[Activity of a short-stay observation unit in an emergency department of a tertiary hospital. A two-year experience]. / Actividad de una unidad de observación en un servicio de urgencias de un hospital terciario: dos años de experiencia.

OBJECTIVES: To describe the characteristics of the activity of a short stay observation unit (SSOU) in a tertiary hospital, and to analyze its influence on the hospitalization rate. MATERIAL AND METHODS: The activity of the SSOU during the first 2 years after opening is described. Descriptive variables were registered. Hospitalization activity during the first 5 months after opening the unit was compared with the activity during the same period in the previous year. RESULTS: From June 1, 2001 to May 31, 2003, 74,989 patients were admitted to the emergency department (ED) and 2,438 (3.25 %) were transferred to the SSOU. The mean age of the patients was 64.55 months. The mean length of stay was 5 hours and 50 minutes. The main discharge diagnoses were gastrointestinal disease (30.2 %), accidents (15 %), respiratory illness (12.5 %) and febrile syndrome (9.8 %). The hospitalization rate in patients admitted to the ED was 5.8 % from June 1, 2000 to October 1, 2000 and was 4.28 % in the same period in 2001. The mean diagnosis-related group (DRG)-weight was 0.8648 in 2000 and was 0.9078 in 2001. Total weight was 680.66 in 2000 and 495.69 in 2001, allowing an approximate saving of 329,162 Euros. CONCLUSIONS: The opening of the SSOU has been useful in the assessment and treatment of common childhood diseases and has helped reduce the hospitalization rate, increase the complexity of inpatients and lower costs.

[Supravalvular aortic stenosis. Apropos of 10 cases]. / Estenosis aórtica supravalvular. A propósito de 10 casos.

We present 10 patients diagnosed of supravalvular aortic stenosis (5 dumb bell shaped, 4 membranous and 1 undifferentiated), 7 in association with Williams-Beuren syndrome, 5 were male and 5 were female. None showed alterations of calcium metabolism and in 8 cases we found other associated cardiac anomalies. In 9, the diagnosis was confirmed with Eco-Doppler. The gradient calculated with the Eco-Doppler had a medium correlation (75%) with the catheterism (Doppler 46 +/- 23 (13-89)-Catheterism 27 +/- 15 (10-50)). 50% had the sinus of Valsalva dilated. Six patients underwent surgery, 5 with an enlargement parch and 1 with a butterfly parch. In 3 cases, associated anomalies were repaired, 2 during supravalvular surgery (one valvular aortic stenosis and one fixed subaortic stenosis). No patient had postoperatory complications.

[Aortic valva atresia with normal left ventricle and interventricular communication]. / Atresia aórtica con ventrículo izquierdo normal y comunicación interventricular.

We present three patients with aortic atresia, normal left ventricle and ventricular septal defect by bidimensional echocardiography. In two patients the Norwood's procedure was performed, but they died in the immediate postoperative time. The different procedures for the correction of this kind of aortic atresia and the necessity of prompt surgical treatment are discussed here.