763780 polymorphism was significantly lower in patients with vulgar Ps (OR = 0.732, p = 0.026). The TT genotype of the IL-17F rs763780 polymorphism was significantly associated with a decreased frequency in individuals with Ps and psoriatic arthritis (PsA) (TT:TC + CC OR = 0.664, p = 0.046). Regarding IL-17RA polymorphisms, the AG genotype of the rs4819554 polymorphism showed a near-significant decrease in psoriasis risk compared to the GG genotype (AG:GG OR = 0.604, p = 0.050). Other polymorphisms in IL-17A, IL-17F and IL-17RA showed no association with Ps. The T allele and TT genotype of the IL-17F rs763780 polymorphism may be associated with a decreased risk of psoriasis. Therefore, the implications of this variant on psoriasis pathogenesis and treatment require further investigation.

Introducción: Las interacciones potenciales medicamentosas pueden contribuir a fracasos terapéuticos y/o posibles iatrogenias cuando son prescritos con dos o más medicamentos susceptibles a interactuar. En México, existen pocos estudios que permitan establecer su panorama actual e importancia en la validación de la prescripción por parte del farmacéutico.Objetivo: Evaluar el impacto del farmacéutico en la identificación y evaluación de interacciones potenciales fármaco-fármaco en prescripciones de pacientes hospitalizados de Medicina InternaMaterial y métodos: Estudio observacional, transversal, retrospectivo, de inclusión continua. Se evaluaron hojas de prescripción completas, diagnóstico indistinto, y ≥2 medicamentos indicados. Se detectaron las interacciones a través del software micromedex 2.0. Agrupándose por frecuencia, gravedad y grupo farmacológico. De manera secundaria, se registraron las interacciones potenciales fármaco parámetro de laboratorio.Resultados: En 94 pacientes, 743 medicamentos distintos, promedio de 8±3 medicamentos/paciente, siendo los analgésicos los más prescritos. Se encontraron 141 interacciones potenciales fármaco-fármaco (IPFF). El 47.9% de los pacientes presentó alguna interacción, de las cuales 38.3% fueron graves; porcentaje que disminuyó a 11.4% post-evaluación del farmacéutico como clínicamente relevantes. Se identificaron las interacciones potenciales fármaco parámetro de laboratorio, el 8.3% fueron graves. Se observó un índice de 1.5 IPFF/paciente, el cual se redujo a 0.20 IPFF/paciente post-evaluación de las mismas por el farmacéutico.Conclusiones: El 47.9% presentó interacciones fármaco-fármaco que, independientemente de su severidad, constituyó un problema no reconocido durante la atención hospitalaria. Identificar aquellas interacciones potenciales validando su relevancia clínica por el farmacéutico clínico, mostró una reducción del 88.7% de las interacciones observadas, permitiendo una vigilancia más dirigida.

Latent tuberculosis infection (LTBI) is a condition that has no clinical signs and symptoms. LTBI patients are characterized by persistent immune responses to Mycobacterium tuberculosis, and approximately 5-10% of these infected individuals will develop active TB at some point in their lives. The antigen transporter associated with antigen processing (TAP1) is a protein involved in the transport of the antigen from the cytoplasm to the endoplasmic reticulum by means of the association with MHC class I molecules. It plays a fundamental role in the immune response, promoting the clearance of intracellular pathogens. Our pilot study aimed to determine the association between TAP1 gene 1177A>G (rs1057141) and 2090A>G (rs1135216) genetic polymorphisms with susceptibility to LTBI. In this case-control study, 153 individuals from shelters were analyzed (46 were LTBI-positive and 92 were controls). Genotyping of the rs11352216 (2090A>G) and rs1057141 (1177A>G) gene IDs was performed using the Applied Biosystems Step One Thermal Cycler Real-Time PCR allelic discrimination technology. The haplotypic analyses were performed with the Arlequin 3.5 program. Social assistance centers and shelters that serve vulnerable populations represent high-risk sites due to overcrowding and the impaired nutritional status of their residents. The G allele (OR=1.99, CI=1.109-3.587, p=0.021) and the GG genotype of rs11352216 (A>G) were associated with susceptibility to LTBI, according to the codominant genetic model (OR=8.32, CI=1.722-61.98, p=0.007). The rs1057141 (A>G) polymorphism was not associated with LTBI risk. The results suggest that carriers of the G allele of rs1135216 (A>G) are susceptible to LTBI.

Glutathione (GSH) protects cells against oxidative stress. Redox modifiers induce GSH biosynthesis and recycling to maintain reduced environment inside cells. Cadmium (Cd2+) is a heavy metal that activates redox-sensitive transcriptional factors. The antioxidant α-lipoic acid (ALA) has shown to modulate GSH pathways. This study aimed to investigate de novo synthesis and recycling pathways for GSH balance by different Cd2+ concentrations and ALA in HepG2 cells. ALA activates Nrf2 pathway leading to GSH increment. Pre-treatment with 1 μM Cd2+ or ALA produces tolerance to 5 μM Cd2+ toxic effects. 5 μM Cd2+ exposure significantly augmented nuclear Nrf2, GSH and GCLC, GCLM, HMOX1, TNFα and IL-6 mRNA expression but not GSR, however these upsurges were significantly abrogated by ALA or 1 μM Cd2+ pre-treatments. Exposure to low Cd2+ concentration generate timely protective responses, similar to that elicited by ALA, maintaining a normal redox balance inside the cell due to GSH replenishment.

Background The aim of this study was to detect and analyze Adverse Drug Reactions (ADRs) through Intensive Pharmacovigilance (IPV) in hospitalized pediatric patients to improve drug safety. Methods A prospective 6-month cross-sectional study was performed in the pediatric service of a regional hospital in Mexico in order to assess hospitalized children from 1 day to 18 years old. The inclusion criteria were: both genders, all hospitalization causes, and at least one prescribed medication (indistinct drug group). Notifications were performed through medical visits, phone calls, or spontaneous reports. ADR suspicions were assessed with severity scales: Naranjo algorithm, Schumock & Thornton and Hartwig and Siegel. Results From a total of 1083 hospital admissions, 19 ADRs were recorded. The average age of patients in years was 7.2 (±5.9). The causality assessment in this study showed that most of the ADRs were probable (68.4%) and 4 certain (8.2%); causality was mainly attributed to antibiotics (AB) and an antiepileptic drug. We found a relationship of AB with ADRs (p

Oxidative stress is a known mechanism induced, among other things, by arsenic toxicity. As a response, the cell triggers the synthesis of antioxidant and stress response elements like glutathione and heme oxygenase. Alpha-lipoic acid (ALA) is a well-known antioxidant that confers protection to oxidative stress conditions. We analyzed the effect of ALA pretreatment on Nrf2-responsive gene expression of HepG2 cells exposed to As 3+ . Cells were treated with 5 mM ALA and 8 h later exposed to 50 μM As 3+ for 24 h, analyzing MTT-activity, glutathione content, Nrf2 induction and antioxidant gene expression. As 3+ increased glutathione (154%), heme oxygenase, glutamate cystein ligase, modifier subunit and metallothionein (35-fold, 10-fold and 9-fold, respectively). ALA prevented the strong expression of heme oxygenase by As 3+ exposure (from 35- to 5-times of control cells), which correlated with the reduction of Nrf2 observed in As 3+ group. ALA pretreatment can down-modulate the response mediated by Nrf2 and provide protection to As 3+ exposed HepG2 cells.

BACKGROUND Infective endocarditis is a disease characterised by heart valve lesions, which exhibit extracellular matrix proteins that act as a physical barrier to prevent the passage of antimicrobial agents. The genus Candida has acquired clinical importance given that it is increasingly being isolated from cases of nosocomial infections. OBJECTIVE To evaluate the activity of caspofungin compared to that of liposomal amphotericin B against Candida albicans in experimental infective endocarditis. METHODS Wistar rats underwent surgical intervention and infection with strains of C. albicans to develop infective endocarditis. Three groups were formed: the first group was treated with caspofungin, the second with liposomal amphotericin B, and the third received a placebo. In vitro sensitivity was first determined to further evaluate the effect of these treatments on a rat experimental model of endocarditis by semiquantitative culture of fibrinous vegetations and histological analysis. FINDINGS Our semiquantitative culture of growing vegetation showed massive C. albicans colonisation in rats without treatment, whereas rats treated with caspofungin showed significantly reduced colonisation, which was similar to the results obtained with liposomal amphotericin B. CONCLUSIONS The antifungal activity of caspofungin is similar to that of liposomal amphotericin B in an experimental model of infective endocarditis caused by C. albicans.