BackgroundACP programs allow patients to express their doubts, fears and preferences about end-of-life care, but often focus on documents instead of communication process. Health workers view ACP in a very positive light but they do not feel adequately trained to have these discussions.AimTo promote ACP with chronic patients and to improve doctors and nurses’ training in ACP.MethodsBottom-up project about ACP with chronic patients, people older than 75 and patients that could die in the next year. Semi-structured interviews in the primary care setting with patients, relatives, doctor and/or nurse and a ACP facilitator.Results279 patients (59% female, mean age 66) participated in 386 interviews (mean duration 42 min) from 1–10–2013 to  1–10–2014. An Advance Directive was drafted in 65% of cases. ACP information was given to 418 people (relatives included). Patients are afraid of pain and suffering but also of loss of autonomy or becoming a burden on the family. They prefer to be cared for at home, except in cases where people that live alone or do not have adequate support from the family. Most of them would like to donate organs after death if it were possible.ConclusionEliciting conversations with patients about end-of-life care is easier if it is not focused on documents and is performed in a primary care setting with their doctor and nurse who they know and trust. The ACP facilitator initiates the conversation, clarifies any doubts, is responsible for the training and simplifies the process of documentation.

Se realizó un estudio randomizado en 40 gestantes que concurrieron a control prenatal al Instituto Materno Perinatal (IMAPE) y que se encontraban en el segundo trimestre de gestación. Un grupo recibió un compuesto no iónico de hidróxido férrico polimaltosa equivalente a 100 mg de hierro elemental asociado a 350 mg de ácido fólico, y el otro grupo no recibió hierro sólo vitaminas. Durante las 8 semanas de tratamiento, que alcanzaron al tercer trimestre del embarazo, se observó que el perfil hemático (Hb., Hcto. y Fe sérico) de las gestantes que recibieron hierro fue significativamente superior a del grupo de control, habiéndose presentado intolerancia al producto (náuseas) en sólo 2,3% de las gestantes. En base a conocimientos universales y a las experiencias adquiridas con el estudio se propone un índice de riesgo para anemia en el embarazo y un esquema de tratamiento en base a la puntuación obtenida en cada caso.