RESUMEN
La elevada incidencia de problemas relacionados con la medicación en la población geriátrica ofrece unaoportunidad al farmacéutico para disminuir la morbilidad y el coste de los tratamientos farmacológicos. Larespuesta a esta demanda, en el ámbito sociosanitario de la Comunidad Valenciana, se plasmó en el Programade Atención Farmacéutica en centros sociosanitarios dependientes de la Dirección General de ServiciosSociales de la Conselleria de Bienestar Social.Este programa de atención farmacéutica sociosanitario, pionero en España, que se inició en el año 1990 enla Residencia Mixta de Carlet (Valencia), se realizó en coordinación con la Conselleria de Sanidad. Actualmente, el Programa de Atención Farmacéutica sociosanitario está implantado en Centros sociosanitarios Públicos y en Centros de Discapacitados Psíquicos, siendo cinco los Servicios de Farmacia ubicados en toda la Comunidad Valenciana, realizándose la dispensación de medicamentos en dosis unitarias.Desde el Servicio de Provisión y Asistencia Farmacéutica de la Dirección General de Farmacia y ProductosSanitarios de la Conselleria de Sanidad, se propone establecer un único modelo de Atención Farmacéuticaen Centros sociosanitarios, dando cobertura no sólo a los Centros de titularidad Pública sino también a losCentros de titularidad Privada. Dicho proyecto de futuro está basado en un análisis DAFO, donde se reflejanlas Debilidades, Amenazas, Fortalezas y Oportunidades del sistema
The high incidence of drug-related problems among the geriatric population provides an opportunity for thepharmacist to reduce the morbidity and costs associated with drug treatments. The response to this demand,in the social health care setting of the Community of Valencia, Spain, was reflected in the PharmaceuticalCare Program in the social health care centers under the General Social Services Administration of the SocialWelfare Department.This program of social health pharmaceutical care, a pioneering effort in Spain, initiated in 1990 at theResidencia Mixta in Carlet, Valencia, was carried out in cooperation with the Health Care Department. To date, the social health pharmaceutical care program has been introduced into public social health care centers and centers for the mentally handicapped. There are now five pharmacy services throughout the Community of Valencia that dispense medications in unit doses.The Pharmaceutical Care and Provision Service of the General Pharmacy and Health Care Products Administrationof the Health Care Department proposes to establish a single model for pharmaceutical care in social health care centers, providing coverage not only to public centers but to private centers as well. Thisprojection for the future is based on a SWOT analysis reflecting the strengths, weaknesses, opportunities and threats of the system (AU)
Asunto(s)
Humanos , Servicios Farmacéuticos/organización & administración , Modelos Organizacionales , Pautas de la Práctica en Medicina , Centros Comunitarios de Salud/organización & administración , Dosis ÚnicaRESUMEN
The authors report a case of primary idiopathic chylopericardium in a previously healthy 2-month-old infant. He was treated with continuous pericardial drainage and low-fat total parenteral nutrition. He remains asymptomatic after 14 months of follow-up. This is the first report of primary idiopathic chylopericardium successfully treated nonoperatively.
Asunto(s)
Drenaje , Nutrición Parenteral , Derrame Pericárdico/terapia , Pericardio/cirugía , Humanos , Lactante , Masculino , Derrame Pericárdico/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
We report 2 infants aged 6 months and one year with an anomalous left coronary artery origin treated surgically at our centre with direct aortic reimplantation of the anomalous coronary. Evolution has been satisfactory, with a great improvement of ventricular function. The mitral incompetence and congestive heart failure have disappeared and myocardic perfusion electrocardiographic patterns were corrected. Because of the unfavorable natural course of the disease and the improvement in techniques of coronary revascularization in infants we recommend an early surgical treatment as soon as it be diagnosed. We consider that the most adequate surgical treatment is the direct aortic reimplantation of the anomalous coronary artery.
Asunto(s)
Anomalías Múltiples/cirugía , Anomalías de los Vasos Coronarios/cirugía , Arteria Pulmonar/anomalías , Arteria Pulmonar/cirugía , Femenino , Humanos , Lactante , MasculinoAsunto(s)
Ecocardiografía , Válvula Pulmonar/anomalías , Medios de Contraste , Humanos , Recién Nacido , MasculinoAsunto(s)
Cardiomiopatías/congénito , Divertículo/congénito , Cardiomiopatías/diagnóstico por imagen , Preescolar , Divertículo/diagnóstico por imagen , Femenino , Defectos del Tabique Interventricular/complicaciones , Ventrículos Cardíacos/diagnóstico por imagen , Humanos , Lactante , Masculino , RadiografíaRESUMEN
20 patients with endocardial cushion defects were studied. Partial forms of common atrioventricular canal and those associated with complex congenital malformations were not considered. The right and left ventricular inflow and outflow tracts were measured and average values of inflow tract/outflow tract were calculated for each anatomical form of the disease. We found this ratio to be significantly smaller in Group B2 compared to Group B1 of Enriquez de Salamanca's classification, the first group being considered to be a more severe congenital malformation than the second. The inflow tract/outflow tract ratio of the right ventricle ranged between 80% and 50%, with an average of 62.3% in Group B1 compared to 62% and 24% with an average of 49% in Group B2. Using Studert's test, this difference was shown to be statistically significant (p = 0.02). On the other hand, there was no correlation between the other parameters or between the severity of the anatomical lesions and the clinical condition. The reduction of the right ventricular inflow tract may give an indication as to the type of atrioventricular valve which may be present.