(Tramadol-warfarin interaction)
Drug and Therapeutics Bulletin 2024;62:36
https://doi.org/10.1136/dtb.2024.000008
Traducido por Salud y Fármacos, publicado en Boletín Fármacos: Farmacovigilancia 2024; 27 (2)
Tags: riesgo de hemorragia, anticoagulantes, tratamiento del dolor y riesgo de hemorragia
Resumen de: Danbury G Susan Gladstone: Informe sobre prevención de muertes futuras [en línea], 2023. Disponible: https://www.judiciary.uk/prevention-of-future-death-reports/susan-gladstone-prevention-offuture-deaths-report/ Consultado el 8 de enero de 2024].
Puntos más importantes
En el Reino Unido, los médicos forenses tienen la obligación de informar los casos en los que consideren que se deben tomar medidas para prevenir futuras muertes.
Un forense investigó el caso de una paciente que murió de hemorragia intraparenquimatosa y subaracnoidea.
La investigación concluyó que la causa de la hemorragia fue una interacción entre warfarina y tramadol que provocó un grado significativo de anticoagulación.
Un forense británico que concluyó que la muerte de una paciente se debió a una interacción generalmente desconocida entre la warfarina y el tramadol ha pedido a NHS (National Health Service o Servicio Nacional de Salud) de Inglaterra que tome medidas para prevenir futuras muertes por dicha interacción [1].
(Pregabalin and gabapentin: sometimes fatal overdoses)
Prescrire International 2024; 33 (257): 72-74
Traducido por Salud y Fármacos, publicado en Boletín Fármacos: Farmacovigilancia 2024; 27 (2)
Tags: insuficiencia renal, prolongación espacio Q-T, opioide, tratamiento neuropatía, metadona, Lyrica
Diferentes estudios han confirmado que la sobredosis de pregabalina, incluso la accidental, conlleva un riesgo de coma y de depresión respiratoria. El riesgo de sobredosis aumenta en los pacientes con insuficiencia renal. La gravedad de tales sobredosis aumenta cuando la pregabalina se combina con un depresor del sistema nervioso central, como un opioide o un medicamento que conlleve un riesgo de prolongación electrocardiográfica del intervalo QT.
La gabapentina también conlleva un riesgo de sobredosis en presencia de insuficiencia renal, con un riesgo significativo de depresión respiratoria cuando se combina con un opioide.
The traditional “drug-event combination” approach is too simplistic for complex side effects such as behavioural changes. We must adjust our methodology to address this intricacy.
Inclusive Dermatology: Creating a Diverse Visual Atlas of Skin Conditions
Mission: Our goal is to collect and share images of dermatological conditions in all skin types, with an emphasis on including those who have been traditionally excluded in medical education. We hope to create a database that celebrates inclusivity and reflects our diverse population, with the ultimate aim of advancing medical education and improving patient care for all and doing our part in beginning to correct these historical disparities and inequities in our field. Here in New Mexico specifically, we are so proud and honored to serve our unique population with its strong Hispanic/Latinx and Native American/American Indian/Indigenous communities among others.
Background: Individuals of color and from underrepresented minorities are often marginalized and known to experience adverse health outcomes, in Dermatology and more broadly. There has traditionally been a deficiency in images and education in Dermatology depicting conditions in all skin types, with fair/white skin being represented as the “norm”. That means learners are typically taught how to recognize various skin condition presentations in fair/white skin only, and as they go on to provide care as physicians and allied health professionals, they are likely not providing the same quality care to patients of color.
We are just starting to understand how these biases can affect patients in so many ways, and we at University of New Mexico (UNM) Dermatology want to do our part and contribute in repairing these structural deficiencies in Dermatology and medicine in general. Expanding the availability of images in varying skin types – Black, brown, white and in between - may help patients, learners and providers recognize skin conditions more readily and therefore be able to deliver more effective, high quality and safe patient care. We are proud to introduce this free resource accessible to any who may benefit. While we also know that there are several large initiatives ongoing at the national level, we aim to start local and highlight the inclusivity and equity for which our program and Department strives.
The Reporting of A Disproportionality analysis for drUg Safety signal detection using spontaneously reported adverse events in Pharmacovigilance (READUS-PV) is an international collaborative which aim at developing the first reporting recommendations for studies using disproportionality analyses in databases of spontaneously reported adverse events. Our goal is therefore to enhance transparency by providing researchers with the minimum reporting…
The CANHEART ‘big data’ research initiative is aimed at measuring and improving cardiovascular health and the quality of ambulatory cardiovascular care provided in Ontario, Canada using the population-based CANHEART cohorts. The CANHEART cohorts were created through the linkage of 19+ routinely collected health administrative, vital statistics, survey and laboratory databases housed at ICES. The strength of these cohorts lies in the large sample size, containing information on 9.8 million Ontarians age 20-105 years, and diversity of the linked databases.
Building upon the insights gained to date through the CANHEART work, we have recently launched a new CANHEART SPOR project aimed at leveraging big data to conduct innovative cardiovascular clinical trials. We aim to: 1) undertake a pragmatic cluster randomized registry-based clinical trial to improve lipid-management amongst intermediate-and high-risk patients residing in high-risk health regions in Ontario (called CHOICES), and 2) develop novel algorithms for measuring clinical outcomes in clinical trials using health-related databases and compare whether they are as accurate as traditional event ascertainment methods in a prospective clinical trial (called INVESTED). These projects will be undertaken by an interdisciplinary team consisting of experts in administrative health databases, implementation science, clinical trials, knowledge translation and patient engagement.
Researcher Paula Byrne writes on what she and her colleagues learned from a meta-analysis of 21 clinical trials involving 140,000 patients.
Our study highlights that patients and doctors need to be supported to make decisions about treatments using evidence from all available studies and presented in a format that helps them understand potential benefits.
This article recommends 33 free books which will teach you the basics of R, how to produce amazing plots, how to apply R to lots of disciplines, and how to efficiently program in R.
This book will teach you how to do data science with R: You’ll learn how to get your data into R, get it into the most useful structure, transform it, visualise it and model it. In this book, you will find a practicum of skills for data science. Just as a chemist learns how to clean test tubes and stock a lab, you’ll learn how to clean data and draw plots—and many other things besides. These are the skills that allow data science to happen, and here you will find the best practices for doing each of these things with R. You’ll learn how to use the grammar of graphics, literate programming, and reproducible research to save time. You’ll also learn how to manage cognitive resources to facilitate discoveries when wrangling, visualising, and exploring data.
El Objetivo del paquete aprendeR es facilitar que nuevas personas puedan R moderno con una curva de aprendizaje baja, y evitando que el inglés sea una barrera para que se puedan centrar en el aprendizaje competencial de R. Se incluyen traducciones al castellano de tutoriales presentes en otros paquetes (learnr, tutorial.helpers, r4ds.tutorials, ...), y eventualmente nuevos tutoriales más adelante.