Reacciones adversas a medicamentos en una unidad quirúrgica de urgencia / Adverse reactions to drugs in a surgical emergency unit

INTRODUCCIÓN: las reacciones adversas a medicamentos en unidades quirúrgicas constituyen un problema de salud poco conocido, por lo que son escasas las investigaciones referentes a este tema.OBJETIVO: caracterizar las reacciones adversas a medicamentos en pacientes operados en la Unidad Quirúrgica de Urgencias del Hospital Militar Central "Dr. Luis Díaz Soto". MÉTODOS: estudio descriptivo, prospectivo y observacional que utilizó métodos de farmacovigilancia activa y pasiva. La muestra fue de los 2 128 pacientes operados durante el 2010, quienes fueron monitoreados diariamente a través de un listado de síndromes orientadores de reacciones adversas y la notificación de los profesionales de la salud. RESULTADOS: de los pacientes operados, 65 (3,05 %) presentaron al menos una reacción adversa a medicamentos, con un índice de aparición del 1,12 %. La mayoría de las notificaciones fueron en pacientes de 45-59 años (40,0 %) y del sexo femenino (69,2 %). Los anestésicos generales y los antimicrobianos aportaron el mayor porcentaje de notificaciones (36,9 % y 18,5 % respectivamente); la cefazolina y la ketamina resultaron los fármacos más notificados con un 13,8 %. La piel fue el sistema de órganos más afectado y el rash cutáneo la manifestación clínica más frecuente (17,8 %). Las reacciones adversas moderadas se presentaron con mayor frecuencia. CONCLUSIONES: se pone de manifiesto la importancia de la vigilancia farmacológica de los medicamentos, en especial en áreas sensibles como las unidades quirúrgicas, donde las reacciones adversas a medicamentos son muy frecuentes.

INTRODUCTION: adverse drug reactions in surgical units constitute a health problem little known, so there is little research concerning this topic. OBJECTIVE: to characterize adverse drug reactions in patients operated on at the Surgical Emergency Unit of "Dr. Luis Díaz Soto" Central Military Hospital. METHODS: a prospective, observational study was conducted using active and passive methods of Drug Safety. The sample consisted of 2128 patients operated in 2010.These patients were monitored daily through a counseling list of syndromes for adverse reactions and by health professional reports. RESULTS: out of the patients operated on, 65 (3.05 %) had at least one adverse drug reaction with a rate of occurrence of 1.12 %. Most reports were in patients aged 45-59 years (40.0 %) and female (69.2 %). the highest rate of reporting was contributed by general anesthetics and antimicrobial (36.9 % and 18.5 % respectively); cefazolin and ketamine were the most reported drugs with 13.8 %. Skin was the most affected organ system and skin rash was the most common clinical manifestation (17.8 %). Moderate adverse reactions occurred more frequently. CONCLUSIONS: the importance of pharmacovigilance is highlighted, especially in sensitive areas such as surgical units, where adverse drug reactions are common.

Reacciones adversas a medicamentos en una unidad quirúrgica de urgencia / Adverse reactions to drugs in a surgical emergency unit

Introducción: las reacciones adversas a medicamentos en unidades quirúrgicas constituyen un problema de salud poco conocido, por lo que son escasas las investigaciones referentes a este tema.Objetivo: caracterizar las reacciones adversas a medicamentos en pacientes operados en la Unidad Quirúrgica de Urgencias del Hospital Militar Central Dr. Luis Díaz Soto. Métodos: estudio descriptivo, prospectivo y observacional que utilizó métodos de farmacovigilancia activa y pasiva. La muestra fue de los 2 128 pacientes operados durante el 2010, quienes fueron monitoreados diariamente a través de un listado de síndromes orientadores de reacciones adversas y la notificación de los profesionales de la salud. Resultados: de los pacientes operados, 65 (3,05 por ciento) presentaron al menos una reacción adversa a medicamentos, con un índice de aparición del 1,12 por ciento. La mayoría de las notificaciones fueron en pacientes de 45-59 años (40,0 por ciento) y del sexo femenino (69,2 por ciento). Los anestésicos generales y los antimicrobianos aportaron el mayor porcentaje de notificaciones (36,9 por ciento y 18,5 por ciento respectivamente); la cefazolina y la ketamina resultaron los fármacos más notificados con un 13,8 por ciento. La piel fue el sistema de órganos más afectado y el rash cutáneo la manifestación clínica más frecuente (17,8 por ciento). Las reacciones adversas moderadas se presentaron con mayor frecuencia. Conclusiones: se pone de manifiesto la importancia de la vigilancia farmacológica de los medicamentos, en especial en áreas sensibles como las unidades quirúrgicas, donde las reacciones adversas a medicamentos son muy frecuentes(AU)

Introduction: adverse drug reactions in surgical units constitute a health problem little known, so there is little research concerning this topic. Objective: to characterize adverse drug reactions in patients operated on at the Surgical Emergency Unit of Dr. Luis D¦az Soto Central Military Hospital. Methods: a prospective, observational study was conducted using active and passive methods of Drug Safety. The sample consisted of 2128 patients operated in 2010.These patients were monitored daily through a counseling list of syndromes for adverse reactions and by health professional reports. Results: out of the patients operated on, 65 (3.05 percent) had at least one adverse drug reaction with a rate of occurrence of 1.12 percent. Most reports were in patients aged 45-59 years (40.0 percent) and female (69.2 percent). the highest rate of reporting was contributed by general anesthetics and antimicrobial (36.9 percent and 18.5 percent respectively); cefazolin and ketamine were the most reported drugs with 13.8 percent. Skin was the most affected organ system and skin rash was the most common clinical manifestation (17.8 percent). Moderate adverse reactions occurred more frequently. Conclusions: the importance of pharmacovigilance is highlighted, especially in sensitive areas such as surgical units, where adverse drug reactions are common(AU)

Empathy and child neglect: a theoretical model.

OBJECTIVE: To present an explanatory theory-based model of child neglect. This model does not address neglectful behaviors of parents with mental retardation, alcohol or drug abuse, or severe mental health problems. In this model parental behavior aimed to satisfy a child's need is considered a helping behavior and, as a consequence, child neglect is considered as a specific type of non-helping behavior. HYPOTHESIS: The central hypothesis of the theoretical model presented here suggests that neglectful parents cannot develop the helping response set to care for their children because the observation of a child's signal of need does not lead to the experience of emotions that motivate helping or because the parents experience these emotions, but specific cognitions modify the motivation to help. IMPLICATIONS: The present theoretical model suggests that different typologies of neglectful parents could be developed based on different reasons that parents might not to experience emotions that motivate helping behaviors. The model can be helpful to promote new empirical studies about the etiology of different groups of neglectful families.

Dispositional empathy in neglectful mothers and mothers at high risk for child physical abuse.

This study investigates whether mothers who are neglectful and at high risk for child physical abuse present a deficit in empathy. Participants were neglectful mothers (n=37), mothers at high risk for child physical abuse (n=22), and nonmaltreating mothers (n=37). The Interpersonal Reactivity Index, a self-report measure assessing specific dimensions of empathy, was used to assess dispositional empathy. No differences between neglectful and non-neglectful mothers were found for perspective taking, empathic concern, and personal distress. High-risk mothers reported less perspective taking and more personal distress than nonmaltreating mothers. No difference between groups was found for empathic concern. The present study supported the hypothesis that parents at high risk for child physical abuse show a deficit in particular aspects of dispositional empathy: personal distress and perspective taking. However, no differences were found between neglectful and nonmaltreating mothers in any dimension of dispositional empathy.