ABSTRACT
La infección fúngica peritoneal es poco frecuente pero supone una elevada mortalidad. A pesar de que la principal recomendación es la retirada de catéter cuando se sospecha que es éste el foco de infección, hay ocasiones en las se requiere considerar otras opciones. La administración de anidulafungina intraperitoneal es una técnica sobre la que hay pocos estudios. Presentamos un caso clínico en el que administramos anidulafungina intraperitoneal y analizamos mediante técnica cualitativa la presencia del antifúngico en distintas muestras. Además, calculamos el porcentaje de reducción de anidulafungina entre el líquido de diálisis en el que la diluimos y este mismo tras permanecer 8 horas en la cavidad peritoneal. (AU)
Peritoneal fungal infection is rare but involves high mortality. Although the main recommendation is catheter removal when it is suspected that this is the focus of infection, there are occasions when other options are required.There are few references about administration of intraperitoneal anidulafungin. We present a clinical case in which we administer intraperitoneal anidulafungin and analyze the presence of this antifungal in different samples using a qualitative technique. In addition, we calculate the percentage reduction of anidulafungin between the dialysis fluid in which we diluted it and this fluid after remain 8 hours in the peritoneal cavity. (AU)
Subject(s)
Humans , Female , Aged , Anidulafungin/analysis , 25783/adverse effects , Candida glabrataABSTRACT
El objetivo del presente trabajo es evaluar si existe relación entre los niveles plasmáticos de efavirenz y la aparición de dislipemia como hipercolesterolemia, hipretrigliceridemia o aumento de LDL-c.Se realizaron niveles plasmáticos de efavirenz a los pacientes en tratamiento con este fármaco desde septiembre de 2012 hasta junio de 2015. Se registraron los parámetros lipídicos correspondientes a cada analítica. Las determinaciones de efavirenz se realizaron mediante cromatografía líquida de alta eficacia. Los datos se manejaron mediante el programa Quick Statistics Calculator y Excel 2007.Los niveles plasmáticos de efavirenz superiores a 4.000 ng/ml se asocian en nuestro estudio con una mayor frecuencia de niveles de colesterol superiores a 200 mg/dl.Este estudio puede ser de utilidad para aquellas zonas en las que usen pautas de tratamiento con este fármaco de manera frecuente. (AU)
The aim of this study is to evaluate if there is a relationship between plasma levels of efavirenz and the occurrence of dyslipidemia such as hypercholesterolemia, hypretrigiceridemia or increased LDL-c.Plasma levels of efavirenz were performed to patients under treatment with this drug during the period from September 2012 to June 2015. Lipid parameters corresponding to each analytical were recorded. Determinations of efavirenz were analyzed by high performance liquid chromatography. Data were managed using the Quick Statistics Calculator and Excel 2007 program.Plasma levels of efavirenz higher than 4,000 ng/ml were associated, in our study, with a higher frequency of cholesterol levels higher than 200 mg/dl.This study may be useful to those areas where treatment guidelines with this drug are used on a frequent basis. (AU)
Subject(s)
Humans , Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination , Hyperlipidemias , Chromatography , 34628 , Pharmaceutical PreparationsABSTRACT
Objetivo: Valorar si un programa de atención farmacéutica integrada (PAFI) en pacientes crónicos mejora la evolución clínica, la calidad de vida de los pacientes y disminuye el consumo de recursos sanitarios. Material y métodos Ensayo clínico, paralelo, abierto y multicéntrico de un PAFI en pacientes con insuficiencia cardiaca (IC) y/o enfermedad pulmonar obstructiva crónica (EPOC) en 8 áreas de salud de Cataluña. Al paciente en intervención le realizaban seguimiento farmacoterapéutico los farmacéuticos de hospital, atención primaria y farmacia comunitaria. Al control, seguimiento habitual. Todos los pacientes fueron seguidos 12 meses y se les realizó un test de calidad de vida al inicio y final del seguimiento. Resultados Participaron 8 hospitales, 8 centros de atención primaria y 109 farmacias comunitarias. Finalizaron el estudio 238 pacientes con un porcentaje de pérdidas del 2,9%. No hubo diferencias significativas en reingresos, visitas al médico o urgencias. Se detectaron 50 problemas relacionados con medicamentos (PRM) en 37 pacientes, siendo estadísticamente significativa la diferencia de PRM entre el grupo intervención y control en pacientes con IC y casi significativa en pacientes con EPOC. El 36% de los PRM fueron moderados-graves. El 94% PRM fueron evitables y el farmacéutico los resolvió en el 90% de los casos. No hubo diferencias entre la calidad de vida al inicio y final del estudio ni en el consumo de recursos sanitarios. Conclusiones Los programas de atención farmacéutica integrada permiten la mejora de la calidad asistencial al paciente, no obstante es necesaria la utilización de registros electrónicos que faciliten la comunicación entre niveles asistenciales (AU)
Objectives: To assess whether an integrated pharmaceutical care programme (IPCP) improvesclinical evolution, patient quality of life, and reduces health costs in chronic patients. Material and methods: A parallel, open, and multi-centre clinical trial of an IPCP in patients with heart failure (HF) and/or chronic obstructive pulmonary disease (COPD) in 8 different health areas in Cataluña. The intervened patient was monitored for pharmacotherapeutic evolution by hospital pharmacists, primary care physicians, and community pharmacists. Controls received normal follow-up. All patients were monitored for 12 months, with quality of life tests administered at the beginning and end of follow-up. Results: We had the participation of 8 different hospitals, 8 primary care centres, and109 community pharmacies. 238 patients completed the study, with 2.9% of participants lost during the study period. There were no significant differences in terms of readmissions, visits to the doctors, or to emergency services. We detected 50 different medication-related problems(MRP) in 37 patients, with a statistically significant difference in terms of MRP between the control and treatment groups of patients with HF, and almost significant differences in COPD patients. MRP were moderate-severe in 36% of cases. MRP were avoidable in 94% of cases, and the pharmacist resolved the issue in 90% of cases. There were no differences in terms of patient quality of life or health costs between the start and end of the study. Conclusions: Integrated pharmaceutical care programs facilitate an improvement in the quality of patient care, but electronic registries are necessary to promote communication between sections of the health care network (AU)
Subject(s)
Humans , Chronic Disease/drug therapy , Polypharmacy , Pharmaceutical Services , Electronic Prescribing , Continuity of Patient Care/organization & administration , Drug Therapy, Computer-Assisted/methodsABSTRACT
OBJECTIVES: To assess whether an integrated pharmaceutical care programme (IPCP) improves clinical evolution, patient quality of life, and reduces health costs in chronic patients. MATERIAL AND METHODS: A parallel, open, and multi-centre clinical trial of an IPCP in patients with heart failure (HF) and/or chronic obstructive pulmonary disease (COPD) in 8 different health areas in Cataluña. The intervened patient was monitored for pharmacotherapeutic evolution by hospital pharmacists, primary care physicians, and community pharmacists. Controls received normal follow-up. All patients were monitored for 12 months, with quality of life tests administered at the beginning and end of follow-up. RESULTS: We had the participation of 8 different hospitals, 8 primary care centres, and 109 community pharmacies. 238 patients completed the study, with 2.9% of participants lost during the study period. There were no significant differences in terms of readmissions, visits to the doctors, or to emergency services. We detected 50 different medication-related problems (MRP) in 37 patients, with a statistically significant difference in terms of MRP between the control and treatment groups of patients with HF, and almost significant differences in COPD patients. MRP were moderate-severe in 36% of cases. MRP were avoidable in 94% of cases, and the pharmacist resolved the issue in 90% of cases. There were no differences in terms of patient quality of life or health costs between the start and end of the study. CONCLUSIONS: Integrated pharmaceutical care programs facilitate an improvement in the quality of patient care, but electronic registries are necessary to promote communication between sections of the health care network.
Subject(s)
Chronic Disease/drug therapy , Pharmaceutical Services/organization & administration , Aged , Aged, 80 and over , Chronic Disease/economics , Chronic Disease/psychology , Drug-Related Side Effects and Adverse Reactions , Female , Health Care Costs , Heart Failure/drug therapy , Humans , Interdisciplinary Communication , Male , Medical Errors/statistics & numerical data , Middle Aged , Pharmaceutical Services/economics , Pharmacists , Pulmonary Disease, Chronic Obstructive/drug therapy , Quality of Health Care , Quality of Life , SpainABSTRACT
The nutritional support team must justify its role by proving that it provides an adequate quality control and supervises the administration of the nutritional support to avoid its inappropriate use. The measures based on the process reported on the improvement opportunities while those based on the results allow an evaluation of the quality. The objective of this study is to present the results of a systematic search for improvement opportunities in two fundamental activities of the nutritional support team: the evaluation of the patient needs, and the adequation of the caloric supply to these needs. The data corresponding to nutritional support and nutritional assessment of 217 patients who initiated central parenteral nutrition during the perioperative surgery period for a laparotomy were registered between January of 1996 and June of 1997. These data were used to calculate 8 selected quality indicators to report on the quality of the activities subject to the evaluation. Moreover, the initial and final values of the nutritional assessment parameters of a sub-group of patients were compared with the aim of obtaining a measure of the result of parenteral nutrition. The final average levels of albumin, prealbumin, transferin, and the Nutritional Prognostic Index were significantly better than the initial data in the subgroup in which these data were available. The analysis of the process indicators allowed the detection of the need to reduce the caloric supply in relation to the protein supply and to promote the use of programs with a caloric supply that was better adjusted to the BMI and/or the patients' weight. It was also shown that it is necessary to increase the number of patients assessed from a nutritional point of view at the beginning and at the end of parenteral nutrition.
