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The relationship between the IgM antibody response, antigenic load as well as the clinical improvement after chemotherapy was studied in order to obtain useful data for the early diagnosis and monitoring leprosy. A level of 82% (94/115) agreement was obtained between IgM UMELISA HANSEN and slit-skin smear examination. Discrepant results were observed in 16 patients who showed positive IgM response despite negative by the skin smear examination. In these patients, the IgM response was seen to be associated to the early signal for bacilli recurrence in the skin. In one of these patients the presence of bacilli was demonstrated in the skin, two months after IgM antibodies being detected by UMELISA HANSEN. Also in one of the treated patients positive by both diagnostic techniques, a remarkable decrease in the IgM antibody levels was seen, correlating with a significant clinical improvement. Moreover it was found a direct relationship between the IgM antibody response and bacterial antigenic load, regardless the time elapsed in the disease's evolution.

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Background and importance The use of telepharmacy technology allows pharmacists to provide clinical pharmaceutical services to patients who need regular services during the COVID-19 pandemic while maintaining distance and minimising faceto-face meetings. Aim and objectives To analyse the implementation of a telepharmacy system in a tertiary hospital as a pilot project during the COVID-19 pandemic. Material and methods Prospective observational study conducted from March 2020 to May 2021 in the Outpatient Unit (OU) of the Pharmacy Service of a tertiary hospital. Telepharmacy was implemented by selecting patients who agreed to participate in this project. A circuit was established in which the pharmacist carried out pharmaceutical care to collect relevant information on the pharmacological treatment of the patients, validated the treatment and proceeded to carry out the hospital dispensing, followed by the dispatch of medication to the Pharmacy Office closest to the patient's home. Once the medication had been dispensed, the hospital pharmacist performed pharmacotherapeutic follow-up telephone consultations to check that everything was correct. Results During this period, 5878 patients attended the OU, 2875 (48.9%) were selected to benefit from the implementation of telepharmacy because of their advanced age, mobility problems, vulnerability due to their disease, and distance due to living in a rural area. 33 515 hospital dispensations were done, 15 500 (46.2%) were dispensed through the telepharmacy system, with an average of 6 hospital dispensations per patient.The largest number of patients served by the telepharmacy system were from Neurology (363, 14.6%) with 2136 dispenses (18.0%), followed by Rheumatology (348; 14.0%) with 1832 dispenses (15.5%), in third place was Dermatology (191; 7.7%) with 889 dispenses (7.5%) and in fourth place Pneumology (112, 4.5%) with 792 dispenses (6.0%). The average number of dispensations per month at OU was 2700, of which 1500 were face-to-face and 1200 were shipments. Conclusion and relevanceThe implementation of telepharmacy has been a new challenge for the Pharmacy Service. It has proved to be a helpful tool to facilitate pharmaceutical care and hospital dispensing of medicines during the pandemic, avoiding face-to-face visits.