Farmacovigilancia en una unidad de cuidados intensivos pediátricos / Pharmacovigilance in a paediatric intensive care unit

Objetivo: Analizar las sospechas de eventos adversos a medicamentosdetectados por farmacéuticos en una unidad de cuidadosintensivos pediátricos.Método: Se registraron las sospechas de eventos adversos amedicamentos detectados por farmacéuticos en una unidad decuidados intensivos durante la concurrencia a rondas médicas(aunque estas no fueron de modo sistemático o continuo) o consultas(abril 2004–mayo 2005). Posteriormente el subcomité defarmacovigilancia analizó las sospechas de forma prospectiva,para confirmarlas y clasificarlas según sus normas.Resultados: Se obtuvieron 19 sospechas de eventos adversosen 17 pacientes, 15 fueron confirmados (78%).En seis casos el farmacéutico propuso cómo tratar el eventoadverso. Tres casos originaron el ingreso en la unidad. Los gruposterapéuticos más frecuentes fueron antimicrobianos, antiepilépticose inmunosupresores.La intensidad correspondió a: fatal 20%, grave 34%, moderada13% y leve 33%. La causalidad fue definitiva 13%, probable54% y posible 33%. El 20% de los eventos se consideró evitable.Conclusiones: Los eventos adversos detectados por los farmacéuticosfueron escasos, ya que no fue posible concurrir asiduamentea la ronda médica. Fue dificultosa la imputabilidad debidoa condiciones críticas del paciente.La mayoría de los eventos sospechados fueron confirmados.Los mecanismos para tratarlos consistieron en adecuación deterapéutica según las características del paciente

Objective: To analyze suspected drug-related adverse eventsas reported by pharmacists in a pediatric intensive care unit.Method: Suspected drug-related adverse events were recordedas reported by pharmacists in an intensive care unit during hospitalrounds (these were neither systematic nor continued) or patientvisits to our clinic (April 2004-May 2005). Later on, the pharmacovigilancesubcommittee prospectively analyzed such suspectedevents in order to confirm them and classify them according totheir rules.Results: Nineteen suspected adverse events were reported for17 patients; 15 were confirmed (78%). In six cases the pharmacistsuggested the way the adverse event was eventually treated. Threecases required admission to an ICU. Drug classes most commonlyinvolved included antimicrobials, anti-epileptic drugs, and immunosuppressants.Severity was: fatal 20%, serious 34%, moderate13%, mild 33%. Causality was definitely established for 13%, probablefor 54%, and possible for 33% of patients; 20% of eventswere considered avoidable.Conclusions: Adverse events reported by pharmacists werefew, as they could not attend hospital rounds on a regular basis.Imputability was difficult due to critical patient conditions. Mostsuspected events were later confirmed. Treatment involved therapyadjustments according to individual patient characteristics

Human papillomavirus genotype distribution and cervical squamous intraepithelial lesions among high-risk women with and without HIV-1 infection in Burkina Faso.

Human papillomavirus (HPV) infection and cervical squamous intraepithelial lesions (SILs) were studied in 379 high-risk women. Human papillomavirus DNA was detected in 238 of 360 (66.1%) of the beta-globin-positive cervical samples, and 467 HPV isolates belonging to 35 types were identified. Multiple (2-7 types) HPV infections were observed in 52.9% of HPV-infected women. The most prevalent HPV types were HPV-52 (14.7%), HPV-35 (9.4%), HPV-58 (9.4%), HPV-51 (8.6%), HPV-16 (7.8%), HPV-31 (7.5%), HPV-53 (6.7%), and HPV-18 (6.4%). Human immunodeficiency virus type 1 (HIV-1) seroprevalence was 36.0%. Human papillomavirus prevalence was significantly higher in HIV-1-infected women (87 vs 54%, prevalence ratio (PR) = 1.61, 95% confidence interval (CI): 1.4-1.8). High-risk HPV types (71 vs 40%, PR = 1.79, 95% CI: 1.5-2.2), in particular HPV-16+18 (22 vs 9%, PR = 2.35, 95% CI: 1.4-4.0), and multiple HPV infections (56 vs 23%, PR = 2.45, 95% CI: 1.8-3.3) were more prevalent in HIV-1-infected women. High-grade SIL (HSIL) was identified in 3.8% of the women. Human immunodeficiency virus type 1 infection was strongly associated with presence of HSIL (adjusted odds ratio = 17.0; 95% CI 2.2-134.1, P = 0.007) after controlling for high-risk HPV infection and other risk factors for HSIL. Nine of 14 (63%) HSIL cases were associated with HPV-16 or HPV-18 infection, and might have been prevented by an effective HPV-16/18 vaccine.