ABSTRACT
BACKGROUND: The hypotheses of autoimmune, allergic or infectious etiology of severe mental illness have been reported in the scientific literature repeatedly. The main objective of this work is to study the relationship of inflammatory, autoimmunity or recent infection markers with the fact of suffering Severe Mental Disorders (SMD). METHODS: In the present case-control study, adult patients with a diagnosis of SMD were compared with controls who underwent routine health checks that included analytical control. Cases with psychosis substance-induced and controls with diagnosis of any psychiatric illness were excluded. In both groups, patients with chronic inflammatory diseases or intercurrent infectious disease were also excluded. A set of common analytical parameters, markers of infectious diseases and inflammatory markers were retrieved for both groups, as well as demographic and clinical data. RESULTS: A total of 212 subjects (81 cases and 131 controls) were recruited. From cases, 70 (86.4%) have a diagnosis of Schizophrenia Disease (SD) and 11 (13.6%) of Schizoaffective Disorder (SAD). In the multivariate model the female sex (OR 0.24, 95% CI 0.12-0.46) and the neutrophil-lymphocyte ratio (OR 3.00, 95% CI 1.91-4.70) were associated with the fact of being case. CONCLUSIONS: Patients with SMD seem to have higher inflammatory markers compared to the general population, being the neutrophil-lymphocyte ratio, the marker associated with more strength. The role of inflammatory processes in the etiology of this type of disorders, if confirmed, opens interesting and innovative therapeutic possibilities.
Subject(s)
Inflammation/metabolism , Lymphocytes/cytology , Mental Disorders/blood , Neutrophils/cytology , Psychotic Disorders/blood , Schizophrenia/blood , Adult , Case-Control Studies , Female , Humans , Male , Mental Disorders/immunology , Middle Aged , Multivariate Analysis , Psychotic Disorders/immunology , Schizophrenia/immunologyABSTRACT
No disponible
Subject(s)
Humans , Taxus baccata/toxicity , Digitalis/toxicity , Antidotes/therapeutic use , Plant Extracts/toxicity , Poisoning/drug therapyABSTRACT
Objetivo. Comparar la efectividad, supervivencia y coste de la quimioembolización transarterial con partículas liberadoras de doxorrubicina (DEB-TACE) y la quimioembolización convencional (cTACE) en pacientes con carcinoma hepatocelular (CHC) irresecable. Material y métodos. Estudio unicéntrico, observacional y retrospectivo que comparó 60 pacientes con CHC irresecable separados en dos grupos comparables de 30 pacientes tratados con DEB-TACE y otros 30 con cTACE. Se realizaron las pruebas de χ2 y t de Student, y se utilizó el método de Kaplan Meier. Resultados. La supervivencia fue menor en hombres y en pacientes con hepatitis C (p = 0,014 y p = 0,003, respectivamente). No hubo diferencias estadísticamente significativas en la supervivencia global a los 5 años (29,99 meses; IC del 95%: 21,38-38,60 y 30,67 meses; IC del 95%: 22,65-38,70; p = 0,626) y la supervivencia libre de progresión (mediana: 11,57 meses; IC del 95%: 0,97-22,18 y 12,80 meses; IC del 95%: 0,00-32,37; p = 0,618). El tiempo medio de ingreso fue de 2,6 y 5,4 días (p < 0,001) para DEB-TACE y cTACE, respectivamente. La toxicidad grado 2-4 fue superior en el grupo cTACE (54 y 31; p < 0,001). El coste del tratamiento fue de 1.581 Euros con DEB-TACE y de 514,63 Euros con cTACE. El coste total medio fue de 3.134 Euros y 3.694,35 Euros, respectivamente (p = 0,173). Conclusión. La quimioembolización en pacientes con CHC irresecable tiene una supervivencia global cercana a 30 meses a los 5 años, independientemente de la técnica empleada. Los costes globales son similares, aunque la mejor tolerancia de la DEB-TACE justifica el mayor coste del procedimiento (AU)
Objectives. To compare the effectiveness, survival and cost in patients with unresectable hepatic cell carcinoma (HCC) treated with trans-arterial chemoembolization using doxorubicin-eluting beads (DEB-TACE) versus conventional TACE (cTACE) in clinical practice. Material and methods. This single-centered retrospective observational study compared 60 consecutive HCC unresectable patients: 30 were treated with DEB-TACE and 30 used cTACE. Comparisons were with χ2 test, Student t-test, and Kaplan Meier method. Results. Of the 60 patients with HCC in non-curative stage, baseline characteristics were similar for both groups of treatment, and of these we observed lower survival in male patients and those who had hepatitis C virus (p = 0.014 and p = 0.003, respectively). No statistically significant differences were observed as a function of treatment employed with respect to overall survival (OS) at 5 years (29.99 months; 95%CI: 21.38-38.60 versus 30.67 months; 95%CI:22.65-38.70; p = 0.626) and progression free survival (PFS) median of 11.57 months (95%CI: 0.97-22.18) versus 12.80 months (95%CI:0.00-32.37; p = 0.618). The median length of hospital admission were 2.6 and 5.4 days (p < 0.001) for DEB-TACE and cTACE, respectively. Toxicities grade 2-4 were higher in cTACE group (54 versus 31; p < 0.001). The cost of the treatment was 1581 Euros for DEB-TACE and 514.63 Euros for cTACE. The overall mean cost of intervention was 3134 Euros and 3694.35 Euros, respectively (p = 0.173). Conclusions. Chemoembolization in patients with unresectable HCC achieved OS close to 30 months at 5 years, independent of the technique employed. Similar overall costs but better tolerance of the DEB-TACE justified the higher costs of the procedure (AU)
Subject(s)
Female , Humans , Male , Chemoembolization, Therapeutic/methods , Chemoembolization, Therapeutic , Doxorubicin/therapeutic use , Carcinoma, Hepatocellular/economics , Carcinoma, Hepatocellular , Ondansetron , Evaluation of the Efficacy-Effectiveness of Interventions , Survivorship , Retrospective Studies , Kaplan-Meier Estimate , CisplatinABSTRACT
OBJECTIVES: To compare the effectiveness, survival and cost in patients with unresectable hepatic cell carcinoma (HCC) treated with trans-arterial chemoembolization using doxorubicin-eluting beads (DEB-TACE) versus conventional TACE (cTACE) in clinical practice. MATERIAL AND METHODS: This single-centered retrospective observational study compared 60 consecutive HCC unresectable patients: 30 were treated with DEB-TACE and 30 used cTACE. Comparisons were with χ(2) test, Student t-test, and Kaplan Meier method. RESULTS: Of the 60 patients with HCC in non-curative stage, baseline characteristics were similar for both groups of treatment, and of these we observed lower survival in male patients and those who had hepatitis C virus (p=0.014 and p=0.003, respectively). No statistically significant differences were observed as a function of treatment employed with respect to overall survival (OS) at 5 years (29.99 months; 95%CI: 21.38-38.60 versus 30.67 months; 95%CI:22.65-38.70; p=0.626) and progression free survival (PFS) median of 11.57 months (95%CI: 0.97-22.18) versus 12.80 months (95%CI:0.00-32.37; p=0.618). The median length of hospital admission were 2.6 and 5.4 days (p<0.001) for DEB(-)TACE and cTACE, respectively. Toxicities grade 2-4 were higher in cTACE group (54 versus 31; p<0.001). The cost of the treatment was 1581 for DEB(-)TACE and 514.63 for cTACE. The overall mean cost of intervention was 3134 and 3694.35 , respectively (p=0.173). CONCLUSIONS: Chemoembolization in patients with unresectable HCC achieved OS close to 30 months at 5 years, independent of the technique employed. Similar overall costs but better tolerance of the DEB-TACE justified the higher costs of the procedure.
Subject(s)
Carcinoma, Hepatocellular/drug therapy , Chemoembolization, Therapeutic , Doxorubicin/therapeutic use , Liver Neoplasms/drug therapy , Disease-Free Survival , Female , Humans , Length of Stay , Male , Retrospective Studies , Survival RateABSTRACT
Se ha observado un aumento del consumo de sustancias vegetales con efecto alucinógeno, algunas de ellas asociadas a ceremonias religiosas ancestrales, siendo muchas de estas sustancias legales o con una regulación parcial. Salvia divinorum es un potente agonista de los receptores kappa, con propiedades disociativas y alucinógenas, de inicio rápido y corta duración. El Kratom (Mytragyna speciosa), posee como alcaloide principal la mitraginina, con efectos estimulantes a dosis bajas (efecto coca-like), y efectos sedativos (efecto opioide-like) a dosis altas. Se han detectado varias muertes asociadas a su consumo. El consumo de hongos alucinógenos aparece de forma cíclica, aunque se ha incrementado su oferta on-line. Se consumen buscando sus efectos alucinógenos sobre todo los pertenecientes a la familia de los psilocybes, los cuales contienen triptaminas con efecto alucinógeno, similar al LSD. El peyote (Lophophora williamsii), cactus rico en mescalina (trimet oxifeniletilamina), produce alucinaciones de los cinco sentidos, y forma parte de la cultura religiosa de los indios norteamericanos. Las daturas, de gran ubicuidad, producen un cuadro anticolinérgico y efectos sobre el sistema nervioso central (delirios, alucinaciones, etc), por su alto contenido en atropina y escopolamina. Otras sustancia utilizadas por sus efectos alucinatorios incluyen la bebida conocida como ayahuasca, y semillas para preparación de infusiones como el Ololiuqui, la Gloria de la mañana (Ipomoea violacea), la Rosa de Hawai (Argyreia nervosa), la Ruda borde (Peganum harmala), y la Iboga (Tabernan the iboga) (AU)
An increase in the consumption of vegetable substances with a hallucinogenic effect has been observed. Some of these substances are associated with ancestral religious ceremonies, while many of them are legal or are partially regulated. Salvia divinorum is a powerful kappa receptor agonist, with dissociative and hallucinogenic properties, which startquickly and have a short duration. Kratom (Mytragyna speciosa) has mitragynine as its principal alkaloid, with stimulating effects at low doses (coke-like effect), and sedative effects(opiate-like effect) at high doses. Several deaths from its consumption have been detected. The consumption of hallucinogenic mushrooms appears in cyclic form, although there has been increase in their online offer. They are consumed in search of their hallucinogenic effects, above all those belonging to the family of psilocybes, which contain tryptamines with a hallucinogenic effect similar to LSD. Peyote (Lophophora psilocybes), a cactus rich in mescaline (trimet oxifeniletilamina),produces hallucinations of the five senses, and forms part of the religious culture of the North American Indians. Daturas, which are ubiquitous, produce anticholinergic symptoms and effects on the central nervous system (delirium, hallucinations, etc.), due to their high atropineand scopolamine content. Other substances used for their hallucinogenic effects include the drink known as ayahuasca, and seeds for preparing infusions like Ololiuqui, Morning Glory (Ipomoea violacea), Hawaian Baby Wood rose (Argyreia nervosa), Syrian Rue (Peganum harmala) and Iboga Rootbark (Tabernan the iboga) (AU)
Subject(s)
Humans , Plant Extracts , Mycotoxins , Hallucinogens , Illicit Drugs/analysis , Substance-Related Disorders , Banisteriopsis , AgaricalesSubject(s)
Dissent and Disputes , Therapeutic Equivalency , Clinical Trials as Topic , Drug Costs , Europe , Evidence-Based Medicine , Government Agencies/organization & administration , Humans , National Health Programs/economics , Pharmaceutical Preparations/classification , Pharmacy/organization & administration , Professional Autonomy , Societies, Scientific , Spain , Treatment OutcomeABSTRACT
La transfusión de sangre alogénica (TSA) no es inocua, y como consecuencia han surgido múltiples alternativas a la misma (ATSA). Existe variabilidad respecto a las indicaciones y buen uso de las ATSA. Dependiendo de la especialidad de los médicos que tratan a los pacientes, el grado de anemia, la política transfusional, la disponibilidad de las ATSA y el criterio personal, estas se usan de forma variable. Puesto que las ATSA tampoco son inocuas y pueden no cumplir criterios de coste-efectividad, la variabilidad en su uso es inaceptable. Las sociedades españolas de Anestesiología y Reanimación (SEDAR), Hematología y Hemoterapia (SEHH), Farmacia Hospitalaria (SEFH), Medicina Intensiva y Unidades Coronarias (SEMICYUC), Trombosis y Hemostasia (SETH) y Transfusiones Sanguíneas (SETS) han elaborado un documento de consenso para el buen uso de la ATSA. Un panel de expertos de las 6 sociedades ha llevado a cabo una revisión sistemática de la literatura médica y elaborado el 2013. Documento Sevilla de Consenso sobre Alternativas a la Transfusión de Sangre Alogénica. Solo se contempla las ATSA dirigidas a disminuir la transfusión de concentrado de hematíes. Se definen las ATSA como toda medida farmacológica y no farmacológica encaminada a disminuir la transfusión de concentrado de hematíes, preservando siempre la seguridad del paciente. La cuestión principal que se plantea en cada ítem se formula, en forma positiva o negativa, como: «La ATSA en cuestión reduce/no reduce la tasa transfusional». Para formular el grado de recomendación se ha usado la metodología Grades of Recommendation Assessment, Development and Evaluation (GRADE) (AU)
Since allogeneic blood transfusion (ABT) is not harmless, multiple alternatives to ABT (AABT) have emerged, though there is great variability in their indications and appropriate use. This variability results from the interaction of a number of factors, including the specialty of the physician, knowledge and preferences, the degree of anemia, transfusion policy, and AABT availability. Since AABTs are not harmless and may not meet cost-effectiveness criteria, such variability is unacceptable. The Spanish Societies of Anesthesiology (SEDAR), Hematology and Hemotherapy (SEHH), Hospital Pharmacy (SEFH), Critical Care Medicine (SEMICYUC), Thrombosis and Hemostasis (SETH) and Blood Transfusion (SETS) have developed a Consensus Document for the proper use of AABTs. A panel of experts convened by these 6 Societies have conducted a systematic review of the medical literature and have developed the 2013 Seville Consensus Document on Alternatives to Allogeneic Blood Transfusion, which only considers those AABT aimed at decreasing the transfusion of packed red cells. AABTs are defined as any pharmacological or non-pharmacological measure aimed at decreasing the transfusion of red blood cell concentrates, while preserving patient safety. For each AABT, the main question formulated, positively or negatively, is: "Does this particular AABT reduce the transfusion rate or not?" All the recommendations on the use of AABTs were formulated according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) methodology (AU)
Subject(s)
Humans , Male , Female , Transplantation, Homologous/instrumentation , Transplantation, Homologous/methods , Transplantation, Homologous , Cost-Benefit Analysis/organization & administration , Cost-Benefit Analysis/standards , Cost-Benefit Analysis , Evaluation of the Efficacy-Effectiveness of Interventions , Anesthesiology/methods , Transplantation, Homologous/standards , Transplantation, Homologous/trends , 50303 , Anesthesiology/organization & administration , Anesthesiology/standards , Erythrocyte Transfusion/trends , Erythrocyte TransfusionABSTRACT
La transfusión de sangre alogénica (TSA) no es inocua, y como consecuencia han surgido múltiples alternativas a la misma (ATSA). Existe variabilidad respecto a las indicaciones y buen uso de las ATSA. Dependiendo de la especialidad de los médicos que tratan a los pacientes, el grado de anemia, la política transfusional, la disponibilidad de las ATSA y el criterio personal, estas se usan de forma variable. Puesto que las ATSA tampoco son inocuas y pueden no cumplir criterios de coste-efectividad, la variabilidad en su uso es inaceptable. Las sociedades españolas de Anestesiología y Reanimación (SEDAR), Hematología y Hemoterapia(SEHH), Farmacia Hospitalaria (SEFH), Medicina Intensiva y Unidades Coronarias(SEMICYUC), Trombosis y Hemostasia (SETH) y Transfusiones Sanguíneas (SETS) han elaborado un documento de consenso para el buen uso de la ATSA. Un panel de expertos de las 6sociedades ha llevado a cabo una revisión sistemática de la literatura médica y elaborado el 2013. Documento Sevilla de Consenso sobre Alternativas a la Transfusión de Sangre Alogénica. Solo se contempla las ATSA dirigidas a disminuir la transfusión de concentrado de hematíes. Se definen las ATSA como toda medida farmacológica y no farmacológica encaminada a disminuir la transfusión de concentrado de hematíes, preservando siempre la seguridad del paciente. La cuestión principal que se plantea en cada ítem se formula, en forma positiva o negativa, como: La ATSA en cuestión reduce/no reduce la tasa transfusional». Para formular el grado de recomendación se ha usado la metodología Grades of Recommendation Assessment, Development and Evaluation (GRADE) (AU)
Since allogeneic blood transfusion (ABT) is not harmless, multiple alternatives to ABT (AABT) have emerged, though there is great variability in their indications and appropriate use. This variability results from the interaction of a number of factors, including the specialty of the physician, knowledge and preferences, the degree of anemia, transfusion policy, and AABT availability. Since AABTs are not harmless and may not meet cost-effectiveness criteria, such variability is unacceptable. The Spanish Societies of Anesthesiology (SEDAR), Hematology and Hemotherapy (SEHH), Hospital Pharmacy (SEFH), Critical Care Medicine (SEMICYUC), Thrombosis and Hemostasis (SETH)and Blood Transfusion (SETS) have developed a Consensus Document for the proper use of AABTs. A panel of experts convened by these 6 Societies have conducted a systematic review of the medical literature and have developed the 2013 Seville Consensus Document on Alternatives to Allogeneic Blood Transfusion, which only considers those AABT aimed at decreasing the transfusion of packed red cells. AABTs are defined as any pharmacological or non-pharmacological measure aimed at decreasing the transfusion of red blood cell concentrates, while preserving patient safety. For each AABT, the main question formulated, positively or negatively, is: Does this particular AABT reduce the transfusion rate or not? All the recommendations on the use of AABTs were formulated according to the Grades of Recommendation Assessment, Development and Evaluation(GRADE) methodology (AU)
Subject(s)
Humans , Blood Transfusion, Autologous , Blood Transfusion/methods , Blood Substitutes/therapeutic use , Anemia/therapy , Glycated Hemoglobin/therapeutic use , Fibrinogen/therapeutic use , Practice Patterns, Physicians'ABSTRACT
Since allogeneic blood transfusion (ABT) is not harmless, multiple alternatives to ABT (AABT) have emerged, though there is great variability in their indications and appropriate use. This variability results from the interaction of a number of factors, including the specialty of the physician, knowledge and preferences, the degree of anemia, transfusion policy, and AABT availability. Since AABTs are not harmless and may not meet cost-effectiveness criteria, such variability is unacceptable. The Spanish Societies of Anesthesiology (SEDAR), Hematology and Hemotherapy (SEHH), Hospital Pharmacy (SEFH), Critical Care Medicine (SEMICYUC), Thrombosis and Hemostasis (SETH) and Blood Transfusion (SETS) have developed a Consensus Document for the proper use of AABTs. A panel of experts convened by these 6 Societies have conducted a systematic review of the medical literature and have developed the 2013 Seville Consensus Document on Alternatives to Allogeneic Blood Transfusion, which only considers those AABT aimed at decreasing the transfusion of packed red cells. AABTs are defined as any pharmacological or non-pharmacological measure aimed at decreasing the transfusion of red blood cell concentrates, while preserving patient safety. For each AABT, the main question formulated, positively or negatively, is: « Does this particular AABT reduce the transfusion rate or not?¼ All the recommendations on the use of AABTs were formulated according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) methodology.
Subject(s)
Blood Transfusion/standards , Complementary Therapies , Humans , Patient Safety , Surgical Procedures, OperativeABSTRACT
Since allogeneic blood transfusion (ABT) is not harmless, multiple alternatives to ABT (AABT) have emerged, though there is great variability in their indications and appropriate use. This variability results from the interaction of a number of factors, including the specialty of the physician, knowledge and preferences, the degree of anemia, transfusion policy, and AABT availability. Since AABTs are not harmless and may not meet cost-effectiveness criteria, such variability is unacceptable. The Spanish Societies of Anesthesiology (SEDAR), Hematology and Hemotherapy (SEHH), Hospital Pharmacy (SEFH), Critical Care Medicine (SEMICYUC), Thrombosis and Hemostasis (SETH) and Blood Transfusion (SETS) have developed a Consensus Document for the proper use of AABTs. A panel of experts convened by these 6 Societies have conducted a systematic review of the medical literature and have developed the 2013 Seville Consensus Document on Alternatives to Allogeneic Blood Transfusion, which only considers those AABT aimed at decreasing the transfusion of packed red cells. AABTs are defined as any pharmacological or non-pharmacological measure aimed at decreasing the transfusion of red blood cell concentrates, while preserving patient safety. For each AABT, the main question formulated, positively or negatively, is: "Does this particular AABT reduce the transfusion rate or not?" All the recommendations on the use of AABTs were formulated according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) methodology.
Subject(s)
Bloodless Medical and Surgical Procedures/standards , Humans , Practice Guidelines as TopicABSTRACT
An increase in the consumption of vegetable substances with a hallucinogenic effect has been observed. Some of these substances are associated with ancestral religious ceremonies, while many of them are legal or are partially regulated. Salvia divinorum is a powerful kappa receptor agonist, with dissociative and hallucinogenic properties, which start quickly and have a short duration. Kratom (Mytragyna speciosa) has mitragynine as its principal alkaloid, with stimulating effects at low doses (coke-like effect), and sedative effects (opiate-like effect) at high doses. Several deaths from its consumption have been detected. The consumption of hallucinogenic mushrooms appears in cyclic form, although there has been increase in their online offer. They are consumed in search of their hallucinogenic effects, above all those belonging to the family of psilocybes, which contain tryptamines with a hallucinogenic effect similar to LSD. Peyote (Lophophora psilocybes), a cactus rich in mescaline (trimetoxifeniletilamina), produces hallucinations of the five senses, and forms part of the religious culture of the North American Indians. Daturas, which are ubiquitous, produce anticholinergic symptoms and effects on the central nervous system (delirium, hallucinations, etc.), due to their high atropine and scopolamine content. Other substances used for their hallucinogenic effects include the drink known as ayahuasca, and seeds for preparing infusions like Ololiuqui, Morning Glory (Ipomoea violacea), Hawaian Baby Woodrose (Argyreia nervosa), Syrian Rue (Peganum harmala) and Iboga Rootbark (Tabernanthe iboga).
Subject(s)
Agaricales , Hallucinogens , Illicit Drugs , Plants , Humans , Substance-Related Disorders/epidemiologyABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Datura stramonium/adverse effects , Datura stramonium/toxicity , Alkaloids/adverse effects , Alkaloids/toxicity , Fever/complications , Central Nervous System , Central Nervous System/pathologyABSTRACT
OBJECTIVE: To estimate the proportion of medication errors in a tertiary hospital, global and for each delivery medication system, to describe the error types and the implied medications, and to analyze the factors associated to the same ones. METHODS: Errors were identified from direct observation of 2,242 opportunities for error (administered doses or prescribed doses not given) by 6 couples of observers. Delivery medication systems were stock in ward, unit dose with electronic prescription and unit dose with computerized transcription. Logistic regression was used to evaluate the association between errors and certain factors. RESULTS: The medication error rate was of 7.2% (CI 95%: 6.1-8.3), and 4.4% (CI 95%: 3.6-5.3) of them reached the patient. For delivery systems, the error rate was of 9.5% (CI 95%: 7.4-11.9) for stock in ward, 7.8% (CI 95%: 5.9-10.0) for electronic prescription and 4.7% (CI 95%: 3.4-6.4) for computerized transcription. The highest error frequency was observed in the administration phase (58.4%) and the omitted dose was the most prevalent error (31.7%). The error rate was associated to the pharmacotherapeutic process, the schedule of administration and the unit of hospitalization. CONCLUSIONS: In one of each 14 opportunities for error a medication error takes place. The different delivery medication systems have different error rates.
Subject(s)
Drug Delivery Systems/statistics & numerical data , Hospitals/statistics & numerical data , Medication Errors/statistics & numerical data , Catchment Area, Health , Cross-Sectional Studies , Humans , Spain/epidemiologyABSTRACT
Objetivo: Estimar la proporción de errores de medicación en un hospitalterciario, tanto de manera global como por sistemas de distribuciónde medicamentos, describir los tipos de error y los medicamentosimplicados y analizar los factores asociados a los mismos.Método: Los errores se identificaron mediante la observación directade 2.242 oportunidades de error (dosis administradas o lasprescritas y no administradas de medicamentos) por 6 pares deobservadores. Los sistemas de distribución fueron stock en planta,dosis unitarias con prescripción electrónica asistida y dosis unitariascon transcripción informatizada. Se utilizó la regresión logísticamúltiple para valorar la asociación entre errores y determinados factores.Resultados: El porcentaje global de error de medicación fue del7,2% (IC del 95%, 6,1-8,3), y un 4,4% (IC del 95%, 3,6-5,3) alcanzaronal paciente. Por sistemas de distribución, el porcentaje de error demedicación fue de 9,5% (IC del 95%, 7,4-11,9) para el stock en planta,7,8% (IC del 95%, 5,9-10,0) para la prescripción electrónica asistiday 4,7% (IC del 95%, 3,4-6,4) para la transcripción informatizada.La mayor frecuencia de errores se observó en la fase de administración(58,4%) y la dosis omitida fue el tipo de error más prevalente(31,7%). El riesgo de error se asoció al proceso farmacoterapéutico,al horario de administración y al tipo de unidad de hospitalización. Conclusiones: En una de cada 14 oportunidades de error se produceun error de medicación. Los distintos sistemas de administraciónde medicamentos tienen tasas de error diferentes
Objective: To estimate the proportion of medication errors in a tertiaryhospital, global and for each delivery medication system, to describethe error types and the implied medications, and to analyze thefactors associated to the same ones.Methods: Errors were identified from direct observation of 2,242 opportunitiesfor error (administered doses or prescribed doses not given)by 6 couples of observers. Delivery medication systems werestock in ward, unit dose with electronic prescription and unit dosewith computerized transcription. Logistic regression was used to evaluatethe association between errors and certain factors.Results: The medication error rate was of 7.2% (CI 95%: 6.1-8.3),and 4.4% (CI 95%: 3.6-5.3) of them reached the patient. For deliverysystems, the error rate was of 9.5% (CI 95%: 7.4-11.9) for stock inward, 7.8% (CI 95%: 5.9-10.0) for electronic prescription and 4.7%(CI 95%: 3.4-6.4) for computerized transcription. The highest errorfrequency was observed in the administration phase (58.4%) andthe omitted dose was the most prevalent error (31.7%). The errorrate was associated to the pharmacotherapeutic process, the scheduleof administration and the unit of hospitalization.Conclusions: In one of each 14 opportunities for error a medicationerror takes place. The different delivery medication systems have different error rates
Subject(s)
Humans , Medication Errors/statistics & numerical data , Medication Systems, Hospital/statistics & numerical data , Tertiary Healthcare , Cross-Sectional StudiesABSTRACT
La aproximación terapéutica a la intoxicación etílica aguda presenta algunos aspectos controvertidos. En este original se revisa su tratamiento mediante la búsqueda estructurada de la literatura publicada al respecto. Se analizan los trabajos hallados y se concluye una pauta a partir de la mejor evidencia disponible
Therapeutic approach to acute alcohol intoxication has some controversial aspects. In this original article, its treatment is reviewed by means of structured search of the literature published. The studies found are critically appraised and a guideline concluded better on the better evidence available
