[An analysis of a general prospective series of 3270 upper digestive hemorrhages]. / Análisis de una serie general prospectiva de 3,270 hemorragias digestivas altas.

The results of a global (general series of 3,270 episodes of upper gastrointestinal haemorrhage (UGH) admitted to our unit between the 15th of April 1983 and the 15th of April 1988 have been analyzed. All the patients entered a prospective protocol with 29 variables. Diagnostic and therapeutic approaches had previously been defined. The incidence of UGH in this area was 160 bleeding episodes/100,000 inhabitants/year. Mean age was 57 +/- 16.8 years and male/female ratio was 2.66/1. The percentage of patients older than 65 years was 33.85%. A history of non-steroidal anti-inflammatory drugs (NSAID) intake within 48 hours before the bleeding episode was obtained in 27.63%. Continued alcohol ingestion was observed in 25.96% and 34.37% of patients gave a history of a previous episode of bleeding. UGH presented with haematemesis and melena in 56% of cases, and 44% only with melena. On admission the bleeding was haemodynamically severe in 12.96% and a 19.69% of the patients had severe associated diseases. Early endoscopy in cases with UGH due to peptic ulcer revealed active bleeding in 16.35% (2.87% in jet and 13.48% oozing) and recent clot/visible vessel in 31.7%. The major causes of bleeding were peptic ulcer (54.31%), esophageal and gastric varices (10.73%) and acute lesions of the gastric mucosa (ALGM) (6.72%). Etiology of the haemorrhage could not be established in 8% of cases. Bleeding was persistent in 20.75% and limited in 79.25% of patients. Emergency surgery was needed in 14.43% of cases. The global mortality of the series was 7.65%.(ABSTRACT TRUNCATED AT 250 WORDS)

Televised violence: a Japanese, Spanish, and American comparison.

In Japan, Spain, and the USA during one week acts of violence (verbal and nonverbal) were rated on the Index of Television Violence by 3 raters in each country. In all three countries televised violence was more likely depicted in interpersonal conflict than against property. Fewer scenes of physical or fatal injury appeared in Japan than in the other two countries. Other observations were made. Replication is urged.

[Analysis of several containment measures of pharmaceutical expenditure in an Ambulatory Surgery Centre]. / Análisis de varias medidas de contención del gasto farmacéutico ambulatorio en una Unidad de Cirugía Mayor Ambulatoria.

OBJECTIVE: In the context of the current crisis, sustainability of National Health Service must be considered a priority issue. To compare several cost saving measures in drug expenditure due to outpatient drug treatment after surgery in an Ambulatory Surgical Centre. MATERIAL AND METHOD: Pharmaco-economic analysis of cost minimization of ambulatory pharmaceutical services during the year 2011. A total of 3,346 patients were operated on and discharged on the same day, were included. Treatments were collected from the discharge report of each patient. We compared changes in real outpatient drug spending after separately applying each of the following measures: 1) increasing the co-payment; 2) improving the quality of prescribing; 3) dispensing by units of drugs through pharmacies, and 4) dispensing through the hospital pharmacy service. RESULTS: The real outpatient pharmaceutical expenditure was 29,454.21€. Increasing the co-payment mean a transfer of 2,091.82€ from the funding institutions to users. Improving the quality of prescriptions, dispensing through units of drugs in the pharmacy, and dispensing through the hospital pharmacy service led to a pharmaceutical expenditure of 24,215.14€, 21,766.24€ and 7,827.71€, respectively. CONCLUSIONS: Only considering co-payment to contain pharmaceutical expenditure arising from prescribing in an Ambulatory Surgical Centre is the least effective measure. The most effective measure, for this purpose, is the supply of drugs through the hospital pharmacy service.

Polymorphism of haptoglobin (HP), group specific component (GC) and alpha-1-antitrypsin (PI) in the resident population of the Basque Country (Spain).

The Basque Country is inhabited by three populations: indigenous inhabitants, immigrants from other regions of the Iberian peninsula and descendants from a mixture of both groups. The principal component analysis of gene frequencies at HP, GC and PI loci shows two groups in the Basque Country: one comprising the indigenous inhabitants and those of mixed descent, the other of immigrants. The first group presents gene frequencies similar to those of inhabitants of the Pyrenees and Central Europe areas, while the second group has frequencies similar to other European and Mediterranean inhabitants.