AVFT – Archivos Venezolanos de Farmacología y Terapéutica

Safety and immunogenicity of vaccines against SARS-CoV-2

2023-04-14

The mortality rate estimated by the WHO worldwide for COVID-19 has been 5.7%, much higher than other communicable infectious diseases, so it is essential to apply a vaccine to the population to reduce the viral spread, according to the WHO there are 23 projects in clinical phase stage III, such as vaccines: ChadOx1, nCov-19, Gam-COVID-Vac, CoronaVac that show promising results in research published by The Lancet Infection Diseases journal, for which we consider correlating the three vaccines and determining which is safer, generates greater immunogenicity and less reactogenicity in volunteer participants, for which we conducted a review bibliography and a meta-analysis of high impact scientific articles, concluding that the three vaccines generate a rapid and intense immune response against SARS-CoV-2, neutralizing antibodies had elevated titers in participants at 28 days, who increased and remained stable with a second dose, although each of them have been tested in different numbers and populations , applying recombinant adenoviral vectors and chemically inactivated virions with adjuvant and placebo for which they are totally different but with the same purpose to generate memory antibodies against SARS-

Environmental education for sustainability: An alternative for adequate disposal of medicines at home

Bartolomé Antonio, Manzolillo Morello — 2023-04-14

Introduction: The easy access to buy medicines causes accumulation at home and due to lack of use or expiration, these products are disposed of by patients and consumers in an inappropriate way, so they become a type of waste that can represent a risk to the environment and raise public health concerns. Objective: Analyze the causes that promote inadequate disposal of unused and expired medicines at home and the environmental education and investigate the level of knowledge, information, and environmental awareness that the people have about the management of these products. Method: A literature review of household surveys on drug disposition was developed using the Campbell Collaboration's systematic review method. Results: In the 21 selected studies, 81% of patients dispose of medicines inadequately in a garbage bin or toilet and 9.2% return them to specialized waste collection centers. Conclusions: The evidence shows that there is little knowledge about the effects on the environment of these products and that education aimed at sustainability plays a fundamental role in reducing and mitigating the possible environmental impacts that may be generated.

Assessment of factors associated with patient safety in the intensive care unit

Janeth Jinete Acendra — 2023-04-14

Introduction: The set of processes, elements and instruments and methodologies based on medical evidence that considerably reduce the risk of the patient suffering an adverse event (AE) of any kind or, failing that, reduce its impact, is called safety of the patient. Patient.

Objective: Identify the factors that affect safety in intensive care services, a relevant indicator of the quality of health care

Methodology: Descriptive, cross-sectional study. Four basic aspects that impact patient safety were reviewed. The prognosis of the patients was evaluated with APACHE II and the need for attention by the TISS score, Adherence to Guidelines, Patient Safety Culture and Perception of Workload. The qualitative variables are summarized through absolute and percentage frequencies. The magnitude of the association between APACHE II and TISS Score was made through χ².

Results: 27 (29.6%) Nurses (ENF) and 64 (70.3%) Certified Nursing Assistants were evaluated. The patients had an APACHE II of 25.9 ± 5.5pts (IQR 23 - 29pts) and a TISS of 24 ± 12.9pts (IQR 14 - 31), with no direct relationship between these two evaluation parameters (χ²: 14.4; p- value: 0.7006). There was a high level of compliance with the Guidelines over 90% and a great capacity for teamwork, also greater than 90%. Both NFS and ACEs demonstrated evidence-based knowledge of their procedures. The most prevalent risk factor was work stress (60.44%) and that this prevented people from resting correctly.

Conclusions: The most important aspect was work stress, which had a negative impact on all aspects of the life of health personnel.

Sociodemographic and clinical factors related to the progression of disability in patients with multiple sclerosis

2023-04-14

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (CNS), with variable prognosis, and significant social impact. The prevalence in Colombia was 7.52 per 100,000 inhabitants during 2013 and has increased by 60% from 2009 to 2013. Objective: identify the sociodemographic and clinical factors related to disability progression in MS. Methodology: A descriptive study with a cross-sectional analytical component was carried out using disability progression as the dependent variable. The medical records of 216 patients living within the Metropolitan Area of Valle de Aburrá, Antioquia, Colombia. Results: In the multivariate model, by adjusting the MS phenotype for the other variables, the following factors were associated with a greater likelihood of having disability progression: primary progressive (OR 3.246, 95% CI 1.294 - 8.145, P-value = 0.012); cerebellar complications (OR 2.498, 95% CI 1.186 - 5.265, P-value = 0.016); antidepressant drugs (OR 2.336, 95% CI 1.054 - 5.176, P-value = 0.037); the presence of other neurological diseases (OR 3.392, 95% CI 1.139 - 10.102, P-value = 0.028); and active lesions on magnetic resonance imaging (OR 2.162, 95% CI 1.042 - 4.485, -P = 0.038). Those with pathologies other than cardiovascular, metabolic, mental, autoimmune, or infectious diseases had a lower likelihood of disability progression (OR 0.138, 95% CI 0.024 - 0.799, P-value = 0.028). Conclusions: The results of the present work can serve as a starting point for monitoring patients, contributing to problem-solving, and improving the quality of life for people with this disease.

Quality of life of hemophiliac patients and satisfaction with their prophylactic treatment in Colombia

2023-04-14

Background: Hemophilia is an X-linked congenital bleeding disorder caused by a deficiency of coagulation factors. By which the therapy with recombinant and factors coagulation protein is necessary all life. This causes both physical and psychosocial changes that affect the quality of life. The objective of this research was to determine the association between quality of life, treatment satisfaction, and clinical severity of vulnerable hemophiliac patients of Cartagena-Colombia. Methods: An observational study was conducted by reviewing medical records of hemophiliacs. Quality of Life (QoL) Questionnaire Hemophilia Mexico and treatment satisfaction (TS) questionnaires were applied to patients with Hemophilia in Cartagena-Colombia. Associations between QoL and clinical severity and bivariate correlations between QoL and TS were assessed. Results: 29 hemophiliac patients between 1 and 60 years old were evaluated. 80% of patients were classified with moderate and severe hemophilia. 76% of individuals presented high QoL and 24% an average QoL; low QoL dimensions were: Knowledge about the disease, risks, physical discomforts, emotional aspects, and school or work absenteeism. TS was high, with results of 5.74 ± 0.06 (0-6 scale). There were correlations between some variables of TS with values of R2> 0.1, p <0.01. Conclusions: QoL perception of patients was high despite their hemophiliac classification as moderate to severe, TS was high as well, showing a positive correlation with some QoL dimensions related directly with hemophilia and emotional aspects.

Evaluation of medical prescriptions quality in a basic hospital in Ecuador

Aida Adriana Miranda Barros — 2023-04-14

Aim: Identify prescription errors in medical prescriptions in the outpatient area of a basic hospital in Ecuador

Materials and Methods: The study was non-experimental, descriptive, qualitative, and retrospective. Medical prescriptions with prescriptions of analgesic, gastroprotective, and antibiotic medications from the outpatient area of a basic hospital in Ecuador were analyzed, during the period from June to September 2020.

Results: 58.62% of prescription errors were found in the medical prescriptions analyzed, with a prevalence of omission of the number of the patient's medical record (16.48%). It is also evidenced that consultation time per patient and work stress are the main factors (15.22%) that influence the loss of quality in prescriptions.

Conclusion: There is a high percentage of prescription errors in the analyzed prescriptions, which suggests that during the validation process carried out by the pharmaceutical staff it should be a key point to detect and correct any errors that put the patient at risk.

Level of radicular stress in upper premolars and pressure exerted in adjacent tissues: a 3D mechanical model

Edison Guamaní Cayo — 2023-04-14

Objective: To compare the level of radicular stress and pressure exerted on adjacent tissues in 1.4 upper premolars with effect and without effect, vertical and axial compression splint in prefabricated posts, fiberglass and titanium vs cast noble metal (Au) and nickel chromium (NiCr) cast metal studs, cemented with self-adhesive self-conditioning resinous cement using the finite element technique. Materials and Methods: An experimental and comparative study was carried out with 8 simulated 3D models of 1.4 upper premolars. The FEMAP 11.1.2 software was used to model the mechanical design in 3D. Results: The radicular stress level is higher in the prefabricated cast Au and NiCr posts both at 360 and 180º compared to the fiberglass and titanium ones, the most representative average being in the NiCr at 360º with 104.23 Mpa and the lowest in Titanium 180º with 83.79 Mpa. The pressure exerted on adjacent tissues, in the premolars, has a higher level in prefabricated posts based on fiberglass and titanium at 180º compared to those made of noble metal and nickel-chromium, the most representative being that of smooth fiberglass at 180º with 1.43 and the lowest is the 360º NiCr with 1.30. Conclusion: The radicular stress level is higher in pre-cast Au and NiCr posts both at 360 and 180º compared to fiberglass and titanium posts, and the level of pressure exerted on adjacent tissues in the premolars has a higher level in prefabricated fiberglass and titanium bolts, both at 180º, compared to Au and NiCr.

Factors associated with academic performance in nursing students

Camilo Andrés Duarte Soto — 2023-04-14

The objective of this article is to characterize the factors that influence academic results in nursing students. It was a field research, quantitative and correlational level, applied to a sample selected at convenience, of 197 students from the 2nd to the 10th semester of the Nursing program of the University of Santander, Cúcuta campus. We worked based on 3 dimensions for the variable of academic performance factors: sociodemographic factors, cognitive factors, and psychological factors. The collection technique used was the survey and the instrument a 26-item questionnaire validated by expert judgments, with the reliability of Cronbach's alpha of 0.7583. Descriptive and inferential statistics were the means for data processing, through Pearson's correlation coefficient. Regarding the sociodemographic factors that influence performance, it was found that 92.57% of the students are economically dependent and that the search for a better quality of life is an academic incentive for performance. It was possible to identify those cognitive factors such as concentration which are relevant for 18.8% and retention for 36.5%. Psychological factors are the most important, both family support and teamwork for 73.1% of students. The isolation of a social circle exerts low academic performance for 48.7% of the students. The correlational study showed that the variable of real impact on performance is motivation, with an r of 0.938175561 and an r² of 0.880173384, the cognitive aspects being inconclusive, although with a positive but low correlation. Regarding marital status, it seems to affect student performance and could be explained from the family occupations that this status implies.

Performance of the Pneumonia Shock Scale for Predicting Clinical Outcomes in Pneumonia

Alirio Rodrigo Bastidas — 2023-04-14

Introduction: the initial assessment of the severity of the patient with Community-Acquired Pneumonia (CAP) is a key point in deciding the site of care and for making management decisions, as well as for establishing complications and prognosis. Currently, comparative studies using the Pneumonia Shock Score vs CURB-65 are still scarce.

Objective: evaluate the performance and performance of the Pneumonia Shock Score in comparison to the CURB-65 in subjects with and without severe CAP as a predictor of the need for mechanical ventilation, in-hospital mortality, and 30-day mortality.

Methodology: a retrospective cohort study in subjects with a diagnosis of CAP and with all the information necessary for the complete calculation of the Pneumonia Shock Score and CURB-65. CAP was defined according to the guidelines of the American Thoracic Society / British Thoracic Society. The following outcomes were considered: in-hospital mortality and 30-day mortality, as independent variables the clinical findings, history, measurement of vital signs, laboratory findings, arterial blood gas values, and diagnostic images.

Results: 1907 subjects entered the definitive analysis for the Pneumonia Shock and CURB-65 scores, 301 patients died during hospitalization and 30-day follow-up. In the present cohort, the average age was 70.5 years (SD 19.44) and 61% of the population were men. The sensitivity turned out to be higher for the CURB-65 score in in-hospital mortality (83.39%) and 30-day follow-up mortality (82.87%). The Pneumonia Shock Score has a curve of receiver operating characteristics for in-hospital and 30-day mortality of 0.748 (95% CI: 0.718-0.778, p <0.001) and 0.739 (95% CI: 0.709-0.769, p <0.001), respectively.

Conclusion: The Pneumonia Shock Score has a similar performance to the CURB-65 for the prediction of mortality in patients with CAP admitted to the intensive care unit.

Prevalence of mental disorders in Peruvian population with COVID-19 attended in the program "Te Cuido Perú".

Dora Raquel Pacheco Vásquez — 2023-04-14

Objetive: This study aims to determine the prevalence of mental disorders in the Peruvian population attended via telephone calls in the "Te cuido Perú" program in the context of the COVID-19 pandemic. Methodology: Descriptive and cross-sectional study, 2,375 people with a diagnosis of COVID-19 attended via telephone call in this program participated. Results: The results indicate that 82.1% of the sample attended presented some type of mental disorder. The most prevalent disorders were anxiety (34.15%), depression (25.22%), acute stress (13.81%), panic disorder (3.24%), adjustment disorder (2.44%), eating disorders (1.64%), obsessive compulsive disorder (0.8%) and other mental disorders (0.8%). Conclusions: These findings suggest the need to establish promotion, prevention, and psychotherapeutic treatment actions to provide better psychological tools to the affected and at-risk population, to enable them to manage and strengthen their coping and adaptation capacity in the face of the COVID-19 pandemic.

Explaining the status of clinical nursing education: a content analysis study in Iran

2023-04-14

Introduction: Challenges and problems of clinical nursing education are the most important factor in determining the quality of nursing students' education. Frequent assessment of the quality of nursing education without considering the existing challenges is an ineffective activity in analyzing the situation of nursing education.

Objective This study aimed to explain the status of clinical nursing education at Jahrom University of Medical Sciences in Iran.

Methodology: A qualitative design based on the conventional content analysis approach was used. This study was conducted at the X University of Medical Sciences in 2018-2019. Data were drawn from 10 semi-structured focus group interviews with 110 nurses, head nurses, instructors, and students. Purposeful sampling was performed. The time and place of the interviews were chosen according to the participants. The interviews were analyzed by Graneheim and Lundman method by MAXQDA software.

Results: 626 in-vivo codes, 46 primary codes, 8 subcategories (lack of attention to the evaluation process, non-participative evaluation, low staff educational cooperation, ineffective instructors, non-educational clinical space, student educational deficits, student drown in the clinic, non-participatory planning), and 3 main categories (planning challenges, implementing challenges and evaluation challenges) were obtained.

Conclusion: Educational leaders must shift to three areas; democratic planning, wise implementation with frequent monitoring, and the use of modern clinical evaluation methods (Based on the participation of learners and other stakeholders).