PubMed · 1109887
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J H Coleman. 1975. Concepts in beta blockade.. https://pubmed.ncbi.nlm.nih.gov/1109887/
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OBJECTIVE: a) To build a detection and evaluation tool of drug interactions (DI) in family practice prescribing; b) to elaborate and to offer a DI report, including appearance mechanism, clinical consequences and appropriate alternatives; c) to evaluate their effectiveness to diminish the DI incidence, and d) to check effectiveness of different diffusion methods. DESIGN: Previous phase: we will build the tool and will elaborate the report. Intervention phase: longitudinal, interventional, multicenter. SETTING: Primary care, Murcia Region. PARTICIPANTS: Family doctors (FD) with computerized clinical history frequently used to prescribe, with indefinite contract and who don't reject to participate. INTERVENTIONS: Randomly we will form 4 FD groups to carry out monthly (6 months): a) Minimal intervention: we mail DI reports; b) generic intervention: DI report is delivered in collective session managed by a trained doctor; c) personalized intervention: discussion peer-to-peer between FD and the trained doctor; d) control group: they won't receive DI information. MAIN MEASUREMENTS: We will measure the evolution of DI incidence and their classification according to relevance and repercussions. Different aspects related with FD and patient characteristics and with organizational environment are measured for subject's describing, inclusion-exclusion criteria assurance and conditioning and confusion factors analysis. DISCUSSION: Limitations. Using a new DI classification make difficult external comparisons, although it is useful because we use generalised and prestigious data sources. Applicability. The project produces a tool to avoid prescription errors. Checking the effectiveness in different corrective measures allows to take reasoned decisions for future interventions in quality care.
The effects of heat treatment on the interaction of lipid and zein in a dry powder system were investigated. Linolenic acid ethyl ester (LAE) was mixed with the zein powder. The glass transition temperature (T(g)) for the dry powder zein was shown to be approximately 107 degrees C by differential scanning calorimetry. The thermogram of the zein-LAE mixed powder showed an exothermic transition near the T(g) of zein. Fourier transform infrared (FT-IR) spectroscopy was used for detecting the structural changes in zein by heat treatment, that is, elevating the temperature from 25 to 160 degrees C. The heat treatment of the powdery zein with and without LAE caused increases in the alpha-helix, beta-turn, and beta-sheet, concomitant with decreases in the intermolecular hydrogen-bonded beta-sheet and random coil. Such changes in the secondary structure were more drastic for the powder with LAE. The heating of the zein-LAE mixed powder also caused decreases in the peaks originating from LAE in the FT-IR spectra. These results suggest that the heat treatment induced the interaction of the zein and LAE in the powdery system. The influence of heating on the antioxidative activity of dry powder zein was studied by measurements of the peroxide value. When zein-LAE mixed powder was heated before storage, the oxidation of LAE was inhibited for 7 days, whereas LAE was oxidized within 1 day in the absence of heat treatment.
We review the evaluation and treatment of patients with drug addictions complicated by other acute or chronic diseases from the perspective of the hospital setting. The spectrum of drug addiction's complications is broad and in many instances it is predetermined by the abuse substance and its administration route. Some complications of intravenous drug addiction have dramatically decreased in the last few years as a result of a better knowledge of hygienic customs and after the implementation of some health interventions such as the provision of sterile injectable devices. Two highly prevalent infections --HIV/AIDS and hepatitis C-- remain from the period in which most HIV infections owed to the intravenous use of heroin. Of note, these two infections largely account for the survival and quality of life of those who quit their addiction. On the other hand, it is still common the hospitalization of patients with both alcohol dependence and intercurrent diseases in whom their drug addiction may pass unnoticed. Other common situations include the treatment of acute patients with cocaine addiction and psychiatric comorbidity, patients under methadone therapy and, in general, all those cases in which, in emergency, ordinary hospital wards and specialized units, a wide differential diagnosis is raised when there is a coexistence of signs and symptoms common to an addiction, infection and/or intoxication. An integral vision of drug addiction and its complications, as well as the clinical evaluation of all health problems, is fundamental for the prognosis and treatment of these patients.