Notes

Tension reactivity and also cultural cognition in pure as well as co-occurring earlier child years relational bullying along with victimization.
Drug-drug interactions may modify the therapeutic effect orthe safety profile of the medicines used in pediatric populations. Althoughinterest on potential drug interactions in these age groups has increased,information on clinically relevant drug-drug interactions is still scarce. Theaim of this study was to explore the prevalence and characteristics ofpotential and clinically relevant drug-drug interactions among pediatricpatients hospitalized in two pediatric hospitals of Mexico City.

A cross-sectional study was conducted on patient records incritical, oncological, burns and other non-critical services by a pediatricresident physician at both hospitals. Micromedex® was used as a sourceof potential drug-drug interactions data. Subsequently, each interaction'sprevalence, severity and evidence level were estimated. Additionally,drug-drug interaction causality with regard to diverse clinical outcomes ofhospitalized patients was determined through the Drug Interaction ProbabilityScale. The clinical consequeght beunderestimated.
Potential drug-drug interactions were common in the pediatric patients studied, whereas the frequency of real drug-drug interactions was low. However, some drug-drug interactions required medical actions in addition to routine monitoring. More information is needed on real drug-drug interactions as those related to failed efficacy might be underestimated.
Deep remission (DR) defined by clinical-biomarker remission and mucosal healing (MH) has emerged as a new therapeutic target in inflammatory bowel disease (IBD). The aim of this study was to define an optimal cut-off concentration for IFX and ADA during maintenance therapy associated with DR. The secondary objective, was to evaluate the influence of variables on anti-TNF concentrations and DR.

Retrospective study including 120 and 122 patients IBD diagnosed who received maintenance therapy with IFX and ADA. Biomarker remission was considered by C-reactive protein (CRP)&lt;5 mg/L and fecal calprotectin (CF)&lt;100 mcg/g. Crohn's disease (CD) clinical remission was defined by a Harvey Bradshaw score&lt;5 and MH by a simple endoscopic score for CD (SES-CD)&lt;3. check details In ulcerative colitis (UC), it was defined as a Mayo total score&lt;3 and Mayo endoscopic subscore&lt;2. Receiver operating characteristic (ROC) test was performed to determine drug concentration thresholds associated with DR./L and FC<100 μg/g. Multivariate regression identified FC<100 μg/g, CRP<5mg/L, IFX ≥3.1μg/mL and ADA concentrations ≥6.3μg/mL as factors significantly associated with DR. CONCLUSIONS Trough IFX and ADA concentrations, CRP<5mg/L and FC<100 μg/g are associated with DR during maintenance therapy. Cutoff point of 3.1 and 6.3 g/mL for IFX and ADA respectively, were identified as DR predictors.
The literature has described the interaction between valproicacid and carbapenems. This interaction leads to decreases in plasmaconcentrations of valproic acid. The main objectives of this study were toassess its relevance in clinical practice, to identify variables associatedwith increased seizure episode rates, and to analyse the impact of pharmaceuticalintervention on avoiding the effects of this interaction.

An observational retrospective study of inpatients withepilepsy admitted between 2016 and 2020. Their pharmacologicaltreatment throughout admission was recorded, and the presence of otherinteractions leading to decreased plasma concentrations of valproicacid was reviewed. The seizure rate during the year prior to admissionwas compared to that during the interaction period. For every episodein which the interaction was detected, an intervention was conducted byproviding the prescriber with information on the interaction and suggestinga change of antibiotherapy as well as the pharmacokinetic monitorlintervention may contribute to preventing seizures associatedwith this combination.
The interaction between valproic acid and meropenem or ertapenem is clinically relevant. It is recommended that this combination should be avoided provided that a viable alternative is available. Pharmaceutical intervention may contribute to preventing seizures associated with this combination.
Cyclin-dependent kinase 4/6 inhibitors have a synergisticeffect in combination with endocrine therapy. This combination is usedas first and subsequent-line treatment for advanced luminal breast carcinomabecause it increases progression-free survival. We analysed clinicalcourse and toxicity in patients treated with palbociclib in our hospital anddetermined potential associations between these variables and clinicopathologicalvariables.

Observational retrospective study including patients withadvanced or metastatic breast cancer treated with palbociclib plus endocrinetherapy at the Hospital Universitario de Cabueñes between 2017and 2020. We analysed clinicopathological variables, toxicity, and survival.Results In total, 72 women and 1 man (median age 63 years) receivedpalbociclib plus an aromatase inhibitor or fulvestrant. When used as firstlinetreatment, progression-free survival was 22 months, and as secondand subsequent-line treatment, progression-free survival was 13 months.Adverse effects (mainly haematological) were experienced by nearly all any patient, although delays and dose adjustments were common (61.7% and 42.7%, respectively). Performance status alone had a significant impact on progression-free survival (22 months in patients with ECOG 0 vs 12 months in patients with ECOG ≥ 1; P = 0.021).

Disease stage, age, and performance status do not limitthe use of treatment with palbociclib, nor its combination with aromataseinhibitors or fulvestrant for first or subsequent-line treatment. Toxicityis easily managed. Real-world results are equivalent to those publishedto date.
Disease stage, age, and performance status do not limit the use of treatment with palbociclib, nor its combination with aromatase inhibitors or fulvestrant for first or subsequent-line treatment. Toxicity is easily managed. Real-world results are equivalent to those published to date.
Hospital pharmacy services have adapted to the COVID‑19pandemic. The aim of the study is to determine the economic consequencesof replacing hospital pharmacy dispensation with other dispensingmethods in the context of biological treatments for psoriasis in Spain.

Multiple dispensation scenarios were evaluated, combiningdifferent dispensation frequencies and sites, and telepharmacy followupintervals. Self- injectable biological medicines for psoriasis (interleukinand tumour necrosis factor alpha inhibitors) were included. All costs(in 2020 euros) were considered from the perspective of the NationalHealth System.

The annual cost of hospital pharmacy-based dispensationsevery 4 weeks combined with telepharmacy monitoring at each administrationranged from €194.9 to €2,088.0 per patient. Across the differentsimulated scenarios, biological medicines associated with the lowest costwere those administered less frequently (every 12 weeks).

In the post-COVID-19 era, new models of hospital pharmaceuticalcare that include changes in drug dispensation and telepharmacystrategies will have economic consequences for the National HealthSystem that merit consideration.
In the post-COVID-19 era, new models of hospital pharmaceutical care that include changes in drug dispensation and telepharmacy strategies will have economic consequences for the National Health System that merit consideration.
To improve the quality of the dispensing process and pharmaceuticalcare in the Outpatient Pharmacy through patient participationand Lean methodology, and to analyse the results obtained in terms ofefficiency and patient satisfaction.

Prospective observational single-centre study. A working groupwas organized with the health care staff involved in outpatient care toapply Lean methodology and detect improvement opportunities. Weused a focus group technique to understand the patients' experience. Theimpact on patient satisfaction was measured through a mass survey mailedout in December 2019 (before introducing the main measures) and inDecember 2020.

More than 30 improvement actions were identified after surveyingthe opinions of the patients and health care staff involved. Nineactions were prioritized, which were mainly related to structural andcircuit changes. Waiting times significantly improved (35% of patientswaited for more than 30 minutes before the improvement actions vs4.5% afterward). The results showed that waiting times and overall satisfactionsignificantly improved in the period between the two surveys. Inboth cases, the degree of satisfaction was higher after introducing theimprovement actions.

We analysed the situation of our Outpatient Service anddesigned the most appropriate improvement actions according to theresources available. This initiative was achieved through patient participation(via a focus group and mass surveys), the participation of health carestaff, and the application of Lean methodology.
We analysed the situation of our Outpatient Service and designed the most appropriate improvement actions according to the resources available. This initiative was achieved through patient participation (via a focus group and mass surveys), the participation of health care staff, and the application of Lean methodology.
To evaluate the importance and need for pharmacists toexpand their role to new activities and to promote and maintain othersthey already carried out prior to the implementation of a new ImmunemediatedInflammatory Diseases Unit to be created in our hospital; toprioritize the new activities incorporated based on the results obtained.

This was a single center cross-sectional based on a survey administeredduring January 2020 to all clinical healthcare providers due to bepart of the new unit, as well as to a sample of patients. It was structuredinto two categories actions related to patients' pharmaceutical care, andactions related to practitioners of the Immune-mediated Inflammatory DiseasesUnit. Each item was assigned a score from 0 to 10, where 10 indicatedmaximum interest or need. A prioritization template was applied to quantifyand evaluate each activity and implement the new ones in order of priority.

A total of 90 responses were obtained (30 from patients and60 from healthcare workers). An analysis waeful in prioritizing the implementation of the new activities to be carried out by the unit.
To provide new insight into the training needs and resourcesrequired by hospital pharmacy resident tutors in Spain, as well as into theirlevel of motivation and satisfaction with their teaching.Method Google Forms® was used to design a survey addressed to hospitalpharmacy resident tutors between January and March 2019. Theysurvey consisted of generic (tutor, hospital, service) and specific questions(available resources, teaching activities, teaching satisfaction, trainingneeds). A univariate exploratory analysis was conducted to study possiblefactors related to teaching satisfaction and motivation.Results Replies were received from 83 tutors (rate of response52.8%), from 15/17 Spanish regions. The annual resident/tutor ratio was4 (IQR = 2- 4). A total of 96.4% of tutors conducted interviews, of whom65.1% did so quarterly. Other activities included the management of externaltraining rotations (97.6%), planning of rotations (97.6%) and annual appraisals (96.4%). Only 17.1% of respondents were given time off their regular duties for their tutorship work, with 71.
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