The inconsistent use of hormonal contraceptive methods can result, during the first year of use, in one in twelve women still having an undesired pregnancy. This may lead to women experiencing fear of becoming pregnant (FBP). We have only found one study examining the proportion of FBP among women who used hormonal contraceptives. To gather further scientific evidence we undertook an observational, cross-sectional study involving 472 women at a Spanish university in 2005–2009. The inclusion criteria were having had vaginal intercourse with a man in the previous three months and usual use for contraception of a male condom or hormonal contraceptives, or no method of contraception. The outcome was FBP. The secondary variables were contraceptive method used (oral contraceptives; condom; none), desire to increase the frequency of sexual relations, frequency of sexual intercourse with the partner, the sexual partner not always able to ejaculate, desire to increase the partner’s time before orgasm, age and being in a stable relationship. A multivariate logistic regression model was used to determine the associated factors. Of the 472 women, 171 experienced FBP (36.2%). Factors significantly associated (p < 0.05) with this FBP were method of contraception (condom and none), desire to increase the partner’s ability to delay orgasm and higher frequency of sexual intercourse with the partner. There was a high proportion of FBP, depending on the use of efficient contraceptive methods. A possible solution to this problem may reside in educational programmes. Qualitative studies would be useful to design these programmes.
The Parry-Romberg syndrome (PRS), also known as hemifacial atrophy, is a rare neurocutaneous disease with the prevalence of 1/700,000 cases. It is more common in women than men, with an early onset of disease usually within the first two decades of life. Even though the etiology of PRS is unknown, it is thought to be a multifactorial disease that involves hereditary, posttraumatic, autoimmune, infectious, and neoplastic factors. There are a variety of systemic manifestations described in PRS including neurological conditions that range from intractable headache to refractory epilepsy. The manifestations must be identified in a timely manner to ensure an early therapeutic intervention, considering that an appropriate approach during the initial phase might halt the disease progression and markedly improve the quality of life in these patients. This article is aimed to describe the case of a 23 years old female with left hemifacial atrophy and dermatologic, dental, and neurologic compromise, associated with refractory temporal lobe epilepsy evidenced in neuroimaging and electrodiagnostic testings.
BackgroundMedication is the leading cause of adverse events related to healthcare. One of the most common safety issues is the lack of accurate and complete information about a patient’s medications during transitions between different levels of care.PurposeTo characterise and evaluate the impact of the implementation of a Medication Reconciliation Programmed (MRP) on the neurosurgery service at a university general hospital.Material and methodsRetrospective study between September 2014 and September 2016 in a university general hospital.The MRP is performed by the pharmacist when the patient is admitted to the neurosurgery department and requested. Home treatment is reviewed from the digital pharmacotherapeutic history and confirmed with the patient by interview. After that, the pharmacist makes recommendations according to the clinical situation of the patient, the drugs already prescribed in their hospital treatment and the ‘Guide to continuity of care for the management of perioperative medication’ developed by the pharmacy service. These recommendations are recorded in each patient’s medical history. When the patient is discharged, a pharmacotherapeutic report is drawn up containing the medication prescribed for discharge and the outpatient medication, which must be continued as a schedule and with identifying illustrations.In order to evaluate the activity of the PCM, it has been measured: patient data, drug-related problems (DRP) identified, days spent in hospital, number of reconciled drugs and intervention carried out (continuation, suspension or therapeutic exchange).ResultsDuring the study period, the pharmacy service reconciled the treatment of 54 neurosurgery patients.The average age of the patients was 65±14 years. The median hospital stay was 5 days (1–30). The number of reconciled drugs was 337, with an average of 6±3 drugs per patient.According to the guide previously mentioned, pharmaceutical interventions were: 49% continue with the usual treatment, 40% discontinue usual treatment during hospitalisation and 11% required therapeutic interchange.Finally, two DRPs were detected and resolved.ConclusionPatients hospitalised in the neurosurgery service can find benefit with MRP performed by pharmacists, ensuring an adequate pharmacotherapeutic approach between the different levels of healthcare.References and/or AcknowledgementsNeurosurgery service.Pharmacy service.No conflict of interest
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