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Objective: The objective of the study was to analyze the diagnostic process and the time until the start of treatment of patients with idiopathic pulmonary fibrosis in relation to the publication of successive clinical practice guide. Material and methods: Multicenter, observational, ambispective study, in which patients includes in the idiopathic pulmonary fibrosis registry of the Spanish Society of Pulmonologist and Thoracic Surgery were analyzed. An electronic data collection notebook was enabled on the society's website. Sociodemographic and clinical variables were collected at diagnosis and follow-up of the patients. Results: From January 2012 to december 2019, 1064 patients were included in the registry, with 929 finally analyzed. The diagnosis process varied depending on the year in which it was performed, and the radiological pattern observed in the high-resolution computed tomography. Up to 26.3% of the cases (244) were diagnosed with chest high-resolution computed tomography and clinical evaluation. Surgical biopsy was used up to 50.2% of cases diagnosed before 2011, while it has been used in 14.2% since 2018. The median time from the onset of symptoms to diagnosis was 360 days (IQR 120-720), taking more than 2 years in the 21.0% of patients. A percentage of 79.4 of patients received antifibrotic treatment. The average time from diagnosis to the antifibrotic treatment has been 309 ± 596.5 days, with a median of 49 (IQR 0-307). Conclusions: The diagnostic process, including the time until diagnosis and the type of test used, has changed from 2011 to 2019, probably due to advances in clinical research and the publication of diagnostic-therapeutic consensus guidelines.
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OBJECTIVE: New drugs developed for SARS-CoV-2 infection, such as nirmatrelvir/ritonavir (NMV/r), represent a potential for oncohematology patients, but also pose a challenge in managing the potential clinically relevant drug-drug interactions (pDDIs) that may arise. The aim of this study is to assess the frequency, severity, and pharmacist detection of pDDIs. METHODS: This prospective, observational, study spanned 8 months, involving 42 oncohematology patients prescribed NMV/r in a tertiary-level hospital. A Board Certified oncology pharmacist assessed pDDIs using three databases and made recommendations to prescribing physicians. Linear and logistic regression analyses were employed to explore the relationship between prescribed drugs and pDDIs. RESULTS: Clinically relevant pDDIs were detected in 76.2% of patients, with 18.1% of all medications involved in drug-drug interactions (DDIs). The most common drugs implicated were atorvastatin and imatinib. Micromedex® identified 63.3% of interactions as major severity, while Lexicomp® and University of Liverpool classifications were less restrictive. Pharmacists prevented most DDIs from reaching patients through different interventions, including treatment monitoring (44.2%), discontinuation (36.5%), and dose reduction (17.3%). CONCLUSION: This study highlights the high prevalence of clinically significant pDDIs in oncohematology patients receiving NMV/r for COVID-19. Pharmacists, as integral members of the healthcare team, played a crucial role in detecting, categorizing, and mitigating these interactions. The results underscore the need for comprehensive studies to evaluate the impact of pharmacist-led interventions in optimizing drug therapy and enhancing patient safety in this vulnerable population.
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Heteroarenes and arenes that contain electron-withdrawing groups are chlorinated in good to excellent yields (scalable to gram scale) using trichloroisocyanuric acid (TCCA) and catalytic Brilliant Green (BG). Visible-light activation of BG serves to amplify the electrophilic nature of TCCA, providing a mild alternative approach to acid-promoted chlorination of deactivated (hetero)aromatic substrates. The utility of the TCCA/BG system is demonstrated through comparison to other chlorinating reagents and by the chlorination of pharmaceuticals including caffeine, lidocaine, and phenazone.
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Objective: to describe and classify the main cultural practices used to relieve orodental pain in people who seek emergency dental care in vulnerable urban and rural areas of central Chile. methodology: a sample of 88 adults residing in urban and rural sectors, who received treatment at primary care emergency dental services in three districts of the central area of Chile was studied using a qualitative descriptive approach of sociocultural epidemiological orientation based on grounded theory. interviews were conducted in the waiting room of the emergency service or at the patient's home. empirical saturation and triangulation of temporal data were protected. results: practices of biomedical origin (self-medication and care received at dental emergency services) and socio-cultural practices were documented. they include the use of chemical products (iodine, phosphorus, battery acid, hydrogen peroxide, gasoline, and alcoholic drinks, among others), herbal infusions (buddleja globosa, aloe vera), mechanical-physical techniques (use of cold or heat, massage); subjects also perform the mechanical manipulation of the area with sharp objects, occasionally extracting the tooth itself. practices occur more frequently at home when the person feels the pain in the affected area, and end on the dental chair with the tooth extraction. conclusions: the coexistence of biomedical practices and alternative cultural strategies was observed. these practices complement each other and make people postpone seeking professional dental care, which may worsen their health condition.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Odontalgia/tratamento farmacológico , Manejo da Dor/métodos , Odontalgia/terapia , Chile , Epidemiologia Descritiva , Inquéritos e QuestionáriosRESUMO
No disponible
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Humanos , Feminino , Adulto , Linfangioleiomiomatose/diagnóstico , Linfangioleiomiomatose , Linfangioleiomiomatose/terapia , Linfangioleiomiomatose/epidemiologia , Linfangioleiomiomatose/patologiaAssuntos
Neoplasias Pulmonares/tratamento farmacológico , Linfangioleiomiomatose/tratamento farmacológico , Neoplasias Retroperitoneais/tratamento farmacológico , Sirolimo/uso terapêutico , Feminino , Volume Expiratório Forçado , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/fisiopatologia , Linfangioleiomiomatose/diagnóstico por imagem , Linfangioleiomiomatose/patologia , Linfangioleiomiomatose/fisiopatologia , Pessoa de Meia-Idade , Indução de Remissão , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/patologia , Serina-Treonina Quinases TOR/antagonistas & inibidores , Tomografia Computadorizada por Raios X , Carga Tumoral , Capacidade VitalRESUMO
En el presente trabajo se describen las características generales, objetivos y aspectos organizativos de los registros de enfermedades respiratorias minoritarias integrados en el Registro Nacional de Enfermedades Raras del Instituto de Investigación de Enfermedades Raras (IIER), con el objetivo de dar a conocer su existencia y fomentar la participación de los profesionales. Se recoge información sobre registros de las siguientes enfermedades: déficit de alfa-1 antitripsina, estenosis traqueal idiopática, histiocitosis pulmonar de células de Langerhans del adulto, linfangioleiomiomatosis, proteinosis alveolar y sarcoidosis
This report describes the general characteristics, objectives, and organizational aspects of the registries of minority respiratory diseases included in the National Registry of Rare Diseases of the Research Institute for Rare Diseases (ISCIII), in order to publicize their existence and encourage the participation of professionals. Information is collected on the following conditions: alpha-1 antitrypsin deficiency, idiopathic tracheal stenosis, adult pulmonary Langerhans cell histiocytosis, lymphangioleiomyomatosis, alveolar proteinosis, and sarcoidosis (AU)
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Humanos , Masculino , Feminino , Doenças Raras/epidemiologia , Doenças Respiratórias/complicações , Doenças Respiratórias/epidemiologia , Registros , Controle de Formulários e Registros/organização & administração , Controle de Formulários e Registros/normas , Ficha Clínica , alfa 1-Antitripsina/análiseRESUMO
This report describes the general characteristics, objectives and organizational aspects of the registries of rare respiratory diseases included in the National Registry of Rare Diseases of the Research Institute for Rare Diseases (ISCIII), in order to publicize their existence and encourage the participation of professionals. Information is collected on the following conditions: alpha-1 antitrypsin deficiency, idiopathic tracheal stenosis, adult pulmonary Langerhans' cell histiocytosis, lymphangioleiomyomatosis, alveolar proteinosis, and sarcoidosis.