Hospital admissions due to adverse drug reactions in the elderly. A meta-analysis.

INTRODUCTION: It is currently admitted that adverse drug reactions (ADRs) account for a great burden of disease. Of particular concern are ADR-induced hospital admissions, particularly in the elderly; they receive most of the medications and they are the most prone to develop ADRs. Therefore, our aim was to carry out a study of ADR-induced hospital admissions focused on the elderly population. METHODS: For the purpose, a systematic review and meta-analysis was performed of those studies addressing ADR-induced hospital admissions in patients over 60 years of age. A computerized search of the literature was carried out in the main databases. The search spans from 1988 to 2015. A pooled prevalence figure was calculated with 95% CIs; heterogeneity was also explored. RESULTS: The final number of selected articles was 42; all of them were published between January 1988 and August 2015. The overall average percentage of hospital admissions was 8.7% (95% CI, 7.6-9.8%). NSAIDs are one of the medication classes more frequently related to these admissions (percentages range from 2.3 to 33.3%). Inappropriate medication as a risk factor was studied in nine studies, four found a statistically significant relationship between those medications and hospital admissions. CONCLUSIONS: Circa one in ten hospital admissions of older patients are due to ADRs. A great burden of disease is due to a few and identifiable medication classes; in most of the cases, the reactions are well known and probably preventable. A sense of purpose and determination is needed by health authorities to face this problem. Doctors, on their part, should be aware when prescribing some specific identifiable medications to these patients. KEY POINTS: 1. One in ten hospital admissions in older patients are due to ADRs; NSAIDs are the medications the most related with these admissions, followed by other common medications used in patients of this age, such as beta-blockers. 2. A great burden of disease is due to medications that are intended to cure or alleviate disease; this burden of disease is not only painful for the patients but also costly. 3. Identified risk factors are particular medication classes and polymedication. In most of the cases, reactions are probably preventable.

Asociación del SNP19 del gen «calpaína 10» a diabetes mellitus tipo 2 y factores de riesgo en población peruana / Association of SNP19 in the gene to type 2 diabetes mellitus and risk factors in Peruvian population

La diabetes mellitus tipo 2 (DM2) se define genéticamente como una enfermedad compleja originada por la interacción del medio ambiente y los genes, que se encuentran ubicados en diferentes regiones del genoma humano. El gen calpaína 10 (CAPN10), localizado en 2q37.3, constituye un gen de susceptibilidad para esta enfermedad. La asociación alélica y haplotópica observada de los polimorfismos de nucleótido simple (SNP) 19, 43 y 63 en poblaciones amerindias y algunas europeas confirmar a estos resultados. En esta investigación se postuló que los SNP 19, 43 y 63 del gen CAPN10 estaban asociados a DM2 en la población peruana. Se analizaron 45 pacientes diabéticos y 58 familiares no diabéticos. Además de los factores de riesgo como la obesidad, el ¨índice de masa corporal (IMC), la hipertrigliceridemia (HTG), la hipertensión arterial (HTA) y la hipercolesterolemia (HC), se identificaron ¨Cmediante reacción en cadena de la polimerasa (PCR)¨C los SNP 19, 43 y 63 del CAPN10. Se analizaron los resultados utilizando las pruebas de equilibrio de Hardy-Weinberg y el análisis de regresión logística condicional. Se observó asociación del SNP19 a DM2 (χ2= 8,31; p= 0,01) e IMC, HTG e HC en familias diabéticas peruanas. El aporte de la investigación radica en haber detectado estas asociaciones en la población diabética peruana (AU)

Type 2 diabetes mellitus (T2DM) is genetically defined as a complex diseasecaused by the interaction of environment and genes, which are located in differentregions from the human genome. Calpain 10 (CAPN10) is a susceptibilitygene for the disease, located in 2q37.3. The allelic and haplotypic associationobserved of SNP¡¯s 19, 43 and 63 in Amerindian and some Europeanpopulations would confirm these results.In this research, it has been postulated that SNP¡¯s 19, 43 and 63 of CAPN10gene were associated with T2DM in Peruvian population. It has been analyzed45 diabetic patients and 58 non-diabetic relatives. Among other risk factor forobesity, such body mass index (BMI), hypertriglyceridemia (HTG), arterial hypertension(HTA), and hypercholesterolemia (HC), it has been identified bypolymerase chain reaction (PCR) SNP¡¯s 19, 43 and 63 of CAPN10. The Hardy-Weinberg test and conditional regression logistic were used to analyze theresults.The results showed association of SNP19 with T2DM (¦Ö2= 8.31; p= 0.01)and BMI, HTG, HC in Peruvian diabetic families. The main contribution of thisresearch is having detected these associations in the diabetic Peruvian population(AU)