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1.
Rev. clín. esp. (Ed. impr.) ; 222(6): 332-338, jun.- jul. 2022. tab
Article in Spanish | IBECS | ID: ibc-219144

ABSTRACT

Objetivo Describir las características y los factores pronósticos a corto plazo de los pacientes con estancia prolongada en Medicina Interna. Material y métodos Estudio retrospectivo de una serie de casos que incluyó pacientes ingresados en un servicio de Medicina Interna de un hospital universitario con tiempos de estancia mayor de 30 días durante cinco años. La información se obtuvo del Conjunto Mínimo Básico de Datos. Las variables de resultado fueron tiempo de estancia muy prolongada, mortalidad intrahospitalaria y resultados adversos en los primeros 30 días tras el alta. Resultados De un total de 11.948 pacientes, 335 (2,8%) tuvieron una estancia prolongada. El tiempo total de estancia fue de 15.271 días (15% del total de tiempo de estancia del servicio). La edad media fue de 74,5 (±13,9) años, siendo 180 (53,7%) varones. La mediana de tiempo de estancia fue de 39 (RIC 34-49) días. El ingreso en la Unidad de Cuidados Intensivos (UCI) (OR = 2,5; IC 95% 1,4-4,7; p = 0,003) y recibir una valoración geriátrica (OR = 0,3; IC 95% 0,8-0,9; p = 0,042) fueron factores independientes con efecto en el tiempo de estancia muy prolongado. Un ingreso hospitalario en año previo fue un factor independiente de un resultado adverso a los 30 días tras el alta (OR = 2,2; IC 95% 1,0-4,8). Conclusiones El porcentaje de pacientes con estancias prolongadas es menor de un 3%, pero tienen un alto impacto en la actividad de un servicio de Medicina Interna. Existen factores asociados con el tiempo de estancia muy prolongada y con la presencia de un resultado adverso precoz tras el alta (AU)


Objective To describe the characteristics and short-term prognostic factors of patients with prolonged stay in internal medicine. Material and methods Retrospective case series study including patients admitted to an Internal Medicine service of a university hospital with lengths of stay greater than 30 days during 5 years. Information was obtained from the Minimum Basic Data Set. Outcome variables were a very long length of stay, in-hospital mortality, and adverse outcomes in the first 30 days after discharge. Results Out of 11,948 patients, 335 (2.8%) cases had a prolonged stay. The total length of stay was 15,271 days (15% of the total length of stay of the service). The mean age was 74.5 (±13.9) years, 180 (53.7%) were male. The median length of stay was 39 (RIC 34-49) days. Intensive Care Unit admission (OR = 2.5; 95%CI 1.4-4.7; p = 0.003) and receiving a geriatric assessment (OR = 0.3; 95%CI 0.8-0.9; p = 0.042) were independent factors with an effect on very long length of stay. Having an admission in the previous year was an independent factor for an adverse outcome 30 days after discharge (OR = 2.2; 95%CI 1.0-4.8). Conclusions The percentage of patients with prolonged length of stay is less than 3%, but they have a high impact on the activity of an internal medicine service. There are factors associated with a very long length of stay and with the presence of an early adverse outcome after discharge (AU)


Subject(s)
Humans , Male , Female , Aged , Patient Readmission , Patient Discharge , Retrospective Studies , Length of Stay , Hospital Mortality , Prognosis
2.
Rev Clin Esp (Barc) ; 222(6): 332-338, 2022.
Article in English | MEDLINE | ID: mdl-35599214

ABSTRACT

OBJECTIVE: To describe the characteristics and short-term prognostic factors of patients with prolonged stay in internal medicine. MATERIAL AND METHODS: Retrospective case series study including patients admitted to an Internal Medicine service of a university hospital with lengths of stay greater than 30 days during 5 years. Information was obtained from the Minimum Basic Data Set. Outcome variables were a very long length of stay, in-hospital mortality, and adverse outcomes in the first 30 days after discharge. RESULTS: Out of 11,948 patients, 335 (2.8%) cases had a prolonged stay. The total length of stay was 15,271 days (15% of the total length of stay of the service). The mean age was 74.5 (±13.9) years, 180 (53.7%) were male. The median length of stay was 39 (RIC 34-49) days. Intensive Care Unit admission (OR = 2.5; 95%CI 1.4-4.7; p = 0.003) and receiving a geriatric assessment (OR = 0.3; 95%CI 0.8-0.9; p = 0.042) were independent factors with an effect on very long length of stay. Having an admission in the previous year was an independent factor for an adverse outcome 30 days after discharge (OR = 2.2; 95%CI 1.0-4.8). CONCLUSIONS: The percentage of patients with prolonged length of stay is less than 3%, but they have a high impact on the activity of an internal medicine service. There are factors associated with a very long length of stay and with the presence of an early adverse outcome after discharge.


Subject(s)
Patient Discharge , Patient Readmission , Aged , Female , Hospital Mortality , Humans , Length of Stay , Male , Retrospective Studies
3.
Rev Esp Quimioter ; 32(5): 440-444, 2019 Oct.
Article in Spanish | MEDLINE | ID: mdl-31558009

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate the incidence of new hepatitis C virus (HCV) infections, based on their sexual orientation, human immunodeficiency virus (HIV) status, geographical regions and coinfection with other sexually transmitted diseases (STDs). METHODS: This study was carried out at the Sandoval Health Center, reference clinic of Sexually Transmitted Diseases (STDs) in Madrid. All HCV seronegative individuals who were reanalyzed for this virus were included, between January 2010 and December 2016. RESULTS: A total of 59 new diagnoses of HCV were diagnosed. The proportion of men who have sex with men (MSM) diagnosed with HCV was 37% in 2010 and 75% in 2016 and was even higher in the group of coinfected with HIV/HCV (94%). A total of 67 seroconverters for HCV were detected (1.2%) of which 100% were MSM. The proportion of HCV seroconverters with HIV was 89%. CONCLUSIONS: HCV infection continues to be a current health problem, especially in HIV-positive MSM.


Subject(s)
HIV Infections/epidemiology , Hepatitis C/epidemiology , Sexual Behavior/statistics & numerical data , Adult , Coinfection/epidemiology , Female , HIV Infections/immunology , Hepatitis C/diagnosis , Homosexuality, Male/statistics & numerical data , Humans , Incidence , Male , Retrospective Studies , Sexually Transmitted Diseases/epidemiology , Spain/epidemiology , Transgender Persons/statistics & numerical data
6.
Rev Esp Quimioter ; 19(2): 152-60, 2006 Jun.
Article in English | MEDLINE | ID: mdl-16964333

ABSTRACT

One hundred and forty-seven Salmonella serotype Typhimurium strains isolated in three provinces in the midwest of Spain were studied. Of these, 93.6% were drug resistant. There were two predominant resistance phenotypes: 43 isolates (29.3%) were resistant to amoxicillin, tetracyclines, chloramphenicol, streptomycin and sulphamethoxazole and 27 isolates (18.4%) to amoxicillin, amoxicillin/clavulanic acid, tetracyclines, chloramphenicol, streptomycin and sulphamethoxazole. Randomly amplified polymorphic DNA (RAPD) analysis and pulsed field gel electrophoresis (PFGE) were performed for molecular typing. Thirty-six DNA band profiles were differentiated by RAPD, and 38 by PFGE. We found a high level of clonality; 27% of strains were identical by both methods. There were additional smaller clonal lines within every area. The highest discriminatory power was obtained with PFGE, but the greatest degree of genetic diversity was observed among Salmonella Typhimurium using both RAPD and PFGE.


Subject(s)
Drug Resistance, Bacterial , Salmonella Infections/epidemiology , Salmonella typhimurium/genetics , Humans , Salmonella Infections/microbiology , Salmonella typhimurium/drug effects , Spain/epidemiology
7.
Rev. esp. quimioter ; 19(2): 152-160, jun. 2006. tab, graf
Article in En | IBECS | ID: ibc-047556

ABSTRACT

One hundred and forty-seven Salmonella serotype Typhimurium strains isolated in three provinces in the midwest of Spain were studied. Ofthese, 93.6% were drug resistant. There were two predominant resistance phenotypes: 43 isolates (29.3%) were resistant to amoxicillin, tetracyclines,chloramphenicol, streptomycin and sulphamethoxazole and 27 isolates (18.4%) to amoxicillin, amoxicillin/clavulanic acid, tetracyclines,chloramphenicol, streptomycin and sulphamethoxazole. Randomly amplified polymorphic DNA (RAPD) analysis and pulsed field gelelectrophoresis (PFGE) were performed for molecular typing. Thirty-six DNA band profiles were differentiated by RAPD, and 38 by PFGE. Wefound a high level of clonality; 27% of strains were identical by both methods. There were additional smaller clonal lines within every area.The highest discriminatory power was obtained with PFGE, but the greatest degree of genetic diversity was observed among SalmonellaTyphimurium using both RAPD and PFGE


Se estudiaron 147 de cepas de Salmonella serotipificadas como Typhimurium procedentes de tres provincias españolas del medio-oeste. El93,6% de ellas eran resistentes a los antimicrobianos. Hubo dos fenotipos de resistencia predominantes: 43 cepas (29,3%) fueron resistentesa amoxicilina, tetraciclinas, cloranfenicaol, estreptomicina y sulfametoxazol, y 27 (18,4%) a amoxicilina, amoxicilina-ácido clavulánico, tetraciclinas,cloranfenicol, estreptomicina y sulfametoxazol. Los distintos patrones de resistencia se determinaron por técnicas de biología molecular:RAPD (Randomly Amplified Polymorphic DNA) y PFGE (Pulsed Field Gel Electrophoresis). Por RAPD se diferenciaron 36 patrones debandas, y por PFGE 38. Se encontró una proporción alta de clones: el 27% de las cepas fueron idénticas por ambos métodos. Además, encada área se encontraron algunos clones diferentes adicionales. Con PFGE se obtuvo el mayor poder discriminatorio, pero el mayor gradode diversidad genética se observó usando ambas técnicas conjuntamente


Subject(s)
Humans , Drug Resistance, Bacterial , Salmonella Infections/epidemiology , Salmonella typhimurium/genetics , Salmonella Infections/microbiology , Salmonella typhimurium , Spain/epidemiology
9.
Rev Esp Quimioter ; 17(1): 29-36, 2004 Mar.
Article in Spanish | MEDLINE | ID: mdl-15201921

ABSTRACT

We studied the antibiotic susceptibility of 309 Salmonella isolates obtained from three hospitals serving the provinces of Salamanca, Avila and Zamora in the region of Castilla y Leon (mid-west Spain). The susceptibility to 18 antibiotics was studied using the agar dilution method, according to NCCLS guidelines, and the most common multiresistance phenotypes were determined for each province. We observed clear susceptibility differences between the two main serotypes found, S. enteritidis and S. typhimurium. Seventy percent of S. typhimurium were resistant to amoxicillin. In 44% of these isolates, amoxicillin resistance was associated with resistance to streptomycin, sulfonamides, tetracyclines and chloramphenicol. S. enteritidis was susceptible to most antibiotics tested; amoxicillin resistance was observed in 23.3%, and nalidixic acid resistance in 49.6%. Resistance to nalidixic acid was higher in S. enteritidis than in any other serotypes. According to NCCLS breakpoints, no strain was resistant to fluoroquinolones. However, according to MENSURA criteria, 9% of S. typhimurium isolates were resistant to ciprofloxacin. Resistance to cotrimazole and gentamicin was less than 10% for all the serotypes tested. The results indicate that S. typhimurium showed greater resistance and a high multidrug resistance rate. Conversely, S. enteritidis showed high resistance only to amoxicillin and nalidixic acid, though in most cases there was no correlation between this resistance and reduced susceptibility to fluoroquinolones.


Subject(s)
Anti-Bacterial Agents/pharmacology , Drug Resistance, Bacterial , Salmonella/drug effects , Humans , Spain
12.
Actas Urol Esp ; 26(10): 816-9, 2002.
Article in Spanish | MEDLINE | ID: mdl-12645381

ABSTRACT

The syphilis is a venereal disease of sexual transmission that incidence is increasing in several groups populations. We report a case of a patient with secondary syphilis who consulted for an atypical solid mass to penile. The clinical evolution, histological examination and analytical tests confirmed the diagnosis of genital syphilis having a satisfactory response to specific antibiotic treatment. The epidemiological, clinical, diagnostic aspects and therapeutic of the genital ulcer disease are discussed.


Subject(s)
Penile Diseases , Syphilis , Humans , Male , Middle Aged , Penile Diseases/diagnosis , Penile Diseases/drug therapy , Syphilis/diagnosis , Syphilis/drug therapy
16.
Med. cután. ibero-lat.-am ; 29(3): 180-183, mayo 2001. ilus
Article in Es | IBECS | ID: ibc-3785

ABSTRACT

Describimos el caso de una mujer de raza blanca, VIH positiva, que inició erupción cutánea fotosensible coincidiendo con el deterioro de su situación inmune marcada por la disminución de linfocitos CD4 y elevada carga viral. Su evolución clínica fue paralela a la inmunitaria con importante mejoría después de recibir triple tratamiento antiretroviral. Discutimos los aspectos patogénicos de estas fotoerupciones que pueden suponer un marcador clinico de la infección VIH y su progresión. Comentamos la importancia del control de la radiación ultravioleta y puvaterapia en pacientes VIH positivos (AU)


Subject(s)
Adult , Female , Humans , Acquired Immunodeficiency Syndrome/complications , Exanthema/etiology , Photosensitivity Disorders/etiology , Acquired Immunodeficiency Syndrome/drug therapy , CD4-Positive T-Lymphocytes/metabolism , Clinical Evolution , Antiviral Agents/pharmacology , PUVA Therapy/methods , Exanthema/diagnosis , Exanthema/radiotherapy , Photosensitivity Disorders/diagnosis , Photosensitivity Disorders/radiotherapy , Face , Hand , Forearm , Back
18.
Scand J Infect Dis ; 31(4): 415-6, 1999.
Article in English | MEDLINE | ID: mdl-10528885

ABSTRACT

Candida species other than C. albicans have been implicated as pathogens in intravascular (bloodstream, intravascular devices, endocarditis) and extravascular (arthritis, osteomielitis, endophtalmitis) infections. C. parapsilosis, however, is rarely implicated in intra-abdominal infections (peritonitis during peritoneal dialysis, complicating surgery or solid-organ transplantation). We describe a case of a 48-y-old male with acute pancreatitis who had a pancreatic abscess produced by primary C. parapsilosis infection. Although he received adequate treatment with antifungal medication and surgical drainage, the outcome was fatal. Because the clinical findings are indistinguishable from bacterial abscesses, Candida species should be considered in cases of complicated pancreatitis, in order to establish a prompt adequate treatment.


Subject(s)
Abscess/diagnosis , Candida/isolation & purification , Candidiasis/diagnosis , Pancreatitis/diagnosis , Abscess/therapy , Acute Disease , Antifungal Agents/therapeutic use , Drainage/methods , Fatal Outcome , Humans , Male , Middle Aged , Pancreatitis/therapy
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