Postoperative care in hypospadias. Common practices and evidence available. / Cuidados postoperatorios en el hipospadias. Prácticas habituales y evidencia disponible.

INTRODUCTION: There are many alternatives available regarding postoperative care in hypospadias surgery. The objective of this study was to assess the current care situation in our environment and to review the evidence available for pediatric surgeons who conduct this procedure. MATERIALS AND METHODS: A survey regarding the main aspects of hypospadias postoperative care was created and distributed to pediatric surgeons. In addition, the evidence currently published in this field was reviewed. RESULTS: A total of 46 replies were achieved. 100% of the surgeons leave in place a probe or stent, and more than 80% remove it after 5 or 7 days. 87.8% of the respondents use a double diaper, but only 65.2% discharge patients early in the postoperative period. 60.9% prescribe antibiotic prophylaxis for as long as the probe remains in place, and 34.8% use full-dose antibiotic therapy. DISCUSSION: There was a general consensus regarding urethroplasty guiding and the use of compression dressings among the pediatric surgeons surveyed. However, more discrepancies were found in the use of antibiotic therapy and early discharge. The currently available evidence and international practice suggest using a probe with double diaper and early discharge, with postoperative antibiotics being limited. In the absence of clear evidence for a specific care type, the patient's experience could be used to choose the best postoperative protocol on an individual basis.

INTRODUCCION: Existen numerosas alternativas en lo que respecta a los cuidados postoperatorios en la cirugía de hipospadias. El objetivo de este estudio es evaluar la situación actual de estos cuidados en nuestro medio y revisar la evidencia existente al respecto para cirujanos pediátricos que realizan este tipo de intervenciones. MATERIAL Y METODOS: Hemos elaborado y distribuido una encuesta que recoge los principales puntos en el cuidado postoperatorio del hipospadias dirigida a cirujanos pediátricos. Se ha realizado revisión de la evidencia actual publicada al respecto en la especialidad. RESULTADOS: Hemos obtenido un total de 46 respuestas. El 100% de los cirujanos dejan algún tipo de sonda o stent y más del 80% están de acuerdo en retirarlo tras 5 o 7 días. El 87,8% de los encuestados utiliza el doble pañal, pero solo el 65,2% da alta precoz en el postoperatorio. Un 60,9% pauta profilaxis antibiótica mientras dure el sondaje y un 34,8% antibioterapia a dosis plenas. DISCUSION: Existe consenso general respecto a la tutorización de la uretroplastia y el uso de apósito compresivo entre los cirujanos pediátricos encuestados. Se detectan más discrepancias en el uso de antibioterapia y el alta precoz. La evidencia actual y la práctica a nivel internacional apunta hacia el uso de la sonda a doble pañal con alta precoz y la limitación del uso de antibióticos postoperatorios. En ausencia de clara evidencia que favorezca un tipo de cuidado u otro, la experiencia del paciente podría ser utilizada para elegir el mejor protocolo postoperatorio individualizado.

XI Congreso SEFAC: fortaleciendo la atención primaria y reivindicando el valor clínico de la farmacia comunitaria / XI SEFAC Congress: strengthening primary care and vindicating the clinical value of community pharmacy

Para seguir dando soluciones a los grandes retos de presente y futuro de la sanidad y a las necesidades cambiantes de los pacientes, debemos tener una atención primaria reforzada y coordinada, que cuente con el apoyo decidido de la Administración, y que abrace los avances tecnológicos y digitales sin renunciar a la presencialidad. Ahora más que nunca, la farmacia comunitaria debe reivindicar su compromiso con los pacientes y su vocación de fortalecer la atención primaria, apostando por su valor clínico. Son estos precisamente los dos puntos sobre lo que descansa el lema del XI Congreso Nacional de Farmacéuticos Comunitarios y IV Reunión Internacional de Farmacéuticos Comunitarios, que SEFAC celebra del 16 al 18 de mayo en Las Palmas con la colaboración del Colegio Oficial de Farmacéuticos de Las Palmas; tres intensas jornadas científico-profesionales en las que ponentes de primer nivel nacional e internacional impartirán contenidos basados en la evidencia científica, la práctica profesional y la actualidad sanitaria de la farmacia comunitaria.(AU)

Biomarkers predicting the controller dose of omalizumab in patients with chronic spontaneous urticaria.

BACKGROUND: Clinical trials showed the efficacy of 300 mg/4 weeks of omalizumab (OMA) during 6 months in patients with severe chronic spontaneous urticaria (CSU). Nevertheless, in real life, many patients require higher doses and/or longer treatment. This study assesses the real-life performance of OMA in severe CSU and identifies factors associated with the response. METHODS: CSU patients eligible for OMA were recruited prospectively. Clinical data and a blood test were collected before OMA initiation. Urticaria Activity Score 7 (UAS7) was calculated at baseline and every 3 months during OMA treatment. CSU control was defined as UAS7 <7 points. This work was partially sponsored by OMA manufacturer. RESULTS: Eighty-nine adults (19.1% males) with severe CSU were recruited. Median duration of CSU prior to OMA initiation was 2 years, and median severity by UAS7 at baseline was 24 points (range 10-42 points). OMA controlled 94.4% of patients, but 17.9% of responders required doses >300 mg/4 weeks. A blood basophil count >20 cells/µL (OR 13.33; 95% CI 3.32-52.63; p < .001) and the absence of hypothyroidism (OR 3.65; 95% CI 0.78-16.95; p = .099) were identified as predictive factors to achieve control with 300 mg/4 weeks. Twelve patients were able to stop OMA during the study (responders in remission, RR). RR had received OMA for a median of 29 months (12-53 months). Conversely, 32 patients had been on OMA for >29 months at the end of the study (active responders, AR). AR had received OMA for a median of 45 months (30-100 months). There were no significant differences in clinical or analytical factors between RR and AR patients. CONCLUSIONS: Low blood basophil count and the presence of hypothyroidism might serve as biomarkers for the controller dose of OMA in severe CSU patients.

Advanced wound healing in a patient with transmetatarsal amputation caused by severe diabetic foot infection: A case report.

Introduction and importance: Diabetic foot accounts for 50% to 95 % of non-traumatic amputations. The healing process of a surgical wound resulting from amputation in the diabetic foot is complex, and it is difficult to achieve an optimal outcome, which should include obtaining a functional stump for the patient. Healing is mainly hindered by infection, vascular disease, and wound size. In turn, biofilm formation significantly delays the healing process, increasing morbidity and impairing the amputee's quality of life. Case presentation: This study analyzes the case of an 80-year-old male patient with diabetes who had failed to respond to previous treatment on an infected wound from a transmetatarsal amputation. The new treatment involved spraying the wound with silver sulfadiazine, lidocaine, and vitamin A aerosol and covering it with gauze dressings soaked in silver sulfadiazine, lidocaine, and vitamin A. The case evolution indicators used were total wound area, percentage of granulation tissue, wound perimeter, and maximum distance between the wound edges. A 3D simulation was also used to assess the wound bed. Clinical Discussion: Biofilm is linked to slower wound healing and wound chronicity, as this community of microorganisms in the wound slows down healing even when there are no apparent signs of infection. Therefore, treatment should be geared toward preventing contamination from leading to biofilm formation. Conclusion: Our results show that silver sulfadiazine, lidocaine, vitamin A gauze dressings, and aerosol have promoted fast and effective healing in a diabetic patient with a wound at high risk of greater amputation.

Decoding clinical and molecular pathways of liver dysfunction in Psoriatic Arthritis: Impact of cumulative methotrexate doses.

BACKGROUND: The occurrence of liver abnormalities in Psoriatic Arthritis (PsA) has gained significant recognition. Identifying key factors at the clinical and molecular level can help to detect high-risk patients for non-alcoholic fatty liver disease in PsA. OBJECTIVES: to investigate the influence of PsA and cumulative doses of methotrexate on liver function through comprehensive in vivo and in vitro investigations. METHODS: A cross-sectional study involving 387 subjects was conducted, 200 patients with PsA, 87 NAFLD-non-PsA patients, and 100 healthy donors (HDs), age and sex-matched. Additionally, a retrospective longitudinal study was carried out, including 83 PsA patients since initiation with methotrexate. Detailed clinical, and laboratory parameters along with liver disease risk were analyzed. In vitro, experiments with hepatocyte cell line (HEPG2) were conducted. RESULTS: PsA patients present increased liver disease risk associated with the presence of cardiometabolic comorbidities, inflammatory markers, onychopathy, and psoriasis. The treatment with PsA serum on hepatocytes encompassed inflammatory, fibrotic, cell stress, and apoptotic processes. At the molecular level, methotrexate impacts liver biology, although the cumulative doses did not affect those alterations, causing any potential damage to liver function at the clinical level. Finally, anti-PDE-4 or anti-JAK decreased the inflammatory profile induced by PsA serum on hepatocytes. CONCLUSION: 1)This study identifies the complex link between liver disease risk, comorbidities, and disease-specific features in PsA patients. 2)Methotrexate dose in PsA patients had no significant effect on liver parameters, confirmed by hepatocyte in vitro studies. 3)Anti-PDE-4 and anti-JAK therapies show promise in reducing PsA serum-induced hepatocyte activation, potentially aiding liver complication management.

An effective method for culturing functional human corneal endothelial cells using a xenogeneic free culture medium.

Endothelial dysfunction is a leading cause of corneal blindness in developed countries and the only available treatment is the endothelial transplantation. However, the limited availability of suitable donors remains a significant challenge, driving the exploration of alternative regenerative therapies. Advanced Therapy Medicinal Products show promise but must adhere to strict regulations that prohibit the use of animal-derived substances. This study investigates a novel culture methodology using Plasma Rich in Growth Factors (PRGF) as the only source of growth factors for primary cultures of human corneal endothelial cells (CECs). CECs were obtained from discarded corneas or endothelial rings and cultured in two different media: one supplemented with xenogeneic factors and other xenogeneic-free, using PRGF. Comprehensive characterization through immunofluorescence, morphological analyses, trans-endothelial electrical resistance measurements, RNA-seq, and qPCR was conducted on the two groups. Results demonstrate that CECs cultured in the xenogeneic-free medium exhibit comparable gene expression, morphology, and functionality to those cultured in the xenogeneic medium. Notably, PRGF-expanded CECs share 46.9% of the gene expression profile with native endothelium and express all studied endothelial markers. In conclusion, PRGF provides an effective source of xenogeneic-free growth factors for the culture of CECs from discarded corneal tissue. Further studies will be necessary to demonstrate the applicability of these cultures to cell therapies that make clinical translation possible.

Sun exposure practices, attitudes and knowledge among students and teachers at a University School of Health Sciences in Ecuador.

Skin cancer incidence is increasing worldwide. Late adolescence and young adulthood are fundamental stages of life to acquire good sun exposure practices, regarding both personal involvement in skin cancer prevention and being a role model for others, especially in a health education environment. This descriptive cross-sectional study is based on the validated CHACES questionnaire to study sun exposure and photoprotection behavior among students and teachers at the School of Health Sciences in the National University of Chimborazo, Riobamba (Ecuador). University members (814 students (89.8 %) and 93 teachers (10.2 %)) were studied, with a predominance of females and light-skin phototypes in both groups. Similar results were obtained regarding sun exposure, with higher recreative exposure in the teachers' group and higher occupational exposure in students. However, students significantly showed lower avoiding midday sun (41.9 % vs 60.9 %), and lower use of sunglasses (10.1 % vs. 41.6 %). Attitudes towards the sun and photoprotection knowledge issues were also equivalent between students and teachers (6.1/10 vs 6.2/10). Students' sunburn rate last year reaches 88.4 % and 52.7 % in teachers (p < 0.001). Using a multivariable logistic regression model, we identified risk factors associated with a greater risk of sunburn in our population. This study highlights areas to be improved regarding knowledge, attitudes and, especially, practices of photoprotection, among students and teachers at the University of Chimborazo. These results point out that awareness-raising campaigns should be implemented to reduce sunburns, morbidity and mortality of skin cancer in this environment.

Economic evaluations of radioembolization with yttrium-90 microspheres in liver metastases of colorectal cancer: a systematic review.

BACKGROUND: Transarterial radioembolization with yttrium-90 (Y-90 TARE) microspheres therapy has demonstrated positive clinical benefits for the treatment of liver metastases from colorectal cancer (lmCRC). This study aims to conduct a systematic review of the available economic evaluations of Y-90 TARE for lmCRC. METHODS: English and Spanish publications were identified from PubMed, Embase, Cochrane, MEDES health technology assessment agencies, and scientific congress databases published up to May 2021. The inclusion criteria considered only economic evaluations; thus, other types of studies were excluded. Purchasing-power-parity exchange rates for the year 2020 ($US PPP) were applied for cost harmonisation. RESULTS: From 423 records screened, seven economic evaluations (2 cost-analyses [CA] and 5 cost-utility-analyses [CUA]) were included (6 European and 1 USA). All included studies (n = 7) were evaluated from a payer and the social perspective (n = 1). Included studies evaluated patients with unresectable liver-predominant metastases of CRC, refractory to chemotherapy (n = 6), or chemotherapy-naïve (n = 1). Y-90 TARE was compared to best supportive care (BSC) (n = 4), an association of folinic acid, fluorouracil and oxaliplatin (FOLFOX) (n = 1), and hepatic artery infusion (HAI) (n = 2). Y-90 TARE increased life-years gained (LYG) versus BSC (1.12 and 1.35 LYG) and versus HAI (0.37 LYG). Y-90 TARE increased the quality-adjusted-life-year (QALY) versus BSC (0.81 and 0.83 QALY) and versus HAI (0.35 QALY). When considering a lifetime horizon, Y-90 TARE reported incremental cost compared to BSC (range 19,225 to 25,320 $US PPP) and versus HAI (14,307 $US PPP). Y-90 TARE reported incremental cost-utility ratios (ICURs) between 23,875 $US PPP/QALY to 31,185 $US PPP/QALY. The probability of Y-90 TARE being cost-effective at £ 30,000/QALY threshold was between 56% and 57%. CONCLUSIONS: Our review highlights that Y-90 TARE could be a cost-effective therapy either as a monotherapy or when combined with systemic therapy for treating ImCRC. However, despite the current clinical evidence on Y-90 TARE in the treatment of ImCRC, the global economic evaluation reported for Y-90 TARE in ImCRC is limited (n = 7), therefore, we recommend future economic evaluations on Y-90 TARE versus alternative options in treating ImCRC from the societal perspective.

Technical Aspects of Using a Second Magnetic Grasper to Improve the Surgical Field in Single Port Revisional Bariatric Surgery.

BACKGROUND: The future of minimally invasive surgery in revisional surgery is experiencing changes with new equipment such as the magnetic assistance that can be used with single port devices in order to perform an incisionless surgery (Luengas R, Galindo J, Castro M, et al. Surg Obes Relat Dis. 2021;17(1):147-152). Magnetic assistance through an auxiliary grasper with two internal magnets serves beyond liver retraction in different steps of the surgery improving the surgical field by obtaining a better visualization and triangulation. PURPOSE: Expose the feasibility of using two internal magnetic graspers by single port performing a conversion surgery of sleeve gastrectomy (SG) to Roux-en-Y gastric bypass (RYGB). METHODS: A 36-year-old female patient underwent a SG in 2015 and consults in 2021 because of severe GERD with a 33-point GERD-HRQL score. She has preoperative evaluation for a conversion surgery from SG to RYGB. Using a single port device through the umbilicus, an additional 5 mm trocar was placed in the left side of the abdomen. Two internal magnets were introduced through the umbilicus, and they were controlled by two external magnets placed over the abdomen with an articulated arm. The first magnet was used for liver retraction and the second one to perform both anastomoses, close the intermesenteric and Petersen defect, acting as an auxiliary grasper. The ethical committee approval was obtained through an informed consent from the participant included in the study.

Communication skills training for medical residents: Enhancing a psychosocial approach of patient care.

OBJECTIVES: One of the issues that has increasingly become relevant to medical practice is the ability to communicate well with patients. Better communication results in better care for the patient, as well as greater satisfaction for the physician. For this reason, the aim of this study was to assess the efficacy of a communication skills training program for medical residents (MR). METHOD: Eighty-six MR underwent a 6-month training program in three phases: a 12-h theory and practice workshop, a period of real practice, and a 4-h workshop in which the most challenging scenarios were role played with an actress. In each phase (T0, T1, and T2), participants' beliefs about their competence in caring for patients' psychosocial aspects and their self-confidence in communication skills were assessed. RESULTS: No differences were found between T0 and T1 in participants' beliefs of self-competence in psychosocial care. However, this competence significantly improved after completion of the entire program. Only 7 of the 12 areas explored in communication skills significantly improved between T0 and T1. However, after T2 completion, significant improvements were observed in all 12 areas. SIGNIFICANCE OF RESULTS: The research results highlight the usefulness and importance of training young doctors to foster their psychosocial approach to patient care and improve their confidence in their own communication skills. The results also show the appropriateness of the structure of the training: the key features of the programme were the follow-up of the participants in three phases over 6 months, and a focus on the needs of the residents and the resolution of difficult clinical cases, with the support of an actress. Therefore, the training presented in this study may become a guide for other trainings in other contexts with similar objectives.

Abordaje quirúrgico inframamario en una paciente con un fibroadenoma gigante juvenil. A propósito de un caso y revisión de la bibliografía / Inframammary removal of giant juvenile fibroadenoma in an adolescent. Case report and review of the literature

Los tumores benignos más comunes de la mama son los fibroadenomas simples. Son tumores sólidos con tejido glandular y fibroso. Aquellos que presentan un tamaño mayor de 5cm se denominan fibroadenomas gigantes. Estos pueden presentar un rápido crecimiento, por lo que se debe realizar un diagnóstico diferencial con el tumor phyllodes u otras enfermedades mamarias.Presentamos el caso de una paciente de 15 años con un fibroadenoma que comenzó con asimetría mamaria y precisó tratamiento quirúrgico mediante abordaje inframamario y enucleación de la masa, con buen resultado estético posterior. Revisamos la bibliografía al respecto.(AU)

Simple fibroadenomas are the most frequent benign tumours of the breast. They are solid tumours with glandular and fibrous tissue. They can present as a mass greater than 5cm, called giant fibroadenomas. The presentation of a rapidly growing mass cannot be easily distinguished from phyllodes tumour or other pathologies.We report the case of juvenile fibroadenoma of the breast in a 15-year-old woman who presented at our hospital with breast asymmetry. She underwent fibroadenoma excision, using inframammary access with good cosmetic outcomes. A detailed literature search and management of these lesions are discussed.(AU)

Economic evaluations of radioembolization with Itrium-90 microspheres in hepatocellular carcinoma: a systematic review.

BACKGROUND: Transarterial radioembolization (TARE) with yttrium-90 microspheres is a clinically effective therapy for hepatocellular carcinoma (HCC) treatment. This study aimed to perform a systematic review of the available economic evaluations of TARE for the treatment of HCC. METHODS: The Preferred Reported Items for Systematic reviews and Meta-Analyses guidelines was followed by applying a search strategy across six databases. All studies identified as economic evaluations with TARE for HCC treatment in English or Spanish language were considered. Costs were adjusted using the 2020 US dollars based on purchasing-power-parity ($US PPP). RESULTS: Among 423 records screened, 20 studies (6 cost-analyses, 3 budget-impact-analyses, 2 cost-effectiveness-analyses, 8 cost-utility-analyses, and 1 cost-minimization analysis) met the pre-defined criteria for inclusion. Thirteen studies were published from the European perspective, six from the United States, and one from the Canadian perspectives. The assessed populations included early- (n = 4), and intermediate-advanced-stages patients (n = 15). Included studies were evaluated from a payer perspective (n = 20) and included both payer and social perspective (n = 2). TARE was compared with transarterial chemoembolization (TACE) in nine studies or sorafenib (n = 11). The life-years gained (LYG) differed by comparator: TARE versus TACE (range: 1.3 to 3.1), and TARE versus sorafenib (range: 1.1 to 2.53). Of the 20 studies, TARE was associated with lower treatment costs in ten studies. The cost of TARE treatment varied widely according to Barcelona Clinic Liver Cancer (BCLC) staging system and ranged from 1311 $US PPP/month (BCLC-A) to 71,890 $US PPP/5-years time horizon (BCLC-C). The incremental cost-utility ratio for TARE versus TACE resulted in a 17,397 $US PPP/Quality-adjusted-Life-Years (QALY), and for TARE versus sorafenib ranged from dominant (more effectiveness and lower cost) to 3363 $US PPP/QALY. CONCLUSIONS: Economic evaluations of TARE for HCC treatment are heterogeneous. Overall, TARE is a cost-effective short- and long-term therapy for the treatment of intermediate-advanced HCC.

The second Mexican consensus on hepatocellular carcinoma. Part II: Treatment.

Hepatocellular carcinoma (HCC) is more frequently manifesting as one of the main complications of cirrhosis of the liver, its principal risk factor. There have been modifications in its incidence over the past decade, related to an epidemiologic transition in the etiology of cirrhosis, with a decrease in the prevalence of hepatitis C and an increase in nonalcoholic fatty liver disease (NAFLD) as a cause, as well as the development of HCC in the non-cirrhotic liver due to NAFLD. Genetic markers associated with the disease have been identified, and surveillance and diagnosis have improved. Regarding treatment, surgical techniques, in both resection and transplantation, have advanced and radiologic techniques, at the curative stage of the disease, have enhanced survival in those patients. And finally, there have been radical changes in the systemic approach, with much more optimistic expectations, when compared with the options available a decade ago. Therefore, the Asociación Mexicana de Hepatología decided to carry out the Second Mexican Consensus on Hepatocellular Carcinoma, which is an updated review of the available national and international evidence on the epidemiology, risk factors, surveillance, diagnosis, and treatment of the disease, to offer the Mexican physician current information on the different topics regarding hepatocellular carcinoma. In this second part of the document, the topics related to the treatment of HCC are presented.

Percepción de los pacientes sobre la atención sanitaria recibida durante la pandemia por COVID-19. Parte I / Patients' perceptions of the health care received during the COVID-19 pandemic. Part I

JUSTIFICACIÓN: Desde la declaración mundial de pandemia (marzo-2020) la mayoría de las consultas médicas en España abandonaron la presencialidad y fueron sustituidas por la telemedicina. Después de 1 año, SEFAC considera necesario realizar una encuesta a pacientes para valorar si han tenido problemas de acceso a los centros de salud (CS) y/o a las especialidades (CE) y a la farmacia comunitaria (FC),OBJETIVOS: saber si los pacientes han tenido problemas de acceso a los CS y/o a las CE y a la FC durante la pandemia.METODOLOGÍA: estudio descriptivo, retrospectivo, de corte transversal y multicéntrico realizado en farmacias comunitarias de todo el territorio nacional durante un mes, del 7 de abril al 7 de mayo de 2021. La representatividad se ha intentado conseguir con un número de 2900 encuestas, estimando una pérdida de un 20%. Se ha realizado la encuesta apacientes ≥ 18 años que han acudido a la farmacia comunitaria a retirar su medicación crónica o aguda y accedido a participar. Se les ha realizado la encuesta de 23 preguntas y pasado las respuestas a un soporte digital. Para el m análisis de los datos se ha utilizado el programa estadístico SPSS® 22.0 para Windows®.RESULTADOS: de los 1512 pacientes encuestados, El 50,60% afirma que le ha resultado muy difícil contactar con el CS cuando lo ha necesitado y un 10,85% dice no haberlo logrado. En cambio, el 92,92% no ha tenido dificultad de acceso a la FC. (AU)

Percepción de los pacientes sobre la atención sanitaria recibida durante la pandemia por COVID-19. Parte II / Patients' perceptions of the health care received during the COVID-19 pandemic. Part II

JUSTIFICACIÓN: desde la declaración mundial de pandemia (marzo-2020) la mayoría de las consultas médicas en España abandonaron la presencialidad y fueron sustituidas por la telemedicina. Después de 1 año, SEFAC considera necesario realizar una encuesta a pacientes para valorar si han tenido problemas de acceso a los centros de salud (CS) y/o a las especialidades (CE) y a la farmacia comunitaria (FC) OBJETIVOS: conocer si han tenido problemas de acceso a los tratamientos y al seguimiento de su enfermedad durante la época de pandemia. Conocer las actuaciones realizadas en la FC durante la pandemia. METODOLOGÍA: Estudio descriptivo, retrospectivo, de corte transversal y multicéntrico realizado en farmacias comunitarias de todo el territorio nacional durante un mes, del 7 de abril al 7 de mayo de 2021. Se ha realizado la encuesta a pacientes ≥ 18 años que han acudido a la farmacia comunitaria a retirar su medicación a participar. Se les ha realizado la encuesta de 23 preguntas y pasado las respuestas a un soporte digital. Para el análisis de los datos se ha utilizado el programa estadístico SPSS® 22.0 para Windows® RESULTADOS: de las 1512 encuestas válidas, el 32,74% afirma haber tenido problemas para renovar su tratamiento y el 56,94% haber necesitado adelanto de medicación para cumplir con el tratamiento. El 25,72% dijo haber tenido problemas para que les realizasen en el centro de salud los controles habituales de presión arterial, el 17,12% para que les realizaran analíticas de glucosa/colesterol y el 3,04% para que le realizaran control de INR en el CS. El 33,53% de los pacientes dijeron haber acudido a medirse la presión arterial a la FC, un 13,42% lo hizo a comprobarse la glucosa o el colesterol y un 1,05% a controlarse el INR. El 19,92% de los encuestados refiere haber recibido atención farmacéutica domiciliaria (AFD). (AU)

Descripción de la herramienta de sobreuso de salbutamol en SEFAC e_XPERT / Description of the salbutamol overuse tool in SEFAC e_XPERT

JUSTIFICACIÓN: La evidencia actual sugiere que el sobreuso de agonistas ß2 de corta duración (SABAs) no solo podría ser uno de los responsables directos de los altos porcentajes de asma no controlado existente en nuestro país sino también de la mortalidad causada por el asma. Este fenómeno no solo se explica por sus efectos directos sino por ser usados de forma reiterada y abusiva como substitutos del uso regular de los Corticoides Inhalados (ICS) en combinación o no con ß2 agonistas de larga duración (LABAs). Los farmacéuticos comunitarios (FC) por su cercanía, accesibilidad y formación están especialmente posicionados para ayudar a otros profesionales sanitarios a identificar pacientes asmáticos mal controlados o en riesgo de estarlo ofreciéndoles educación sanitaria y derivándolos a la consulta médica en los casos que sea necesario. Este aspecto adquiere especial relevancia en la detección de abuso o sobreuso de SABAs que además suele venir acompañado de una baja adherencia al tratamiento antinflamatorio de mantenimiento.OBJETIVOS: descripción de la herramienta de sobreuso de Saba desarrollada en SEFAC e_XPERT.MATERIAL Y MÉTODOS: la herramienta de Sobreuso de SABA desarrollada en SEFAC e_XPERT se encuentra disponible en la página web https://www.sefacexpert.org/a/registry-campaign-workplace/1 y dispone de diferentes tests para llevar a cabo como la Regla del Asma, el Test de Adhesión a los Inhaladores (TAI), y el Test de Control del Asma (ACT), para evaluar el uso excesivo de SABA, el manejo de los dispositivos de inhalación y el control de la patología asmática. (AU)

Registro de farmacéuticos comunitarios capacitados para vacunar frente a la COVID-19 / Register of Community Pharmacists Trained to Vaccinate against COVID-19

JUSTIFICACIÓN: el principal objetivo de la vacunación es prevenir la enfermedad y disminuir su gravedad y mortalidad. Con la aparición de las vacunas frente a la COVID-19, el gobierno español en diciembre de 2020 se marcó como objetivo alcanzar una cobertura vacunal mínima del 70% en la población antes del verano de 2021. Los farmacéuticos comunitarios (FC) han colaborado con las autoridades sanitarias en la vacunación, en numerosos países europeos.OBJETIVOS: colaborar con las administraciones sanitarias en la vacunación de la población española frente a la COVID-19. Formar al farmacéutico comunitario para vacunar frente a la COVID-19.METODOLOGÍA: ofrecer a las autoridades sanitarias un registro voluntario de FC capacitados para vacunar a la población contra la COVID-19. Para ello realizamos las siguientes acciones: 1-Diseñar en febrero de 2021 un curso de formación acreditado sobre vacunación frente a la COVID-19 para los FC y ofrecérselo gratuitamente a socios y simpatizantes de sefac, así como a los colegios de farmacéuticos españoles. 2-Invitar a los FC que superaban el curso de formación a inscribirse en un registro voluntario de FC dispuestos a vacunar de forma altruista fuera de las farmacias comunitarias en aquellos lugares que las autoridades sanitarias lo requiriesen. 3-Ofrecer a las autoridades sanitarias de las 17 Comunidades Autónomas (CCAA) españolas en coordinación con los COFS correspondientes el registro de FC dispuestos a vacunar.4-Informar de esta iniciativa a los medios de comunicación, el 16 de julio de 2021, a través una nota de prensa.RESULTADOS: se matricularon en el curso 1.700 FC, y lo terminaron y superaron 1.100 (64,7%). De ellos, 1.000 (90,9%) se inscribieron en el registro de FC dispuestos a vacunar. Ninguna de las 17 CCAA a las que se les ofreció el registro aceptó el ofrecimiento. (AU)

Jornadas SEFAC 2021. Farmacéuticos comunitarios: sanitarios, clínicos y asistenciales / SEFAC 2021 Conference. Community pharmacists: health, clinical and care pharmacists

INTRODUCCIÓN: desde 2013 se celebran bienalmente las Jornadas SEFAC como foro de encuentro para que farmacéuticos comunitarios (FC) actualicen sus conocimientos y los nuevos retos profesionales.OBJETIVOS: actualizar los conocimientos científicos del FC . Debatir sobre los retos profesionales del colectivo. Reunir presencialmente a los FC tras 9 meses de pandemia sin contacto. Facilitar la detección de bulos sobre medicamentos. Aumentar los socios de sefacMETODOLOGÍA: Se realizaron 15 jornadas acreditadas en Valladolid, Oviedo, Santiago, Barcelona, Badajoz, Alicante, Madrid, Santander, Palma de Mallorca, Murcia, Zaragoza, Bilbao, Ciudad Real, Las Palmas y Córdoba entre el 18 de septiembre y el 1 de diciembre de 2021 bajo el lema Farmacéuticos comunitarios: sanitarios, clínicos y asistenciales. El programa de 6 horas de duración constó de 3 talleres (en cada uno se podía elegir entre dos temáticas), dos mesas redondas y un escape room. Las jornadas se estructuraron en dos bloques horarios (mañana o tarde) idénticos que compartían las dos mesas redondas, para facilitar y compatibilizar la asistencia del FC con la jornada laboral. RESULTADOS: asistieron 2.036 FC (87,4% de los inscritos), 73,7% fueron mujeres. Con respecto al tipo de ejercicio profesional un 15,5% eran farmacéuticos adjuntos, un 29,67% titulares, el 1,62% sustitutos y 52,80% otros. El 50,3% fueron socios de SEFAC (19,7% de todos los socios de sefac). El 53% de los FC acudió por la mañana, el 37% por la tarde y el resto la jornada completa. Se realizaron 48 nuevos socios. (AU)