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What is a living will?

A living will is a document of advance healthcare directives in which a person (freely and with sufficient legal capacity) provides instructions which must be respected regarding different health options. It refers to medical treatments (acceptance or rejection of some of them), what you want to do with your organs and your body and if you want to be buried or cremated. It also refers to whether you want to prolong your life when your situation is irreversible. It is up to you to decide.
 
This document helps to bring meaning to our life in consistence with our identity and values. We can be seen and understood by others and ourselves more clearly. Our values are based upon our inheritance, our learning, and the values we decide to have. They enable us to be
ourselves, not just one of the crowd. We are what we choose to be.
 
The living will encapsulates ethical and sacred values:
 
- Ethical values: we speak of the human good, being free, it is about perfecting the person. It is manifested by justice, honesty, solidarity, and peace.
 
- Sacred values: we speak of the search for the absolute being, be you agnostic or atheist.
 
These values are based on the human person as the only good and on people believing in God, transcendence, human dignity.
 
This document would be included in your medical records. With it, you take ownership of your own death, the master of your existence until the end of your life. You can control what happens to you when you die based on values that you have been building throughout your
life. You decide, just as you have decided how to live your life. If you do not do this, and you are then not in a position to decide, others will decide for you.
 
It is in your interest to communicate your wishes to your relatives as it may be important for medical assessment when a patient arrives in the emergency room.
 
Each autonomous region gives a name to this document. In the Valencian Community it is called a Record of Advance Healthcare Directives, (Registro de Voluntades Anticipadas (DVA),
Conselleria de Sanidad).
 
http://www.san.gva.es/web/dgcal/voluntades-anticipadas
You can also go to the SAIP (Patient customer service in the hospital).
 
Paloma Corbí Gallego
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WHAT IS CBD?

CBD (cannabidiol) has aroused great interest in the pharmaceutical world due to its legalization in some
European countries

But what is CBD? It is one of the more than 100 cannabinoids that we can find in the Cannabis plant and is
one of the most interesting for its therapeutic properties. Another known cannabinoid is THC (delta-9-
tetrahydrocannabinol), which, unlike CBD, produces psychostimulant and dangerous health effects. In
greater or lesser concentration all varieties of Cannabis contain cannabinoids, however, today due to
genetic manipulation, it is possible to create variants with a high concentration of CBD that, at the same
time, are low in THC.

The most common way to consume CBD is in oil form, although we can also find it in topical or cosmetic
products. The oil is obtained from the buds or flowers of the plant by extraction, as this is where the
highest amount of CBD is found. It is important not to confuse cannabidiol oil with hemp seed oil; the latter
does not contain CBD but omega 3 and 6 which are also beneficial for your health but with different
pharmaceutical indications.

In 2017 the WHO Expert Committee on Drug Dependence concluded that there is evidence that CBD is not
addictive, nor harmful and can be a useful treatment for the following diseases:

- Anxiety: It reduces anxiety, restlessness, tiredness, stress, and concentration problems.

- Parkinson's disease: Reduces agitation, nightmares, and aggressive behaviour.

- Neuropathies: Analgesic effect in patients with neuropathies who are resistant to other treatments.

- Antibiotic: Activity against methicillin-resistant Staphylococcus aureus.

- Antiemetic: Reduces nausea.

Although much progress has been made in this field and there are numerous studies that support the
effectiveness of CBD, it is necessary to conduct more clinical trials to determine aspects such as side effects
or possible interactions with other drugs.

Text: María Jesús Pascual Faus

Keywords: CBD oil, cannabis, cannabidiol

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CONTRACEPTIVES

This advice section recaps what you should do if you forget a contraceptive pill, a patch falls off, or if a vaginal ring gets broken or expelled. These rules are also applicable in the case of vomiting and diarrhoea.

- If you vomit less than two hours after taking the contraceptive pill, it is recommended to take another one.

- If your patch has come off and you realise in less than 24 hours, put a new patch on and it will make no difference. If more than 24 hours have passed, put a new one on, start a new four-week cycle and use a condom for the first 7 days of the new cycle.

- If the vaginal ring is expelled and less than 3 hours have passed, wash the ring with warm or cold water, not hot water, and reinsert it. If it breaks, replace it with a new one as soon as possible and use a condom for the first 7 days.

- The contraceptive pill with progestin and oestrogen: if you forget to take the pill, take
another one as soon as possible. It is not considered a missed pill if you take it within 24 hours (even if you take 2 pills in less than 24 hours). The contraceptive action is still effective if there has not been another missed pill in the previous seven days. If more than one pill has been missed, it is recommended to use a condom.

- The contraceptive pill with progestogen alone: if you forget to take it for more than three hours, continue taking it and use a condom for the following two days.

Another point to consider when using contraceptives, is if there are more than two risk
factors (these could be thrombophlebitis, obesity, a family history of problems using
contraceptive methods, over 35 years old, smoker, hypertension, or migraines). In this case, it is important to consult a doctor to find other options that would be more suitable.

Contraceptives do not prevent sexually transmitted diseases, always use a condom to
prevent them.

Remember the importance of regular check-ups when using these contraceptive methods, especially adolescents.

Paloma Corbí Gallego

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The role of a pharmacist with the vaccine against COVID-19

In our "day to day lives" we see the "fear and uncertainty" that the vaccination process is causing. This is mainly due to the amount of information that comes through the media, social networks and in the social environment. So, what is our role exactly? We are here to give you the most up-to-date health information possible and reinforce prevention and health promotion measures.

We know that 92% of Spanish people trust their pharmacist and, given the current situation, for many of you, we are the only healthcare professionals that you have been able to talk to face to face. Therefore, I am going to explain, in brief, the points which are causing the most doubts. To start with, her is an explanation of the different types of vaccines and to which group the ones marketed in Spain belong;

  1. a) Inactivated virus vaccines. They contain the entire "inactivated" or destroyed SARS-Cov-2 virus or fragments thereof.
  2. b) Attenuated virus vaccines. They contain the weakened virus with its reduced virulence
  3. c) Subunit vaccines. They contain the “spike protein” (the protein found on the outer surface of the virus and responsible for the penetration of the virus into human cells). This protein is recognized by our body and generates specific immunity.
  4. d) Nucleic acid-based vaccines. These vaccines make our own cells produce the “spike protein” and generate specific immunity. Pfizer y Moderna belong to this group of vaccines.
  5. e) Viral vector vaccines. In this case, a harmless virus is used that is used to produce the "spike protein". Astra-Zeneca belongs to this group of vaccines.

Therefore, it is VERY IMPORTANT to know that these are not vaccines with the inactivated or attenuated virus, which could become more dangerous, they are vaccines based on a methodology that has been in practice for years.

Continuing on the topic of the safety of these vaccines, which is something that worries many of you, the three vaccines have been tested in clinical trials with tens of thousands of volunteers and proven to be safe. As such, they have been authorized by independent regulatory agencies around the world for their use. Another important piece of information is that the Society of International Pharmacovigilance continuously evaluates safety and now holds data on the tens of thousands of millions of doses that have been administered around the world.

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If you’re feeling unwell, change your clothes!

LEROS Negro

No, no, no…..it’s a new line that we’ve started to work with; therapeutic textiles.

We are in the habit of resorting to medication as soon as we are in pain or don’t feel well. However, research is starting to offer other solutions. One option is textiles that have certain properties that can affect our bodies through their contact with the skin. It is like putting on a cream, but instead of absorbing it, it just stays in contact. This way, the liver and kidneys do not have to work at eliminating the effects of medication.

What problems can we help you to resolve using this system?

Firstly, it can treat some feet related problems. Have you got fungus, do you sweat too much, do you have to work with special footwear (that doesn’t allow your feet to breathe), are you diabetic or have chafing? We now have socks available that, due to their properties, help the skin to heal from wounds and prevent them, they are of special interest to diabetics. You may not know, but Spain has the second highest rate of foot amputations in the world for diabetics, and the life expectancy after amputation is very low after one year. By taking this measure we can help you to avoid amputation. These socks are also of interest if you do sports such as hiking or if you want to do the St. James’ Way (el Camino de Santiago). Special socks are also available for those that have suffered an amputation.

Secondly, for women that are having treatment for breast cancer, have dermatitis where the bra rubs the skin, fungus or recent scars, we now have a top, Vidabra, developed by Ascires Biomedical Group. With this top, they aim to bring the number of women that have to abandon cancer treatment due to skin lesions, down to zero and also eliminate scars, fungus and chafing.

Thirdly, your hands: if you are a cook or tend to have lesions on your hands (fungus, sensitive skin etc), we now have gloves that have been made with the same material as the previous products, and aim to reduce hand-related problems and speed up recovery.

Lastly, for your head, yes, you heard correctly! If you’ve recently had a hair transplant, been operated on and have scars on your scalp, or suffer with actinic keratosis and that part of your head is being treated, we have a hat that guarantees a successful graft, reduces scarring and scabs, and thereby reduces the risk of infection.

If you have any of these problems, or another that you think could be related, tell us, we will be delighted to help. For those of you that really enjoy doing sport, you should know that this therapeutic material, MUVU, has been created by the same company that makes Lurbel sports clothes.

Facebook: What do a hiker, a woman receiving breast cancer treatment, a cook, a fan of the St. James’ Way and a man that’s fractured his skull in a car accident have in common? ……….We can help to improve the quality of life of all of them. Discover how in our blog.

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We’re back with some news

Amanecer en la playa 1

Finally…… we have some time to give you some news and tell you about changes in our pharmacy.

Firstly, as you must have noticed, since March we’ve been overloaded with work. We’ve discovered many things during these months about human nature: people have been kind and understanding; people have disregarded the health of others, coming into the pharmacy without a mask (when they were available); others stand out for their generosity and offers while some have been rude and demanding, unaware of the seriousness of the situation. We have learnt a lot about human nature, but personally, I have also learnt a lot about the nature of this team. Thank you Paloma, Nuria, Borja and Elena for your humanity, professionality and smiles on the outside as well as on the inside. People with even forty years’ experience wouldn’t show your grace and professionalism.

Secondly, I would like to thank you for your patience. Having to maintain social distancing has meant that we have not been able to treat you as quickly as we would do under normal circumstances. At the same time, we would like you to be aware that we continue to dedicate the time you need so please be just as generous when we have to dedicate that time to someone else in front of you. Also, be aware that every time you come to us and you are not clear about what you need, and we deal with your request, that there may be another person waiting.

Thirdly, we’d like to give you some good news. Our pharmacy has participated in a national pilot project called “Indica Pro”, which is the protocol taken by pharmacies to treat patients with minor symptoms (such as indigestion, skin irritations, breathing problems). This service is provided at the request of the patient when they don’t know what medicine to buy, and they ask the pharmacist what would be most appropriate for their health problem. We are currently number one in the Valencia province for cases registered and resolved. This means that when you come into our pharmacy, you will be treated by two professionals, Nuria and Paloma, who are known, not only in the neighbourhood, but also across the province. For this reason, I believe we should all recognise their achievement by showering them with love and affection and, if you don’t, quite frankly you’re being mean 😉.

In fourth place, we’d like to inform you that we now cover three new areas:

  • Probiotics for treating certain ailments (which is giving fantastic results)
  • A new line in phytotherapy, Aboca, which complements Pranorom and Arko
  • A new line of treatment related to textiles

We will explain each of these gradually.

Lastly, once again, we would like to remember Asunción with our love and affection. She passed away in the first wave of the pandemic…… your memory and your smile will always be with us.

And for those of us that are still here, keep working hard, there’s still so much to be done.

If you’re feeling unwell, change your clothes!

No, no, no…..it’s a new line that we’ve started to work with; therapeutic textiles.

We are in the habit of resorting to medication as soon as we are in pain or don’t feel well. However, research is starting to offer other solutions. One option is textiles that have certain properties that can affect our bodies through their contact with the skin. It is like putting on a cream, but instead of absorbing it, it just stays in contact. This way, the liver and kidneys do not have to work at eliminating the effects of medication.

What problems can we help you to resolve using this system?

Firstly, it can treat some feet related problems. Have you got fungus, do you sweat too much, do you have to work with special footwear (that doesn’t allow your feet to breathe), are you diabetic or have chafing? We now have socks available that, due to their properties, help the skin to heal from wounds and prevent them, they are of special interest to diabetics. You may not know, but Spain has the second highest rate of foot amputations in the world for diabetics, and the life expectancy after amputation is very low after one year. By taking this measure we can help you to avoid amputation. These socks are also of interest if you do sports such as hiking or if you want to do the St. James’ Way (el Camino de Santiago). Special socks are also available for those that have suffered an amputation.

Secondly, for women that are having treatment for breast cancer, have dermatitis where the bra rubs the skin, fungus or recent scars, we now have a top, Vidabra, developed by Ascires Biomedical Group. With this top, they aim to bring the number of women that have to abandon cancer treatment due to skin lesions, down to zero and also eliminate scars, fungus and chafing.

Thirdly, your hands: if you are a cook or tend to have lesions on your hands (fungus, sensitive skin etc), we now have gloves that have been made with the same material as the previous products, and aim to reduce hand-related problems and speed up recovery.

Lastly, for your head, yes, you heard correctly! If you’ve recently had a hair transplant, been operated on and have scars on your scalp, or suffer with actinic keratosis and that part of your head is being treated, we have a hat that guarantees a successful graft, reduces scarring and scabs, and thereby reduces the risk of infection.

If you have any of these problems, or another that you think could be related, tell us, we will be delighted to help. For those of you that really enjoy doing sport, you should know that this therapeutic material, MUVU, has been created by the same company that makes Lurbel sports clothes.

Facebook: What do a hiker, a woman receiving breast cancer treatment, a cook, a fan of the St. James’ Way and a man that’s fractured his skull in a car accident have in common? ……….We can help to improve the quality of life of all of them. Discover how in our blog.

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When someone decides to “leave” of their own accord

suicidio

Some years ago, a friend of mine commited suicide. It took me completely by surprise and I was 2000 km away. I had just finished my pharmacy degree, and I still have the message he sent to congratulate me on obtaining my degree under such extenuating circumstances.

He was an extremely intelligent and sensitive man, who lived comfortably, he had friends… everything you could wish for. I couldn’t understand how this could have happened.

Months later, when talking to his nephew, he commented that my friend had tried in the past, and that there was a tendency in the family to solve certain problems by “getting out of the way”. He, himself, had also tried various times. However, he told me that when his ten year old son tried to commit suicide, he realised that he had to change the dynamics, as after all, his son had only copied what he had seen in his family environment. He made a pact with his son that this would never happen again. A number of years have passed since that conversation, and it gives me such joy to hear from him or read his jokes on Facebook: a battle won in the face of life

Every year, in Spain, 10 people die every day due to suicide: twice the amount of road traffic accidents, and there are 8,000 attempts every year. It could easily be something that affects you closely.

Suicide is multifactorial (it is affected by different genetic, social, psychological aspects etc) and can affect anyone from any population group. It is true that even experts are sometimes unable to detect suicidal behaviour before an attempt, but this does not mean that those around them cannot intervene, reducing the risk of carrying through with the idea. There are verbal and behavioural signs before an attempt that, if known, are relatively easy to detect.

If you are considering suicide as a solution to your suffering, it is important to know that your problems, however serious they are, can always be approached with help. Ask for help and create your own personal safety plan.

If someone you know is thinking about suicide, listen to them, wthout judgement. The best thing to do is offer understanding and listen, especially at a time when our society is overloading people with serious problems of solitude.

Lastly, if someone you know has commited suicide, give yourself time to grieve, and let your mind take in the emotional impact. It is important to follow guidelines to avoid emotional harm, such as blaming yourself.

Due to the nature of this blog, we cannot go deeper into this topic, however we can provide you with a link to a Guide for those affected, family members, teachers and survivors from the Teléfono de la Esperanza (Hope line). We hope that you find it interesting if you should wish to find out more on this topic.

Dedicated to those that have gone, and to those that are left behind.

https://www.telefonodelaesperanza.org/noticias/view/8318/guia-para-la-prevencion-del-suicidio-%28comunidad-valenciana%29

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Myths about how and what to feed babies and children

bulos

These days you can read a lot about everything on the internet but it’s important to do so discerningly. Let’s start by tackling some of the hearsay about feeding little ones.


“Feeding a baby on demand is a mistake”
Nowadays, pediatricians recommend feeding on demand: when the baby is looking for the breast. Although, they do advise not to let more than 3 hours pass between feeds and that a newborn eats between eight and twelve times a day (in 24 hours).


“Salt can be added to baby food”
It is a common error that affects your baby’s health (it can be linked to high blood pressure and illnesses related to arteries and blood vessels in adulthood). In addition, it is important to check the amount of salt in prepared foods.


“There are foods that prevent colic in infants”
We should bear in mind that colic in infants usually appears at four months, an age at which no foods other than breast milk or formula have been introduced.


“Sweets are a reward for eating healthy food”
By establishing a distinction we are teaching a child that healthy food is an “obligation”, making it more and more tedious every time they eat it.


“A vegetarian diet is the best for children”
If well prepared, this diet can meet all the needs of the child, but this does not happen in one hundred percent of cases. If not carried out properly, a child can easily lack in certain basic nutrients needed for their development. Ideally, a healthy and varied diet should be established.


“Increasing the amount of spinach is enough to make up for a lack of iron”
Spinach has a high iron content, however, the majority of it cannot be absorbed by our bodies. Red meat and liver contain iron that can be better absorbed. A trick for increasing the amount of iron we can get from spinach is to eat it raw, in a salad, dressed with lemon juice (vitamin C favours the absorption of iron).


“An overweight child is nothing to worry about.”
Height and weight control by your pediatrician is essential to identify good nutrition. Childhood eating habits lay the foundations for how we eat as adults, with related illnesses appearing more and more frequently.

Diana Olmedilla Sanz

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Your medical tests... in the comfort of your pharmacy

tets

Sometimes, if we have to get a blood/urine test done, it can be a logistical nightmare: where? When? How do I organize myself? Before or after dropping off the children at school?
To give you a greater (and better) service, from now on, you can ask for these tests to be done in our pharmacy, and we will provide you with the results as quickly as possible. Blood is taken by a clinical analyst. With our system you can also specify the tests that your private insurance doctor has requested.
There is an extensive list of different tests that you can do with us, and includes aspects such as the usual indicators of serology, urine (for example glucose, urea, uric acid, levels of magnesium, zinc or copper or different vitamins). We also test for chickenpox, toxoplasma, herpes, folic acid and hepatitis C viral load, microbiology, food sensitivity or parasitology among others. These analyses include spermiograms, antimulerian hormone detection, genetic tests (such as non-invasive prenatal tests) or fetal sex.
The objective is twofold: on the one hand we collaborate with your doctor to maintain or improve your health, and on the other hand we help you to take better care of your health independently and proactively, to delay the onset of illnesses as much as possible, and also, at your convenience.
The cost is very competitive compared to market rates, and brings with it the advantage of proximity (avoid traveling, with its consequent expense in petrol, parking or public transport) and saving time (freeing up time to do the things you want).
Finally, your results will be available in our pharmacy within a few days depending on the type of analysis requested. This way, you can provide the information to your doctor in the shortest time possible.
Please ask if you have any questions, try it and let us know.
Text: Victoria González de Buitrago

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Lactose intolerance versus cow's milk protein allergy

intolerancia-lactosa

Frequently, even in the movies, we hear of people suffering from a "lactose allergy", however, this phenomenon does not actually exist. We will go into further detail about the difference, but as a general rule, it is known that allergies come about in the presence of a protein, whereas, the fact is that lactose is a carbohydrate. Therefore, we refer to lactose intolerance and cow's milk protein allergy (CMPA), which is the most frequent among milks, although there are also allergies to others (goat, sheep, buffalo etc).
Another characteristic to bear in mind is that CMPA is more common in children under the age of five, and will normally, except in a few cases, disappear with age. However, in the case of intolerance, it is just the opposite: it gets worse with age.
The severity of the problem also marks a clear difference between the two phenomena. In terms of allergy we are talking about a failure in the immune system, which among its consequences can lead to anaphylactic shock, and therefore death. However, in the case of lactose intolerance we are dealing with a digestive problem, and its consequences are by no means as severe.
With regards to allergies, all allergen consumption should be avoided, which can sometimes be masked in other foods (sausages, meat ...). In the case of infants, breastfeeding can be prolonged as long as possible, and the mother should avoid drinking milk during that time. Or, an alternative is to turn to hypoallergenic formulas. It is not advisable to use soy milk, due to its nutritional disadvantages, unless under the close supervision of a pediatrician. Nor should milk without lactose be used as the protein is still present.
In the case of lactose intolerance, it is best to reduce the consumption of dairy products as much as possible, although those that are fermented or low lactose can be used. It is also advisable, if you are not going to eat at home and you know that you are going to eat dairy products (for example, a trip to Italy), to carry lactase tablets with you in order to help the body metabolize lactose and avoid abdominal swelling or gas that is usually associated with intolerance.
If this is a topic of particular interest to you, one of our colleagues has written an article in a pharmaceutical journal, here is a link if you would like to read more on the subject (the article is only available in Spanish):
http://elfarmaceutico.es/index.php/profesion/item/10554-intolerancia-frente-a-alergia#.Xfy5vVVKiM8

Text: Victoria González de Buitrago

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Barefooting

barefooting

This strange word refers to a new trend that, as usual, has nothing to it. It involves walking barefoot, in contact with nature: on small stones, grass, sand, leaves...


It is based, in part, on going back to our origins, when our predecessors walked barefoot, feeling every branch, leaf or stone wherever they went.


This activity improves circulation, helping your veins to push the blood, that flows through your legs, upwards (venous return). As a result, your legs will not feel as heavy and it prevents varicose veins. It also helps to maintain muscle tone in your limbs.


It is an ideal exercise for relaxing andrelieving stress while enjoying different sensations from being in contact with nature.

It is important to choose the space where you are going to do this activity carefully. The area needs to be free of dangerous objects and among nature or relaxing music (atmospheric music with the sounds of the forest, the sea..., chill out style music).

In some countries, such as the United States and Columbia, special routes have been set up and designed for doing barefooting. Do you think it could be common practice in our country? It’s a two for one: it relaxes you while keeping you fit, two basic requirements for a better quality of life.


Barefooting is not advisable if you have mycosis or other types of infections and take precautions if you have pains such as plantar fasciitis. Nevertheless, it is recommended for all ages and life situations (adapting the activity in each case).


It can be done individually, in pairs or groups, however it is best to be silent and enjoy the atmospheric sounds, so you can get the most out of the experience.

Are you going to try it?


Text: Diana Olmedilla Sanz

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My son won't let go of his mobile phone!

mi-hijo-no-suelta-el-movil

A very common complaint from a lot of parents is that their child can’t move without looking at their phone, or that they spend too much time on social media or video games. The question that parents ask themselves (or should ask themselves in some cases) is whether their child is showing signs of addiction.

According to a study carried out in 2018, in the region of Madrid, about the use of IT among adolescents aged 15 to 16, approximately half of said teenagers have developed anti-social behaviour problems associated with the use of internet, video games, instant messaging or social networks. Only 32% of them make good use of the internet, 42.7% of their phone, 59% of video games, 56% of instant messaging and 60.8% of social networks. In another study published this year by the Ministry of Health, 22.3% of 18 year old Spanish people compulsively use the internet, of which a higher percentage are female (23.4%) compared to males (16.4%).

To get a clearer idea of the size of this problem, imagine the consequences if we were talking about 68% of our youths abusing alcohol to varying degrees; 57,7% would be driving a car out of control, or 39,8% would be taking ecstasy.

What are the signs that parents should be aware of? When a teenager.....
- doesn’t take care of their health, their relationship with friends and family
- has outbursts of impatience when they lose connection or it slows down
- is not able to limit their time online and loses track of time
- is not honest about the amount of time they spend online
- is, at times, over excited while online
- sleeps less than 5 hours or is online for an abnormally long time
- is criticised by those close to them for spending too much time on technological devices.

This is to say that it is not just about the length of time they spend online, but also about the degree to which their daily life is affected.

Risk factors tend to be linked to those who are impulsive, extremely shy, have difficulty in confronting daily challenges, are looking for a state of high emotion or lack affection, among others.

In these situations, parents need to be involved, on the one hand, in prevention (highlighting communication, development of self-esteem and assertiveness, social behaviour regarding resolving conflicts and how to use their time wisely) and on the other hand, collaborating with a specialised psychologist, taking a cognitive behavioural therapy approach.

Bearing in mind the results from the region of Madrid, we would like you to think about your child’s use of IT. If you have any doubts as to whether their use is appropriate, ask in our pharmacy and we will be happy to provide you with some steps to help you find the best solution for your situation.

Text: Victoria González de Buitrago

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Hemophilia

Hemophilia belongs to the group of pathologies called "rare diseases". It is an inherited blood coagulation disorder linked to a mutation in the genes of coagulation factors VIII or IX.

If the missing factor is VIII we are talking about hemophilia A, if it is IX then it’s hemophilia B. Type A is five times more common than type B. The severity of the disease depends on how much of the clotting factor is missing:
● severe (less than 1% of factor activity in the blood)
● Moderate (between 1 y el 5 % activity)
● Mild (between 5 y el 25 % activity).

The main symptom is non-stop bleeding, which can occur for no apparent reason. In more severe cases, internal bleeding may occur.

For these patients, if they begin to bleed, it must be stopped immediately.

It is highly recommended to do physical exercise (avoiding contact sports because of the risk of bleeding injuries: football, rugby, boxing, hockey...) and maintain a healthy diet. The most preferable sports are walking, swimming, golf, table tennis...

Treatment involves replenishing the deficient coagulation factor VIII or IX, intravenously with periodic visits to the hospital. In addition, this can sometimes be combined with medication which helps to coagulate the blood such as tranexamic acid and desmopressin, dispensed in pharmacies. If you have any questions about the treatment do not hesitate to ask us and we will be happy to help you.

It is very important that the patient always let doctors, nurses, pharmacists and surgeons know of their condition; there are a multitude of interactions and precautions to consider.
If you want to read more about this disease you can check out the following pages:
https://www.wfh.org/es/page.aspx?pid=932 , https://www.fedhemo.com or http://www.ashecova.org/

Diana Olmedilla Sanz

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A Healthy Memory

                                                                                                                                                                                           

Today we would like to thank you for the heart felt interest you have taken in our project “A Healthy Memory”, based on the initiative “It’s never too early”.

For those that have not yet heard about it, the project forms part of a study carried out by: CSIC, through the Valencia Institute of Biomedicine; Arnau Hospital in Vilanova; SEMERGEN (Spanish Society of Primary Care Physicians); SEFAC (Spanish Society of Community Pharmacies); Association of Alzheimer Families in Valencia, coordinated by Cardenal Herrera University.

In order to take part, you will have an interview with two researchers who will detect whether the lack of attention you think you have can be corrected by giving your cerebral circulation a bit of help, or if your doctor needs to give you a more in-depth examination.

Our objective is to keep your memory in the best condition possible because, as you may not know, it is possible to detect Alzheimer’s up to 20 years before it appears. Therefore, if it is detected in time, it is possible to delay its onset by some years. The extra years you can live without this illness are years that you can enjoy with your family, friends and life.

To begin, we are laying the foundations with your participation in the study (and thanks, once again to Lucrecia Moreno, and Hernán Ramos, from CEU Cardenal Herrera, for trusting in us). The second phase will involve informing you of the risk factors that may be of interest to you, for example, not many people know that hearing problems or having LDL cholesterol levels of 120mg/dl increase your risk of developing this illness, as does the consumption of anti-depressants or psychotropic medication.

Throughout 2019 and 2020 we will be there for you, as we always are, to help you improve your lifestyle, as well as learn how to observe yourself, so that you can enjoy life for as long as possible, after all, that’s what life is all about, or at least it should be.

For those who would like more information, please ask in the pharmacy. Interviews take place every Tuesday between 9:30 and 13:30, they are individual, and last approximately 45 minutes. We must warn you that, at the moment there is a waiting list, but the sooner you put your name down, the sooner we can take care of you.

Text: Victoria González de Buitrago

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How do I breastfeed by baby?


The first time breastfeeding raises many doubts. This is normal as both mother and child must learn, it is a new experience for both.
There are different positions, the midwife or the gynecologist will advise you, but it is up to you to decide which is best for your situation.


-Position one: the mother, leaning backwards with the back supported, the baby is placed on the mother’s breast and it is the baby that finds the nipple naturally.
-Position two: the mother holds the baby in one arm and offers the opposite breast, meaning that if the baby is held in the left arm, the right breast is offered, if held in the right arm, the left is offered.
-Position three: the mother holds the baby with one arm and places the nose in front of the nipple. The baby -feeds from the same side as the arm that holds them.
-Position four: the mother lies on the bed with the baby at their side. The mother can help the baby stay in the right position with their arm. This can be useful after a cesarean.


The main problem that occurs while breastfeeding can be the appearance of cracks on the nipple. To avoid this it is recommended to:
➢ Moisturise from the first months of pregnancy
➢ Maintain a good breastfeeding position
➢ Removing the baby from the breast should be gentle (try inserting the tip of your finger into the baby’s mouth, slowly, so that the mouth opens and doesn’t pull on the nipple when coming off).
➢ Monitor the wetness of the area (excess dampness can cause cracks and other problems)
➢ It is not recommended to wash the breast before every feed as it eliminates the area’s natural skin protection, showering once a day is enough.
We hope, with this advice, you find it easy to feed your baby and you do not suffer with painful cracks, making each feed a time to connect and enjoyable for both of you.

Text: Diana Olmedilla Sanz
Pharmacist

English translation: Nicola McGrath.

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ADHD: Attention Deficit and Hyperactivity Disorder

In recent years, we have heard a lot about ADHD, Attention Deficit and Hyperactivity Disorder, especially in children. But, what is it exactly? Is it a fashion or a way for laboratories to sell more medication to deal with children that used to be labelled as “lively”?
Firstly, from an anatomical point of view, there are physical differences in the structure of the brain compared to other children; some areas are seen to be smaller (corpus callosum, caudate nucleus, etc.), but this may correct itself over time.

It has also been observed that less is released of two neurotransmitters, the two related to attention and motor regulation; noradrenaline and dopamine. For this reason neurotransmission is not the same and the working memory, how alert one is and attention span are affected.

The consequences in childhood can cause academic problems, changes to behaviour, problems with social interaction and low self-esteem. In adolescence, added to these issues, it can also be cause for criminal behaviour and aggression. Hence, detecting ADHD early on is imperative. Unfortunately, this is not easy as the diagnosis can currently take from 3 to 5 years.

The three basic symptoms of ADHD are: hyperactivity, impulsiveness and lack of attention. In reality, there are 3 types of ADHD, despite the common belief that we are always talking about “lively” children:
● The inattentive /distractible type (scatty, cannot pay attention to detail, poor organisational skills, forgetful, etc.)
● the hyperactive / impulsive type (finds it difficult to stay seated, seems to be constantly moving, has difficulty waiting their turn, etc.)
● The combined type, showing symptoms of both.
It is currently believed that ADHD is genetically predisposed, and considered to be up to 76% hereditary. For this reason, it is fairly common that when a child is diagnosed, one of their parents is also found to have ADHD. Once diagnosed, it is easier to understand why some aspects of life seem more complicated for them than for others and they can be given tools to help them manage these aspects more easily.

Treatment for ADHD can be psychological, psycho pedagogical and only in cases where considered necessary, pharmacological.

If you would like more information, or you have concerns about this topic, please contact the author of this article in order to help you take or eliminate measures that you think may help your child, such as referring you to your pediatrician so they can investigate further.

Text: Victoria Gonzalez de Buitrago
Pharmacist

 

English translation: Nicola McGrath.

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Our furry friends and us

foto-veterinaria-productos

Did you know that in our pharmacy they have always part of the team? Years ago, we had two furry friends on the payroll: Bosa and Monty who protected us against those who tried to steal from us or threatened us. They were clean, affectionate and well-trained, if you saw them in the street you knew where they worked.

We miss not having them around, however neither the law nor the space allows it at the moment. That’s not to say that we don’t love it when one comes to visit us with you when you pick up your medication.

The veterinary aspect is becoming more and more important in the health sector, not only regarding what we eat but also having animals as household pets. Dogs, cats, birds, fish....they all require certain care regimes in order to safeguard their health and well-being, and also that of those around them.

For this reason, this year with have decided to improve both our veterinary training and widen the range of products we have at your disposal: pipettes, anti-parasite treatments and other products, as well as the usual veterinary medication that we always have available. As you probably know, the only place authorised to sell veterinary medication is pharmacies because of the effect they can have on our health. If subjected to a health inspection, pharmacies are in the unique position of meeting all the requirements necessary to be able to provide medication to patients (in this case your pet) that have been kept in appropriate storage conditions, whereas a vet can only provide one day’s medication in isolated cases.

If you have any doubts, don’t hesitate to ask us. Your health and that of your furry friends are invaluable and we are here to help you look after both.
Text: Victoria González de Buitrago.
English translation: Nicola McGrath.

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Heavy legs syndrome. How can we make the symptoms better?

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Summer is here, the temperature has risen and more and more often our patients come to the pharmacy asking for advice about pain, heaviness, tiredness and even cramps they feel in their legs. This is what is known as HEAVY LEGS SYNDROME which between 20 and 30 percent of the adult population suffer from at some point in their lives. It can appear for different reasons such as thyroid or hormonal problems, vascular illnesses, consumption of pharmaceuticals, arthritis, kidney failure, menstruation, but in most cases it is due to CHRONIC VENOUS INSUFFICIENCY (CVI).

Although not a health risk, it can affect your quality of life. Apart from the pharmacological treatments (if needed), there are some basic health and dietary habits that are recommendable, for example:
-Lose weight: avoid or try to lose excess weight (diet, walk for 1 hour a day and drink 2 litres of water a day).
-Prolonged sitting or standing: avoid prolonged periods of staying still in the same position. If this is unavoidable, wear compression socks and carry out circular movements with your ankles and stretch and flex your legs, here are some examples:
- Footwear and clothing: avoid tight clothing as they impede the return of blood flow to the heart. Comfortable and light footwear is recommended with a heel of less than 3 cm (for flat feet use orthopaedic insoles).
-Avoid constipation as any excess abdominal pressures may cause IVC to develop. Eat a balanced diet, increasing the amount of food high in fibre.
-Temperature: legs exposed to excess heat may experience cutaneous vasodilation, making them feel swollen.
-Rest, keeping inferior limbs elevated higher than the heart for 15-30 minutes, a few times a day to lessen the symptoms and oedema, accompanied by massages in an upward motion.
-When resting at night, raise your legs between 20 and 25 cm to reduce oedema, which in turn will make putting on elastic compression stockings easier.
-Hydrotherapy: showers and massages with cold water or alternating between cold and warm water, stimulate blood flow. Just walking in water is enough to improve the return of blood flow to the heart.
-Physical exercise (swimming, cycling, walking): 30 minutes a day stimulates the muscle pump system which improves the return of blood flow to the heart.
-Keep skin well moisturised to avoid cracks and itchiness developing: scratching can damage the surface of the skin. Choose soaps/cleansers carefully and use moisturising vegetable oils.

As well as these measures, treatments are available either in the form of gels, sprays and massage oils for the skin or in the form of capsules, tablets, and oleo capsules containing active ingredients from natural sources which aid microcirculation and blood flow.

If you suffer from this syndrome, don’t hesitate to come by the pharmacy. We are here to help improve your quality of life and make sure this syndrome doesn’t get in the way of you fully enjoying the summer.
Text: Nuria Pérez
Nicola McGrath.

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Cellulite, can anything be done?

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More and more patients, mainly women, come to the pharmacy asking about the effectiveness of anti cellulite creams and if capsules or syrups can be taken for those “dimples” appearing on their thighs and buttocks as they just can't get rid of them. The answer is yes, they are effective, both the creams and oral treatments, but as a complement to certain hygiene and dietary measures discussed here below.
From a medical point of view, cellulitis is the inflammation of the connective tissue under the skin, normally caused by a bacterial infection. As far as the skin is concerned, cellulitis is a localised subcutaneous tissue disorder that initially affects the subcutis and in more advanced cases the dermis. In this affliction, dimples form from fatty tissue, water and toxins, causing a change to the surface of the skin known as “orange peel skin”. It is more common in women as the female hormones, oestrogen and progesterone, favour liquid retention and fat accumulation.
Different types of cellulitis exist (hard, flaccid and edematous) with varying degrees of severity. For all types, there are basic hygiene and dietary measures to be taken; do physical exercise, maintain a balanced diet, moderate the salt and additives intake, avoid refined or processed food, have the correct intake of minerals (Ca and Mg), drink plenty of liquids, do not smoke (this worsens circulation and generates free radicals), avoid alcohol ( this increases lipogenesis), control coffee and coca-cola intake, avoid tight clothing and ill fitting footwear, avoid excessive heat, frequently change your posture to avoid stagnation and sleep 8 hours a day.
Complementary to these basic measures, various treatments are used on the skin (always massaging upwards) that contain essential oils (cedar EO, rosemary ct camphor EO, cypress EO...) and thrombolytic substances (caffeine, theophylline, theobromine, carnitine...). It is essential to apply these treatments correctly and consistently. Oral treatments usually contain active ingredients with lipolytic action (caffeine, mucopolysaccharides , L-carnitine, fucus...) and those that promote drainage (meadowsweet, horsetail, dandelion, artichoke.....)
Given the different types of cellulitis and treatments that exist, don’t hesitate to come by the pharmacy so we can recommend the most suitable treatment for you. Remember, we are here to look after you.
Text: Nuria Perez

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New Health Challenges 1: Multiple Chemical Sensitivity Syndrome

SQM

This year we are focussing on some of the health challenges that society is faced with, especially western societies.
Multiple chemical sensitivity syndrome was recognised as an illness in Spain, in 2014, after already being recognised in other countries (Germany in 2000, Austria en 2001, Japan in 2009, Switzerland in 2010 and Denmark in 2012).
In Spain, this illness has been underdiagnosed due to the amplitude of the different ways it can manifest itself; it is sometimes related to or labelled as an allergy making it difficult to know how widespread it is. However, based on studies by the Ministry of Health in 2015, when including those with allergy symptoms, the prevalence could be as high as 19%. To date, 300,000 people have been officially diagnosed. This would tally with data from the United States where figures are estimated to be between 5 and 15% of the population.
In the course of this illness, the patient’s tolerance to chemical substances in the atmosphere decreases and substances that wouldn’t normally affect them or anyone else before, now do. Some of the trigger products are smoke, cleaning products, air fresheners, tarmac, glue, cosmetics, paint, medicines, and hair dye. Other agents found in the atmosphere, such as electromagnetic or sound waves (microwaves, WiFi etc), can also be a trigger.
Some of the usual symptoms are:
● generally feeling unwell
● dizziness, vertigo or imbalance
● nasal discomfort; dryness, itching, sneezing
● dry mouth, dry cough, itchiness or phlegm in the throat
● headaches, heaviness or tension in the head
● anxiety, nausea
● heart palpitations
● eye discomfort
Apart from how incapacitating these symptoms can be, and the progress of the illness, which is chronic (a simple visit to the cinema can be a challenge due to the type of cleaning products used, not to mention hotels), patients are more likely to develop thyroid related immunity diseases such as rheumatoid arthritis, lupus or multiple sclerosis.
There is currently no cure for this illness, hence it is essential to avoid any trigger agents.
In the next few years, undeniably, there will be a debate about how to combine modern living with health issues. To give an example, Brussels is the first large city to limit 5G technology due to its effects on our health. Likewise, some small towns in California have made the same decision for the same reasons.
To finish, the following link is to a documentary by Televisión Española (Spanish Television), which talks about how the lives of those that suffer with this illness are affected.
Link: http://www.rtve.es/alacarta/videos/documentos-tv/dtv-carga-toxica/2187803/

Text: Victoria González de Buitrago

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“Victoria González de Buitrago Martínez ha sido beneficiaria del Fondo Europeo de Desarrollo Regional cuyo objetivo es mejorar la competitividad de las Pymes y gracias al cual ha puesto en marcha un Plan de Internacionalización con el objetivo de mejorar su posicionamiento competitivo en el exterior durante el año 2018-2019. Para ello ha contado con el apoyo del Programa XPANDE de la Cámara de Comercio de Valencia.”

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