[Identifying improvement opportunities in the management of hepatitis C]. / Identificación de oportunidades de mejora del tratamiento de la hepatitis C.

OBJECTIVE: Hepatitis C represents a public health concern with more than 170 million carriers. The goal of this study was to identify improvement opportunities in the management of hepatitis C, and the pharmaceutical actions performed for the prevention and solution of medication-related problems in patients seen at the Pharmaceutical Care Outpatient Unit. METHOD: A longitudinal study (January to October 2005) with patients monoinfected by hepatitis C virus receiving ribavirin and peginterferon alfa (2a or 2b). Data collection took place during the interview at the time of antiviral dispensation. Adverse reactions were classified according to CTCEA v3.0 criteria. Iaser methodology was used to identify patients with improvement opportunities regarding treatment. RESULTS: In all 109 patients and 201 improvement opportunities were identified. Pharmacotherapeutic morbidity was identified from adverse events (blood toxicity, pseudoflu syndrome, etc.) in 425 occasions; 388 pharmaceutical actions were performed, 41.23% to prevent adverse effects and 39.95% to provide patients or carers with information. CONCLUSIONS: In all, 99.01% of patients had safety problems. Pharmacotherapeutic morbidity from adverse effects was less common than reported in clinical trials of these drugs. Most pharmaceutical actions were preventive in nature. Iaser methodology allows to identify patients with improvement opportunities regarding hepatitis C treatment and the prevention of pharmacotherapeutic morbidity.

Identificación de oportunidades de mejora del tratamiento de la hepatitis C / No disponible

Objetivo: El objetivo de este estudio es identificar las oportunidadesde mejora del tratamiento de la hepatitis C y las actuacionesfarmacéuticas realizadas para la prevención y resolución deproblemas relacionados con la medicación en los pacientes atendidosen la unidad de atención farmacéutica a pacientes externos.Método: Estudio longitudinal (enero a octubre de 2005) conpacientes monoinfectados por el virus de la hepatitis C en tratamientocon ribavirina y peginterferón alfa (2a o 2b). La recogidade datos se realizó durante la entrevista con el paciente en elmomento de la dispensación de los antivirales. Las reaccionesadversas se clasificaron según los criterios CTCEA v3.0. Para laidentificación de pacientes con oportunidades de mejora en sutratamiento se empleó la metodología Iaser®.Resultados: Se incluyeron 109 pacientes con 201 oportunidadesde mejora. Se identificó morbilidad farmacoterapéutica porefectos adversos (toxicidad hematológica, síndrome pseudogripal,etc.) en 425 ocasiones. Se realizaron 388 actuaciones farmacéuticas,el 41,23% para prevenir efectos adversos y el 39,95% paraproveer de información al paciente o cuidador.Conclusiones: El 99,01% de pacientes presentaba problemasde seguridad. La morbilidad farmacoterapéutica por efectosadversos es de menor frecuencia que la publicada en ensayos clínicoscon estos medicamentos. Las principales actuaciones farmacéuticasrealizadas fueron de tipo preventivo. La metodologíaIaser® permite la identificación de pacientes con oportunidades demejora del tratamiento de la hepatitis C y la prevención de morbilidadfarmacoterapéutica

Objective: Hepatitis C represents a public health concernwith more than 170 million carriers. The goal of this study was toidentify improvement opportunities in the management of hepatitisC, and the pharmaceutical actions performed for the preventionand solution of medication-related problems in patients seenat the Pharmaceutical Care Outpatient Unit.Method: A longitudinal study (January to October 2005) withpatients monoinfected by hepatitis C virus receiving ribavirin andpeginterferon alfa (2a or 2b). Data collection took place duringthe interview at the time of antiviral dispensation. Adverse reactionswere classified according to CTCEA v3.0 criteria. Iaser®methodology was used to identify patients with improvementopportunities regarding treatment.Results: In all 109 patients and 201 improvement opportunitieswere identified. Pharmacotherapeutic morbidity was identifiedfrom adverse events (blood toxicity, pseudoflu syndrome, etc.) in425 occasions; 388 pharmaceutical actions were performed,41.23% to prevent adverse effects and 39.95% to providepatients or carers with information.Conclusions: In all, 99.01% of patients had safety problems.Pharmacotherapeutic morbidity from adverse effects was lesscommon than reported in clinical trials of these drugs. Most pharmaceuticalactions were preventive in nature. Iaser® methodologyallows to identify patients with improvement opportunities regardinghepatitis C treatment and the prevention of pharmacotherapeuticmorbidity

[Herpes simplex 1 virus Mollaret meningitis]. / Meningitis de Mollaret por virus herpes simple 1.

Mollaret meningitis is a rare disease characterized by recurrent and self-limited episodes of aseptic meningitis. It is considered a disease with benign etiology and it has been related to viral infections: Epstein-Barr virus and herpes simplex virus (HSV), type 2 most frequently. Herpes simplex 1 virus has been rarely isolated in the cerebrospinal fluid in patients with Mollaret meningitis; to this end culture, expansion with PCR, and inmunoblot has been utilized. In this article a case of Mollaret meningitis related to type 1 HSV is described. The interest is the demonstration of the herpes simplex virus type 1 within the cytoplasm of the Mollaret cells with a immunohistochemical technique (ABC-peroxidase method) using monoclonal antibodies anti HSV-1 in order to support the diagnosis, being this the first case described in the literature.