Treatment of acute myelogenous leukemia in a Mexican pediatric hospital.

Acute leukemia is the most common malignancy in children, and accounts for nearly 35% of all childhood cancers. Acute myelogenous leukemia (AML) constitutes about 20% of acute leukemias. Initially, treatment of AML involves the immediate management of emergencies associated as hyperleukocytosis, tumor lysis syndrome, hemorrhages and infections. Therefore we performed a retrospective, descriptive and transversal study to investigate the drugs used in patients with AML who were admitted at the Hospital del Niño DIF from 2007 to 2008. Data were collected from hospital. The data included demographic, clinical data and drug usage. A total of 13 patients (12 male and 1 female) were included (prevalence of 16.5% among all cancers in the hospital). The mean age of patients was 6.2 +/- 4.6 years. The mortality rate was 30.8%. Twelve different drugs were given to the patients (10 antineoplastic agents, ondansetron and folinic acid). The median number of drugs/inpatient was 5.4 (range 3-9). Four-hundred thirty-one doses of antineoplastic drugs were administered in 409 sessions. The most used were cytarabine (55.9 %), followed by doxorubicin (7.2 %) and vincristine (6.7 %). Three-hundred twenty-four doses of ondansetron were administered in 409 sessions. We conclude that AML is common in our hospital with a high mortality rate. Also, the antineoplastic agent most used was the pyrimidine analogue cytarabine.

Prevalence and treatment of persistent pulmonary hypertension in the newborn in a Mexican pediatric hospital.

Persistent pulmonary hypertension of the newborn is defined as the failure of the normal circulatory transition that occurs after birth. It is a syndrome characterized by marked pulmonary hypertension that causes hypoxemia and right-to-left extra-pulmonary shunting of blood. In the treatment of persistent pulmonary hypertension of the newborn, the goal is to increase oxygen flow to the baby's organs to prevent serious health problems. Treatment may include medication, mechanical ventilation and respiratory therapy. We performed a retrospective, descriptive and transversal study to investigate the prevalence and treatment of neonatal patients with persistent pulmonary hypertension who were admitted at the Hospital del Niño DIF from 2004 to 2008. Data, collected from hospital charts, included demographic, clinical course and use of medication. A total of 38 patients were included (prevalence of 5.7%). The average age of patients was 8.4 +/- 1.4 days. The mortality rate was 42.1%. Data were collected and 45 different drugs were given to the pediatric patients. The median number of drugs/inpatient was 8.3 (1-18). The therapeutic class most prescribed was anti-infective (29.9% of all the prescriptions), followed by cardiovascular and renal drugs (26.4% of all the prescriptions) and gastrointestinal agents (14.6% of all the prescriptions). Ranitidine was the drug most commonly used, followed by ampicillin and midazolam. We found a high mortality rate and as in many studies, the therapeutic class most used were anti-infectives.

Medication use during hemodialysis in children with end-stage renal disease in a Mexican pediatric hospital.

Chronic renal failure requiring dialysis or transplantation is known as end-stage renal disease. Several drugs are used to treating the symptoms, co-morbid conditions and treatment side effects of end-stage renal disease. We investigated drug treatment during the period of hemodialysis in children with end-stage renal disease in the Hospital del Niño DIF, Pachuca, Hidalgo, Mexico. Data were collected from hospital records. The data included demographic, clinical data and those on drug usage. A total of 13 patients were included. The average age of patients was 14.2 +/- 2.1 years. Eighteen different medications were administered; the mean number of drugs during the period of hemodialysis was 1.3 +/- 0.6 (range 1-4). Two-hundred sixteen doses of medication were administered in 130 hemodialysis sessions. The drugs most used were erythropoietin (42.7 %), followed by dextrose solution (18.9 %), calcium gluconate (10.4 %), iron dextran (9.1%) and nifedipine (5.5 %). Medications may be used to help control some of the issues associated with kidney failure or hemodialysis. Our study showed that few drugs are administered to children with ESRD during their period of hemodialysis.

Drug utilization in intensive care units in a pediatric hospital.

The main objective of the present study was to investigate the use of drugs in the pediatric intensive care units (PICUs) at a pediatric hospital. Data were equally collected from charts of PICUs of the Hospital del Niño DIF, Pachuca, Hidalgo, Mexico in 2007. The data included demographic, clinical data and those on drugs usage. A total of 45 patients were included at the study, all (100%) of whom received one or more drugs. Data were collected and 57 different drugs were given to the pediatric patients. The median number of drugs/inpatient was 6.9 (1-17). The therapeutic class most prescribed was anti- infective (30.6 % of all the prescriptions), followed by electrolytes (13.3 % of all the prescriptions) and gastrointestinal agents (12.9 % of all the prescriptions). KCI was the drug most commonly used (64.4 % of all the patients) followed by ranitidine and amikacin (both with 51.1 % of all the patients). As in many studies, the therapeutic class most used was the anti-infectives. Substantial variation exists in hospitalists' reported management of common pediatric conditions. To decrease undesirable variation in care, a stronger evidence base for inpatient pediatric care must be built.