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OBJECTIVES: Up to 20% of HIV-related focal brain lesion (FBL) diagnoses cannot be determined without invasive procedures. In such cases, brain biopsy is an important step in the evaluation algorithm. The aims of this study were to describe the clinical outcomes of patients with FBL, the proportion of diagnoses confirmed by brain biopsies and their aetiologies, and to analyse the proportion of patients in whom the biopsy motivated a change in therapeutic management. METHODS: A retrospective cohort study was performed. The data from clinical records of patients with HIV-related FBL admitted between January 2005 and December 2015 were reviewed. RESULTS: A total of 137 patients were included in the study. The median age was 39 years [interquartile range (IQR) 33-44.5 years]. The median CD4 count was 54 cells/µL (IQR 21-124 cells/µL). Cerebral brain biopsy was performed in 21.16% of patients (29 of 137); 68.9% of these individuals (20 of 29) were diagnosed by histology, with results of central nervous system (CNS) lymphoma in 20.6% (six of 29), progressive multifocal leucoencephalopathy in 6.8% (two of 29), toxoplasmosis in 6.8% (two of 29), tuberculoma in 6.8% (two of 29), and other diagnoses in 27.6% (eight of 29). In nine patients, the histology was nonspecific. In 75.8% of patients (22 of 29), the result of the biopsy led to a change in the therapeutic management. We did not observe higher rates of mortality related to the procedure. Overall mortality at 30 and 90 days was similar in patients who were and were not biopsied. CONCLUSIONS: In this retrospective cohort study, cerebral biopsy was associated with significant adjustments in therapeutic management for a high percentage of patients.

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Introducción. Diversas publicaciones han relacionado el declive funcional con la aparición de síntomas, especialmente psicológicos o psiquiátricos, como ansiedad y depresión. Por otra parte, un trastorno depresivo inicial o previo al declive funcional también suele empeorarlo. Nos planteamos conocer la relación entre la existencia de declive funcional medido mediante descenso en índice de Barthel (IB) y la presencia de síntomas. Material y métodos. Estudio analítico prospectivo con los pacientes derivados a un Equipo de Soporte para Atención Domiciliaria (ESAD). Resultados. Seiscientos treinta y ocho casos, 53,9% (N=344) hombres, 56% (N=357) oncológicos y 44% (N=281) no oncológicos. La edad media fue 79,64 ± 10,8 años. Obtuvimos diferencias significativas (p<0,001) en declive funcional medido mediante descenso medio en el IB entre pacientes oncológicos (34,4) y no oncológicos (12,12). Encontramos diferencias significativas (p<0,001) en todos los síntomas registrados (dolor, disnea, anorexia, náuseas, ansiedad, depresión e insomnio) con mayor frecuencia en pacientes oncológicos, salvo en el caso de la agitación psicomotriz. En pacientes con mayor grado de declive funcional, con descensos en IB superior a 20 puntos, se detectó mayor presencia de síntomas. Salvo determinados analgésicos, no hubo diferencias en los tratamientos previos; sí encontramos diferencias en diversos tratamientos pautados por el ESAD. Conclusiones. La existencia de declive funcional y su grado pueden verse relacionados con la aparición de síntomas, especialmente en el paciente oncológico (AU)

Introduction. Several publications have related functional decline to the appearance of symptoms, especially psychiatric or psychological ones, such as anxiety and depression. Moreover, an initial depressive disorder or prior to functional decline usually worsens it. It was decided to investigate the relationship between the presence of functional decline, measured by a decrease in the Barthel index (BI), and the presence of symptoms. Material and methods. A prospective analytical study conducted on patients referred to a Home Care Support Team (HCST). Results. The study included 638 cases, of which 53.9% (N=344) were male, 56% (N=357) with cancer and 44% (N=281) geriatric. The mean age was 79.64 years+- 10.8. Significant differences (P<.001) were found in functional decline measured by mean decline in the BI between cancer (34.4) and non-cancer patients (12.12). Significant differences (P<.001) were also found in all recorded symptoms (pain, dyspnoea, anorexia, nausea, anxiety, depression, and insomnia), more frequently in cancer patients, except psychomotor agitation. A higher presence of symptoms was detected in patients with greater functional decline, with decreases in BI above 20 points. There were no differences in previous treatments, except in certain analgesics. Differences were found in the different treatments prescribed by HCST. Conclusions. The presence of functional decline and its level may be related to the appearance of symptoms, especially in cancer patients (AU)

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Introducción. La sedación, como medida terapéutica utilizada en el ámbito de los Cuidados Paliativos, sigue presentando para muchos profesionales dificultad en su manejo e indicaciones. Es muy variada la bibliografía existente en este sentido, muchas veces exclusiva de los pacientes oncológicos. Nuestro objetivo es analizar las características de los pacientes atendidos por un Equipo de Soporte para Atención Domiciliaria que precisaron sedación frente a los no sedados, para determinar posibles factores condicionantes de la misma que puedan ayudar en la toma de decisiones. Método. Estudio analítico prospectivo realizado en el sector sanitario de Barbastro (Huesca) desde septiembre del año 2007 hasta febrero del año 2011. La población a estudio fueron los pacientes derivados al Equipo de Soporte para Atención Domiciliaria de Barbastro. Variables principales. Edad, sexo, antecedentes médicos, síntomas, Barthel previo y actual, Karnofsky, cuidador principal, fármacos previos, fármacos tras intervención, sedación sí/no. Resultado. Requirieron sedación el 16,6% (n=106) de los casos (N=638). Los pacientes sedados fueron más jóvenes, sin diferencias por sexo. Un 83% fueron oncológicos. La presencia de metástasis no mostró diferencias respecto a la necesidad de sedación. Los pacientes sedados presentaron un mayor declive funcional, determinado mediante un descenso en el índice de Barthel y un peor Karnofsky. Los pacientes sedados mostraron una mayor frecuencia de síntomas no controlados, con excepción de agitación psicomotriz, hecho determinado por las medicaciones usadas pre y postintervención. Conclusiones. La presencia de enfermedad oncológica, con existencia de declive funcional marcado, clínica no controlada y necesidad de determinadas medicaciones para el control de la sintomatología pueden determinar la necesidad de sedación al final del proceso, por encima de otros factores como la comorbilidad del paciente (AU)

Introduction. Sedation, used as a therapeutic measure in the field of Palliative Care, continues to present difficulties for many professionals in its management and indications. Is varied existing literature in this regard, often exclusive cancer patients. Our objective is to analyse the characteristics of patients attended by a Home Care Support Team who required sedation compared to non-sedated patients, for possible determining factors for its use that could help in decision-making. Method. A prospective analytical study conducted in Barbastro (Huesca) from September 2007 to February 2011. The study population are patients referred to the Home Care Support Team of Barbastro. Main variables. Age, sex, medical history, symptoms, previous and current Barthel, Karnofsky, primary caregiver, previous drugs, drugs after intervention, sedation yes/no. Results. Required sedation 16.6% (n=106) of the cases (N=638). Sedated patients were younger, with no differences in sex, and the large majority (83%) were oncology patients. The presence of metastases showed no differences in need for sedation. Sedated patients have an increased functional impairment, determined by Barthel index decreased and a worse Karnofsky. Sedated patients showed increased frequency of uncontrolled symptoms, except psychomotor agitation, a fact determined by the medications used pre- and post-intervention. Conclusions. The presence of neoplastic disease, marked with existence of functional decline, and uncontrolled clinical need for certain medications to control symptoms may determine the need for sedation at the end of the process, above other factors such as patient comorbidity (AU)

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INTRODUCTION: Sedation, used as a therapeutic measure in the field of Palliative Care, continues to present difficulties for many professionals in its management and indications. Is varied existing literature in this regard, often exclusive cancer patients. Our objective is to analyse the characteristics of patients attended by a Home Care Support Team who required sedation compared to non-sedated patients, for possible determining factors for its use that could help in decision-making. METHOD: A prospective analytical study conducted in Barbastro (Huesca) from September 2007 to February 2011. The study population are patients referred to the Home Care Support Team of Barbastro. MAIN VARIABLES: Age, sex, medical history, symptoms, previous and current Barthel, Karnofsky, primary caregiver, previous drugs, drugs after intervention, sedation yes/no. RESULTS: Required sedation 16.6% (n=106) of the cases (N=638). Sedated patients were younger, with no differences in sex, and the large majority (83%) were oncology patients. The presence of metastases showed no differences in need for sedation. Sedated patients have an increased functional impairment, determined by Barthel index decreased and a worse Karnofsky. Sedated patients showed increased frequency of uncontrolled symptoms, except psychomotor agitation, a fact determined by the medications used pre- and post-intervention. CONCLUSIONS: The presence of neoplastic disease, marked with existence of functional decline, and uncontrolled clinical need for certain medications to control symptoms may determine the need for sedation at the end of the process, above other factors such as patient comorbidity.

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Este artículo está compuesto de dos partes. La primera parte consiste en un meta-análisis sobre la situación de las parejas que sufren de dificultades de infertilidad o esterilidad. En este sentido, se han analizado diferentes bases de datos, artículos, revistas, libros, tesis doctorales y autores en lengua hispana desde el año 2000 hasta el año 2013. De este modo, la principal conclusión es que hace falta mucho más investigación por parte de las ciencias sociales, como por ejemplo, la psicología. La segunda parte consiste en una propuesta de escala para medir el desajuste que provocan estas dificultades en la relación de pareja. En ella se miden la comunicación oral y gesto-afectiva, los sentimientos y actos de fracaso o abandono de la relación, y la percepción del apoyo marital y la presión familiar y social de la pareja de modo individual. Por lo tanto y para finalizar, la principal conclusión de ambas partes es la necesidad de mayores estudios desde dichas disciplinas (AU)

This article comprises two main parts. The first one is a meta-analysis of the situation of couples who have trouble conceiving. This analysis has been carried out by reviewing several data bases, articles, magazines, books, doctoral theses and authors in Spanish language published between 2000 and 2013. The main conclusion drawn is that more research needs to be done by social sciences such as psychology. The second part is a scale proposal for measuring the imbalance these difficulties cause in couple relationships. The following is measured within the scale: oral and nonverbal communication, feelings and acts of relationship failure or abandonment, perception of spousal support and both familiar and social pressure of the couple as an individual. Hence and finally, the main conclusion drawn from both parts is that further research is required from aforementioned disciplines (AU)

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The aim of this study was to develop a user-friendly checklist for critical appraisal of indirect comparisons of drugs, considering clinical, methodological/statistical and quality aspects, mainly to be applied in drug evaluation in the decision-making context. After conducting a review of the literature, we used group consensus to establish the key points of the checklist, focusing mainly on indirect comparisons, but including topics related to network meta-analysis or multiple treatment comparisons. The coordinating group elaborated the first draft, which was reviewed by external experts, re-evaluated by the coordinating group and finally assessed by 23 drug evaluation experts trained in indirect comparisons, who applied the checklist to one study. The Kappa index of agreement was calculated and the final checklist was developed by group consensus including the external experts. The checklist has two parts. The first consists of three eliminatory key questions while the second includes 17 items: 5 regarding quality, 5 regarding clinical issues and 7 dealing with methodology/statistics. The median kappa values of the 23 evaluations were 0.83 (range 0.67-0.93), 0.61 (0.54-0.91) and 0.36 (0.22-1) with regard to quality, clinical aspects and methodology/statistics, respectively. A structured checklist was developed to facilitate critical appraisal of key issues in indirect comparisons, including comments for assessing the consequences of its application to drug evaluation in the decision-making context. Agreement between reviewers in clinical and quality items was good, but weaker in methodology/statistics ones.

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AIM: Milligan-Morgan hemorrhoidectomy (MM) is still the most common treatment for grades III and IV hemorrhoids despite prolonged post-operative anal pain and wound healing. This multicenter, double blind, randomized, controlled trial was designed to assess the safety and the efficacy of anal wound cleansing with Triclosan (Proctocid®) in the control of symptoms and healing time after MM. METHODS: A total of 113 patients with grades III and IV hemorrhoids, undergoing open hemorroidectomy by diathermy or Ligasure vessel sealing device, were randomly assigned to Triclosan or sodium hypochlorite solution. All patients received analgesics and a fiber-rich diet after hemorrhoidectomy. Postoperative anal pain, bleeding and/or secretion and itch were assessed 7, 14 and 21 days after hemorrhoidectomy by a Visual Analogue Scale (VAS) and the day of complete re-epithelialization of anal wounds was recorded. RESULTS: Fifty-five patients were randomized for Triclosan treatment and 58 for the control drug. The two groups were comparable for demographics, severity of hemorrhoids and technique used for the hemorrhoidectomy. The comparison of days to get complete anal wound healing shows a trend of significance (P=0.05) for the Triclosan group. Bleeding and/or secretion, anal pain and itch were significantly better (P=0.003; P<0.0001 and P=0.01, respectively). CONCLUSION: Triclosan solution for the treatment of post-hemorrhoidectomy wounds is safe and improves the control of post-operative symptoms and wound healing time compared to sodium hypochlorite.

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WHAT IS KNOWN AND OBJECTIVE: Psoriatic arthritis is an autoimmune disease characterized by chronic inflammation of the skin and joints. Anti-TNF drugs reduce the severity of the disease in the long term. This study compares the efficacy and safety of adalimumab, etanercept, infliximab and golimumab in patients with psoriatic arthritis. METHODS: Direct comparison was based on a literature search of drug comparison studies, whereas indirect treatment comparison was based on phase III clinical trials with biological agents, involving similar populations and durations, and with the same outcome. ACR50 was taken as primary outcome for comparison, whereas ACR20 and ACR70 were used as secondary outcomes. Indirect comparisons were made using infliximab as the reference drug and the Bucher method. In calculating δ (the maximum acceptable difference as a clinical criterion of equivalence), use was made of half of the absolute risk reduction obtained in the meta-analysis of the clinical trials included in the indirect comparison (ARR 32%; δ: 16%). The four anti-TNF drugs were also compared in relation to the secondary outcomes and adverse effects. RESULTS AND DISCUSSION: Reported direct and indirect comparisons of the four drugs did not include golimumab, and did not yield conclusive results. Four clinical trials - one for each drug studied - were identified. The estimated differences for the primary outcome, ACR50, between infliximab and the other drugs were adalimumab (ARR 4%, 95% CI -9·5 to 17·5), etanercept (ARR 4%, 95% CI -10·5 to 18·5) and golimumab (ARR 9%, 95% CI -5·4 to 23·4). Likewise, there were no relevant differences between the drugs in relation to the secondary efficacy outcomes, except for etanercept, which was less effective in ACR70 response. For adverse reactions, there were also no significant differences except for injection site, reactions which were more frequent with etanercept, with a mean difference of 26% relative to infliximab. WHAT IS NEW AND CONCLUSION: No significant differences were found in ACR50 responses to the four drugs after 24 weeks. Injection-site reactions were more common with etanercept, but this was insufficient to invalidate the inference that clinically the four drugs can be regarded as clinically equivalent for the treatment of psoriatic arthritis.

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Objetivo: Cuantificar el uso de comparaciones indirectas (CI) en los informes de evaluación de medicamentos publicados en internet por el Grupo de Evaluación de Novedades, Estandarización e Investigación en Selección de Medicamentos (GENESIS).Método Estudio retrospectivo de los informes redactados en 2008-2009. Registro de la existencia de comparadores y características de los estudios comparativos directos e indirectos incluidos. Resultados En el 95% de los 337 informes analizados existe un comparador activo, en el 50% hay un estudio frente a éste. En 114 informes (34%), se referencia una CI, el 69% elaborada por el autor del informe. La mayoría fueron CI narrativas, ninguna ajustada. En los casos sin CI podría haberse realizado en el 16% y era dudoso en el 24%.ConclusionesMuchos medicamentos tienen comparador pero no estudios directos frente a éste, las CI deberían incorporarse en los informes en mayor medida y con criterios de calidad. (AU)

Objective: Quantify use of indirect comparisons (IC) in drug evaluation reports published on the GENESIS Group web page for new drug assessment, standardisation, and drug selection research. Method: Retrospective study of drug reports written between 2008 and 2009. Data collected: presence of an active comparator and details from any direct and indirect comparative studies included. Results: An active comparator was present in 95% of the 337 analysed reports; 50% included a direct comparative study vs comparator. In 114 reports (34%), an IC was used; 69% of the ICs were made by the report author. Most ICs were narrative and none were adjusted. An IC could have been made in an additional 16% of the cases and possibly in 24% more. Conclusions: Most evaluated drugs have an active comparator but studies comparing them directly are not as common. ICs could be included in more reports along with quality control criteria (AU)

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OBJECTIVE: Quantify use of indirect comparisons (IC) in drug evaluation reports published on the GENESIS Group web page for new drug assessment, standardisation, and drug selection research. METHOD: Retrospective study of drug reports written between 2008 and 2009. DATA COLLECTED: presence of an active comparator and details from any direct and indirect comparative studies included. RESULTS: An active comparator was present in 95% of the 337 analysed reports; 50% included a direct comparative study vs comparator. In 114 reports (34%), an IC was used; 69% of the ICs were made by the report author. Most ICs were narrative and none were adjusted. An IC could have been made in an additional 16% of the cases and possibly in 24% more. CONCLUSIONS: Most evaluated drugs have an active comparator but studies comparing them directly are not as common. ICs could be included in more reports along with quality control criteria.

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Objetivo Cuantificar la actividad de las Comisiones de Farmacia y Terapéutica (CFyT) con relación a la evaluación y selección de medicamentos, y describir la variabilidad en las decisiones de incorporación de los mismos. Método Estudio descriptivo transversal basado en un cuestionario dirigido a los 513 hospitales españoles con más de 75 camas. Se incluyeron preguntas referidas a las resoluciones de la CFyT, el posicionamiento terapéutico y los informes de evaluación. El reclutamiento se realizó entre noviembre de 2007 y enero de 2008. La variabilidad en las conclusiones de las CFyT se expresa en 5 categorías o grados de coincidencia. Resultados Participaron 175 hospitales, tasa de respuesta del 34% (54% de las camas). El número medio (DE) de medicamentos-indicación evaluados por hospital en 2006 fue 10,35 (7,45). La proporción de evaluaciones que concluyen en inclusión o rechazo del fármaco fue del 75,3 y 21,4%, respectivamente. En el 16,2% se concluyó en equivalencia terapéutica. Se establecieron condiciones de uso en un 64%, y se incluyeron en una guía clínica en un 33%. En cuanto a la variabilidad, en el 81,0% de las evaluaciones se coincide en la conclusión de incluir o de rechazar el medicamento, en el 19,0% se ha tomado la decisión opuesta a la mayoritaria. Conclusiones La actividad de evaluación y selección de medicamentos en los hospitales es considerable. La proporción de medicamentos aprobados es similar en los diferentes tipos de hospital. La variabilidad en la decisión de inclusión es amplia y similar a estudios realizados en otros países. Indican la conveniencia de estandarización de la metodología (AU)

Objective To quantify the Spanish Pharmacy and Therapeutics Commission (P&TC) activity with regard to assessing and selecting drugs and describing variability in decisions made to include them. Method Descriptive, cross-sectional study based on a questionnaire aimed at 513 hospitals with more than 75 beds. We included questions referring to the P&TC resolutions, the therapeutic positioning and assessment reports. Recruitment was carried out between November 2007 and January 2008. Variability among P&TC conclusions was presented in five categories or levels of coincidence. Results One hundred and seventy-five hospitals participated, with a response rate of 34% (54% of beds). The mean number of drug-indications assessed per hospital was 10.35 (7.45). The proportion of assessments that conclude with drug inclusion or rejection was 75.3% and 21.4%, respectively. 16.2% concluded with therapeutic equivalence. Conditions for use were established for 64% of them, and 33% were included in a clinical guide. With regard to variability, 81.0% of assessments coincided with the conclusion to include or reject the drug. A contradictory decision was made for 19.0%.ConclusionsDrug assessment and selection in hospitals are considerable. The proportion of drugs approved is similar in different types of hospitals. There is extensive variability as regards deciding upon inclusion and is similar to studies conducted in other countries. They indicate that a standardising methodology would be recommendable (AU)

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Objetivo Identificar productores de información farmacoterapéutica no publicada en revistas biomédicas orientada a la evaluación y posicionamiento terapéutico de los medicamentos y desarrollar un buscador para el acceso a dicha información. Métodos Recopilación de sitios web productores de información sobre uso racional de los medicamentos e independientes de los intereses promocionales. Páginas web de acceso libre, y en castellano, gallego, catalán o inglés. Diseño de un buscador mediante aplicación «búsqueda personalizada» de Google. Resultados Se han recopilado 159 direcciones de Internet y se han clasificado en 9 etiquetas. El buscador, denominado AlquimiA y accesible desde http://www.elcomprimido.com/FARHSD/AlquimiA.htm, permite recuperar información de las fuentes seleccionadas. Conclusiones Se han identificado las principales fuentes de información farmacoterapéutica no publicada en revistas biomédicas. El buscador constituye una herramienta útil para la búsqueda y acceso a las publicaciones de «evidencia gris» en Internet (AU)

Objective To identify publishers of pharmacotherapeutic information not found in biomedical journals that focuses on evaluating and providing advice on medicines and to develop a search engine to access this information. Methods Compiling web sites that publish information on the rational use of medicines and have no commercial interests. Free-access web sites in Spanish, Galician, Catalan or English. Designing a search engine using the Google “custom search” application. Results Overall 159 Internet addresses were compiled and were classified into 9 labels. We were able to recover the information from the selected sources using a search engine, which is called “AlquimiA” and available from http://www.elcomprimido.com/FARHSD/AlquimiA.htmConclusionsThe main sources of pharmacotherapeutic information not published in biomedical journals were identified. The search engine is a useful tool for searching and accessing “grey literature” on the Internet (AU)

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The unilateral boarding of the primary hiperparatiroidism constitutes a technical option increasingly secondhand and adapted for the characteristics of this surgery. This type of boarding has been possible for the appearance of the Tc sestamibi, of the subspecialization of the surgery and of the determination of the PTH intraoperatory. Later we expose an epidemiological, descriptive and retrospective study from january 2004 to December 2008. During this time there were controlled in the hospital Ramon and Cajal of Madrid a total of 195 patients for primary hiperparatiroidism. Of them, 140 were submitted to unilateral exploration by suspicion of the solitary adenoma. The correlation between the findings of Tc sestamibi and surgical was correct in all the cases (139) except one concerns to right or left side. It failed in 30 cases in which there was detected badly the top and low location. As for the results the adenoma was extirpated correctly in 135 of 140 patients. This way we can say that the combination of the gammagraphy, a surgeon with experience and the support of the PTH intraoperatory they meet a high rate of treatment in case of adenomas in the unilateral boarding on a rate of hipercalcemia appellant or persistently between 3 percent-5 percent, rate similar to the obtained one for expert surgeons on having fulfilled an exploratory cervicotomy (considered "gold standard") but with minor postoperatory morbidity, minor pain and minor surgical time.

El abordaje unilateral del hiperparatiroidismo primario constituye una opción técnica cada vez más usada y apropiada debido a las características de esta cirugía. Este tipo de abordaje ha sido posible por la aparición del Tc sestamibi, de la subespecialización de la cirugía y de la determinación de la PTH intraoperatoria. A continuación exponemos un estudio epidemiológico, descriptivo y retrospectivo desde enero de 2004 a diciembre de 2008. Durante este tiempo fueron intervenidos en el hospital Ramón y Cajal de Madrid un total de 195 enfermos por hiperparatiroidismo primario. De ellos, 140 fueron sometidos a exploración unilateral por sospecha de adenoma único. La correlación entre los hallazgos gammagráficos y quirúrgicos fue correcta en todos los casos (139) menos uno en cuanto a lo que a lateralidad se refiere. Falló en 30 casos en los que se detectó mal la localización superior e inferior. En cuanto a los resultados, se extirpó el adenoma correctamente en 135 de los 140 pacientes. Así podemos decir que la combinación de la gammagrafía, de un cirujano con experiencia y el apoyo de la PTH intraoperatoria proporciona una elevada tasa de curación en el caso de adenomas paratiroideos en el abordaje unilateral con una tasa de hipercalcemia recurrente o persistente entre el 3 por ciento-5 por ciento, tasa similar a la obtenida por cirujanos expertos al realizar una cervicotomía exploradora (considerada gold standard) pero con menor morbilidad postoperatoria, menor dolor y menor tiempo quirúrgico.

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Objetivo: valorar el entorno familiar y los hábitos de la población adolescente de nuestra área para detectar posibles factores asociados con alteraciones de la autoimagen o un mayor riesgo de presentar un trastorno de la alimentación. Material y métodos: 158 entrevistas a adolescentes que cursaban 1.º y 2.º de Enseñanza Secundaria Obligatoria, recogiendo sexo, edad, entorno familiar y social, horas de pantallas y contenidos, horas de deporte, horas de lectura y contenidos, autoimagen, test de actitud ante la alimentación (EAT-26) y somatometría. Resultados: el análisis de regresión logística mostró una asociación estadísticamente significativa entre la autoimagen correcta y las horas de deporte practicado (B = 0,11; p = 0,047), el hecho de tener hermanos (B = -1,4; p = 0,019), la puntuación total en el EAT-26 (B = -0,06; p = 0,005) y el índice de masa corporal (B = -0,1; p = 0,031). Conclusiones: el fomento del ejercicio físico y la difusión de ideas correctas sobre la imagen corporal pueden influir positivamente en una mejor autoimagen de la población adolescente y, del mismo modo, ayudar a prevenir posibles trastornos de la alimentación (AU)

Objetive: To evaluate familiar environment and habits of teenager population from our area to detect factors associated with alterations of self-image or an increased risk of presenting an eating disorder. Methods: One hundred and fifty-eight teenagers from first to second course of ESO (Obligatory Secondary Education) were interviewed collecting information about gender, age, family and social environment, time of screens viewing and contents, time of sport practicing, time of reading and contents, self-image, Eating Attitudes Test (EAT-26) and anthropometry. Results: The logistic regression showed a statistically significant association between self-image and time of sport practicing (B = 0.11; p = 0.047), having brothers (B =-1.4; p = 0.019), total punctuation on EAT-26 (B =-0.06; p = 0.005) and Body Mass Index (B =-0.1; p = 0.031). Conclusions: Promotion of sport practicing and healthy ideas about body image could improve teenager self-image and help to prevent the development of eating disorders (AU)

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Objetivo: Establecer un procedimiento normalizado de trabajo en caso de rotura de cadena de frio. Metodo Se seleccionaron los medicamentos termolabiles incluidos en la guia farmacoterapeutica del hospital y se reviso la bibliografia disponible, clasificandolos en categorias con un protocolo de actuacion en cada caso. Resultados Se revisaron 254 medicamentos (162 principios activos). La distribucion por categorias fue In addition, 433 (4.3%) of dispensed doses were returned to the Pharmacy Department. After the Unit Dose Quality Control Group conducted their feedback analysis, 64 improvement measures for Pharmacy Department nurses, 37 for pharmacists, and 24 for the hospital ward were introduced. Conclusions: The SSS programme has proven to be useful as a quality control strategy to identify Unit Dose Distribution System errors at initial, intermediate and final stages of the process, improving the involvement of the Pharmacy Department and ward nurses (AU)

Objective: To establish a standard operating procedure in the event of cold chain failure. Method: We selected thermolabile drugs included in the hospitals pharmaceutical guide. We performed a review of the available literature, classifying each drug into a given category with an intervention protocol for each one. Results: We reviewed 254 drugs (162 active ingredients). Categories were: A (stable ≥ 28 day sat 25◦C): 65 drugs; B (≥7 days at 25◦C): 47 drugs; C (≥48hat25◦C): 30 drugs; D (< 48 h at25◦C): 47 drugs; E (unstable> 8◦C): 12 drugs; F (batch-dependent) 22 drugs. 31 drugs were not classified in any category. The intervention protocol consisted of establishing a system to monitor the products concerned, and discarding or returning them to the laboratory if they were to exceed the time or temperature limit indicated for each category. Discussion: The aim of this study is to make intervention quicker in the event of cold chain failure (AU)

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OBJECTIVE: To identify publishers of pharmacotherapeutic information not found in biomedical journals that focuses on evaluating and providing advice on medicines and to develop a search engine to access this information. METHODS: Compiling web sites that publish information on the rational use of medicines and have no commercial interests. Free-access web sites in Spanish, Galician, Catalan or English. Designing a search engine using the Google "custom search" application. RESULTS: Overall 159 internet addresses were compiled and were classified into 9 labels. We were able to recover the information from the selected sources using a search engine, which is called "AlquimiA" and available from http://www.elcomprimido.com/FARHSD/AlquimiA.htm. CONCLUSIONS: The main sources of pharmacotherapeutic information not published in biomedical journals were identified. The search engine is a useful tool for searching and accessing "grey literature" on the internet.

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