[Detection of people at risk of having diabetes in the community pharmacy with the Findrisc test 2014-2021]. / Detección de personas en riesgo de padecer diabetes en la farmacia comunitaria con el test de Findrisc en los años 2014-2021.

Aim: To analyze diabetes risk screening using the Findrisc questionnaire, performed in Spanish community pharmacies (CP) since 2014. Methods: Descriptive cumulative study of the results of campaigns from Global Diabetes Day, in 2014, 2016-2018, 2020 and 2021. Subjects: Users ≥18 years not diagnosed with diabetes with signed consent. Variables: Findrisc test score, mean (m) and standard deviation (SD) and subjects at risk intervals, n (%). Demographic (sex, age) and anthropometric variables, body mass index (BMI) (kg/m2), waist circumference (cm), capillary glycaemia (SD) (mg/dL). Results: A total of 1146 pharmacists took part; 12,402 users. A total of 8799 (70.9%) had BMI ≥25 kg/m2; 7366 (59.4%) were taking anti-hypertensives, 6047 (48.8%) with excessive abdominal circumference. In total, 5962 (48.0%) had a family history of diabetes.Average risk (Findrisc score) was 11.3 (4.6), without any sex differences (P>0.05). The number of subjects with high/very high risk (F≥15) was 3107 (25.0%) without any sex differences (P>0.05). The high/very high risk increased with age, from 282 (15.1%) people aged 45 to 54 up to 1695 (40.1%) people aged >64. A total of 1762 (14.2%) were referred to the doctor. There are no data on the result.Average interview time: 10.3 (5.3) minutes, no differences between sexes (P>0.05). Conclusions: One quarter of those surveyed had a high/very high risk and one in seven were referred to the doctor.The most prevalent risk factors were BMI, hypertension, abdominal circumference and family history of diabetes.Interprofessional communication should be improved as no result was obtained from referrals to the doctor.

Robotic sacrocolpopexy for the treatment of pelvic organ prolapse in elderly women: comparative analysis of safety and efficacy versus younger women.

INTRODUCTION: Pelvic organ prolapse is a condition with high prevalence in elderly women. With increasing life expectancy and a desire for improved quality of life, a rise in the frequency of surgical treatments for these women is anticipated. The aim is to compare complication, success, and satisfaction rates among elderly patients (aged >70 years) in comparison to younger women undergoing robotic sacrocolpopexy, thereby assessing the safety and efficacy of this surgery in this group of patients. METHOD: A prospective observational comparative study of 123 robotic sacrocolpopexies conducted between December 2016 and June 2022. Patients were stratified by age (cutoff point: 70 years). Baseline characteristics, type, and grade of prolapse, intra and postoperative data, complications, functional and anatomical outcomes, and satisfaction levels were collected. RESULTS: Among the 123 patients, 62.6% were under 70 years old, while 37.4% were 70 years or older, exhibiting similar baseline characteristics, prolapse grade, and type. The percentages of intraoperative (6.5%) and postoperative complications (4.4-9%) were comparable in both age groups. Furthermore, success and satisfaction rates exceeded 90%, with no significant differences between women under and over 70 years during a two-year follow-up. CONCLUSION: Robotic sacrocolpopexy is at least as effective and safe in women aged 70 years or older as in younger individuals, with no higher rates of intra and postoperative complications and similar rates of anatomical and subjective success.

Pseudomonas aeruginosa bloodstream infections in children and adolescents: risk factors associated with carbapenem resistance and mortality.

BACKGROUND: Pseudomonas aeruginosa bloodstream infections (PA-BSIs) are a serious disease and a therapeutic challenge due to increasing resistance to carbapenems. Our objectives were to describe the prevalence and risk factors associated with carbapenem resistance (CR) and mortality in children with PA-BSI. METHODS: A retrospective, multi-centre study was carried out, including patients aged <20 years with PA-BSI in four tertiary hospitals in Madrid (Spain) during 2010-2020. Risk factors for CR PA-BSIs and 30-day mortality were evaluated in a multi-variable logistic regression model. RESULTS: In total, 151 patients with PA-BSI were included, with a median age of 29 months (interquartile range: 3.5-87.1). Forty-five (29.8%) cases were CR, 9.9% multi-drug resistant and 6.6% extensively drug resistant. The prevalence of CR remained stable throughout the study period, with 26.7% (12/45) of CR mediated by VIM-type carbapenemase. Patients with BSIs produced by CR-PA were more likely to receive inappropriate empiric treatment (53.3% vs 5.7%, P<0.001) and to have been previously colonized by CR-PA (8.9% vs 0%, P=0.002) than BSIs caused by carbapenem-susceptible P. aeruginosa. CR was associated with carbapenem treatment in the previous month (adjusted odds ratio (aOR) 11.15) and solid organ transplantation (aOR 7.64). The 30-day mortality was 23.2%, which was associated with mechanical ventilation (aOR 4.24), sepsis (aOR 5.72), inappropriate empiric antibiotic therapy (aOR 5.86), and source control as a protective factor (aOR 0.16). CONCLUSION: This study shows a concerning prevalence of CR in children with PA-BSIs, leading to high mortality. Inappropriate empiric treatment and sepsis were associated with mortality. The high prevalence of CR with an increased risk of inappropriate empiric treatment should be closely monitored.

Actinotignum schaalii infection: Challenges in diagnosis and treatment.

Actinotignum schaalii affects elderly people and is associated with individuals with urological-related predispositions, but can be found in a variety of locations, such as cutaneous, intraabdominal, genitourinary and surgical infections. Disseminated infections occur less frequently and are by and large related to urinary tract colonisation. This pathogen is often neglected due to growth requirements, especially in urinary tract infections. We present 107 Actinotignum schaalii isolated from genitourinary samples (80.4%), from skin and soft tissue infections (13.1%), from bone and deep tissue infection (4.7%) and from blood cultures (1.9%). The automated system Alfred 60/AST was paramount for the isolation of 77.6% of the UTI. All the isolates tested were susceptible to penicillin, ampicillin, linezolid, vancomycin, teicoplanin, rifampicin and tetracycline. In conclusion, we present a large series of Actinotignum schaalii infections. This pathogen is hard to isolate, and is resistant to commonly used empirical antimicrobials.

Detección de personas en riesgo de padecer diabetes en la farmacia comunitaria con el test de Findrisc en los años 2014-2021 / Detection of people at risk of diabetes in the community pharmacy with the Findrisc test in the years 2014-2021

Objetivo: analizar los resultados de las campañas de SEFAC de cribado del riesgo de padecer diabetes, realizados en las farmacias comunitarias españolas desde 2014. Métodos: estudio descriptivo acumulativo de los resultados de las campañas del Día Mundial de la Diabetes, en 2014, 2016-2018, 2020 y 2021. Pacientes: usuarios ≥18 años no diagnosticados de diabetes con consentimiento firmado. Variables: puntuación del test de Findrisc, media (m) y desviación estándar (DE) y participantes en intervalos de riesgo, n (%). Variables demográficas (sexo, edad) y antropométricas, índice de masa corporal (IMC) (kg/m2), perímetro de cintura (cm), glucemia capilar m (DE) (mg/dl). Resultados: participaron 1.146 farmacéuticos, 12402 usuarios. 8.799 (70,9 %) tenían IMC ≥25 kg/m2. 7366 (59,4 %) tomaban antihipertensivos. 6047 (48,8 %) con perímetro abdominal excesivo. 5962 (48,0 %) tenían antecedentes familiares de diabetes. El riesgo medio (puntuación Findrisc) fue de 11,3 (4,6), sin diferencias entre sexos (p>0,05). El número de participantes con riesgo alto/muy alto (F≥15) fue 3107 (25,0 %) sin diferencias entre sexos (p>0,05). El riesgo alto/muy alto aumenta con la edad, de 282 (15,1 %) personas de 45-54 años hasta 1695 (40,1 %) personas >64 años. Se derivaron al médico 1762 (14,2 %), sin datos de resultado. Tiempo medio de entrevista: 10,3 (5,3) minutos, sin diferencias entre sexos (p>0,05). Conclusiones: la cuarta parte de los encuestados tenían riesgo alto/muy alto y fueron derivados al médico uno de cada siete. Los factores de riesgo más prevalentes fueron IMC, hipertensión arterial, perímetro abdominal y antecedentes familiares de diabetes. Debe mejorarse la comunicación interprofesional, pues no se obtuvo resultado de las derivaciones al médico. (AU)

Aim: To analyze diabetes risk screening using the Findrisc questionnaire, performed in Spanish community pharmacies (CP) since 2014. Methods: Cumulative descriptive study of the results of the World Diabetes Day campaigns, in 2014, 2016-2018, 2020 and 2021. Subjects: users ≥18 years not diagnosed with diabetes with signed consent. Variables: Findrisc test score m (SD) and participants in risk intervals, n (%). Demographic (sex, age) and anthropometric variables, body mass index (BMI) (kg/m2), waist circumference (cm), capillary glycemia m (SD) (mg/dl). Results: 1146 pharmacists, 12402 users. 8799 (70.9 %) had BMI ≥25 Kg/m2. 7366 (59.4 %) were taking antihypertensive drugs. 6047 (48.8 %) with unhealthy abdominal perimeter. 5962 (48.0 %) had a family history of diabetes. The mean risk (F score) was 11.3 (4.6), with no differences between sexes (p<0.05). The number of participants with high/very high risk (F≥15) was 3107 (25.0%) with no differences between sexes (p<0.05). High/very high risk increased with age, from 282 (15.1%) persons aged 45-54 years to 1695 (40.1%) persons >64 years. A total of 1762 (14.2% of the total) were referred to a physician.Mean interview time: 10.3 (5.3) minutes, with no differences between sexes (p<0.05). Conclusions: One quarter of the respondents were at high/very high risk and one in seven were referred to a physician. The most prevalent risk factors were BMI, hypertension, abdominal circumference and family history of diabetes. Interprofessional communication should be improved, as no results were obtained from referrals to the physician. (AU)

Assessment of chitosan-based adsorbents for glyphosate removal.

Exposure to glyphosate produces various toxic effects, due to this, different methods have been evaluated for its elimination. The objective of this work was to formulate chitosan-based adsorbents and evaluate their efficiency in the removal of glyphosate in vitro. Four films were made by varying the weight ratio of silica/chitosan particles, and four sponges were made by varying the chitosan/chitosan ratio in a reticulated manner. Both adsorbents were characterized based on their porosity, water absorption, glyphosate removal, and reusability. It was found that increasing the porosity in both films and sponges resulted in an increase in the adsorption efficiency of glyphosate. The adsorption process exhibited a better fit in both adsorbents to the pseudo-second-order model. The adsorption of glyphosate to the films fit better with the Langmuir model, demonstrating that the process occurs in the form of a monolayer. In the case of sponges, the adsorption of glyphosate fit better with the Freundlich model, indicating that the process takes place in a multilayer form. Finally, when the reusability was evaluated, the adsorbents showed a loss of effectiveness. However, they still proved to be an efficient alternative for the removal of glyphosate in water, providing a cost-effective and environmentally friendly solution.

Farmacovigilancia de las vacunas frente a la COVID-19 en farmacias comunitarias. Resultados tras la segunda dosis y comparación entre ambas / Pharmacovigilance of vaccines against COVID-19 in community pharmacies. Results after the second dose and comparison between both

Objetivos: detección y seguimiento de sospechas de reacciones adversas (RA) en farmacias comunitarias tras la segunda dosis de vacunas frente a la COVID-19. Comparación entre dosis.Material y métodos: diseño: estudio observacional prospectivo.Sujetos: vacunados frente a la COVID-19, mayores de edad, que consintieron participar.Variables: número y porcentaje de participantes con RA. Su número, tipo y frecuencia. Repercusión en su vida diaria. Relaciones entre variables.Aprobado por CEIm-G.Resultados: 693 participantes con la 2ª dosis, 63,6 % mujeres. Edad media 56,8 años. 312 (45,0 %) vacunados, 49,4 % de mujeres y 37,3 % de hombres (p<0,0001), refirieron al menos una RA: 43,9 % con Comirnaty®, 37,7 % con Vaxzevria®, 63,0 % con Spikevax®.Se registraron 972 RA, 75,2 % en mujeres y 24,8 % en hombres (p<0,0001). Media 1,4/vacunado (máximo 11). Las más prevalentes: dolor en punto de inyección 197 (28,4 %), cansancio/fatiga 141 (20,3 %), mialgia 112 (16,2 %), cefalea 95 (13,7 %), fiebre 84 (12,1 %).51 encuestados con RA necesitaron ayuda profesional: 10 del médico, 6 en urgencias, 3 en hospital (1 derivado), 33 en la farmacia. A 70 (15,1 %) les impidió su actividad diaria. Se comunicaron RA de 201 vacunados.Los vacunados con RA y su número fueron menos tras la administración de la 2ª dosis (p<0,05).Relación inversa (p<0,05) entre “edad” y “número de vacunados con RA”, “necesidad de atención profesional” e “impidió la actividad diaria”.Conclusiones: el número de vacunados con RA y su número fue alto también con la segunda dosis, aunque menor que tras la primera. Mujer y menor edad son predictores de riesgo de sufrir RA tras la vacunación frente a COVID-19.(AU)

Anatomía y diseño de colgajos musculocutáneos en reconstrucción nasal / Anatomy and Design of Musculocutaneous Flaps in Nasal Reconstruction

La nariz es una localización habitual de asiento de tumores cutáneos. Las arterias principales que vascularizan la nariz discurren en el espesor del tejido celular subcutáneo. La disección en el plano submuscular permite diseñar colgajos musculocutáneos fiables y seguros, adaptados a la morfología del defecto. Su gran versatilidad los convierte en colgajos de primera elección para la cobertura de defectos ubicados en localizaciones más complejas, como el canto interno del ojo o el ala nasal. Presentamos la técnica quirúrgica de los colgajos musculocutáneos procerus, nasalis de morfología V-Y y colgajo nasalis de pared lateral empleados tras exéresis tumorales. La descripción se acompaña de imágenes realizadas por los autores en pacientes y en disecciones cadavéricas para la mejor comprensión de dichos colgajos (AU)

The nose is a common site for skin tumors. The main arteries that supply the nose extend through the subcutaneous tissue. Submuscular dissection facilitates the design of safe, reliable musculocutaneous flaps that adapt well to the morphology of nasal defects. The diversity of these flaps makes them the first choice for reconstructing defects in more complex regions, such as the inner canthus of the eye and the nasal ala. We describe the surgical design of the procerus, V-Y nasalis, and lateral wall nasalis musculocutaneous flaps used to repair defects following tumor excision. The descriptions are illustrated by photographs taken by the authors during procedures and in cadaveric dissections (AU)

[Translated article] Anatomy and Design of Musculocutaneous Flaps in Nasal Reconstruction / Anatomía y diseño de colgajos musculocutáneos en reconstrucción nasal

The nose is a common site for skin tumors. The main arteries that supply the nose extend through the subcutaneous tissue. Submuscular dissection facilitates the design of safe, reliable musculocutaneous flaps that adapt well to the morphology of nasal defects. The diversity of these flaps makes them the first choice for reconstructing defects in more complex regions, such as the inner canthus of the eye and the nasal ala. We describe the surgical design of the procerus, V-Y nasalis, and lateral wall nasalis musculocutaneous flaps used to repair defects following tumor excision. The descriptions are illustrated by photographs taken by the authors during procedures and in cadaveric dissections (AU)

La nariz es una localización habitual de asiento de tumores cutáneos. Las arterias principales que vascularizan la nariz discurren en el espesor del tejido celular subcutáneo. La disección en el plano submuscular permite diseñar colgajos musculocutáneos fiables y seguros, adaptados a la morfología del defecto. Su gran versatilidad los convierte en colgajos de primera elección para la cobertura de defectos ubicados en localizaciones más complejas, como el canto interno del ojo o el ala nasal. Presentamos la técnica quirúrgica de los colgajos musculocutáneos procerus, nasalis de morfología V-Y y colgajo nasalis de pared lateral empleados tras exéresis tumorales. La descripción se acompaña de imágenes realizadas por los autores en pacientes y en disecciones cadavéricas para la mejor comprensión de dichos colgajos (AU)

Farmacovigilancia de las vacunas frente a COVID-19 en farmacias comunitarias. Resultados tras la primera dosis / Pharmacovigilance of vaccines against COVID-19 in community pharmacies. Results with the first dose

Objetivos: detección, notificación y seguimiento de sospechas de reacciones adversas (RA) tras la administración de la primera dosis de la vacuna frente a la COVID-19 en usuarios de las farmacias comunitarias y su repercusión sobre la salud y vida diaria. Métodos: diseño: observacional prospectivo. Sujetos: personas vacunadas frente a la COVID-19, mayores de edad, que firmaron el consentimiento informado. Variables: número y porcentaje de participantes que presentaban al menos una RA. Número, tipo y frecuencia de posible reactividad. Repercusión en su vida diaria. El estudio fue aprobado por el CEIm-G (Exp. 2021-007).Resultados: colaboraron 10 farmacias de Pontevedra y 2 de Ourense. 781 casos, 488 (62,5 %) mujeres. Edad 56,8 (DE=17,9) años. 389 (49,8 %) en grupo de riesgo.495 (63,4 %) vacunados, 321 mujeres (65,8 %) y 174 (59,4 %) hombres refirieron al menos una RA: 236 (53,0 %) frente a Comirnaty®, 157 (82,6 %) a Vaxzevria®, 69 (66,3 %) a Spikevax® y 33 (80,5) a Janssen®.Se registraron 1.367 RA, 1,8 por persona vacunada. Las más prevalentes (el % es sobre el total de pacientes): dolor en punto de inyección 375 (48,0 %), cansancio/fatiga 170 (21,8 %), escalofríos 118 (15,1 %), cefalea 117 (15,0 %), dolor muscular 112 (14,3 %) y fiebre 98 (12,5 %). De los 495 encuestados con RA, necesitaron ayuda profesional 77 (15,6 %): del médico de familia 30 (39,0 %), 9 (11,7 %) en servicio de urgencias, 1 (1,3 %) en hospital y 37 (48,1 %) en la farmacia. A 118 (15,1 %) les impidió desarrollar su actividad diaria.Se comunicaron las RA que refirieron 264 vacunados (53,3 %).Conclusiones: el número de vacunados que manifestaron haber sufrido RA fue alto. Dolor en el punto de inyección fue la RA más prevalente. La mitad fueron atendidos en la farmacia. Aunque fueron en general leves, afectaron notablemente a su vida diaria. (AU)

[Pharmacovigilance of vaccines against COVID-19 in community pharmacies. Results with the first dose]. / Farmacovigilancia de las vacunas frente a COVID-19 en farmacias comunitarias. Resultados tras la primera dosis.

Aim: Detection, reporting and monitoring of suspected Adverse Drug Reactions (ADR) in users of community pharmacies and their impact on health and daily life. Methods: Design: prospective observational. Subjects: people vaccinated against COVID-19, of legal age, who signed informed consent. Variables: number and percentage of participants who had at least one ADR. Number, type and frequency of possible reactivity. Impact on your daily life. The study was approved by CEIm-G (Exp. 2021-007). Results: 10 pharmacies from Pontevedra and 2 from Ourense collaborated. 781 cases, 488 (62.5%) women. Age 56.8 (SD=17.9) years. 389 (49.8%) in risk group.495 (63.4%) vaccinated, 321 women (65.8%) and 174 (59.4%) men, reported at least one ADR: 236 (53.0%) Comirnaty®, 157 (82.6%) Vaxzevria®, 69 (66.3%) Spikevax® and 33 (80.5) Janssen®.1,367 ADR were recorded. The most prevalent: pain at the injection point 375 (48.0%), tiredness/fatigue 170 (21.8%), chills 118 (15.1%), headache 117 (15.0%), muscle pain 112 (14.3%) and fever 98 (12.5%).Of the 495 respondents with ADR, 77 (15.6%) needed professional help: from the family doctor 30 (39.0%), 9 (11.7%) in the emergency department, 1 (1.3%) in the hospital and 37 (48.1%) in the pharmacy. 118 (15.1%) were unable to carry out their daily activity.ADR were reported from 264 (53.3%) vaccinated. Conclusions: The number of vaccinated people who reported having suffered RA was high. Pain at the injection site the most prevalent. Half were treated at the pharmacy. Although they were generally mild, they markedly affected his daily life.

[May Measurement Month 2019: Screening Analysis In Spanish Community Pharmacies and Detection of Masked Hypertension]. / Campaña de medida de la presión arterial ('May Measurement Month') 2019: análisis del cribado en farmacias comunitarias españolas y detección de hipertensión enmascarada.

Aim: To know within the scope of the May Measurement Month (MMM) project, the blood pressure (BP) situation in the Spanish population, disseminate the importance of its periodic measurement and estimate the prevalence of masked hypertension (MH). Methods: Transversal descriptive study in Spanish community pharmacies during May 2019. Variables: Systolic blood pressure (SBP), diastolic blood pressure (DBP) in millimetres of mercury (mmHg), heart rate (HR) in beats per minute (bpm).Subjects with BP ≥130/85 and <149/90 were offered the possibility of home blood pressure monitor- ing (HBPM) to confirm MH. Results: A total of 3402 valid records performed by 491 pharmacists. In all 61.9% women, mean age 56.6 years. A total of 143 (4.2%) had never measured BP and 918 (27.0%) had not measured BP in the last year; 1047 were taking anti-hypertensives, of whom 45.7% had high BP.A total of 780 (22.9%) subjects had high BP values; both, 252 (7.4%). mSBP and mDBP was 125.0 mmHg and 76.5 mmHg, respectively; higher in men (P<0.001). mHR was 72.6 bpm..A direct relationship was detected between SBP and DBP and BMI (P<0.0001). mSBP and mHR were higher in smokers (P<0.0001). In diabetic patients, SBP, DBP and HR were greater.A total of 61 subjects with suspected MH agreed to undergo HBPM. A total of 25 (40.1%) resulted in BP ≥135/85 mmHg. Conclusions: Almost a quarter of subjects had BP ≥140/90 mmHg. The risk factors most closely related to high BP were overweight, diabetes and age; 40% of suspected cases of MH were confirmed by means of HBPM.

[Pharmacovigilance of vaccines against COVID-19 in community pharmacies. Results after the second dose and comparison between both]. / Farmacovigilancia de las vacunas frente a la COVID-19 en farmacias comunitarias. Resultados tras la segunda dosis y comparación entre ambas.

Aim: Detection and tracing of suspicious adverse reactions (ARs) in community pharmacies after the second of COVID-19 vaccine dose. Comparison between doses. Methods: Design: prospective observational study. Subjects: Vaccinated against COVID-19, of legal age, who consent to participate. Variables: Number and percentage of participants with ARs. Number, type and frequency of ARs. Impact on their daily life. Relations between variables.Approved by the Galician Ethical Committee of Research with medicines. Results: 693 participants with the 2nd dose, 63.6% women. Age 56.8 years. 312 (45.0%) vaccinated, 49.4% women and 37.3% men (p<0.0001), reported at least one AR: 43.9% with Comirnaty®, 37.7% with Vaxzevria®, 63.0% with Spikevax®.There were 972 ARs, 75.2% in women and 24.8% in men (p<0.0001). Mean 1.4/vaccinated (maximum 11). The most prevalent AR: pain at injection site 197 (28.4%), tiredness/fatigue 141 (20.3%), myalgia 112 (16.2%), headache 95 (13.7%), fever 84 (12.1%).51 participants with ARs needed professional help: 10 from the doctor, 6 in the emergency room, 3 in hospitals (1 referral), 33 in the pharmacy. 70 (15.1%) were prevented from their daily activity. 201 Ars from vaccinated persons were reported.Number of people vaccinated with ARs and the number of ARs were less with the 2nd dose (p<0.05).Inverse relationship (p<0.05) between "age" and "number of vaccinated with ARs", "need for professional care" and "prevented daily activity". Conclusions: The number of vaccinated participants with ARs and their number was also high with the second dose, although lower than with the first. Women and younger people are predictive of increased risk of AR after vaccination against COVID-19.

Campaña de medida de la presión arterial (‘May Measurement Month’) 2019: análisis del cribado en farmacias comunitarias españolas y detección de hipertensión enmascarada / May Measurement Month 2019: Analysis of screening in Spanish community pharmacies and detection of masked hypertension

Objetivo: conocer dentro del proyecto May Measurement Month (MMM), la situación de la presión arterial (PA) en la población española, difundir la importancia de su medida periódica y estimar la prevalencia de hipertensión enmascarada (HEN). Métodos: estudio descriptivo transversal en farmacias comunitarias españolas durante mayo de 2019. Sujetos: usuarios adultos que consentían participar. Variables: presión arterial sistólica (PAS), presión arterial diastólica (PAD) en milímetros de mercurio (mmHg), frecuencia cardíaca (FC) en latidos/minuto (lat/min) A los participantes con PA ≥130/85 y <149/90 se les ofrecía realizar automedida (AMPA) para confirmar HEN. Resultados: 491 farmacéuticos recogieron 3.402 registros válidos (61,9% mujeres), edad media 56,6 años. 143 (4,2 %) nunca se habían medido la PA y 918 (27,0 %) no la habían medido en el último año. 1.047 tomaban antihipertensivos, de los que el 45,7 % tenían la PA alta. 780 (22,9 %) participantes tenían valores elevados de PA; ambos, 252 (7,4 %). La PASm fue 125,0 y la PADm 76,5 mmHg, mayor en hombres (p<0,001). La FCm fue de 72,6 lat/min. Se encontró relación directa entre PAS y PAD e IMC (p<0,0001). PADm y FCm fueron mayores en fumadores (p<0,0001). En pacientes diabéticos, PAS, PAD y FC fueron mayores. 61 participantes con sospecha de HEN aceptaron realizar AMPA. 25 (40,1 %) resultaron con PA ≥135/85 mmHg. Conclusiones: casi uno de cada cuatro participantes tenía valores de PA ≥140/90 mmHg. Los factores de riesgo relacionados más estrechamente con la PA elevada fueron sobrepeso, diabetes y edad. El 40 % de las sospechas de HEN se confirmaron mediante AMPA (AU)

Elevación de seno conBetafosfato Tricálcico yposterior colocación deimplantes. A propósito deun caso / Sinus lift with tricalcium beta-phosphate and subsequent implant placement. Case report

La extracción o pérdida dental supone la remodelación del alveolo y una pérdida progresiva del hueso alveolar residual. Esta disminución en altura, debido a la presencia delseno maxilar en el sector posterosuperior, puede comprometer la disponibilidad ósea adecuada para la colocación de implantes. Como solución a esto, surge la técnica de elevación de seno. En esta técnica, se emplean diversos materiales de injerto, entre los que se encuentran el betafosfatotricálcico (b-TCP). Este material presenta propiedades osteoconductivas y osteoinductivas. Además, se reabsorbe más fácil que otros sustitutos óseos y es fácilmente reemplazado por nuevo hueso. Se ha comparado su comportamiento clínico con otros materiales de injerto, sin encontrar diferencias significativas. Además, a 10 años, los implantes colocados en elevaciones de seno realizadas con b-TCP han mostrado altas tasas de supervivencia. Caso clínico. Se presenta el caso clínico de una paciente, mujer de 52 años de edad, sin antecedentes médicos de interés. Acude a consulta por dolor en el 26. Tras la exploración diagnóstica radiológica e intrabucal se aconsejó a la paciente la extracción del 26. Ocho meses después, y realizando un estudio con CBCT se informó a la paciente sobre la posibilidad de rehabilitación con implantes, previa cirugía de elevación sinusal. Se realizó la elevación sinusal con b-TCP como material de injerto. Pasados tres meses, se procedió a la colocación de tres implantes, adquiriendo estos una buena estabilidad primaria Discusión y conclusiones. Se utilizan diversos materiales de injerto en la técnica de elevación sinusal, injertos de hueso autólogo, xenoinjertos e injerto aloplásticos. Se ha comparado el comportamiento clínico del b-TCP con otros materiales de injerto sin mostrar diferencias significativas. Por otro lado, se ha estudiado un periodo de espera menor a 6 (AU)

Tooth extraction or loss involves alveolar remodelling and progressive loss of residual alveolar bone. This reduction in height, due to the presence of the maxillary sinus in the posterosuperior sector, can compromise adequate bone availability for implant placement. The sinus lift technique has emerged as a solution to this problem. In this technique, various grafting materials are used, including beta-phosphatidic acid (b-TCP). This material has osteoconductive and osteoinductive properties. In addition, it is more easily resorbed than other bone substitutes and is easily replaced by new bone. Its clinical behaviour has been compared with other graft materials, without finding significant differences. In addition, at 10 years, implants placed in sinus lifts performed with b-TCP have shown high survival rates. Clinical case: The clinical case of a 52-year-old female patient with no medical history of interest is presented. She went for consultation due to pain in tooth 26. Following the radiological and intraoral diagnostic examination, the patient was advised to have tooth 26 extracted. Eight months later, and after a CBCT study, the patient was informed about the possibility of rehabilitation with implants, following sinus lift surgery. The sinus lift was performed with b-TCP as graft material. After three months, three implants were placed, acquiring a good primary stability. Discussion and conclusions: different graft materials are used in the sinus lift technique, autologous bone grafts, xenografts and alloplastic grafts. The clinical performance of b-TCP has been compared with no significant differences found. Furthermore, a waiting period of less than 6 months has been studied for the placement of implants. These implants showed high primary stability and survival rates of 99-100%. Therefore, b-TCP is a safe material for sinus lifts and allows the placement of implants in a healing time of less than 6 months (AU)

Efectos adversos de las vacunas frente al SARS-CoV-2 en farmacéuticos comunitarios de Pontevedra / Adverse effects of SARS-CoV-2 vaccines in community pharmacists of Pontevedra

Objetivo: analizar los registros de sospechas de efectos adversos (EA) de las vacunas frente al SARSCoV-2 administradas a farmacéuticos comunitarios (FC) y personal auxiliar.Métodos. Diseño: estudio observacional transversal, en febrero-abril de 2021. Sujetos: farmacéuticos, técnicos y auxiliares de la provincia de Pontevedra que ejercen en contacto con los pacientes, vacunados con la primera dosis frente al SARS-CoV-2.Variables: número, tipo y frecuencia de EA, características demográficas.Procedimiento: se habilitó un formulario en la web del Colegio de Farmacéuticos de Pontevedra. Se anunció a los FC colegiados de la provincia su existencia y la conveniencia de cumplimentarlo.Resultados: 167 participantes, de los que 153 manifestaron síntomas compatibles con reactividad a la vacuna, 122 (93,1 %) mujeres y 31 (86,1 %) hombres. 146 (95,4 %) habían recibido Vaxzevria®, 116(79,4 %) mujeres y 30 (20,6 %) hombres, y 7 (4,6 %) Comirnaty®, 6 (85,7 %) mujeres y 1 (14,3 %) hombre. Se comunicaron 823 EA, 811 (5,3 DE=2,8 EA, 0-12 por paciente) con Vaxzevria® y 12 (0,9 DE=1,0 EA, 0-3 por paciente) con Comirnaty®. EA más frecuentes: dolor en punto de inyección, 128 (87,7 %); escalofríos, 107 (73,3 %); dolor muscular, 106 (72,6 %). En los tres casos, mayor proporción de mujeres (p<0,01). El número máximo de EA manifestados por un participante fue 12. 132 (86,3 %) vacunados que refirieron EA, 106 (86,9 %) mujeres y 26 (83,9 %) hombres, necesitaron medicamentos para aliviar los síntomas. 77 (46,1 %) no pudieron desarrollar sus actividades diarias y 47 (28,1 %) no pudieron trabajar el día siguiente. Conclusiones: el número de EA comunicados por farmacéuticos y personal auxiliar vacunados fue alto. Aunque no fueron graves, afectaron de manera considerable a su actividad diaria y laboral. (AU)

Calidad de vida y síntomas persistentes tras hospitalización por COVID-19. Estudio observacional prospectivo comparando pacientes con o sin ingreso en UCI / Quality of life and persistent symptoms after hospitalization for COVID-19. A prospective observational study comparing ICU with non-ICU patients

Antecedentes/contexto: Existe una tendencia en los pacientes hospitalizados por COVID-19 a desarrollar síntomas persistentes y a presentar una disminución en su calidad de vida tras el ingreso hospitalario. Métodos: Estudio de cohorte prospectivo de pacientes con COVID-19 con ingreso hospitalario entre el 1 de marzo al 30 de abril de 2020. El objetivo primario fue comparar la calidad de vida relacionada con la salud y la presencia de síntomas persistentes seis meses después del ingreso, comparando los pacientes que requirieron ingreso en UCI con los que no lo precisaron. Resultados: De los 242 pacientes hospitalizados durante el período de estudio, 44 (18,2%) necesitaron ingreso en UCI. Cuarenta (16,5%) pacientes fallecieron durante el ingreso hospitalario. Doscientos dos (83,5%) pacientes fueron dados de alta del hospital. A los seis meses, 183 (75,6%) pacientes completaron los cuestionarios (32 pacientes UCI y 151 pacientes no UCI). Noventa y seis (52,4%) refirieron disminución de la calidad de vida y 143 (78,1%) describieron síntomas persistentes. Un número mayor de pacientes de UCI mostraron un empeoramiento de su calidad de vida (71,9 vs. 43,7%, p = 0,004). No hubo diferencias en la proporción de pacientes con síntomas persistentes entre los pacientes con UCI y sin UCI (87,5 vs. 76,2%, p = 0,159). Los pacientes de UCI mostraron con mayor frecuencia disnea de esfuerzo (78,1 vs. 47,7%, p = 0,02), disnea de pequeños esfuerzos (37,5 vs. 4,6%, p < 0,001) y astenia (56,3 vs. 29,1%, p = 0,003). Conclusiones: Los supervivientes de COVID-19 que necesitaron hospitalización presentaron síntomas persistentes y un deterioro de su calidad de vida. Los pacientes de UCI refirieron una mayor disminución de su calidad de vida, en comparación con los pacientes que no precisaron UCI.(AU)

Background: Hospitalized COVID-19 patients are prone to develop persistent symptoms and to show reduced quality of life following hospital admission. Methods: Prospective cohort study of COVID-19 patients admitted to a hospital from March 1 to April 30, 2020. The primary outcome was to compare health related quality of life and persistent symptoms six months after hospital admission, of COVID-19 patients who required ICU admission with those who did not. Results: Among the 242 patients hospitalized during the defined period of time, 44 (18.2%) needed ICU admission. Forty (16.5%) patients died during hospital admission. Two hundred and two (83.5%) patients were discharged alive from the hospital. At six months, 183 (75.6%) patients completed the questionnaires (32 ICU patients and 151 non ICU patients). Ninety-six (52.4%) reported decreased quality of life and 143 (78.1%) described persistent symptoms. More ICU patients showed worsening of their quality of life (71.9 vs. 43.7%, P = 0.004). There were no differences in the proportion of patients with persistent symptoms between ICU and non ICU patients (87.5 vs. 76.2%, P = 0.159). ICU patients showed more frequently dyspnea on exertion (78.1 vs. 47.7%, P = 0.02), dyspnea on light exertion (37.5 vs. 4.6%, P < 0.001), and asthenia (56.3 vs. 29.1, P = 0.003). Conclusions: Survivors of COVID-19 needing hospitalization had persistent symptoms and a decline in the quality of life. ICU patients referred a large decrease of their quality of life compared with non ICU patients.(AU)

Quantitative assessments of late radiation-induced skin and soft tissue toxicity and correlation with RTOG scales and biological equivalent dose in breast cancer

PurposeRadiation-induced toxicity (RIT) is usually assessed by inspection and palpation. Due to their subjective and unquantitative nature, objective methods are required. This study aimed to determine whether a quantitative tool is able to assess RIT and establish an underlying BED-response relationship in breast cancer.MethodsPatients following seven different breast radiation protocols were recruited to this study for RIT assessment with qualitative and quantitative examination. The biologically equivalent dose (BED) was used to directly compare different radiation regimens. RIT was subjectively evaluated by physicians using the Radiation Therapy Oncology Group (RTOG) late toxicity scores. Simultaneously an objective multiprobe device was also used to quantitatively assess late RIT in terms of erythema, hyperpigmentation, elasticity and skin hydration.ResultsIn 194 patients, in terms of the objective measurements, treated breasts showed higher erythema and hyperpigmentation and lower elasticity and hydration than untreated breasts (p < 0.001, p < 0.001, p < 0.001, p = 0.019, respectively). As the BED increased, Δerythema and Δpigmentation gradually increased as well (p = 0.006 and p = 0.002, respectively). Regarding the clinical assessment, the increase in BED resulted in a higher RTOG toxicity grade (p < 0.001). Quantitative assessments were consistent with RTOG scores. As the RTOG toxicity grade increased, the erythema and pigmentation values increased, and the elasticity index decreased (p < 0.001, p = 0.016, p = 0.005, respectively).ConclusionsThe multiprobe device can be a sensitive and simple tool for research purpose and quantitatively assessing RIT in patients undergoing radiotherapy for breast cancer. Physician-assessed toxicity scores and objective measurements revealed that the BED was positively associated with the severity of RIT.

Intraoperative irradiation in breast cancer: preliminary results in 80 patients as partial breast irradiation or anticipated boost prior to hypo-fractionated whole breast irradiation

PurposeTo present the first results of intraoperative irradiation (IORT) in breast cancer with a low-energy photon system used as partial breast irradiation (PBI) or as an anticipated boost before whole breast hypo-fractionated irradiation (IORT + WBI), concerning tolerance, side effects, quality of life, and patient-reported outcomes.Materials and methodsEighty patients treated with an Intrabeam® system of 50 kV X-rays received a 20 Gy dose intraoperatively were included. Moderate daily hypofractionation of 2.7 Gy in 15 fractions up to 40.5 Gy was administered if high-risk factors were present. Acute post-operative toxicity, surgery complications, chronic toxicity, patient-reported cosmesis and Breast-Q questionnaire were performed at follow-up visits.ResultsThirty-one patients were treated as PBI and the remaining 49 as IORT + WBI. Only the IORT + WBI group presented acute toxicity, mainly mild acute dermatitis (11 patients) and one subacute mastitis. A total of 20 patients presented fibrosis (18 patients grade I, 2 patients grade II), 15 (30.5%) patients in the IORT + WBI group and 3 (9.6%) patients in the group of PBI. The cosmesis evaluation in 73 patients resulted poor, fair, good or excellent in 2, 7, 38 and 26 patients, respectively. In PBI group Breast-Q scored higher, especially in terms of their psychosocial well-being (78 vs 65) and satisfaction with radiation-induced toxicity (77 vs 72, respectively) compared to IORT + WBI group.ConclusionIORT is a well-tolerated procedure with low toxicity, good cosmesis and favorable patient-reported outcomes mainly when administered as PBI.