Flow-limiting compression is a frequent finding during conventional hemostasis after transradial catheterization. Absence of radial artery flow during compression represents a strong predictor of radial artery occlusion.

This may affect treatment efficacy positively in the long term. No conflict of interest. AdvAntAges And disAdvAntAges of An electronic Prescribing system. AsPects to consider during PhArmAcist vAlidAtion.

BackgroundBaker’s cyst (BC) is synovial fluid accumulation in the gastrocnemius semimembranous bursa that communicates with the knee joint, often secondary to degenerative or inflammatory joint disease. Its breakdown usually produces swelling and pain of the affected lower limb, leading to loss of function. Normally, it does not require treatment unless it is symptomatic. In such cases, the cyst can be aspirated to reduce its size, with subsequent intra-articular administration of 40 mg triamcinolone acetonide to reduce inflammation. Synovectomy and intra-articular methotrexate (IAM) are reserved for refractory cases. However, in the bibliography review, we have only found two citations of IAM.PurposeTo describe the tolerability and effectiveness of IAM in the treatment of BC in a patient with rheumatoid arthritis (RA).Material and methodsA 54-year-old man with RA, treated with subcutaneous methotrexate 15 mg weekly and intravenous tocilizumab monthly,also presented with a relapsing cyst in the right lower limb aspirated on two previous occasions. In the presence of severe calf muscle damage, the patient was admitted to the hospital. Pig-tail drainage catheter was placed and washes with 20 ml of saline per nursing shift were made. After 3 days without improvement, interventional radiology service in cooperation with internal medicine contacted the hospital pharmacy requesting 25 mg methotrexate and 80 mg methylprednisolone for intra-articular administration. Via the interventional radiology service, precharged syringes of methotrexate and methylprednisolone were administrated by intra-articular injection through the catheter.Results2 months later, the patient’s disease was under control with an improvement in inflammatory markers: C reactive protein and erythrocyte sedimentation were 1 mg/mL and 12 mm/h, respectively, compared with 94 mg/L and 108 mm/h before methrotexate administration. 6 months later, he has not presented any signs of swelling and the inflammatory markers have remained <1 mg/L and 2 mm/h.ConclusionAdministration of IAM for the treatment of BC could be considered a well tolerated treatment option in recurrent and refractory cases to conventional treatment. Our patient presented analytical and subjective clinical improvement. However, more experience and follow-up are needed to draw conclusions to apply to clinical practice.References and/or AcknowledgementsSee explanation to reviewersNo conflict of interest.

BackgroundDetection of drug related problems (DRP) and medication reconciliation (MR) are essential to decrease the harmful effects in patients. If any DRP is found during admission, it is important to notify not only the professional responsible but also the general practitioner (GP).PurposeTo identify and notify DRP and discrepancies between chronic treatment and hospital medications when patients are admitted to the traumatology department (TD) in a hospital with 400 beds.Material and methodsPatients over the age of 65 years admitted to the TD with 5 or more chronic medications were included. Pharmacists reviewed the treatment 24 hours after hospitalisation, to perform MR, taking into consideration the patient’s interview and clinical history. Moreover, the patient’s medical prescription and analytical parameters were reviewed every day. If any DRP or any change in medication was found during admission, patients and their GPs were informed.ResultsBetween November 2015 and July 2016, 241 pharmaceutical recommendations (PR) were registered, corresponding to 230 patients. 60% were accepted, 13.4% were justified discrepancies and 26.6% were not accepted. From the 241 PR, 80.8% were discrepancies between usual medication and medication on hospitalisation and 19.2% were DRP (inappropriate medications in patients with Parkinson’s disease and elderly patients, dose adjustment in patients with renal insufficiency, interactions, sequential therapy and adequacy of treatment). From the MR discrepancies, more than half (52.2%) were related to omission of medication, 29.6% were discrepancies found with the dose prescribed and 18.6% were related to medication prescribed at admission time that patients were not taking any more. During this period of time, 18 GPs were informed about detected DRP and changes in medication during hospital admission.ConclusionPharmacists integration in multidisciplinary teams can help to detect and resolve discrepancies between chronic treatment and hospital medications and minimise DRP. It is essential to update GPs if any discrepancies or changes in medication have been found during healthcare transition.No conflict of interest