Tecnologías de la información y la comunicación al servicio de la atención farmacéutica: “Tu farmacéutico de guardia”, una web por y para los pacientes / Information and communication technologies at the service of pharmaceutical care: «Your pharmacist on duty», a website by and for patients

Objetivo: Alineado con la recomendación de la OMS de incorporar a la atención sanitaria diferentes estrategias de salud digital, el objetivo es doble: describir las funcionalidades y recursos de una página web creada para formar e informar a los pacientes y analizar la actividad de la herramienta tras un periodo de funcionamiento de seis años.Material y métodos: Los pasos que se siguieron en la creación de la web fueron: 1) desarrollo del logotipo y sistema de marca; 2) creación de contenidos tanto escritos como audiovisuales y 3) campaña de lanzamiento. Para evaluar su uso se realizó un estudio descriptivo retrospectivo (septiembre 2015 – noviembre 2021) en el que se recogieron los indicadores clave de rendimiento.Resultados: La web se estructuró en 11 grupos de patologías disponiendo de información escrita (179 fichas) y audiovisual (61 videos) sobre medicamentos y un repositorio de temas actuales sobre la salud a modo de noticias (515 reseñas publicadas). Desde su lanzamiento se han registrado un total de 176.530 visitas por 150.004 usuarios diferentes. En noviembre de 2020 se rediseñó la web, optimizándola para móviles con un diseño de marca renovado; hecho que reportó un importante crecimiento de las visitas, siendo el móvil (74,9%) el dispositivo de visualización más utilizado en este último periodo. (AU)

Objectives: To write the functionalities and resources of a web page created to train and inform patients and to analyze the activity of the tool after a six-year operating period. These two objectives are aligned with the WHO recommendation to incorporate different digital health strategies into health care.Material and methods: To create the web page we followed the next steps: 1) development of the logo and brand system; 2) creation of written and audiovisual content and 3) launch campaign. To evaluate the use of the web page, a retrospective descriptive study was carried out (September 2015 – November 2021) and key performance indicators were collected.Results: The website was structured into 11 groups of pathologies, including written information (179 files) and audiovisual information (61 videos) about drugs and a repository of current health topics shown as news (515 published reviews). Since its launch, a total of 176,530 visits have been registered by 150,004 different users. In November 2020 the web was redesigned, optimizing it for mobile devices and with a renewed brand design. This update reported a significant growth in visits, with mobile phones being the most used display (74.9%) in this last period. (AU)

Efficacy of a topical gel containing chitosan, chlorhexidine, allantoin and dexpanthenol for pain and inflammation control after third molar surgery: A randomized and placebo-controlled clinical trial.

BACKGROUND: The aim of this study was to evaluate and compare the postoperative effect of a topic gel containing chlorhexidine, chitosan, allantoine and dexpanthenol versus a placebo for pain and inflammation control after third molar surgery. MATERIAL AND METHODS: A gel combining 0.2% chlorhexdine, 0.5% chitosan, 5% dexpanthenol, 0.15% allantoin and 0.01% sodium saccharin was selected for this split mouth randomized controlled and double-blind trial including 36 patients with bilaterally and symmetrically impacted lower third molars. The teeth (n=72) were randomly divided into two groups before surgical removal: control group (CG; in which a placebo was given) and experimental group (EG). Swelling, trismus, postoperative pain, wound healing and complications were measured and recorded in order to evaluate differences between the placebo and experimental product. RESULTS: Five patients suffered from an alveolitis in the CG (13.9%), and none in the study group (0%), but no statistically significant difference was found (p=0.063). From day 0 to day 7, trismus and swelling were significantly less pronounced in the EG, and wound healing was considered 'good' in 22.2% for the CG and 97.2% for the EG (p<0.001). Mean VAS scores during the seven postoperative days were statistically lower in the study (2.56±1,19) compared to the placebo group (3.25±1.6) (p=0.002). The mean consumption of analgesic pills during the first 92 hours was also statistically lower in the EG (0.26±0.51) in comparison to the CG (0.56±0.67) (p=0.003). CONCLUSIONS: The use of an experimental gel containing chlorhexidine, chitosan, allantoine and dexpanthenol seems to significantly reduce postoperative pain, trismus and signs of inflammation. Future studies should further evaluate, if the gel is effective in dry socket preventing after third molar removal.

Abordaje nutricional en pacientes críticos diagnosticados de neumonía por COVID-19 / Nutritional approach in critical patients diagnosed with pneumonia by COVID-19

OBJETIVO: Evaluar las actuaciones nutricionales en pacientes con diagnóstico de neumonía COVID-19 en una Unidad de Cuidados Intensivos (UCI) y su ajuste a las guías de las sociedades Europea y Americana de Nutrición Clínica. METODOLOGÍA: Estudio retrospectivo observacional de 2 meses de duración en pacientes con diagnóstico de neumonía COVID-19 con ingreso en UCI. Se utilizaron los programas ICCA(R), OrionClinic(R) y Kabisoft(R) para obtener las variables de los pacientes. RESULTADOS: Ingresaron 27 pacientes, de los cuales 20 precisaron soporte nutricional. Un 65% eran hombres y la media de edad fue 62 ± 13,2 años. Los requerimientos energéticos teóricos fueron entre 1.535-1.800 Kcal/día. Permanecieron 2,5 ± 4,5 días en planta previo a su estancia en UCI, que fue de 17 ± 6,9 días. Al término del estudio, el 15% de pacientes fueron alta, el 35% seguían hospitalizados y el 50% fueron éxitus. La variación de los datos analíticos al ingreso y alta fue: proteínas +1,3 g/dl, albúmina +1,2 g/dl, linfocitos +0,5*103/mm3, PCR -114,5 mg/l y triglicéridos +19,4 mg/dl. Un 10% recibieron remdesivir y un 30% tocilizumab como tratamientos de segunda línea. Todos fueron intubados y tratados con propofol; el 75% requirió posición decúbito prono. Todos los pacientes requirieron nutrición enteral, siendo la fórmula hiperproteica-hipercalórica con fibra la más utilizada. Un 70% necesitó nutrición parenteral total, utilizándose formulaciones hiperproteicas-hipocalóricas de forma prioritaria y suplementadas con vitaminas y oligoelementos. CONCLUSIÓN: Dentro del complicado manejo de este tipo de pacientes, las intervenciones nutricionales han sido necesarias en un 75% de ellos y la adherencia a las guías actuales se ha dado en todos los casos, con resultados favorables

PURPOSE: Evaluate nutritional performance in patients with COVID-19 pneumonia admitted to the Intensive Care Unit (ICU). Adjustment done following the guidelines of the European and American societies for Clinical Nutrition. METHODOLOGY: Retrospective observational during 2 months study of some patients with pneumonia by COVID-19 in ICU. Informatic programs ICCA(R), OrionClinic(R) and Kabisoft(R) were used to obtain variables of patients. RESULTS: 27 patients were admitted in ICU, while 20 of them required nutritional support. There were 65% of men with average age about 62 ± 13.2. Their theoretical nutritional requirements were between 1,535-1,800 kcal/day. They stayed 2.5 ± 4.5 days in the hospital before their ICU admission. They were 17 ± 6.9 days on average in ICU. At the end of this study, 15% of patients were discharged, 35% were hospitalized, and 50% were dead. The variation of the analytical data at admission and discharge was: proteins +1.3 g/dl, albumin +1.2 g/dl, lymphocytes +0.5*103/mm3, PCR -114.5 mg/l and triglycerides +19.4 mg/dl. 10% took remdesivir and 30% tocilizumab. All of them were intubated and treated with propofol and 75% required prone position. All of patients required enteral nutrition being the hyperprotein-hypercaloric with fiber formula the most used. 70% required central total parenteral nutrition being mostly hyperprotein-hypocaloric and supplemented with vitamins and trace elements. CONCLUSION: Within the complicated management of this type of patients, nutritional interventions have been necessary in 75% of them and adherence to current guidelines has occurred in all cases, with favorable results

Epidemiology and treatment of adenoid cystic carcinoma of the minorsalivary glands: A meta-analytic study

Objectives: To evaluate the epidemiological aspects of adenoid cystic carcinoma (ACC) and to evaluate the differenttherapeutic possibilities as well as the percentage of survival.Study Design: A retrospective, meta-analytic, observational study was carried out by selecting a total of 13 articles,which provided a sample size of 263 cases of patients who had been diagnosed with ACC in the minorsalivary glands.Results: ACC was found to be more common among women (56.5%) and the average age at diagnosis was 55.26years old. The primary location of the tumor was in the palate in 57% of the cases, the predominant pattern beingcribiform. The treatment of choice was therapy combined with surgery and radiotherapy in 62.7% of the subjects.The overall survival rate was 70.76% and 56.76%, at 5 and 10 years respectively.Conclusions: Early detection of adenoid cystic carcinoma is necessary in order to enable making an earlier prognosis and thus enable a better quality of life for the patient (AU)

Meta-analytic study on the frequency and treatment of oral antral communications.

OBJECTIVE: To determine the optimum surgical treatment for oral antral communications (OAC) and to understand the main post-operative complications. STUDY DESIGN: Meta-analytical, observational and retrospective study of 1.072 cases of OAC obtained from a literature review of 15 articles. RESULTS: OAC occur slightly more often in men and during the fourth decade of life. Its primary etiological factor is dental extraction, most often affecting the third molar. The most common treatment has been the use of Bichat's fat pad grafts, whereas the technique with the highest percentage of complications has been the use of the palatal rotation flap. The most frequent complication has been the fistulization of the OAC. CONCLUSIONS: Early diagnosis of OAC and its treatment within 48 hours of evolution are fundamental in order to properly resolve this pathology. The use of Bichat's fat pad grafts is a simple technique that offers excellent vascularization and results.

Elevación sinusal con injerto de ramamandibular y colocación de implantes en una sola fase: a propósito de un caso / Sinus elevation with mandibular ramus graft and placement of implants in a single phase: regarding one case

Introducción: La pérdida de volumen óseo en sectores posteriores maxilares puede condicionar el tratamiento con implantes. Para ello se disponen de técnicas quirúrgicas regladas que permiten aumentar el hueso residual alveolar y permitir esta colocación de implantes. Existen numerosas zonas óseas donantes, como la rama mandibular. Cuando se dispone de altura ósea residual suficiente para garantizar la estabilidad de los implantes, estos se pueden colocar en la misma cirugía. Paciente y Método: Varón de 53 años remitido para la colocación de implantes en sector posterior maxilar derecho. Se le sometió a cirugía de elevación de seno maxilar con injerto de ramamandibular y material liofilizado, con colocación de implantes en una misma fase, y un seguimiento clínico a cuatro años en carga protésica Conclusiones: La técnica de elevación de seno maxilar con injerto de rama mandibular y colocación de implantes en una sola fase se trata de un procedimiento seguro con resultados predecibles cuando existe hueso residual suficiente para asegurar la estabilidad primaria de los implantes (AU)

Introduction: The loss of bone volume in posterior maxillary sectors can condition implant treatments. Therefore, regulated surgical techniques that permit increasing the residual alveolar bone and allow the placement of implants is available. There are numerous donor bone areas, such as the mandibular ramus. When sufficient residual bone height is available to guarantee the stability of the implants, they can be placed in the same surgery. Patient and Method: Male of 53 years of age referred for the placement of implants in right posterior maxillary sector. He was subjected to surgery to elevate the maxillary sinus with graft from mandibular ramus and lyophilised material, with placement of implants in the same phase, and clinical monitoring for four years in prosthetic load. Conclusions: The technique of maxillary sinus elevation with mandibular ramus graft and placement of implants in a single phase deals with a safe procedure with predictable results when there exists sufficient residual bone to ensure the primary stability of the implants (AU)