ABSTRACT
Introducción: Los pacientes ancianos se caracterizan por el alto grado de polimedicación. Este factor se ha mostrado el más importante en la aparición de efectos adversos (EAF). El estudio de los fármacos ayuda a establecer cuales son inapropiados y por lo tanto se deben retirar, disminuyendo de esta forma la posibilidad de EAF. Material y Métodos: Estudio prospectivo y observacional. Criterio de inclusión: pacientes de > 64 años que ingresan en Medicina Interna. Se definió como fármaco inapropiado los medicamentos de baja utilidad terapéutica (UTB), los no indicados, y los inadecuados para el anciano. Mediante el programa informático SPSS 11.5 se analizaron las posibles variables relacionadas con el consumo. Resultados: Se incluyeron en el estudio 172 ancianos. La media de medicamentos por persona y día fue de 5,34 (0-15). El 52,5% consumían un fármaco inapropiado (36,6% inadecuado para el anciano, 15% noindicado y 12% UTBs). El análisis multivariante asocia el consumo de estos fármacos a un mayor número de patologías (p < 0,012), a un mayor consumo de medicamentos (p < 0,001) y a la procedencia de residencias de ancianos (p < 0,001). Sólo el consumo de fármacos no adecuados para el anciano se asocia a aumento de EAF. Conclusión: La mitad de los ancianos toma al menos un fármaco deforma innecesaria, y la mayoría de estos fármacos favorece la aparición de EAF
Background: The elderly patients are characterized by the high degree of polymedication. This factor is the most important in the appearance of adverse effects (EAD). The study of the medicaments helps to establish which are inappropriate and therefore they must move back, diminishing of this form EADs possibility. Patients and Method: Prospective and observacional Study. Criterion of incorporation: patients of > 64 years old, hospitalized in an Internal Medicine Service. There were defined as inappropriate medicament the medicines of low therapeutic utility, them not indicated, and the inadequate ones for the elder. By means of the SPSS 11.5 program the possible variables related with the consumption were analyzed. Results: 172 elders were included in the study. The average of medicines for person and day belonged to 5.34 (0-15). 52.5% was consuming an inappropriate medicament (36.6% inadequate for the elder, 15% not indicated, and 12% UTBs). The analysis multivariant associates the consumption of these medicaments with a major number of diseases (p <0.012), to a major consumption of medicines (p < 0.001) and to the origin of the nursing residences (p < 0.001). Only the consumption of medicaments not adapted for the elder is associated with increase of EAD. Conclusion: The half of the elders takes at least a medicament of unnecessary form, and the majority of these medicaments favors appearance of EAD
Subject(s)
Humans , Male , Female , Aged , Internal Medicine/methods , Internal Medicine/statistics & numerical data , Drug Evaluation/adverse effects , Drug Evaluation/methods , Drug Hypersensitivity/complications , Drug Incompatibility , Pharmacoepidemiology/methods , Prospective Studies , Signs and Symptoms , Multivariate Analysis , Histamine H1 Antagonists/adverse effectsABSTRACT
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Subject(s)
Humans , Male , Female , Autoimmunity/physiology , Autoimmunity/immunology , Molecular Biology/methods , Molecular Epidemiology/methods , Molecular Epidemiology/trends , Molecular Biology/trends , Guillain-Barre Syndrome/pathology , Guillain-Barre Syndrome/immunologyABSTRACT
BACKGROUND: The elderly patients are characterized by the high degree of polymedication. This factor is the most important in the appearance of adverse effects (EAD). The study of the medicaments helps to establish which are inappropriate and therefore they must move back, diminishing of this form EAD's possibility. PATIENTS AND METHOD: Prospective and observacional Study. Criterion of incorporation: patients of > 64 years old, hospitalized in an Internal Medicine Service. There were defined as inappropriate medicament the medicines of low therapeutic utility, them not indicated, and the inadequate ones for the elder. By means of the SPSS 11.5 program the possible variables related with the consumption were analyzed. RESULTS: 172 elders were included in the study. The average of medicines for person and day belonged to 5.34 (0-15). 52.5% was consuming an inappropriate medicament (36.6% inadequate for the elder, 15% not indicated, and 12% UTBs). The analysis multivariant associates the consumption of these medicaments with a major number of diseases (p < 0.012), to a major consumption of medicines (p < 0.001) and to the origin of the nursing residences (p < 0.001). Only the consumption of medicaments not adapted for the elder is associated with increase of EAD. CONCLUSION: The half of the elders takes at least a medicament of unnecessary form, and the majority of these medicaments favors appearance of EAD.
Subject(s)
Drug Prescriptions/statistics & numerical data , Drug-Related Side Effects and Adverse Reactions , Polypharmacy , Age Factors , Aged , Data Interpretation, Statistical , Drug Prescriptions/standards , Drug Utilization/standards , Female , Homes for the Aged , Humans , Male , Multivariate Analysis , Nursing Homes , Prospective StudiesSubject(s)
Autoimmune Diseases/genetics , Autoimmune Diseases/immunology , Autoimmune Diseases/microbiology , Autoimmunity/genetics , Autoimmunity/immunology , Molecular Biology , Molecular Epidemiology , Animals , Autoimmune Diseases/etiology , Behcet Syndrome , Cats , Female , Genetic Predisposition to Disease , Humans , Male , Risk Factors , Selection, Genetic , Sex FactorsSubject(s)
Goiter, Nodular/complications , Heart Failure/etiology , Pulmonary Edema/etiology , Thyrotoxicosis/etiology , Acute Disease , Diagnosis, Differential , Female , Heart Failure/diagnosis , Humans , Middle Aged , Pulmonary Edema/diagnosis , Severity of Illness Index , Thyrotoxicosis/diagnosisABSTRACT
CONTEXT: Mycoplasma pneumonia has been related to several conditions. With this study we have tried to establish the condition more frequently associated and their physiopathological mechanism. METHOD: One-hundred and five patients admitted to Puerta de Hierro Hospital between March 1996 and July 2001, with IgM positive serology to Mycoplasma were evaluated. Thirty four cases were selected upon the basis of two criteria: patients which positivity was confirmed by seroconversion, elevation of the antibody titer, or confirmation by complement fixation were included, and patients with some intercurrent condition or with other diagnoses were ruled out. RESULTS: 26 patients (77%) showed a respiratory infection, and 20 of them showed a pneumonia. Two types of complications were observed. The first type were the complications due to an invasion of the tissue by Mycoplasma, with 5 cases of pleuropericarditis and three cases of pleuritis; in 5 of these there was simultaneously a respiratory process. The second type were the complications mediated by an autoimmune mechanism, with two cases of reactive arthritis, one case of vasculitis with cutaneous predominance, one case of urticaria a frigore, three cases of lymphocytic meningitis, one case of disseminated encephalitis, one patient with Guillain-Barré syndrome and one case of Adie's tonic pupil. Six of these patients showed a respiratory infection on the previous days with an average delay of 10 days between the beginning of the respiratory symptomatology and the appearance of one of these diseases. CONCLUSIONS: Mycoplasma pneumoniae can give rise to disease through a mechanism of direct invasion and through autoimmunity mechanisms. The second group of complications is seen by more frequency in young women.
Subject(s)
Arthritis, Reactive/etiology , Mycoplasma pneumoniae/isolation & purification , Pericarditis/etiology , Pleurisy/etiology , Pneumonia, Mycoplasma/complications , Vasculitis/etiology , Adolescent , Adult , Antibodies, Bacterial/blood , Female , Humans , Male , Pneumonia, Mycoplasma/immunology , Serologic TestsABSTRACT
BACKGROUND: The absence of studies that evaluate the effect of the medical acts is an example of "mala praxis". The irrational use of medications is one of these cases. This study shows the characteristics of the drugs consumption in elders. MATERIAL AND METHODS: We include 53 elders hospitalized between 1/02/02 and the 31/05/02. RESULTS: The elders received an average of 6.45 medicaments/day. The factors of more consumption are the origin from nursing home residents and the number of previous surgeries. The adverse effects were related in 25% of the hospitalizations. CONCLUSIONS: The basis of this situation is in the loss of the global perspective of the patients and in the abuse of the sanitary resources. Each drug is the result of an isolated medical act, determining the appearance of iatrogenic disease.
Subject(s)
Drug Utilization/statistics & numerical data , Hospitalization/statistics & numerical data , Aged , Aged, 80 and over , Drug-Related Side Effects and Adverse Reactions , Female , Humans , Iatrogenic Disease , Male , Nursing Homes/statistics & numerical data , Pilot Projects , Polypharmacy , Prospective StudiesABSTRACT
Fundamento: La ausencia de estudios sobre el resultado de actos médicos conlleva mala praxis. El uso irracional de fármacos es uno de estos casos. Este estudio muestra las características del consumo de medicamentos en mayores de 65 años. Material y métodos: Se incluyeron 53 pacientes mayores de 65 años ingresados desde el 1/02/02 al 31/05/02. Resultados: La media de fármacos es 6,45/día. Los factores de mayor consumo son la procedencia de residencia y la existencia previa de un mayor numero de cirugías. El 25 por ciento de ingresos está relacionado con efectos secundarios. Conclusiones: La perdida del enfoque global del enfermo y el abuso de los recursos sanitarios son la base de esta situación. Cada fármaco es el resultado de actos médicos aislados, condicionando el desarrollo de iatrogenia (AU)
Subject(s)
Male , Female , Aged, 80 and over , Aged , Humans , Iatrogenic Disease , Prospective Studies , Polypharmacy , Pilot Projects , Nursing Homes , Hospitalization , Drug Utilization , Pharmaceutical PreparationsSubject(s)
Acute Kidney Injury/etiology , Embolism/complications , Renal Artery , Aged , Aged, 80 and over , Female , HumansABSTRACT
No disponible