Rapid, low-cost MR imaging protocol to document central nervous system and sinus abnormalities prior to pediatric hematopoietic stem cell transplantation.

Patients undergoing bone marrow transplant (BMT) are at risk for infectious complications, including those of the sinus. Central nervous system (CNS) abnormalities related to the chemotherapy or radiation that the patient received for the treatment of underlying malignancy or to transplant-related effects are also commonly seen. The only effective way to differentiate pre- and post-transplant causes is to have a baseline evaluation prior to the admission for transplant. The current method used to evaluate these patients is head CT. However, CT is not accurate to demonstrate CNS abnormalities and exposes the patient to radiation. MRI, despite better sensitivity for white matter abnormalities, has not been routinely used because of the higher cost and longer duration of the exam. Therefore, we designed a fast, low-cost and radiation-free MRI-based protocol to simultaneously evaluate sinus and brain abnormalities.

Costos hospitalarios de las enfermedades cerebro vasculares (ECV) en el Hospital La Caleta Chimbote 2004-2005 / Hospital costs of cerebrovascular diseases (CVD) in the Hospital La Caleta Chimbote 2004-2005

Introducción y objetivo: La atención de pacientes con ECV, demanda cuidados y gastos económicos inmediatos que los pacientes tienen que asumir debido a que los hospitales no cuentan con todos los recursos de infraestructura y diagnóstico. Se lleva a cabo un estudio de costos en las dos fases de atención de las ECV y en que forma los factores de riesgo contribuye a encarecerlos. Métodos: Se realiza un estudio prospectivo, longitudinal y descriptivo en las historias clínicas de pacientes con enfermedad cerebrovascular, del Hospital La Caleta de Chimbote, en el periodo 2004-2005. Resultados: Fase aguda: Costo de las hemorragias intracerebrales $492.00 e infartos cerebrales $323.00. Infartos cerebrales con factores de riesgo $ 338.00 y sin riesgo $284.00. Costo en la fase ambulatoria de los infartos cerebrales $ 880.00 y de las hemorragias $578.00. Infartos cerebrales con factores de riesgo $748.00 y sin factores de riesgo $733.00. Conclusiones: los costos en la fase aguda son mayores para las hemorragias cerebrales en la fase ambulatoria los costos son mayores para los infartos cerebrales, sin diferencias entre los factores de riesgo. Los costos son diferentes a otros países, debido a la infraestructura, medios diagnósticos a los costos ocultos en los cuidados hospitalarios.

Introduction and objective: The immediate attention of patients with ECV, demand well-taken care of and economic expenses that the patients must assume because the hospitals do not count on all the resources of infrastructure and diagnosis. A study of costs in the two phases of attention of the ECV is carried out and in which it forms the risk factors contribute to increase in price them. Methods: A prospective, longitudinal and descriptive study is made in clinical histories of patients with disease to cerebrovascular of the hospital the creek of Chimbote in period 2004-2005. Results: Acute phase: Cerebral cost of intracerebral hemorrhages $492.00 and infarcts $ 323.00. Cerebral infarcts with factors of risk $338.00 and without risk $284.00. Cost I the ambulatory phase of cerebral infarcts $880.00 and hemorrhages $ 578.00. Cerebral infarcts with factors of risk $ 748.00 and without factors of risk $733.00. Conclusions: The costs in the acute phase are greater for the cerebral hemorrhages, in the ambulatory phase the costs are grater for the cerebral infarcts without differences between the risk factors. The costs are different from other countries due to the infrastructure, means diagnoses to the hidden costs in the hospitable cares.