Guía para el abordaje del paciente oncológico por el farmacéutico comunitario / Guide for the community pharmacist's approach to the oncology patient

INTRODUCCIÓN: el aumento del número de pacientes oncológicos, la aparición de nuevos fármacos orales, así como la cronicidad de algunos tratamientos, hacen necesario ofrecer desde la farmacia comunitaria, una atención integral al paciente oncológico y a sus familias.OBJETIVOS. Principal: Establecer pautas de actuación profesional a pacientes oncológicos y a sus familias por el farmacéutico comunitario (FC). Secundarios: 1. Elaborar una guía que incluya apartados relativos a la comunicación, psicología, derivación a los servicios de la Asociación Contra el Cáncer en Barcelona (ACCB) y revisión de los tratamientos oncológicos, que minimice sus efectos adversos, interacciones y mejore la adherencia al tratamiento. 2. Difundir la guía a los FC de Barcelona y resto de España.MATERIALES Y MÉTODOS: la edición de los contenidos se realizó conjuntamente por dos FC de SEFAC y un psicólogo de la ACCB, llevando la coordinación la Fundación Sefac, mediante reuniones telemáticas y revisiones en línea. Se analizaron las principales estrategias psicológicas y terapéuticas actualmente empleadas en la clínica, revisando diversas fuentes de información (artículos originales, bases de datos como Pubmed/Medline o Cochrane Plus, libros, guías de práctica clínica y cursos de formación editados por sociedades científicas, boletines terapéuticos y fichas técnicas de medicamentos) publicadas especialmente en los últimos 10 años.RESULTADOS: la Guía fue publicada en noviembre del 2021 y presentada en una sesión webinar a los socios de SEFAC. Se encuentra disponible gratuitamente para socios de SEFAC en la dirección: https://www.sefac.org/documentos-para-profesionales- publicaciones-sefac/proyecto-del-abordaje-del-paciente-oncologico-porConsta de dos bloques diferenciados: Bloque 1. Orientado al acompañamiento del paciente oncológico y familiares por el FC. (AU)

Implicación en Cataluña de los Servicios de Anestesiología y Reanimación en la pandemia por SARS-CoV-2. Una solución real coste-efectiva para una crisis sanitaria sin precedentes / Involvement in Catalonia of the Anaesthesiology and Resuscitation Services in the SARS-CoV-2 pandemic. A real, cost-effective solution to an unprecedented health crisis

No disponible

Modularity and Blended Methodology on Master Education for Donation and Transplantation.

Transplant Procurement Management and the University of Barcelona has offered a Master of Donation and Transplantation degree since 2004. The aim of this study is to analyze the number of participants, their profiles, and scores to evaluate improving measures introduced since 2011, when the modular structure was stablished. The data is organized in 3 groups: number of participants, profile, and scores in each module. The variables for the profile are gender, nationality, and background. According to the number of participants, 127 professionals were trained since 2011, with a decrease in the last classes (21; 20; 15). Regarding their profiles, from 2011 until 2016 the proportion of women was higher (63.13%). The background heterogeneity was an average of 4 different backgrounds in each edition, and medicine was most frequent background for students (58.27%). Participants were from 37 countries, mostly from the United States (45.6%) and Europe (40.9%). As for the scores, participants were evaluated in 4 modules (Donation, Transplantation, Management, and Tissue Banking), an internship, and a final master dissertation. The Donation module presented the lowest score (7.45/10) and the Transplantation module the highest (8.22/10). Considering that the main characteristics of the master's degree are the participants' internationality and heterogeneity, improvement measures must continue focusing on flexibility in the module selection and promoting the online modality.

Encuesta nacional sobre la tromboprofilaxis y el manejo de los anticoagulantes y antiagregantes en pacientes neuroquirúrgicos y neurocríticos / National survey on thromboprophylaxis and anticoagulant or antiplatelet management in neurosurgical and neurocritical patients

Objetivos. Conocer la práctica clínica de los anestesiólogos españoles en la tromboprofilaxis y el manejo de los anticoagulantes y antiagregantes en pacientes neuroquirúrgicos y neurocríticos. Material y métodos. Encuesta diseñada desde la Sección de Neurociencia de la Sociedad Española de Anestesiología y Reanimación, con 22 preguntas, difundida y contestada en formato electrónico, disponible entre junio y octubre de 2012. Resultados. De los 73 centros hospitalarios con servicio de Neurocirugía incluidos en el Catálogo Nacional de Hospitales, se recibió respuesta válida a la encuesta on line por parte de 41 anestesiólogos de 37 centros (tasa de respuesta del 50,7%). Se consideró una respuesta de cada centro. Solo el 27% de los centros respondedores disponían de un protocolo escrito específico para el manejo de estos pacientes. La tromboprofilaxis mecánica se utilizó hasta en un 80%, aunque de forma variable, y la farmacológica en un 75% de los centros. La enoxaparina fue la heparina de bajo peso molecular más utilizada en pacientes sometidos a craneotomía (78%). En la mitad de los centros respondedores se realizaron craneotomías manteniendo el tratamiento con ácido acetilsalicílico en los pacientes con antecedentes de cardiopatía isquémica, stent coronario y antiagregación dual. Conclusiones. La tromboprofilaxis mecánica es más utilizada que la farmacológica en la población neuroquirúrgica de nuestro país. El manejo de los pacientes tratados previamente con anticoagulantes presenta una marcada variabilidad clínica entre los diferentes hospitales, mientras que el tratamiento con antiagregantes se modifica en función de si se trata de profilaxis primaria o secundaria (AU)

Objectives. To determine the protocols used by Spanish anaesthesiologists for thromboprophylaxis and anticoagulant or antiplatelet drugs management in neurosurgical or neurocritical care patients. Material and methods. An online survey with 22 questions, with one or multiple options, launched by the Neuroscience Subcommittee of the Spanish Anaesthesia Society and available between June and October 2012. Results. Of the 73 hospitals included in the National Hospitals Catalogue, a valid response to the online questionnaire was received by 41 anaesthesiologists from 37 sites (response rate 50.7%). Only one response per site was used. A specific protocol was available in 27% of these centres. Mechanical thromboprophylaxis is used, intraoperatively or postoperatively, in 80%, and pharmacological treatment is used by 75% of respondents. Enoxaparin was the most frequent heparin used in craniotomy patients (78%). Craniotomies were performed maintaining acetylsalicylic acid treatment in patients with coronary stents and double anti-platelet treatment in a half of the centres. Conclusions. Mechanical thromboprophylaxis is used more frequently than the pharmacological approach in neurosurgical or neurocritical populations in Spanish hospitals. Management of patients under previous anticoagulant treatment was highly heterogeneous among hospitals included in this survey. Previous antiplatelet treatment is modified depending on primary or secondary prescription (AU)

National survey on thromboprophylaxis and anticoagulant or antiplatelet management in neurosurgical and neurocritical patients.

OBJECTIVES: To determine the protocols used by Spanish anaesthesiologists for thromboprophylaxis and anticoagulant or antiplatelet drugs management in neurosurgical or neurocritical care patients. MATERIAL AND METHODS: An online survey with 22 questions, with one or multiple options, launched by the Neuroscience Subcommittee of the Spanish Anaesthesia Society and available between June and October 2012. RESULTS: Of the 73 hospitals included in the National Hospitals Catalogue, a valid response to the online questionnaire was received by 41 anaesthesiologists from 37 sites (response rate 50.7%). Only one response per site was used. A specific protocol was available in 27% of these centres. Mechanical thromboprophylaxis is used, intraoperatively or postoperatively, in 80%, and pharmacological treatment is used by 75% of respondents. Enoxaparin was the most frequent heparin used in craniotomy patients (78%). Craniotomies were performed maintaining acetylsalicylic acid treatment in patients with coronary stents and double anti-platelet treatment in a half of the centres. CONCLUSIONS: Mechanical thromboprophylaxis is used more frequently than the pharmacological approach in neurosurgical or neurocritical populations in Spanish hospitals. Management of patients under previous anticoagulant treatment was highly heterogeneous among hospitals included in this survey. Previous antiplatelet treatment is modified depending on primary or secondary prescription.

Consideraciones y conducta neuroanestesiológica postoperatoria / Postoperative neuroanesthesiologic considerations and management

La cirugía de fosa posterior y/o región craneorraquídea presenta una elevada tasa de morbimortalidad postoperatoria, escasamente descrita en la literatura científica. El propósito de esta revisión es describir las evidencias disponibles en la bibliografía respecto a las complicaciones asociadas y su manejo neuroanestesiológico y/o neurocrítico; así como resaltar los factores predisponentes que pueden influir en el incremento de la tasa de complicaciones.El conocimiento de las complicaciones relacionadas con la patología neuroquirúrgica de la fosa posterior, puede ayudar a su prevención o a la instauración de un tratamiento adecuado que permita minimizar sus consecuencias. Con este objetivo, en las diferentes bases de datos bibliográficos se realizó una búsqueda sistemática, en castellano e inglés, con los artículos comprendidos entre 1966 y 2012. Además se revisaron los manuscritos que se consideraron relevantes en las pesquisas bibliográficas identificadas. La emesis y el dolor postoperatorio son las complicaciones postoperatorias más frecuentemente descritas, seguida por el edema de la lengua y/o vía aérea, la afectación de pares craneales y la aparición de fístula de líquido cefalorraquídeo durante el postoperatorio. El resto de complicaciones fueron referidas como poco frecuentes. La cirugía de fosa posterior y craneorraquídea cervical posterior tiene mayor morbilidad y mortalidad que la cirugía del compartimento supratentorial. Además de las complicaciones de toda craneotomía, la cirugía infratentorial presenta complicaciones específicas. El trabajo en equipo entre todas las especialidades y estamentos implicados en la atención al paciente es fundamental para disminuir la morbimortalidad asociada a estos procedimientos (AU)

Surgery of the posterior fossa and/or craniospinal region has a high rate of postoperative morbidity and mortality, which has rarely been described in the scientific literature. This review aims to describe the available evidence in the literature on the complications associated with this type of surgery and its neuroanesthesiological and/or neurocritical management, as well as to highlight the predisposing factors that can increase the complications rate. Knowledge of the complications related to neurosurgical disorders of the posterior fossa could aid in their prevention or help in the selection of appropriate treatment that would minimize their consequences. A systematic literature search was made in Spanish and English for articles published between 1966 and 2012 in various databases. Articles considered important in the identified literature were reviewed. The most frequently described postoperative complications were vomiting and postoperative pain, followed by edema of the tongue and/or airway, involvement of the cranial nerves, and the development of cerebrospinal fluid fistulas. The remaining complications were reported as being uncommon. Posterior fossa and posterior cervical surgery produces higher morbidity and mortality than surgery of the supratentorial space. In addition to the complications involved in all craniotomies, infratentorial surgery has specific complications. Team work among all the specialties and staff involved in the care of these patients is essential to reduce the morbidity and mortality associated with these procedures (AU)

Propuesta sobre las competencias en Anestesiología, Reanimación y Terapéutica del Dolor de un graduado de Medicina. Consenso del profesorado de las universidades de Cataluña / No disponible

No disponible

Combination therapy for erectile dysfunction: a randomized, double blind, unblinded active-controlled, cross-over study of the pharmacodynamics and safety of combined oral formulations of apomorphine hydrochloride, phentolamine mesylate and papaverine hydrochloride in men with moderate to severe erectile dysfunction.

Oral therapy has become first line treatment for patients with mild to moderate erectile dysfunction (ED). Studies have shown that sildenafil may not be effective in all patients, and has been associated with a variety of adverse effects and an adverse interaction with nitrates and inhibitors of cytochrome P450 enzymes. The objective was to compare the efficacy and safety of three different oral combinations with the highest dose of sildenafil in men with moderate to severe ED. Randomized, double blind, unblinded active-controlled, Phase II study was carried out at three sites in Mexico. After a 4-week placebo run-in period, patients received all four of the following treatments using a 4-way cross-over design: 40 mg phentolamine (PM) +6 mg apomorphine (Apo); 40 mg PM +150 mg papaverine (Pap); 40 mg PM +6 mg Apo +150 mg Pap (Tricombo); 100 mg sildenafil (SC). With the exception of sildenafil tablets, all study medication was blinded. Moderate to severe ED was defined as a less than 50% vaginal penetration success rate during the placebo run-in period. A total of 44 patients were enrolled, of whom 36 completed all four treatment periods. All treatments produced a significant effect in primary efficacy variable (Sexual Encounter Profile) compared to baseline, however, no statistically significant differences were found between treatments. A significant period effect was observed. Also, the four treatments were found not to differ significantly in five out of six secondary efficacy variables. The lowest incidence of treatment-related adverse events (AE) occurred in the 40 mg PM +6 mg Apo group (9.8%), followed by 100 mg SC (15%), and the other two combinations (16.7 and 17.5%, respectively). Nasocongestion and headache were the most frequently reported AE. An oral combination of vasoactive agents may provide an alternative approach to sildenafil. Based on these results a combination of phentolamine and apomorphine warrants further clinical investigation.

[First experiences in evaluating the clinical competence of family doctors in Catalonia]. / Primeras experiencias en evaluación de la competencia clínica de los médicos de familia de Catalunya.

OBJECTIVES: To construct a valid instrument to evaluate the clinical competence of family doctors and establish professional standards. DESIGN: Construction of an objective and structured clinical evaluation test by the Test Committee of the Catalan Society of Family and Community Medicine (SCMFiC) with 27 representative clinical situations of primary care practice. This used various evaluative instruments and lasted 5 hours and 30 minutes. SETTING: 2 Barcelona health districts for the two runnings of the test. PARTICIPANTS: Family doctors, SCMFiC members, who took part voluntarily after having been invited by letter. MEASUREMENTS AND MAIN RESULTS: 23 doctors took part in the first running of the test. Their average age was 36.6 (SD 6.9) and 52.2% of them were women. 46 doctors took part in the second test. Their average age was 30.9 (SD 2.1) and 76.1 were women. The test had an overall reliability coefficient (Cronbach's alpha) of 0.83 the first time and 0.65 the second time. The overall mean score of the participants the first time was 56.9 (SD 19.2), with 100 the top score possible, and 62.1 (SD 4.1) the second time. CONCLUSIONS: This SCMFiC experiment is the first time the clinical competence of family doctors has been assessed in our area. It was a reliable and valid test to assess the competence of our health professionals.

Primeras experiencias en evaluación de la competencia clínica de los médicos de familia de Catalunya / First experiences in evaluation of the clinical competence of family doctors in catalonia

Objetivo. Construir un instrumento válido para evaluar la competencia clínica de los médicos de familia y establecer el estándar de la profesión. Diseño. Construcción de una prueba de evaluación clínica objetiva y estructurada por parte del Comité de Prueba de la Societat Catalana de Medicina Familiar i Comunitària (SCMFiC) con 27 situaciones clínicas representativas de la práctica de atención primaria, utilizando diversos instrumentos evaluativos, con una duración total de 5 horas y 30 minutos. Emplazamiento. Dos áreas básicas de salud de Barcelona para la realización de las dos ediciones de la prueba. Participantes. Médicos de familia, miembros de la SCMFiC, que participaron voluntariamente tras haber sido invitados por carta. Mediciones y resultados principales. En la primera edición de la prueba participaron 23 médicos, con una edad media de 36,6 años (DE, 6,9), siendo un 52,2 por ciento mujeres. En la segunda edición participaron 46 médicos, con una edad media de 30,9 (DE, 2,1), siendo un 76,1 mujeres. La prueba tuvo un coeficiente global de fiabilidad, alfa de Cronbach, de 0,83 en su primera edición y 0,65 en su segunda. La puntuación media global de los participantes de la primera edición fue de 56,9 (DE, 19,2), siendo 100 la puntuación máxima obtenible y la de los participantes de la segunda edición, 62,1 (DE, 4,1). Conclusiones. La experiencia de la SCMFiC es la primera por lo que refiere a la evaluación de la competencia clínica de los médicos de familia en nuestro ámbito, y se trata de una prueba fiable y válida para valorar la competencia de nuestros profesionales (AU)

["Euthanasia of children" during dictatorship of national socialism: "special children's department" Ansbach in Germany]. / "Kindereuthanasie" während der nationalsozialistischen Diktatur: Die "Kinderfachabteilung" Ansbach in Mittelfranken.

Focus of this paper is a description of "child euthanasia" during National Socialism 1939-1945 in the "specialized children's department" of the Ansbach state hospital. The historical and ideological bases for euthanasia and the development of child and adolescent psychiatry are explained. Material was found in public archives and trial records of German courts. 156 case histories of children who were killed in the Ansbach state hospital were evaluated. Child euthanasia in Ansbach was done in the same stereotyped way as in other specialized children's departments. The 156 children were aged between one week and 16 years. 39 children died within the first three months, 31 children died within three to six months in hospital. Most children were autopsied, at least 86 brains were examined neuropathologically. The trials against the involved physicians were quashed finally in 1968.

[Chairman of the German Society for Child Psychiatry and Educational Therapeutics in World War II]. / Der Vorsitzende der Deutschen Gesellschaft für Kinderpsychiatrie und Heilpädagogik im Zweiten Weltkrieg.

Hans Heinze was one of the three experts on child euthanasia in the "Reichsausschuss zur wissenschaftlichen Erfassung erb- und anlagebedingter schwerer Leiden" and head of the first "Kinderfachabteilung" in Brandenburg-Görden, Germany. He was one of the experts in the euthanasia "Aktion T4". He became nominated president of the "Deutsche Gesellschaft für Kinderpsychiatrie und Heilpädagogik" after Paul Schröder who died in 1941. The documents about his function exist in five German archives.

[Promoting reading and spelling in children with computer programs]. / Lese- und Rechtschreibförderung von Kindern durch Computerprogramme.

OBJECTIVES AND METHODS: Sixteen students trained their reading and spelling skills with the computer programmes Budenberg 1 and 2 and the Comles Package for 1000 minutes over a one-month period. RESULTS: Following one month of computer training, reading test scores had improved for seven of the 16, and spelling test scores for three children whose basic performance had been poor. Three and a half months of school instruction later, the reading test scores had improved for nine children, while there was no effect upon the spelling scores for most of the students.

[Higher professional education as a means for development in nursing]. / La formación superior como instrumento para el desarrollo de la enfermería.

The author reflects on how higher training contributes to development in Nursing, understanding by this term the discipline but also the set of professionals which exercise it. Therefore, the author analyzes those elements which are part of professional development; be this intrinsic, professional discourse, excellent professional exercise, market dominance, syndical capacity or representation. The author ends her article with a very simple proposal: make a world full of care, with a recognition of successes, a correction of errors and a deepening of attitudes.