EVALUATION OF DRUGS

Author: PIEDRA SÁNCHEZ FERNANDO.
Year: 2003.
University: COMPLUTENSE DE MADRID [www.ucm.es].
Place of defense: FACULTAD DE FARMACIA.
Place of preparation: FACULTAD DE FARMACIA.

Summary: The aim of the thesis was the study of evolution in the treatment of cancer hospital, between the years 1994 and 2003, the Jimenez Diaz Foundation (Clinica de la Concepcion), which is the referral hospital for the districts of Central and Arganzuela Madrid municipality through the analysis of the medical records of 3,403 patients oncohematológicos. First, it describes the legal framework, especially the Order of April 22, 1992 to the Autonomous Community of Madrid regulated operating rules and requirements for the centers, services and facilities that handle cytotoxic drugs, and that prompted the creation units preparing cytotoxic drugs in the Pharmacy Services for those hospitals that do not yet have them, and the consolidation of existing units. Here are highlights the development of the Pharmaceutical Care by hospital pharmacists in the area Onco-Hematológica. To achieve the objectives of the study, after creating a database, which combined computer records of the preparations of chemotherapy developed by the Unit for Reconstruction Medicines cytotoxic Service Pharmacy and provided to patients by high of Service Coding and file, and compare it with the evolution of the population served during those ten years the results are presented chronologically indicating for each type of cancer and year: the total number of schemes used chemotherapy, the number of schemes used in each sex, the number of schemes in each line of treatment, the average age of patients at the beginning of a scheme, the range of ages of the patients at the beginning of a scheme, the average duration of the scheme, the average number of cycles per outline and the average number of doses of medicines scheme. In addition, it has been estimated the average cost per cycle of drug treatment of cancer at the hospital has undergone a considerable change with the introduction of a generation of drugs that has allowed new therapeutic strategies, the so-called Modulators of the Biological Response, more selective and insurance that classic chemotherapeutic; that the use in therapeutic oncohematológica of hematopoietic growth factors that mitigate myelosuppression and anemia caused by chemotherapy, has coincided with the decrease in the duration of treatment schemes; that pharmacotherapy of cancer each year has meant a higher percentage of overall spending from the hospital, and that the senescence has been a minor cause of this increase in spending to grow not by the costs of an aging population served, but by the introduction of new therapeutic drugs, high price, and the possibility of treating more patients ocn better quality of life and longer, the result of clinical research. That's why, the effectiveness of treatments of chemotherapy should be considered by the Health Authorities in the allocation of economic resources to combat cancer in hospitals. Our thesis is complemented by an annex which includes etadísticas population as well as a glossary of antineoplastic drugs.

Author: MARTIN CONDE M. TERESA.
Year: 2003.
University: BARCELONA [www.ub.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: OBJECTIVES To identify and characterize the problems associated with medication (adverse reactions failures therapeutic dose related and poisoning) causing incomes in the medical services of the Hospital Clinic in Barcelona, through the Emergency Department. MATERIALS AND METHODS: The collection has been carried out during the months of August to November 1999 and January to May 2000. The patients involved had fallen to a random selection of patients admitted, through the Emergency Department at the medical services of the Hospital Clinic in Barcelona. During that period have earned a total 1800 income for 1663 patients. For each of these revenues has been reviewed medical records and interviewed the patient, in order to obtain detailed information consumption of drugs at the time of admission. The causal relationship between medicine and MRP (problem related to the medication) has been established using the algorithm Karch-Lasagna changed. RESULTS The number of income due to PRM, including cases definitive, probable and possible, has been of 215 (11.9%). Of these cases, 108 (50.2%) have fallen to adverse effects 100 (46.5%) for therapeutic failures related to the dose and 7 (3.3%) poisoning. Leaving aside possible cases to get a causal relationship better defined, the number of PRM because income has been of 139 (7.7%). The 46.3% of revenue due to adverse effects have been due to NSAID and 10.2% fármcos cardiovascular. In earnings due to poor compliance major pharmaceutical groups have been implicated diuretics (33.0%) and broncodilatadores-antiasmáticos (24.2%). The 47.2% of the interviewed patients (n = 1132) did not comply with the prescribed treatment correctly. Following criteria Schumock and Thornton modified, a 68.4% of revenue due to PRM been considered preventable. CONCLUSIONS * The number of admissions due to PRM is high, and in many cases could have been avoided. * Most of the adverse reactions have been caused by NSAIDs. * More than a third of patients fail to comply properly with the prescribed treatment. Although in many cases it has not been possible to relate income to mal-cumplimiento, these patients are a risk group for filing PRM. * Ensuring an adequate therapeutic pharmacology and engaged in the education and training of patients, it could reduce costs and minimize visits to emergency and avoidable hospitalizations.

Author: LÓPEZ TORRES ENRIQUE.
Year: 2004.
University: MÁLAGA [www.uma.es].
Place of defense: FACULTADA DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: They have been extensively studied the therapeutic benefits of olive oil (decrease in the oxidation of LDL cholesterol, HDL-cholesterol and increase in their positive relationship with vascular disease). Some of the major compounds of this oil are the phenolic compounds, which includes the hidroxitirosol for their high antioxidant power and their possible use as a neuroprotective. One of the characteristics of it is in its polarity determines that its low lipid solubility and hence its low concentration in the oil. This paper assesses from a pharmacological properties antixoidantes in an experimental model of anoxia-reoxigenacón, exploring the major biochemical pathways related tissue damage in ischemic cerebral level, hidroxitirosol (HT), and two of its esters, increase its lipid solubility; acetate and oleato of hidroxitirosilo. It used 10 groups of 8 male rats Wistar (80 in total). They were subjected to different treatment for a week: HT or their esters (5 or 10 mg / kg / day) and another group treated with vitamin E 100mg/kg/día more control group. We analyzed parameters of oxidative stress (MDA, GSH, WP,% GSSG / WP, enzymes related), and parameters of cellular damage (iNOS activities, cNOS, protaglandinas, peroxinitritos, nitratos-nitritosLDH) after a week of treatment and after being subjected brains a model anoxia-reoxigenación. It shows a great strength of the compounds analyzed in terms of in Vitro inhibition of lipid peroxidation by the following order: HT increased acetate hidroxitirosilo greater oleato of hidroxitirosilo. In this regard, in addition to reducing the Peroxidación of lipid membrane, significantly increases the defenses antioxidants (glutathione system) cells. On the other hand there was a reduction in the parameters indicative of cellular damage (prostaglandin E2 and route tissue nitric oxide), demonstrating a clear effect citoprotector of the three compounds analyzed. The effect citoprotector of esters hidroxitirosilo relates to a greater extent with its antioxidant effect, while HT could vehiculizar most of this effect through other avenues of cell damage, including the accumulation of prostaglandins or encouragement from the oxide inducible nitric synthase. In conclusion, this study demonstrates the potency antioxidant and neuroprotectora HT and its esters (superior to the currently employed in clinic), thus opening a potential use of these compounds in therapy, still subject to bioavailability and clinical studies conducted by the same research group.

Author: JIMÉNEZ NUÑEZ FRANCISCO DE PAULA GABRIEL.
Year: 2004.
University: MÁLAGA [www.uma.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: In the last decade, much progress has been made in understanding the pathophysiology of rheumatoid arthritis (RA), in which the involvement of free radicals has been demonstrated. Today we know that free radicals are implicated in the pathogenesis of many diseases. The direct relationship with the inflammatory process and its influence on various enzymatic activities help to enhance the study of oxidative status as a pattern biochemical predictor of the evolution of various pathologies. The study of etipatogenia of RA, focused on the change that occurs on the biochemical pathways related to the oxidative state, will advance the knowledge of new therapeutic strategies. In this regard, the objectives of the study were to: Assess the state oxidative peripheral in patients with RA, correlating the results with the degree of inflammatory activity and progression of the disease and assess the relationship between comorbidities and RA. It conducted an observational study, descriptive, cross a population with RA (68 patients) (compared with healthy control group, n = 30) (consulting rheumatology CH Carlos Haya). We extracted 15 ml of blood from each patient. It proceeded to the separation of plasma and red blood cells. It was subsequently measured parameters associated with oxidative stress: MDA, glutathione and related activities glutathione, SOD. Correlation of clinical and biochemical parameters. The demographic characteristics of the population were similar to those of other studies (age, sex, activity and progression of the disease). The RA patients of the study presented an imbalance of oxidative state with an increase in lipid peroxidation and reduced antioxidant defense; decrease of reduced glutathione and enzymatic activities glutation-px and glutation-rd, as well as a decrease in plasma SOD activity and an increase in mitochondrial SOD. What makes you think that in RA there is a commitment of intracellular antioxidant system. Oxidative stress is associated with increased activity of RA. The depletion of glutathione and reduced activities related enzyme (mainly glutation-px), conditional greater activity and worse progression of the disease. In short, at lower antioxidant capacity increased aggressiveness of the disease. In light of these results are likely to establish a relationship between biochemical parameters representing inflammation, oxidative stress and cell damage and the activity and progression of the disease. A job well documented, with a comprehensive discussion and analysis of results and with a view clinics important, especially with the possibility of the use of antioxidants in the treatment of this disease.

Author: MARTÍNEZ LOSA MARÍA MAGDALENA.
Year: 2004.
University: VALENCIA [www.uv.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE FARMACIA.

Summary: The phosphorylation and defosforilación of cellular proteins are involved in many important biological processes such as growth or differentiation is essential and regulated in multicellular organisms for intercellular communication. PTKs and PTPs jointly maintain homeostasis in the tyrosine phosphorylation of cellular proteins. In this work, we made it our goal to investigate the effects tirfostina and genisteina inhibitors PTKs and OV and ODP inhibitors PTPs, developed on different cellular responses proinflammatory of human eosinophil induced by peptide quimiotáctico fMLP. The results of our study revealed the importance of PTKs and PTPs to inhibit responses such as the release of ROS, CCA and EPO, synthesis of LTC4, chemo or apoptosis, pointing inhibition of signaling pathways that activate the MAPKs ERK1 / 2 and p38 as possible mechanisms of action for its activity

Author: GONZÁLEZ DÍAZ HUMBERTO.
Year: 2004.
University: SANTIAGO DE COMPOSTELA [www.usc.es].
Place of defense: FACULTAD DE FARMACIA.
Place of preparation: FACULTAD DE FARMACIA.

Summary: This thesis has been corroborated the importance of theoretical studies QSAR in drug development. In this regard, developed unified representations of molecular descriptors and some groups were defined for the first time the molecular descriptors based on "Chains of Kharkov" (CM). It also developed an interpretation of physical chemistry at the same analogy with thermodynamics. These descriptors are applied to studies OSAR giving actual examples of its effectiveness in the discovery of new active compounds, and their ability to predict some experimental toxicological values and distribution. The new models using descriptors based CM were compared with other studies QSAR described in the literature or obtained in this work results. It introduced new molecular descriptors which codifies various levels of the structure of macromolecular proteins bearing in mind the sequence information partially 3D structure 3D or surface structure. These descriptors were applied to QSAR studies with proteins and compared with others described in the literature obtained excellent results. It introduces new molecular descriptors which codifies various levels of the macromolecular structure of nucleic acids, with particular emphasis on the secondary structure of RNA. These descriptors are applied to studies of local interaction fármaco-ARN and bioinformatics studies. The models developed were compared successfully against other provided by the literature. In addition, some of the predictions were confirmed experimentally.

Author: LÓPEZ RAMIRO MIGUEL IGNACIO.
Year: 2004.
University: GRANADA [www.ugr.es].
Place of defense: FACULTAD DE FARMACIA UNIVERSIDAD DE GRANADA.
Place of preparation: FACULTAD DE FARMACIA.

Summary: The emphasis on health by good control of blood pressure (BP), requires, in addition to desirable, the collaboration of all health professionals in the fight against high blood pressure (hypertension). With that end, the Office of Pharmacy, as establishing close and accessible to citizens, can provide leverage for good control of the PA. There are many works that demonstrate the positive impact of pharmaceutical care in controlling hypertension, most directed from estates to guno from pharmaceutical and clinical settings. This paper aims to describe the sercico of mddida and control of the pressure from a Oficiana pharmacy by a pharmacist comunitrio. The work has been desrrollado in an Office of Pharmacy where the whole person who requested the measure pressure artiral he has seen the value in the detrminación (SBP, DBP and pressure pulse DB), as well as age, sex and the taking of antihypertensive medications. In subsequent visits, seha registered addition, the possible change in the medication. Access to this service has always been voluntary on the part of the patient, exist in any case, when it was thought necessary, a recommendation by the pharmacist on convenineica to monitor the values of PA. Blood pressure was measured with esfignmonmanómetro mercury calibration siguientod regarding the technique of recomencdacines of the Spanish Society of Hypertension. For each of the variables studied, it has become a description of the statistical parameters basic rates for qualitative variables and measures of central tendency and spread to quantitative. In order to assess the realición between variables were tested X2, logistic regression, and multiple regression. The conclusions that have been reached in this study are summarized as follows: 1. The delivery of pharmaceutical care service in hypertension is feasible and the results that are observed are consistent with those obtained in the search of primary care. 2. The population profile plaintiff service tension in the whole purpose of the study is an adult, average age 54 years, and females (64.2%) found this population group most concerned about their level of blood pressure going available for inspection by the Office of Pharmacy. 3. The men are the first to submit figures of hypertension at younger ages, however accessed later to medical therapy. 4. Failure to return figures nomotenssas in the fourth visit made advisable patient referral to primary care physician. 5. The monitoring in hypertensive patients had a better control of the numbers of blood pressure than those who have not been followed up. The number of days required to reverse an episode hypertensive to normnontenso decreases significantly with pharmaceutical care. 6. Treatment of hypertension mostly to be done with monotherapy, with a group of fármcos that act on the renin-angiotensin system is the most used. 7. Only 12.5% are hypertension with two and the rest with three or more drugs. 8. As a result of implementing the Care Farmaceutica in pharmacy conmunitaria is achieved improve adherence to drug treatment. 9. There mahyor familiarity and tranaquilidad for the patient when measured blood pressure with his farmáceutico, so qe reduces the phenomenon gown balnca and c 8 omo e 536 stress pre-medida. 10. The patient receives aducación health adiccional by the pharmacist suited to their levels of blood pressure and medication. 11. The pharmacist plays a very important role in detecting hipertansión blood in your community, as well as the monitoring of treatment. 12. The pharmacist is prepared for:-Identifying risk factors cardiovascularaes in patients. PRM-Detect and prevent and treat potential undesirable effects. - Monitor the use of antihypertensive medications. - Educate the hypertensive patient for autocuidade their health.

Author: PASTOR MANSILLA MARIA FRANCISCA.
Year: 2004.
University: SALAMANCA [www.usal.es].
Place of defense: FACULTAD DE FARMACIA.
Place of preparation: FACULTAD DE MEDICINA.

Author: FLORES DORADO MACARENA.
Year: 2004.
University: GRANADA [www.ugr.es].
Place of defense: FACULTAD DE FARMACIA.
Place of preparation: FACULTAD DE FARMACIA.

Summary: Bearing in mind that Primary Health Care is where there is almost 90% of total prescriptions and consumption of drugs in all countries, there is a need to monitor Pharmaco in health centers. An integrated work in the rest of the health team, seems to be the most valid alternative for improving the use of medicines and the results of the same patients in primary care. OBJECTIVE identify, resolve and prevent problems associated with drugs in patients polimedicados a quota Medical Center Health Salvador Knight of Grenada. METHODOLOGY The study was conducted at the Center for Health Salvador Knight of Grenada. The study duration was four months. In implementing the tracking methodology Dáder adapted applied to the health center to work with the patient's physician. RESULTS were included in the study 99 patients polimedicacos, 63 are women and 36 men. The average age of the study population was 74.75 years with an average of 7.65 medications for different patient. We identified a total of 47 PRM in 44 patients, which means that 47.4% of patients cared provided some PRM. For the PRM largest categories were those relating to safety 51.06% of the total. Of the 47 PRM identified in patients following evaluation, it intervened to try to solve them in 51% of cases, and the 91.67% of the cases in which they intervened, the PRM was resolved. Of the total PRM identified, 78.7% were preventable.

Author: MARTÍN TORRECILLAS ANTONIO RAMÓN.
Year: 2004.
University: SEVILLA [www.us.es].
Place of defense: FACULTAD DE FARMACIA.
Place of preparation: DEPARTAMENTO FARMACOLOGÍA, FACULTAD DE FARMACIA.

Summary: While the causes of IBD remain, and therefore we do not have a curative treatment, the last few years have brought significant advances in understanding the mechanisms of pathogenicity. We evaluated the effects of a compound selective inhibitor of COX-2, rofecoxib, compared with resveratrol, selective inhibitor of COX-1 on colonic mucosa subjected to experimental colitis (acute colitis caused by DSS: acute and chronic colitis induced TNBS). In the models used parameters studied inflammatory and immunological response, as well as some molecular signaling mechanisms (MPO activity, levels of cytokines: IL-1beta and TNF-alpha, production of prostanoids: PGE2 and PGD2, expression of both isoforms of the COX and protein NF-kappa B apoptosis or programmed cell death). Also, we will examine in vitro production of inflammatory mediators in some of the murine macrophage line RAw 264.7 stimulated with bacterial LPS. Both rofecoxib as resveratrol, reduced the severity and extent of macro-and microscopic damage induced by TNBS or DSS, decreasing biochemical parameters and the expression of inflammatory proteins COX-2 and NF-kappaB. Both molecules in trial also enhanced cell death caused by hapteno. Finally molecules in the trial minimized the levels of TNF-alpha and nitric oxide by LPS in macrophages of the line RAw.

Author: MAYAYO SINUÉS ESTEBAN.
Year: 2004.
University: ZARAGOZA [www.unizar.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: Objectives: The objective was to determine the effect of substitution therapy with rhGh on enzymatic activities NAT2, CYP1A2, Xantina oxidase and CYP3A in children with selective deficit of GH. We also evaluated the potential influence of gender and puberal Stadium. Methods: It has been two groups. One éllos of 31 children with GH deficit to study the activities NAT2, CYP1A2 and xanthine oxidase using caffeine as a drug test. We evaluated the metabolic ratios indicative of each of these activities before and one month after treatment with 0,166 mg / kg / week. The metabolites were measured by HPLC. The other group consisted of 35 children with deficits GH treated for one month with rhGH for alternative dose study of possible changes in the enzyme activity CYP3A. It included a control group of 35 healthy children with normal height and weight and matched for age (+-6 months), sex and puberal stadium with patients. We assessed the ratio beta-hidroxicortisol / urinary free cortisol in the evening. Results: The results show that the substitution therapy with rhGH during one month of GH deficient children does not alter the enzymatic activities NAT2, xanthine oxidase and CYP1A2 in the light of the absence of statistical significance when comparing the sample before and after treatment. By dividing children on the basis of sex there were no differences between males and females and where segregation was conducted according to the stadium puberal Nor were apparent differences between prepubescent and adolescents. With regard to the activity CYP3A we noticed some new findings in humans suggest that GH may be an important modulator factor in humans in relation to the metabolism of most existing drugs. Thus: The deficit is associated with increased activity CYP3A in both sexes but evidenciable only at the stadium prepubertal. By contrast, when comparing the sample before treatment with that obtained a month after its start seeing an effect dimórfico sex with a decreased activity in males and an upward trend in women, although they without reaching significance statistics. The effect was dependent on puberty stage while only observed in prepubescent children. To determine the situation in which children were left after a month of treatment in relation to the controls, we compared their activity CYP3A finding that the increase in the deficit and the subsequent decrease with treatment normalized enzyme activity in males compared to the controls . By contrast girls continued to increase its activity to levels high statistical significance. Again the effect was dependent puberal stadium to be detectable only in prepubescent girls. As the ratio of cortisol measured metabolic activity CYP3A4 and CYP3A5 proceeded to genotipar to 20 patients in order to discriminate whether it was possible activity CYP3A4 and CYP3A5. All children were found to be carrying the haplotype CYP3A4 * 1A/CYP3A5 * 3 meaning that there was no such expression in liver CYP3A5, which exclude such participation. Conclusions: The data suggest that treatment with rhGH for one month does not modify the enzymatic activities NAT2, CYP1A2 or xanthine oxidase. GH deficiency is associated with higher activity CYP3A regardless of gender and puberal dependence of the stadium. The tratameinto replacement rhGh for one month results in a decline in activity CYP3A in prepubescent boys qu normalized with the controls and significantly increased activity in women ends up potential clinical relevance.

Author: FORNOS PÉREZ JOSÉ ANTONIO.
Year: 2004.
University: VIGO [www.uvigo.es].
Place of defense: FACULTAD DE BIOLOGÍA.
Place of preparation: UNIVERSIDAD DE VIGO.

Summary: The aim of the thesis is to investigate whether the pharmaceutical intervention consisting of structured and continuous health education to increase awareness and reduce and / or prevent complications, monitoring of metabolic variables, improve awareness and use of medicines for diabetes diseases and added (Council pharmacist, Dispensation active monitoring Pharmaco) during 12 months in office pharmacy, reduces morbo-mortalidad of type 2 diabetic patients. A study of non-intervention pharmacology, prospective, longitudinal, randomized, intervention group (n = 56) incorporating monitoring and control group (n = 56), which performs the usual care of type 2 diabetic patients with treatment HLA more than two months. In 14 community pharmacies (25 pharmacists) in the province of Pontevedra (Galicia). The variables were measured; HbA1c. Glucemia baseline, lipid profile (T cholesterol, HDL and LDL cholesterol, triglycerides), albumin / creatinine, SBP and DBP, BMI. Also knowledge of the disease and awareness / compliance with pharmacotherapy and the PRM; And lifestyle. Were the index of confidence in the 95% and was considered the significance p less 0.05. The homogenicidad of groups at the beginning was studied by Student's t (test Kolmogorov-Lilliefros) and Mann-Whitney (Wilcoxon). The technique of Chi and Fisher. The results were evaluated by the Student t or Wilcoxon and / or McNemar test for paired data. The variance analysis of the various groups was conducted by ANOVA. The correlations were determined by Pearson's r or Spearman Rho. RESULTS There was a significant improvement in the intervention group compared with control group in MRP / patient (-1.07 +-1.1 vs. 0.57 + - 0.71 p less 0.0001), knowledge (5.3 +-5.3 vs. -0.7 +-3.5 p less 0.0001) , HbA1c (-0.5 + - 1.2 vs. 0.7 + - 0.9% p less 0.0001), Glucemia baseline (-18.9 + - 55.9 vs. 8.9 + - 37.2 mg / dl p = 0.0004), total cholesterol (-19.7 +-36.9 vs. - 1.5 +-30.7 mg / dl p = 0.0054) and PAS / -8.0 + - 15.7 vs. 1.2 +-16.2 mmHg, p = 0.0006). The number of medications per patient (0.4 + - 0.8 vs. 0.1 +-0.7 p = 0.0270), the number of errors per patient knowledge of drugs and medicine (-1.0 + - 0.8 vs. 0.0 + - 0.6 p less 0.0001) and the number of errors per patient compliance and medicine (-0.4 + - 0.8 vs. 0.1 + - 0.5 p less 0.0001). CONCLUSIONS The pharmaceutical intervention reduces morbo-mortalidad of type 2 diabetic patients.

Author: GIMENO SIERES ELVIRA.
Year: 2005.
University: VALENCIA [www.uv.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: INSTITUTO DE HISTORIA DE LA CIENCIA Y DOCUMENTACION LOPEZ PIÑERO.

Summary: The objective of this nuclear work is the realization of a portfolio of magazines Spanish Pharmacy and Pharmacology. Since he became a documentary analysis of the information obtained and the study of different bibliometric indicators of survival, movement in databases and productivity. They also studied the impact factor and evaluation of the portfolio of magazines circulating in databases analyzed. A final goal was the development of a collective catalog with magazines active analyzed, with the funds existing libraries Spanish. For its realization reviewed directories and periodicals ISSN'S ULRICH, the Universal Decimal Classification, CDU, as well as the databases of national and international EMI ICYT, IPA, SCI EXPANDED MEDLINE, EMBASE, BIOSIS PREVIEWS, ANALYTICAL ABSTRACTS, FSTA , SCIFINDER SCHOLAR, CHEMISTRY CITATION INDEX, using the appropriate search strategy for the recovery of information in each of the databases used.

Author: FORTEZA GONZÁLEZ GABRIEL.
Year: 2005.
University: ROVIRA I VIRGILI [www.urv.cat].
Place of defense: FACULTAT DE MEDICINA I CIÈNCIES DE LA SALUT.
Place of preparation: FACULTAT DE MEDICINA I CIÉNCIES DE LA SALUT.

Summary: INTRODUCTION According to the current literature on chronic pain, it is considered that the SDMF attend central and peripheral mechanisms System Neuromuscular common to the myofascial pain of the trunk and extremities, although their exact nature remains unknown. Various theories point to an excess of muscle activity with the final release of toxic metabolites. The risk factors include unsuitable positions, a sedentary lifestyle, especially nutritional imbalances deficit Vitamínico-, habits mouth parafuncionales, sleep disorders and disturbances joints. Traditionally, the treatment of SDMFM has included the use of NSAIDs, occlusal splint, drugs muscle relaxants, antidepressants, physical therapy and relaxation techniques. Among the highlights local treatments puncture dry and the infiltration of various drugs, and even of normal saline. Assumptions: The TBA is an effective method of treating SDMFM. Objectives: To assess the potential effectiveness, adverse reactions, the TBA in a group of volunteer patients, suffering from SDMFM, by conducting a clinical trial parallel, randomized and double-blind conditions. MATERIALS AND METHODS was designed a clinical trial pilot unicéntrico, prospective, randomized, controlled and double-blind, in order to determine the effectiveness of Botulinum toxin A (TB) in the treatment of SDMFM. Patients who agreed to participate in the study were subjected to the Inventory. Clinical Multiaxial of Millon-II to assess his personality. During the period between September 2001 and September 2002, 72 patients suffering from SDMFM agreed to participate in the study. The diagnosis of SDMFM was conducted based on the diagnostic criteria defined by Sworkin and LeResche -Research Diagnostic Criteria for Temporomandibular Disorders- for muscle disorders (group I) for the SDMFM. We selected 30 whose personality test was normal, divided randomly into two groups of 15 patients each: Botulinum toxin * * Placebo The questionnaire patient's pain was measured using a current spontaneous Visual Analog Scale (VAS): 0 = no pain: 100 = maximum pain imaginable), and an index through multiple functional EVA. It also measured the opening mouth maximum interincisal not forced. In the study group were injected TB A (Botox ®) in the masseter muscles and temporary, on both sides, 5 points for each twenty scattered muscle. The control group was injected physiological saline, following the same distribution that the group toxin. Tests were carried out subsequent to the 2,4,8 and 16 weeks of treatment. RESULTS rate prior to treatment. The pain was located preferably in both muscles masesteros, while in the temporary location occurred in half the cases, approximately. The distribution was similar in both groups. The opening mouth was near normal in both groups (39.6 in the toxin and 37.3 in the placebo). Results: In both groups the overall improvement was pronounced and persistent over time (up to 16 weeks) with an outstanding statistical significance (p less 0001), but the same for both. Side effects. Patients treated with TBA show a marked loss of effectiveness chewing. Of the 13 patients treated with TBA 12, ie 87.5%, presented the symptoms, sometimes as dominant symptom, accompanied by feelings of fatigue by chewing (p less 0001). CONCLUSIONS The toxin botulínicamuestra l 8 to same 495 analgesic efficacy than placebo. The answer analgésia pain and overall assets have statistical significance in both groups and is present over 16 weeks. In conclusion, the TBA is effective in treating SDMFM, as is placebo. These results imply the presence of a physical mechanism of action (Local lysis or dilution of toxic metabolites) at the trigger points or bands such as those described in the literature, dry needling, or simply placebo.

Author: RODRIGUEZ CERON GEMA.
Year: 2005.
University: VALLADOLID [www.uva.es].
Place of defense: FACULTAD DE MEDICINA DE VALLADOLID.
Place of preparation: FACULTAD DE MEDICINA UNIVERSIDAD DE VALLADOLID.

Summary: Allergic reactions during anesthesia are a concern to anesthesiologists, because we are the professionals most likely to cause an adverse reaction due to the intravenous administration and in a short period of time a large number of drugs. The actual frequency of severe allergic reactions during anesthesia is unknown and is located between 1/4.000 and 1/23.000 anesthesia, with a mortality rate of 3 to 10%. The substances most frequently involved are the neuromuscular relaxant (succinylcholine, rocuronium and atracurium) followed by latex and antibiotics, with very rare allergic reactions caused by local anesthetics. The diagnosis of an allergic reaction has to be conducted with clinical and laboratory criteria (triptasa serum and metilhistamina in urine), and subsequently a study should be undertaken delayed by skin tests (prick-test) at 4-6 weeks of allergic reaction, to determine the drug cause. We raised a prospective observational study conducted during the years 2002 and 2003 on 897 patients for analysis by prick-test the prevalence of patients who are sensitive to the drugs used during surgical interventions. The objectives of this study were aware of the prevalence of prick-test positive for drugs, detect pharmacological groups that have a higher prevalence, analyze the influence of risk factors in the presentation of prick-test positive and establish the level of concordance between the background of prior history of adverse reaction to a drug and the outcome of prick-test specific to the drug. Results: 51% of patients had a prick-test positive. The highest percentage of positive skin tests is accounted antibiotics, followed by Aines and analyze the drugs used primarily anesthetic, the largest percentage came from the neuromuscular relaxant, followed by iodine and latex. Among the risk factors are the history of adverse reaction to drugs, atopy and general anesthesia after which influence the presentation of prick-test positive. There was an excellent match between patients covered the history of adverse reaction to penicillins and other antibiotics and prick-test positive in front of them, and a poor match between the fact declare a history of allergy to angún drug without knowing where and prick-test positive to any of the drugs studied. Therefore, there is a positive match high when it is suspected the substance responsible for the allergic reaction, if not, the match is low and does not justify the conduct of prick-test.

Author: LUQUE HERNÁNDEZ M. JOSÉ.
Year: 2005.
University: MÁLAGA [www.uma.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: The project conducted for this study has as one of its main features intended to make it possible to launch in the future the full treatment in the context of current organizational and functional public medicine in this country, which has developed a program following the intervention of how much detail as possible the recommendations in place internationally within the scientific community, with the logical adjustments to the operation of the health system to which we belong. As a result, it has eliminated the use of drugs and surgery in the treatment of overweight and obesity, and that resources are not available in the field of study. The control arm will be treated the same way it is handled now obesity in the majority of primary care consultations, which provides them with a written diet. In this way, they will see the differences in anthropometric measures and late changes in eating habits and physical activity between the two groups following the year of the study. The first part was conducted a cross-sectional study of descriptive prevalence in the second part of a randomized clinical test whose minimum target of the program was the loss of 5% of body weight in the first 6 months. The main results were found: More than 60% of the population attached to the health center (and not consulting consultant) introduced pathology overweight, and BMI half the overweight for a Type II or preobesidad. The 38% of the subjects are within the ranges of overweight and 25.2% are obese. The cardiovascular risk factors more closely linked to overweight are diabetes melliltus and hypertension. The prevalence of diabetes among obese is about 20% higher than those that are not: The hypertensive are about 25% more common among the obese. This association was maintained even after adjusting with age. After the maintenance phase of treatment, with a total duration of 12 months, will get a loss of 5% by weight, nearly half of the group that was involved (45.3%), and a quarter of control (24 , 3%), which creates a gap of 21% between the two arms of the trial. However, differences in the achievement of optimal goal of a 10% decrease in weight although there are, are not significant. A 17.9% of participants in the treated group and 12.9% in the control achieved a reduction in weight over 10%.

Author: NARBONA CARRION FELIX.
Year: 2005.
University: MÁLAGA [www.uma.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA, UNIVERSIDAD DE MÁLAGA.

Summary: The main objective of this paper is to describe the effects on the interaction plaqueta-endotelio, oxidative stress and tissue biochemical mechanisms involved in a model anoxia-reoxigenación the oral administration of two different doses of olive oil daily for one month to a certain number of rats. It has used a variety of experimental methods in order to cover the various parameters (zoométricos, and biochemical parameters that describe the interplay plaqueta-endotelio). The results confirm a positive balance in terms of effects on platelet aggregation, antithrombotic properties and antioxidant effect in animals treated with olive oil compared to the control group. Regarding the process anoxia-reoxigenación there is a decrease in cell death in treated rats compared with control group, which was confirmed by a decrease in oxidative stress brain, a decrease in the production of prostaglandin E2 and nitric oxide.

Author: HERRERA GUTIERREZ MANUEL.
Year: 2005.
University: MÁLAGA [www.uma.es].
Place of defense: FACULTAD DE MEDICINA.

Summary: INTRODUCTION The techniques continuous renal replacement (TCRR) are the substitution therapy for acute renal failure in patients serious choice. Its use is accompanied by an inevitable activation of the coagulation of the circuits that affects the performance of the art and implies the need for anticoagular circuits, increasing the risk of bleeding in these patients. OBJECTIVES AND METHODS determine the safety and efficacy of unfractionated heparin, or epoprostenol combined use of both to maintain porous filters or assess the possibility of not anticoagular in high-risk patients. This is an analysis of a prospective registry applied to all patients treated in the ICU of the hospital Carlos Haya through TCRR from 1994 to 2004. RESULTS The survival of the filters is related to mechanical factors (blood flow, filtration fraction) and clinical (platelets). Regimens used anticoagulants (heparin in patients without problems, epoprostenol with coagulopathy or thrombocytopenia, therapy mixed with hypercoagulability cases or no treatment in patients at high risk of bleeding) provide similar length of time and low risk of bleeding, although the frequency of bleeding it is higher in the group of patients treated with unfractionated heparin.

Author: VICENS MANERO MARTA.
Year: 2005.
University: SALAMANCA [www.usal.es].
Place of defense: FACULTAD DE FARMACIA.
Place of preparation: DEPARTAMENTO FISIOLOGIA Y FARMACOLOGIA.

Summary: In this work Doctoral Thesis has been investigated capacity hipocolesterolemiante three derivatives of bile acids which we call Bapas ( "bile acid polyamine"). The hypothesis was that these compounds could inhibit the reabsorption of bile acids ileal natural without being abducted from the gut lumen, stimulating the conversion of cholesterol into bile acids and reducing new, thus, in serum cholesterol. The synthesis of the compounds was carried out through the formation of amide linkages between the carboxyl group acid glicocólico and amino groups of the N (3-aminopropil) -1.3 -propanodiamina. The Bapas have demonstrated the ability to inhibit the liver and ileal transport of bile acids in various experimental models both in vitro and in the pattern of expression of membrane transport proteins in the frog Xenopus laevis oocytes, which in some cases to reduce the attraction came up to 80%, as "in vivo" in the model rat ileum perfused in situ, which found that although competing for the intestinal bile acid transporters, they themselves had a poor absorption by the ileal mucosa. The administration of Bapas to mice significantly reduced from the "pool" total bile acids, which appear without toxic effects on liver or kidney at the doses tested. Treatment with the Bapas altered gene expression of key liver enzyme responsible for the synthesis of bile acids and cholesterol and bile acid transporters liver and bowel as a result of the collapse of the "pool" acid bilares. In summary, the ability of Bapas inhibit intestinal absorption of bile acids to decrease the size of the "pool" of these organic anions and the absence of adverse effects suggest that might be useful in the treatment of hypercholesterolemia.

Author: ARZUAGA MUNSURI ALAZNE.
Year: 2005.
University: PAÍS VASCO [www.ehu.es].
Place of defense: FACULTAD DE FARMACIA.
Place of preparation: FACULTAD DE FARMACIA.

Summary: The objective of this pilot memory has been evaluating the extracorporeal elimination of piperacillin / tazobactam in critically ill patients with varying degrees of renal dysfunction undergoing continuous renal replacement techniques. The pharmacokinetics of piperacillin / tazobactam (4g/0.5g every 8, 6 or 4h, administered by infusion in the 20 min) has been studied in sixteen patients undergoing haemofiltration venovenosa continuing. Patients were grouped according to the degree of renal impairment (CLCR lower 10 mL / min: 10 minor CLCR lower 50 mL / min and CLCR increased 50 mL / min). Furthermore, we have developed methods of HPLC simple and reproducible for the determination of piperacillin and tazobactam and has done a comprehensive study of stability. The adjustment of the data has been carried out following the compartment models and no-compartimental. The fraction of elimination or sieving coefficient (SC) of piperacillin and tazobactam has proved to be independent of the degree of renal impairment. The SC tazabactam was similar to the fraction of free drug in plasma. However, the SC piperacillin proved to be significantly lower than the unbound fraction to plasma proteins. Also, it has been found that the greater the degree of renal impairment, the greater the contribution of the technical extracorporeal elimination of piperacillin and tazobactam. On the other hand, there has been accumulating tazobactam in any of the patients. In addition, the administration of piperacillin every 4 hours in patients with CLCR increased 50 mL / min, provides securities time exceeds CMOs more favorable than those obtained by the administration of piperacillin every 6 hours, which increases the probability of success of treatment microorganisms presenting WCC higher. Finally, the in vitro study has revealed that polysulphone membrane is more permeable to piperacillin and tazobactam the membrane AN69Â ®. In addition, it has been observed that the fraction of elimination obtained in vitro AN69Â ® polysulphone and applying hemofilatración continuous or continuous hemodialysis is similar to the fraction of the drug not linked to plasma proteins, both for piperacillin to tazobactam.