Serum and CSF alpha-synuclein levels do not change in COVID-19 patients with neurological symptoms.

SARS-CoV-2 infection can associate diverse neurological manifestations. Several studies have provided proof to support the theory of neurotropic involvement of SARS-CoV-2. Alpha-synuclein has been described as a native antiviral factor within neurons, and upregulation of this protein can be seen in animals that suffered other neuroinvasive infections. To assess if increased expression of this protein takes place in COVID-19 patients with neurological symptoms, we analyzed serum total alpha-synuclein levels in three groups: seven COVID-19 patients with myoclonus, Parkinsonism and/or encephalopathy; thirteen age- and sex-matched COVID-19 patients without neurological involvement and eight age- and sex-matched healthy controls. We did not find differences among them. In a subset of four patients, the change in serum alpha-synuclein before and after the onset of neurological symptoms was not significant either. Cerebrospinal fluid alpha-synuclein levels were also similar between neurological COVID-19 and healthy controls. Overall, these results cannot support the hypothesis of alpha-synuclein upregulation in humans with neurological symptoms in COVID-19. Further research taking into account a larger group of COVID-19 patients including the whole spectrum of neurological manifestations and disease severity is needed.

[Study of the relationship between adherence to back school and coping with pain in patients with chronic low back pain]. / Estudio de la relación entre adherencia a la Escuela de la Espalda y afrontamiento del dolor en pacientes con lumbalgia crónica.

INTRODUCTION: Back School (BS) is a treatment modality for patients with chronic low back pain with educational contents associated with other therapeutic measures such as exercise. If followed, it is effective but it is well known that it is difficult to make changes to daily habits. This study evaluated whether patients completing BS had a predominance of active strategies in coping with pain, as they adhered better to the recommendations of BS. MATERIAL AND METHOD: Prospective observational study to evaluate BS adherence in patients with chronic low back pain. Adult patients attending BS were included in the study. Patients whose educational level, concomitant pathology or personal situation prevented them from completing the study were excluded. The patients were evaluated at the beginning and after the third session of BS. The variables studied were adherence to exercises and recommendations, coping with pain, pain intensity, functional disability and other sociodemographic characteristics. RESULTS: A total of 67.2% of the 116 included patients acknowledged that they did not perform the exercises and recommendations of BS every day. No relationship was established between patients with active strategies for coping with pain and adherence to BS. Functional capacity and pain intensity did not differ between adherent and non-adherent patients. CONCLUSIONS: This study did not demonstrate that adherence to the exercises and habits taught in BS is related to coping with pain strategies, pain intensity and functional capacity in patients with chronic low back pain.

Mesoterapia como opción terapéutica en patología dolorosa del aparato locomotor / Mesotherapy as a therapeutic option in painful condition of locomotor apparatus

Introducción. La mesoterapia es una técnica que consiste en la aplicación de múltiples inyecciones intradérmicas (dermis profunda) con diferentes fármacos según las patologías a tratar. Es utilizada en distintas especialidades médicas, siendo especialmente interesante su uso en dolor, síntoma prevalente en nuestra especialidad. Introducción. El objetivo de este trabajo es valorar la eficacia y seguridad de este tratamiento en pacientes con patología dolorosa crónica del aparato locomotor. Material y métodos. Realizamos un estudio prospectivo de los resultados obtenidos con la aplicación de esta técnica en 59 pacientes, derivados a la consulta de Rehabilitación y afectos de distintas patologías. Los fármacos utilizados para el tratamiento del dolor fueron una combinación de Piroxicam, Lidocaína al 1% y Pentoxifilina. Para evaluar resultados utilizamos al inicio y final del proceso la Escala Visual Analógica (EVA), el Cuestionario de salud EuroQol-5D (EQ-5D tarifa) y la medición del diámetro de la zona dolorosa. El análisis estadístico se realizó con el programa informático SPSS V15.0 y el método consistió en una comparación de medias utilizando una t de student para datos emparejados de cada uno de las tres instrumentos de medida utilizados. Resultados y conclusiones. Ningún paciente abandonó el tratamiento. Edad media: 46 años. El 74,5% de pacientes fueron mujeres. La cervicalgia fue la patología más frecuentemente tratada. Demostramos una mejoría estadísticamente significativa (p<0,001) de la patología dolorosa del aparato locomotor tras el tratamiento con mesoterapia, con unos descensos medios de 52,28mm (IC 95%: 44,78–59,79) en la EVA y de 45,86cm (IC 95%: 30,97–60,75) en el diámetro de la lesión y un aumento medio en el EQ-5D tarifa de 0,3550 (IC 95%: 0,2924–0,4177). Como únicos efectos secundarios, un 26% de pacientes presentaron hematomas en la zona de aplicación que se resolvieron espontáneamente. Resultados y conclusiones. La mesoterapia es un método de tratamiento eficaz y seguro para el tratamiento de la patología dolorosa crónica del aparato locomotor(AU)

Introduction. Mesotherapy is a technique that consists in the application of multiple intradermal injections (deep dermis) with different drugs according to the conditions to be treated. It is used in different medical specialties, its use being especially interesting in pain, a prevalent symptom in our specialty. Introduction. This work has aimed to assess the effectiveness and safety of this treatment in patients with chronic painful condition of the locomotor apparatus. Material and methods. We conducted a prospective study of the results obtained with the application of this technique in 59 patients, referred from the Rehabilitation Service, suffering from different conditions. The medications used for pain treatment were a combination of Piroxicam, Lidocaine 1% and Pentoxifylline. The Visual Analogue Scale (VAS), the Health Questionnaire EuroQol-5D (EQ-5D Index score) and the measurement of the painful zone diameter were used to evaluate the results. The statistical analysis was conducted with the SPSS V15.0 computer program and the method consisted in a comparison of means, using the Student's T test for matched data of each of the 3 measurement instruments used. Results and conclusions. None of the patients dropped out of the treatment. Their mean age was 46 years old and 74.5% of the patients were women. Neck pain was the most frequently treated condition. We have demonstrated a statistically significant improvement (p<0.001) of the painful condition of the locomotor apparatus after mesotherapy treatment, with mean decreases of 52.28mm (95% CI: 44.78–59.79) in the VAS, 45.86cm (95% CI: 30.97–60.75) in the lesion diameter and average increase in the EQ-5D Index score of 0.3550 (95% CI: 0.2924–0.4177). As side effects, 26% of the patients had hematomas in the application zone that resolved spontaneously. Results and conclusions. Mesotherapy is a safe and effective method for the treatment of chronic painful condition of the locomotor apparatus(AU)

Claudicación intermitente como manifestación del síndrome de Pratesi / Intermittent claudication as a clinical expression of Pratesi's syndrome

El síndrome de Pratesi se caracteriza por la existencia de múltiples fístulas arteriovenosas en los miembros inferiores y por afectar preferentemente al varón durante la edad media de la vida. Clínicamente, cursa con claudicación intermitente bilateral en la pantorrilla, no progresiva, con períodos de remisión espontánea, asociada a frialdad subjetiva en los pies, con aumento real de la temperatura. No aparece dolor en reposo y no se asocia a trastornos tróficos.Presentamos el caso de un varón de 36 años con dolor en el gemelo interno del miembro inferior derecho, desde hacía años, que le impedía realizar esfuerzos continuos. La confirmación diagnóstica se realizó mediante estudio angiográfico, tratándose de manera conservadora. La presencia de múltiples comunicaciones arteriovenosas dificulta el tratamiento quirúrgico, resultando imposible ligarlas todas.El objetivo principal de la presentación de este caso clínico es describir las características clínicas de este síndrome y aportar un nuevo caso a los pocos referidos en la literatura médica revisada (AU)

The syndrome of Pratesi is characterised by the existence of multiple arteriovenous fistulas in lower members, which affect mainly men in their middle age. Clinically evolves with non progressive bilateral intermittent claudication in calf, with periods of spontaneous remission, associated to a subjective coldness in feet together with a real increase of temperature. No pain appears when at rest, and trophic disorders are not associated.AbstractWe present the case of a man of thirty-six with a pain in the inner gemellus of his right lower member. It has prevented him from making a continued effort for years. Diagnosis should be confirmed by means of angiographic study and the treatment was conservative. The present of multiples communication arteriovenous is difficult for the chirurgical treatment because it is impossible to joint them all. The main objective of this clinical case presentation is to describe the clinical characteristics of this syndrome and also provide a new case to the few reported in the literature reviewed (AU)

[Computer-aided electronic prescribing in Spanish hospitals]. / Características de la prescripción electrónica asistida en hospitales españoles.

OBJECTIVE: To describe electronic prescribing in a sample of Spanish hospitals and activities derived from its implementation in Hospital Pharmacy Departments, software features and acceptance. METHOD: A survey that included data related to program implantation and performance in hospitals with diverse characteristics was designed. It was posted at the Sociedad Española de Farmacia Hospitalaria website for a 6-month period and completed by phone. RESULTS: A total of 47 hospitals answered the survey. 13 (27.7%) had electronic prescribing systems, and of these, 8 of them had more than 75% of beds included in the system. In 15 (31.9%) hospitals that did not have it, its implementation was in project in the near future. Software applications used in this new health technology were not homogeneous, while integration of applications that facilitate Pharmaceutical Care tasks was infrequent. In 61.5% of the hospitals with electronic prescribing, transcription used to be the pharmacist s task. In 92.3% of these hospitals, order validation is currently carried out by pharmacists. The degree of satisfaction with the system was rated as good or very good by 92.3% of pharmacists. CONCLUSIONS: Computer-aided electronic prescribing appears to be a helpful tool for restructuring Department organization and investing time in new activities. A more ambitious and effective approach to clinical activities will therefore be possible. System optimization requires taking into account factors such as worker time investment, since new activities will be developed, along with the need for training courses.

Características de la prescripción electrónica asistida en hospitales españoles / Computer-aided electronic prescribing in spanish hospitals

Objetivo: Conocer las características de la prescripción electrónicaen una muestra de hospitales españoles, describir las actividadesderivadas de su implantación en los Servicios de Farmacia,características de los programas utilizados y su aceptación.Método: Se diseñó una encuesta que recogía datos de implantacióny funcionamiento del programa en hospitales con distintascaracterísticas. Se publicó en la web de la SEFH durante 6 mesesy se completó telefónicamente.Resultados: De 47 hospitales encuestados, 13 (27,7%) disponende prescripción electrónica asistida, en 8 de ellos estáimplantada en más del 75% de sus camas. En 15 (31,9%) de loscentros donde no disponen de ella, la implantación es un proyectoa corto-medio plazo. Existe dispersión en los programas utilizadosy son de instauración reciente. La integración de aplicacionescruzadas para desarrollar atención farmacéutica está poco explotada.En el 61,5% de los centros con prescripción electrónica asistida,la transcripción tradicionalmente era función del farmacéutico.En un 92,3% valida los tratamientos. Su satisfacción es buena omuy buena en un 92,3%.Conclusiones: Las capacidades de la prescripción electrónicaasistida y los cambios graduales en las funciones que desarrolla elfarmacéutico a raíz de su implantación podrían potenciar el desarrollode programas más amplios de atención farmacéutica.Para la optimización del uso del sistema es importante considerarfactores como la inversión en tiempo del personal, teniendoen cuenta que se asumen nuevas actividades, y la necesidad deformación de los usuarios

Objective: To describe electronic prescribing in a sample of Spanish hospitals and activities derived from its implementation in Hospital Pharmacy Departments, software features and acceptance. Method: A survey that included data related to program implantation and performance in hospitals with diverse characteristics was designed. It was posted at the Sociedad Española de Farmacia Hospitalaria website for a 6-month period and completed by phone. Results: A total of 47 hospitals answered the survey. 13 (27.7%) had electronic prescribing systems, and of these, 8 of them had more than 75% of beds included in the system. In 15 (31.9%) hospitals that did not have it, its implementation was in project in the near future. Software applications used in this new health technology were not homogeneous, while integration of applications that facilitate Pharmaceutical Care tasks was infrequent. In 61.5% of the hospitals with electronic prescribing, transcription used to be the pharmacist’s task. In 92.3% of these hospitals, order validation is currently carried out by pharmacists. The degree of satisfaction with the system was rated as good or very good by 92.3% of pharmacists. Conclusions: Computer-aided electronic prescribing appears to be a helpful tool for restructuring Department organization and investing time in new activities. A more ambitious and effective approach to clinical activities will therefore be possible. System optimization requires taking into account factors such as worker time investment, since new activities will be developed, along with the need for training courses

[Analyzing the evolution of a Pharmacy Department using a relative value unit system]. / Análisis de la evolución de un Servicio de Farmacia a través del sitema de unidades relativas de valor.

INTRODUCTION: This study proposes the use of relative value units (RVU) as a clinical management tool to evaluate departmental services. OBJECTIVES: To measure productivity from 2000 to 2002 by estimating RVU. To determine RVU cost in constant Euros and evaluate system efficiency during this period of time. METHODS: Retrospective, observational study of a pharmacy department s production. RVU assigned to each activity have been obtained from a standardized document drawn up by the Sociedad Española de Farmacia Hospitalaria. Cost of each RVU was determined based on total cost assigned to the pharmacy department and the total number of RVUs produced. RESULTS: Drug dispensation activities account for 76% of the total production, followed by elaboration activities (21%). CONCLUSIONS: Productivity in our department has increased 46.48% in this period of time, while efficiency has increased by 23.8%.

Análisis de la evolución de un Servicio de Farmacia a través del sistema de unidades relativas de valor / Analyzing the evolution of a Pharmacy Department using a relative value unit system

Introducción: El presente trabajo propone el empleo de las unidades relativas de valor (URV), como herramienta de gestión clínica para valorar la actividad de Servicios. Objetivo: Medir la actividad productiva del último trienio a través de su cuantificación mediante la estimación de las URV producidas. Calcular el coste de la URV en € constantes. Evaluar la eficiencia del sistema durante el periodo 2000-2002.Material y método: Estudio observacional retrospectivo de la producción del Servicio de Farmacia. El valor en URV asignado a cada actividad se ha obtenido de un catálogo normalizado elaborado por la SEFH. El coste por URV se obtiene dividiendo el coste total asignado a Farmacia por el total de URV producidas. Resultado: El Área de Dispensación representa el 76 por ciento de toda la producción del Servicio, y la de elaboración el 21 por ciento. Conclusiones: En el periodo de estudio se ha incrementado la actividad en un 46,68 por ciento y la eficiencia en un 23,8 por ciento (AU)

Información electrónica: una herramienta para mejorar la atención farmacéutica al paciente con VIH / Electronic information: a tool for the improvement of HIV patient care by the pharmacist

Este trabajo pretende conocer la demanda de información electrónica de los pacientes con infección por VIH y recopilar una lista de direcciones de páginas web con información de calidad sobre el tratamiento dirigida a este grupo de población.Se ha realizado una encuesta sobre el uso de internet entre los pacientes con tratamiento antirretroviral que acuden a la consulta de atención farmacéutica y se han efectuado búsquedas en internet a través de buscadores generales utilizando las palabras clave "SIDA", "tratamiento" y "curación". Los resultados muestran la existencia de un interés por parte de los pacientes con VIH a disponer de información en internet (37 por ciento). La búsqueda ha permitido reunir 16 direcciones con información de calidad, aunque también ha reflejado que circulan por la red electrónica tratamientos para el SIDA sin ninguna base científica.El trabajo pone de manifiesto la necesidad de proporcionar información electrónica fidedigna a los pacientes con VIH que lo precisen, además de orientarles a evaluar la encontrada en la red por su propia cuenta (AU)