22 years have passed since the first issue of Correo Farmacéutico was published and since then, this specialized newspaper has witnessed an evolution of the pharmacy that is increasingly professionalized in its work of assisting the population.. This birthday has served as the starting signal for the FarmaAsist awards, which distinguish the healthcare work of the pharmacy.

The first edition of these awards, which have the endorsement of the General Council of Colleges of Pharmacists and with the support of Stada, Bidafarma and Sandoz, recognize programs for the development and implementation of professional services that improve the health results of the population. One of the axes of these initiatives is collaborative work with other professionals in the health care system.

The winners have collected a limited edition by the architect Pilar García Ferrer (on Instagram, @pilsferrer), at an event held in Madrid at the Carlos Amberes Foundation and led by Gema Suarez, coordinator of Correo Farmacéutico.

They have received their award in the presence of Celia Gómez, General Director of Professional Organization of the Ministry of Health; Raúl Pesquera, Minister of Health of Cantabria; Jesús Aguilar, President of the General Council of Official Colleges of Pharmacists of Spain; Antonio Mingorance, president of Bidafarma; Ignacio Ortín, commercial director of Sandoz; Mar Fábregas, general director of Stada, and Rosario Serrano, business director of the Health Area of Unidad Editorial, and Daniel Aparicio, editorial director of Correo Farmacéutico.

The pharmacy, an example of change

Daniel Aparicio has only been in charge of the Unidad Editorial Health Area for a month, although he recalled that he began his career at Diario Médico 25 years ago. He has pointed out that many major current health issues are still valid, “such as the importance of an inclusive Health State pact, the reform of the Framework Statute or the Medicines Law or the importance of ER being a specialty…”.

“In 2023 we continue talking about the same thing, one of the few oases in which the conversation has evolved has been Pharmacy and pharmacists, who in these years have affirmed your position as agents of change in the sector and have strengthened your presence with own voice”, Aparicio pointed out to the audience. “Correo Farmacéutico has witnessed this evolution in which you have found a space for dialogue with society that has enriched us all”.

The director of CF thanked the work of the jury, made up of Ana Dago, president of Pharmaceutical Care; Carina Escobar, president of the Platform of Patient Organizations; Domingo del Cacho, president of the territorial delegation of the Spanish Society of Health Managers in Madrid; Ana López Casero, treasurer of the General Council of Official Colleges of Pharmacists of Spain, and Vicente Baixauli, president of the Spanish Society of Clinical, Family and Community Pharmacy.

Rosario Serrano, Ignacio Ortín, Celia Gómez, Raúl Pesquera, Jesús Aguilar, Mar Fábregas, Antonio Mingorance and Daniel Aparicio. SERGIO G. VALERO

Later, he gave way to the Cantabrian counselor, who highlighted the raison d'être of these awards, which “add value to healthcare pharmacy, a highly valuable field in the health framework”.

“With professional services, the pharmacist develops his skills for the prevention of disease and the improvement of the health of the population, which is what we aspire to from the health organizations”, assured Pesquera, who has urged the rest of the authorities to count on pharmacists.

In particular, it has emphasized the role of the rural pharmacy, especially in nuclei at risk of depopulation. “For an elderly person on a mountain, if they do not have health care, but do not have a pharmacy nearby, it is the prelude to having to go out”.

Gender violence and digitization

The president of the Council of COF has closed the act by congratulating CF, “which has been and is a benchmark for the pharmaceutical profession”. Coinciding with Pesquera, Aguilar stressed that pharmacists have managed to make progress in the last four years in their integration into the health system: “Pharmacists and pharmacies are an essential part of the National Health System”.

Within the evolution of recent years, it has influenced the work of the profession in the social field, with initiatives “on issues of such depth as unwanted loneliness and the fight against gender violence”.

He has also highlighted the effort for digitization and the creation of platforms in collaboration with autonomous communities, Nodofarma Asistencial, Farmahelp, Cismed or the private electronic prescription. “The care axis is the backbone of everything, because that is our reason for being as health workers”.

Although it is not explicitly marked as such on the agenda, the Interterritorial Council Plenary session scheduled for this Friday will discuss how the possible decision to withdraw or ease the mandatory nature of masks in health and social health environments is finally articulated.. This is an issue that, in Spain, goes back a long way, since several voices have been requesting for some time that the measure against covid-19 be adapted to the health and care reality derived from the SARS-CoV-2 crisis.

The celebration of this meeting between Health and the regional officials was announced less than a week ago by the Minister of Health, José Miñones, during an interview on Radio Nacional. Miñones stressed that the last decision on this matter corresponds to the technicians and experts. “You have to do it rigorously, you have to do it seriously,” he said, adding that it will be the experts who will guide the withdrawal process; that is, if it is done “prolongedly, definitively or in stages”.

However, as this newspaper has been able to learn, there are autonomies that question this, since it has not yet been announced that a meeting of the Public Health Commission will be held before this Interterritorial meeting, dated for Friday from 5:00 p.m.. As this newspaper has already published, in the previous meetings of this commission, held before the regional elections of 28-M, there was no quorum on this matter and there were different positions between some regions; For this reason, there are autonomies that consider it necessary for the members of the commission to meet again to approach positions and structure how the process of softening or withdrawing the measure should be carried out.

Said proposals, according to sources close to the Interterritorial Council, must take into account the “vulnerable environments” and those in which the chronic, elderly and polymedicated population lives, as is the case of residences. In them, as they point out, said obligation should be maintained; while in other environments where it is now mandatory to wear a mask, it should be softened, following the criteria that already existed before the arrival of the pandemic.

An “electoralist” measure

Miñones' announcement to convene the Interterritorial Council and address this issue in it generated reactions as soon as it occurred. One of them was that of the acting Minister of Health of Madrid, Enrique Ruiz Escudero, who pointed out that it is an “electoralist” proposal.. In fact, he recalled that his region has been asking for months to “review the strategy” against covid-19 thinking about “the vulnerability of people and people with active infection.”

“As of today there is no further progress, which responds to something that we have seen during all these years, which is how the Ministry of Health is going to use a public health measure with an electoral character, as it has always done”, pointed out Ruiz Escudero, who added that “it is a disgrace” that the ministry uses this issue “when the epidemiological and care situation is exactly the same as it was four months ago.”

“If that decision is made, it is welcome; but of course the electoral nature that the Ministry of Health uses for all its measures is sometimes embarrassing,” he concluded.

The celebration of this Interterritorial Council also takes place in a complex political scenario, not only because of the general elections in barely a month, but also because in the communities where regional elections have just been held, the councilors are still in office, in many of They continue to produce government agreements and it is more than likely that several will change their political color.

Moreover, it is very possible that several regional councilors attend this meeting of the Interterritorial Council, not only in office, but also as one of their last institutional acts in office.

Should this issue have been addressed earlier?

The approach to the mandatory nature of masks in health settings in this Interterritorial Council, in the second half of June and several weeks after the World Health Organization (WHO) decided to lift the international emergency due to covid, also raises another question: Has the political analysis and corresponding decisions on this issue taken too long? And it is that, at the beginning of last May, this newspaper collected the unknowns that investigations and experts launched around the debate generated in Spain about maintaining the mandatory nature of the mask in health settings: Was it still necessary as a measure to combat the transmission of the virus? SARS-CoV-2? Would it be appropriate to remove the obligation or soften the measure? Is there evidence to support these decisions?

These questions arose after other neighboring countries had decided to ease this obligation and after studies were published that raised doubts about the impact of the measure.

Whether it is late or not, everything indicates that a decision will come out of the meeting this Friday between Health and the autonomous communities that could modify the Royal Decree published in the Official State Gazette on February 8 and in which the health environments are specified. and socio-sanitary in which the use of the mask is still mandatory.

The 'tentacles' of SARS-Cov-2 are elongated. The infection, as we have verified during the pandemic, is capable of affecting multiple organs and systems of our body, causing a long list of problems.

In the brain, the particular imprint of Covid is singular, as has just been demonstrated by research from the Queensland Brain Institute in Brisbane (Australia) in which the Spanish Ramón Martínez-Mármol has participated.

According to their data, Covid-19 can cause neurons to fuse, which causes them to malfunction and can lead to neurological symptoms.. Although the studies have so far been carried out only in the laboratory, the researchers point out that the phenomenon could be behind some of the symptoms of persistent Covid, such as brain fog.. Details of the work are published in the journal Science Advances.

“Our results present a neural alteration that can persist for a long time in our brains,” says Martínez-Mármol via email. “We rule out that this is responsible for all the symptoms observed in patients with persistent Covid, but it may be a mechanism involved in some of them.”

The Spanish researcher Ramón Martínez-Mármol.

The ability of SARS-Cov-2 to cause some cells to fuse was known. For example, its effects on lung cells have been studied and several studies have pointed to fusion as one of the causes of the respiratory symptoms, sometimes very severe, caused by the infection.. However, until now its ability to cause a fusion between neurons had not been demonstrated.

In fact, “the neuronal fusion induced after a viral infection had not been demonstrated to date”, emphasizes Martínez-Mármol. This phenomenon, he explains, “had only been observed on a few exceptional occasions in certain invertebrates, such as the nematode Caenoarbditis elegans.”

The 'key' to the virus

According to experiments in mouse cell cultures and human brain organoids grown using stem cells, SARS-CoV-2 infection can cause fusion between neurons (and between neurons and other brain cells) through the ACE2 receptor, the 'key ' that the virus uses to penetrate those cells. In an already infected cell, the S protein of the virus uses other ACE2 receptors to trigger fusion with 'neighboring' neurons, as a way to continue expanding.

The fusion that the researchers were able to observe through staining of two different types of neurons in mouse and human brain organoids caused a disruption in communication between neurons.

Fused neurons present “a profound alteration in their pattern of electrical activity,” explains Martínez-Mármol. “By merging, they become fully synchronized activity, as if they were a single entity. And this can be a problem”, points out the Spanish researcher. Because precisely the “individuality” of neurons is a crucial factor for the functioning of the nervous system.

A disturbance in the 'electrical circuit'

The Australian team uses an analogy to explain the alterations caused by neuronal fusion. If we think about the electrical circuit that connects our house, the fusion would cause that, when a single switch is activated, either the lights in the kitchen and the bathroom would turn on at the same time or that they would all remain off.

“In 10% of cases, when neurons fuse with non-neuronal cells, such as astrocytes, the neurons stop working. This is significant since in our brain there are more non-neuronal cells than neurons”, adds the researcher, who stresses that it was precisely the Spaniard Santiago Ramón y Cajal who, at the end of the 19th century, established the Neuronal Theory and “postulated that neurons are units individuals that communicate with each other directionally through the space between them. This theory has been demonstrated in the vast majority of living organisms.. And we have now discovered that it can be precisely viruses that, after infecting neurons, have the capacity to alter said individuality”, explains Martínez-Mármol.

According to the researcher, the next steps that the team wants to take include studying the long-term effects of the aforementioned fusion in the brain of mice and analyzing how this fusion affects their behavior, memory or relationship with other animals.. They also want to extend the research to many other viruses, also fusogenic and that cause brain infections, to see if the effects on neurons are similar and if this fusion is the mechanism that explains the neurological symptoms that are sometimes associated with these disorders.. On the other hand, the team also wants to demonstrate the existence of fusion in brain samples donated to science, as well as evaluate possible treatments to “first prevent and then reverse said neuronal fusion”, concludes the researcher.