RESUMO
Analizar los resultados de un programa de conciliación e información de medicación al alta hospitalaria en un servicio de urología. Material y Método: Fueron incluidos los pacientes ingresados en el servicio de urología durante 2009 con mayor complejidad en su tratamiento domiciliario. Éste fue registrado, confirmándose previamente mediante una entrevista con el paciente la adherencia al mismo, así como problemas relacionados con la medicación habitual (PRMs). A partir de la epicrisis, se concilió la medicación prescrita con el tratamiento ambulatorio, resolviendo las discrepancias con el facultativo responsable. Por último, se entregó al paciente un cronopictograma con el listado completo de su medicación a partir del episodio asistencial y recomendaciones sobre su tratamiento con la explicación verbal del mismo. Realizamos una encuesta de satisfacción a los facultativos para conocer el conocimiento del programa y su valoración. Resultados: Se seleccionaron 260 pacientes, de los cuales en 102 (39 por ciento) se detectaron PRMs. Las discrepancias más frecuentes fueron: prescripción incompleta (28 por ciento), administración inadecuada (22 por ciento), medicamento no indicado (18 por ciento) y duplicidad (16 por ciento). Los PRMs se clasificaron en orden a la severidad, de las 102 discrepancias: el 68 por ciento no habrían causado daño al paciente y el 32 por ciento habría requerido monitorización. La valoración global del programa fue muy positiva para los facultativos. Conclusión: La conciliación de medicación reduce los PRMs, sobre todo en las transiciones asistenciales de los pacientes. Creemos que esta actividad asistencial debería realizarse de manera habitual en los hospitales, para aumentar la seguridad de los pacientes, en el marco de un sistema de reducción de riesgos para la salud y mejora de la calidad asistencial.
To analyze the results of a medication reconciliation and drug information program at discharge, in an urology department. Materials and Methods: Patients with more complexity in their home treatment, admitted in this facility during 2009, were included in the study. Preadmission regimens were recorded and the patients were asked about drug-related problems (DRP) and drug adherence. On the day of discharge, prescribed medication was reconciled with the outpatient treatment, resolving discrepancies with the prescribers. Finally, the patients were given a complete list of their medications and oral recommendations. We conducted a survey with physicians to enquire about their reconciliation program knowledge and their assessment. Results: 260 patients were selected, of which in 102 (42 percent) DRP were detected. The most frequent discrepancies were: incomplete prescription (28 percent), incorrect administration (22 percent), inappropriate medication (18 percent) and therapeutic duplication (16 percent ). The DRP were classified according to their severity, of the 102 discrepancies, 68 percent would not have caused harm to the patient and 32 percent would require monitoring. On the survey, about the overall evaluation of the program, it was highly regarded for the most of the physicians. Conclusion: Medication reconciliation reduces the DRP, especially at transition in healthcare of patients. We believe that activity should be carried out routinely in hospitals, to increase the patients safety, as part of a system to reduce health risks and improving the quality of care.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Alta do Paciente , Erros de Medicação , Prescrições de Medicamentos , Unidade Hospitalar de Urologia , Sistemas de MedicaçãoRESUMO
OBJECTIVE: To report one case of idiopathic granulomatous orchitis, an extremely rare disease, in a 76-year-old patient. METHODS/RESULTS: The pathology department received a testicle with the clinical/radiological diagnosis of testicular tumor. The pathologic study showed absence of neoplasias and presence of morphological findings compatible with idiopathic granulomatous orchitis. CONCLUSIONS: The idiopathic granulomatous orchitis is an entity of unknown etiology, clinically or ultrasonographically not distinguishable from testicular neoplasias, the diagnosis of which is made after orchiectomy.
Assuntos
Granuloma/patologia , Orquite/patologia , Idoso , Granuloma/complicações , Granuloma/cirurgia , Humanos , Masculino , Orquite/complicações , Orquite/cirurgia , Doenças Testiculares/complicações , Doenças Testiculares/patologia , Doenças Testiculares/cirurgiaRESUMO
OBJECTIVES: In the middle of the 20th century, Urology in Valencia was fully consolidated as a surgical speciality since Prof. Molla started it about the end of the 19th century; Dr. Felipe Alcala Santaella Nuñez stands out as the chairman of the Department of Urology of the "Hospital Provincial de Valencia", after his father Dr. Rafael Alcalá Santaella. He achieved to form a group of renowned professionals, some of which still are in active practice. METHODS: We reviewed all his scientific work and the journals it was published in, mainly Archivos Espaioles de Urologia, through the Department of Medical History of the University of Valencia. His biography was reconstructed using the "Biographic and Bibliographic History of Spanish Urology" by Drs. E. Maganto Pavón and M. Pérez Albacete, as well as direct interviews with family members. DISCUSSION: We emphasize the magnificent approach to the clinical presentations of tuberculosis he does in his doctoral thesis, analyzing its types by location, main features, and most adequate treatment. He also emphasized the importance of relapse in lithiasic patients and recommendations to be follow, as well as the condition of bladder neoplasias. CONCLUSIONS: We consider Dr. Felipe Alcalá Santaella Nuñez as a wide-experience-professional who mode solid contributions to the regional urology in his times, thanks to his excellent surgical abilities and dedication.
Assuntos
Urologia/história , História do Século XX , EspanhaRESUMO
OBJECTIVES: We find that Urology at the end of the 20th century was a consolidated speciality as a result of years of evolution and development, and the studies and works of authors whose contributions are considered today the basements of our speciality. So we think that Urology should be understood with its historical references, because, as Aristotle said "... thinks are better understood when one has got to clearly see how they were formed..." Numerous specialists contributed to this; among them we can cite Prof. Rafael Alcala Santaella, the object of this bibliographic and scientific works compilation paper. METHODS: We reviewed all his scientific works. Original articles have been obtained from Medicina Ibera, Revista Española de Cirugía y Urología, and Cirugía, Urología y Ginecología. His most important urologic work is Clinic Urology (1942), divided in 3 volumes. For his biography we used the biographic and bibliographic historical source of Spanish urology over the 20th-century and direct family members interviews. RESULTS: He analyzed topics as important as voiding disorders and the study of urine pyuria. He gave special importance to the study of prostatic pathology, its diagnosis by means of cystourethrography, and the modification of surgical techniques, as well as the results of urinary diversions performed in his department. CONCLUSIONS: Due to his extensive scientific and technical contributions he is one of the most outstanding figures of Valencia's Urology over the first half of the 20th century, together with Rafael Molla Rodrigo and Nicasio Benlloch Giner.