ABSTRACT
We present a case of a man diagnosed with systemic lupus erythematosus, associated antiphospholipid syndrome and Evans syndrome, who developed a severe thrombocytopenia refractory to treatment with first-line drugs, cyclophosphamide and rituximab, and who responded to romiplostim with a normalization of the platelet recount, which later enabled a therapeutic splenectomy to be performed.
Subject(s)
Anemia, Hemolytic, Autoimmune/complications , Anemia, Hemolytic, Autoimmune/drug therapy , Receptors, Fc/therapeutic use , Recombinant Fusion Proteins/therapeutic use , Thrombocytopenia/drug therapy , Thrombocytopenia/etiology , Thrombopoietin/therapeutic use , Adult , Anemia, Hemolytic, Autoimmune/blood , Anemia, Hemolytic, Autoimmune/surgery , Antibodies, Monoclonal, Murine-Derived/therapeutic use , Antiphospholipid Syndrome/complications , Antiphospholipid Syndrome/drug therapy , Cyclophosphamide/therapeutic use , Humans , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/drug therapy , Male , Platelet Count , Rituximab , Splenectomy , Thrombocytopenia/blood , Thrombocytopenia/complications , Thrombocytopenia/surgeryABSTRACT
No disponible
Subject(s)
Male , Adult , Humans , Stroke/etiology , Myxoma/diagnosis , Heart Neoplasms/diagnosisABSTRACT
No disponible
Subject(s)
Humans , Spain , Hospitalization , Length of Stay , Health Services MisuseABSTRACT
No disponible
Subject(s)
Humans , Outcome Assessment, Health Care , Patient Readmission , SpainABSTRACT
No disponible
Subject(s)
Humans , Spain , Time Factors , Muscular Diseases , Patient Admission , Postoperative Complications , Creatine Kinase , Hypothyroidism , Emergency Service, HospitalABSTRACT
No disponible
Subject(s)
Humans , Hospital Departments , Internal Medicine , Process Assessment, Health Care , Patient AdmissionABSTRACT
BACKGROUND: Study about the admissions appropriateness in the Internal Medicine ward of Hospital Juan Ramón Jiménez. MATERIAL AND METHODS: Retrospective review of the admissions in the first three months of 1997 not coming from any other ward. Two physicians not responsible of the admission evaluated separately the medical records by using the Appropriateness Evaluation Protocol. 201 patients were selected randomly from the 518 admissions which accomplished the criteria formerly exposed. RESULTS: 13.4% of the admissions did not fulfill any criteria of the Appropriateness Evaluation Protocol. The most frequent inadequate admission cause was for diagnostic purposes (66%). No significative difference was found in the percentage of inappropriate admissions with respect to age, gender, days of stay and number of previous admissions. CONCLUSIONS: The percentage of inappropriate admissions was slightly lower than that of similar studies carried out in similar conditions, probably because of the possibility of moving the patient to lower levels of care units according their needs.
Subject(s)
Internal Medicine , Patient Admission , Adolescent , Adult , Aged , Aged, 80 and over , Female , Hospital Departments , Humans , Length of Stay , Male , Middle Aged , Regional Health Planning , Retrospective Studies , SpainABSTRACT
Fundamento: Estudio de la adecuación de los ingresos en el Servicio de Medicina Interna del Hospital Juan Ramón Jiménez. Material y Métodos: Revisión retrospectiva de los ingresos durante el primer trimestre de 1997 no provenientes de otro servicio. Se estudiaron 201 pacientes, seleccionados aleatoriamente de entre los 518 ingresos que cumplían los requisitos expuestos aplicándoles la escala AEP (Appropiateness Evaluation Protocol). Resultados: El 13,4% de los ingresos realizados no cumplía ningún criterio de adecuación del Protocolo AEP. El motivo más frecuente de ingreso inadecuado fue completar estudio (66,7%). No se encontró diferencia significativa en el porcentaje de ingresos inapropiados con respecto a edad, género, tiempo de estancia, y multingreso-no multingreso. Conclusiones: El porcentaje de ingresos inadecuados fue ligeramente inferior al de otros estudios realizados a nivel similar, probablemente debido a la posibilidad de traslado de enfermos a unidades de menor nivel asistencial, de acuerdo con sus necesidades (AU)