ABSTRACT
INTRODUCTION: Varicella (chickenpox) can cause serious complications and admission to hospital. Several countries included the varicella vaccine in their immunization schedules. MATERIAL AND METHODS: A descriptive and retrospective study of hospitalizations due to varicella and its complications was conducted in a referral center from 2005 to 2011. RESULTS: A total of 1192 children with varicella were seen in the emergency room, of which 99 (8.5%) required admission. The annual incidence of admissions due to varicella and varicella complications was, 19.4 and 15.3 cases per 100,000 children under 14 years, respectively. Complications were more common in children under 5 years (79.5%), and with no underlying disease (78.2%). Infection of skin and soft tissue was the most common complication (62%). The mean hospital stay was 4.5 days (SD 4). CONCLUSIONS: Varicella causes high morbidity, and is more frequent in absolute terms in healthy children under 5 years of age. Therefore, routine vaccination recommended by the Immunization Advisory Committee should be mandatory.
Subject(s)
Chickenpox/epidemiology , Patient Admission/statistics & numerical data , Adolescent , Chickenpox/complications , Child , Child, Preschool , Female , Humans , Infant , Male , Retrospective Studies , Tertiary Care CentersABSTRACT
Introducción: Los «medicamentos de alto riesgo» son aquellos con un «riesgo» muy elevado de causar daños graves o incluso mortales cuando se produce un error en el curso de su utilización. El Institute for Safe Medication Practices (ISMP) elaboró una relación aplicable a la población general, sin diferenciar población pediátrica y adulta, por lo que existe carencia de información para la población pediátrica. El objetivo de este trabajo es elaborar una lista de medicamentos de alto riesgo adaptada a la población pediátrica y neonatal que sirva de referencia para el personal sanitario de un hospital pediátrico. Material y métodos: Se realizó una búsqueda bibliográfica en mayo del 2012 en las principales bases de datos biomédicas, para identificar posibles listas o referencias publicadas en relación con medicamentos de alto riesgo en población pediátrica y neonatal. Resultados: Se encontraron 15 trabajos, seleccionándose 9 para el objetivo principal del estudio. Se elaboró una lista guía tomando como base la del ISMP, añadiendo fármacos con alta percepción de riesgo para la población pediátrica y eliminando aquellos cuyo uso en pediatría era anecdótico. Conclusiones: No se encontró una lista publicada que se adaptase totalmente a nuestro objetivo. La lista de medicamentos de alto riesgo en población pediátrica y neonatal elaborada puede ser modelo de referencia para hospitales pediátricos. Su conocimiento y utilización, así como actividades derivadas de la misma enmarcadas dentro de la política de seguridad, ayudará a evitar errores de medicación en cada proceso de la cadena terapéutica (prescripción, transcripción, dispensación y administración) (AU)
Introduction: «High-risk drugs» are those that have a very high «risk» of causing death or serious injury if an error occurs during its use. The Institute for Safe Medication Practices (ISMP) has prepared a high-risk drugs list applicable to the general population (with no differences between the pediatric and adult population). Thus, there is a lack of information for the pediatric population. The main objective of this work is to develop a high-risk drug list adapted to the neonatal or pediatric population as a reference model for the pediatric hospital health workforce. Material and methods: We made a literature search in May 2012 to identify any published lists or references in relation to pediatric and/or neonatal high-risk drugs. Results: A total of 15 studies were found, from which 9 were selected. A model list was developed mainly based on the ISMP one, adding strongly perceived pediatric risk drugs and removing those where the pediatric use was anecdotal. Conclusions: There is no published list that suits pediatric risk management. The list of pediatric and neonatal high-risk drugs presented here could be a «reference list of high-risk drugs » for pediatric hospitals. Using this list and training will help to prevent medication errors in each drug supply chain (prescribing, transcribing, dispensing and administration) (AU)
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Medication Errors/prevention & control , Pharmaceutical Preparations/analysis , Risk Factors , Drug Dosage CalculationsABSTRACT
INTRODUCTION: «High-risk drugs¼ are those that have a very high «risk¼ of causing death or serious injury if an error occurs during its use. The Institute for Safe Medication Practices (ISMP) has prepared a high-risk drugs list applicable to the general population (with no differences between the pediatric and adult population). Thus, there is a lack of information for the pediatric population. The main objective of this work is to develop a high-risk drug list adapted to the neonatal or pediatric population as a reference model for the pediatric hospital health workforce. MATERIAL AND METHODS: We made a literature search in May 2012 to identify any published lists or references in relation to pediatric and/or neonatal high-risk drugs. RESULTS: A total of 15 studies were found, from which 9 were selected. A model list was developed mainly based on the ISMP one, adding strongly perceived pediatric risk drugs and removing those where the pediatric use was anecdotal. CONCLUSIONS: There is no published list that suits pediatric risk management. The list of pediatric and neonatal high-risk drugs presented here could be a «reference list of high-risk drugs ¼ for pediatric hospitals. Using this list and training will help to prevent medication errors in each drug supply chain (prescribing, transcribing, dispensing and administration).
Subject(s)
Formularies as Topic , Prescription Drugs/adverse effects , Child , Humans , Infant, Newborn , Medication Errors/prevention & control , Risk FactorsABSTRACT
OBJECTIVES: To evaluate the effectiveness of a fast track diagnosis and treatment program for colorectal cancer (CRC) in reducing the diagnosis to treatment interval (DTI) and tumor stage. To analyze the association between DTI and tumor stage. METHODS: A quasi-experimental study with a control group was conducted, and 156 incident cases of CRC referred through a preferential pathway between July 2005 and December 2008 in a tertiary hospital were included, after excluding those treated urgently, treated by endoscopic polypectomy only or having periodic colonoscopies. A control group of 156 patients was randomly selected from all the patients referred through habitual pathways, frequency matched by tumor location, age and year of entry. Data was analyzed with multivariate linear and logistic regression. RESULTS: Mean DTI was 39.20 days (95% CI: 36.21-42.42) for fast track patients and 63.40 days (95% CI: 57.08-70.41) for controls (p < 0.001), and this difference persisted after multivariate analysis. The odds of having a DTI longer than 30 days was 4.79 (95% CI: 2.19-10.51) higher for controls. There were no significant differences in tumor stage according to the pathway followed. Independently of the track followed, a DTI longer than 30 days was associated with advanced tumor stages for colon cancer, while it was associated with low stages for rectal cancer. CONCLUSIONS: The PDTR strategy is effective in reducing DTI and may reduce patients' and relatives' anxiety. However, it is far from reaching the DTI recommended. The achieved reduction of the delay has no impact on tumor stage.
Subject(s)
Adenocarcinoma/diagnosis , Adenocarcinoma/surgery , Clinical Protocols , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/surgery , Early Diagnosis , Adenocarcinoma/pathology , Aged , Aged, 80 and over , Biomarkers, Tumor/analysis , Biopsy , Carcinoembryonic Antigen/blood , Colonic Polyps/pathology , Colonic Polyps/surgery , Colonoscopy , Colorectal Neoplasms/pathology , Diagnostic Imaging , Female , Gastrointestinal Hemorrhage/etiology , Hospitals, Urban , Humans , Male , Middle Aged , Neoplasm Staging , Referral and Consultation , Sampling Studies , Time FactorsABSTRACT
Objetivos: evaluar la efectividad de un programa de diagnóstico y tratamiento rápido (PDTR) del cáncer colorrectal (CCR) en la reducción del intervalo diagnóstico-terapéutico (IDT) y el estadio tumoral. Analizar la asociación entre IDT y estadio tumoral. Métodos: estudio cuasiexperimental con grupo control en el que se incluyeron 156 casos incidentes de CCR atendidos por el PDTR entre julio de 2005 y diciembre de 2008 en un hospital de tercer nivel, tras excluir los que requirieron tratamiento urgente, tratados solo por polipectomía endoscópica o con colonoscopías periódicas. Un grupo control de 156 pacientes fue seleccionado al azar de los atendidos por el circuito habitual con la misma localización tumoral, edad y año de ingreso. Para el análisis se utilizó regresión lineal y logística. Resultados: la media del IDT fue de 39,20 días (IC 95%: 36,21-42,42) en los pacientes del programa y de 63,40 días (IC 95%: 57,08-70,41) en el grupo control (p < 0,001); esta diferencia se mantuvo en el análisis multivariado. La probabilidad de un IDT mayor de 30 días fue 4,79 (IC 95%: 2,19-10,51) veces superior en los controles. No se encontraron diferencias significativas en el estadio tumoral según el circuito asistencial. Independientemente del circuito, un IDT > 30 días se asoció con un estadio tumoral avanzado en los tumores de colon, mientras que en los de recto se asoció con estadios precoces. Conclusiones: el PDTR es efectivo reduciendo los tiempos asistenciales y con ello seguramente reduce la angustia de pacientes y familiares. No obstante, está lejos de alcanzar el IDT recomendado. La reducción de la demora conseguida no tiene impacto en el estadio tumoral(AU)
Objectives: to evaluate the effectiveness of a fast track diagnosis and treatment program for colorectal cancer (CRC) in reducing the diagnosis to treatment interval (DTI) and tumor stage. To analyze the association between DTI and tumor stage. Methods: a quasi-experimental study with a control group was conducted, and 156 incident cases of CRC referred through a preferential pathway between July 2005 and December 2008 in a tertiary hospital were included, after excluding those treated urgently, treated by endoscopic polypectomy only or having periodic colonoscopies. A control group of 156 patients was randomly selected from all the patients referred through habitual pathways, frequency matched by tumor location, age and year of entry. Data was analyzed with multivariate linear and logistic regression. Results: mean DTI was 39.20 days (95% CI: 36.21-42.42) for fast track patients and 63.40 days (95% CI: 57.08-70.41) for controls (p < 0.001), and this difference persisted after multivariate analysis. The odds of having a DTI longer than 30 days was 4.79 (95% CI: 2.19-10.51) higher for controls. There were no significant differences in tumor stage according to the pathway followed. Independently of the track followed, a DTI longer than 30 days was associated with advanced tumor stages for colon cancer, while it was associated with low stages for rectal cancer. Conclusions: the PDTR strategy is effective in reducing DTI and may reduce patients and relatives anxiety. However, it is far from reaching the DTI recommended. The achieved reduction of the delay has no impact on tumor stage(AU)
