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Three dimensional magnetic textures are a cornerstone in magnetism research. In this work, we analyze the stabilization and dynamic response of a magnetic hopfion hosted in a toroidal nanoring with intrinsic Dzyaloshinskii-Moriya interaction simulating FeGe. Our results evidence that unlike their planar counterparts, where perpendicular magnetic anisotropies are necessary to stabilize hopfions, the shape anisotropy originated on the torus symmetry naturally yields the nucleation of these topological textures. We also analyze the magnetization dynamical response by applying a magnetic field pulse to differentiate among several magnetic patterns. Finally, to understand the nature of spin wave modes, we analyze the spatial distributions of the resonant mode amplitudes and phases and describe the differences among bulk and surface modes. Importantly, hopfions lying in toroidal nanorings present a non-circularly symmetric poloidal resonant mode, which is not observed in other systems hosting hopfions.

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Objetivo: El presente estudio da respuesta a la pregunta: ¿Existen diferencias en el nivel de actividad física de mujeres chilenas antes y durante el confinamiento por COVID-19? Método: El estudio tiene un diseño no experimental longitudinal de tendencia con un n=1.051 mujeres chilenas jóvenes. Se midieron las diferencias en el nivel de actividad física entre los grupos pre (preCOVID) y post (COVID-19); y de la muestra COVID-19 con los datos teóricos tanto de estudios de actividad física previos como de encuestas nacionales gubernamentales. Resultados: las mujeres del grupo COVID-19 presentan niveles de actividad física significativamente más bajos que las mujeres de la muestra preCOVID-19; y que las muestras de mujeres de estudios empíricos anteriores. Conclusión: en tiempos de COVID-19 las mujeres jóvenes chilenas presentan un nivel de actividad física significativamente menor en tiempos previos al confinamiento. (AU)

Objective: The present study answers the question: Are there differences in the level of physical activity of Chilean women before and during confinement by COVID-19? Method: The study has a non-experimental longitudinal trend design with n = 1,051 young Chilean women. Differences in the level of physical activity between the pre (preCOVID) and post (COVID-19) groups were measured; and of the COVID-19 sample with theoretical data from both previous physical activity studies and national government surveys. Results: the women of the COVID-19 group present lower levels of physical activity than the women of the preCOVID-19 sample; and the samples of women from previous empirical studies. Conclusion: in times of COVID-19, young Chilean women present a lower level of physical activity, in previous times without lockdown due to the pandemic. (AU)

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A near-threshold proton resonance in ^{11}B at E_{ex}=11.44±0.04 MeV is observed via the reaction ^{10}Be(d,n)^{11}Be→^{10}Be+p in inverse kinematics, measured with a beam of the radioactive isotope ^{10}Be. The resonance energy at E_{res}=211(40) keV is consistent with a proton signal observed by Ayyad et al. in the ß-delayed proton decay of ^{11}Be. By comparison to a distorted wave Born approximation calculation, a 0.27(6) spectroscopic factor is extracted and a tentative (ℓ=0) character is assigned for this resonance. The significant cross section in the proton-transfer (d,n) reaction, as well as the observation of its proton-decay signal, point to the threshold-resonance character of this state. The position of this state, its structure, and strong coupling to the s-wave continuum represent an ideal case to study quantum near-threshold many-body dynamics of unstable states. The presence of this state is an important step toward understanding the excessively large beta-delayed proton-decay branch of ^{11}Be.

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In this work, we report the excitation of spin-waves modes in skyrmion clusters hosted in Co/Pt nanodots by applying an in-plane magnetic field pulse. The direction at which the magnetic field is applied enables the excitation of five main spin-waves modes that are understood in terms of only azimuthal-like modes, which are shown to be strongly dependent on the number of skyrmions stabilized in the system. This feature converts the present system in a mechanism to activate and suppress a set of given modes, which in turn we propose to be utilized as a magnonic key based skyrmion cluster. Our results could be useful in manufacturing potential magnonic logic devices based in skyrmionic textures.

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Objectives: Sacubitril/valsartan is a drug for chronic heart failure (CHF), approved by Drugs Regulatory Agencies based on the results of the PARADIGM-HF, which could have several limitations on internal validity and applicability. Furthermore, this drug has a high economic impact. The objectives of this study are to evaluate effectiveness and safety of sacubitril/valsartan in CHF, as well as to evaluate adequation to use criteria stablished in a Health Management Area (HMA). Methods: Retrospective, observational study including adult patients with CHF who were receiving sacubitril/valsartan during 2017 in an HMA. The treatment effectiveness was assesed by death and/or hospitalization rates related to CHF. Frequency of adverse events was used to safety evaluation. Furthermore, adequation rate was assessed. Findings: A total of 68 patients were included. Death or hospitalization rates due to CHF at 12 months were 32.3% globally (2.9% and 29.4% respectively). Among patients analyzed, 33.8% presented hypotension, during the first year after treatment initiation. Overall adequation rate was 67.6%. Conclusions: A high percentage of death and/or hospitalization due to CHF was observed. Hypotension is a frequent adverse event which leads to dose adjustment and/or drug withdrawal. Overall adequation rate of sacubitril/valsartan prescription is acceptable. (AU)

Objetivos: El sacubitril/valsartán es un medicamento para la insuficiencia cardíaca crónica (ICC), aprobado por las agencias reguladoras de medicamentos en base a los resultados del ensayo pivotal PARADIGM-HF, que podría tener varias limitaciones en la validez interna y la aplicabilidad. Además, este fármaco tiene un alto impacto económico. Los objetivos de este estudio son evaluar la efectividad y la seguridad de sacubitril/valsartán en la ICC, así como evaluar la adecuación a los criterios establecidos en un Área de Gestión de Salud (AGS). Métodos: Estudio observacional retrospectivo que incluye pacientes adultos con ICC que recibieron sacubitril/valsartán durante 2017 en una AGS. La efectividad del tratamiento fue evaluada mediante la tasa de mortalidad y/o hospitalización relacionadas con la ICC. La frecuencia de los eventos adversos se utilizó para la evaluación de seguridad. Además, se evaluó la tasa de adecuación. Resultados: Se incluyeron un total de 68 pacientes. Las tasas de mortalidad u hospitalización por ICC a los 12 meses fueron del 32,3% a nivel global (2,9% y 29,4%, respectivamente). Entre los pacientes analizados, el 33,8% presentó hipotensión durante el primer año después del inicio del tratamiento. La tasa de adaptación global fue del 67,6%. Conclusiones: Se observó un alto porcentaje de muerte y/o hospitalización por ICC. La hipotensión es un evento adverso frecuente que conduce al ajuste de la dosis y/o a la retirada del medicamento. La tasa general de adecuación de la prescripción de sacubitril/valsartán es aceptable. (AU)

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The high frequency dynamic behaviors of magnetic nanorings with variable anisotropy along their radius have been studied using micromagnetic simulations. The dynamic susceptibility spectrum and spatial localization of the ferromagnetic resonance modes are investigated by varying anisotropy gradients in nanorings of 200 nm of external radius, with different internal radii. Both the resonant frequencies and the number of peaks depend on the lower energy magnetization configuration which in turn is a function of anisotropy gradients. Besides, it is shown that the effects of the anisotropy gradient are relevant even for the narrowest ring of 10 nm wide. The idea of controlling frequencies by modifying the anisotropy gradients of the system suggests the possibility of using these nanostructures in potential magnetic controllable frequency devices.

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In this work we performed a detailed numerical analysis on the static and dynamic properties of magnetic antidot arrays as a function of their geometry. In particular, we explored how by varying the shape of these antidot arrays from circular holes to stadium-shaped holes, we can effectively control the magnetic properties of the array. Using micromagnetic simulations we evidenced that coercivity is very sensitive to the shape of antidots, while the remanence is more robust to these changes. Furthermore, we studied the dynamic susceptibility of these systems, finding that it is possible to control both the position and the number of resonance peaks simply by changing the geometry of the holes. Thus, this work provides useful insights on the behavior of antidot arrays for different geometries, opening routes for the design and improvement of two-dimensional technologies.

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OBJECTIVE: The inappropriate use of antibiotics in our environment increases the risk of multi-resistant bacteria, therefore it is necessary to present studies to meet and promote the proper use of antimicrobial. METHODS: Retrospective observational study in which patients who are receiving ertapenem during the period of stady (5 ½ months), were included. The adequacy of the indication to the conditions of use agreed in the Hospital was evaluated and the evolution of the treatment was monitored until the end, determining the degree of therapeutic de-escalation. RESULTS: 84 ertapenem prescriptions were included. The vast mayority of the prescriptions were carried out by Internal Medicine (41.7%) and the main indication was urinary tract infection (47.2%). Microbiological cultures were requested in the 75% of the patients before the first dose of ertapenem. The prescription was adapted in 69 (82.14%) of ertapenem patients to the criteria approved by the Hospital. Regarding the evolution of antibiotic therapy, treatment with ertapenem continued until resolution of the infection in 58.33% of patients. In 15 of 23 (66.21%) patients with the possibility of therapeutic de-escalation it was performed after 2-3 days of empirical treatment. CONCLUSIONS: The vast majority of treatments ertapenem fit the criteria of prescription our Hospital. The high percentage of patients with microbiological results available, allowed in many patients the appropriate adjustment of the treatment in the first 72 hours.

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In this study we assessed the influence of three different environmental salinities (5, 15 and 31 psu during 90 days) on growth, osmoregulation, energy metabolism and digestive capacity in juveniles of the Notothenioid fish Eleginops maclovinus. At the end of experimental time samples of plasma, liver, gill, intestine, kidney, skeletal muscle, stomach and pyloric caeca were obtained. Growth, weight gain, hepatosomatic index and specific growth rate increased at 15 and 31 psu and were lower at 5 psu salinity. Gill Na(+), K(+)-ATPase (NKA) activity presented a "U-shaped" relationship respect to salinity, with its minimum rates at 15 psu, while this activity correlated negatively with salinity at both anterior and posterior intestinal portions. No significant changes in NKA activity were observed in kidney or mid intestine. Large changes in plasma, metabolite levels and enzymatic activities related to energy metabolism in liver, gill, intestine, kidney and muscle were generally found in the groups exposed to 5 and 31 psu compared to the 15 psu group. Only the pepsin activity (digestive enzymes) assessed enhanced with environmental salinity, while pyloric caeca trypsin/chymotrypsin ratio decreased. This study suggests that juvenile of E. maclovinus presents greater growth near its iso-osmotic point (15 psu) and hyperosmotic environment (31 psu). Acclimation to low salinity increased the osmoregulatory expenditure as seen by the gill and anterior intestine results, while at high salinity, branchial osmoregulatory activity was also enhanced. This requires the mobilization of lipid stores and amino acids, thereby holding the growth of fish back. The subsequent reallocation of energy sources was not sufficient to maintain the growth rate of fish exposed to 5 psu. Thus, E. maclovinus juveniles present better growth efficiencies in salinities above the iso-osmotic point and hyperosmotic environment of this species, showing their best performance at 15 psu as seen by the main osmoregulatory and energy metabolism enzymatic activities.

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The need to expand aquaculture production has led to other fish to be considered as potential species for culture, such as the sub-Antarctic notothenioid Eleginops maclovinus (Valenciennes, 1830). The aim of this study was to determine the cumulative effect of density and pathogen infection by protein extract of Piscirickettsia salmonis on skeletal muscle metabolism. In a first experiment, specimens were submitted to three different stocking densities: (1) 3.1 kg m(-3), (2) 15 kg m(-3) and (3) 60 kg m(-3), for a period of 10 days. In a second experiment, metabolic changes caused by an infection of P. salmonis protein extract (a single injection of 0.5 µL P. salmonis protein extract g body weight(-1) was inoculated in the fish) and its combined effect with stocking density was assessed during a period of 10 days. This study concludes that stress caused by high stocking density led to the reorganization of some metabolic routes to fulfill skeletal muscle energy needs. Furthermore, infection response by pathogen P. salmonis differed when stocking density increased, suggesting an increase of energy needs with density in skeletal muscle of infected fish.

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El infarto pulmonar es una lesión isquémica del parénquima que acontece en el contexto de un tromboembolismo pulmonar cuando la obstrucción arterial priva de perfusión a dicha zona y la circulación bronquial adyacente no aporta el flujo necesario. Aparece aproximadamente en un 40% de los tromboembolismos pulmonares. Como médicos de Urgencias podríamos diagnosticar el infarto pulmonar a pie de cama del paciente de forma rápida, sencilla, inocua y eficiente con la disponibilidad de ecógrafos en nuestras urgencias y centros de salud. La posibilidad de aproximarnos al diagnóstico etiológico con una primera sospecha clínica sumando factores de riesgo, sintomatología, signos clínicos y radiológicos y el uso de pruebas de imagen in situ, incrementa notablemente nuestra sensibilidad y especificidad (AU)

Pulmonary infarction is a parenchymal ischemic lesion that occurs in the context of a pulmonary embolism when arterial blockage deprives perfusion to that area and the adjacent bronchial circulation does not provide the necessary flow. It appears in approximately 40% of pulmonary embolisms. Emergency Physicians are able to diagnose a pulmonary infraction at the patient bedside, in a quick, easy, safe and efficient way with the availability of ultrasound in our Emergency Rooms and Health Centres. The possibility of approaching the aetiology, firstly with a clinical suspicion then adding risk factors, symptoms, clinical and radiological signs and the use of in situ imaging, increases the sensitivity and specificity of the diagnosis (AU)

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Pulmonary infarction is a parenchymal ischemic lesion that occurs in the context of a pulmonary embolism when arterial blockage deprives perfusion to that area and the adjacent bronchial circulation does not provide the necessary flow. It appears in approximately 40% of pulmonary embolisms. Emergency Physicians are able to diagnose a pulmonary infraction at the patient bedside, in a quick, easy, safe and efficient way with the availability of ultrasound in our Emergency Rooms and Health Centres. The possibility of approaching the aetiology, firstly with a clinical suspicion then adding risk factors, symptoms, clinical and radiological signs and the use of in situ imaging, increases the sensitivity and specificity of the diagnosis.

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El derrame pericárdico (DP) es una entidad que se diagnostica con poca frecuencia en Urgencias. Presentamos este caso, en el que gracias a la adquisición de nuevas técnicas innovadoras por parte de los médicos especialistas en urgencias, la ecocardiografía, se consigue llegar al diagnóstico de DP y cuantificarlo como grave, sin compromiso hemodinámico, en el mismo Servicio de Urgencias. Posteriormente, en planta, se establece el diagnóstico etiológico, al cumplir la paciente 4 criterios diagnósticos de lupus eritematoso sistémico (LES). El LES es una enfermedad autoinmune, inflamatoria, crónica y con afectación multisistémica, de causa desconocida, siendo la pericarditis la afectación cardiaca más frecuente, aunque es raro que se llegue a una situación de taponamiento cardiaco. El curso clínico de esta enfermedad es variable, dependiendo el pronóstico de la gravedad y del tipo de órganos implicados. El tratamiento se basa en el uso de antiinflamatorios no esteroideos(AINE), corticoides, antipalúdicos e inmunosupresores (AU)

Pericardial effusion (Pericardial effusion (PE) is a condition that is rarely diagnosedin the Emergency Department. We present this case inwhich thanks to the new technologies developed by theEmergency Department medical personnel, it was possible toreach the diagnosis of PE using the echocardiography and todetermine its severity, without compromising the hemodynamicswithin the Emergency Department itself.Once the patient had been transferred out of the EmergencyDepartment, the etiological diagnosis was established asthe patient had 4 Systemic Lupus Erythematosus criteria(SLE). SLE is an autoimmune, inflammatory, chronic illnesswith multisystemic effect, of unknown origin. Pericarditis isthe most frequent heart condition (although it is unusual fora cardiac tamponade to develop). The clinical course for thisillness varies, depending on the severity and type of organsinvolved. Treatment is based on the use of NSAIDs, corticoids,antimalarial and immunosuppressive medications (AU)

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Objetivo: Los objetivos del presente estudio fueron describir la modificación que se realiza de la antibioterapia empírica indicada a los pacientes ingresados desde el área de urgencias en los primeros días de estancia en la planta de hospitalización y conocer las características de dicho tratamiento antibiótico. Método: Estudio prospectivo y observacional en el que se incluyó a pacientes mayores de 14 años que ingresaron desde el área de urgencias con al menos un antibiótico prescrito y tuvieron una hospitalización de al menos 72 h. Se realizó un seguimiento diario de cada caso durante los primeros 3 días de hospitalización, documentando el tipo de infección diagnosticada, los datos microbiológicos y la antibioterapia empírica prescrita y sus modificaciones. Resultados: Se incluyó a 225 pacientes. Los diagnósticos más frecuentes fueron infección respiratoria, neumonía e infección de la piel y los tejidos blandos, y los antibióticos más empleados fueron amoxicilina-ácido clavulánico, levofloxacino y cefalosporinas de tercera generación. Se solicitó al menos un tipo de muestra microbiológica a 80 enfermos (36%). De las 225 pautas antibióticas prescritas en urgencias, 94 (42%) fueron modificadas durante las primeras 72 h de hospitalización: 37 (16%) pautas se cambiaron por completo, 31 (14%) se suspendieron totalmente y en 26 (12%) se añadió o suspendió algún antimicrobiano, aunque sólo en 40 de ellas (42%) se dispuso de cultivos para dirigir el tratamiento. Conclusiones: La frecuencia con la que las pautas antimicrobianas prescritas en urgencias se modificaron durante los primeros días de estancia en la planta de hospitalización es elevada, y destaca la escasa utilización de los resultados microbiológicos para realizar estos cambios (AU)

Objective: The aims of this study were to determine the empirical antibiotic therapy used in patients admitted to the Emergency Department who were later hospitalised, and to describe the antibiotic changes during their first days of hospitalisation. Method: All 14-year-old patients admitted to the Emergency Department who were started on antibiotic therapy and subsequently were hospitalised for at least 72 hours in an in-patient hospital ward, were included in a prospective observational study. Patients underwent daily follow-up during the first three days of hospitalisation. The type of infection, microbiological data and empirical antibiotic therapy and its changes were registered. Results: 225 patients were included in this study. The most frequent types of infection diagnosed were infection of the respiratory airways, pneumonia and skin and soft-tissue infection. Amoxicillin-clavulanic acid was the most widely prescribed antibiotic followed bylevofloxacin and third generation cephalosporins. Microbiological samples were taken in 80 (36%) patients. Of the 225 antimicrobial regimens started in the Emergency Department, 94 (42%) were changed during the first 72 hours of hospitalisation: 37 (16%) were completely modified, 31 (14%) were discontinued and antibiotics were added or stopped from the existing regimen in 26 cases(12%). Among these 94 patients whose treatment was changed, only in 40 (42%) there was a microbiological result for aiding in the adjustment of the antibiotic therapy. Conclusion: The frequency of early changes during inpatient hospitalisation to antimicrobial regimens which were initially prescribed in the Emergency Department is high. Microbiological results were rarely used to guide these changes (AU)

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OBJECTIVE: The aims of this study were to determine the empirical antibiotic therapy used in patients admitted to the Emergency Department who were later hospitalised, and to describe the antibiotic changes during their first days of hospitalisation. METHOD: All 14-year-old patients admitted to the Emergency Department who were started on antibiotic therapy and subsequently were hospitalised for at least 72 hours in an in-patient hospital ward, were included in a prospective observational study. Patients underwent daily follow-up during the first three days of hospitalisation. The type of infection, microbiological data and empirical antibiotic therapy and its changes were registered. RESULTS: 225 patients were included in this study. The most frequent types of infection diagnosed were infection of the respiratory airways, pneumonia and skin and soft-tissue infection. Amoxicillin-clavulanic acid was the most widely prescribed antibiotic followed by levofloxacin and third generation cephalosporins. Microbiological samples were taken in 80 (36%) patients. Of the 225 antimicrobial regimens started in the Emergency Department, 94 (42%) were changed during the first 72 hours of hospitalisation: 37 (16%) were completely modified, 31 (14%) were discontinued and antibiotics were added or stopped from the existing regimen in 26 cases (12%). Among these 94 patients whose treatment was changed, only in 40 (42%) there was a microbiological result for aiding in the adjustment of the antibiotic therapy. CONCLUSION: The frequency of early changes during inpatient hospitalisation to antimicrobial regimens which were initially prescribed in the Emergency Department is high. Microbiological results were rarely used to guide these changes.

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In addition to its classic glycolytic role, glyceraldehyde-3-phosphate dehydrogenase (GAPDH) has been implicated in many activities unrelated to glycolysis, such as membrane fusion, binding to host proteins and signal transduction. GAPDH can be the target of several modifications that allow incorporation to membranes and possible regulation of its activity; among these modifications is mono-ADP-ribosylation. This post-translational modification is important for the regulation of many cellular processes and is the mechanism of action of several bacterial toxins. In a previous study, we observed the extracellular ADP-ribosylation of a 37-kDa ameba protein. We report here that GAPDH and cysteine synthase A are the main ADP-ribosylated proteins in Entamoeba histolytica extracellular medium, GAPDH is secreted from ameba at 37 degrees C in a time-dependent manner, and its enzymatic activity is not inhibited by ADP-ribosylation. Extracellular GAPDH from ameba may play an important role in the survival of this human pathogen or in interaction with host molecules, as occurs in other organisms.

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Due to the wide variety of equipment existing in clinical areas, there is an important question: which and how often electrical safety tests most be applied to the medical equipment. There are important differences about the electrical safety, such as the electrical insulation or the hazard considering the connection between patient and electrical instrumentation. The objective of this work was to develop an Electrical Safety Priority Index for Medical Equipment(ESPIME) involving different classifications related with electrical safety, in order to provide a numeric code indicating the priority and frequency for applying the electrical safety tests to medical equipment. The index were applied to the medical equipment in critical care locations and the result,were used to defined which set of medical equipment would be the first for developing and applying electrical safety tests in a private hospital in Mexico City.

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OBJECTIVE: To identify and analyze the most common causes for the discontinuation of antiretroviral therapy, including the co-formulation of abacavir, lamivudine and zidovudine (ABC-3TC-AZT). METHOD: An observational, retrospective study was carried out on patients receiving antiretroviral therapy with ABC-3TC-AZT seen in the Pharmacy Department s outpatient unit from February 2002 through June 2004. The causes for discontinuation among patients withdrawing from this therapy were analyzed. Adherence was assessed using computerized dispensation records. A Kaplan-Meier survival analysis was designed in order to identify factors predictive of discontinuation. RESULTS: In all, 114 patients (85 males, 74.6%) received this therapy - 25.4% of them were naïve patients - and 34.2% (39/114) withdrew from this regimen, amongst them 44.8% (13/29) of naïve subjects. In 92.3% of cases this happened before treatment week 48. Discontinuation causes included: adverse reactions (46.1%), voluntary discontinuation (33.3%), clinical decision (15.4%), and other reasons (5.1%). A possible hypersensitivity reaction to ABC was reported for 9 patients. A greater likelihood of discontinuation was associated with detectable viral load at therapy onset, ex-parenteral drug abuser status, and naïve status (p < 0.05). CONCLUSIONS: A high percentage of discontinuations due to adverse events and voluntary withdrawal was found, particularly early during treatment. Patients who may therapeutically benefit from this regimen, particularly naïve subjects, should be identified, and interventions to improve adherence and optimize recovery parameters should be implemented.

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Objetivo: Identificar y analizar las causas más frecuentes de discontinuación de la terapia antirretroviral que incluye la co-formulación: abacavir, lamivudina y zidovudina (ABC-3TC-AZT). Método: Estudio retrospectivo observacional de los pacientesen tratamiento antirretroviral con ABC-3TC-AZT, atendidos en la unidad de pacientes externos del servicio de farmacia durante el periodo comprendido entre febrero de 2002 y junio de 2004. Se analizó la causa de discontinuación en aquellos pacientes que no siguieron con esta terapia. Se evaluó la adherencia mediante los registros informáticos de dispensación. Se diseñó un análisis de supervivencia de Kaplan-Meier para identificar factores predictivos de discontinuación. Resultados: Un total de 114 pacientes (85 hombres, 74,6%) fueron tratados con esta terapia. Un 25,4% era naïve. El 34,2% (39/114) de los pacientes discontinuó el tratamiento. Entre ellos, el 44,8% (13/29) de los sujetos naïve. En el 92,3% del total de casos esto ocurrió antes de alcanzar las 48 semanas en tratamiento. Las causas de discontinuación fueron: reacciones adversas (46,1%), abandono voluntario (33,3%), decisión clínica (15,4%) y otros motivos (5,1%). Posible reacción de hipersensibilidad a ABC fue descrita en 9 pacientes. Se relacionó tener carga viral detectable al inicio del tratamiento, ser ex-ADVP, y paciente naïve, con mayor probabilidad de discontinuación (p < 0,05). Conclusiones: Se encontró un alto porcentaje de discontinuación debido a efectos adversos y abandono voluntario, principalmente al inicio del tratamiento. Es necesario identificar a aquellos pacientes a los cuales este esquema les puede aportar un beneficio terapéutico, especialmente los sujetos naïve, y realizar intervenciones para mejorar la adherencia y optimizar así los parámetros de recuperación

Objective: To identify and analyze the most common causes for the discontinuation of antiretroviral therapy, including the coformulation of abacavir, lamivudine and zidovudine (ABC-3TCAZT). Method: An observational, retrospective study was carried out on patients receiving antiretroviral therapy with ABC-3TC-AZT seen in the Pharmacy Department’s outpatient unit from February 2002 through June 2004. The causes for discontinuation among patients with drawing from this therapy were analyzed. Adherence was assessed using computerized dispensation records. A Kaplan-Meier survival analysis was designed in order to identify factors predictive of discontinuation. Results: In all, 114 patients (85 males, 74.6%) received this therapy – 25.4% of them were naïve patients – and 34.2% (39/114) with drew from this regimen, amongst them 44.8%(13/29) of naïve subjects. In 92.3% of cases this happened before treatment week 48. Discontinuation causes included: adverse reactions (46.1%), voluntary discontinuation (33.3%), clinical decision (15.4%), and other reasons (5.1%). A possible hypersensitivity reaction to ABC was reported for 9 patients. A greater likelihood of discontinuation was associated with detectable viral load at therapy onset, ex-parenteral drug abuser status, and naïve status (p < 0.05). Conclusions: A high percentage of discontinuations due to adverse events and voluntary withdrawal was found, particularly early during treatment. Patients who may therapeutically benefit from this regimen, particularly naïve subjects, should be identified, and interventions to improve adherence and optimize recovery parameters should be implemented

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