Tipos de tratamientos prescritos en un grupo de pacientes diabéticos en una farmacia comunitaria / Types of treatments prescribed in a group of diabetic patients in a community pharmacy

OBJETIVO: conocer el porcentaje de pacientes que tienen prescrito tratamiento para la diabetes mellitus, tipo de tratamiento y comparativa con el Plan Integral de Diabetes de Andalucía. MÉTODOS: se incluyó en el estudio a todos aquellos pacientes que accedieron a la Farmacia Felisa Baena de Linares (Jaén) y quisieron facilitar su tratamiento completo (n = 500). A través de un estudio observacional se comprobó el tipo de tratamiento y su coincidencia con el Plan Integral de Diabetes. RESULTADOS: se comprobó que el 19,2 % de los pacientes objeto de estudio presentaban diabetes, de estos, el 75 % solo estaba en tratamiento por vía oral y el 9 % solo con insulina. De los resultados obtenidos se comprobó que un 80 % de los pacientes tenía prescrita metformina ya fuese en monoterapia, en combinación con otros antidiabéticos orales o con insulina. Del total de los pacientes con diabetes solo el 1 % tenía prescrito glucagón y un 16 % tiras reactivas, muy por debajo de lo establecido en el Plan Integral de Diabetes, que debería haberse encontrado en este caso en un 47 % de los pacientes. CONCLUSIONES: en nuestro entorno existe un alto número de pacientes con diabetes, predominando la terapia con metformina. Hay un bajo porcentaje de pacientes que tiene prescrito glucagon y tiras reactivas, comparado con el Plan Integral de Diabetes, lo que supone un riesgo para la salud del paciente. De aquí la importancia de desarrollar programas de salud desde la farmacia para que los pacientes conozcan los controles de la diabetes

OBJECTIVE: To determine the percentage of patients who are prescribed treatment for diabetes mellitus, type of treatment and comparison with the Plan Integral Diabetes (Junta Andalucía). METHODS: The study included all patients who accessed the Felisa Baena Pharmacy Linares (Jaen) and wanted to facilitate complete treatment (n = 500). Through an observational study the type of treatment of patients and the relationship with the Plan Integral Diabetes. RESULTS: It was found that 19.2% of patients in the study had diabetes, of these, 75% were only treatable orally and 9% only with insulin. From the results obtained it was found that 80% of patients were prescribed metformin either in monotherapy, in combination with other oral agents or insulin. Of all patients with diabetes only 1% had prescribed glucagon and 16% test strips, well below the provisions of the Plan Integral Diabetes, which should have been in this case 47% of patients. CONCLUSIONS: In our environment there is a high number of patients with diabetes, metformin therapy predominating. There is a low percentage of patients who have been prescribed glucagon and test strips compared with the Plan Integral Diabetes, which pos-es a risk to patient health. Hence the importance of developing health programs from the pharmacy so that patients are aware how to control diabetes

Oropharyngeal dysphagia in early stages of myotonic dystrophy type 1.

INTRODUCTION: Myotonic dystrophy type 1 (DM1) is a multisystemic disorder characterized mainly by skeletal muscle alterations. Although oropharyngeal dysphagia is a prominent clinical feature of DM1, it remains poorly studied in its early disease stages. METHODS: Dysphagia was investigated in 11 presymptomatic DM1 carriers, 14 patients with DM1 and 12 age-matched healthy controls, by using fiberoptic endoscopic evaluation of swallowing (FEES) and clinical scores. RESULTS: Scores for the FEES variables, delayed pharyngeal reflex, posterior pooling, and postswallow residue were significantly greater in patients with DM1 and in presymptomatic DM1 carriers than in healthy controls (P < 0.05); oropharyngeal dysfunction was more severe in patients than in presymptomatic carriers. Penetration/aspiration was found altered exclusively in patients with DM1 (P < 0.05). DISCUSSION: Swallowing dysfunction occurs in presymptomatic DM1 carriers. Timely diagnosis of dysphagia in preclinical stages of the disease will aid in the timely management of presymptomatic carriers, potentially preventing medical complications. Muscle Nerve, 2019.

Neural correlates of cognitive impairment in schizophrenia.

BACKGROUND: Cognitive impairment is an established feature of schizophrenia. However, little is known about its relationship to the structural and functional brain abnormalities that characterise the disorder. Aims To identify structural and/or functional brain abnormalities associated with schizophrenic cognitive impairment. METHOD: We carried out structural magnetic resonance imaging (MRI) and voxel-based morphometry in 26 participants who were cognitively impaired and 23 who were cognitively preserved, all with schizophrenia, plus 39 matched controls. Nineteen of those who were cognitively impaired and 18 of those who were cognitively preserved plus 34 controls also underwent functional MRI during performance of a working memory task. RESULTS: No differences were found between the participants who were cognitively intact and those who were cognitively impaired in lateral ventricular volume or whole brain volume. Voxel-based morphometry also failed to reveal clusters of significant difference in grey and white matter volume between these two groups. However, during performance of the n-back task, the participants who were cognitively impaired showed hypoactivation compared with those who were cognitively intact in the dorsolateral prefrontal cortex among other brain regions. CONCLUSIONS: Cognitive impairment in schizophrenia is not a function of the structural brain abnormality that accompanies the disorder but has correlates in altered brain function.