Impact of pharmaceutical validation on prescribing errors in a neonatal intensive care unit. Randomised and controlled study.

Purpose: To compare the frequency of electronic prescription errors when the prescription was validated by the clinical pharmacist vs. when it was not. Methods: This prospective randomised controlled study was conducted in three phases. A randomised phase, in which patients were divided into control and intervention groups, and a pre- and post-intervention phase were consecutively performed to analyse the impact of pharmaceutical validation of prescriptions in a neonatal intensive care unit (NICU). This study was performed at a highly complex NICU at a tertiary hospital. All patients born during the study period who were admitted to the NICU, with a stay lasting ≥24 h, and received active pharmacological treatment were included in the study. Pharmaceutical validation was performed according to the paediatric pharmaceutical care model. A high level of validation was selected for this study. In the intervention group, discrepancies found during the review process were communicated to the medical team responsible for the patients and resolved on the same day. Results: In total, 240 patients were included in this study. Sixty-two patients were allocated to the pre-intervention (n = 38) or post-intervention (n = 24) groups, and 178 patients were randomly sorted into two groups, control (n = 82 newborns) and intervention (n = 96 newborns). During the randomisation phase, the number of prescription errors detected was significantly lower in the intervention group than that in the control group (129 vs. 270; p < 0.001). Similarly, prescription errors reaching the patient were significantly reduced from 40% (n = 108) in the control group to 1.6% (n = 2) in the intervention group. In the pre- and post-intervention periods, the prescription lines containing prescription errors decreased from 3.4% to 1.5% (p = 0.005). Conclusions: This study showed that the pharmaceutical validation process decreased both the number of errors in the electronic prescribing tools and the number of prescription errors reaching the patient.

Mortality rates for Parkinson's disease are increasing in Spain. An age-period-cohort and joinpoint analysis of mortality rates from 1981 to 2020.

BACKGROUND: Mortality in Parkinson's disease is increasing worldwide, but Spanish data need further study. OBJECTIVE: To analyse the mortality trends of Parkinson's disease in Spain between 1981 and 2020. METHODS: This observational retrospective study assessed the Parkinson's disease mortality data from 1981 to 2020 collected from the National Statistics Institute of Spain. Age-standardised mortality rates were analysed by age and sex groups, detecting significant mortality trends through a joinpoint analysis. Age-period-cohort effect and potential years of life lost analyses were conducted. The European standard population of 2013 was considered for the analyses. RESULTS: A total of 88 034 deaths were assessed. The overall age-standardised mortality rate rose throughout the period from 3.67 to 8.57 per 100 000 inhabitants. Mortality rates in men were higher than in women, 11.63 versus 6.57 deaths per 100 000 inhabitants. The sex ratio showed an increase in premature mortality in men during 2020. The overall joinpoint analysis recorded a rise in mortality, primarily since the 20th century, mainly in male and older groups, that matched with a period effect. The age effect was detected, confirming higher mortality at an older age. The analysis of potential years of life lost detected a growth in this rate, changing from 0.66 in 1981 to 1.06 in 2020. CONCLUSIONS: Mortality data for Parkinson's disease in Spain rose significantly in forty years. Mortality rate was higher in the male and age group above 75 years of age. The sex ratio showed premature mortality in men in 2020, which will need further study.

[Effectiveness of Wii Fit Balance board in comparison with other interventions for post-stroke balance rehabilitation. Systematic review and meta-analysis]. / Efectividad de la Wii Fit Balance frente a otras intervenciones para la recuperacion del equilibrio en pacientes postictus. Revision sistematica y metaanalisis.

INTRODUCTION: Virtual reality is a booming therapeutic tool within the neurorehabilitation field. Among the different non-inmersive virtual reality systems, the most outstanding is the platform, Wii Fit Balance. AIM: To review the scientific literature published in recent years about the effectiveness of Wii Fit Balance tool. The use of this platform for balance training in patients who have suffered a stroke compared to conventional therapies is going to be analyzed from a quantitative and qualitative point of view. SUBJECTS AND METHODS: A search of the databases has been carried out: PubMed, Lilacs, PEDro, Scopus, Web of Science and Cochrane Library. Descriptors employed were «Wii Fit Balance¼, «Wii¼, «stroke¼, «ictus¼ and «balance¼. Studies were analyzed methodologically by PEDro Scale. For those possible variables a meta-analysis was elaborated. RESULTS: Sixteen randomized clinical trials were selected for the systematic review and six of them were included in the meta-analysis. Results for the descriptive analysis were heterogeneous. This situation is confirmed through the meta-analysis results, because the analyzed variables for static and dynamic balance show intra-group improvement and no significant differences between groups post-intervention. CONCLUSION: Wii Fit Balance, virtual reality platform, is an available therapeutic tool which has been shown at least as effective as conventional balance training in post-stroke patients.

TITLE: Efectividad de la Wii Fit Balance frente a otras intervenciones para la recuperacion del equilibrio en pacientes postictus. Revision sistematica y metaanalisis.Introduccion. La realidad virtual es una herramienta terapeutica en auge dentro del campo de la neurorrehabilitacion. Entre los sistemas de realidad virtual no inmersiva mas empleados destaca la videoconsola Wii Fit Balance. Objetivo. Revisar la literatura cientifica publicada en los ultimos años acerca de la efectividad de la herramienta Wii Fit Balance para el entrenamiento del equilibrio en pacientes que han sufrido un ictus en comparacion con las terapias convencionales y analizar dicha informacion desde un punto de vista cuantitativo y cualitativo. Sujetos y metodos. Se ha llevado a cabo una busqueda en las bases de datos PubMed, Lilacs, PEDro, Scopus, Web of Science y Cochrane Library. Los descriptores de busqueda utilizados fueron «Wii Fit Balance¼, «Wii¼, «stroke¼, «ictus¼ y «balance¼. Se analiza la calidad metodologica de los estudios incluidos a traves de la escala PEDro. Para las variables que fue posible, se llevo a cabo un metaanalisis. Resultados. Se seleccionaron 16 ensayos clinicos aleatorizados para la revision sistematica, y seis de ellos se incluyeron en el metaanalisis. Dentro del analisis descriptivo se observo heterogeneidad de resultados. Esta misma situacion se confirmo a traves de los resultados del metaanalisis, ya que tanto para las variables de equilibrio estatico como dinamico analizadas se observaron mejoras intragrupo, pero sin que existieran diferencias significativas entre grupos postintervencion. Conclusiones. La plataforma de realidad virtual Wii Fit Balance es una herramienta terapeutica valida que ha demostrado ser al menos igual de efectiva que el entrenamiento convencional del equilibrio en pacientes postictus.

[Lapatinib plus transtuzumab for HER-2 positiva metastatic breast cancer: experience of use]. / Lapatinib en combinación con trastuzumab en el tratamiento del cáncer de mama metastásico HER2 positivo: Experiencia de uso.

OBJECTIVE: To describe the outcomes produced by concomitant use of HER2-receptor inhibitors Lapatinib and Trastuzumab for the treatment of HER 2-positive metastatic breast cancer. METHOD: Retrospective observational study. Patients treated with Trastuzumab and Lapatinib between January of 2010 and May of 2012 were selected. Demographical and clinical data were gathered. RESULTS: 23 patients with metastatic breast cancer (mean age 59.3 ± 13.3 years) were included. All of them had received an average of 5 treatment lines with at least one of them including Trastuzumab. The median progression-free survival rate with combined Lapatinib + Trastuzumab, with or without associated chemotherapy was 7 months (95% CI: 2.78-11.21) and 3 months for the patients only receiving Lapatinib and Trastuzumab. Seven patients experienced adverse events and in four patients the treatment was stopped due to toxicity. CONCLUSIONS: The treatment with HER2-receptor inhibitors in our patients resulted in progression-free survival rates similar to those published in clinical trials with patients receiving Lapatinib + Trastuzumab not combined with any other anti-cancer therapy, with good treatment tolerability.

Objetivo: Describir los resultados obtenidos con la utilización conjunta de dos inhibidores del receptor HER2 (lapatinib y trastuzumab) en el tratamiento del cáncer de mama metastático HER 2 positivo. Método: Estudio observacional retrospectivo. Se seleccionaron pacientes en tratamiento con trastuzumab y lapatinib entre enero de 2010 y mayo de 2012. Se recogieron datos demográficos y clínicos. Resultados: Se incluyeron 23 pacientes con cáncer de mama metastático (edad media de 59,3 ± 13,3 años). Todos ellos habían recibido una media de 5 líneas de tratamiento previo con al menos una línea de tratamiento con trastuzumab. La mediana de supervivencia libre de progresión con lapatinib + trastuzumab combinado con o sin otra quimioterapia asociada fue de 7 meses (IC 95%: 2,78-11,21) y de 3 meses para las pacientes que sólo recibieron lapatinib y trastuzumab. Siete pacientes tuvieron efectos adversos y en cuatro pacientes se suspendió el tratamiento por toxicidad. Conclusiones: El tratamiento con dos inhibidores del receptor HER2 en nuestras pacientes ha resultado en una supervivencia libre de progresión similar a la de los ensayos clínicos publicados cuando las pacientes recibieron lapatinib + trastuzumab y no se combinó con otra terapia antineoplásica, con buena tolerancia al tratamiento.