Safety of fluoroquinolones.

Fluoroquinolones (FQs) are one of the most commonly prescribed classes of antibiotics. Although they were initially well tolerated in randomized clinical trials, subsequent epidemiological studies have reported an increased risk of threatening, severe, long-lasting, disabling and irreversible adverse effects (AEs), related to neurotoxicity and collagen degradation, such as tendonitis, Achilles tendon rupture, aortic aneurysm, and retinal detachment. This article reviews the main potentially threatening AEs, the alarms issued by regulatory agencies and therapeutic alternatives.

Seroprevalence for measles among healthcare workers in Madrid, Spain.

BACKGROUND: Immunity of healthcare workers (HCWs) against measles is a particular concern. They are more likely to contract it than the general population due to their occupational exposure which may cause a nosocomial outbreak. AIM: To assess the measles immune status of HCWs at five Spanish university hospitals. PATIENTS AND METHODS: Serologic testing (IgG) for measles by chemiluminescence indirect immunoassay (CLIA) was carried out prospectively and consecutively in HCWs from five university hospitals. All HCWs were classified into four epidemiological groups: vaccinated individuals, those with a history of measles disease, subjects with no history of measles or vaccination, and those who did not know whether they had measles or were vaccinated, and into five professional categories: physicians, nurses, nursing assistants, other clinical workers and non-clinical workers. A logistic regression model was constructed to identify the factors independently associated with immunity to measles. RESULTS: The study group was composed of 2157 HCWs. 89% had protective antibodies against measles. Of the 238 non-immune HCWs, 199 (83.6%) had been vaccinated, compared with 1084 of the 1919 (56.5%) immune individuals (P<0.0001). The parameters significantly predictive of having protective antibodies against measles were: older age (P<0.0001), epidemiological status (P=0.0002, mainly past measles disease), and professional category (P=0.02, in particular nurses). CONCLUSION: This study shows that HCWs, including those previously vaccinated, are currently at risk of measles and suggests that those with a natural history of infection are better protected. Therefore, knowledge and maintenance of immunity to measles are an essential part of infection control among HCWs.

Review of effectiveness criteria in the application of Telemedicine

Telemedicine is a very useful tool and resource for medical diagnosis and treatment. Since its inception in the 70s it has developed progressively, demonstrating the clinical benefit it brings to patients and being increasingly present in the daily activities of clinicians. Different studies have tried to define and limit its effectiveness at the time of application versus face-to-face assistance, this being an important variable to clarify. This article reviews the different variables that have been coined to define the effectiveness when trying to demonstrate the cost-effectiveness of including telemedicine in daily healthcare activity

La telemedicina es una herramienta y recurso de gran utilidad para el diagnóstico y tratamiento médico. Desde su inicio en la década de los 70 se ha desarrollado de forma progresiva, demostrando el beneficio clínico que aporta a los pacientes y estando cada vez más presente en la actividad diaria de los clínicos. Diferentes estudios han tratado de definir y acotar su efectividad a la hora de aplicarse versus la asistencia presencial, siendo esta una variable importante a despejar. Este artículo realiza una revisión de las diferentes variables que se han acuñado para definir efectividad a la hora de tratar de demostrar la rentabilidad de incluir la telemedicina en la actividad asistencial diaria