RESUMO
INTRODUCTION: During the SARS-CoV-2 pandemic, there has been a decrease in the supervision of the medication of subjects with chronic diseases. Customized automated dosing systems (SPDA) are devices that allow medication to be dispensed and administered, which have proven to be safe and effective for the patient and cost-effective for the healthcare system. METHODS: an intervention study was carried out on patients from January to December 2019 in a residential centre for the elderly with more than 100 beds. The economic costs derived from manual dosing were compared with those of an automated preparation (Robotik Technology®). RESULTS: Of the 198 patients included, 195 (97.47%) of them were polymedicated. Of the total of 276 active substances of registered medicinal products, it was possible to include them in the process of automating the preparation of the SPDA 105 active pharmaceutical ingredients. A cost reduction of EUR 5062.39 per year was found using SPDA. Taking into account the active ingredients of emblistable and non-emblistable medicines, the use of SPDA resulted in savings of EUR 6120.40 per year. The system contributed to the detection of cases of therapeutic duplication and reduced the time to prepare the medication. CONCLUSIONS: the use of SPDA is a useful and economically profitable strategy for its use in residential centres for the elderly.
RESUMO
It is thought that many of the idiopathic pancreatitis could have a genetic base. Approximately 50% of them correspond to CFTR (cystic fibrosis transmembrane conductance regulator gene) and SPINK-1 (serine protease inhibitor Kazal type 1) mutations. A recent study compares patients with acute pancreatitis and SPINK-1 mutation with patients with idiopathic acute pancreatitis. The study highlights a 12-fold increased risk of developing pancreatic cancer with SPINK-1 mutation versus the control group. Nonetheless, authors conclude that only specific pN34s mutation is related to pancreatic cancer. This relation is controversial, and international consensus guidelines for the follow-up in chronic pancreatitis with pancreatic cancer still do not recommend follow-up in SPINK-1 p. N34S mutation. We believe that developing prospective studies in which subgroups of patients with SPINK-1 mutation benefit from closer follow-ups would be necessary.
Assuntos
Pancreatite , Inibidor da Tripsina Pancreática de Kazal , Humanos , Doença Aguda , Proteínas de Transporte/genética , Predisposição Genética para Doença , Mutação , Neoplasias Pancreáticas/genética , Pancreatite/genética , Estudos Prospectivos , Inibidor da Tripsina Pancreática de Kazal/genéticaRESUMO
No disponible
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Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Pancreatite/diagnóstico , Doenças Autoimunes/diagnóstico , Diagnóstico Diferencial , Carcinoma Ductal Pancreático/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Pancreatite/classificaçãoRESUMO
In this paper, we analyse the medical specialty training system in Spain (the so-called "residency system"). In order to do so, we a) summarize its historical evolution; b) describe the five major architectural pillars on which the system is currently based; c) analyse the special contract of the specialist-in-training; d) discuss the three major challenges for the medical specialist training future: the evolution and expansion of the residency system to other health professions, the issue of grouping specialties with a common core trunk and the continuity of the learning process; and e) draw four conclusions that may be relevant for those who are in the process of developing or revising their own medical specialization systems.
Assuntos
Educação de Pós-Graduação em Medicina , Internato e Residência , Medicina , Especialização , Humanos , EspanhaRESUMO
No disponible
Assuntos
Humanos , Educação Médica/tendências , Modelos Educacionais , Internato e Residência/métodos , Avaliação Educacional , Serviços de Integração Docente-Assistencial , Preceptoria/organização & administraçãoRESUMO
No disponible
No disponible
