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Describir un caso clínico de un paciente tratado con amoxicilina (AMX) mientras cursaba una infección viral, en el que se detectaron errores de medicación (EM) y reacciones adversas a medicamentos (RAM). Descripción del caso clínico: Paciente masculino de 7 años y 23 kg concurrió a la guardia del hospital presentando fatiga, fiebre y ganglios linfáticos inflamados. Se diagnosticó faringitis bacteriana y se indicó AMX 50 mg/kg/día vía oral/8 h. Al día siguiente, el paciente fue nuevamente al hospital presentando rash cutáneo en todo el cuerpo. Se advirtió evento adverso (EA) por diagnóstico erróneo y se diagnosticó mononucleosis infecciosa (MI). Se suspendió la AMX y hubo remisión del rash. Un farmacéutico hospitalario realizó la imputación utilizando el algoritmo de Naranjo (puntaje 5-8) y notificó al Sistema Unificado de Farmacovigilancia de Córdoba. Discusión: Es fundamental el diagnóstico adecuado de la MI para evitar el uso inapropiado de antibióticos ante una infección viral. En el caso descripto ocurrió un EM en la etapa de prescripción, debido al diagnóstico incorrecto, y una RAM por el uso de AMX. El puntaje obtenido permitió catalogar a esta RAM como probable, no pudiendo ser considerada definida/probada por no haber reexposición; aunque el EA apareció luego de la administración de un fármaco sospechoso y no existieron causas alternativas para explicar esta reacción. Además, el EA desapareció tras suspender la AMX. Esto enfatiza el rol protagónico del farmacéutico para promover la seguridad de pacientes y la importancia de las notificaciones. Goal: To describe a clinical case of a patient treated with amoxicillin (AMX) while he had a viral infection. In this case, medication error (ME) as well as adverse drug reaction (ADR) were detected. Description of the clinical case: A 7- year-old, 23-kg male patient attended to the hospital with the following symptoms: fatigue, fever and swollen lymph nodes. Pharyngitis caused by bacteria was diagnosed and orally administration of AMX 50 mg/kg/day each 8 h was indicated. One day later, the patient returned to the hospital with skin rash throughout the body. An adverse event (AE) was noticed due to an error in the diagnosis, which was corrected and infectious mononucleosis (MI) was detected. AMX was suspended and remission of the rash was observed. A hospital pharmacist performed the imputation using the Naranjo algorithm (score 5-8) and notified to the Sistema Unificado de Farmacovigilancia of Cordoba. Discussion: Proper diagnosis of IM is essential to avoid inappropriate use of antibiotics when the patients present viral infections. In this clinical case, a ME occurred at the prescription, due to the incorrect diagnosis, and an ADR because of the use of AMX. The score obtained allowed us to classify this ADR as probable, and it could not be considered definite/proven because there was no re-exposure. However, the AE occurred after the administration of a suspected drug and there were no alternative causes to explain this reaction. In addition, the AE disappeared after suspending the AMX. This emphasizes the leading role of the pharmacist in promoting patient safety and the relevance of notifications. Fil: García, Mónica Cristina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Unidad de Investigación y Desarrollo en Tecnología Farmacéutica. Universidad Nacional de Córdoba. Facultad de Ciencias Químicas. Unidad de Investigación y Desarrollo en Tecnología Farmacéutica; Argentina Fil: Cavigliasso, Julieta. Universidad Nacional de Córdoba. Facultad de Ciencias Químicas; Argentina Fil: Gola, Camila. Universidad Nacional de Córdoba. Facultad de Ciencias Químicas; Argentina Fil: Valentín, Rocío. Universidad Nacional de Córdoba. Facultad de Ciencias Químicas; Argentina Fil: Seguro, María Laura. No especifíca; Fil: Romañuk, Carolina Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Unidad de Investigación y Desarrollo en Tecnología Farmacéutica. Universidad Nacional de Córdoba. Facultad de Ciencias Químicas. Unidad de Investigación y Desarrollo en Tecnología Farmacéutica; Argentina

Studies regarding the neoplastic infiltration of the skin overlying canine subcutaneous soft tissue sarcoma (sSTS) are lacking. In case of the absence of tumor infiltration, there would be the possibility of leaving this unaffected skin in place, thus simplifying surgery. The aim of the study was to investigate whether the skin overlying sSTSs is infiltrated by neoplastic cells. Dogs with sSTSs treated surgically were prospectively enrolled. After excision, the skin was dissected from the tumor along the natural surgical plane of cleavage and histologically evaluated. Twenty-nine dogs with an sSTS were included (22 grade I, 6 grade II, and 1 grade III). The sSTS-overlying skin was not tumor-infiltrated in 14/29 cases (48.3%). A higher frequency of infiltration was observed in higher grade sSTSs (grades II and III, 100%; P = .006); nevertheless, 8/22 grade I sSTSs (36%) also showed cutaneous infiltration. This infiltration involved the dermis of the skin directly in contact with the tumor (multifocal in 11 and diffuse in four cases). Although the cutaneous tumor infiltration is less frequent in grade I sSTSs and a wide excision may still be the safest treatment for any sSTS for a greater possibility of local control, this study opens the possibility to a less aggressive cutaneous excision, but still with a local curative intent, as only the skin directly in contact with the sSTS has been proven to be tumor-infiltrated. Additional studies are warranted to confirm that excision of only this skin may guarantee a complete local control, especially in lower-grade sSTSs.

Background Doxorubicin (DOX) is widely used in both human and veterinary oncology although the onset of multidrug resistance (MDR) in neoplastic cells often leads to chemotherapy failure. Better understanding of the cellular mechanisms that circumvent chemotherapy efficacy is paramount. The aim of this study was to investigate the response of two canine mammary tumour cell lines, CIPp from a primary tumour and CIPm, from its lymph node metastasis, to exposure to EC50(20h) DOX at 12, 24 and 48 h of treatment. We assessed the uptake and subcellular distribution of DOX, the expression and function of P-glycoprotein (P-gp) and Breast Cancer Resistance Protein (BCRP), two important MDR mediators. To better understand this phenomenon the effects of DOX on the cell cycle and Ki67 cell proliferation index and the expression of p53 and telomerase reverse transcriptase (TERT) were also evaluated by immunocytochemistry (ICC). Results Both cell lines were able to uptake DOX within the nucleus at 3 h treatment while at 48 h DOX was absent from the intracellular compartment (assessed by fluorescence microscope) in all the surviving cells. CIPm, originated from the metastatic tumour, were more efficient in extruding P-gp substrates. By ICC and qRT-PCR an overall increase in both P-gp and BCRP were observed at 48 h of EC50(20h) DOX treatment in both cell lines and were associated with a striking increase in the percentage of p53 and TERT expressing cells by ICC. The cell proliferation fraction was decreased at 48 h in both cell lines and cell cycle analysis showed a DOX-induced arrest in the S phase for CIPp, while CIPm had an increase in cellular death without arrest. Both cells lines were therefore composed by a fraction of cells sensible to DOX that underwent apoptosis/necrosis. Conclusions DOX administration results in interlinked modifications in the cellular population including a substantial effect on the cell cycle, in particular arrest in the S phase for CIPp and the selection of a subpopulation of neoplastic cells bearing MDR phenotype characterized by P-gp and BCRP expression, TERT activation, p53 accumulation and decrease in the proliferating fraction. Important information is given for understanding the dynamic and mechanisms of the onset of drug resistance in a neoplastic cell population.