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BACKGROUND: The rate of potential adverse drug events is reported to be 3 times higher among pediatric inpatients than among their adult counterparts. Various methods have been suggested to reduce medication errors in pediatric patients. One of the most influential of these strategies is inclusion of a clinical pharmacist on the multidisciplinary care team. However, there is currently no literature describing the inventory of pharmacy services provided to pediatric patients in Canadian adult hospitals. OBJECTIVES: The primary objective of this study was to describe pediatric and neonatal pharmacy services provided in adult hospitals in Canada. The secondary objective was to determine whether the services provided correspond to services that pharmacists working in Canadian pediatric hospitals identified as important for adult hospitals that provide pediatric services. METHODS: Two web-based surveys were created, focusing on 35 pharmacy services. The first survey was intended for adult hospitals, and the second for pediatric hospitals. The surveys were distributed by e-mail and were completed in January and February 2018. RESULTS: A total of 55 and 43 valid responses were received from respondents in adult hospitals and pediatric hospitals, respectively. An inventory of pharmacy services provided by adult hospitals to their pediatric and neonatal patients was obtained. Of the adult hospitals that responded, 61% (33/54) had pharmacists assigned to pediatric or neonatal units. The frequency with which most pharmacy services were provided was comparable to the importance identified by pharmacists working in pediatric hospitals. However, for the provision of education during admission and at discharge and for the provision of medication reconciliation at discharge, frequency and importance were not comparable. CONCLUSIONS: Adult hospitals with a pharmacist assigned to an inpatient pediatric or neonatal clinical area met most expectations of pharmacists working in pediatric hospitals in terms of pharmacy services provided. However, some services require optimization for this patient population.
CONTEXTE: On rapporte que le taux de réactions indésirables potentielles aux médicaments est trois fois plus élevé chez les enfants hospitalisés que chez les adultes. Diverses méthodes ont été proposées pour réduire les erreurs de médication chez les patients pédiatriques. L'une des stratégies les plus influentes consiste à inclure un pharmacien clinique au sein de l'équipe de soins pluridisciplinaire. Cependant, il n'existe actuellement aucun document dressant l'inventaire des services de pharmacie offerts aux patients pédiatriques dans les hôpitaux canadiens pour adultes. OBJECTIFS: L'objectif principal de cette étude consistait à décrire les services de pharmacie pédiatriques et néonataux offerts dans les hôpitaux pour adultes au Canada. L'objectif secondaire consistait quant à lui à déterminer si les services offerts à la population pédiatrique dans les hôpitaux pour adultes correspondaient à ceux que les pharmaciens travaillant dans les hôpitaux pédiatriques canadiens reconnaissaient comme étant importants. MÉTHODES: Deux sondages en ligne se focalisant sur 35 services de pharmacie ont été créés. Le premier était destiné aux hôpitaux pour adultes et le deuxième aux hôpitaux pédiatriques. Les sondages ont été distribués par courriel et effectués en janvier et février 2018. RÉSULTATS: Cinquante-cinq (55) répondants des hôpitaux pour adultes et 43 des hôpitaux pédiatriques y ont répondu en bonne et due forme. Les investigateurs ont obtenu en outre la liste des services de pharmacie offerts par les hôpitaux pour adultes à leurs patients pédiatriques et néonataux. Soixante et un pour cent (61 %), soit 33 sur 54, des répondants provenant des hôpitaux pour adultes à étaient des pharmaciens affectés aux unités pédiatriques ou néonatales. La fréquence de l'offre de la majorité des services de pharmacie était d'importance comparable à ce que les pharmaciens travaillant dans les hôpitaux pédiatriques ont relevé. Toutefois, pour ce qui est des instructions données au patient à l'admission et au congé et de la prestation du bilan des médicaments au congé, la fréquence et l'importance de ces services n'étaient pas comparables. CONCLUSIONS: Les hôpitaux pour adultes disposant d'un pharmacien affecté à un domaine clinique pédiatrique ou néonatal répondaient à la plupart des attentes des pharmaciens travaillant dans les hôpitaux pédiatriques en termes d'offre de services de pharmacie. Cependant, certains services demandent à être optimisés pour cette population de patients.
RESUMEN
UNLABELLED: Helicobacter pylori has been associated with gastric adenocarcinoma and gastric lymphoma. We report on the systematic evaluation of serologic detection of H. pylori in a lymphoma case-control study. METHODS: Cases (N = 536) were consecutive patients newly diagnosed with a lymphoid malignancy between 1998 and 2002 in four centers in Spain. Lymphomas were diagnosed and classified using the WHO Classification. Controls (N = 603) were hospitalized patients frequency-matched to the cases by 5-year age group, sex, and study center. Severe immunocompromised patients were excluded as controls. Patients underwent a personal interview and blood sampling. H. pylori infection was evaluated by the presence of IgG antibodies using the Premier enzyme immunoassay kit (Meridian Diagnostics Inc., Cincinnati, OH). Logistic regression analysis was used to estimate the odds ratios and 95% confidence intervals (OR, 95% CI) for lymphoma categories. RESULTS: Anti-H. pylori antibodies were detected in 68.5% of the cases and 71.3% of the controls (P = 0.29) H. pylori was associated with a 3-fold excess risk of splenic marginal B-cell lymphoma (OR = 3.97, 95% CI = 0.92-17.16). H. pylori was not associated with an overall increased risk of extranodal lymphomas (OR = 0.73, 95% CI = 0.44-1.22) but when specific sites were explored, the four mucosa-associated lymphoid tissue and the six diffuse large B-cell lymphomas primary localized in the stomach were all H. pylori seropositive. CONCLUSION: Persistent infection with H. pylori may be implicated in the development of lymphomas of the gastric mucosa and of the spleen. These results could have clinical implications in the management of splenic marginal zone lymphomas.