Enfermedad cardiovascular previa y posterior a la infección por COVID-19. Supervivencia a un año / Cardiovascular disease before and after COVID-19 infection: One-year survival

Objetivos Analizar el riesgo de COVID-19 con relación a la morbilidad previa, así como el riesgo de nuevos eventos cardiovasculares (ECV) en pacientes COVID-19 y la supervivencia a un año. Metodología Estudio casos-control y estudio de cohortes prospectivo. Se incluyeron 275 pacientes aleatorizados >18 años diagnosticados de COVID-19 y se aparearon con 825 COVID-19 negativos por edad y sexo (proporción 1:3). Las variables principales fueron diagnóstico de COVID-19 y eventos post-COVID-19. Se estudiaron variables sociodemográficas, comorbilidad y ECV previo. Se realizaron sendos modelos predictivos de factores asociados al desarrollo de COVID-19 y de ECV post-COVID-19, así como un análisis de supervivencia a un año. Resultados Los varones con ECV previo duplican el riesgo de padecer COVID-19 (odds ratio [OR] 2,11; intervalo de confianza [IC] 95% 1,32–3,36). En las mujeres el riesgo aumenta con la edad (OR 1,01; IC 95% 1,00–1,02), la diabetes mellitus (DM) (OR 1,90; IC 95% 1,14–3,17) y el deterioro cognitivo (OR 4,88; IC 95% 2,50–9,53). La inmunosupresión actúa como factor protector en ambos sexos. La edad (OR 1,02; IC 95% 1,00–1,04), hipertensión arterial (HTA) (OR 2,21; IC 95% 1,17–4,17), la infección COVID-19 (OR 4,81; IC 95% 2,89–7,98) y el ECV previo (OR 4,46; IC 95% 2,56–7,75) predicen el desarrollo de un nuevo ECV post-COVID-19. Los pacientes COVID-19 positivos tienen menor supervivencia (mediana de siete vs. 184 días). Conclusiones El ECV previo en varones y la DM junto al deterioro cognitivo en mujeres aumentan el riesgo de presentar COVID-19. La edad, HTA, ECV previo y la infección COVID-19 predicen la aparición de un ECV (AU)

Aim To analyze the risk of COVID-19 in relation to previous morbidity; to analyze the risk of new cardiovascular events (CVE) in COVID-19 patients and one-year survival. Methodology Case–control study and prospective cohort study. Two hundred and seventy-five randomized patients >18 years old with COVID-19 were included and matched with 825 without COVID-19 by age and sex (ratio 1:3). The main variables were diagnosis of COVID-19 and post-COVID-19 events. Sociodemographic variables, comorbidity, and previous CVD were studied. Two predictive models of factors associated with the development of COVID-19 and post-COVID-19 CVE were performed, as well as a one-year survival analysis. Results Men with a previous CVE double the risk of suffering from COVID-19 (OR 2.11; 95% CI: 1.32–3.36). In women, the risk increases with age (OR 1.01; 95% CI: 1.00–1.02), diabetes (DM) (OR 1.90; 95% CI: 1.14–3.17) and cognitive impairment (OR 4.88; 95% CI: 2.50–9.53). Immunosuppression acts as a protective factor in both sexes. Age (OR 1.02; 95% CI: 1.00–1.04), arterial hypertension (OR 2.21; 95% CI: 1.17–4.17), COVID-19 infection (OR 4.81; 95% CI: 2.89–7.98) and previous CVE (OR 4.46; 95% CI: 2.56–7.75) predict the development of a new post-COVID-19 CVE. Positive COVID-19 has lower survival (median 7 days vs. 184 days). Conclusions Previous CVE in men and DM along with cognitive impairment in women increase the risk of presenting COVID-19. Age, arterial hypertension, previous CVE, and COVID-19 infection predict the appearance of new CVE (AU)

[Cardiovascular disease before and after COVID-19 infection: One-year survival]. / Enfermedad cardiovascular previa y posterior a la infección por COVID-19. Supervivencia a un año.

AIM: To analyze the risk of COVID-19 in relation to previous morbidity; to analyze the risk of new cardiovascular events (CVE) in COVID-19 patients and one-year survival. METHODOLOGY: Case-control study and prospective cohort study. Two hundred and seventy-five randomized patients >18 years old with COVID-19 were included and matched with 825 without COVID-19 by age and sex (ratio 1:3). The main variables were diagnosis of COVID-19 and post-COVID-19 events. Sociodemographic variables, comorbidity, and previous CVD were studied. Two predictive models of factors associated with the development of COVID-19 and post-COVID-19 CVE were performed, as well as a one-year survival analysis. RESULTS: Men with a previous CVE double the risk of suffering from COVID-19 (OR 2.11; 95% CI: 1.32-3.36). In women, the risk increases with age (OR 1.01; 95% CI: 1.00-1.02), diabetes (DM) (OR 1.90; 95% CI: 1.14-3.17) and cognitive impairment (OR 4.88; 95% CI: 2.50-9.53). Immunosuppression acts as a protective factor in both sexes. Age (OR 1.02; 95% CI: 1.00-1.04), arterial hypertension (OR 2.21; 95% CI: 1.17-4.17), COVID-19 infection (OR 4.81; 95% CI: 2.89-7.98) and previous CVE (OR 4.46; 95% CI: 2.56-7.75) predict the development of a new post-COVID-19 CVE. Positive COVID-19 has lower survival (median 7 days vs. 184 days). CONCLUSIONS: Previous CVE in men and DM along with cognitive impairment in women increase the risk of presenting COVID-19. Age, arterial hypertension, previous CVE, and COVID-19 infection predict the appearance of new CVE.

Development of a calculator to establish indications to refer patients with lumbar degenerative disease for spinal surgery consultation. / Desarrollo de una calculadora para establecer indicación de derivación a consulta de cirugía del raquis en patología degenerativa lumbar.

BACKGROUND AND AIM: Low-back pain remains a common pathological entity in the Western population. We have found no data in the literature that assess whether, with correct physical examination and evaluation of simple x-rays of the spine, it is possible to diagnose patients who are highly likely to be candidates for lumbar spine surgery and thus reduce the care burden and resource consumption that this disorder entails. The aim of the study was to develop a user-friendly calculator that allows only patients who are strong candidates for surgical treatment to be referred for spinal surgery consultation. MATERIAL AND METHOD: An observational and retrospective study that included all adult patients from the healthcare area of Talavera de la Reina (Toledo, Spain) with a clinical and/or radiological diagnosis of degenerative lumbar spine disease referred by other specialists over one calendar year to the spinal surgery unit to assess whether surgery was indicated after unsuccessful conservative treatment. All the patients were assessed under the same protocol with a follow-up of 6years, at the end of which we performed a check of those who had undergone lumber spine surgery. RESULTS: A total of 201 patients were studied and at the end of the 6-year follow-up, a total of 77 patients had been operated. Concordance of 70% was found between the indication for surgical treatment and the treatment received at the end of the follow-up. Therefore a logistic regression was performed in an attempt to predict the patients that could be referred to the spinal surgery units and from that a calculator was generated, which included the plain x-ray variable as an essential item, and which showed as statistically significant (P<.05): age, Waddell's non-organic signs, Lasegue's sign and plain x-ray assessment. Once this tool had been obtained, the likelihood of undergoing surgery was calculated for all patients who were proposed surgical treatment, obtaining results above 62% as the cut-off point when using the calculator. CONCLUSIONS: The use of the calculator predicts the possibility of being a candidate for surgical treatment with 70% reliability. Therefore, patients with a result in the calculator of above 62% should be referred for spinal surgery consultation for assessment by a specialist.

[Value of molecular imaging to examine the brain]. / Aportacion de la imagen molecular en la exploracion del cerebro.

TITLE: Aportacion de la imagen molecular en la exploracion del cerebro.

Variability and trends in the consumption of drugs for treating attention-deficit/hyperactivity disorder in Castile-La Mancha, Spain (1992-2015). / Variabilidad y tendencias en el consumo de fármacos para los trastornos por déficit de atención e hiperactividad en Castilla-La Mancha, España (1992-2015).

INTRODUCTION: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common behavioural disorders of childhood; its prevalence in Spain is estimated at 5-9%. Available treatments for this condition include methylphenidate, atomoxetine, and lisdexamfetamine, whose consumption increases each year. MATERIAL AND METHODS: The prevalence of ADHD was estimated by calculating the defined daily dose per 1,000 population per day of each drug and the total doses (therapeutic group N06BA) between 1992 and 2015 in each of the provinces of Castile-La Mancha (Spain). Trends, joinpoints, and annual percentages of change were analysed using joinpoint regression models. RESULTS: The minimum prevalence of ADHD in the population of Castile-La Mancha aged 5 to 19 was estimated at 13.22 cases per 1,000 population per day; prevalence varied across provinces (p<.05). Overall consumption has increased from 1992 to 2015, with an annual percentages of change of 10.3% and several joinpoints (2000, 2009, and 2012). methylphenidate represents 89.6% of total drug consumption, followed by lisdexamfetamine at 8%. CONCLUSIONS: Analysing drug consumption enables us to estimate the distribution of ADHD patients in Castile-La Mancha. Our data show an increase in the consumption of these drugs as well as differences in drug consumption between provinces, which reflect differences in ADHD management in clinical practice.

Seasonal variation of pharmaceutically active compounds in surface (Tagus River) and tap water (Central Spain).

Numerous studies have shown the presence of pharmaceutically active compounds (PhACs) in different environmental compartments, for example, in surface water or wastewater ranging from nanograms per litre to micrograms per litre. Likewise, some recent studies have pointed to seasonal variability, thus indicating that PhAcs concentrations in the aquatic environment may depend on the time of year. This work intended to find out (1) whether Tagus fluvial and drinking water were polluted with different groups of PhACs and (2) if their concentrations differed between winter and summer seasons. From the 58 substances analysed, 41 were found belonging to the main therapeutic groups. Statistical differences were seen for antibacterials, antidepressants, anxiolytics, antiepileptics, and cardiovascular drugs, with higher concentrations being detected in winter than in summer. These results might indicate that the PhACs analysed in this study undergo lower environmental degradation in winter than in summer. In order to confirm these initial results, a continuous monitoring should be performed especially on those PhACs that either because of an elevated consumption or an intrinsic chemical persistence are poorly degraded during winter months due to low temperatures and solar irradiation. It is especially important to identify which of these specific PhACs are in order to recommend their substitution by equally effective and safe substances but also environmentally friendly.

Influence of local factors in the relationship between mortality and heat waves: Castile-La Mancha (1975-2003).

INTRODUCTION: All the climate-change studies undertaken to date agree that one of the principal consequences of this phenomenon is the increase in heat waves, which, without exception, are linked to marked rises in mortality. The characteristics that modulate and determine the relationship between high temperatures and health must therefore be ascertained in the greatest possible detail, so that really effective prevention plans can be designed to address temperature extremes. METHODS: We examined the effect of heat waves on daily non-accidental-cause mortality across all age groups in the Castile-La Mancha region (Spain) from 1975 to 2003. Quantitative analyses were performed using autoregressive integrated moving average (ARIMA) models, with other covariates, such as pressure trends, relative humidity, and duration and chronological number of heat waves. RESULTS: Mortality increased significantly with respect to the mean, when temperatures exceeded the designated provincial thresholds in Castile-La Mancha. For each degree centigrade that temperatures exceeded these thresholds, the percentage increase in mortality amounted to increases of approximately 12% over the daily mean, albeit with clear provincial variations. The longest heat waves were associated with daily mortality, with those at the end of summer causing the lowest mortality. Meteorological situations most closely associated with increases in mortality were cyclonic conditions accompanied by low humidity. CONCLUSIONS: Spatio-temporal variability in the temperature-mortality relationship must be studied in order to enable really effective heat-wave prevention plans to be drawn up. The influence of variables, such as heat-wave duration or time of appearance, is important in the total increase in mortality during temperature extremes. Since parameters, such as humidity or pressure trends, can play very different roles in different geographical settings, they should be analysed separately from temperature.

¿Controlamos correctamente la diabetes desde atención primaria en Talavera de la Reina (Toledo)? / Do we control diabetes correctly from Primary Care in Talavera de la Reina (Toledo)?

Introducción. La diabetes mellitus es una enfermedad crónica con elevada morbilidad, con un elevado coste sanitario y social, cuyo correcto control es fundamental. La glucohemoglobina (HbA1c) se ha convertido en un elemento de controversia sobre su utilidad diagnóstica y de monitorización de la enfermedad. Material y métodos. Se han analizado todas las determinaciones de HbA1c de la población no pediátrica de la Gerencia de Atención Primaria de Talavera de la Reina (Toledo) entre los años 2006 a 2008. Todas las muestras han sido analizadas en el Servicio de Análisis Clínicos del Hospital Nuestra Señora del Prado de Talavera de la Reina de acuerdo a las normas internacionales. La concentración de HbA1c a partir de la que se ha considerado un buen o mal control de la DM es del 7%. Todos los resultados se han agregado por peticionario y por centro de salud. Resultados. Se han realizado 26.611 determinaciones, con un valor medio de la concentración de HbA1c 6,9%. No existen diferencias estadísticamente significativas entre centros de salud (p>0,05) ni entre profesionales (p>0,05). El 57,1% de la población del área está bien controlada, sin que existan diferencias estadísticamente significativas entre centros de salud (p>0,05). Conclusión. Nuestra población tiene un grado de control adecuado de su glucemia, de acuerdo a los valores de HbA1c, y no existen diferencias significativas entre centros de salud o entre los profesionales. La no existencia de diferencias estadísticas no significa que no se aprecie una variabilidad en el grado de control. Debemos seguir trabajando por reducir las diferencias encontradas, para que la población pueda acceder a los mismos niveles de salud (AU)

Introduction: Diabetes mellitus is a chronic disease with high morbidity, high health and social costs, and in which control is crucial. Glycosylated haemoglobin (HbA1c) has become a matter of controversy on its usefulness in diagnosing and monitoring the disease. Material and methods: We analysed all measures of HbA1c measurements in the population non-paediatric Primary Care population in Talavera de la Reina (Toledo, Spain) between the years 2006-2008. All samples were analysed in the Laboratory of the Hospital Nuestra Se˜nora del Prado, Talavera de la Reina in line with international standards. The concentration of HbA1c which has been considered to show good or poor control of DM is 7%. All results have been analysed by requester or by health centre. Results: A total of 26,611 determinations were made, with a mean HbA1c concentration of 6.9%. No statistically significant differences were found between health centres (p > .05) or between the professionals who requested the test (p > .05). The majority, 57.1% of the population of the area, was well controlled, with no statistically significant differences between health centres (p > .05). Conclusion: Our population has an adequate level of blood glucose control, according to the values of HbA1c values, with no significant differences between health centres or professionals. The absence of statistical differences does not necessarily mean that no variation was observed in the level of control. We must continue working to reduce the differences found, so that patients may have access to the same levels of health (AU)

Análisis de la comunicación médico paciente: ¿transmitimos y reciben lo esencial? / Doctor-patient communication: do we transmit and receive what is essential?

Objetivo. Conocer la información percibida por el paciente tras consulta hospitalaria. Material y métodos. Estudio descriptivo de tipo transversal. Emplazamiento. Hospital Nuestra Señora del Prado, Talavera de la Reina. Participantes. Pacientes mayores de 14 años remitidos a consultas externas del hospital de referencia. Se seleccionaron 96 pacientes, colaboraron 87 (90,6%). Se comprobó la coincidencia entre la información percibida por el paciente, obtenida a través de encuesta telefónica, con respecto a la registrada en la historia clínica por el médico. Resultados. Creían conocer el motivo de consulta 80 (94%) pacientes. No recordaban cambios de tratamiento 4 (5%) pacientes, ni consejo sobre hábitos de vida 2 (2%). Contrastando con historia clínica había 89% de coincidencia. No había diferencias significativas (p>0,05) con edad, audición, número de visitas, tiempo, ni especialidades. Conclusión. La mayoría de pacientes comprendió el mensaje transmitido por el médico, aunque convendría optimizar la comunicación para alcanzar el 100% de comprensión (AU)

Objective. To determine the information received by the patient after a hospital consultation. Material and methods. A descriptive cross-sectional study. Location. Hospital Nuestra Señora del Prado, Talavera de la Reina (Spain). Participants. Patients over 14 years referred to hospital outpatient clinics. We selected 96 patients, of which 87 (90.6%) took part. Measurements. Checking the agreement between the information received by the patient, obtained via telephone survey, and that in the history by the physician. Results. A total of 80 (94%) patients thought they knew the reason for visit. Four (5%) patients did not remember changes in treatment, and 2 (2%) forgot advice on changes in lifestyle. In contrast to clinical history there was 89% agreement. There were no significant differences (P>0.05) with age, hearing problems, number of visits, time allocations, or specialties. Conclusion. Most patients understood the message conveyed by the physician, although the communication must be optimised to achieve 100% comprehension (AU)

Mortality from cold waves in Castile--La Mancha, Spain.

INTRODUCTION: As is known, the effects of extreme temperatures on mortality are characterised by an annual periodicity, with a rise centred in the winter months. The most recent epidemiological studies show that mortality caused by cold waves is, in many cases, comparable to that caused by the severest heat waves. This study sought to quantify the rise in mortality due to extreme cold and the factors that determine the relationship between these variables in Castile-La Mancha (Spain). METHODS: We examined the effect of extreme winter temperature on daily non accidental cause mortality in Castile - La Mancha from 1975 to 2003, for all ages. Quantitative analyses were performed using ARIMA models, with other covariates, such as influenza, pressure trends, relative humidity, and cold wave duration and chronological number. RESULTS: There were two mortality peaks: a short-term peak (with a lag of 3 to 7 days); and a longer term peak (of under two weeks). Excess mortality during cold waves was around 10% per degree centigrade below the threshold temperature for all the provinces except Guadalajara, where an increase of only 4.61% was detected. Mortality increased in response to rises in cold-wave duration and relative humidity. Cold waves occurring at the end of the "winter" season caused the greatest mortality. CONCLUSIONS: This study confirms that daily mortality in Castile - La Mancha increases during cold waves. Efficient cold-wave prevention plans must therefore be implemented. Such plans should be based on in-depth knowledge of the causes that underlie and modulate the relationship between low temperatures and health effects.

[Variability and trends in dementia drug consumption in Castile-La Mancha (Spain). Estimated prevalence of Alzheimer's disease]. / Variabilidad y tendencias en el uso de fármacos contra la demencia. Estimación de la prevalencia de la enfermedad de Alzheimer en Castilla-La Mancha.

BACKGROUND: Alzheimer disease (AD) is one of the most prevalent degenerative disorders in the population over 65 years. We believe that the prevalence in Spain is between 4-11% for the population over 65 years-old. Drugs are currently available to treat this disease in its different phases. MATERIAL AND METHODS: We estimated the prevalence of AD by calculating the defined daily doses per 100 inhabitants over 65 years old and days of dementia drugs (therapeutic group N06DA and N06DX) for the years 2004-2008 for each of the provinces of Castile-La Mancha (Spain). We have provided the data requirements specified by the Regional Health Service of Castile-La Mancha. RESULTS: The prevalence of AD is than 2.98 per 100-days for the whole region, there is variation in drug use and consumption, with a predominance of donepezil in all provinces except Guadalajara. On the whole, the consumption of these drugs has increased by 8% annually. CONCLUSIONS: The consumption of dementia drugs is used to estimate the distribution of AD in Castile-La Mancha (Spain). These figures do not yet accurately estimate the prevalence of the disease, despite the increase in consumption. We can establish the variability in medical practice for this disease.

Variabilidad y tendencias en el uso de fármacos contra la demencia. Estimación de la prevalencia de la enfermedad de Alzheimer en Castilla-La Mancha / Variability and trends in dementia drug consumption in Castile-La Mancha (Spain). Estimated prevalence of Alzheimer's disease

Introducción: La enfermedad de Alzheimer (EA) es uno de los trastornos degenerativos más importantes en la población mayor de 65 años. Se estima que la prevalencia en España está en el 4-11% en esa población. En la actualidad hay fármacos para el tratamiento de esta enfermedad en sus diferentes fases. Material y métodosSe estima la prevalencia de EA mediante el cálculo de las dosis diarias definidas/100 habitantes mayores de 65 años y día de fármacos contra la demencia (grupo terapéutico N06DA y N06DX), durante los años 2004-2008, para cada una de las provincias de Castilla-La Mancha. Se ha dispuesto de los datos de las prescripciones indicadas por el SESCAM. Resultados: La prevalencia mínima de EA es de 2,98/100 habitantes y día para el conjunto de la región, con variabilidad en su uso y consumo, y predominio del donepezilo en todas las provincias, excepto Guadalajara. En su conjunto, el consumo de estos fármacos se ha incrementado un 8% anual. Conclusiones: El consumo de fármacos contra la demencia permite estimar la distribución de EA en Castilla-La Mancha. Las cifras obtenidas no permiten todavía estimar con precisión la prevalencia de la enfermedad, pese al aumento en su consumo. Sí se puede establecer la variabilidad en la práctica médica frente a esta enfermedad (AU)

Background: Alzheimer disease (AD) is one of the most prevalent degenerative disorders in the population over 65 years. We believe that the prevalence in Spain is between 4-11% for the population over 65 years-old. Drugs are currently available to treat this disease in its different phases. Material and methods: We estimated the prevalence of AD by calculating the defined daily doses per 100 inhabitants over 65 years old and days of dementia drugs (therapeutic group N06DA and N06DX) for the years 2004-2008 for each of the provinces of Castile-La Mancha (Spain). We have provided the data requirements specified by the Regional Health Service of Castile-La Mancha.Results: The prevalence of AD is than 2.98 per 100-days for the whole region, there is variation in drug use and consumption, with a predominance of donepezil in all provinces except Guadalajara. On the whole, the consumption of these drugs has increased by 8% annually. Conclusions:The consumption of dementia drugs is used to estimate the distribution of AD in Castile-La Mancha (Spain). These figures do not yet accurately estimate the prevalence of the disease, despite the increase in consumption. We can establish the variability in medical practice for this disease (AU)

Evolución del consumo de antibióticos en la Comunidad de Madrid (1992-2007) / No disponible

Objetivo: El objetivo es estimar la magnitud de las infecciones utilizando los estándares del protocolo de vigilancia del proyecto europeo HELICS. Métodos: Se han utilizado los protocolos y manuales del proyecto HELICS y la aplicación informática HELICSwin. Procedimientos vigilados: prótesis de cadera y rodilla, cesáreas, colostomías y colecistectomías. Se utilizan los indicadores: IA y DI (tasas estratificadas según el índice de riesgo NNIS). Resultados: Los pacientes sujetos a vigilancia fueron 221. La IA de ILQ en prótesis de cadera fue de 0, 0%, de rodilla del 2,1%: cesárea, 1,8% colecistectomía, 6,5% y en cirugía de colon del 26%. Discusión: Este es el primer año de vigilancia de la ILQ con el programa HELICSwin en nuestro hospital. El estudio puede suponer un cambio cultura necesario para abaratar en la seguridad clínica del paciente, aunque en algunos procedimientos los indicadores de ILQ están por encima de los datos publicados por el último informe nacional de HELICS (AU)

Objective: The aim is to estimate the magnitude of the infections using the surveillance protocol standards of the European project: HELICS. Methods: The methods used are the protocols and manuals of the HELICS PROJECT AND the HELICSwin computer applications caesarean, colostomies and cholecytectomies. Indicators used: accumulated incidence and density of the incidence (stratified rates according to the NNIS risk index). Results: The patients under surveillance were 221. The IA of ISQ was 0% in hip prosthesis, 2,1% in knee prosthesis, 1,8% in caesarean, 6,5% in cholecystectomy and 26% in colon surgery. Results: The patients under surveillance were 221. The IA of ISQ was 0% in hip prosthesis, 2,1% in knee prosthesis, 1,8% in caesarean, 6.5% in cholecystectomy and 26% in colon surgery. Discussion: This is the first ISQ year of surveillance with the HELICSwin programme in our hospital. The study can imply a necessary cultural change to make progress in the clinic security of the patient although, in some procedures, the ISQ indicators are above the data published by the HELICS report 2007 (AU)

Errores en la Central de Esterilización: seguridad de los dispositivos sanitarios / No disponible

Objetivo: Cuantificar y tipificar los errores que se producen en una central de esterilización. Material y métodos: Se trata de una central con gestión externalizada con un sistema de calidad implantado y certificado con la UNE-EN-ISO 9001: 2000 en el año 2003 (Certificado 2003/0656/ER/01). La esterilización es un proceso especial que exige la medida de indicadores de proceso en desinfección y esterilización de los dispositivos médicos. Resultados: Se han procesado 76.805 cajas entre los años 2004 y 2006. Los indicadores han mejorado desde 20004 a 2006, detectándose un 1,34% de errores en 2006 frente a 4,23% de 2004. Se han reducido los fallos de esterilización y la presencia de suciedad tras el lavado. Conclusiones: La central de esterilización como centro productor del hospital está sometida a diferentes normas y leyes, que garantizan la seguridad de los pacientes y la calidad de la atención sanitaria (AU)

Objetive: To quantify and to classify the errors that take place in a central sterilization. Materials and methods. It is a central of sterilization with an outsourcing management and with an implanted system of quality and certificated with the UNE-EN-ISO 9001:2000 IN 2003 (Certified 2003/0656/ER/01). Sterilization is a special process that demands the measurement of process indicators for disinfection and sterilization of the medical devices during 2004 and 2005. Results: We have been processed 76.805 boxes form 2004 and 2006. The indicators have improved form 2004 to 2006. It has been detected 1,34% of errors in 2006 as opposed to the 4,23% in 2004. We have been reduce the errors by sterilization failures and the defects in the washing. Conclusions. The Central of Sterilization like producing centre of the hospital is put under different norms and laws, that they guarantee the security of the patients and the quality of the sanitary attention (AU)

Terapia multicomponente grupal del tabaquismo en Atención Primaria / No disponible

No disponible

La protección del medio ambiente, el óxido de etileno y las centrales de esterilización / No disponible

No disponible