[The assessment of the nutritional status of patients in the terminal stage of liver disease who are candidates for orthotopic liver transplantation]. / Valoración del estado nutricional de los pacientes en estadio terminal de enfermedad hepática, candidatos a trasplante ortotópico de hígado.

Orthotopic liver transplant (OLT) is nowadays an accepted procedure for the treatment of patients with end-stage liver disease. Because of the significant state of malnutrition of such patients, we decided to evaluate the nutritional condition of patients accepted by the hospital's Transplants Committee as candidates for this type of therapy, with the eventual aim of discovering the types of malnutrition in the different pathologies, and which were the most frequent. The sample studied showed a significant prevalence of malnutrition. Patients with viral hepatitis showed only visceral type malnutrition, which affected 100% of them. The ethanolic cirrhosis group presented all types of malnutrition-energy-calorific (35%), protein (24%) and visceral (53%), while the group of other liver diseases presented 15% of energy-calorific malnutrition and 85% visceral. From these results, we conclude that the sample studied has a high prevalence of malnutrition and that the importance of its detection makes it possible to reduce pre- and post-surgical morbidity and mortality rates with an appropriate nutritional support.

[Literature review on the stability of diluted mixtures of cytostatic agents]. / Revisión bibliográfica de la estabilidad de las mezclas diluidas de citostáticos.

Up-to-date, evidence-based consensus protocols are an increasingly incorporated tool in health care. These protocols, clinical pathways, etc., represent a major support of health-care quality, namely scientific-technical quality. Compliance with these protocols by all team members guarantees that all patients be provided with an adequate level of health-care quality in the light of current knowledge and using available means. This principle of uniformity and quality in health care is essential for all, no matter the level of health care delivered or the activity being developed. In the Pharmacy Department and, more specifically, in the Unit of Cytostatic Agent Reconstitution and Dosing, knowledge and consensus on stability conditions and timing for diluted mixtures are essential to reach area-related quality standards. From literature references that are most relevant to or most widely used by in-hospital pharmacy departments, we designed a documented stabilities protocol to be used as a tool to: Augment preparation quality by including a documented expiry date within labels, optimize management on the basis of scientific criteria for mixtures not administered to patients and returned to the Pharmacy Department and design alternatives to hospitalization and outpatient delivery programs to improve end-user satisfaction and, therefore, health-care quality.

[Assessment of prescription in discharge reports at a university hospital]. / Evaluación de la prescripción de medicamentos en los informes de alta en un hospital universitario.

OBJECTIVE: To determine and analyze drug prescription at hospital discharge, mainly regarding generic drug use, use of novel but irrelevant therapeutic agents and use of low therapeutic value drugs (LTVD). MATERIAL AND METHODS: In a retrospective study 195 discharge reports from 11 different departments in a 450-bed general hospital were analyzed for a monthly period. An Access database allowed us to record the number of prescriptions, each drugs therapeutic group according to the Anatomical Therapeutic Chemical (ATC) Classification System, prescribed drugs for which generics are available, prescribed C-group drugs, LTVD drugs, etc. RESULTS: Following an analysis of results, only 6.17% of all drugs were prescribed according to their generic name, when this would have been possible in 22.8%. If only the most efficient agents had been prescribed, savings would have amounted to 589.3 Euros. In all, 1.28% of prescribed drugs were LTVD, and 1.15% had irrelevant therapeutic value. CONCLUSION: Although specialized medical prescription represents a minimum of total prescriptions in a healthcare area, measures intended to improve quality will have a positive impact on primary care prescriptions. These measures include information to physicians on more efficient preparations, plus the design of a Pharmacotherapeutic Guide to unify pharmacologic criteria in the Area.