ABSTRACT
BACKGROUND: Rotavirus (RV) vaccines are available in Spain since 2006 but are not included in the National Immunization Program. RV vaccination has reached an intermediate vaccination coverage rate (VCR) but with substantial differences between provinces. The aim of this study was to assess the ratio of RV gastroenteritis (RVGE) admissions to all-cause hospitalizations in children under 5 years of age in areas with different VCR. METHODS: Observational, multicenter, cross-sectional, medical record-based study. All children admitted to the study hospitals with a RVGE confirmed diagnosis during a 5-year period were selected. The annual ratio of RVGE to the total number of all-cause hospitalizations in children < 5 years of age were calculated. The proportion of RVGE hospitalizations were compared in areas with low (< 30%), intermediate (31-59%) and high (> 60%) VCR. RESULTS: From June 2013 to May 2018, data from 1731 RVGE hospitalizations (16.47% of which were nosocomial) were collected from the 12 study hospitals. RVGE hospital admissions accounted for 2.82% (95 CI 2.72-3.00) and 43.84% (95% CI 40.53-47.21) of all-cause and Acute Gastroenteritis (AGE) hospitalizations in children under 5 years of age, respectively. The likelihood of hospitalization due to RVGE was 56% (IC95%, 51-61%) and 27% (IC95%, 18-35%) lower in areas with high and intermediate VCR, respectively, compared to the low VCR areas. CONCLUSIONS: RVGE hospitalization ratios are highly dependent on the RV VCR. Increasing VCR in areas with intermediate and low coverage rates would significantly reduce the severe burden of RVGE that requires hospital management in Spain. Clinical trial registration Not applicable.
Subject(s)
Gastroenteritis , Rotavirus Infections , Rotavirus Vaccines , Rotavirus , Child , Child, Preschool , Cross-Sectional Studies , Gastroenteritis/epidemiology , Gastroenteritis/prevention & control , Hospitalization , Humans , Infant , Rotavirus Infections/epidemiology , Rotavirus Infections/prevention & control , Spain/epidemiology , Vaccination , Vaccination CoverageABSTRACT
INTRODUCTION: the prevalence of hospital malnutrition is high and involves an increase in health care costs. Home hospitalization (HH) allows better clinically stable patient control after an acute illness by a highly specialized health care team. OBJECTIVE: to know the nutritional condition of home hospitalization patients using a computer application that allows the implementation of early nutritional measures at home and improves post-hospital control of these patients. MATERIAL AND METHODS: prospective multicenter study of the nutritional condition of patients in four different home hospitalization centers during a period of two consecutive months in 2016. Variables were collected: home hospitalization, age, gender, reason for admission, associated morbidity, origin, diagnosis, social assessment, previous nutritional support, height, weight, weight loss, time of weight loss, total proteins, albumin, lymphocytes, cholesterol, body mass index (BMI), nutritional condition, type and degree of malnutrition. Nutritional condition was assessed using the application HEN-Persan and results were statistically analyzed using the SPSS 21.0 software. RESULTS: no significant differences were found between the four centers. In home hospitalization patients, 36% presented a normal nutritional screening and 87% presented some degree of malnutrition, while combined malnutrition prevailed (63%). Depending on the nutritional degree, 36% of patients had mild malnutrition, 27% presented moderate malnutrition and 35% had severe malnutrition. CONCLUSIONS: a computer application allows for an immediate, secure and reliable nutritional assessment in home hospitalization that helps introduce early nutritional measures and improve post-hospital control of patients.
INTRODUCCIÓN: la malnutrición hospitalaria tiene una elevada prevalencia y comporta un incremento del coste sanitario. La hospitalización a domicilio (HaD) permite el control en el domicilio de un episodio hospitalario agudo estable clínicamente por un equipo sanitario especializado.Objetivo: conocer el estado nutricional de los pacientes que ingresen en HaD con una misma aplicación informática (app) para poder instaurar medidas nutricionales precoces en el domicilio y mejorar la evolución posthospitalaria de los pacientes. MATERIAL Y METODOLOGÍA: estudio multicéntrico prospectivo y descriptivo del estado nutricional en cuatro unidades de HaD, durante un periodo de dos meses consecutivos durante el año 2016. Se recogieron las variables: unidad de HaD, edad, sexo, motivo de ingreso, patología asociada, procedencia, diagnóstico, valoración social, soporte nutricional previo, talla, peso, pérdida de peso, tiempo de la pérdida de peso, proteínas totales, albúmina, linfocitos, colesterol, índice de masa corporal (IMC), estado nutricional según el IMC, riesgo nutricional, tipo y grado de desnutrición. Se realizó la valoración nutricional con la app HEN-Persan y se analizaron los resultados estadísticamente con el programa informático SPSS 21.0. RESULTADOS: no existen diferencias significativas entre las cuatro unidades. Globalmente, el 36% de pacientes ingresados en HaD presentaban un estado nutricional normal. El 87% presentaba algún tipo de malnutrición, predominando la desnutrición de tipo mixta (63%). Según el grado,fue leve (36%), moderada (27%) y grave (35%). CONCLUSIONES: la utilización de una app permite tener una valoración nutricional inmediata, de manera fácil, segura y fiable en HaD, para poder introducir medidas nutricionales precoces y mejorar la evolución posthospitalaria de los pacientes.
Subject(s)
Home Care Services , Hospitalization , Malnutrition/prevention & control , Nutrition Assessment , Nutritional Status , Acute Disease/therapy , Female , Hospitalization/statistics & numerical data , Humans , Male , Malnutrition/epidemiology , Middle Aged , Nutritional Support , Patient Care Team , Prospective Studies , Weight LossABSTRACT
Introducción: la malnutrición hospitalaria tiene una elevada prevalencia y comporta un incremento del coste sanitario. La hospitalización a domicilio (HaD) permite el control en el domicilio de un episodio hospitalario agudo estable clínicamente por un equipo sanitario especializado. Objetivo: conocer el estado nutricional de los pacientes que ingresen en HaD con una misma aplicación informática (app) para poder instaurar medidas nutricionales precoces en el domicilio y mejorar la evolución posthospitalaria de los pacientes. Material y metodología: estudio multicéntrico prospectivo y descriptivo del estado nutricional en cuatro unidades de HaD, durante un periodo de dos meses consecutivos durante el año 2016. Se recogieron las variables: unidad de HaD, edad, sexo, motivo de ingreso, patología asociada, procedencia, diagnóstico, valoración social, soporte nutricional previo, talla, peso, pérdida de peso, tiempo de la pérdida de peso, proteínas totales, albúmina, linfocitos, colesterol, índice de masa corporal (IMC), estado nutricional según el IMC, riesgo nutricional, tipo y grado de desnutrición. Se realizó la valoración nutricional con la app HEN-Persan y se analizaron los resultados estadísticamente con el programa informático SPSS 21.0. Resultados: no existen diferencias significativas entre las cuatro unidades. Globalmente, el 36% de pacientes ingresados en HaD presentaban un estado nutricional normal. El 87% presentaba algún tipo de malnutrición, predominando la desnutrición de tipo mixta (63%). Según el grado, fue leve (36%), moderada (27%) y grave (35%). Conclusiones: la utilización de una app permite tener una valoración nutricional inmediata, de manera fácil, segura y fiable en HaD, para poder introducir medidas nutricionales precoces y mejorar la evolución posthospitalaria de los pacientes
Introduction: the prevalence of hospital malnutrition is high and involves an increase in health care costs. Home hospitalization (HH) allows better clinically stable patient control after an acute illness by a highly specialized health care team. Objective: to know the nutritional condition of home hospitalization patients using a computer application that allows the implementation of early nutritional measures at home and improves post-hospital control of these patients. Material and methods: prospective multicenter study of the nutritional condition of patients in four different home hospitalization centers during a period of two consecutive months in 2016. Variables were collected: home hospitalization, age, gender, reason for admission, associated morbidity, origin, diagnosis, social assessment, previous nutritional support, height, weight, weight loss, time of weight loss, total proteins, albumin, lymphocytes, cholesterol, body mass index (BMI), nutritional condition, type and degree of malnutrition. Nutritional condition was assessed using the application HEN-Persan and results were statistically analyzed using the SPSS 21.0 software. Results: no significant differences were found between the four centers. In home hospitalization patients, 36% presented a normal nutritional screening and 87% presented some degree of malnutrition, while combined malnutrition prevailed (63%). Depending on the nutritional degree, 36% of patients had mild malnutrition, 27% presented moderate malnutrition and 35% had severe malnutrition. Conclusions: a computer application allows for an immediate, secure and reliable nutritional assessment in home hospitalization that helps introduce early nutritional measures and improve post-hospital control of patients
Subject(s)
Humans , Male , Female , Middle Aged , Home Care Services/statistics & numerical data , Malnutrition/epidemiology , Malnutrition/prevention & control , Nutrition Assessment , Nutritional Status , Acute Disease , Patient Care Team , Prospective Studies , Weight LossABSTRACT
The term cancer of unknown primary site includes metastatic tumours with different histology and behaviour. Although most of them have a poor short-term prognosis, some patients can benefit from a treatment and will achieve a longer survival. The treatable cases are: metastases of squamous carcinoma in cervical or inguinal adenopathies, metastases of adenocarcinoma in axilar adenopathies in women, malignant ascites due to adenocarcinoma in women, osteoblastic bone metastases in men with elevated serum prostatic specific antigen levels, poorly differentiated tumours with features of a germinal extragonadal tumour, poorly differentiated neuroendocrine carcinomas and patients with a single metastasis. Chemotherapy must be considered in the rest of patients, although the optimum regimen is not well established yet.
Subject(s)
Neoplasms, Unknown Primary/pathology , Neoplasms, Unknown Primary/therapy , Humans , Neoplasms, Unknown Primary/classificationABSTRACT
Cancer of unknown primary site (CUPS) is a heterogeneous entity defined by the presence of a histologically-proven metastatic neoplasm, in which the original tumor cannot be identified after a targeted study. The current guidelines for CUPS focus is not based on the search for the primary neoplasm but rather on the identification of patients who may benefit from a treatment that will prolong their survival, based on the clinical and histological characteristics of each case. By improving the diagnostic study, we avoid using fruitless tests in patients with limited therapeutic possibilities and poor short-term prognosis.
Subject(s)
Neoplasms, Unknown Primary/diagnosis , Adenocarcinoma/diagnosis , Biomarkers, Tumor/blood , Carcinoma/diagnosis , Carcinoma, Squamous Cell/diagnosis , Diagnosis, Differential , Female , Humans , Male , Neoplasms, Unknown Primary/diagnostic imaging , Neoplasms, Unknown Primary/mortality , Neoplasms, Unknown Primary/pathology , Neoplasms, Unknown Primary/therapy , Neuroendocrine Tumors/diagnosis , Ovarian Neoplasms/diagnosis , Positron-Emission Tomography , Practice Guidelines as Topic , Prostatic Neoplasms/diagnosisABSTRACT
No disponible
Subject(s)
Male , Aged , Humans , Pulmonary Atelectasis/diagnosis , Amyloidosis/complications , Amyloidosis/diagnosis , Pulmonary Atelectasis/complications , Bronchial Diseases/complications , Bronchial Diseases/diagnosis , Lung Diseases/complications , Lung Diseases/diagnosisABSTRACT
This study analyzes the effect of highly active antiretroviral therapy (HAART) on visceral leishmaniasis in human immunodeficiency virus-infected individuals. We describe 66 episodes diagnosed in our hospital from 1994 through 2000 (35 episodes in patients who were not receiving HAART and 31 episodes in patients who were receiving HAART). Since HAART became available, the incidence of visceral leishmaniasis has significantly decreased and the number of first episodes has decreased, although the number of relapses is increasing.
Subject(s)
Anti-HIV Agents/adverse effects , Antiretroviral Therapy, Highly Active/adverse effects , Leishmaniasis, Visceral/etiology , Adult , Anti-HIV Agents/therapeutic use , Female , HIV Infections/complications , HIV Infections/drug therapy , Humans , Incidence , Leishmaniasis, Visceral/epidemiology , Male , Middle AgedABSTRACT
We compare a rapid dilution method for the determination of antiviral susceptibility of herpes simplex virus (HSV) with the plaque reduction assay. A total of 84 HSV clinical isolates were studied by both methods to detect in-vitro resistance to acyclovir and foscarnet. The rapid method showed for the detection of HSV isolates resistant to acyclovir and foscarnet, a sensitivity of 96. 8% and 100% and specificity of 100% and 100%, respectively. This method provides an easy and accurate screening procedure for the susceptibility testing of HSV to antiviral agents.
Subject(s)
Acyclovir/pharmacology , Antiviral Agents/pharmacology , Foscarnet/pharmacology , Herpesvirus 1, Human/drug effects , Herpesvirus 2, Human/drug effects , Viral Plaque Assay/methods , Herpes Simplex/virology , Herpesvirus 1, Human/isolation & purification , Herpesvirus 2, Human/isolation & purification , Humans , Microbial Sensitivity Tests/methods , Sensitivity and SpecificityABSTRACT
The in-vitro activity of sparfloxacin and eight other antimicrobial agents against 64 non-tuberculous mycobacteria (non-MAI) (40 rapidly growing and 24 slowly growing) was compared with those of ciprofloxacin, ofloxacin, amikacin, tobramycin, cefoxitin, imipenem, clarithromycin and doxycycline. Sparfloxacin presented the same activity as ciprofloxacin, being highly active against rapidly growing mycobacteria and showing good in-vitro activity against slowly growing mycobacteria. Amikacin was very active against rapidly growing mycobacteria and clarithromycin presented good activity against all mycobacteria tested. These results suggest that sparfloxacin is a valid agent to be considered in the treatment of Mycobacterium spp. infections.
