Case Report: Fatigue and Bleeding in a Polymedicated Patient Using Several Herbal Supplementations, Detected with g-Nomic® Software.

This was a case report of severe fatigue and bleeding in a 65-year-old man with ischemic heart disease who was wearing a stent and taking multiple medications for hypertension and diabetes. The use of a drug interaction and personalized prescription software (g-Nomic®) revealed potential interactions, involving acetylsalicylic acid and several non-pharmaceutical products including ginger, blueberry extracts, pineapple juice, docosahexaenoic acid and liquorice. Correction of these interactions resulted in complete remission of the reported side effects. This supports the idea that non-pharmaceuticals potentiated the effects of acetylsalicylic acid on haemostasis, producing the bleeding that would have caused fatigue. It is important to use appropriate tools to detect drug interactions that also take into account commonly used non-pharmaceutical products. Drug interactions can be considered illnesses by themselves.

[Evaluation of an applied program for the prevention and control of tuberculosis]. / Valoración de la aplicación de un programa de prevención y control de tuberculosis.

BACKGROUND: To evaluate the efficacy of a tuberculosis prevention and control program applied in the health care area of Cadiz (Spain). MATERIALS AND METHODS: Tuberculosis cases diagnosed by microbiological criteria (Ziehl-Neelsen/auramine smear and/or culture in Löwenstein-Jensen medium) from 1996 to 2000 were analyzed in relation to epidemiologic characteristics of the patients. Susceptibility studies were performed from 1997 onwards using the proportion method described by Canetti, Rist and Grosset. RESULTS: The rate of tuberculous infections gradually dropped from 38.4 cases/100,000 inhabitants in 1996 to 16.0 cases/100,000 inhabitants in 2000. Along the study period, the percentage of men affected by the disease ranged from 81.2% in 1996 to 70.0% in 2000. In 1996, 26.0% of tuberculous patients were HIV-positive, and in 2000, 27.5%. The sensitivity of microbiologic diagnosis increased considerably from 60.4% in 1996 to 67.5% in 2000. Multi-drug resistance (9.2% en 1997) has virtually disappeared in our area since 1998 (1.6%).CONCLUSIONS. Implementation of a plan for the prevention and control of tuberculosis in our geographic area was effective, resulting in a decrease in the infection rate to less than 25 cases/100,000 inhabitants, and improvements in microbiologic diagnosis and compliance with treatment. Tuberculous disease has affected an increasingly higher proportion of women, regardless of HIV status. Antimicrobial resistance, particularly multi-drug resistance is now low in our area.

Valoración de la aplicación de un programa de prevención y control de tuberculosis / Evaluation of an applied program for the prevention and control of tuberculosis

ANTECEDENTES. Evaluar la aplicación de un programa de prevención y control de la tuberculosis en el área sanitaria de Cádiz. MATERIAL Y MÉTODOS. Se analizan los casos de tuberculosis diagnosticados microbiológicamente (tinción de Ziehl-Neelsen/auramina y/o cultivo en medio de Löwenstein-Jensen) desde 1996 a 2000, considerando las características epidemiológicas de los pacientes. Se realizó estudio de sensibilidad a partir de 1997 por el método de las proporciones de Canetti, Rist y Grosset. RESULTADOS. La tasa de infección tuberculosa desciende de manera progresiva desde 38,4 casos/100.000 habitantes en 1996, hasta 16,0 casos/100.000 habitantes en el año 2000. El porcentaje de hombres afectados por la enfermedad osciló a lo largo del estudio desde el 81,2 por ciento en 1996 al 70,0 por ciento en 2000. El 26,0 por ciento de los pacientes con tuberculosis eran positivos para el virus de la inmunodeficiencia humana (VIH) en 1996, y el 27,5 por ciento en el año 2000. La sensibilidad del diagnóstico microbiológico aumentó de forma importante desde el 60,4 por ciento en 1996 al 67,5 por ciento en 2000. La multirresistencia (9,2 por ciento en 1997) prácticamente desaparece de nuestra área a partir de 1998 (1,6 por ciento). CONCLUSIONES. La implantación del Programa de Prevención y Control de la Tuberculosis en nuestra área sanitaria se ha mostrado eficaz, al conseguir una disminución de la tasa de infección por debajo de 25 casos/100.000 habitantes y una mejora en el rendimiento del diagnóstico microbiológico y en la adherencia de los pacientes al tratamiento. La enfermedad tuberculosa afecta cada vez más a mujeres, con independencia de si están infectadas por el VIH o no. En el momento actual, la resistencia observada en nuestra zona geográfica es escasa, sobre todo la multirresistencia (AU)