Linfangitis aguda tubular por Rickettsia sibirica mongolitimonae / Tubular acute lymphangitis caused by Rickettsia sibirica mongolitimonae

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Prescripción de antibióticos y cambios en las resistencias a antimicrobianos en el área de salud de Segovia (2007-2011) / Antibiotic prescribing and changes in antimicrobial resistances in the health area of Segovia (Spain) during the period between 2007 and 2011

Introducción. Se analizó la prescripción de antibióticos y las resistencias de patógenos respiratorios y urinarios más frecuentes del Área de Salud de Segovia durante el periodo 2007-2011 para determinar su variabilidad, su tendencia temporal y su posible correlación con los cambios en los patrones de las resistencias microbianas. Material y métodos. Estudio transversal retrospectivo. El consumo de antibióticos se expresó en dosis diaria definida (DDD) por 1000 habitantes día (DHD). La resistencia se expresó en porcentajes. El análisis de tendencias se realizó con los coeficientes de correlación de Spearman y de Pearson. Resultados. La prescripción media de antibióticos fue 14,17 DHD, el coeficiente y razón de variación 38,93% y 17,94. Las penicilinas fueron el grupo más prescrito (73%). La ubicación rural, la ausencia de formación MIR, la distancia al hospital y el porcentaje de pacientes >65 años, mostraron relación significativa con mayor prescripción de antibióticos. Las resistencias de E. coli a cotrimoxazol y de H. influenzae a amoxicilina descendieron un 8% y la de S. pyogenes a eritromicina un 5%. Las resistencias de S. pneumoniae a penicilina y de E. coli a cefalosporinas aumentaron ambas un 12%. La correlación entre prescripción antibiótica y resistencias antimicrobianas no mostró resultados significativos. Conclusiones. La prescripción de antibióticos descendió un 3,2% durante el periodo mientras que el uso de fármacos de amplio espectro se incrementó. La variabilidad entre médicos prescriptores fue importante, geográfica e interindividualmente. No se obtuvieron datos concluyentes de correlación entre prescripción antibiótica y resistencias (AU)

Introduction. We analyzed the antibiotic prescribing and resistances of respiratory and urinary pathogens more common in the Health Area of Segovia in the period 2007-2011. The aim of the study was to investigate variability, time trends of antibiotic prescribing and correlation with changes in the antimicrobial resistance patterns. Material and methods. Retrospective cross-sectional study. Antibiotic consumption was expressed in defined daily doses (DDD) per 1000 inhabitants per day (DHD). The antimicrobial resistance was expressed in percentages. Trend analysis was performed testing Spearman and Pearson correlation coefficients. Results. The average antibiotic prescribing was 14.17 DHD, the coefficient and low ratio was 38.93% and 17.94. Penicillins was the most prescribed group (73%). Rural localization, lack of training MIR, distance to hospital and percentage of patients >65 years; showed significant association with increased antibiotic prescribing. Resistance of E. coli to cotrimoxazole and resistance of H. influenzae to amoxicillin decreased both by 8%. Resistance of S. pyogenes to erythromycin decreased by 5%. Resistances of S. pneumoniae to penicillin and E.coli to cephalosporins were both increased by 12%. Correlation between antibiotic prescription and resistances did not show singnificative results. Conclusions. Prescribing of antibiotics decreased by 3.2% during the period. The use of broad-spectrum antibiotics was increased. Geographic wide variation in antibiotic prescribing was detected, also between physicians. There were not obtained conclusive data from the correlation between antibiotic prescribing and antimicrobial resistance (AU)

Cáncer gástrico en un hospital español: Hospital General de Segovia (2005-2008) / Gastric cancer in a Spanish hospital: Segovia General Hospital (2005-2008)

Estimar la incidencia, características anatomopatológicas, patrones de tratamiento y supervivencia-mortalidad del cáncer gástrico en la población de Segovia durante los años 2005-2008.MétodosEstudio descriptivo retrospectivo. Se incluyeron los 163 pacientes diagnosticados de cáncer gástrico en el Hospital General de Segovia en dicho periodo. Resultados Estimamos una incidencia de 25 casos/100.000 habitantes con una proporción varones/mujeres de 1,6:1 y una edad media de presentación de 72 años. El diagnóstico en estadios avanzados III y IV (64,5%), la alta frecuencia del carcinoma intestinal (56,4%) y el antro gástrico como localización más frecuente (48,8%), han sido las características del tumor más destacables. Al final del estudio un 54,2% de los pacientes habían fallecido, presentando una media de supervivencia global de 19 meses. La estadificación tumoral, el número de ganglios afectados y el tipo histológico difuso fueron los principales factores pronóstico desfavorables. A pesar de recibir tratamiento quirúrgico con intención curativa, el 63,2% de los tumores en estadios iniciales (I y II) presentaron recidiva durante el estudio. Conclusiones El riesgo de cáncer gástrico en Segovia es mayor en varones con edad en torno a los 70 años. Los estadios avanzados son la presentación más frecuente al diagnóstico y las recidivas en estadios iniciales son comunes, lo que dificulta las posibilidades de curación. Es necesario hacer un diagnóstico precoz del cáncer gástrico y mejorar los tratamientos (AU)

Objective: To estimate the incidence, pathological characteristics, treatment patterns, survival and mortality of gastric cancer in Segovia from 2005-2008.Methods: We conducted a retrospective, descriptive study of 163 patients diagnosed with gastric cancer at the Segovia General Hospital during the study period. Results: We estimated a gastric cancer incidence of 25 cases/100,000 inhabitants. The ratio of men to women was 1.6:1. The mean age was 72 years. The most important findings were diagnosis in stages III and IV (64.5%), the high frequency of intestinal carcinoma (56.4%) and the gastric antrum as the most frequent localization (48.8%). At the end of the study, 54.2%of patients had died and the median overall survival was 19 months. The main factors for an unfavorable prognosis were advanced tumoral stage (III and IV), the number of nodes involved, and diffuse histological type. Despite surgical treatment with curative intent, 63.2% of tumors at early stages (I and II) recurred during the study. Conclusions: The risk of gastric cancer in Segovia is higher in men aged over 70 years. Most tumors are diagnosed at advanced stages and recurrences are common, limiting the possibility of cure. Early diagnosis of this entity and improved treatments are required (AU)

[Gastric cancer in a Spanish hospital: Segovia General Hospital (2005-2008)]. / Cáncer gástrico en un hospital español: Hospital General de Segovia (2005-2008).

OBJECTIVE: To estimate the incidence, pathological characteristics, treatment patterns, survival and mortality of gastric cancer in Segovia from 2005-2008. METHODS: We conducted a retrospective, descriptive study of 163 patients diagnosed with gastric cancer at the Segovia General Hospital during the study period. RESULTS: We estimated a gastric cancer incidence of 25 cases/100,000 inhabitants. The ratio of men to women was 1.6:1. The mean age was 72 years. The most important findings were diagnosis in stages III and IV (64.5%), the high frequency of intestinal carcinoma (56.4%) and the gastric antrum as the most frequent localization (48.8%). At the end of the study, 54.2% of patients had died and the median overall survival was 19 months. The main factors for an unfavorable prognosis were advanced tumoral stage (III and IV), the number of nodes involved, and diffuse histological type. Despite surgical treatment with curative intent, 63.2% of tumors at early stages (I and II) recurred during the study. CONCLUSIONS: The risk of gastric cancer in Segovia is higher in men aged over 70 years. Most tumors are diagnosed at advanced stages and recurrences are common, limiting the possibility of cure. Early diagnosis of this entity and improved treatments are required.