Introduction: Anisocorias are a relatively frequent reason for consultation in neuroophthalmology units. They remain a diagnostic challenge for specialists as they may be due to several aetiological factors. In the absence of other accompanying symptoms, anisocorias are usually due to benign processes. Benign episodic mydriasis (BEM) is an isolated cause of intermittent pupil asymmetry in which the pathophysiology is still not fully understood; it is predominant in young women with migraine.Subjects, material, and methods: We describe the epidemiological and clinical characteristics of patients with BEM, assessed in a neuro-ophthalmology unit in a tertiary hospital.Results: A total of 7 patients were diagnosed with BEM, all of them females, with a mean age of 33 ± 10 years. The patients presented with pupil asymmetry (n = 5) and blurred vision (n = 2), and 6 of the 7 patients had unilateral involvement. The duration of impairment varied from a few minutes to 48 hours. Four patients (57%) had a clinical history of migraine without aura. The episodes in these 4 patients were recurrent (75%), often lasted for a few minutes (75%), and had associated blurred vision (50%). The neuroimaging studies were normal.Discussion: BEM appears predominantly in young women. It is frequently related to a previous history of migraine, and the specialist must consider if it is a concomitant symptom of common migraine, migraine with aura, or ophthalmoplegic migraine. Although BEM has unilateral predominance, there may be alternation of the affected eye or even bilateral impairment during the same episode, which makes us question the adequacy of the term to describe the process. Imaging tests are not recommended in the absence of other accompanying symptoms, or in short-term episodes. Benign episodic mydriasis in a neuro-ophthalmology clinic 291 PALABRAS CLAVE Anisocoria; Aura inusual; Equivalentes migrañosos; Midriasis benigna episódica; Migraña sin aura; Migraña oftalmopléjica Midriasis benigna episódica. Experiencia en una consulta monográfica de neuro-oftalmología de un hospital terciario ResumenIntroducción: Las anisocorias son un motivo de consulta relativamente frecuente en unidades de neuro-oftalmología (UNO). Suponen un reto diagnóstico por la variedad de procesos que pueden ocasionarla. En ausencia de síntomas acompañantes, suelen estar ocasionadas por procesos benignos. La midriasis benigna episódica (MBE) es una causa aislada de asimetría pupilar intermitente, de fisiopatología no esclarecida y predominio en mujeres jóvenes migrañosas.Sujetos, material y métodos: Describimos las características epidemiológicas y clínicas de los pacientes con MBE valorados en una UNO de un hospital terciario.Resultados: Un total de 7 pacientes fueron diagnosticadas de MBE. Todas eran mujeres, con edad media de 33 ± 10 años. Los motivos de consulta fueron asimetría pupilar (n = 5) y visión borrosa (n = 2) de presentación fundamentalmente unilateral (n = 6). La duración fue variable, desde minutos hasta 48 h. Cuatro pacientes (57%) presentaban...
BEM appears predominantly in young women. It is frequently related to a previous history of migraine, and the specialist must consider if it is a concomitant symptom of common migraine, migraine with aura, or ophthalmoplegic migraine. Although BEM has unilateral predominance, there may be alternation of the affected eye or even bilateral impairment during the same episode, which makes us question the adequacy of the term to describe the process. Imaging tests are not recommended in the absence of other accompanying symptoms, or in short-term episodes.
BackgroundThe proper methods of storage of medicines are of great importance for the maintenance of their stability and therefore their efficacy and safety. Some factors that may affect the drug are: moisture, light, heat, air, time, bacteria and fungal growth.PurposeThe aim of the study is to research household storage habits of oral drugs dispensed by the outpatient hospital pharmacy service.Material and methodsProspective, observational study. All attendees to the outpatient pharmacy service during a period of 1 month were invited to voluntarily participate in the study. An anonymous survey was conducted including 17 items regarding sociodemographic data, knowledge about package insert conservation information content, conservation of original packaging and leaflet, place of home storage, presence of children at home, review of expiry dates and place where expired medication is discarded. Analysis of the influence of socio-demographic factors on wrong storage practices was performed by Chi-square test.ResultsOne hundred and eighty-five patients were included. Mean age (±SD) was 56 (±14.7) years. 49.7% patients did not have any studies and 50.3% had secondary or university studies. Sixty-two per cent of patients remembered to have been informed by the pharmacist about storage conditions and 53.1% knew that this information was included in the leaflet. Regarding the place of storage, 36.5% used the bedroom followed by the kitchen (33.7%), living room (36.5%) and bathroom (5.5%). Most of the patients admitted to retaining the original container (70.6%) or leaflet (68.8%). Drugs were generally stored in a closed place (79.8%), nevertheless 47% of patients admitted that it was accessible (26.5% lived with children). Some patients stored medicines inappropriately under cool conditions (9.2%) or near to a heat source (6.5%). Thirty-five per cent kept medicines that were no longer needed and 22% did not check the expiration date. 24.5% of patients threw out their medicines in the rubbish. A relationship between level of education and this behaviour was observed. The wrong practice was more frequent among patients with a high level of studies (p<0.01).ConclusionA significant proportion of patients presented an information gap regarding drug storage conditions. Several wrong storage practices were identified. There is room for improvement regarding these issues and the pharmacist’s role in patient education could be important.No conflict of interest
contraindicated medications include: unadministered contraindicated medications (220 cases, 42.8%); drugs taken intermittently or pro re nata (PRN) (147, 28.6%); administered by a clinical decision (79, 15.4%); local administration (21, 4.1%); meaningless words(44, 8.6%); and emergency medication (three, 0.6%). The reasons for prescribing contraindicated medications with drug-drug interaction in cases of anti-diabetic agents with CT contrast medium were as follows: unadministered contraindicated medications(95 cases, 76.0%), meaningless words (22, 17.6%) and administered by a clinical decision (eight, 6.4%). Reasons for other genitourinary organ and rectal agents with vasodilator were PRN (54 cases, 38.3%), administered by a clinical decision (42, 29.8%), unadministered contraindicated medications (29, 20.6%) and meaningless words (16, 11.3%). Reasons for NSAID with other cardiovascular drugs were PRN (65 cases, 69.9%), unadministered contraindicated medications (16, 17.2%) and local administration (13, 28.9%). Conclusion We confirmed that certain medications were sometimes prescribed using an incorrect reason. Some clinicians input a reason that was something other than a PRN drug use, or entered a meaningless words. It is necessary to improve the system of entering the reasons why clinicians prescribe contraindicated drugs. REFERENCES AND/OR ACKNOWLEDGEMENTSWe acknowledge the assistance of Soojeong Yoon.No conflict of interest.
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