Trends in gastrointestinal bleeding in the Region of Valencia (2000-2005). Relationship to sales of nonsteroidal anti-inflammatory drugs and acid suppression medication

Objective Describe 2000-2005 time trends of prescription for NSAIDs, proton pump inhibitors (PPIs) and hospital admissions for gastrointestinal (GI) bleeding. Methods Time series analysis of gastrointestinal (GI) bleeding admission and drugs’ Defined Daily Dose per 1000 people per day (DDD/1000/day) in the Region of Valencia, Spain, from January 2000 to December 2005.ResultsDispensation of NSAIDs went from 42.7 DDD/1000 people/day in 2000 to 58.3 DDD/1000 people/day in 2005. During the same period, dispensation of PPIs went from 26.3 DDD/1000 people/day to 68.5 DDD/1000 people/day (both are statistically significant). The rate of hospitalisations for gastrointestinal bleeding during this period oscillated between 142 and 126 admission per 100 000 inhabitants/year. No year showed significant differences compared to 2000.ConclusionA substantial increase in the NSAID use from 2000 to 2005 was not accompanied by changes in GI bleeding hospitalisation rates in Valencia, but GI bleeding rates continued to be high, suggesting a need to improve NSAIDs use (AU)

Objetivo Describir las tendencias temporales durante el periodo 2000-2005 de la prescripción de AINE, inhibidores de la bomba de protones (IBP) y los ingresos hospitalarios por hemorragia gastrointestinal (GI).Métodos Análisis de series cronológicas de ingresos por hemorragia GI y de las dosis diarias definidas (DDD) de medicamento por cada 1.000 personas y día (DDD/1.000/día) en la Comunidad Valenciana desde enero de 2000 hasta diciembre de 2005.ResultadosLa dispensación de AINE ha aumentado desde 42,7 DDD/1.000/día en 2000 a 58,3 DDD/1.000/día, y la de IBP pasó de 26,3 DDD/1.000/día a 68,5 DDD/1000/día (ambos son cambios estadísticamente significativos). La tasa de ingresos por hemorragias GI durante este periodo pasó de 142 a 126 por cada 100.000 habitantes/año. En relación a 2000, ninguno de los años analizados muestra diferencias significativas. Conclusiones El aumento sustancial del uso de AINEs entre 2000 y 2005 no se vio acompañado de cambios en la tasa de ingresos hospitalarios en Valencia, pero la tasa de hemorragias GI siguieron siendo altas, lo que sugiere que es necesario mejorar la utilización de los AINE (AU)

Trends in gastrointestinal bleeding in the Region of Valencia (2000-2005). Relationship to sales of nonsteroidal anti-inflammatory drugs and acid suppression medication.

OBJECTIVE: To describe 2000-2005 time trends of prescription for NSAIDs, proton pump inhibitors (PPIs) and hospital admissions for gastrointestinal (GI) bleeding. METHODS: Time series analysis of gastrointestinal (GI) bleeding admission and drugs' Defined Daily Dose per 1000 people per day (DDD/1000/day) in the Region of Valencia, Spain, from January 2000 to December 2005. RESULTS: Dispensation of NSAIDs went from 42.7 DDD/1000 people/day in 2000 to 58.3 DDD/1000 people/day in 2005. During the same period, dispensation of PPIs went from 26.3 DDD/1000 people/day to 68.5 DDD/1000 people/day (both are statistically significant). The rate of hospitalisations for gastrointestinal bleeding during this period oscillated between 142 and 126 admission per 100 000 inhabitants/year. No year showed significant differences compared to 2000. CONCLUSION: A substantial increase in the NSAID use from 2000 to 2005 was not accompanied by changes in GI bleeding hospitalisation rates in Valencia, but GI bleeding rates continued to be high, suggesting a need to improve NSAIDs use.

«Lenguaje común» frente a independencia del patrocinador en la evaluación económica de medicamentos / No disponible

No disponible

Análogos de insulina: un pequeño paso para el hombre, un gran "peso" para la sociedad / Insulin analogues: a small step for mankind, a great “weight” for society"

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[Multicenter study on the prevalence of hyperglycemia among hospitalized patients with parenteral nutrition]. / Estudio multicéntrico de prevalencia de hiperglucemia en pacientes hospitalizados con nutrición parenteral.

OBJECTIVE: The aim of this cross-sectional national multicentric study was to determine the prevalence of hyperglycemia in patients with parenteral nutrition and to assess other clinical factors associated with this complication. METHOD: All Spanish hospital pharmacy services were invited to participate in the study. RESULTS: Twenty eight (28) pharmacy services agreed to participate. The study included 442 patients. The prevalence of hyperglycemia (plasma levels > 200 mg/dL) was 26.7%. Eighty four point two per cent of the patients received less than 3.5 mg/kg/minute of glucose, this infusion rate being considered as the safe threshold. In most patients, follow-up of glycemia was based on capillary blood determination with reactive strips and in 27.6% of the cases in which insulin was prescribed, it was added to the parenteral nutrition bag, in full or in part. No significant correlations were found between glycemia and the clinical factors studied (disorders, fever, medication), except for insulin. CONCLUSIONS: This national multicentric study of the prevalence of hyperglycemia among patients with parenteral nutrition, leaded by hospital pharmacists, was a joint effort aimed to better understand this metabolic complication. Findings are consistent with those reported by other authors and have allowed us to describe the current situation.

Estudio multicéntrico de prevalencia de hiperglucemia en pacientes hospitalizados con nutrición parenteral / Multicentric study on the prevalence of hyperglycemia among hospitalized patients with parenteral nutrition

Objetivo: El objetivo de este estudio nacional transversal multicéntricofue evaluar la prevalencia de hiperglucemia en pacientescon nutrición parenteral y evaluar otros factores clínicos relacionadoscon esta complicación.Método: Se ofertó participar en el estudio a todos los serviciosde farmacia de los hospitales españoles.Resultados: Accedieron a participar 28 servicios de farmacia.El estudio incluyó 442 pacientes. La prevalencia de hiperglucemia(valores séricos > 200 mg/dL) se situó en el 26,7%. El 84,2% depacientes recibieron menos de 3,5 mg/kg/minuto de glucosa,velocidad de infusión postulada como umbral de seguridad. Elseguimiento mayoritario de la glucemia fue mediante determinaciónen sangre capilar con tiras reactivas y el 27,6% de los casosen que se pautó insulina, esta estaba aditivada en la bolsa de nutriciónparenteral, total o parcialmente. No se pudieron demostrarcorrelaciones significativas entre la glucemia y los factores clínicosestudiados (patologías, fiebre, medicación), pero sí con la insulina.Conclusiones: Este estudio multicéntrico nacional sobre laprevalencia de hiperglucemia en pacientes con nutrición parenteral,liderado por farmacéuticos de hospital, constituye un esfuerzointegrado para conocer mejor esta complicación metabólica. Losdatos descritos se sitúan dentro de los aportados por otros autoresy nos han permitido caracterizar la situación actual

Objective: The aim of this cross-sectional national multicentricstudy was to determine the prevalence of hyperglycemia inpatients with parenteral nutrition and to assess other clinical factorsassociated with this complication.Method: All Spanish hospital pharmacy services were invitedto participate in the study.Results: Twenty eight (28) pharmacy services agreed to participate.The study included 442 patients. The prevalence ofhyperglucemia (plasma levels > 200 mg/dL) was 26.7%. Eightyfour point two per cent of the patients received less than 3,5mg/kg/minute of glucose, this infusion rate being considered asthe safe threshold. In most patients, follow-up of glycemia wasbased on capillary blood determination with reactive strips and in27.6% of the cases in which insulin was prescribed, it was addedto the parenteral nutrition bag, in full or in part. No significantcorrelations were found between glycemia and the clinical factorsstudied (disorders, fever, medication), except for insulin.Conclusions: This national multicentric study of the prevalenceof hyperglycemia among patients with parenteral nutrition,leaded by hospital pharmacists, was a joint effort aimed to betterunderstand this metabolic complication. Findings are consistentwith those reported by other authors and have allowed us todescribe the current situation

[3 possible sources of microbiologic contamination in the preparation of formulations for parenteral nutrition]. / Estudio de tres potenciales fuentes de contaminación microbiológica en la elaboración de nutriciones parenterales.

It is well known that the microbiological control of "all in one" nutritional preparations is difficult. In this work we evaluated and compared the potential contaminants that may be present in the process of manufacturing in a Centralized Unit of Parenteral Nutrition. The study has been centered on the microbiological contamination that may be introduced by the technician, by the raw materials, and that existing in the work area. A microbiological contact technique was used. The results obtained showed that the main microbiological contaminants are introduced by the technician when not observing strict aseptic measures. Another source of contamination is represented by PVC bags when they are manipulated in the pre-sterile area and are not sprayed with alcohol 70 degrees. Therefore, PVC contamination arises from the hands of the technician. Significant differences in contamination between hands washed with germicidal soap and sterile gloves and between clean and sterile surgical dressing could not be demonstrated.