Efficacy and tolerability of human fibrinogen concentrate administration to patients with acquired fibrinogen deficiency and active or in high-risk severe bleeding.

BACKGROUND AND OBJECTIVES: Fibrinogen deficiency is a cause for massive haemorrhage whose management in emergency situations is the subject of debate. Plasma-derived fibrinogen concentrates are indicated for reversing the haemorrhagic diathesis found in congenital and acquired deficiencies. MATERIALS AND METHODS: We report on the results of an observational study that evaluated the effects of fibrinogen concentrates in patients suffering from various forms of acquired severe hypofibrinogenaemia with life-threatening consumptive thrombo-haemorrhagic disorders (surgery, trauma and digestive haemorrhage), or underlying disease states that limit fibrinogen synthesis (hepatic dysfunction, haematological malignancies). RESULTS: Sixty-nine patients were identified and included, in whom most of the processes (62%) corresponded to consumptive hypofibrinogenaemia. After a median dose of 4 g, a mean absolute increase of 1.09 g/l in plasma fibrinogen was measured and coagulation parameters were significantly improved (P < 0.001). Mortality rates of 32.3% and 44.2% were reported after 24 h and 72 h, respectively. CONCLUSION: We conclude that the administration of fibrinogen concentrates in unresponsive, life-threatening haemorrhage with acquired hypofibrinogenaemia improves laboratory measures of coagulation, and may also be life saving. Although observational in nature, our data indicate a direct relationship between plasma fibrinogen levels and survival in acquired fibrinogen deficiency. Further studies are warranted to ascertain a clear relationship between fibrinogen levels and survival.

[Drug information management through the intranet of a hospital center]. / Original Breve Gestión de la información de medicamentos mediante la intranet de un centro hospitalario.

OBJECTIVE: This paper describes the methodology used for the implementation and validation of a network resource incorporated to the intranet of the Hospital, in order to retain and disseminate information from the Drug Information Center (DIC) of a pharmacy service in a hospital center. METHOD: A working group designed the structure, contents, memory needs, priority of access for users and a quality assessment questionnaire. RESULTS: The resource developed by the working group had a capacity of 70 Gb and its structure was based on HTML documents, including files with different format and 12 theme areas. Two levels of priority of access were established depending on the user and two persons were in charge of the resource. The questionnaire was delivered after three months of use. Sixty nine per cent of the users regarded the resource as very useful and 31%, as useful. The final structure, according to the results of the survey, had 11 theme areas. CONCLUSIONS: The use of the hospital Intranet in order to include and organize DIC information can be very simple and economic. Furthermore, the involvement of all the users in its design and structure can facilitate the practical use of this tool and improve its quality.

Gestión de la información de medicamentos mediante la intranet de un centro hospitalario / Drug information management through the intranet of a hospital center

Objetivo: En el presente trabajo se describe la metodología deimplantación y validación de un recurso de red incluido en la intranetdel Hospital, para almacenar y difundir la información delCentro de Información de Medicamentos (CIM) de un servicio defarmacia en un centro hospitalario.Método: Un grupo de trabajo diseñó la estructura, contenido,necesidades de memoria, prioridades de acceso de los usuarios yuna encuesta para evaluar la calidad.Resultados: El recurso obtenido de 70 Gb de capacidad seestructuró mediante documentos HTML incluyendo archivosde diferente formato con 12 áreas temáticas. Se establecieron2 niveles de prioridad de acceso según el usuario y dos responsablesdel recurso. La encuesta realizada tras tres meses de utilizaciónmostró que el 69% de los usuarios, consideró el recurso muyútil, y el 31% lo calificó de útil. La estructura final, según los resultadosde la encuesta fue de 11 áreas temáticas.Conclusiones: La utilización de la intranet del hospital paraincluir y estructurar la información del CIM puede realizarse deuna forma sencilla y económica. Además, la participación detodos los usuarios en su diseño y estructura, puede facilitar la utilidadpráctica de esta herramienta y aumentar su calidad

Objective: This paper describes the methodology used for theimplementation and validation of a network resource incorporatedto the intranet of the Hospital, in order to retain and disseminateinformation from the Drug Information Center (DIC) of a pharmacyservice in a hospital center.Method: A working group designed the structure, contents,memory needs, priority of access for users and a quality assessmentquestionnaire.Results: The resource developed by the working group had acapacity of 70 Gb and its structure was based on HTML documents,including files with different format and 12 theme areas.Two levels of priority of access were established depending on theuser and two persons were in charge of the resource. The questionnairewas delivered after three months of use. Sixty nine percent of the users regarded the resource as very useful and 31%, asuseful. The final structure, according to the results of the survey,had 11 theme areas.Conclusions: The use of the hospital Intranet in order toinclude and organize DIC information can be very simple and economic.Furthermore, the involvement of all the users in its designand structure can facilitate the practical use of this tool andimprove its quality

Daclizumab en la prevención del rechazo agudo en el trasplante de riñón y en otros órganos sólidos / Daclizumab for the prevention of acute rejection in kidney and other solid organ transplantation

Daclizumab es un anticuerpo monoclonal humanizado utilizado en la prevención del rechazo agudo en el trasplante renal. Se une específicamente a la subunidad del receptor de la interleucina-2 de la superficie de los linfocitos T activados, inhibiendo así la proliferación de linfocitos T, una vía determinante en la respuesta inmune del rechazo del injerto. La administración intravenosa de cinco dosis de 1 mg/kg, una 24 horas antes del trasplante y las otras cuatro a intervalos de 14 días, ha demostrado ser segura y eficaz en la reducción de la incidencia de rechazo agudo en los ensayos clínicos, siendo un fármaco bien tolerado que no aumenta la incidencia de neoplasias e infecciones oportunistas de forma significativa (AU)