ABSTRACT
Se brindó Servicio de Indicación Farmacéutica y Seguimiento Farmacoterapéutico (SFT) a una mujer de 61 años, exfumadora, diagnosticada de hipertensión y cáncer de mama, que presentaba tos persistente. Tomaba 4 medicamentos.Tras revisión de la farmacoterapia y análisis de narrativas extraídas de entrevistas en profundidad, se determinó la presencia de tos como Problema Relacionado con Medicamentos (PRM) derivado del uso de un IECA (Inhibidor de la Enzima Conver-tidora de Angiotensina). Se realizaron derivaciones al Médico de Atención Primaria (MAP) proponiendo sustitución farmacológica por ARAII (Antagonista de Receptor de Angiotensina II), que fueron declina-das por no existir similitud de criterio clínico.Durante este periodo la paciente acudió a médi-cos privados, probando diferentes tratamientos farmacológicos, así como a sesiones de medicina tradicional (acupuntura) sin obtener mejoría.Tras un año de SFT, se logra aceptación de la pro-puesta del farmacéutico por el MAP, lo cual derivó en una resolución del PRM, un proceso de desme-dicalización y una mejora en salud que permitió a la paciente retomar sus actividades cotidianas. (AU)
Minor Ailment Service and Pharmacotherapeutic Follow-up (PFU) was provided to a 61-year-old woman, ex-smoker, diagnosed with hypertension and breast cancer, who presented persistent cough. She was taking 4 medications.After the review of the pharmacotherapy and analy-sis of narratives extracted from in-depth interviews, the presence of cough was determined as a Drug Related Problem (DRP) derived from the use of an ACEI (Angiotensin-converting enzyme inhibitors). Referrals to the Primary Care Physician (PCP) were made, proposing pharmacological substitution for ARBs Angiotensin II receptor blocker), which were declined because there was no similarity in clinical criteria.During this period, the patient went to private doc-tors, trying different pharmacological treatments, as well as traditional medicine sessions (acupunc-ture) without obtaining improvement.After a year of PFU, acceptance of the pharmacist's proposal was achieved by the PCP, which led to a resolution of the DRP, a deprescription process and an improvement in health that allowed the patient to resume her daily activities. (AU)
Subject(s)
Humans , Female , Aged , Pharmaceutical Services , Medication Errors , Deprescriptions , Inappropriate Prescribing , Patient Safety , AftercareABSTRACT
El trabajo presenta una propuesta didáctica para la formación docente de profesionales del área de la salud denominada Indagación Dialógica Problematizadora (IDP) y probada en el espacio curricular Formación didáctico-pedagógica en salud del Centro de Desarrollo de la Enseñanza Superior en Salud (CEDESS), Universidad Federal de San Pablo. La misma se diseñó en el marco de un proyecto binacional entre Brasil y Argentina, y se desarrolló en formato presencial y virtual. La implementación de IDP permitió generar una dinámica comunicacional coherente con el posicionamiento constructivista y posibilitar un cambio en las formas comunicativas del docente y de los alumnos, guiadas desde la problematización de situaciones cercanas a las experiencias de los mismos. La implementación de esta innovación educativa fue coherente con los cambios curriculares derivados de las actuales políticas de salud para Brasil...
O trabalho apresenta uma proposta didática para a formação docente de profissionais da área da saúde denominada Indagação Dialógica Problematizadora (IDP), que foi avaliada no espaço curricular Formação didático-pedagógica em saúde, formato presencial e virtual, oferecida pelo Centro de Desenvolvimento do Ensino Superior em Saúde (Cedess), Universidade Federal de São Paulo. A experiência realizou-se no contexto de um projeto binacional entre Brasil e Argentina. A implementação da IDP permitiu gerar uma dinâmica comunicativa coerente com o posicionamento construtivista e possibilitou uma mudança nas formas comunicativas, do docente e dos alunos, guiadas a partir da problematização de situações relacionadas às experiências dos pós-graduandos. A implementação desta inovação educativa foi coerente com as mudanças curriculares derivadas das atuais políticas de saúde e educação no Brasil...
This paper presents a teaching strategy for education of health professionals called Dialogic Problematizing Inquiry (DPI), which was evaluated in the course Teaching Methodology in Health Education, promoted by the Development of Higher Education in Health Center, at Federal University of Sao Paulo. It was designed in the framework of a bilateral project between Brazil and Argentina, and was developed in presencial and virtual format. The implementation of DPI generated a communication dynamic that was coherent with a constructivist perspective and enabled a change in teacher and students communication manners, which were guided by close-to-student-problematizing situations. The implementation of this teaching innovation was consistent with the curriculum changes stemming from current health policies in Brazil...
Subject(s)
Humans , Male , Female , Curriculum , Universities , Health Education , Health Promotion , Argentina , BrazilABSTRACT
Purely extradural lumbar spinal arteriovenous malformations (AVMs) are rare lesions that have diverse presentations and imaging features. The treatment of a symptomatic high flow paraspinal AVM with multiple feeders remains a challenge. We report the first use of an Ascent balloon (dual lumen balloon catheter) to deliver Onyx with excellent penetration to a paraspinal AVM.
Subject(s)
Arteriovenous Malformations/therapy , Embolization, Therapeutic/methods , Lumbar Vertebrae/blood supply , Angiography, Digital Subtraction , Arteriovenous Malformations/diagnosis , Arteriovenous Malformations/diagnostic imaging , Dimethyl Sulfoxide/therapeutic use , Embolization, Therapeutic/instrumentation , Female , Humans , Magnetic Resonance Imaging , Middle Aged , Polyvinyls/therapeutic use , Treatment OutcomeABSTRACT
Purely extradural lumbar spinal arteriovenous malformations (AVMs) are rare lesions that have diverse presentations and imaging features. The treatment of a symptomatic high flow paraspinal AVM with multiple feeders remains a challenge. We report the first use of an Ascent balloon (dual lumen balloon catheter) to deliver Onyx with excellent penetration to a paraspinal AVM.
Subject(s)
Arteriovenous Malformations/therapy , Balloon Occlusion/instrumentation , Balloon Occlusion/methods , Dimethyl Sulfoxide/administration & dosage , Polyvinyls/administration & dosage , Female , Humans , Lumbar Vertebrae , Middle AgedABSTRACT
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Subject(s)
Humans , Social Control, Formal , Legislation as Topic , Technology Assessment, Biomedical , Global Health , International Acts , Communicable Diseases, Emerging/prevention & control , International CooperationABSTRACT
OBJECTIVE: To discover people's nutritional habits and their distance from the Mediterranean diet. DESIGN: Cross-sectional, descriptive study. SETTING: Gavà 2 Health District, Barcelona, Spain. PARTICIPANTS: 614 obtained at random from patients attending the centre. Stratified in 3 age groups (15-35, 36-64, and over 64). MAIN MEASUREMENTS: Validated questionnaire of the consumption by groups of food over the previous week. Then figures were compared with the standard values of the Mediterranean diet. RESULTS: Outstanding results were: 60% insufficiency in consumption of carbohydrates; 70.7% insufficiency in green vegetables, fruit and root vegetables; 75% of optimum consumption of pulses; 64% deficient consumption of milk products; 66% optimum consumption of fish; 73.8% optimum consumption of eggs; 71.2% proper intake of white meat; 64.2% excessive consumption of red meat and processed meats, which reached 86.6% among 15-35 year olds. There was a BMI over 25 in 59% of women and 63% of men, with obesity being most common among women and people over 64 years old. CONCLUSIONS: The population studied consumed an excessive amount of food with high contents of saturated fat, especially young people. There is a deficit in the intake of slowly absorbed carbohydrates and a less than ideal consumption of fruit, green vegetables and root vegetables, which was more marked among the young. The consumption of milk products was below the recommended amount. Pulses, fish and white meat were close to the right levels. This pattern is far from ideal and leads to higher risk of prevalent chronic illnesses.
Subject(s)
Diet, Mediterranean , Feeding Behavior , Adolescent , Adult , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Surveys and QuestionnairesABSTRACT
Objetivo. Conocer los hábitos alimentarios y su distanciamiento de la dieta mediterránea. Diseño. Estudio descriptivo, transversal. Emplazamiento. ABS Gavà 2. Barcelona. Participantes. Se incluyó a 614 pacientes obtenidos aleatoriamente de los pacientes que acudían al centro. La población fue estratificada en 3 franjas de edad (15-35, 36-64 y > 64 años). Mediciones principales. Cuestionario validado del consumo por grupos de alimentos en la última semana. Posteriormente se comparó con los valores estándar de dieta mediterránea. Resultados. Se observa un 60% de consumo insuficiente de hidratos de carbono, un 70,7% de consumo insuficiente de verduras, frutas y hortalizas, un 75% de consumo óptimo de legumbres, un 64% de consumo deficiente de lácteos, un 66% de consumo óptimo de pescado, un 73,8% de consumo óptimo de huevos, un 71,2% de consumo adecuado de carne blanca, y un 64,2% de consumo excesivo de carne roja y embutidos, que llega a ser del 86,6% a los 15-35 años. Se observó un IMC > 25 en el 59% de las mujeres y el 63% de los valores; la obesidad fue más frecuente en mujeres y en > 64 años. Conclusiones. La población estudiada consume un exceso de alimentos con alto contenido en grasas saturadas, especialmente los jóvenes. Hay un déficit en la ingesta de hidratos de carbono de absorción lenta y un consumo inferior al ideal de frutas, verduras y hortalizas, más acusado también en jóvenes. El consumo de lácteos es inferior al aconsejado. La ingesta de legumbres, pescado y carne blanca se aproxima a los niveles correctos. Este patrón difiere del ideal, lo que supone un mayor riesgo de enfermedades crónicas prevalentes
Setting. Gavà 2 Health District, Barcelona, Spain. Participants. 614 obtained at random from patients attending the centre. Stratified in 3 age groups (15-35, 36-64, and over 64). Main measurements. Validated questionnaire of the consumption by groups of food over the previous week. Then figures were compared with the standard values of the Mediterranean diet. Results. Outstanding results were: 60% insufficiency in consumption of carbohydrates; 70.7% insufficiency in green vegetables, fruit and root vegetables; 75% of optimum consumption of pulses; 64% deficient consumption of milk products; 66% optimum consumption of fish; 73.8% optimum consumption of eggs; 71.2% proper intake of white meat; 64.2% excessive consumption of red meat and processed meats, which reached 86.6% among 15-35 year olds. There was a BMI over 25 in 59% of women and 63% of men, with obesity being most common among women and people over 64 years old. Conclusions. The population studied consumed an excessive amount of food with high contents of saturated fat, especially young people. There is a deficit in the intake of slowly absorbed carbohydrates and a less than ideal consumption of fruit, green vegetables and root vegetables, which was more marked among the young. The consumption of milk products was below the recommended amount. Pulses, fish and white meat were close to the right levels. This pattern is far from ideal and leads to higher risk of prevalent chronic illnesses
