Reacción cútanea debida a remdesivir en paciente con enfermedad por SARS-CoV-2 / Skin reaction due to remdesivir in a patient with SARS-CoV-2 disease

En diciembre de 2019 se detectó por primera vez en la ciudad china de Wuhan una nueva enfermedad infecciosa con el nombre oficial de COVID-19, causada por un nuevo tipo de coronavirus denominado virus SARS-CoV-2, la infección se ha propagado rápida y extensamente por todo el mundo, por lo que el 11 de marzo de 2020 la Organización Mundial de la Salud la declaró pandemia. Al tratarse de una nueva infección, no existe por el momento evidencia que permita recomendar un tratamiento específico, en la actualidad el único medicamento con indicación autorizada por la Agencia Europea de Medicamentos (EMA) es el remdesivir. A continuación presentamos el caso de una reacción adversa a remdesivir, si bien no fue grave, cabe destacar la importancia de notificar efectos adversos y más en medicamentos novedosos como este. (AU)

In December 2019, a new infectious disease with the official name of COVID-19 was detected for the first time in the Chinese city of Wuhan, caused by a new type of coronavirus called SARS-CoV-2 virus, the infection has spread rapidly and widely throughout the world, which is why on March 11, 2020, the World Health Organization declared it a pandemic. As it is a new infection, there is currently no evidence to recommend a specific treatment, currently the only drug with an indication authorized by the European Medicines Agency (EMA) is remdesivir.We present the case of an adverse reaction to remdesivir, although it was not serious, it is worth highlighting the importance of reporting adverse effects and more in novel drugs like this one. (AU)

[Current research status in pharmaceutical care]. / Estado actual de la investigación en atención farmacéutica.

OBJECTIVE: A systematic review of studies on pharmaceutical care research from June 1999 to June 2004 was carried out. METHOD: Medline, Current Contents, Cochrane Library, IDIS, and Teseo were used as data sources. Works were categorized according to evidence levels and recommendation grades in clinical practice guidelines. The JADAD method was used for quality quantification. RESULTS: In all, 129 references were found; 19.4% (n = 25) were randomized studies; 2.3% (n = 3) had blinded assessors; losses to follow-up were documented in 7.8% (n = 10); 4.7% (n = 6) had a Jadad score= 3; 8.5% (n = 11), 14.7% (n = 19), 5.4% (n = 7), and 20.9% (n = 27) had evidence levels Ia, Ib, IIa, and IIb, respectively; 44.2% (n = 57) and 6.2% (n = 8) had levels III and IV, respectively; 23.3% (n = 30) had a recommendation grade A; 26.4% (n = 34) had a grade B; 44% (n = 55) had C and 6.2% (n = 8) had D. Most common study types included: descriptive (39.5%), trials including patients (32.6%), and reviews (17.8%); 59.5% of reviewed clinical trials were controlled, randomized clinical trials (CRCTs). Studies were double-blind in 7.1% of cases. Discontinuations and exclusions were recorded in 23.8% of cases. Randomization was appropriate in 11.9% of cases; 14.3% of clinical trials had 3 points, and 85.7% of studies were of poor quality. CONCLUSIONS: Work methodology should be more rigorous. The use of universally accepted methods is needed to enhance the quality of studies (Jadad system, Consort list). The performance of observational, prospective, multicenter investigations allowing the effectiveness and efficiency of pharmaceutical care to be measured would be most beneficial. Works should measure health-related quality of life (SF-36 questionnaire) and patient satisfaction.

Estado actual de la investigación en atención farmacéutica / Current research status in pharmaceutical care

Objetivo: Realizar una revisión sistemática de los estudios sobre investigación en atención farmacéutica entre junio de 1999 y junio de 2004. Método: Se utilizaron como fuentes de datos Medline, Current Contents, Cochrane Library, IDIS y Teseo. Se categorizaron los trabajos según los niveles de evidencia y grados de recomendación de las guías de práctica clínica. Para cuantificar la calidad de los estudios se empleó el método Jadad. Resultados: Se encontraron 129 referencias. El 19,4% (n=25) fueron estudios randomizados; el 2,3% (n=3) tuvieron evaluadores ciegos; en el 7,8% (n=10) se documentaron las pérdidas de seguimiento. El 4,7% (n=6) tuvo una puntuación de Jadad=3. El 8,5% (n=11), el 14,7% (n=19), el 5,4% (n=7) y el 20,9% (n=27) tuvieron niveles de evidencia Ia, Ib, IIa y IIb, respectivamente. El 44,2% (n=57) y el 6,2% (n=8) fueron III y IV, respectivamente. El 23,3% (n=30) tuvieron grado de recomendación A; el 26,4% (n=34) B; el 44% (n=55) C y el 6,2% (n=8) D. Los tipos de estudio más frecuentes fueron: descriptivo (39,5%), ensayos con pacientes (32,6%) y las revisiones (17,8%). El 59,5% de los ensayos clínicos revisados fueron controlados y aleatorizados (ECCA). El estudio fue doble ciego en el 7,1% de los casos. Se registraron los abandonos y exclusiones en el 23,8%. La aleatorización fue adecuada en el 11,9%. El 14,3% de los ensayos clínicos tuvo 3 puntos y el 85,7% de los estudios fueron de baja calidad. Conclusiones: La metodología de los trabajos debería ser más rigurosa. Es necesario utilizar métodos universalmente aceptados para aumentar la calidad de los estudios (sistema Jadad, lista Consort). Sería conveniente realizar trabajos observacionales, prospectivos multicéntricos, que permitan medir la efectividad y la eficiencia de la atención farmacéutica. Los trabajos deberían medir la calidad de vida relacionada con la salud de los pacientes (cuestionario SF-36) y el grado de satisfacción de los mismos

Objective: A systematic review of studies on pharmaceutical care research from June 1999 to June 2004 was carried out. Method: Medline, Current Contents, Cochrane Library, IDIS, and Teseo were used as data sources. Works were categorized according to evidence levels and recommendation grades in clinical practice guidelines. The JADAD method was used for quality quantification. Results: In all, 129 references were found; 19.4% (n=25) were randomized studies; 2.3% (n=3) had blinded assessors; losses to follow-up were documented in 7.8% (n=10); 4.7% (n=6) had a Jadad score=3; 8.5% (n=11), 14.7% (n=19), 5.4% (n=7), and 20.9% (n=27) had evidence levels Ia, Ib, IIa, and IIb, respectively; 44.2% (n=57) and 6.2% (n=8) had levels III and IV, respectively; 23.3% (n=30) had a recommendation grade A; 26.4% (n=34) had a grade B; 44% (n=55) had C and 6.2% (n=8) had D. Most common study types included: descriptive (39.5%), trials including patients (32.6%), and reviews (17.8%); 59.5% of reviewed clinical trials were controlled, randomized clinical trials (CRCTs). Studies were double-blind in 7.1% of cases. Discontinuations and exclusions were recorded in 23.8% of cases. Randomization was appropriate in 11.9% of cases; 14.3% of clinical trials had 3 points, and 85.7% of studies were of poor quality. Conclusions: Work methodology should be more rigorous. The use of universally accepted methods is needed to enhance the quality of studies (Jadad system, Consort list). The performance of observational, prospective, multicenter investigations allowing the effectiveness and efficiency of pharmaceutical care to be measured would be most beneficial. Works should measure health-related quality of life (SF-36 questionnaire) and patient satisfaction

[A review on Hansen's disease]. / Revisión de la enfermedad de Hansen.

Hansens disease or leprosy is considered a pre-eradicated condition in Spain, with a prevalence rate of 0.1 cases per 10,000 inhabitants (below 1 case per 10,000 inhabitants, which was the World Health Organizations health goal worldwide for year 2000). The purpose of this review was to study this disease with a particular focus on its clinical aspects (diagnosis, forms, complications, etc.) and drug therapy. Main sources used for this review included Micromedex Healthcare System, PudMed, Cochrane Library, and World Health Organization recommendations. Leprosy is characterized by the existence of various clinical forms, among which tuberculoid leprosy and lepromatous leprosy stand out, even though a wide variety of intermediate forms may appear between these two extremes. The high complexity and variability of forms and clinical pictures, together with epidemiology and drug accessibility- since the disease shows a high prevalence in a number of developing countries-results in various treatment regimens being currently used. This makes eradication difficult and contributes to the existence of many different treatments following different recommendations on leprosy, as is the case with WHO-delivered guidelines. However, current treatments share a common base made up of several combined drugs, particularly rifampicin, dapsone, and clofazimin. Active principles most recently added to the multitherapy of leprosy include fluoroquinolones, tetracyclines, and macrolides. The most significant conclusion on this disease is that leprosy is currently considered a scarcely transmitted (natural resistance in 95% of the population), easily diagnosed, and good prognosis condition when early diagnosis and adequate treatment occur. Patient contagiousness disappears within a few weeks after treatment onset, and a normal community life may be led.