Subject(s)
Acute Coronary Syndrome/therapy , Adrenergic beta-Antagonists/therapeutic use , Myocardial Revascularization , Acute Coronary Syndrome/diagnosis , Acute Coronary Syndrome/mortality , Acute Coronary Syndrome/physiopathology , Adrenergic beta-Antagonists/adverse effects , Aged , Female , Humans , Male , Middle Aged , Myocardial Revascularization/adverse effects , Myocardial Revascularization/mortality , Prospective Studies , Registries , Risk Factors , Time Factors , Treatment OutcomeABSTRACT
Desde agosto del año 2008 el Servicio de Farmacia del Hospital El Cruce cuenta con una Unidad Centralizada de Reconstitución de Citostáticos (UCRC). Los objetivos del presente son, describir las tareas realizadas por la Unidad de Reconstitución de Citostáticos, y analizar su producción. Estudio descriptivo retrospectivo. Se incluyeron todas las tareas realizadas y la producción global de la UCRC desde agosto de 2008 a agosto de 2010. Se utilizaron para la recolección de la información, la base de datos de intervenciones farmacéuticas, los registros informáticos de órdenes de elaboración y las prescripciones médicas.Con el presente trabajo se pudo demostrar la responsabilidad asumida por el servicio de Farmacia frente a, la farmacoterapia del paciente oncológico. Compromiso que se refleja en la intervención farmacéutica y su registro, y que da como resultado una mejora en la calidad de atención y seguridad del paciente. El manejo de medicamentos citostáticos. Por medio de la centralización de los procesos relacionados con este tipo de medicamentos se disminuye la exposición del personal a los posibles riesgos en la salud, y se trabaja en un área específica, con el equipamiento adecuado y personal protegido y entrenado. La creciente demanda de estos medicamentos en nuestro hospital demostrado por la respuesta que brinda el Servicio de Farmacia.
Subject(s)
Pharmacists , Pharmacy Administration , Pharmaceutical Services , Health Personnel , Comprehensive Health Care , Cytostatic Agents , Electronic Health RecordsABSTRACT
BACKGROUND AND PURPOSE: It is unsettled whether stroke-associated infection (SAI) is an independent prognostic factor, and a recent clinical trial failed to show that antibiotic prophylaxis prevented SAI. Contrarily, this trial suggested that antibiotic prophylaxis impaired clinical recovery. We sought to evaluate the predisposing factors and clinical consequences of SAI to gather additional insight on the need of exploring other antibiotics in acute stroke. METHODS: Between March 2001 and April 2002, 229 consecutive patients were admitted into the neurological wards within 24 hours of stroke onset. Demographics, risk factors, National Institutes of Health Stroke Scale (NIHSS) score, vital data, imaging, and laboratory findings were prospectively evaluated. SAI was treated as early as possible. Multivariate regression analyses assessed predisposing factors of SAI and the independent association between SAI and poor stroke outcome at day 7 (Rankin >2). RESULTS: Sixty (26%) patients developed SAI, most frequently chest infections, and within 3 days of stroke onset. Tube feeding (odds ratio [OR], 3.2; 95% CI, 1.3, 7.8) was the strongest predisposing factor of SAI. Poor outcome at hospital discharge was associated to baseline NIHSS score (OR, 10.0; 95% CI, 1.5, 100) and tube feeding (OR, 16.6; 95% CI, 2.9, 100.0), adjusted for confounders including antibiotic use. SAI was not independently associated to poor outcome (OR, 0.9; 95% CI, 0.9, 1.0). CONCLUSIONS: SAI is a marker of the severity of stroke without an independent outcome effect when it is promptly treated. These results support current stroke guidelines that advise prompt treatment of infection and warn against antibiotic prophylaxis. Yet, these recommendations should not prevent the performance of acute stroke trials assessing the value of antibiotics with acknowledged neuroprotective properties.
