ABSTRACT
To further hold drug safety defense,rapid alert and emergency response should be done well for drug safety events in order to provide reference for effective prevention and response to drug safety incidents. The disposal process of the series events of me-dicinal capsules with excessive chromium was reviewed,and the features were analyzed to explore the emergency response and alert sys-tem for drug safety in China. To set up drug safety emergency monitoring mechanism,risk analysis and assessment mechanisms,proce-dures startup mechanism,crisis ending and follow-up assessment mechanism,appropriate public opinion guide mechanism,and a clear legal status of rapid test in the disposal of drug safety incidents are effective means to improve drug safety rapid alert and emergency re-sponse,which can provide necessary guarantees for drug safety and regulation.
ABSTRACT
O objetivo desse trabalho foi identificar, por meio de uma revisão sistemática, os sistemas de avaliação precoce existentes que são aplicados às gestantes, descrevendo os parâmetros vitais utilizados, as semelhanças\diferenças, bem como a efetividade desses instrumentos. Trata-se de um estudo de revisão sistemática, cujas pesquisas foram realizadas utilizando as bases de dados MEDLINE, SciELO, LILACS, BIREME e PubMed sendo encontrados 191 artigos. Excluíram-se os artigos que não tinham como foco o estudo, restando 16 artigos. Os resultados encontrados foram quatro instrumentos de avaliação aplicadas em pacientes para predizer deterioração fisiológica, sendo eles: EWS, NEWS, MEWS, MEOWS. Os instrumentos apresentaram pontos positivos relevantes, como indicadores do gerenciamento do cuidado, de custo hospitalar e social, porém, recomendando-se mais estudos para refinamento. O MEOWS é a ferramenta mais apropriada às condições maternas, não validada, e que necessita de adaptação às alterações fisiológicas relacionadas às diferentes morbidades. Sugere-se aumentar o corpo de estudos sobre este instrumento a fim de melhorar a sua especificidade, tornando-a uma ferramenta mais ajustada e confiável como preditora de near miss.
Early assessment systems applied to pregnant women, describing vital parameters, similarities/differences, and the efficaciousness of such tools, are analyzed. Systematic review was based on databases MEDLINE, SciELO, LILACS, BIREME and PubMed, with 191 scientific articles. The articles without the theme as focus were excluded and only 16 papers were analyzed. Results showed four evaluation tools applied to patients to predict physiological deterioration, namely, EWS, NEWS, MEWS, MEOWS. The tools had relevant positive points, such as indicators of care management, hospital and social costs, even though further studies were needed for better evaluation. MEOWS is the best tool for maternal conditions, albeit non-validated, and should be adapted to physiological changes related to different diseases. Further studies on this tool should be undertaken to improve its specificity and make it more reliable as a near miss predictor.
ABSTRACT
The China Infectious Disease Automated-alert and Response System (CIDARS) was successfully implemented and became operational nationwide in 2008.The CIDARS plays an important role in and has been integrated into the routine outbreak monitoring efforts of the Center for Disease Control (CDC) at all levels in China.In the CIDARS,thresholds are determined using the'Mean+2SD'in the early stage which have limitations.This study compared the performance of optimized thresholds defined using the'Mean +2SD'method to the performance of 5 novel algorithms to select optimal 'Outbreak Gold Standard (OGS)'and corresponding thresholds for outbreak detection.Data for infectious disease were organized by calendar week and year.The'Mean+2SD',C1,C2,moving average (MA),seasonal model (SM),and cumulative sum (CUSUM) algorithms were applied.Outbreak signals for the predicted value (Px) were calculated using a percentile-based moving window.When the outbreak signals generated by an algorithm were in line with a Px generated outbreak signal for each week,this Px was then defined as the optimized threshold for that algorithm.In this study,six infectious diseases were selected and classified into TYPE A (chickenpox and mumps),TYPE B (influenza and rubella) and TYPE C [hand foot and mouth disease (HFMD) and scarlet fever].Optimized thresholds for chickenpox (P55),mumps (P50),influenza (P40,P55,and P75),rubella (P45 and P75),HFMD (P65 and P70),and scarlet fever (P75 and Ps0) were identified.The C1,C2,CUSUM,SM,and MA algorithms were appropriate for TYPE A.All 6 algorithms were appropriate for TYPE B.C1 and CUSUM algorithms were appropriate for TYPE C.It is critical to incorporate more flexible algorithms as OGS into the CIDRAS and to identify the proper OGS and corresponding recommended optimized threshold by different infectious disease types.
ABSTRACT
Introducción: el asma es una enfermedad psicosomática que constituye un importante problema de salud mundial. El clima y el tiempo influyen sobre la salud humana. Es conocida la influencia de los factores ambientales en la aparición de las crisis agudas de asma bronquial. Objetivo: diseñar una estrategia de intervención comunitaria, sobre la base de la asociación del asma con los cambios meteorotrópicos, con el fin de alertar, tempranamente, de la posibilidad de desencadenamiento de las manifestaciones clínicas, mitigarlas y reducir las crisis de asma. Métodos: se diseñó un plan de acción que incluye a médicos, los pacientes y sus tutores que acudieron al servicio de urgencia del policlínico "Ana Betancourt", y sus consultorios médicos, durante el año 2010. Todos se adiestraron en la interpretación y procesamiento del modelo de pronóstico biometeorológico, cuyos resultados alertará sobre su accionar diario ante los riesgos meteorotrópicos. Resultados: se propone una estrategia de intervención comunitaria, con el fin de reducir, en al menos 20 por ciento, el número de pacientes con crisis de asma, y su gravedad. Conclusiones: los factores ambientales influyen en la aparición de las crisis agudas de asma bronquial. Las condiciones de hiperoxia o aumento de la densidad parcial de oxígeno en el aire son predecibles, y se puede alertar, oportunamente, a las autoridades de salud sobre su ocurrencia, lo que permite ejecutar planes de acción y medidas profiláctico preventivas que minimicen los impactos desfavorables de los cambios de tiempo anunciados.
Introduction: asthma is a psychosomatic disease becomes important health problem at world scale. The climate and time influenced on the human health. It is known the influence of environmental factors on the appearance of acute crises of bronchial asthma. Objective: to design a community intervention strategy based on the association of asthma with the meteorotropic changes to alert early on the possibility of triggering clinical manifestations, to alleviate and to reduce the asthma crises. Methods: an action plan was designed including physicians, patients and their custodians came to emergence service of "Ana Betancourt" polyclinic and its consulting rooms over 2010. All them were trained in the interpretation and processing of the bio-metereological prognosis form, whose results will alert on its daily action in face of metereotropic risks. Results: authors propose a community intervention strategy to reduce in at least a 20 percent the number of patients with asthma crises and its severity. Conclusions: environmental factors influenced on the appearance of acute crises of bronchial asthma. The hyperoxia conditions or the increase in partial density of oxygen in the air are predicable, allowing to alert at time to health authorities on its occurrence to carry out actions plans and prophylactic-preventive measures to minimize the unfavourable impacts of the climatic changes reported.