Profilaxis antibiótica en los pacientes con reflujo vesico-ureteral grado III / Antibiotic prophylaxis in patients with grade III vesicoureteral reflux

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[Acute gastroenteritis: the cost of an ambulatory care sensitive condition]. / Gastroenteritis aguda: coste de una causa de ingreso potencialmente evitable.

INTRODUCTION: Acute gastroenteritis (AGE) has been defined as an ambulatory care sensitive condition. The recommended treatment consists of oral rehydration and rapid reintroduction of food. Nevertheless, AGE remains an important cause of hospitalization. The objective of the present study was to analyze the patient characteristics, management, and costs associated with hospitalizations due to AGE in a pediatrics department. PATIENTS AND METHODS: We conducted a prospective observational study of patients aged 1 month to 14 years old admitted to our hospital because of AGE over a 1-year period. Information was collected on clinical presentation, etiology, treatment, tests, length of hospital stay, and costs associated with the episode. RESULTS: AGE was the cause of admission in 16.5 % of our patients (65 episodes, 62 patients) with two seasonal peaks (February-March and August). A causative agent was isolated in 68.6 % of the patients with a stool test (35 % rotavirus, 31.3 % Salmonella, 1.9 % Shigella). Although 74 % of the patients had mild dehydration, exclusive oral rehydration therapy was provided in very few patients: 89.2 % of the patients were treated with IV therapy and 20 % with antibiotics. The total length of stay was 206 days (mean 3.1 days). The direct medical cost was 44,254.74 euros (median 710.46 euros/patient, 95 % CI: 616.37-804.56 euros) and the main component of this cost (82.9 %) was hospitalization. Conclusions AGE was one of the main causes of hospitalization in our department. The use of oral rehydration was low. The economic and social cost was considerable.

Gastroenteritis aguda: coste de una causa de ingreso potencialmente evitable / Acute gastroenteritis: the cost of an ambulatory care sensitive condition

Introducción La gastroenteritis aguda (GEA) ha sido definida como una condición de hospitalización potencialmente evitable y en la que se recomienda rehidratación oral y reintroducción precoz de la alimentación. A pesar de ello, constituye un motivo de ingreso frecuente. Analizaremos las características de los pacientes, el tratamiento y los costes de los ingresos por GEA en un servicio pediátrico. Material y métodos Estudio prospectivo observacional de pacientes de 1 mes a 14 años de edad que ingresaron en nuestro hospital por GEA durante un año. Se recogió información sobre clínica, etiología, tratamiento, exploraciones complementarias, estancia hospitalaria y costes asociados al episodio. Resultados La GEA constituyó el 16,5 % (65 ingresos, 62 pacientes) de los ingresos en nuestro servicio con dos picos estacionales (febrero-marzo y agosto). Se aisló microorganismo en el 68,6 % de los pacientes con estudio microbiológico (35 % rotavirus; 31,3 % Salmonella; 1,9 % Shigella). El uso de rehidratación oral fue muy bajo, pese a que el 74 % de los pacientes tenía deshidrataciones leves. Recibió sueroterapia el 89,2 % de los pacientes y el 20 %, antibioterapia. La estancia global fue de 206 días (media: 3,1 días). El coste médico directo fue de 44.254,74 euros (media: 710,46 euros por paciente, intervalo de confianza del 95 %: 616,37-804,56 euros), siendo el 82,9 % del coste generado por la estancia hospitalaria. Conclusiones La GEA constituyó una de las primeras causas de hospitalización en nuestro servicio de pediatría. El uso de pautas de rehidratación oral fue bajo. El coste económico y social es considerable

Introduction Acute gastroenteritis (AGE) has been defined as an ambulatory care sensitive condition. The recommended treatment consists of oral rehydration and rapid reintroduction of food. Nevertheless, AGE remains an important cause of hospitalization. The objective of the present study was to analyze the patient characteristics, management, and costs associated with hospitalizations due to AGE in a pediatrics department. Patients and methods We conducted a prospective observational study of patients aged 1 month to 14 years old admitted to our hospital because of AGE over a 1-year period. Information was collected on clinical presentation, etiology, treatment, tests, length of hospital stay, and costs associated with the episode. Results AGE was the cause of admission in 16.5 % of our patients (65 episodes, 62 patients) with two seasonal peaks (February-March and August). A causative agent was isolated in 68.6 % of the patients with a stool test (35 % rotavirus, 31.3 % Salmonella, 1.9 % Shigella). Although 74 % of the patients had mild dehydration, exclusive oral rehydration therapy was provided in very few patients: 89.2 % of the patients were treated with IV therapy and 20 % with antibiotics. The total length of stay was 206 days (mean 3.1 days). The direct medical cost was 44,254.74 € (median 710.46 €/patient, 95 % CI: 616.37-804.56 €) and the main component of this cost (82.9 %) was hospitalization. Conclusions AGE was one of the main causes of hospitalization in our department. The use of oral rehydration was low. The economic and social cost was considerable

Infección tuberculosa en la población de 5 años de edad en la comarca del Baix Empordà (Girona) / Tuberculous infection in the population of 5-year-olds in the region of Baix Empordà in Girona (Spain)

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