Prostatitis: A Review.

PURPOSE OF REVIEW: Pathologies of the prostate in men are one of the most prevalent clinical conditions today [1]. Specifically, pelvic inflammatory disease such as prostatitis can cause symptoms and syndromes different from urological ones, such as bowel or nervous system manifestations. This has a largely negative impact on the quality of life of patients. Therefore, it is convenient to know and update the information about the therapeutic approach to prostatitis, which is a challenge that involves different medical specialties. The aim of this article is to provide summarized and focused evidence to help in the therapeutic approach of patients with prostatitis. A computer-based search of the PubMed and Cochrane Library databases was used to perform a comprehensive literature review on prostatitis, with special interest in recent findings and latest therapeutic guideline recommendations. RECENT FINDINGS: Recent discoveries about the epidemiology and clinical classifications of prostatitis seem to incur in an increasingly individualized and directed management, with the aim of covering all the confluent factors in prostatic inflammatory pathology. In addition, the role of new drugs and combination with phytotherapy open up a range of new treatment possibilities, although future randomized studies will be necessary to better understand how to use all treatment modalities. Despite all the knowledge acquired about the pathophysiology of prostate diseases, and due to their interrelation with other pelvic systems and organs, there are still gaps that make it difficult for us to provide an optimal and standardized treatment in many of our patients. Being aware of the influence of all the factors potentially involved in prostate symptoms is crucial for a correct diagnosis and establishing an effective treatment plan.

Haz lo que haces tan bien que tus pacientes querrán verlo de nuevo; sistema automatizado de valoración de la satisfacción de los usuarios en CMA / Do what you do so well that your patients will want to see it again; automated user satisfaction rating system at CMA

Introducción: La valoración que el paciente hace de la atención prestada es un indicador importante de la calidad del servicio prestado, demostrando ser eficaz en la mejora continua de la calidad asistencial a fin de detectar debilidades que ayuden a desarrollar estrategias de mejora. Uno de esos medidores es el Net Promoter Score (NPS), sistema de medición que indica la probabilidad que se recomiende el servicio a un familiar o amigo. En mayo de 2021 comenzó una prueba piloto con la cual se impulsa un proceso de automatización del sistema de evaluación de la satisfacción del paciente. El objetivo de este estudio es obtener una valoración cuantificable de la satisfacción de nuestros pacientes, conociendo el NPS de nuestra unidad. Metodología: Se realizó un estudio retrospectivo de los datos obtenidos a través de las encuestas realizadas digitalmente por los pacientes en un periodo comprendido desde el 21 de mayo de 2021 al 31 de marzo de 2022. Resultados: La satisfacción global ha sido muy alta, estando el 95,4 % de los pacientes feliz. Se obtuvo un NPS de 87, lo que sitúa a nuestra unidad en datos de excelencia. Conclusiones: Las herramientas cuantitativas de medición ayudan a mantener una monitorización continua de los estándares de calidad para identificar problemas, corregirlos y/o prevenirlos. Las encuestas informatizadas deben ser eficientes, de fácil desarrollo y efectuadas con regularidad (AU)

Introduction: The patient’s evaluation of the care provided is an important indicator of the quality of the service offered, proving to be effective in the continuous improvement of the quality of care, in order to detect weaknesses that help to develop strategies for improvement. One such measure is the Net Promoter Score (NPS), a system of measurement that indicates the probability that the service will be recommended to a family member or friend. In May 2021, a pilot test will begin to drive a process of automation of the patient satisfaction evaluation system. The aim of this study is to obtain a quantifiable assessment of the satisfaction of our patients, knowing the NPS of our department. Methodology: A retrospective study was carried out of the data obtained from the surveys carried out digitally by patients in the period from 21 May 2021 to 31 March 2022. Results: Overall satisfaction was very high, with 95.4% of patients being happy, and an NPS of 87 was obtained, which places our department in a position of excellence. Conclusions: Quantitative measurement tools help to keep a continuous monitoring of quality standards in order to identify problems, correct them and/or prevent them. Computerised surveys must be efficient, easy to develop and carried out regularly (AU)

Monitorización farmacocinética de antagonistas del factor de necrosis tumoral: utilidad clínica en enfermedad inflamatoria intestinal / Pharmacokinetics monitoring of tumour necrosis factor inhibitors: utility in inflammatory bowel disease management

Introducción: El fracaso de la terapia con biológicos en la enfermedad inflamatoria intestinal (EII) es un problema común. La monitorización farmacocinética es una herramienta que podría permitir optimizar estos tratamientos mediante la individualización de la posología en los diferentes escenarios clínicos. Objetivo: Describir las determinaciones de concentraciones séricas de infliximab y adalimumab en pacientes con EII y evaluar el impacto de las recomendaciones farmacocinéticas en la toma de decisiones clínicas y la evolución de los pacientes.Métodos: Estudio trasversal observacional retrospectivo de dos años de duración (2017-2018) de las determinaciones de inhibidores del factor de necrosis tumoral (anti-TNF) realizadas en pacientes del Servicio de Medicina Digestiva de un hospital general. Resultados: Se realizaron 133 determinaciones correspondientes a 66 sujetos (38% tratados con adalimumab; 62% infliximab). El principal motivo de monitorización (>55%) fue la presencia de enfermedad activa. Más de la mitad de los pacientes tenían concentraciones fuera del intervalo terapéutico (el 51% de adalimumab y 37% de infliximab presentaban una exposición subóptima). La recomendación de mantener la pauta posológica previa se propuso en <40% de los informes farmacocinéticos, siendo el grado de aceptación de la recomendación superior al 80% en todos los casos. Los datos analíticos de inflamación se redujeron tras la monitorización sin mostrar significación estadística en todos los casos.Conclusión: La mayoría de pacientes con EII tratados con anti-TNF presentan concentraciones de fármaco inadecuadas. La monitorización ha demostrado ser una herramienta útil para guiar la toma de decisiones terapéuticas y podría contribuir en la mejora de los parámetros clínicos de estos pacientes. (AU)

Introduction: The failure of biologic therapy in inflammatory bowel disease (IBD) is a common problem. The pharmacokinetic monitoring is a useful tool that allows to optimize these treatments.Objective: To describe the pharmacokinetic determinations of plasma concentrations of infliximab and adalimumab in patients with IBD and evaluate its impact on clinical decision.Method: Retrospective, observational study of two years duration (2017-2018) of the tumor necrosis factor (anti-TNF) inhibitor determinations performed in patients of the Digestive Service of a general hospital.Results: A total of 133 determinations were obtained about 66 subjects (38% adalimumab, 62% infliximab). The main reason (>55%) of the request for monitoring was the presence of active disease. More than half of the patients had concentrations outside the therapeutic range (51% of patients with adalimumab and 37% of those with infliximab had plasma levels below the lower range considered suboptimal). The maintenance of the previous dosage was recommended only in <40% of the monitoring and the degree of acceptance of the interventions were more than 80% in all cases. The analytical data of inflammation were reduced after monitoring without showing statistical significance in all cases.Conclusion: Standard anti-TNF regimen was not adequate to obtain range concentrations in more than half of analyzed cases. Monitoring has proven to be very useful in supporting clinical decision and it may promote an improvement in the clinical parameters of patients with IBD. (AU)

Evaluación del grado de adherencia al tratamiento intravenoso no antineoplásico de pacientes ambulatorios / Evaluation of the degree of adherence to non-antineoplastic intravenous treatment of ambulatory patients

Introducción: La falta de adherencia al tratamiento farmacológico es un problema prevalente y relevante en la evolución clínica.Objetivo: Evaluar el grado de adherencia al tratamiento intravenoso no antineoplásico de pacientes crónicos que acuden al hospital de día (HD), identificar los factores relacionados y analizar los desvíos de programación de la cita previa en el HD y su impacto en el Servicio de Farmacia (SF).Material y métodos: Estudio descriptivo longitudinal retrospectivo de tres años de duración (2017-2019) que incluyó a los pacientes que acudieron al HD a administrarse el tratamiento. Los datos de adherencia se extrajeron de los registros del SF y los datos demográficos-clínicos, de las historias clínicas electrónicas. El grado de adherencia se expresó en porcentaje (adherencia adecuada ≥90%). La asociación entre las variables y el grado de adherencia se estudió mediante test estadísticos de contraste de hipótesis.Resultados: Se incluyeron 300 pacientes, 60% mujeres, edad media 47 años. El 18% presentaron una adherencia inadecuada. La adherencia se asoció con la edad, el medicamento administrado, el intervalo posológico y la persistencia al tratamiento (p<0,05). El 5,6% del trabajo de HD se desvió de la programación suponiendo un trabajo adicional para el SF.Conclusiones: El grado de adherencia al tratamiento era inadecuado en casi una cuarta parte de la población. La edad, el medicamento infundido, el intervalo posológico y la persistencia al tratamiento se asociaron con la adherencia de los pacientes. Los desvíos en la programación de HD se tradujeron en trabajo sobreañadido para el SF. (AU)

Introduction: The lack of adherence to pharmacological treatment of patients with chronic diseases it is a relevant problem.Objective: To assess the degree of adherence to the non-chemotherapy intravenous treatment of chronic patients who came to the outpatient clinic (OC), to identify the possible specific factors related to therapeutic compliance and to analyze the appointment changes in the OC and its impact on the Pharmacy Department (PD).Material and methods: Retrospective longitudinal descriptive study of three years duration (2017-2019). This included patients who went to the OC to receive the treatment. Adherence data were extracted from the PD records and demographic-clinical data from the review of electronic health records. Besides, the degree of adherence was expressed as a percentage (adherence adequate ≥90%). The association between the variables studied and the degree of adherence was estimated by means of statistical tests of hypothesis contrast.Results: A total sample size of 300 patients were included, mean age 47 years, 60% women. Adherence of the treatment was inadequate in 18% of patients. The variables that showed a statistically significant association with adherence were the age, the drug delivered, the dosage interval and the persistence of treatment (p<0.05). 5.6% of OC work deviated from schedule and it meant additional work to the PD.Conclusions: The degree of adherence to the intravenous ambulatory treatment was inadequate in approximately a quarter of the population. The age, the infused drug, the dosage interval and the persistence of treatment were the variables that showed association with the adherence. Changes to OC programming resulted in over-added work for the PD. (AU)

Parry-Romberg Syndrome and Temporal Lobe Refractory Epilepsy: Case Report.

The Parry-Romberg syndrome (PRS), also known as hemifacial atrophy, is a rare neurocutaneous disease with the prevalence of 1/700,000 cases. It is more common in women than men, with an early onset of disease usually within the first two decades of life. Even though the etiology of PRS is unknown, it is thought to be a multifactorial disease that involves hereditary, posttraumatic, autoimmune, infectious, and neoplastic factors. There are a variety of systemic manifestations described in PRS including neurological conditions that range from intractable headache to refractory epilepsy. The manifestations must be identified in a timely manner to ensure an early therapeutic intervention, considering that an appropriate approach during the initial phase might halt the disease progression and markedly improve the quality of life in these patients. This article is aimed to describe the case of a 23 years old female with left hemifacial atrophy and dermatologic, dental, and neurologic compromise, associated with refractory temporal lobe epilepsy evidenced in neuroimaging and electrodiagnostic testings.

Ondas de choque extracorpóreas y regeneración medular / Extracorporeal shock wave therapy and bone marrow regeneration

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Desarrollo y validación de un cuestionario de satisfacción de pacientes con el seguimiento farmacoterapéutico en farmacias comunitarias / Development and validation of a patient satisfaction questionnaire on pharmaceutical care in community pharmacies

Objetivo. Desarrollar y validar un cuestionario de rápida administración para valorar la satisfacción de los pacientes con el servicio de seguimiento farmacoterapéutico (SFT) en las farmacias comunitarias españolas. Material y métodos. Se diseñó un cuestionario autoadministrable semiestructurado centrado en la percepción de los pacientes sobre la experiencia acumulativa con el servicio de SFT. El mismo fue revisado por un panel de 8 expertos en 2 rondas. La validación se realizó en farmacias comunitarias que aceptaron participar y que prestaban el servicio de SFT. Se incluyeron a todos los pacientes o a sus cuidadores que concurrieron durante el período de estudio y que supieran leer y escribir. A fines de valorar las evidencias de validez como estructura interna se realizó un análisis factorial exploratorio de componentes principales y la fiabilidad se estimó a través del coeficiente alfa de Cronbach. Resultados. Participaron 8 farmacias comunitarias pertenecientes a 7 provincias de España y se obtuvieron 103 cuestionarios. El análisis factorial reveló un único componente explicando el 33,6% de la varianza total. Se obtuvo un coeficiente alfa de Cronbach de 0,75. Los pacientes expresaron comentarios adicionales en un 9,7% de los cuestionarios que se relacionaron a resaltar la atención recibida y a agradecer por el servicio de SFT recibido. Conclusiones. El cuestionario desarrollado ha presentado evidencias de validez de contenido, validez como estructura interna y fiabilidad para valorar la satisfacción de los pacientes con el servicio de SFT en las farmacias comunitarias españolas (AU)

Objective. To develop and validate a rapid administration questionnaire to assess patient satisfaction with the pharmaceutical care (PhC) service in Spanish community pharmacies. Methods. A semi-structured and self-administered questionnaire was designed focused on the cumulative experience of patients with the PhC service. This was reviewed by a panel of 8 experts in 2 rounds. The validation was carried out in community pharmacies that performed the PhC service and agreed to participate. All patients or their caregivers who attended a pharmacy during the study period, and who could read and write, were included. An exploratory factor analysis was performed to assess the validity as evidence of internal structure and reliability was estimated using Cronbach's alpha coefficient. Results. A total of 8 community pharmacies belonging to 7 provinces of Spain took part and 103 questionnaires were obtained. Factor analysis revealed a single component explaining 33.6% of the total variance. We obtained a Cronbach's alpha coefficient of 0.75. Patients additional comments expressed in 9.7% of the questionnaires were related to emphasising, and thanking for, the care provided by the PhC service. Conclusions. The questionnaire developed has provided evidence of content validity, internal structure validity, and reliability to assess the patient satisfaction with the PhC service in Spanish community pharmacies (AU)

[Development and validation of a patient satisfaction questionnaire on pharmaceutical care in community pharmacies]. / Desarrollo y validación de un cuestionario de satisfacción de pacientes con el seguimiento farmacoterapéutico en farmacias comunitarias.

OBJECTIVE: To develop and validate a rapid administration questionnaire to assess patient satisfaction with the pharmaceutical care (PhC) service in Spanish community pharmacies. METHODS: A semi-structured and self-administered questionnaire was designed focused on the cumulative experience of patients with the PhC service. This was reviewed by a panel of 8 experts in 2 rounds. The validation was carried out in community pharmacies that performed the PhC service and agreed to participate. All patients or their caregivers who attended a pharmacy during the study period, and who could read and write, were included. An exploratory factor analysis was performed to assess the validity as evidence of internal structure and reliability was estimated using Cronbach's alpha coefficient. RESULTS: A total of 8 community pharmacies belonging to 7 provinces of Spain took part and 103 questionnaires were obtained. Factor analysis revealed a single component explaining 33.6% of the total variance. We obtained a Cronbach's alpha coefficient of 0.75. Patients additional comments expressed in 9.7% of the questionnaires were related to emphasising, and thanking for, the care provided by the PhC service. CONCLUSIONS: The questionnaire developed has provided evidence of content validity, internal structure validity, and reliability to assess the patient satisfaction with the PhC service in Spanish community pharmacies.

Microbiological water quality and its relation to nitrogen and phosphorus at the Pareja limno-reservoir (Guadalajara, Spain).

Bordering on the edge of the Entrepeñas reservoir (Guadalajara, Spain), next to the village of Pareja, a small dam that allows a body of water to develop with a constant level has been built. Initiatives like this (which we have termed "limno-reservoirs") are innovative in Spain and around the world. Earlier reservoirs such as this one were constructed to create a habitat for birds, but the Pareja limno-reservoir is the first to promote socio-economic development. In order to study this limno-reservoir, this research group set up an environmental observatory, analyzing, among other variables, microbiological water quality and nutrient content. After a year and a half of research, it was observed that the concentration of microorganisms is lower in the limno-reservoir than in the river that feeds it, possibly due to the nutrient depletion in the lentic ecosystem. In the limno-reservoir, the total coliforms and enterococci concentrations fall within the European Bathing Water Directive limits, but in the river these concentrations are sometimes higher. The nutrient load in the limno-reservoir is low, with nutrient variations influencing native microorganisms, but not for total coliforms and enterococci. However, the development of special conditions in the bottom has been observed in winter, facilitating coliforms and enterococci survival. This research is very interesting since the creation of limno-reservoirs is rising in Spain and no research is being done on their behaviour.

Mujer joven con disnea / Young woman with dyspnoea

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