Accuracy of transcutaneous bilirubin on covered skin in preterm and term newborns receiving phototherapy using a JM-105 bilirubinometer.

OBJECTIVE: Determine the suitability of transcutaneous bilirubin (TCB) as a tool to assess the effectiveness of phototherapy on patched skin. STUDY DESIGN: A prospective observational study was conducted. We covered a fragment of skin (sternum) with a photo-opaque patch. Several simultaneous TCB and TSB measurements were performed with the JM-105 bilirubinometer. Bland and Altman test evaluated the agreement between bilirubin levels. RESULT: A total of 217 patients were studied, 48.8% were preterm. The mean difference between TSB and TCB before the start of treatment was 1.07 mg/dL. During phototherapy, differences on covered skin were 0.52, 0.27, and 0.39 mg/dL at 24, 48, and 72 h of therapy respectively. The best correlation was observed at 48 h in preterm infants. CONCLUSION: The measurement of TCB on patched skin (PTCB) is useful for monitoring the response to phototherapy in term and preterm infants. We use a patch with a removable flap that eases successive measures without disturbing the patients.

Prenatal Therapy with Magnesium Sulfate and Its Correlation with Neonatal Serum Magnesium Concentration.

INTRODUCTION: Antenatal magnesium sulfate (MgSO4) administration has shown to be effective in minimizing cerebral palsy and severe motor dysfunction at the age of 2 years. The aim of this study is to determine the relationship between the magnesium dose delivered to the mother and the magnesium concentration in the neonates. MATERIALS AND METHODS: A prospective cohort study was conducted on neonates of less than 32 weeks' gestation admitted to the neonatal intensive care unit of University Hospital Complex of Vigo from December 2012 to July 2015. Comparative analysis of magnesium levels between the groups of neonates exposed to MgSO4 and the control group. RESULTS: A total of 118 neonates were included in the study. The mothers of 62 of them had received MgSO4 as a neuroprotective agent. There was a significant correlation between the full dose of MgSO4 received by the mother and the levels of magnesium in the neonate in the first 24 hours of life (r2 = 0.397; p < 0.001). CONCLUSION: The MgSO4 dose received by the mother has a linear relationship with the magnesium levels obtained in neonates.

Calidad de la prescripción antibiótica en un servicio de urgencias pediátrico hospitalario / Antibiotic prescribing in a paediatric emergency department

Introducción: Una política antibiótica correcta en los servicios de urgencias pediátricos es esencial dado el alto número de consultas por patología infecciosa. El objetivo es conocer la adecuación del tratamiento antibiótico prescrito a los niños atendidos en un servicio de urgencias pediátrico. Material y métodos: Revisión retrospectiva de los informes de alta de niños atendidos en el servicio de urgencias pediátrico por otitis media aguda, faringoamigdalitis aguda o neumonía adquirida en la comunidad durante el 2008. Se seleccionó una muestra aleatoria de 100 casos para cada patología. La adecuación del antibiótico se valoró para los siguientes aspectos: enfermedad subsidiaria de tratamiento antibiótico, elección de antibiótico adecuado, dosis, intervalo y duración del mismo. Una actitud errónea en cualquier parámetro se consideró prescripción inadecuada. La valoración de la adecuación se realizó acorde a los protocolos existentes en urgencias. Resultados: Se prescribió antibiótico a 219 pacientes (73%). La prescripción antibiótica fue inadecuada en 67 niños (22,3%). Se pautó antibiótico innecesariamente a 15 (6,8%) y en 4 (2%) la selección del mismo fue incorrecta. A un niño (1,2%) no se pautó antibiótico cuando estaba indicado. La duración del tratamiento fue incorrecta en 22 casos (11,5%), todos por una menor duración, el intervalo en 20 (10,1%), y la dosis en 13 (6,5%). Conclusiones: En las patologías estudiadas existió un uso adecuado de antibiótico, con unas tasas de adecuación altas para la decisión de tratar y la elección del antibiótico. La duración incorrecta del tratamiento fue el principal motivo de prescripción inadecuada. Es necesario adoptar medidas para la corrección de los aspectos más deficitarios detectados (AU)

Introduction: Adequate antibiotic prescribing in Paediatric Emergency Departments (PEDs) is a necessity due to the high number of patients consulting for infectious diseases. The aim of this study was to evaluate the antibiotic prescription quality in a PED. Material and methods: Retrospective study of patients attending a PED and diagnosed with acute otitis media, pharyngotonsillitis or community-acquired pneumonia during 2008. A random sample of 100 cases for each disease was selected. The parameters employed for assessing the prescribing quality were: illness subject to being treated with antibiotics, adequate antibiotic, dosage, interval of administration and length of treatment. An error in any of these parameters was considered an inappropriate prescription. The appropriateness of the antibiotic prescriptions was assessed based on the recommendations described on our hospital protocols. Results: Antibiotics were prescribed to 219 patients (73%). Therapy was considered to be inappropriate in 67 children (22.3%). Unnecessary treatment was indicated in 15 cases (6.8%) and in 4 patients (2%) the antibiotic selected was incorrect. Antibiotic was not prescribed to one patient subject to being treated (1.2%). The treatment length was wrong in 22 cases (11.5%), inappropriately short in all of them, the interval of administration in 20 (10.1%) and dosage in 13 (6.5%). Conclusions: The use of antibiotics was appropriate for the diseases analysed, particularly as regards to the indication and antibiotic selection. The length of the treatment was the aspect found to be most deficient. Some important measures should be undertaken in order to improve antibiotic prescription quality (AU)

[Antibiotic prescribing in a paediatric emergency department]. / Calidad de la prescripción antibiótica en un servicio de urgencias pediátrico hospitalario.

INTRODUCTION: Adequate antibiotic prescribing in Paediatric Emergency Departments (PEDs) is a necessity due to the high number of patients consulting for infectious diseases. The aim of this study was to evaluate the antibiotic prescription quality in a PED. MATERIAL AND METHODS: Retrospective study of patients attending a PED and diagnosed with acute otitis media, pharyngotonsillitis or community-acquired pneumonia during 2008. A random sample of 100 cases for each disease was selected. The parameters employed for assessing the prescribing quality were: illness subject to being treated with antibiotics, adequate antibiotic, dosage, interval of administration and length of treatment. An error in any of these parameters was considered an inappropriate prescription. The appropriateness of the antibiotic prescriptions was assessed based on the recommendations described on our hospital protocols. RESULTS: Antibiotics were prescribed to 219 patients (73%). Therapy was considered to be inappropriate in 67 children (22.3%). Unnecessary treatment was indicated in 15 cases (6.8%) and in 4 patients (2%) the antibiotic selected was incorrect. Antibiotic was not prescribed to one patient subject to being treated (1.2%). The treatment length was wrong in 22 cases (11.5%), inappropriately short in all of them, the interval of administration in 20 (10.1%) and dosage in 13 (6.5%). CONCLUSIONS: The use of antibiotics was appropriate for the diseases analysed, particularly as regards to the indication and antibiotic selection. The length of the treatment was the aspect found to be most deficient. Some important measures should be undertaken in order to improve antibiotic prescription quality.