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1.
Appl Opt ; 60(4): A222-A233, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33690373

RESUMEN

Assisted reproductive technologies seek to improve the success rate of pregnancies. Morphology scoring is a common approach to evaluate oocyte and embryo viability prior to embryo transfer in utero, but the efficacy of the method is low. We apply biodynamic imaging, based on dynamic light scattering and low-coherence digital holography, to assess the metabolic activity of oocytes and embryos. A biodynamic microscope, developed to image small and translucent biological specimens, is inserted into the bay of a commercial inverted microscope that can switch between conventional microscopy channels and biodynamic microscopy. We find intracellular Doppler spectral features that act as noninvasive proxies for embryo metabolic activity that may relate to embryo viability.


Asunto(s)
Embrión de Mamíferos/fisiología , Holografía/instrumentación , Microscopía/instrumentación , Oocitos/fisiología , Adenosina Trifosfato/metabolismo , Animales , Embrión de Mamíferos/citología , Femenino , Guanosina Trifosfato/metabolismo , Holografía/métodos , Humanos , Microscopía/métodos , Oocitos/citología , Carne de Cerdo , Embarazo
2.
J Clin Pharm Ther ; 46(3): 724-730, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33368439

RESUMEN

WHAT IS KNOWN AND OBJECTIVE: Initial treatment recommendations of COVID-19 were based on the use of antimicrobial drugs and immunomodulators. Although information on drug interactions was available for other pathologies, there was little evidence in the treatment of COVID-19. The objective of this study was to analyse the potential drug-drug interactions (pDDIs) derived from the medication used in COVID-19 patients in the first pandemic wave and to evaluate the real consequences of such interactions in clinical practice. METHODS: Cohort, retrospective and single-centre study carried out in a third-level hospital. Adult patients, admitted with suspected COVID-19, that received at least one dose of hydroxychloroquine, lopinavir/ritonavir, interferon beta 1-b or tocilizumab and with any pDDIs according to "Liverpool Drug Interaction Group" between March and May 2020 were included. The possible consequences of pDDIs at the QTc interval level or any other adverse event according to the patient's medical record were analysed. A descriptive analysis was carried out to assess possible factors that may affect the QTc interval prolongation. RESULTS AND DISCUSSION: Two hundred and eighteen (62.3%) patients of a total of 350 patients admitted with COVID-19 had at least one pDDI. There were 598 pDDIs. Thirty-eight pDDIs (6.3%) were categorized as not recommended or contraindicated. The mean value difference between baseline and pDDI posterior ECG was 412.3 ms ± 25.8 ms vs. 426.3 ms ± 26.7 ms; p < 0.001. Seven patients (5.7%) had a clinically significant alteration of QTc. A total of 44 non-cardiological events (7.3%) with a possible connection to a pDDI were detected. WHAT IS NEW AND CONCLUSION: The number of pDDIs in patients admitted for COVID-19 in the first pandemic wave was remarkably high. However, clinical consequences occurred in a low percentage of patients. Interactions involving medications that would be contraindicated for concomitant administration are rare. Knowledge of these pDDIs and their consequences could help to establish appropriate therapeutic strategies in patients with COVID-19 or other diseases with these treatments.


Asunto(s)
Anticuerpos Monoclonales Humanizados/efectos adversos , Tratamiento Farmacológico de COVID-19 , Hidroxicloroquina/efectos adversos , Interferon beta-1b/efectos adversos , Lopinavir/efectos adversos , Ritonavir/efectos adversos , Adyuvantes Inmunológicos/efectos adversos , Anciano , COVID-19/complicaciones , Estudios de Cohortes , Inhibidores del Citocromo P-450 CYP3A/efectos adversos , Interacciones Farmacológicas , Inhibidores Enzimáticos/efectos adversos , Femenino , Humanos , Masculino , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , SARS-CoV-2
3.
Int J Cancer ; 143(8): 1954-1962, 2018 10 15.
Artículo en Inglés | MEDLINE | ID: mdl-29761480

RESUMEN

Testicular germ cell tumors (TGCTs) are a clinically and pathologically heterogeneous disease, and little is known of its genetic basis. Only low susceptibility risk loci have been identified for both sporadic and familial cases. Therefore, we tried to identify new susceptibility genes responsible for familial testicular cancer that may contribute to increasing our knowledge about the genetic basis of the disease. Nineteen Spanish families with at least two affected individuals with TGCT were selected. WES was performed on those individuals using an Illumina Hiseq2000 sequencing platform. Data were analyzed under a monogenic and polygenic model of inheritance, and candidate variants were evaluated in a case-control association study performed on 391 Spanish sporadic cases and 1,170 healthy Spanish controls. Results were replicated in a second series consisting of 101 TGCTs from the Cancer Genome Atlas (TGCA) and 27,000 controls from the Exome Aggregation Consortium (ExAC) database. Logistic regression was carried out to analyze the association strength (risk) of candidate variants obtained among cases and controls in different populations. Despite the sample size, we detected a significant earlier age of onset in familial TGCT (28y) than sporadic cases (33y), using a Mann-Whitney U test. We identified significant variants in the comparative study of TGCT cases (391) versus controls (almost 1,170), and three of them [PLEC (OR = 6.28, p = 6.42 × 10-23 ) (p.Arg2016Trp), EXO5 (OR = 3.37, p = 4.82 × 10-09 ) (p.Arg344AlafsTer10) and DNAH7 (OR = 1.64, p = 0.048)] were replicated as potential candidates that may contribute to explaining the genetic basis of TGCT.


Asunto(s)
Dineínas Axonemales/genética , Exonucleasas/genética , Predisposición Genética a la Enfermedad/genética , Plectina/genética , Neoplasias Testiculares/genética , Adolescente , Adulto , Anciano , Estudios de Casos y Controles , Niño , Preescolar , Exoma/genética , Femenino , Herencia/genética , Humanos , Lactante , Masculino , Persona de Mediana Edad , Linaje , Factores de Riesgo , Secuenciación del Exoma/métodos , Adulto Joven
4.
Clin Ther ; 43(4): e111-e121, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33712271

RESUMEN

PURPOSE: To evaluate the effectiveness, adverse reactions, and adherence to treatment of hypolipidemic inhibitors of proprotein convertase subtilisin/kexin type 9 (PCSK9is) in a context of real clinical practice. METHODS: We present an observational, retrospective, descriptive, multicenter study of patients with hypercholesterolemia who began treatment with PCSK9is between January 2017 and December 2019, with a minimum treatment period of 3 months. The main variable we recorded was the frequency of cardiovascular events (cardiovascular death, myocardial infarction, stroke, coronary revascularization, and hospitalization for unstable angina) in patients treated with PCSK9is. We recorded patient demographic characteristics and cardiovascular risk factors at onset of treatment as well as LDL-C levels and their reductions at 3, 6, 12, and 24 months. We calculated adherence to treatment and recorded the adverse reactions during treatment. FINDINGS: A total of 154 patients were studied, 64 (41.6%) of whom were treated with alirocumab and 90 (58.4%) with evolocumab. The initial dose of alirocumab was 75 mg every 14 days in 48 patients (75%) and 150 mg eery 14 days in 16 (25%). All patients who in the evolocumab group received a dose of 140 mg every 14 days. The mean (SD) basal LDL-C level was 159.6 (50.1) mg/dL, the level at 3 months was 87.9 (49.9) mg/dL (mean [SD] decrease, 44.5% [28.2%]), the level at 6 months was 86.7 (49.2) mg/dL (mean [SD] decrease, 46.3% [25.6%]), and the level at 12 months was 80.5 (41.4) (mean [SD] decrease, 48.9% [23.0%]). These values were maintained at 24 months (mean [SD], 80.3 [41.8] mg/dL; mean [SD] decrease, 47.9% [27.8%]). The percentage decrease of LDL-C for both drugs was approximately 50%, which was maintained until 24 months after treatment. Six patients (3.9%) presented with some cardiovascular event: acute myocardial infarction (2 [1.3%]), stroke (1 [0.65%]), coronary revascularization (1 [0.65%]), and hospitalization for unstable angina (2 [1.3%]). We did not see any adverse reactions related to PCSK9i treatment in 76.5% of patients. In the first 6 months, adherence to treatment with PCSK9is, measured as the possession ratio, was a mean (SD) of 99.4% (3.9%). In the rest of the study period (6-24 months), the mean (SD) adherence to treatment was 99.2% (4.7%). IMPLICATIONS: The frequency of cardiovascular events in patients treated with PCSK9is was low and occurred despite adequate adherence to treatment (100% possession ratio) with PCSK9is and concomitant treatment with other hypolipidemics. The effectiveness of PCSK9is is similar to that referred to in other published studies with PCSK9is, and this was maintained in the long term (24 months) with few adverse events, all of which were mild.


Asunto(s)
Anticolesterolemiantes , Inhibidores de Hidroximetilglutaril-CoA Reductasas , Hipercolesterolemia , Proproteína Convertasa 9 , Anticuerpos Monoclonales/efectos adversos , Anticolesterolemiantes/efectos adversos , LDL-Colesterol , Humanos , Hipercolesterolemia/tratamiento farmacológico , Inhibidores de PCSK9 , Estudios Retrospectivos , Subtilisinas , Resultado del Tratamiento
5.
J Pediatr ; 157(2): 228-32, 2010 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-20400110

RESUMEN

OBJECTIVE: To compare the eradication rates among the different point mutations and the efficacy of triple therapy and a sequential regimen according to genotypic resistance. STUDY DESIGN: Post hoc retrospective cohort study in a tertiary referral center for pediatric gastroenterology in southern Italy. All 168 children who were positive for Helicobacter pylori were enrolled. Patients had received clarithromycin-based 7-day triple therapy (73 children) or 10-day sequential therapy regimen (95 children). Real-time polymerase chain reaction for assessing clarithromycin resistance was performed on sections of paraffin-embedded gastric biopsy samples. RESULTS: H pylori eradication was achieved in 16 of 32 (50%) children with the A2143G mutation, in 8 of 10 patients with either A2142G or A2142C strains (80%), and in 112 of 116 children with susceptible strains (88.9%). The presence of A2143G mutation was associated with a lower cure rate compared with the rate in the absence of this mutation (50% vs. 89%; P = .001). The sequential regimen achieved a higher cure rate than triple therapy in patients with A2143G mutant strains (80% vs nil; P < .001). CONCLUSIONS: The A2143G mutation confers higher risk of treatment failure. Sequential regimen has higher efficacy than standard therapy, even in children with A2143G mutatant strains.


Asunto(s)
Claritromicina/farmacología , Farmacorresistencia Bacteriana , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori/efectos de los fármacos , Helicobacter pylori/genética , Adolescente , Antibacterianos/farmacología , Biopsia , Niño , Preescolar , Estudios de Cohortes , Quimioterapia Combinada , Femenino , Genotipo , Infecciones por Helicobacter/microbiología , Humanos , Masculino , Mutación , Estudios Retrospectivos
6.
Clin Transl Oncol ; 22(2): 201-212, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31981079

RESUMEN

In the last 2 decades, clinical genetics on hereditary colorectal syndromes has shifted from just a molecular characterization of the different syndromes to the estimation of the individual risk of cancer and appropriate risk reduction strategies. In the last years, new specific therapies for some subgroups of patients have emerged as very effective alternatives. At the same time, germline multigene panel testing by next-generation sequencing (NGS) technology has become the new gold standard for molecular genetics.


Asunto(s)
Ensayos Clínicos como Asunto/normas , Neoplasias Colorrectales/prevención & control , Predisposición Genética a la Enfermedad , Mutación , Proteínas de Neoplasias/genética , Guías de Práctica Clínica como Asunto/normas , Neoplasias Colorrectales/genética , Humanos , Oncología Médica , Sociedades Médicas
7.
Farm Hosp ; 44(7): 61-65, 2020 06 13.
Artículo en Inglés | MEDLINE | ID: mdl-32533674

RESUMEN

Hospital Pharmacy Service (HPS) in Spain have been impacted by the health  crisis caused by the COVID-19 pandemic. Thus, the outbreak has forced HPSs to adapt their outpatient consultation services to Telepharmacy to optimize clinical  outcomes and reduce the risk of contagion. The purpose of this article is to  describe and analyze the experience of HPSs with outpatient Telepharmacy  during the COVID-19 pandemic and expose the lessons learned. Measures have  been adopted in on-site outpatient pharmacy clinics to prevent exposure of  patients and professionals to the virus. These measures are based on national  and international recommendations on social distancing and hygiene. With  regard to remote outpatient pharmacy services, teleconsultation with drug  dispensing has been promoted based on five basic procedures, each with its  advantages and limitations: home drug delivery from HPSs, with the advantage  of universal access and the limitation of entailing a substantial investment in  resources; HPS coordination with primary care pharmacists, which requires no  investments but with limited access to some geographic areas; HPS coordination with community pharmacists based on a large network of pharmacies, which  requires the patient to go to the pharmacy, without confidentiality being  guaranteed for any patient; geolocation and hospital-based medication  dispensing, which provides universal access and direct traceability, but entails  investment in human resources; and HPS coordination with associations of  patients, which does not entail any additional cost but limits the information  available on the diseases of society members. Three main lessons have been learned during the pandemic: the satisfactory capacity of HPS to provide outpatient pharmacy consultation services in the setting of a public health crisis; the usefulness of Telepharmacy for the clinical follow-up, healthcare coordination, outpatient counseling, and informed dispensing and delivery of  medication (with a high level of satisfaction among patients); and the need to  foster Telepharmacy as a complementary tool through a mixed model of  outpatient pharmacy consultation service that incorporates the advantages of  each procedure and adapts to the individual needs of each patient in a context of humanized healthcare.


Los servicios de farmacia hospitalaria (SFH) en España se han visto afectados  por la crisis sanitaria provocada por SARS-CoV-2 y han tenido que adoptar sus  procedimientos de atención farmacéutica (AF) al paciente externo (PE) mediante estrategias de Telefarmacia, con los objetivos de maximizar los resultados en  salud y reducir el riesgo de contagio. El objetivo de ese artículo es describir y  analizar los procedimientos AFPE durante la pandemia SARS-CoV-2 y comunicar  las lecciones aprendidas en los SFH. En relación con las consultas externas de AF presenciales, se han adoptado medidas para minimizar el contagio viral de  pacientes y profesionales, siguiendo las recomendaciones nacionales e  internacionales de referencia de distanciamiento temporal, espacial y  recomendaciones higiénicas. En cuanto a las consultas externas de AF no  presenciales, se han potenciado las teleconsultas con dispensación del  tratamiento en base a cinco procedimientos básicos, cada uno de ellos con sus  ventajas y limitaciones: dispensación domiciliaria desde SFH que presenta las  ventajas de la universalidad de acceso, pero requiere una elevada inversión en  recursos; coordinación del SHF con farmacéuticos de atención primaria, que  conlleva una nula inversión en recursos, pero limita el acceso a determinadas zonas geográficas; coordinación del SFH con farmacéuticos comunitarios, que  utiliza una amplia red de oficinas de farmacia, pero exige el desplazamiento del  paciente sin garantías de confidencialidad para todos los casos; geolocalización y dispensación hospitalaria, que permite un acceso universal y trazabilidad directa, pero requiere un incremento en recursos humanos; y coordinación del SFH con  asociaciones de pacientes, que no requiere inversión económica, pero limita el  acceso a las patologías de los asociados. Destacamos finalmente tres lecciones  aprendidas: la capacidad de AFPE de SFH españoles ante una crisis sanitaria; la  utilidad de la Telefarmacia para el seguimiento clínico, la coordinación  asistencial, información al PE, dispensación y entrega informada (con elevada  satisfacción de los pacientes); y la necesidad de potenciar la Telefarmacia como herramienta complementaria, en un modelo mixto de AFPE que incorpore las  ventajas de cada uno de los procedimientos adaptándose a las necesidades individuales de los pacientes en un entorno de humanización de la asistencia  sanitaria.


Asunto(s)
Atención Ambulatoria/organización & administración , Betacoronavirus , Infecciones por Coronavirus , Atención a la Salud/organización & administración , Pandemias , Servicio de Farmacia en Hospital/organización & administración , Neumonía Viral , Telemedicina/organización & administración , COVID-19 , Atención a la Salud/estadística & datos numéricos , Consejo Dirigido/organización & administración , Asesoramiento a Distancia/organización & administración , Predicción , Geografía Médica , Necesidades y Demandas de Servicios de Salud , Servicios de Atención de Salud a Domicilio/organización & administración , Hospitales Universitarios/organización & administración , Humanos , Sistemas de Medicación en Hospital/organización & administración , Pacientes Ambulatorios , Educación del Paciente como Asunto/organización & administración , Servicio de Farmacia en Hospital/estadística & datos numéricos , SARS-CoV-2 , España
8.
Acta Otorrinolaringol Esp ; 59(9): 455-62, 2008 Nov.
Artículo en Español | MEDLINE | ID: mdl-19080777

RESUMEN

OBJECTIVE: To evaluate the prevalence and clinical characteristics of children with altered balance, as well as to establish the level of importance of the audiological, balance and imaging studies in the diagnosis of infantile vestibular pathology. PATIENTS AND METHOD: We report a descriptive, retrospective and non-randomized study performed at the Otorhinolaryngology Department of the Complejo Hospitalario Universitario de Santiago de Compostela (Santiago de Compostela University Hospital, Santiago de Compostela, Spain). The study included 125 patients under 16 years of age who consulted due to alterations in their balance over a period of twelve years (1996 to 2007); they are distributed into three groups based on age: 0 to 5, 6 to 10, and 11 to 15 years. RESULTS: Childhood benign paroxysmal vertigo (64 %) is the most frequent syndrome in our series, with 32.5 % of patients associating common migraine. Together with diagnoses of infantile positional vertigo and psychogenic vertigo, was more frequently found in the 11 to 15 year-old age group (P< .05). Age, gender and the results of the imaging studies (computerized tomography of the brain and magnetic resonance of the head) were not related to the presentation of associated migraine nor to the diagnosis (P>.05). CONCLUSIONS: Clinical history and the neuro-otological examination are the key elements of the diagnosis of infantile vestibular pathology; it is also important to standardize and group patients by age. Imaging studies only contribute high diagnostic performance in children presenting neurological symptoms, persistent headache or who have sustained head trauma.


Asunto(s)
Vértigo/epidemiología , Adolescente , Distribución por Edad , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Masculino , Trastornos Migrañosos/epidemiología , Estudios Retrospectivos , Vértigo/diagnóstico , Vértigo/fisiopatología , Vestíbulo del Laberinto/fisiopatología
9.
Auris Nasus Larynx ; 44(1): 40-45, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-27146006

RESUMEN

OBJECTIVE: Cochlear implants (CI) are electronic devices that enable the auditory rehabilitation and the management of individuals with severe to profound bilateral hearing loss, and nowadays, advanced age is not considered a contraindication for cochlear implantation and several studies have shown that older adults do benefit from CI, with improvements in hearing abilities and quality of life. METHODS: Retrospective analysis of patients older than 18 years who underwent cochlear implant surgery in a tertiary academic centre. RESULTS: 57 patients met the inclusion criteria: 25 (43.9%) male and 32 (56.1%) female. Total percentage of minor complication was 24.6% and major complication was 17.5%. The most common minor complication in our series was vestibular disorder, and the most common major complication was device failure. No correlation was found among age, previous meningitis, anatomical variables or comorbidities with the appearance of complications. CONCLUSION: Cochlear implantation is a safe surgical technique for rehabilitation of severe to profound sensorineural hearing loss. According to our results, neither the age over 65 years nor the presence of comorbidities does have a direct impact over the complication rates in our patients.


Asunto(s)
Implantación Coclear , Pérdida Auditiva Sensorineural/rehabilitación , Complicaciones Posoperatorias/epidemiología , Centros Médicos Académicos , Adolescente , Adulto , Anciano , Mareo/epidemiología , Disgeusia/epidemiología , Femenino , Hematoma/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Dehiscencia de la Herida Operatoria/epidemiología , Centros de Atención Terciaria , Acúfeno/epidemiología , Enfermedades Vestibulares/epidemiología , Adulto Joven
10.
Acta Otorhinolaryngol Ital ; 36(6): 450-458, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28177327

RESUMEN

The treatment of supraglottic carcinoma remains a controversial issue. Five accepted surgical and non-surgical oncological treatments have been currently established: standard horizontal supraglottic laryngectomy (HSL), supraglottic CO2 laser microsurgery (TLM), transoral robotic surgery, radiotherapy alone and radiotherapy in combination with chemotherapy. Some studies have shown that complications of head and neck surgeries increase significantly in patients over 65 years compared to younger patients. We designed a retrospective analysis to assess the rate of complications and functional outcomes of patients treated by TLM and HSL in cases of T1-T3 supraglottic squamous cell carcinomas (SCC) in a tertiary University Hospital. Results were compared between patients younger and older than 65 years. We found significant differences in the rate of aspiration pneumonia (p = 0.026), mean time to decannulation (p = 0.001) and mean hospital stay (p = 0.007) in patients treated by TLM, which was higher and longer in the group of patients over 65 years of age. Regarding HPL, we only found significant differences in the mean time to decannulation (p = 0.001), which was longer in the group of patients younger than 65 years. According to our results, TLM or HPL can both be a safe surgical option for patients older than 65 years, but previous evaluation of lung function before surgery is mandatory because of an increased risk of aspiration pneumonia in patients with lung problems, especially when treated by TLM. Concerning functional outcomes in patients older than 65 years, TLM reduces the postoperative rate of tracheostomy, mean time required for decannulation and mean hospital stay compared with HPL. However, no significant difference in the occurrence of aspiration pneumonia, dysphagia or in the mean length of NGT feeding was found.


Asunto(s)
Carcinoma de Células Escamosas/cirugía , Glotis , Neoplasias Laríngeas/cirugía , Laringectomía/métodos , Terapia por Láser , Microcirugia , Anciano , Anciano de 80 o más Años , Humanos , Terapia por Láser/métodos , Microcirugia/métodos , Persona de Mediana Edad , Boca , Recuperación de la Función , Estudios Retrospectivos , Resultado del Tratamiento
11.
Farm. hosp ; 44(supl.1): 61-65, 2020. tab
Artículo en Español | IBECS (España) | ID: ibc-190481

RESUMEN

Los servicios de farmacia hospitalaria (SFH) en España se han visto afectados por la crisis sanitaria provocada por SARS-CoV-2 y han tenido que adoptar sus procedimientos de atención farmacéutica (AF) al paciente externo (PE) mediante estrategias de Telefarmacia, con los objetivos de maximizar los resultados en salud y reducir el riesgo de contagio. El objetivo de ese artículo es describir y analizar los procedimientos AFPE durante la pandemia SARS-CoV-2 y comunicar las lecciones aprendidas en los SFH. En relación con las consultas externas de AF presenciales, se han adoptado medidas para minimizar el contagio viral de pacientes y profesionales, siguiendo las recomendaciones nacionales e internacionales de referencia de distanciamiento temporal, espacial y recomendaciones higiénicas. En cuanto a las consultas externas de AF no presenciales, se han potenciado las teleconsultas con dispensación del tratamiento en base a cinco procedimientos básicos, cada uno de ellos con sus ventajas y limitaciones: dispensación domiciliaria desde SFH que presenta las ventajas de la universalidad de acceso, pero requiere una elevada inversión en recursos; coordinación del SHF con farmacéuticos de atención primaria, que con-lleva una nula inversión en recursos, pero limita el acceso a determinadas zonas geográficas; coordinación del SFH con farmacéuticos comunitarios, que utiliza una amplia red de oficinas de farmacia, pero exige el desplazamiento del paciente sin garantías de confidencialidad para todos los casos; geolocalización y dispensación hospitalaria, que permite un acceso universal y trazabilidad directa, pero requiere un incremento en recursos humanos; y coordinación del SFH con asociaciones de pacientes, que no requiere inversión económica, pero limita el acceso a las patologías de los asociados. Destacamos finalmente tres lecciones aprendidas: la capacidad de AFPE de SFH españoles ante una crisis sanitaria; la utilidad de la Telefarmacia para el seguimiento clínico, la coordinación asistencial, información al PE, dispensación y entrega informada (con elevada satisfacción de los pacientes); y la necesidad de potenciar la Telefarmacia como herramienta complementaria, en un modelo mixto de AFPE que incorpore las ventajas de cada uno de los procedimientos adaptándose a las necesidades individuales de los pacientes en un entorno de humanización de la asistencia sanitaria


Hospital Pharmacy Service (HPS) in Spain have been impacted by the health crisis caused by the COVID-19 pandemic. Thus, the outbreak has forced HPSs to adapt their outpatient consultation services to Telepharmacyto optimize clinical outcomesand reduce the risk of contagion. The purpose of this article is to describe and analyze the experience of HPSs with out-patient Telepharmacy during the COVID-19 pandemic and expose the les-sons learned. Measures have been adopted in on-site outpatient pharmacy clinics to prevent exposure of patients and professionals to the virus. These measures are based on national and international recommendations on social distancing and hygiene. With regard to remote outpatient pharmacy services, teleconsultation with drug dispensing has been promoted based on five basic procedures, each with its advantages and limitations: home drug delivery from HPSs, with the advantage of universal access and the limitation of entailing a substantial investment in resources; HPS coordination with primary care pharmacists, which requires no investments but with limited access to some geographic areas; HPS coordination with community pharmacists based on a large network of pharmacies, which requires the patient to go to the pharmacy, without confidentiality being guaranteed for any patient; geolocation and hospital-based medication dispensing, which provides universal access and direct traceability, but entails investment in human resources; and HPS coordination with associations of patients, which does not entail any additional cost but limits the information available on the diseases of society members. Three main lessons have been learned during the pandemic: the satisfactory capacity of HPS to provide outpatient pharmacy consultation services in the setting of a public health crisis; the usefulness of Telepharmacy for the clinical follow-up, healthcare coordination, outpatient counseling, and informed dispensing and delivery of medication (with a high level of satisfaction among patients); and the need to foster Telepharmacy as a complementary tool through a mixed model of outpatient pharmacy consultation service that incorporates the advantages of each procedure and adapts to the individual needs of each patient in a context of humanized healthcare


Asunto(s)
Humanos , Atención Ambulatoria/organización & administración , Betacoronavirus , Infecciones por Coronavirus , Atención a la Salud/organización & administración , Telemedicina/organización & administración , Neumonía Viral , Servicio de Farmacia en Hospital/organización & administración , Atención a la Salud/estadística & datos numéricos , Consejo Directivo , Geografía Médica , Necesidades y Demandas de Servicios de Salud , Educación del Paciente como Asunto/organización & administración , España , Sistemas de Medicación en Hospital/organización & administración , Pacientes Ambulatorios
12.
Vet Parasitol ; 47(1-2): 9-15, 1993 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-8493772

RESUMEN

Infection by Cryptosporidium was detected in 94 (71.75%) asymptomatic adult cattle from 131 fecal samples examined microscopically. In two cases Cryptosporidium oocysts were observed which were distinctly larger (5.5-6.5 microns x 6.6-7.0 microns) than those we had seen in the majority of feces examined (4.0-4.5 microns x 4.0-4.5 microns) and these specimens were considered to be Cryptosporidium muris; it is possible that the other oocysts should be considered as Cryptosporidium parvum. The seroprevalence of IgG antibodies to Cryptosporidium was 63.35% as detected by indirect fluorescent antibody test (IFAT) and 51.41% by enzyme-linked immunosorbent assay (ELISA). In 27 cases, the presence of IgG antibodies to Cryptosporidium (as tested by IFAT and ELISA) in serum samples was correlated with oocyst excretion.


Asunto(s)
Anticuerpos Antiprotozoarios/sangre , Enfermedades de los Bovinos/parasitología , Criptosporidiosis/parasitología , Cryptosporidium parvum/aislamiento & purificación , Heces/parasitología , Inmunoglobulina G/sangre , Animales , Bovinos , Enfermedades de los Bovinos/inmunología , Criptosporidiosis/inmunología , Cryptosporidium parvum/inmunología , Ensayo de Inmunoadsorción Enzimática/veterinaria , Técnica del Anticuerpo Fluorescente/veterinaria
13.
J Parasitol ; 79(1): 67-70, 1993 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-8437060

RESUMEN

Demineralized water was enriched with a known number of Cryptosporidium parvum oocysts obtained from fresh calf feces, which were purified and exposed to ultraviolet (UV) light (15,000 mW/sec) for different lengths of time. Coccidium-free litters of CD-1 neonatal mice then were inoculated intragastrically with the treated water. Seven days postinoculation mice were killed and C. parvum infection prevalence and intensity determined. In mice inoculated with C. parvum-enriched water that had been exposed to UV light for at least 150 min, no infection occurred.


Asunto(s)
Criptosporidiosis/prevención & control , Cryptosporidium parvum/efectos de la radiación , Rayos Ultravioleta , Animales , Bovinos , Ratones , Organismos Libres de Patógenos Específicos , Abastecimiento de Agua
14.
An Otorrinolaringol Ibero Am ; 31(3): 205-14, 2004.
Artículo en Español | MEDLINE | ID: mdl-15259842

RESUMEN

Facial nerve schwannomas are relatively uncommon lesions. The clinical features depend upon the localization and extent of the lesion. The most common presenting symptom is that of a slowly progressive facial nerve palsy, because of facial schwannoma usually are located near the geniculate ganglion. A case of facial schwannoma is reported: a woman presenting a sudden facial palsy did not respond to medical and rehabilitation treatment. First, a Bell's palsy was diagnosed and then the facial nerve schwannoma with imaging techniques. A review about facial nerve schwannomas is reported.


Asunto(s)
Neoplasias Faciales/diagnóstico , Nervio Facial/diagnóstico por imagen , Nervio Facial/patología , Neurilemoma/diagnóstico , Neoplasias Faciales/cirugía , Nervio Facial/cirugía , Femenino , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Neurilemoma/cirugía , Tomografía Computarizada por Rayos X
15.
Asia Pac J Clin Oncol ; 7(3): 193-6, 2011 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-21884431

RESUMEN

Carcinoids of the ampulla of Vater are infrequent tumors of which a quarter of cases have been detected in patients with type I neurofibromatosis. This hereditary disease is also associated with gastrointestinal stromal tumors (GIST). However, the coincidence of these three entities together have only been formerly detected in five cases. A 53 year-old female patient, diagnosed with type I neurofibromatosis, with a malignant carcinoid of ampulla of Vater and multiple gastrointestinal stromal tumors in the duodenum and jejunum, was treated with total pancreatectomy and the excision of her intestinal tumors. Five-years on, a follow-up showed the patient to be well, and free from tumor recurrence. The coexistence of an ampullary carcinoid tumor, GIST and neurofibramatosis is very rare. Radical curative surgical resection is a good treatment option, but the optimal management of this is not yet well established.


Asunto(s)
Ampolla Hepatopancreática/patología , Tumores del Estroma Gastrointestinal/patología , Neurofibromatosis/patología , Neoplasias Pancreáticas/patología , Ampolla Hepatopancreática/cirugía , Femenino , Tumores del Estroma Gastrointestinal/cirugía , Humanos , Persona de Mediana Edad , Neurofibromatosis/cirugía , Neoplasias Pancreáticas/cirugía
16.
Chemother Res Pract ; 2010: 426973, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-22482051

RESUMEN

Vesical clear cell adenocarcinoma is an uncommon tumour. The description of nearly all published cases focuses on histological issues, providing few clinical particulars and limited followup. The treatment choice is resection. No publications have been found regarding systemic treatments for advanced disease. We present a case of metastatic clear cell adenocarcinoma of the bladder treated with chemotherapy.

18.
Rev. medica electron ; 34(3): 373-380, mayo-jun. 2012.
Artículo en Español | LILACS-Express | LILACS | ID: lil-644760

RESUMEN

Se presenta un caso clínico asistido de urgencia en el Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez Hernández, de la ciudad de Matanzas, en el año 2012, con un cuerpo extraño intraocular a nivel del cristalino en una paciente del sexo femenino, de 43 años de edad, ama de casa, con antecedente de trauma ocular en su hogar. En el examen físico presentaba déficit visual de 0,3 con herida corneal, que afectaba, además, limbo corneo escleral y cristalino con cuerpo extraño incluido. En examen ecográfico se observó imagen ecogénica compatible con cuerpo extraño a nivel del cristalino. Se suturó córnea y se extrajo cuerpo extraño con evolución satisfactoria; no presentando secuelas.


We present a clinical case attended at the emergency unit of the University Clinic-Surgical Hospital Comandante Faustino Perez, of Matanzas, in 2012, with a foreign intraocular body at the level of the crystalline lens in a female patient aged 43 years old, housewife, with antecedents of an ocular trauma at home. At the physical examination she had a visual deficit of 0,3, and a corneal injury affecting also the cornea-scleral limbus and the crystalline with an included foreign body. At the echographic examination we found an echogenic image compatible with a foreign body at the level of the crystalline. The cornea was sutured and the foreign body was extracted with a satisfactory evolution; there were not sequels.

19.
Appl Environ Microbiol ; 58(11): 3514-6, 1992 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-1482177

RESUMEN

Primary clarifier effluent (procedure B) and final effluent (procedure A) from a wastewater treatment plant were enriched with Cryptosporidium parvum oocysts obtained from the feces of naturally infected calves. Procedure B samples alone were subjected to a laboratory simulation of activated-sludge treatment. Coccidium-free neonatal CD-1 mice were then inoculated intragastrically with procedure A or procedure B samples. Seven days after inoculation, the intensity of oocyst infection in procedure B mice was 91% less than in procedure A mice (controls).


Asunto(s)
Criptosporidiosis/prevención & control , Cryptosporidium parvum/fisiología , Aguas del Alcantarillado , Eliminación de Residuos Líquidos , Animales , Bovinos/microbiología , Cryptosporidium parvum/aislamiento & purificación , Ratones
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