To our knowledge, this report was the first available study of the equipment and human resources utilized for RRT in AKI patients in Latin America.

Background: The diagnosis of vitreoretinal lymphoma (VRL), a rare subtype of primary central nervous system lymphoma (PCNSL), currently relies on the histopathology of vitreous biopsy. Misdiagnoses occasionally happen due to the extremely low number of cancerous cells in vitreous fluid, and the examination of visual acuity and fundus can be subjective and inaccurate during VRL treatment monitoring.Methods: This study enrolled 16 VRL patients whose baseline aqueous humor (AH) and/or vitreoretinal fluid (VF) specimen subject to comprehensive genomic profiling using targeted next generation sequencing. Serial post-treatment AH or VF samples were also available for five patients. Cerebrospinal fluid (CSF) sampling and MRI examination were performed for patients showing symptoms of CNS metastasis.Results: Mutational profiles of baseline samples revealed that MYD88 (L265P) and/or CD79B activating mutations were present in 62.5% (10/16) of the cohort, whereas about 56% (9/16) of the patients carried IRF4 mutations and half (8/16) had CDKN2B copy-number loss, both of which the frequency was much higher in VRL than PCNSL. Mutations identified in baseline AH or VF specimens were highly concordant with comparable allele frequencies (AFs). Moreover, partial response was observed in 1 out of 7 patients (objective response rate [ORR], 14%) treated with ibrutinib, a BTK inhibitor that has demonstrated anti-tumor efficacy in PCNSL (ORR: 65%). Changes of variant AFs observed in post-ibrutinib samples were closely associated with changes in interleukin 10 (IL-10) levels indicative of treatment response. In addition, both AH and VF biopsies appeared to have more mutations detected at higher AFs when compared to CSF samples in patients who had signs of CNS metastasis (N ¼ 5).Conclusions: AH represents a substitute for vitreous fluid as a rich source of eyespecific tumoral genomic information, and we demonstrated that molecular profiling of the AH has clinical utility for VRL diagnosis and treatment monitoring. While different genomic traits may underlie variability in response to ibrutinib between VRL and PCNSL, further research of larger sample size is warranted.Legal entity responsible for the study: Sun Yat-

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BackgroundAppropriate, accurate and timely distribution of medicines to patients is a pharmacist’s responsibility. Automated dispensing cabinets (ADCs) improve efficiency in distribution; but patient safety may be compromised if they are used incorrectly.PurposeTo analyse pharmaceutical interventions in ADC dispensing, in order to adopt steps that improve patient safety.Material and methodsA descriptive study was conducted in a 470-bed specialist hospital. Over 8 months (April–December 2013) pharmaceutical interventions in drugs dispensing to 9 infirmary units with ADC were collected. Interventions were made and recorded during ADC drug replacement in hospital wards, or during incident resolution at the pharmacy cabinet control point. All interventions made during the study period were analysed to determine their category and frequency. Interventions were recorded according Hernández and Poveda’s classification of medicines errors in ADC.Results290 interventions were collected. The most frequent type of intervention was that related to incorrect ADC procedures and handling (59.7%). In this category, interventions were due to stock discrepancies (79), medicine devolutions discrepancies (35), lack of concordance with opiate stocks (25), wrong medicine location (17), and drug load (17). Another category identified was intervention related to the structure and functioning of the ADC (29.3%), and includes the following events: door blockage (29), drawer break/obstruction (14), other mechanical structural fault (19), mistakes in the ADC-hospital census connection (8), system breakdown (7), refrigerator failure (7) and electric supply failure (1). The less frequent intervention categories were those related to inappropriate handling and storage (11.0%), and included interventions caused by expired medicines (15), lack of opiate prescriptions (6), damaged medicines (3), cabinet start-up (1), quarantine drug unload (19), and other reasons (6).ConclusionThe most common interventions on automated dispensation process are related to handling of cabinets. Therefore it’s necessary to remind nurses periodically that correct handling of ADCs is essential to guarantee medicine availability and optimal storage, both necessary for safe drug use.References and/or acknowledgementsNo conflict of interest.

BackgroundPolypharmacy and inappropriate prescribing (IP) are well known risk factors for adverse drug reactions, which commonly cause adverse clinical outcomes in older people.PurposeTo measure the prevalence of inappropriate drug prescriptions in elderly patients who attend the emergency room and to assess the influence on emergency visits and hospitalisations of a multidisciplinary healthcare team project designed to identify and resolve them.Material and methodsMulticentric randomised controlled trial. Patients >65 years old admitted in the emergency room were randomised to a control or intervention group. Pharmacists reviewed chronic medication of patients assigned to the intervention group and identified IP according to STOPP-START criteria. The cases were discussed with emergency physicians and when judged appropriate a recommendation to modify drug treatment was sent to the primary care physician. The control group received the standard of care that did not include chronic medication review. The main outcome measure was the difference in the rate of hospitalisation and emergency visits between groups after 1 year of follow-up. We present preliminary results of IP prevalence in elderly patients.ResultsFour hospitals participated in the study and 665 patients were included (342 allocated to control and 305 to the intervention group). Mean age in the control group was 78.2 years and 78.99 years in the intervention group. The total number of drugs patients were receiving at the moment of inclusion was 3.275. Of these, 17.9% were IP according to STOP-START criteria. 530 recommendations to modify treatment were send to primary care physician. 81.1% of evaluated patients had IP.ConclusionIn our study, we found a high prevalence of IP and a high number of recommendations to modify drug treatment in older people were done. The final results of the study will clarify if these interventions improve clinical outcomes.No conflict of interest.