Potential use of ivermectin for the treatment and prophylaxis of SARS-CoV-2 infection.

PURPOSE OF THE STUDY: Currently no treatment has been proven to be efficacious for patients with early symptoms of COVID-19. Although most patients present mild or moderate symptoms, up to 5-10% may have a poor disease progression, so there is an urgent need for effective drugs, which can be administered even before the onset of severe symptoms, i.e. when the course of the disease is modifiable. Recently, promising results of several studies on oral ivermectin have been published, which has prompted us to conduct the present review of the scientific literature. METHODS: A narrative review has been carried out, focusing on the following four main topics: a) short-term efficacy in the treatment of the disease, b) long-term efficacy in the treatment of patients with post-acute symptoms of COVID-19, c) efficacy in the prophylaxis of the disease, and c) safety of ivermectin. RESULTS: The reviewed literature suggests that there seems to be sufficient evidence about the safety of oral ivermectin, as well as the efficacy of the drug in the early-treatment and the prophylaxis of COVID-19. CONCLUSIONS: In the view of the available evidence, the Frontline COVID-19 Critical Care Alliance (FLCCC) recommends the use of oral ivermectin for both prophylaxis and early-treatment of COVID-19. Further well-designed studies should be conducted in order to explore the efficacy and safety of invermectin at low and high doses, following different dosing schedules, in both, the short and long-term treatment.

Recurrencias loco-regionales en pacientes con cáncer de mama invasivo que presentan 3 ganglios positivos o menos. ¿Está indicada la radioterapia? / Locoregional recurrence in patients with invasive breast cancer and three or fewer positive nodes. is radiotherapy indicated?

Introducción: Existe consenso a nivel internacional del papel de la radioterapia (RT) sobre cadenas ganglionares en pacientes con cáncer de mama en estadios iniciales que presentan 4 o más ganglios positivos, sin embargo, no ocurre lo mismo cuando el número de ganglios afectados es menos de 4. Ya que el hospital Txagorritxu no realiza de forma sistemática tratamiento adyuvante con RT sobre cadenas ganglionares en pacientes que presentan 3 ganglios positivos o menos, se realizó un estudio para evaluar las recurrencias loco-regionales durante los cinco primeros años tras el tratamiento en este grupo de pacientes. Material y métodos Estudio retrospectivo. Se realizó un seguimiento de 5 años tras la finalización del tratamiento. Los datos fueron extraídos de la historia clínica de cada paciente. Los resultados obtenidos en nuestros pacientes se compararon con los obtenidos por Overgaard et al en el subgrupo de pacientes con 3 ganglios o menos que recibieron RT en cadenas ganglionares. Resultados No se observaron recurrencias loco-regionales a los 5 años de la finalización del tratamiento. No se encontraron diferencias estadísticamente significativas entre nuestros pacientes y los del grupo de Overgaard et al (p=0,5412).Conclusiones A la vista de los resultados obtenidos, no parece necesareo tratar con radioterapia sobre cadenas ganglionares, a todas las pacientes con cancer de mama en estadios iniciales que presenten tres o menos ganglion afectados (AU)

Introduction: There is international consensus on the role of regional lymph node radiotherapy in patients with early stage breast cancer and four or more positive lymph nodes. However, the decision is less clear when fewer than four affected lymph nodes are affected. As our hospital does not systematically carry out adjuvant radiotherapy in regional lymph nodes in patients with three or fewer positive lymph nodes, we assessed locoregional recurrence in this group of patients during the first 5 years after treatment. Material and Methods: We performed a retrospective study based on a 5-year follow-up after the end of treatment. Data were obtained from the patients’ clinical histories. Outcomes were compared with those reported by Overgaard et al in a subgroup of patients with three or fewer affected lymph nodes receiving radiotherapy in the regional lymph nodes. Results: No locoregional recurrence was detected up to 5 years after treatment. No significant differences were found between our patients and those of Overgaard (p = 0.5412).Conclusion: In view of the obtained results it does not seem necesary to treat with radiotherapy on lymph node chains to all early stage breast cancer patiens with three or fewer affected lymphnodes (AU)

¿Se realizan las mismas actividades preventivas en las consultas docentes que en las no docentes? / Are the same prevention activities carried out in teaching clinics as in non-teaching ones?

Introducción. Se conoce la variabilidad existente entre los equipos de atención primaria en la realización de actividades preventivas existiendo un mayor cumplimiento cuando la carga asistencial es menor y postulándose la falta de tiempo como la barrera principal para la atención preventiva. Asimismo, la docencia a médicos residentes es otra actividad más dentro de las propias del tutor de médicos de residentes, y que incrementa la carga laboral en la consulta. Introducción. El objetivo principal es determinar si existe diferencia en la cumplimentación de actividades preventivas entre las consultas que tienen a su cargo un médico residente en medicina de familia y comunitaria y las consultas no docentes. Material y métodos. Estudio descriptivo transversal que incluyó como población a estudio los 143 médicos especialistas de medicina de familia y comunitaria (pertenecientes a los 13 centros de salud de Vitoria-Gasteiz) que estaban en situación laboral activa en enero de 2010. Se recogieron datos referentes al grado de cumplimiento de actividades preventivas en Osabide (historia digital única) a fecha enero de 2010. Resultados. Se observaron diferencias estadísticamente significativas en las actividades de cribado de tensión arterial (61,52±14,35 frente 53,87±15,89; p=0,037) y de consumo de alcohol (60,67±16,92 frente a 52,77±17,91; p=0,047) entre las consultas docentes y no docentes. Conclusiones. A partir de los resultados se puede sugerir que el tiempo que el tutor invierte en la docencia a los médicos residentes no tiene un efecto negativo en el proceso preventivo, por lo que es necesario involucrar a todos los facultativos en dicho proceso (AU)

Introduction. We know the variability in carrying out preventive activities between primary care teams; increasing compliance when workload is lower, and the lack of time is postulated as the main barrier to preventive care. Likewise, teaching medical residents is one more activity within those of the medical residents tutor and increases the workload in the clinic. Introduction. The main objective of this study was to determine if there are differences in the level of carrying out prevention activities among physicians who are tutors of residents in family medicine and physicians who are not tutors. Material and methods. We conducted a cross sectional study involving 143 family medicine physicians (belonging to the 13 Primary Health Centres in Vitoria-Gasteiz) who were in active work in January 2010. We collected data on the level of prevention activities accomplishment “Osabide” (single digital history). Results. We only found statistically significant differences in the activities “screening blood pressure” (61.52±14.35 vs 53,87±15.89; P=.037) and “alcohol consumption” (60.67±16.92 vs 52.77±17.91; P=.047) between teaching and non-teaching clinics. Conclusions. From the results obtained in this study it can be suggested that time spent by tutors in teaching resident physicians does not have a negative effect on the prevention process; therefore necessary to involve all physicians need to be involved in this process (AU)

[Maximum stability of thermolabile drugs outside the refrigerator]. / Estabilidad máxima de los medicamentos termolábiles fuera de nevera.

OBJECTIVE: To review the maximum stability of thermolabile drugs at room temperature (22-25 degrees C) in order to quickly act in case of breakage of the cold chain. METHOD: The study included all drugs available in the pharmacy service from August 17, 2004 to October 15 of the same year, date in which the review was performed, that had to be kept at a temperature ranging between 2 degrees and 8 degrees C. Different drug laboratories were contacted and asked for written information on the matter. RESULTS: The results are reported in a table. One hundred seventy three medicinal products including 83 drugs were reviewed. CONCLUSIONS: Some information provided by the pharmaceutical industry allows the use of drugs even when the cold chain has been broken. This information must be used only in isolated cases, not as a routine.

Estabilidad máxima de los medicamentos termolábiles fuera de nevera / Maximum stability of thermolabile drugs outside the refrigerator

Objetivo: Revisar la estabilidad máxima de los medicamentostermolábiles a temperatura ambiente (22-25 °C) con el fin depoder actuar rápidamente en caso de ruptura de la cadena de frío.Método: Se incluyeron en el estudio todos aquellos principiosactivos disponibles en el servicio de farmacia desde el 17 de agostodel 2004 hasta el 15 de octubre del mismo año, fecha en laque se llevó a cabo la revisión, y que requerían para su conservaciónuna temperatura entre 2 y 8 °C. Se contactó con los diferenteslaboratorios farmacéuticos solicitándoles información porescrito al respecto.Resultados: Se muestran en forma de tabla. Se revisaron173 especialidades farmacéuticas correspondientes a 83 principiosactivos.Conclusiones: Existe información proveniente de la industriafarmacéutica que permite la utilización de medicamentos para losque se ha roto la cadena de frío. Esta información ha de ser únicamenteempleada en casos puntuales, y no de manera rutinaria

Objective: To review the maximum stability of thermolabiledrugs at room temperature (22-25 °C) in order to quickly act incase of breakage of the cold chain.Method: The study included all drugs available in the pharmacyservice from August 17, 2004 to October 15 of the sameyear, date in which the review was performed, that had to be keptat a temperature ranging between 2° and 8 °C. Different druglaboratories were contacted and asked for written information onthe matter.Results: The results are reported in a table. One hundredseventy three medicinal products including 83 drugs were reviewed.Conclusions: Some information provided by the pharmaceuticalindustry allows the use of drugs even when the cold chain hasbeen broken. This information must be used only in isolatedcases, not as a routine