Adult T-cell leukemia/lymphoma (ATLL) is a largely incurable disease. Cutaneous involvement is common and could be first symptom of the disease. We analyzed 169 patients with ATLL of whom 63 had cutaneous involvement. Cutaneous involvement was found in 48, 27, 17, and 60% of acute, lymphomatous, chronic and smoldering ATLL cases, respectively. Eight cases had primary cutaneous tumoral variant. Erythroderma (24%) and plaques (22%) were the most frequent skin lesions. The presence of cutaneous involvement was associated with better overall survival compared to non-cutaneous involvement (aHR 0.55 [95% CI: 0.37-0.82], p < 0.01; 1-year OS 53 vs. 27%, respectively, p ¼ 0.012). Combination zidovudine and interferon-alpha (AZT-IFN) yielded high response rates (overall response, OR ¼ 100%, n ¼ 8; complete response 62.5%) compared to chemotherapy (OR ¼ 33.3%, n ¼ 12/36). In conclusion, cutaneous involvement was associated with better survival in Latin American patients with ATLL. AZT-IFN demonstrated encouraging responses in ATLL patients with cutaneous involvement.

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BackgroundThe drugs listed in fertility treatments are complex in both their preparation and handling, and in routes of administration, in most cases subcutaneously. Hospital pharmacies are now responsible for dispensing these drugs. Thus it is necessary to implement pharmaceutical care programmes to improve patient information and, ultimately, the effectiveness of these treatments.PurposeTo analyse the user’s level of satisfaction, by anonymous written survey, with a pharmaceutical care programme for fertility treatments.Material and methodsTransversal study over 7 months (September 2014 to March 2015). The pharmaceutical care programme consisted of: (A) initial interview with the patient in order to gain information on allergies and interactions between prescribed medications and regular medications. Dosage, method of administration, handling, storage conditions and adverse effects of these drugs were also explained; (B) follow-up interviews after each medical check-up where adherence was checked, drug related problems were resolved and prescribed medication was dispensed.To assess the level of satisfaction, a 5 question survey with a Likert Scale was delivered to each patient. The 5 questions assessed the quality of care and usefulness of information received by the pharmacist. In addition, the users were requested to indicate, in order of importance, the following three aspects: (1) confidentiality and privacy, (2) information received by the pharmacist and (3) accessibility and facilities. Finally, the questionnaire included an overall assessment of the attention provided in a scale of 1–10 (10 being the highest rating). Ethics approval was obtained.Results62 users received the survey and 54 completed it. 100% of patients who completed the survey felt very satisfied with the information received from the pharmacist and with the care received. The information received by the pharmacist was the most important factor for 63% of respondents. The overall rating average for helpfulness/care received was 9.09 points.ConclusionAccording to the results of our survey and the high level of user satisfaction, we can conclude that pharmaceutical care programmes in fertility treatments are an important strategy for achieving optimal treatment compliance by the patient.No conflict of interest.

BackgroundImplementation of new technologies in the drug administration phase (AP) is one of the recommendations suggested by most of the health agencies in order to prevent medication errors (ME).PurposeTo asses the effectiveness of a bar code assisted chemotherapy system (BCCS) in cancer patients.Material and methodsProspective before and after study performed in a hospital centre in two phases. Over a 12 month period, ME in the administration were registered by review of the medication orders and medical history. The BCCS (ONCOSCAN) was designed and implemented. A follow-up period of another 12 months was assessed. The difference in rates of ME recorded before and after the BCCS system was implemented was analysed. The main purpose of this technology is to ensure that chemotherapy medication is administered correctly by scanning the bar codes and the preparation label of the medication orders, at the correct dose, at the correct time, at the correct infusion rate, to the correct patient.Sample size was determined to identify an expected error reduction of ME with result of harm to patient of 75% and a type I error of 0.05 with 80% power. Student t tests were used to compare error rates between periods.Results500 patients were collected, 250 in each period. 6584 prescription lines were reviewed, 3240 in the first period and 3344 in the second period. There were no ME reported at AP in the medical history of the patient in the first period. After implementation of BCCS, 28 ME were detected and avoided (0.84% of intravenous mixtures; p < 0,01); 19 of them corresponded to the administration in a different order than established in the treatment protocol and 9 patients did not have the correct chemotherapy treatment to be administered. In every case the system sent out advice and 100% of ME detected were avoided.ConclusionBar code assisted chemotherapy systems allow identification of ME before they reach oncology patients, avoiding harm and increasing the safety of the care process.No conflict of interest.

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