Retrospective Analysis of 291 Cases of Medical Malpractice Involving Death / 法医学杂志

Objective To study the medical malpractice cases involving death, and discuss the identification ideas and methods of medical malpractice cases. Methods A total of 291 medical malpractice cases involving death accepted and settled from January 2012 to December 2017 at the Judicial Appraisal Center of Southern Medical University were collected. Based on the age, gender, hospital level, clinical department, whether or not autopsy was performed, cause of death, cause of medical mistakes, causality and causative potency of the appraised person, statistical analysis was made. Results There were more males than females in medical malpractice cases involving death. Mostly young adults or children were involved in these cases. The number of cases involving tertiary hospitals was the highest; among the clinical departments, the internal medicine department had the largest number of cases, followed by surgery, obstetrics and gynecology, pediatrics, etc. Autopsy rate has a trend of increasing year by year. Most patients die from the natural outcomes of their disease or ineffective treatment. Most hospitals have certain medical mistakes, and have an indirect correlation with the patient's death, mainly slight factors. Conclusion Judicial appraisal of medical malpractice should follow the principle of "one-effect and multi-cause", and comprehensively consider various factors such as, the diseases and constitution of the patient, natural outcomes of the diseases, the current medical technology and the level of diagnosis and treatment of the hospital, etc.

Hepatocarcinoma y trasplante hepático en Perú: resultados de 15 años del Departamento de Trasplantes del Hospital Nacional Guillermo Almenara Irigoyen - EsSalud / Liver transplant and hepatocellular carcinoma in Peru: outcome after 15 years in the transplant department of the Guillermo Almenara Hospital - EsSalud

El carcinoma hepatocelular (CHC) es una neoplasia con incidencia y prevalencia significativa en el mundo. Ésta en gran porcentaje se origina en el hígado cirrótico. El trasplante hepático bajo condiciones especiales, ha demostrado ser efectivo en el tratamiento simultáneo de ambas condiciones. En América latina la información es escasa. Este es un estudio de tipo descriptivo retrospectivo de corte transversal, cuyo universo es conformado por los primeros 200 trasplantes de hígado de nuestra serie (Años 2000-2015). Durante el periodo mencionado 26 (13%) pacientes tuvieron diagnóstico de CHC. De los 26 trasplantados con CHC, 21 (81%) pacientes fueron de sexo masculino. El promedio de edad fue 59,7 años. La etiología cirrótica más frecuente fue NASH con 9 (35%) casos, seguida de VHC y OH con 6 (23%). El promedio de AFP pre trasplante fue de 113,3. El ¨downstaging¨ fue realizado en 4 pacientes. La sobrevida global obtenida es de 90,9% a más de 5 años. La sobrevida libre de recurrencia en nuestra serie es de 95,5% a 5 años.

Hepatocellular carcinoma (HCC) is a neoplasm with significant incidence and prevalence in the world. In large percentage it originates from a cirrhotic liver. Liver transplantation under special conditions is effective in the simultaneous treatment of both conditions. Information is scarce in Latin America. This is a cross-sectional study of the first 200 liver transplants of our series (Years 2000-2015). During this period, 26 (13%) patients had a diagnosis of HCC. Of the 26 transplanted with HCC, 21 (81%) patients were male. The average age was 59.7 years. The most frequent cirrhotic etiology was NASH with nine (35%) cases, followed by HCV and OH with six (23%). The average of AFP pre-transplant was 113.3. Downstaging was performed in four patients. The overall survival obtained is 90.9% over 5 years. The recurrence-free survival in our series is 95.5% at 5 years.

Síndrome hepatopulmonar y trasplante hepático: experiencia en el departamento de trasplantes del Hospital Nacional Guillermo Almenara Irigoyen - EsSalud / Hepatopulmonar syndrome and liver transplantation: experience in the transplantation department of the Guillermo Almenara Irigoyen National Hospital - EsSalud

Introducción: El síndrome hepatopulmonar (SHP) es una complicación grave de la enfermedad hepática, la cual se caracteriza por la presencia de vasodilatación intrapulmonar e hipoxemia progresiva, siendo el trasplante de hígado el único tratamiento efectivo. Objetivo: Mostrar nuestros resultados de los pacientes con síndrome hepatopulmonar sometidos a trasplante hepático. Materiales y métodos: Estudio retrospectivo, descriptivo y trasversal. Desde marzo del 2000 a diciembre del 2016 se realizaron 226 trasplantes de hígado. Del total, se excluyeron a 25 pacientes: 12 retrasplantes, 9 trasplantes dobles higadoriñon, 2 trasplantes con falla hepática aguda, 2 trasplantes en pacientes no cirróticos. De los 201 pacientes con diagnóstico pretrasplante de cirrosis hepática, 19 tuvieron criterios de SHP; quienes fueron distribuidos según edad, sexo, nivel de hipoxemia (pO2), score CHILD, score MELD. La reversibilidad de la hipoxemia post trasplante se midió con una cutt off de p0(2) >75 mmHg. Resultados: La prevalencia del SHP en nuestra serie fue 9,45%. La edad promedio fue 41 años (14-65); la relación M/F de 1,65. El 78,94% (15/19) fueron adultos. 89,5% (17/19) fueron score de CHILD B y C, y el 68,4% tuvieron SHP severo y muy severo. En el 94,11% de los pacientes se demostró reversibilidad del SHP. La tasa de mortalidad temprana en los pacientes con SHP fue 10,4%. Conclusiones: La prevalencia del SHP fue del 9,45%. Los pacientes trasplantados con y sin SHP tuvieron similar sobrevida.

Introduction: Hepatopulmonary syndrome (HPS) is a serious complication of liver disease, which is characterized by the presence of intrapulmonary vasodilation and progressive hypoxemia. Liver transplantation is the only effective treatment. Objective: To show our results of patients with hepatopulmonary syndrome undergoing liver transplantation. Materials and methods: Retrospective, descriptive and cross-sectional study. From March 2000 to December 2016; 226 liver transplants were performed. Of the total, 25 patients were excluded: 12 retransplantation, 9 liver-kidney combined transplants, 2 transplants for acute liver failure, 2 transplants in non-cirrhotic patients. Of the 201 patients with pretransplant diagnosis of liver cirrhosis, 19 filled criteria for SHP; who were distributed according to age, sex, hypoxemia level (pO2), Child-Pugh score and MELD score. The reversibility hypoxemia after liver trasplantation was measured with a cut-off of p0(2) >75 mmHg. Results: The prevalence of SHP in our series was 9.45%. The average age was 41 years (14-65); the M / F ratio of 1.65. The 78.94% (15/19) were adults. 89.5% (17/19) were Score of Child-Pugh B and C, and 68.4% had severe and very severe SHP. In 94.11% of patients, reversibility SHP founded. The early mortality rate (30 days) in patients with SHP was 10.4%. Conclusions: The prevalence of HPS in our series was 9.45%. Transplanted patients with and without SHP had similar survival.

Revisión sistemática de la farmacorresistencia en enterobacterias de aislamientos hospitalarios en Colombia / Systematic review of antimicrobial resistance in Enterobacteriaceae isolates from Colombian hospitals

Introducción. La resistencia bacteriana es un problema de salud pública a nivel mundial que compromete seriamente la capacidad de tratar las infecciones. Objetivo. Describir el perfil de resistencia a los antimicrobianos marcadores en enterobacterias identificadas en hospitales colombianos. Materiales y métodos. Se hizo una revisión bibliográfica sistemática de las publicaciones indexadas en Medline, Embase y Lilacs, además de la búsqueda manual de todos los números de revistas colombianas reconocidas en el campo de la infectología y otros afines para identificar referencias no disponibles electrónicamente. Resultados. Se identificaron 43 estudios y reportes de vigilancia epidemiológica con información sobre la resistencia de las enterobacterias en hospitales, principalmente de Bogotá, Cali y Medellín. La tasa de resistencia en Escherchia coli oscila entre 3 y 11 %, 5 y 20 % y 0,2 a 0,8 % para piperacilina-tazobactam, cefalosporinas de tercera generación y carbapenémicos, respectivamente. En aislamientos de Klebsiella pneumoniae , la resistencia oscila entre 21,8 y 48,1 % frente a piperacilina-tazobactam, 20 y 35 % frente a cefalosporinas de amplio espectro y 3 y 8 % frente a carbapenémicos, con variaciones importantes por ciudades, niveles de atención y circunstancias clínicas. Conclusiones. La diseminación de la resistencia bacteriana en enterobacterias aisladas en hospitales colombianos es un problema creciente que requiere medidas prontas para cortar las cadenas de transmisión.

Introduction: Bacterial resistance is a public health problem worldwide that seriously compromises the possibility to treat infections. Objective: To identify levels of resistance to antibiotic markers in Enterobacteriaceae isolates from Colombian hospitals. Materials and methods: A systematic literature survey was done including articles indexed in Medline, Embase and LILACS. A manual search was made of Colombian scientific journals and other publications on infectious disease that were not available electronically. Results: In total, 43 observational studies and epidemiological reports were identified with information about resistance among Enterobacteriaceae isolates in Colombian hospitals, mainly from Bogotá, Cali and Medellín. The resistance rate of Escherichia coli ranges from 3 to 11%, 5 to 20% and from 0.2 to 0.8% for piperacillin-tazobactam, third generation cephalosporins and carbapenems, respectively. For Klebsiella pneumoniae resistance rates ranges from 21.8 to 48.1% to piperacillin-tazobactam, 20 to 35% to broad-spectrum cephalosporins and 3 to 8% to carbapenems, with significant variations by cities, levels of care and clinical settings. Conclusions: The spread of bacterial resistance in Enterobacteriaceae isolated in Colombian hospitals is a growing problem that calls for priority action to cut the chains of transmission.

Caracterización fenotípica de aislamientos de Acinetobacter baumannii en una institución de salud de alta complejidad de Cali / Phenotypic characterization of Acinetobacter baumannii isolates in a high-complexity healthcare institution in the city of Cali

Introducción. La caracterización fenotípica de las bacterias del género Acinetobacter mediante pruebas bioquímicas y microscópicas es posible. Varios estudios han demostrado que los aislamientos provenientes de infecciones asociadas a la atención en salud presentan una elevada resistencia a los antibióticos de primera elección. Objetivo. Describir los patrones de resistencia de los aislamientos de Acinetobacter baumannii obtenidos en una institución de salud, así como sus características fenotípicas y los posibles mecanismos de resistencia. Materiales y métodos. Se realizó un estudio descriptivo de corte transversal con 28 informes de muestras tomadas a pacientes hospitalizados con infección por A. baumannii . Las pruebas de sensibilidad para ceftazidime, cefepime, meropenem, amikacina y ciprofloxacina se realizaron con el sistema automatizado Vitek ® y la clasificación de sensible, intermedia y resistente se hizo con base en el protocolo establecido por el Clinical and Laboratory Standards Institute para el año 2007. Resultados. El mayor porcentaje de aislamientos correspondió al sexo masculino (53,6 %), a la sala de infectología (28,5 %) y al mes de septiembre (21,4 %); el tipo de muestra más frecuente fue el de secreción endotraqueal (53,6 %). A partir de los patrones de los perfiles de sensibilidad a los antibióticos empleados se obtuvieron 13 filotipos. Conclusión. Acinetobacter baumannii es un agente patógeno resistente a múltiples antimicrobianos, involucrado en brotes de infecciones asociadas a la atención en salud. Los patrones de los perfiles de resistencia permiten inferir que los posibles mecanismos de resistencia presentes en la mayoría de los aislamientos son la producción de betalactamasas de espectro extendido, las enzimas modificadoras del antibiótico y la modificación del sitio diana.

Introduction: Phenotypic characterization of the Acinetobacter genus bacteria through biochemical and microscopic tests is possible. Studies have shown that the isolates from health-care associated infections show high resistance to first-line antibiotics. Objective: To describe the resistance patterns of the A. baumannii isolates obtained in a health care institution, the phenotypic characteristics of the isolates, and the possible resistance mechanisms. Materials and methods: A descriptive cross-sectional study was conducted with 28 reports of samples taken from patients hospitalized with infection by A. baumannii . Susceptibility testing for ceftazidime, cefepime, meropenem, amikacin, and ciprofloxacin was performed with the Vitek ™ automated system and the susceptible, intermediate, and resistant classification was based on the protocol established by the Clinical and Laboratory Standards Institute for 2007. Results: The highest percentage of isolates corresponded to males (53.6 %), to the infectology ward (28.5 %), and to the month of September (21.4 %); the most frequent sample site were endotracheal secretions (53.6 %). From the profile patterns for susceptibility to antibiotics used, 13 phylotypes were obtained. Conclusion: Acinetobacter baumannii is a pathogen resistant to multiple antimicrobial agents involved in outbreaks of health-care associated infections. The resistance profile patterns allow inferring that the possible resistance mechanisms present in the majority of the isolates are: Production of extended-spectrum b -lactamases, antibiotic modifying enzymes, and target site modification.

Medical legal dispute in hospitals of different grades: a retrospective study on 206 cases / 法医学杂志

OBJECTIVE@#To analyze the characteristics of medical malpractice from different grades of hospitals and to explore forensic investigation strategies in assessing medical dispute.@*METHODS@#A total of 206 cases of medical dispute from 2009 to 2010 investigated by the Department of Forensic Medicine in Nanjing Medical University were selected and analyzed according to fault incidence, fault-prone part, and degree of causality in the treatment.@*RESULTS@#Among the 206 cases analyzed, tertiary hospitals, secondary hospitals and primary hospitals showed medium, high and low error rate, respectively. A majority of medical malpractice cases were distributed in the departments of surgery, medicine and gynecology.@*CONCLUSION@#The frequency and severity of medical malpractice in primary hospitals were high, which were gradually reduced in tertiary and secondary hospitals.

Estudio epidemiológico descriptivo de pacientes presentados al Comité de Oído del Servicio de ORL del Hospital Clínico de la Universidad de Chile entre los años 2004 y 2011 / Descriptive epidemiological study of patients presented at Ear committee of the ORL Department of the Hospital Clínico de la Universidad de Chile between the years 2004 and 2011

Introducción: En el Servicio de Otorrinolaringología del Hospital Clínico de la Universidad de Chile, existe una instancia de revisión semanal de los casos que generan más discusión diagnóstica en patología de oído y del sistema vestibular, que denominamos Comité de Oído. Objetivos: En este trabajo se pretende describir las características epidemiológicas de los pacientes evaluados en este comité. Material y método: Se realizó un estudio de tipo retrospectivo donde se revisaron los registros del libro del Comité de Oído entre los años 2004 y 2011. Resultados: Se obtuvo un total de 1.081 diagnósticos realizados en el Comité de Oído. El promedio de edad de los pacientes fue de 39,9 años, siendo el 57% de sexo femenino. La patología de oído medio fue la más frecuente representando el 71%% del total de las consultas. El diagnóstico individual más frecuente fue la otitis media crónica colesteatomatosa en el 19,3% de los casos. Conclusión: Estos resultados nos permiten conocer las características de los pacientes con patologías de oído y sistema vestibular que generan más controversia en nuestro servicio.

Introduction: At the Otolaryngology Department of the Hospital Clinico de la Universidad de Chile, there is a committee of weekly meeting that reviews cases that generate the most controversy in ear and vestibular system pathology. Aim: This paper aims to describe the epidemiological characteristics of patients evaluated at this committee. Material and method: We performed a retrospective study that reviewed the records of the ear committee between the years 2004 and 2011. Results: A total of 1081 diagnostics were made at the committee. The average age was 39.9 years, and 57% were female patients. Middle ear pathology was the most frequent, accounting for 71%% of all diagnostics. The most frequent individual diagnostic was cholesteatomatous chronic otitis media in 19.3(0)% of cases. Conclusion: These results allow us to know epidemiological characteristics of patients with ear and vestibular system diseases, and those cases that generate the most controversy in our service.

Propuesta de un nuevo indicador para calificar la capacidad de publicación en hospitales docentes / Proposal of a new indicator to qualify the publication capacity of teaching hospitals

Las publicaciones cient[ificas son un reflejo de la marcha de un departamento hospitalario. Nuestros hospitales se caracterizan por producir pocos trabajos para las revistas médicas y la web. Presentamos aquí metodologías foráneas para evaluar esas instituciones y se razona sobre lo difícil de obtener resultados precisos. Proponemos un indicador empírico llamado Indice de Publicaciones que anunciaría la capacidad productiva de los departamentos en ese campo. Faltan referencias venezolanas para enriquecer este aspecto de la pesquisa de buenos hospitales en nuestro país

Scientific papers are the mirror of hospital departments performance. Our hospital produce few papers for journals and the web. We present foreign methods to evaluate hospital, taking into account the difficulties to obtain occurate results. Here, we suggest an empirical indicator called “Index of Publications” which should show the publication capacity of medical departments. Venezuelan references are needed to enrich the screening of good hospitals in our country

Cutaneous drug reactions in patients admitted to the dermatology unit at the University Hospital of the West Indies, Kingston, Jamaica / Reacciones cutáneas medicamentosas en pacientes ingresados en la Unidad de Dermatología del Hospital Universitario de West Indies, Kingston, Jamaica

OBJECTIVE: Cutaneous reactions are among the most common adverse reactions to drugs. The purpose of this study is to examine the aetiology and outcome of cutaneous drug reactions among patients admitted to the Dermatology Ward at the University Hospital of the West Indies. SUBJECTS AND METHODS: This was a retrospective study looking at all patients who were admitted with a diagnosis of a cutaneous drug eruption from January 1, 1997 to December 31, 2005. Data included patient demographics, date of admission to hospital, duration of hospitalization and a detailed drug history including any previous episodes of drug sensitivity. All drugs reportedly ingested by the patients up to three months prior to their cutaneous reaction were documented and the period of time between drug ingestion and the appearance of skin lesions was also noted. Clinical diagnosis, co-morbidities, histopathological diagnosis, final outcome and all ensuing disabilities were noted. The data retrieved were collated and analyzed using SPSS 12.0. RESULTS: The results showed a female to male ratio of 2.2:1. The categories of drugs most commonly implicated were antimicrobials followed by anti-epileptic drugs and nonsteroidal anti-inflammatory drugs. The most common form of drug eruption requiring admission was the exanthematous drug eruption followed by erythema multiforme, toxic epidermal necrolysis and Stevens-Johnson syndrome. CONCLUSION: In general, the causative agents identified and the types of drug eruptions were similar to those found in previous studies. However, the anti-epileptic drugs, phenytoin and carbamazepine, ranked among the most commonly implicated drugs which differ significantly from other studies.

Las reacciones cutáneas se hallan entre las reacciones adversas más comunes frente a los medicamentos. El propósito de este estudio fue examinar la etiología y la evolución clínica de las reacciones cutáneas medicamentosas entre pacientes ingresados a la sala de dermatología en el Hospital Universitario de West Indies. MÉTODOS: Este es un estudio retrospectivo que pasa revista a todos los pacientes que fueron ingresados con diagnóstico de erupción cutánea desde el 1ero. de enero de 1997 al 31 de diciembre de 2005. RESULTADOS: Los resultados mostraron una proporción hembra-varón de 2.2:1. Las categorías de los medicamentos más frecuentemente implicados fueron los antimicrobianos, seguidos por los medicamentos antiepilépticos y los antiinflamatorios no esteroideos. La forma más común de erupción que requirió ingreso a causa de medicamentos, fue la erupción exantemática medicamentosa seguida por el eritema multiforme, la necrólisis epidérmica tóxica, y el síndrome de Stevens-Johnson. CONCLUSIÓN: En general, los agentes causativos identificados y los tipos de erupciones medicamentosas, fueron similares a los hallados en estudios previos. Sin embargo, los antiepilépticos conocidos como fenitoína y carbamazepina, estuvieron entre los medicamentos más comúnmente implicados, presentándose en tal sentido una diferencia significativa con los otros estudios.

A study on rational drug prescribing and dispensing in outpatients in a tertiary care teaching hospital of Western Nepal.

OBJECTIVES: To analyze the prescriptions of out-patients for rational prescribing and dispensing and to evaluate the patient's knowledge regarding use of drugs, using INRUD indicators. METHODS: A cross-sectional, descriptive study was conducted at the Manipal Teaching Hospital, Pokhara, Nepal during the time period from June 10th to August 19th 2004. RESULTS: Totally 247 prescriptions were randomly selected for analysis, wherein 720 drugs were prescribed. Only 15% of drugs were prescribed by generic name, 21.67% of the total drugs consisted of fixed-dose combinations, only 40% of drugs were from the Essential drug list of Nepal and 29.44% (n=212) were from the WHO Essential drug list. It was found that more than half (54.17%) of the drugs were from Nepalese National Formulary and 35.69% were from WHO model formulary. Dermatological products were most commonly prescribed followed by drugs acting on central nervous system, antimicrobials and drugs acting on cardiovascular system. Among the drugs dispensed, 79.16% were oral followed by topical (18.19%) and parenteral forms (2.98%). Diagnosis was mentioned only in 3.23% (n=8) of the prescriptions and the average cost per prescription was found to be 241.11 Nepalese rupees (US$ 3.26). It was found out that pharmacist labelled only 0.4% of the medication envelopes with the name of the patient. However, 82.6% of the medication envelopes were labelled with name of the drug and 87.0% with drug strength. Only 53.8% (n=133) of the patient knew both the duration of the therapy and administration time of drugs. CONCLUSION: There is a need for educational intervention for prescribers and both managerial and educational intervention for the hospital pharmacists to improve prescribing and dispensing.

Corneal characteristics in myopic patients.

OBJECTIVES: To evaluate the characteristics of the cornea in myopic patients. MATERIAL AND METHOD: A retrospective study of 420 eyes in 210 patients who visited the Excimer Laser Surgery Clinic at Siriraj Hospital, Mahidol University from January 1999 to June 2002 was conducted. All cases that were eligible for myopic refractive surgery were included in the present study. A preoperative ocular examination was done in a fashionable method, including manifest refraction and Orbscan Topography to evaluate corneal thickness, corneal curvature and corneal diameter Statistical analysis was performed to identify the characteristics of the cornea in the patients. RESULTS: The mean age of the patients was 31.66 +/- 7.77 years. (ranging from 16-51). The mean manifest refraction (spherical equivalent) was -4.9 +/- 2.29 diopters (ranging from -0.50 to -13.75). The mean corneal diameter (white to white) was 11.60 mm +/- 0.37 mm (ranging from 10.8-12.9). The thinnest point of the cornea varied from 409 to 597 microns (mean = 522.55) and located mostly in the infero-temporal quadrant of the eye (23.69% in the right and 32.05% in the left). The mean curvature of the corneal was 44.6 +/- 13.8 diopters (ranging from 39.05-47.65). The mean corneal astigmatism was 1.34 +/- 0.71 diopters and 93.96% were with the rule astigmatism. Positive angle kappa was found in 408 eyes (97%) but all cases were within a 0.5 mm horizontal and 0.3 mm vertical radius from the pupillary axis. CONCLUSION: Characteristics of the cornea in Thai myopic patients were demonstrated in the present study. Most of the cornea showed with the rule astigmatism with positive angle kappa and the thinnest point, located at the infero-temporal quadrant.

Utilisation of ophthalmic services by foreign nationals in Johor: a review of 452 patients

Between 1st January 1999 and 31st December 2000, 452 foreign nationals were treated at the Department of Ophthalmology, Hospital Sultanah Aminah, Johor Bahru. Eighty-five percent were male. The peak age range was from 21 to 30 years old. The patients were predominantly Indonesians (61%). A history of trauma was present in 63% of patients. Eight percent of eyes had severe visual impairment. Six patients (1.3%) were blind by WHO standards. Traumatic eye conditions, inflammatory/allergic eye conditions and degenerative eye conditions comprised 66%, 13% and 10% respectively of ocular pathology seen. The commonest ocular findings were corneal foreign body, corneal abrasion and subconjunctival haemorrhage.

El servicio de urgencias en un hospital de tercer nivel: su comportamiento durante cinco años: estudio preliminar / The emergency service in a third level hospital: its benavior during five years: a preliminary study

Antecedentes: un servicio de urgencias es aquel capaz de proporcionar una atención médica inmediata a las contingencias de un padecimiento que ocurren en forma aguda. Objetivo: mostrar el comportamiento del servicio de urgencias adultos del Hospital Regional General Ignacio Zaragoza de enero de 1989 a diciembre de 1993. Material y métodos: en un estudio observacional, prolectivo y descriptivo se incluyeron todos los adultos que asistieron al servivio de Urgencias del Hospital Regional General Ignacio Zaragoza. Resultados: se atendieron un total de 231,229 pacientes en la consulta de urgencias. El 84 por ciento egresó a su domicilio. Conclusión ocho de cada diez admisiones al servicio de urgencias pudieron haber sido sustituidas por otras alternativas de atención médica

Satisfacción de los usuarios del consultorio externo de traumatología del Hospital de Primeros Auxilios, 1997

Investigación sobre la satisfacción de los usuarios del consultorio externo de traumatología del Hospital de Primeros Auxilios de Asunción, llevada a cabo entre los meses de enero a febrero del año 1997, en el cual se investiga a través de un cuestionario respecto a la accesibilidad, señalización, confort y trato proporcionado, así como el tiempo de espera y la duración de la consulta médica en el mismo

Estudio de habitos de prescripcion de medicamentos en servicios de salud del hospital de clinicas de La Paz (Bolivia) 1998 / Study of habits of prescription of medicaments in health units of hospital clinics of La Paz (Bolivia) 1998

Tomando en cuenta indicadores planteados por la Organizacion Mundial de la Salud (OMS), se llevo a efecto en el primer semestre de 1998, el presente estudio, en 12 diferentes servicios del Hospital de clinicas - Universitario de la ciudad de La Paz (Bolivia), recolectandose un total de 1308 recetas. La totalidad de estas recetas fueron escrutadas. Los prescriptores de estas recetas fueron profesionales medicos, trabajadores y estudiantes internos, en el mencionado Hospital. En ellas se estudio el numero, el promedio, y la proporcion de prescripciones conteniendo antibioticos, analgesicos, solucioes parenterales, formas inyectables, proporcion de farmacos considerados sin efecto terapeutico demostrable, prescripcion de farmacos de dispensacion controlada, proporcion de antidiarreicos, prescripcion bajo nombre generico o comercial, grado de cumplimiento de requisitos legales de prescripcion, claridad de las instrucciones y otros datos inherentes a medicamentos prescritos por receta. Los resusltados se ofrecen a consideracion del lector, junto a algunas conclusiones y recomendaciones generales. algunos de los indicadores encontrados en el estudio demuestran que un alto porcentaje del universo estudiado, no cumple con requisitos legales vigentes, los cuales permiten despejar al paciente interrogantes tales como, que medicamento le estan prescibiendo, identificacion, procedencia y responsable de la prescripcion, etc. El estudio demuestra que el 70.6 por ciento (923) de 1308 recetas prescritas no lleva identificacion del profesional o el numero de la matricula o de registro profesional. Solo el 29.4 por ciento (385) tenia identificacion con el nombre o matricula profesional de quienes prescribieron, asumiendo que hay una falta de conocimiento del personal de salud de las normas vigentes, o una gran mayoria no quiere asumir responsabilidad por la prescripcion que realizo