Relationships between supply performance of pharmacies in Chile and their quality of customer service

Purpose

This paper aims to describe relationships between constructs adapted to the pharmaceutical field with respect to the measurement of the supply chains strategic and operational performance in private pharmacies, relating it to the quality of service perceived by users.

Design/methodology/approach

Relationships among the indicated constructs were validated through the use of structural equation models. This study includes the use of questionnaires adapted and applied to suppliers (pharmaceutical chemists and supply staff), operational managers (pharmacy assistants) and users (patients and clients) who visit different segments of pharmacies, such as chain businesses and independents located in the region of Valparaíso, Chile. The sample collected information from 128 establishments and 601 people, through which different relationships between segments were compared.

Findings

A structural model was validated on the basis of statistical principles. Furthermore, positive relationships were observed in the constructs studied where pharmacy chains had a statistical significance of less than 5 per cent between the responsibility of the supply process and the experience of the users, whereas independent pharmacies had a very significant causal relationship between operational managers and users.

Practical implications

The proposal can help predict the quality of service perceived by the user based on the behavior of sales and supply staff, which may be similar in other markets with similar characteristics.

Originality/value

The structural model proposed is original and adapts measurement scales validated from previous studies to be able to apply them in the pharmaceutical retail market.

X-shaped inferior extensor retinaculum and its doubtful use in the Bröstrom-Gould procedure

PURPOSE

The inferior extensor retinaculum (IER) is an aponeurotic structure located in the anterior aspect of the ankle. According to the literature, it can be used to reinforce a repair of the anterior talofibular ligament in ankle instability. Despite its usual description as an Y-shaped structure, it is still unclear which part of the retinaculum is used for this purpose, or if it is instead the crural fascia that is being used. The purpose of this study is to define the anatomical characteristics of the IER to better understand its role in the Broström-Gould procedure.

METHODS

Twenty-one ankles were dissected. The morphology of the IER and its relationship with neighbouring structures were recorded.

RESULTS

Seventeen (81%) of the IER in this study had an X-shaped morphology, with the presence of an additional oblique superolateral band. This band, by far the thinnest of the retinaculum, is supposed to be used to reinforce the repair of the anterior talofibular ligament. The intermediate dorsal cutaneous nerve (lateral branch of the superficial peroneal nerve) was found to cross the retinaculum in all cases.

CONCLUSIONS

The IER is most commonly seen as an X-shaped structure, but the fact that the oblique superolateral band is a thin band of tissue probably indicates that it may not add significant strength to ankle stability. Furthermore, the close relationship of the retinaculum with the superficial peroneal nerve is another factor to consider before deciding to perform a Broström-Gould procedure. These anatomical findings advise against the use of the Gould augmentation.

[Prevalence of HIV, hepatitis B virus and Treponema pallidum in inmates in the Preventive Detention Center of Arica, Chile]

BACKGROUND

The risk groups for sexual transmitted diseases (STDs) are sex workers, drug addicts, young people in early sexual initiation, and population in prison.

AIM

To determine the prevalence of HIV, Treponema pallidum and hepatitis B Virus (HBV) in male inmates at the Preventive Detention Center (CDP) of Arica.

METHODS

The study was conducted in 140 inmates, with informed consent. Epidemiological survey and blood sampling was conducted. The positive tests were sent to the Hospital Regional of Arica for confirmation and the National Reference Laboratory for confirmation.

RESULTS

STD prevalence was 13.6%. The most prevalent was VDRL positive (7.1%) followed by HIV infection (5.7%) and HBV (2.9%). The highest rate (57.9%) occurred in individuals under 31 years old. 63.2% were in an overcrowded situation, 42.1% of cases corresponded to those whose age of sexual activity onset of was before age 15 and 94.7% used drugs.

CONCLUSIONS

The study reasserts the predisposing factors for the transmission of STDs as age, early sexual debut, drug abuse and overcrowding, noting that prisons are highly vulnerable environments where overcrowding, sexual condition, early sexual initiation, high drug abuse and the lacking spouses visits provide an epidemiological context favorable for increased STD.

[Skin lesions of a disseminated histoplasmosis in Peru]

The dermatological manifestations of disseminated histoplasmosis present in about 17% of the cases, is a challenge for its diagnosis. We report the case of a patient from the northern coast of Peru, who presented diffuse dermal lesions, erythema-violaceous nodules, and ulcers histopathologically compatible with the infection of the genus Histoplasma var. capsulatum.

Comparison of treatment of basal cell carcinoma between surgery and intralesional photodynamic therapy: A cross-sectional study

BACKGROUND

Surgery is the treatment of choice in basal cell carcinoma (BCC), but new less invasive techniques are in development such as photodynamic therapy. The main problem of this technique is the limited depth penetration of topical photosensitizers. The use of an intralesional photosensitizer plus an irradiation with a 630 nm laser should increase this penetration.

OBJETIVES

To compare the effectiveness in treatment of BCC between surgery and intralesional photodynamic therapy (I-PDT). To identify the clearance rate differences between intralesional or external irradiation in I-PTD group.

METHODS

A retrospective study of 102 patients with different histological types of BCC (mean depth of 2.44 mm) was performed. A total of 51 patients were treated with surgery and 51 with I-PDT, injecting 5-aminolevulinic acid 1% in the tumor and later irradiated with a 630 nm laser (intralesionally or externally: 25 and 26 patients respectively). Histological samples were obtained before and after treatment.

RESULTS

A total of 41/51 Patients in the surgery group vs 42/51 patients in I-PDT group achieved a complete clearance after treatment (p 0.79). There were no differences in success rates between intralesional vs external irradiation in I-PDT group (p 0.46).

LIMITATIONS

Small sample size and retrospective study.

CONCLUSION

I-PDT achieved high clearance rates in the treatment of BCC similar to surgery. There were no differences in success rates between intralesional vs external irradiation in I-PDT group. PDT might be an interesting option of treatment where surgery it is not possible.

SCATTER DOSE VALUES IN LOWER EXTREMITIES FOR STAFF DURING PAEDIATRIC INTERVENTIONAL CARDIOLOGY PROCEDURES: AN EXPERIMENTAL APPROACH

The aim of this study was to determine experimentally the scatter dose at the cardiologist's lower extremities in 10 common types of paediatric interventional cardiology procedures and categorised in four age groups of simulated patients, on the basis of measurements taken from characterisation of X-ray systems together with average fluoroscopy time values and the number of cine frames used as references. The highest scattered dose rates recorded during the simulations were 700 and 4000 µSv h-1 for the low fluoroscopy and cine modes, respectively. Scattered dose at cardiologist's lower extremities for the four age groups of simulated patients and procedures ranged from 1 to 28 µSv (aged below 1 y), 6 to 58 µSv (below 5 y), 13 to 155 µSv (below 10 y) and 29 to 375 µSv (below 15 y). The present study showed a maximum annual dose that may reach the cardiologist's lower extremities of 90 mSv.