[Program of drug information for patients discharged from the hospital]. / Programa de información de medicamentos para pacientes dados de alta en el hospital.

OBJECTIVE: To describe the introduction of a medicine information programme by the Pharmacy Service and to evaluate this programme, analysing the usefulness of the information supplied. SETTING: "12 de Octubre" University Hospital, Health Area 11, Madrid. PATIENTS: Patients discharged by the Internal Medicine Service over a six-month period, with patients with HIV or palliative treatment being excluded. INTERVENTIONS: On their hospital discharge, patients were informed orally and in writing on the medicine's dosage, action and side-effects, as well as general considerations during treatment. After 30 days the patients concerned were polled by telephone. RESULTS: Information was supplied to 163 patients. The average number of medicines prescribed on discharge was 4.6. Average age was 65 +/- 15 years. 141 patients were interviewed. 8.5% did not answer the telephone interview. 90.8% consulted the written information received and 10% had difficulty in understanding them. 77% wished to receive oral and written information. 95% found the information useful. When questioned on the number of medicines they took, 88.6% of the patients gave a reply which coincided with the medicines prescribed on discharge. 88.4% understood the indication of the treatment and 35% remembered the commercial names. 93% knew the intervals between doses and 76% knew what to do if they forgot a dose. CONCLUSIONS: In the group of patients under study, a high demand for information on medication was identified. The great majority considered useful the information provided by the Pharmacy Service.

[Non-secretory myeloma. Report of a case with negative immunofluorescence in the tumor cells (author's transl)]. / Mieloma no secretor. Exposición de un caso con inmunofluorescencia negativa en las células tumorales.

A 39-year-old patient with bilateral paralysis of the VI cranial nerve was studied. Numerous foci of intracranial osteolysis were discovered as well as on the right calvicle and several ribs. Two bone marrow aspirates gave results within normal limits. A biopsy of the lesion on the right calvicle led to the diagnosis of myelomatosis. Immunoelectrophoresis showed that paraprotein was not present in serum and urine. Immunofluorescence with antisera marked with fluorescein was negative in the diseased bone marrow. Treatment with melphalan and prednisone given alternately produced an improvement in all of the lytic lesions within several months; 20 months after treatment was started no new destructive bony lesions have appeared. There have been very few reported cases of non-secretory myeloma. In most of these cases the presence of immunoglobulins in the tumoral cells has been shown by immunofluorescence. The absence of the immunoglobulins, as described in our case, is extremely rare. Unlike most cases of non-secretory myeloma published to date, our patient has a favorable clinical course after treatment was administered.