Background-Diabetes and heart failure frequently coexist. Our aim was to assess the association between diabetes and short-and long-term outcomes in all patients admitted to the hospital for the first time with heart failure in Scotland between 1986 and 2003. Methods and Results-A total of 116 556 patients were studied, of whom 13% (nϭ15 161) had a diagnosis of diabetes.At 30 days, diabetes was associated with a lower case fatality. By 1 year, the association between diabetes and better outcome was reversed, and diabetes was a significant independent predictor of higher case fatality. The longer term risk of death associated with diabetes was greatest in younger patients. In patients aged 65 years or younger, the hazard ratio for mortality at 5 years associated with diabetes was 1.41 (95% CI, 1.31 to 1.52) for men and 1.64 (1.50 to 1.79) for women. The risk associated with diabetes was less in patients aged 75 years or older: a hazard ratio in men 1.16 (1.10 to 1.22) and in women 1.15 (1.10 to 1.20). In the younger age group the risk associated with diabetes was significantly greater in women than in men (Pϭ0.005 for diabetes-sex interaction). Diabetes was also a significant independent predictor of heart failure readmission, and again the risk was greatest in younger women. Conclusions-Although diabetes was associated with a lower case fatality at 30 days, by 1 year it was a significant independent predictor of higher case fatality. The risk associated with diabetes was greatest in young patients, and in young patients the risk was greatest in women. (Circ Heart Fail. 2008;1:234-241.)

The intervention of a pharmacist reduced the incidence of delayed CINV and improved medication adherence.

Our study confirms low adherence with both local and international recommendations for antiemetic prescriptions. However, we could not prove that adherence involves a CINV reduction. Adherence did not seem to be influenced by the doctor's perception of the patient's risk of emesis.

In Spain, adrenalectomy is performed in hospitals of varying complexity. Laparoscopic approach is the rule, with good results in terms of morbidity and stay. High-volume centers and surgeons had best results in terms of use of minimally invasive surgery and hospital stay.

No abstract

Multiple sclerosis patients' treatment adherence during a period of one year has been lower than the ideal. The causes should therefore be analysed and corrective measures established.

Background Erlotinib, gefitinib and crizotinib are tyrosine kinase inhibitors (TKIs) used in the treatment of non-small cell lung cancer (NSCLC). Their hepatic metabolism involves several cytochrome p450 isoenzymes, making them susceptible to potential interactions. Purpose To identify and analyse potential interactions between TKI and the patients’ home treatment, and to determine the degree of acceptance of recommendations by the clinician. Materials and methods In our prospective study, we selected all patients with NSCLC treated with TKIs using the Pharmacy Landtools software, monitoring them over a period of six months. Sociodemographic, clinical and home treatment (HT) data were obtained through electronic medical histories. HT was confirmed by interviewing patients. The interactions were consulted in the SPC, the Micromedex and Lexicomp databases and related scientific articles. Results 19 patients were studied (31.58% men and 68.42% women) with a median age of 71 years (aged 46–83). 11 patients were treated with gefitinib, 5 with erlotinib and 3 with crizotinib. 18 potential interactions were detected, distributed as follows: 44.44% gefitinib and 27.78% erlotinib and crizotinib, respectively. 75% were due to the use of proton pump inhibitors. Of these interactions, only those considered relevant were reported (72.22%). 92.31% recommendations were accepted, resulting in substitution (83.33%) or withdrawal (16.67%) of the drug. During our intervention period, no side effects related to a drug-drug interaction were detected. Conclusions Although TKI interactions are described in the literature, they are not always detected by the clinician. It is essential to detect, report and improve patients’ drug treatment, preventing these potential interactions which may result in adverse effects or in lack of effectiveness of the antitumor treatment. No conflict of interest.