O uso da homeopatia em TDAH: relato de caso / The use of homeopathy in ADHD: case report

Esse trabalho apresenta um relato de caso de uma criança com diagnóstico de Transtorno de Déficit de Atenção e Hiperatividade (TDAH) e intervenção com homeopatia. O objetivo é verificar eficácia da homeopatia para o TDAH. Concluiu-se que a intervenção com homeopatia apresentou resultados significativos no tratamento deste caso, como aumento da atenção e do rendimento escolar, diminuição dos comportamentos impulsivos, trazendo consequências positivas para o indivíduo e o seu relacionamento familiar.

This works presents a case report of a child diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and intervention with homeopathy. The objective is to verify the effectiveness of homeopathy for ADHD. It was concluded that the intervention with homeopathy showed significant results in the treatment of this case, such as increased attention and school performance, decreased impulsive behavior, bringing positive consequences for the individual and his family relationship.

A fresh look at the concept of Genus Epidemicus: findings from the Clificol Project

The Clificol® COVID-19 Support Project is an innovative international data collection project aimed at tackling some of the core questions in homeopathy, including the notion of Genus Epidemicus. Aims:To shed some light on the notion of Genus Epidemicus in the context of this infection. Going beyond that, the project aims to use these data to tackle more fundamental questions, such as the role of symptoms and rubrics in treatment individualisation. Methodology:This online multi-national data-collection project is supported by the ECH, ECCH, ICH, HRI, LMHI, and other professional associations. The collected data includes demographic information, severity, conventional diagnosis and treatment, presenting symptoms as well as the remedies prescribed. The outcome of treatment was tracked using the ORIDL scale. The concept of Genus Epidemicus, including the role of treatment individualisation, was investigated by analysing whether presenting symptoms cluster into distinct groups (K-Means clustering approach). The symptom data originating from China was obtained using a questionnaire. Results and discussion: 20 Chinese practioners collected 359 cases, primarily in the first half of 2020 (766 consultations, 363 prescriptions). The cluster analysis found two to be the optimum number of clusters. These two symptomatic clusters had a high overlap with the two most commonly prescribed remedies in that population: In cluster 1 there were 297 prescriptions, 95.6% of which were Gelsemium sempervirens, incluster 2, there were 61 prescriptions, 95.1% of which were Bryonia alba. Under the assumption of a single genus epidemicuswe would expect to see a single cluster of symptoms. The data from the Chinese population were not compatible with this assumption. Conclusion:This was the first study that investigated the notion of Genus Epidemicus by using modern statistical techniques. These analyses identified at least two distinct symptom pictures. The notion of a single COVID-19 Genus Epidemicus did not apply to this population.

Homeopatia: opção terapêutica no tratamento de infecções de vias aéreas superiores em pediatria

As infecções de vias aéreas superiores são quadro comum e recorrente em pediatria, sendo comum o uso de antibióticos mesmo em quadros de origem viral, e havendo poucas opções terapêuticas para tratamento efetivo. Esse trabalho apresenta as principais infecções de vias aéreas superiores em pediatria, avaliando o tratamento alopático convencional e discutindo possibilidades de tratamento homeopático. Através de revisão narrativa de literatura, apresenta os medicamentos homeopáticos mais utilizados, discutindo a Matéria Médica dos mesmos com suas principais características e indicações nas afecções citadas.(AU)

Upper respiratory tract infections are common and recurrent in pediatrics, and the use of antibiotics is common even in cases of viral origin, with few therapeutic options for effective treatment. This paper presents the main upper respiratory tract infections in pediatrics, evaluating conventional allopathic treatment and discussing possibilities of homeopathic treatment. Through a narrative literature review, it presents the most commonly used homeopathic medicines, discussing their Materia Medica with their main characteristics and indications in the ailments cited.(AU)

Principios filosóficos de la homeopatía / Philosophical principles of homeopathy

De una manera clara, directa y muy didáctica, los autores de este trabajo realizan un recorrido por los principios que configuran la estructura de la filosofía homeopática, rescatando muchos de los conceptos inscritos en algunas de las obras literarias del célebre Higinio G. Pérez, fundador de la Escuela Libre de Homeopatía, y del fisiólogo norteamericano Walter Bradford Cannon, los cuales, por supuesto, son coincidentes con muchos de los preceptos hipocráticos y hahnemaniannos. Para complementar su análisis, los investigadores refieren las opiniones de algunos otros científicos (fisiólogos y biólogos) y citan de manera textual diversos parágrafos del doctor Samuel Hahnemann, al tiempo que expresan su opinión sobre la vigencia de dichas premisas en la época moderna...

In a clear direct and very didactic manner the authors of this paper perform a journey by the principles that configure the philosophical structure of homeopathy, recovering many of the concepts written in various of the literary works of the notorious physician Higinio G. Pérez, founder of the Homeopathic Free Scholl and from the north American physiologist Walter Bradford Cannon, which of course, are coincidental with most of the Hippocratic an Hanemanniann precepts. In order to complete their analysis, these researchers refer the opinions of some other scientists (Physiologist and Biologists) and quoted verbatim various paragraphs of Dr. Samuel Hahnemann, at the same time, that they state their personal opinion on the validity of these assumptions in modern times...

Principios filosóficos de la homeopatía / Philosophical principles of homeopathy

De una manera clara, directa y muy didáctica, los autores de este trabajo realizan un recorrido por los principios que configuran la estructura de la filosofía homeopática, rescatando muchos de los conceptos inscritos en algunas de las obras literarias del célebre Higinio G. Pérez, fundador de la Escuela Libre de Homeopatía, y del fisiólogo norteamericano Walter Bradford Cannon, los cuales, por supuesto, son coincidentes con muchos de los preceptos hipocráticos y hahnemaniannos. Para complementar su análisis, los investigadores refieren las opiniones de algunos otros científicos (fisiólogos y biólogos) y citan de manera textual diversos parágrafos del doctor Samuel Hahnemann, al tiempo que expresan su opinión sobre la vigencia de dichas premisas en la época moderna. (AU)

In a clear direct and very didactic manner the authors of this paper perform a journey by the principles that configure the philosophical structure of homeopathy, recovering many of the concepts written in various of the literary works of the notorious physician Higinio G. Pérez, founder of the Homeopathic Free Scholl and from the north American physiologist Walter Bradford Cannon, which of course, are coincidental with most of the Hippocratic an Hanemanniann precepts. In order to complete their analysis, these researchers refer the opinions of some other scientists (Physiologist and Biologists) and quoted verbatim various paragraphs of Dr. Samuel Hahnemann, at the same time, that they state their personal opinion on the validity of these assumptions in modern times. (AU)

Health literacy in the pharmacy setting: defining pharmacotherapy literacy / Alfabetismo en salud en el entorno de la farmacia: definiendo el alfabetismo en farmacoterapia

Objective: All currently available definitions of health literacy may be considered quite general. Given the complex nature of the patient-pharmacy encounter and the varying tasks required to properly and successfully consume or administer medication or to adhere to a pharmaceutical care regimen, these available definitions may describe inadequately a patient's health literacy for the purpose of pharmacotherapy and pharmacist intervention. Therefore, the objective of this research was to conceptualize the Pharmacotherapy Literacy construct. Methods: Licensed pharmacists (n=2,368) were mailed a questionnaire providing them with the Healthy People 2010 definition of health literacy and asked, «Given this definition, how would you define Pharmacotherapy Literacy?». A total of 420 usable surveys were returned of which 176 (42%) included responses to the open-ended question concerning pharmacotherapy literacy. Responses were reviewed independently and collectively by the authors. Common themes were identified, compared and discussed until consensus was reached. An initial definition was formulated and distributed to six doctoral-trained academicians and practicing pharmacists who were asked to offer their opinions of the definition as well as suggestions for its improvement. The definition was modified and subjected to further review from 15 additional doctoral-trained academicians and practicing pharmacists who provided feedback concerning its improvement.Results: Based on the recommendations received from the academicians and pharmacists, the following, definition was formulated by the authors: Pharmacotherapy Literacy - An individual's capacity to obtain, evaluate, calculate, and comprehend basic information about pharmacotherapy and pharmacy related services necessary to make appropriate medication-related decisions, regardless of the mode of content delivery (e.g. written, oral, visual images and symbols). Conclusions: As the ever-changing pharmacy environment continues to advance and become more complex in nature, a definition of health literacy specific to the pharmacy setting-thereby providing a name and a focus-may improve medication consumption, medication safety, and the patient-pharmacist relationship (AU)

Objetivo: Todas las definiciones actualmente disponibles de alfabetismo en salud (literacia en salud) pueden considerarse bastante generales. Dada la naturaleza compleja del encuentro farmacéutico-paciente, y las diversas tareas necesarias para consumir o administrar medicamentos con éxito y para cumplir con los regímenes terapéuticos, estas definiciones disponibles pueden describir inadecuadamente la literacia en salud de un paciente con el propósito de la intervención farmacéutica en farmacoterapia. Por tanto, el objetivo de esta investigación fue conceptualizar el constructo del alfabetismo en farmacoterapia. Métodos: Se envió por correo un cuestionario a farmacéuticos en ejercicio (n=2,368) proporcionándoles la definición de alfabetismo en salud del Healthy People 2010 y se les preguntó «Dada esta definición, cómo definiría el alfabetismo en farmacoterapia?». Se recibieron un total de 420 cuestionarios utilizables, de los que 176 (42%) incluían respuestas a la pregunta abierta relativa al alfabetismo en farmacoterapia. Las respuestas fueron revisadas independiente y colectivamente por los autores. Se identificaron los temas comunes, y se compararon y discutieron hasta que se llegó a un consenso. Se formuló una definición inicial y se distribuyó a seis académicos doctorados que ejercen en farmacia a los que se les pidió que dieran sus opiniones sobre la definición e hiciesen sugerencias para su mejora. La definición fue modificada y sometida a nueva revisión de otros 15 académicos doctorados y ejercientes en farmacia que proporcionaron un retorno en relación a la mejora. Resultados: Basados en las recomendaciones recibidas de los académicos y de los farmacéuticos, los autores formularon la siguiente definición: Alfabetismo en farmacoterapia (literacia en farmacoterapia) - La capacidad individual de obtener, evaluar, calcular y comprender información básica sobre farmacoterapia y servicios relacionados con farmacia necesarios para tomar decisiones apropiadas relativas a medicamentos, independientemente del modo en que se recibe el contenido (p.e. escrito, oral, imágenes visuales, y símbolos). Conclusiones: Como el entorno siempre cambiante de la farmacia continúa a avanzar y hacerse más complejo, una definición de alfabetismo en salud específica para el medio farmacéutico- por tanto, que proporcione un nombre y un foco - puede mejorar el consumo de medicación, la seguridad de los medicamentos y la relación pacientefarmacéutico (AU)

La depresión como factor de riesgo cardiovascular en la vejez / Depression as a Cardiovascular Risk Factor in Old Age

Se realiza una revisión de trabajos sobre la comorbilidad entre la depresión y el factor de riesgo cardiovascular en la vejez. Se considera la importancia del diagnóstico de depresión en la vejez que suele subdiagnosticarse con los riesgos pertinentes, entre ellos la elevada morbimortalidad cardiovascular, con el objetivo de realizar un tratamiento adecuado de ambas patologías. Se evalúan los factores de riesgo, genéticos, personalidad, la sintomatología semejante de la depresión geriátrica con enfermedades médicas, la comorbilidad, sus mecanismos fisiopatológicos, neuroendócrinos, activación plaquetaria, hipercoagulabilidad, inflamatorios, citoquinas, disfunción endotelial.Se presentan estudios controlados psicofarmacológicos para poder realizar una adecuada elección del antidepresivo teniendo en cuenta la polifarmacia frecuente en este grupo etario y las posibles interacciones. Así mismo, la declaración de la Asociación Psiquiátrica Europea (EPA), con el apoyo de la Asociación Europea para el Estudio de la Diabetes (EASD) y la Sociedad Europea de Cardiología (ESC) para el cuidado interdisciplinario del enfermo psiquiátrico.

A review of studies on the comorbility between depression and cardiovascular risk factor in old age. We consider the magnitude of diagnosis of depression in old age often sub-diagnosed with the relevant risks, including the high cardiovascular morbidity and mortality in order to make appropriate treatment of both pathologies. We evaluated risk factores, genetic, personality, similar symptoms of geriatric depression with medical illness, comorbidity, pathophysiologic mechanisms, neuroendocrine, platelet activation, hypercoagulability, inflamatory cytokines, and endothelial dysfunction. Psychopharmacological controlled studies are presented to perform an adquate antidepressant choice considering the frequent polypharmacy and possible interactions in this age group. Likewise the statement of the European Psychaitric Association (EPA), with support from The European Assocation for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC) for interdisciplinary care of psychiatric patient.

Línea estratégica 4: Optimización del tratamiento individualizado / No disponible

No disponible

Línea estratégica 4: Optimización del tratamiento individualizado / No disponible

No disponible

La problemática de la protección de las invenciones farmacéuticas en los acuerdos internacionales de libre comercio / The problem of protection of pharmaceutical inventions in free trade agreements

El medicamento no es una simple mercancía, ya que su objetivo no es otro que prevenir, aliviar o curar enfermedades en la población y su comercialización responde a intereses sanitarios de protección de la salud. Sin embargo, el acceso a los medicamentos debe compatibilizarse con la promoción de la innovación y desarrollo de otros nuevos que completen el actual arsenal terapéutico, sin olvidar el fin económico de las industrias productoras. Para que esto sea posible el sistema de protección jurídica de las invenciones a través de la patente se aplica en la actualidad al sector farmacéutico, a la cual se le ha dado forma a lo largo de los años, y logra su mayor relevancia a nivel internacional en el Acuerdo sobre los Aspectos de los derechos de propiedad intelectual relacionados con el comercio (ADPIC) firmado por la Organización Mundial de Comercio. El objetivo del trabajo es analizar el sistema Europeo de protección de las invenciones a través de la patente, examinando los distintos sistemas de protección, tanto a nivel internacional: ADPIC y UE; como nacional (España)(AU)

The drug is not a commodity, because its objective is to prevent, alleviate or cure diseases in the population and its marketing meets health interests of health protection. However, access to medicines must be reconciled with the promotion of innovation and development of new ones that complement the current armamentarium, not to mention the economic purpose of producing industries. To make this possible the system of legal protection of inventions through the patent is now applied to the pharmaceutical sector, which has been shaped over the years and achieved the most important international the Agreement on Trade-Related Intellectual Property Rights Trade Related Property Rights (TRIPS) signed by the World Trade Organization. The study aims to analyze the European system of protection of inventions through the patent, examining the different systems of protection, both internationally: TRIPS and EU and national (Spain)(AU)

Risk factors of self-reported adverse drug events among Medicare enrollees before and after Medicare Part D / Factores de riesgo de eventos adversas medicamentosos autoreportados entre asegurados en Medicare antes y después de Medicare Part D

Objectives: Quantify risk factors for self-reported adverse drug events (ADEs) after the implementation of Medicare Part D, quantify self-reported ADEs before and after Medicare Part D and quantify the association between self-reported ADEs and increased use of prescription medication. Methods: The design was a longitudinal study including an internet survey before Medicare Part D in 2005 (n=1220) and a follow-up survey in 2007 (n=1024), with n=436 responding to both surveys. Harris Interactive® invited individuals in their online panel to participate in this study. Individuals who were 65 or older, English speakers, US residents and enrolled in Medicare were included. Data collected and used in analysis included self-reported ADE, socio-demographics, self-rated health, number of medications, symptoms experienced, concern and necessity beliefs about medicines, number of pharmacies, and whether doses were skipped or stopped to save money. Results: In 2007, reporting an ADE was related to concern beliefs, symptoms experienced and age. ADEs were experienced by 18% of respondents in 2005 and 20.4% in 2007. The average number of medications increased from 3.82 (SD=2.82) in 2005 to 4.32 (SD=3.20) in 2007 (t= -5.77, p<0.001). Among respondents who answered both surveys (n=436), 18.4% reported an ADE in 2005 while 24.3% reported an ADE in 2007. The increase in self-reported ADE was related to concern beliefs (OR=1.12, 95%CI=1.05, 1.19) and symptoms experienced (OR= 3.27, 95%CI=1.60, 6.69), not number of medications (OR=1.04, 95%CI=0.77, 1.41). Conclusion: Discussing elderly patients' beliefs about their medicines may affect their medication expectations, symptom interpretation and attributions and future medication attributions (AU)

Objetivos: Cuantificar los factores de riesgo para eventos adversos medicamentosos (ADE) auto-reportados después de la implantación de Medicare Part D, cuantificar los ADE auto-reportados antes y después de Medicare Part D, y cuantificar la asociación entre ADE auto-reportados y el aumento del uso de medicamentos prescritos. Métodos: El diseño fue un estudio longitudinal incluyendo un cuestionario por internet antes de Medicare Part D en 2005 (n=1220) y una investigación de seguimiento en 2007 (n=1024), con n=436 que respondieron a los dos cuestionarios. Harris Interactive® invitó a individuos de su panel on-line a participar en este estudio. Se incluyó a individuos que tenían 65 o más 65 años, anglo-parlantes, residentes en USA y beneficiarios de Medicare. Los datos recogidos y utilizados en el análisis incluyeron los ADE auto-reportados, socio-demografía, salud auto-relatada, número de medicamentos, síntomas que sufrían, preocupaciones y creencia de la necesidad de medicinas, número de farmacias, y si se saltaban dosis o abandonaban para ahorrar dinero. Resultados: En 2007, las ADE comunicadas estaban relacionadas con creencias de problemas, síntomas manifestados y la edad. Los ADE fueron padecidos por un 18% de los respondentes en 2005 y 20,4% en 2007. La media de medicamentos aumentó de 3,82 (SD=2,82) en 2005 a 4,32 (SD=3,20) en 2007 (t= -5.77, p<0.001). Entre los respondentes que contestaron los dos cuestionarios (n=436), el 18,4% comunicó un ADE en 2005 mientras que el 24,3% comunicó un ADE en 2007. El aumento de ADE auto-reportados estaba relacionado con las creencias de problemas (OR=1.12, 95%CI=1.05, 1.19) y los síntomas manifestados (OR= 3.27, 95%CI=1.60, 6.69), pero no con el número de medicamentos (OR=1.04, 95%CI=0.77, 1.41). Conclusión: Discutir con los ancianos sus creencias sobre medicamentos puede afectar sus expectativas sobre su medicación, interpretación y atribuciones de síntomas, y futuras atribuciones de medicación (AU)

Nuevos horizontes en el tratamiento del fallo cardíaco / New horizons in the treatment of the cardiac failure

Varias investigaciones clínicas generan nuevos conocimientos acerca del tratamiento medicamentoso de la insuficiencia cardíaca. La Sociedad Americana de Insuficiencia Cardíaca (Heart Failure Society of América y el Colegio Americano de cardiólogos Sociedad Americana del corazón (American College of Cardiology-American Heart Association crearon las guías del 2005 y el 2006 respectivamente. Recientemente se han revisado varias investigaciones en base a la evidencia actual y resumida de los cambios propuestos por estas instituciones, basado en estos estudios las nuevas guías incluyen recomendaciones más amplias y fuertes como la terapia con betabloqueadores y recomendaciones para el uso de los bloqueadores del receptor de la angiotensina II. Los antagonistas de la aldosterona espironolactona y eplerenone, se incluyen también. Los farmacéuticos deben tener un nivel básico de conocimientos sobre las nuevas guías de insuficiencia cardíaca para desarrollar nuevas estrategias en el tratamiento de la insuficiencia cardiaca (AU)

Several clinical investigations generate new knowledges about the medicinal treatment of cardiac insufficiency. Heart Failure Society of America and the American College of Cardiologists- American Heart Association created the guides of the 2005 and the 2006 respectively. Recently have checked several investigations on the basis of current evidence and summarized the changes proposed by these institutions, based on these studies the new guides include more ample and strong recommendations like the beta-blockers therapy and recommendations for the use of the angiotensin II receptor blocker. Aldosterona's antagonists spironolactone and eplerenone, are also include. The pharmacists must have a basic level of knowledge on the new guides of cardiac insufficiency to develop new strategies in the heart failure treatment (AU)

Nuevos horizontes en el tratamiento del fallo cardíaco / New horizons in the treatment of the cardiac failure

Varias investigaciones clínicas generan nuevos conocimientos acerca del tratamiento medicamentoso de la insuficiencia cardíaca. La Sociedad Americana de Insuficiencia Cardíaca (Heart Failure Society of América y el Colegio Americano de cardiólogos Sociedad Americana del corazón (American College of Cardiology-American Heart Association crearon las guías del 2005 y el 2006 respectivamente. Recientemente se han revisado varias investigaciones en base a la evidencia actual y resumida de los cambios propuestos por estas instituciones, basado en estos estudios las nuevas guías incluyen recomendaciones más amplias y fuertes como la terapia con betabloqueadores y recomendaciones para el uso de los bloqueadores del receptor de la angiotensina II. Los antagonistas de la aldosterona espironolactona y eplerenone, se incluyen también. Los farmacéuticos deben tener un nivel básico de conocimientos sobre las nuevas guías de insuficiencia cardíaca para desarrollar nuevas estrategias en el tratamiento de la insuficiencia cardiaca.

Several clinical investigations generate new knowledges about the medicinal treatment of cardiac insufficiency. Heart Failure Society of America and the American College of Cardiologists- American Heart Association created the guides of the 2005 and the 2006 respectively. Recently have checked several investigations on the basis of current evidence and summarized the changes proposed by these institutions, based on these studies the new guides include more ample and strong recommendations like the beta-blockers therapy and recommendations for the use of the angiotensin II receptor blocker. Aldosterona's antagonists spironolactone and eplerenone, are also include. The pharmacists must have a basic level of knowledge on the new guides of cardiac insufficiency to develop new strategies in the heart failure treatment.

Fármacos diagnósticos, herramienta valiosa en la valoración optométrica de rutina / Diagnostic medicines: a valuable tool in optometric daily consultation

El objetivo de presentar este artículo, es retomar el tema de los medicamentos de uso diagnóstico, específicamente los ciclopléjicos, forma de acción farmacológica, tipos, efectos oculares, efectos no deseados, contraindicaciones.Todo con el ánimo de difundir más el uso de esta herramienta en la consulta diaria y en los casos que es mandatario, a partir del conocimiento y de una revisión extensa del tema.

The purpose of this article was to take again the topicof medicines of diagnostic use, mainly the cycloplegicmedicines, their pharmacologic action, types, oculareffects, undesirable effects, contraindications. Allof this with the intention of spreading more the useof this tool in daily consultation and in mandatorycases, from the knowledge and extensive review ofthe topic.

Homeopatia: prática médica coadjuvante / Homeopathy: coadjutant medical practice

Em vista do binômio saúde-doença da concepção homeopática abranger aspectos diversos da individualidade humana, a escolha do medicamento deve englobar as características psíquicas, emocionais, gerais e físicas do paciente. Neste processo de "individualização do medicamento", o entendimento da complexidade humana exige tempo e dedicação, encontrando a resposta satisfatória após um conjunto variável de atuações. Atuando de forma coadjuvante às demais práticas médicas, o médico homeopata deve ter consciência de que poderá suspender os medicamentos alopáticos necessários à manutenção da integridade do paciente tão somente quando tiver certeza da ação substitutiva do medicamento homeopático escolhido. Deste modo, estará cumprindo o aforismo hipocrático primo non nocere.(AU)

Considering that in the homeopathic conception, the binomial health-disease encompasses several aspects of human individuality, choice of the medication should include the patient's psychic, emotional, general and physical characteristics. In this process of "individualization of medication", understanding the human complexity demands time and dedication to finding the satisfactory reply after a variable number of attempts. Acting as coadjutant to other medical practices, the homeopath should be aware that he may only interrupt administration of the allopathic drugs necessary for maintenance of the patient's integrity when he is assured of the substitutive action of the homoeopathic medication chosen. This way, the Hippocratic aphorism primo non nocere will be fulfilled.

O pharmakon na interface do dispositivo analítico: a pathos na busca de sua verdade / Pharmacon in the interface of the analytical setting: pathos in search of its truth

O artigo é um convite à problematização da indicação do medicamento antidepressivo e, portanto, do diagnóstico e do papel do psiquiatra como o estranho-familiar no relação psicanalítica no tempo urgente da atualidade. Apresenta resumidamente as últimas contribuições sobre o diagnóstico abrangente, idiográfico, e utiliza duas vinhetas clínicas com a finalidade precípua de ilustrar o pathos antes e depois da utilização dos psicofárcamos(AU)

O pharmakon na interface do dispositivo analítico: a pathos na busca de sua verdade / Pharmacon in the interface of the analytical setting: pathos in search of its truth

O artigo é um convite à problematização da indicação do medicamento antidepressivo e, portanto, do diagnóstico e do papel do psiquiatra como o estranho-familiar no relação psicanalítica no tempo urgente da atualidade. Apresenta resumidamente as últimas contribuições sobre o diagnóstico abrangente, idiográfico, e utiliza duas vinhetas clínicas com a finalidade precípua de ilustrar o pathos antes e depois da utilização dos psicofárcamos.

Impacto de las actividades de uso racional del medicamento en médicos que nunca han recibido esta información / Impact of activities designed to improve the rational use of drugs on doctors who have never received the information before

Los médicos del Instituto Social de la Marina en España, a partir de enero de 2005, se incorporaron a trabajar para los sistemas de salud de la comunidad autónoma donde trabajaban, en el caso de Andalucía al Sistema Andaluz de Salud. Desde ese momento integraron en su trabajo los objetivos del nuevo sistema sanitario al que pertenecen, entre ellos el Uso Racional del Medicamento. El presente artículo explica la metodología seguida para difundir e inculcarles la importancia de una prescripción de calidad, siguiendo los indicadores establecidos por grupos de expertos. Tras catorce meses trabajando en su nueva plaza, se observa una disminución general del importe de un 9,77% y una mejora muy considerable en los indicadores cualitativos de prescripción, fundamentalmente en lo referente a la prescripción por principio activo, al empleo de omeprazol como antiulceroso y de simvastatina como hipolipemiante de elección

From January 2005 all doctors employed by the “Instituto Social de la Marina” in Spain were incorporated into the health services of the corresponding Autonomous Communities in which they worked: in the case of Andalousia, the “Sistema Andaluz de Salud”. Henceforward, they were required to assimilate all the objectives of the health system to which they now belonged, the Rational Use of Drugs included. This paper sets out the methodology employed to transmit the information and to highlight the importance of quality prescription in accordance with indicators established by groups of experts. After fourteen months in their new positions, an overall decrease in cost of 9.77% has been noted, along with a very appreciable improvement in quality prescription indicators, primarily with regard to active ingredient prescription, the use of Omeprazol in the treatment of ulcers and of Simvastatin as the drug of choice in the treatment of hyperlipidaemias

Especialidades farmacéuticas de diagnóstico hospitalario (DH) y de uso hospitalario (H) / Medicines for hospital diagnostic and hospital use

Se considera la aparición y evolución de los conceptos uso hospitalario y diagnóstico hospitalario aplicados a determinadas especialidades farmacéuticas, la escasa e incompleta normativa publicada y se sugiere la conveniencia de establecer una regulación concreta oficial y, al mismo tiempo, que se completen aspectos no suficientemente claros

It consider the apparition and the evolution of the concepts for hospital use and for hospital diagnostic, applied to medicines, the limited and insufficient norm publish and suggest the convenience to establish one official regulation and to complete aspects not intelligible