Factors associated with the use of medicines and self-medication during the COVID-19 pandemic in 12 Latin American countries.

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has triggered a rise in the global phenomenon of self-medication. The use of medicines with unsubstantiated claims of benefit for the prevention and/or treatment of infected people has been widely adopted. Objective: To determine the factors associated with the use of medicines and self-medication by Latin American populations during the COVID-19 pandemic. Methods: This analytical cross-sectional study was conducted via an analysis of secondary data collected from 8777 responses from 12 Latin American countries obtained from a survey on the use of medicines and self-medication during the pandemic. Results: Respondents who reported using Paracetamol, Ibuprofen, or antibiotics (ABx) disclosed this as self-medication in 26.9%, 16.6%, and 9.7% of cases respectively. In our multivariate analysis, significant associations were found between: self-medication by individual choice and the use of Hydroxychloroquine, ABx, or non-steroidal anti-inflammatory drugs (NSAIDs) (p = 0.026, = 0.003, and <0.001 respectively); self-medication on the recommendation of a family member, with ABx, Paracetamol, Ibuprofen, or other NSAIDs (p <0.001, <0.001, <0.001, and <0.001 respectively); and self-medication on the recommendation of another person, with Chloroquine, Hydroxychloroquine, Azithromycin, Penicillin, other ABx, Warfarin, Ivermectin, Paracetamol, Ibuprofen, or other NSAIDs (p <0.001, <0.001, <0.001, = 0.001, <0.001, <0.001, = 0.004, <0.001, <0.001, and <0.001 respectively). Conclusion: There was a significantly high prevalence of self-medication in our Latin American study population, including the use of medicines not recommended for COVID-19 treatment and/or prevention. The implementation of public health measures aimed at combating the worrying COVID-19 infodemic is essential to prevent this ongoing issue and its associated negative impacts on both current public health and future medication efficacy. This is especially important in the case of ABx due to the threat of a future antimicrobial resistance pandemic.

Impacto de crioterapia como prevención de mucositis / Impact of cryotherapy in preventing mucositis

El mieloma múltiple es la segunda neoplasia hematológica en orden de frecuencia. Se define por la presencia de células plasmáticas monoclonales con capacidad para producir una paraproteína monoclonal y causar alteraciones clínicas en forma de anemia es una patología tratable pero invasiva como consecuencia del tratamiento quimioterápeutico el revestimiento mucoso de la boca sufre alteraciones, lo que puede dar lugar a su inflamación y ulceración, la gravedad de la mucositis oral puede evaluarse utilizando diferentes escalas. Según el grado que alcance puede interferir en el estado funcional y calidad de vida del paciente causando dolor, desnutrición e infecciones locales o sistémicas. Genera retraso del tratamiento, prolonga la estancia hospitalaria, incrementa el gasto sanitario. Una de las medidas preventivas es la crioterapia, que realiza el principio básico de vasoconstricción para limitar la toxicidad local de ciertas terapias, la hipotermia resultante produce una reducción del flujo sanguíneo por efecto de la vasoconstricción con la disminución de los efectos citotóxicos por concentración de los fármacos en el área que se enfrió. La misma está indicada para la prevención de mucositis en drogas de vida media corta, tales como el melfalán en altas dosis.Uno de los objetivos propuestos fue comparar el grado de mucositis alcanzado por los pacientes que realizaron crioterapia de enero a septiembre del año 2017 con lo que no realizaron crioterapia durante el mismo periodo del 2016.

Multiple myeloma is the second most frequent hematologic neoplasia. It is defined by the presence of monoclonal plasmatic cells that can produce a monoclonal paraprotein and cause clinical alterations, like anemia. The pathology is treatable but invasive. The chemotherapy can alter the mucosa lining of the mouth, causing inflammation and ulceration. The seriousness of the oral mucositis can be evaluated by using different scales. Depending on the degree reached, it can interfere in the functional status and life quality of the patient, causing pain, malnutrition and local or systemic infections. It delays the treatment, prolongs the hospitalization and increases the health care costs. One of the preventive steps is cryotherapy that applies the basic principle of vasoconstriction to limit the local toxicity of certain therapies. The resulting hypothermia reduces the blood flow, and diminishes the cytotoxic effects by concentrating the drugs in the area that was chilled. Cryotherapy is indicated to prevent mucositis when short half-life drugs, such as melphalan in high doses, are used. One of the proposed goals was to compare the degree of mucositis developed by patients who received cryotherapy from January to September 2017, to those who did not receive cryotherapy during the same period in 2016.