Estudio piloto de seguridad y eficacia descongestiva del ácido hialurónico al 0.2% / Pilot study of safety and decongestant efficacy of 0.2% hyaluronic acid

Introducción: Los síntomas de congestión nasal tienen una influencia negativa en la calidad de vida de los pacientes. Los tratamientos disponibles son parcialmente eficaces, por lo que es deseable el desarrollo de productos que ayuden a aliviar estos síntomas. El objetivo de este estudio fue investigar la efectividad y la tolerabilidad de un inhalador con ácido hialurónico en niños. Material y métodos: Se llevó a cabo un estudio piloto, prospectivo, multicéntrico, no comparativo, con un inhalador con ácido hialurónico al 0,2%, en niños de 2-11 años de edad que presentaban congestión nasal. El inhalador se administró durante 7 días, con dos visitas, una de inicio (día 0) y otra final (día 7), y un registro domiciliario diario de los síntomas. Se evaluaron la efectividad, la tolerabilidad, la facilidad de uso y la satisfacción de los usuarios. Resultados: El estudio se realizó en 99 pacientes. Se observaron mejoras estadísticamente significativas (p <0,001) entre la visita inicial y la final, así como en las valoraciones al tercer y sexto días, en cuanto a congestión nasal, dificultad para respirar por la nariz, moqueo, respiración bucal de día y de noche y dificultad para dormir, comer y realizar una actividad física. La satisfacción de los usuarios e investigadores fue mayor del 80%. Conclusiones: El inhalador con ácido hialurónico tuvo gran efectividad y buena tolerabilidad en niños con síntomas de congestión nasal, y fue valorado muy positivamente por parte de los investigadores, los padres y los niños mayores de 8 años

Background: Persistent congestive nasal symptoms have a negative influence on patients' quality of life, daily activities and sleep. The current available treatments are partly effective, and it would be desirable to develop products which help to relieve these symptoms. The purpose of this study was to research into the effectiveness and safety of a nasal spray with hyaluronic acid in children. Methods: This was a pilot, prospective, multicentric, uncontrolled study with a 0.2% hyaluronic acid nasal spray, tested in children aged from 2 to 11 with nasal congestion. The spray was used for 7 days, with two visits, basal (day 0) and final (day 7), and a daily record of symptoms by parents. Effectiveness, safety, ease of use and users’ satisfaction were assessed. Results: 99 patients were included. Statistically significant improvements (p <0.001) were observed in the parameters studied between basal and final visits, and at the third and sixth day: nasal congestion, difficulty in breathing through the nose, runny nose, breathing through the mouth during the day and during the night, and difficulty in sleeping, eating and performing physical activities. Satisfaction of users and researchers was greater than 80%. Conclusions: The nasal spray with hyaluronic acid had high effectiveness and safety in children with nasal congestion symptoms, and was evaluated very positively by researchers, parents and children older than 8

Calidad del registro de quimioterapia en los servicios de farmacia hospitalaria de Andalucía / Chemotherapy registry quality in Andalusian hospital pharmacy departments

Objetivo: Analizar la calidad de los registros de las unidadescentralizadas de citostáticos de los hospitales de Andalucía y la disponibilidadde datos para analizar la utilización de estos fármacos.Método: Se elaboró un cuestionario ad hoc, usando variablesrelativas a la cobertura de información sobre pacientes y tratamientos,grado de informatización y organización. Los cuestionarios secumplimentaron en septiembre de 2005 mediante encuesta al responsablede los tratamientos quimioterápicos de los 19 servicios defarmacia de los hospitales que tratan pacientes oncológicos enAndalucía.Resultados: La tasa de respuesta fue del 100%, aunque un serviciono contaba con unidad centralizada de citostáticos. La coberturade preparación centralizada fue del 89% para hospital de día, el84% para pacientes ingresados, el 79% para pacientes hematológicosy el 69% para pacientes pediátricos. El registro está informatizadosólo en 13 hospitales (68%), con una gran variabilidad en losprogramas usados. La dispensación de temozolamida y de capecitabinacuenta con registro propio en el 68 y 42% de los casos. El nombredel paciente y el nombre y la dosis del citostático son los únicosdatos que se registran en todos, mientras que el nombre del protocolosólo se registra en el 47%, el diagnóstico, estadiaje y clasificaciónTNM en el 58, 31 y 16% respectivamente.Conclusiones: Existe una gran variabilidad en los sistemas deinformación para la gestión de uso de citostáticos, y carenciasimportantes en la disponibilidad de datos del paciente para realizarestudios de utilización y adecuación de la prescripción

Objective: To analyze registry quality in centralized cytostatictherapy units in Andalusian hospitals, and the availability of datato analyze the use of these drugs.Method: An ad hoc questionnaire was designed using variablesrelated to information coverage on patients and their treatments,data processing extent, and organization. Questionnaireswere completed in September 2005 by surveying people responsiblefor chemotherapy in all 19 pharmacy departments inAndalusian hospitals that treat oncologic patients.Results: Response rate was 100%, but one department hadno centralized cytostatic therapy unit. Centralized preparationcoverage was 89% for the day hospital, 84% for inpatients, 79%for hematologic patients, and 69% for pediatric patients. Registriesare computerized in only 13 hospitals (68%) with a varietyof software programs. Temozolamide and capecitabine dispensationhas a separate registry in 68% and 42% of cases, respectively.Patient name, and cytostatic name and dosage are the onlydata recorded in all instances, while protocol name is only recordedin 47%, and diagnosis, staging, and TNM categorization in58%, 31%, and 16% of cases, respectively.Conclusions: There is great variability regarding informationsystems for cytostatic use management, and a relevant shortage ofpatient data available for prescription use and adaptation studies

[Chemotherapy registry quality in Andalusian hospital pharmacy departments]. / Original breve Calidad del registro de quimioterapia en los servicios de farmacia hospitalaria de Andalucía.

OBJECTIVE: To analyze registry quality in centralized cytostatic therapy units in Andalusian hospitals, and the availability of data to analyze the use of these drugs. METHOD: An ad hoc questionnaire was designed using variables related to information coverage on patients and their treatments, data processing extent, and organization. Questionnaires were completed in September 2005 by surveying people responsible for chemotherapy in all 19 pharmacy departments in Andalusian hospitals that treat oncologic patients. RESULTS: Response rate was 100%, but one department had no centralized cytostatic therapy unit. Centralized preparation coverage was 89% for the day hospital, 84% for inpatients, 79% for hematologic patients, and 69% for pediatric patients. Registries are computerized in only 13 hospitals (68%) with a variety of software programs. Temozolamide and capecitabine dispensation has a separate registry in 68% and 42% of cases, respectively. Patient name, and cytostatic name and dosage are the only data recorded in all instances, while protocol name is only recorded in 47%, and diagnosis, staging, and TNM categorization in 58%, 31%, and 16% of cases, respectively. CONCLUSIONS: There is great variability regarding information systems for cytostatic use management, and a relevant shortage of patient data available for prescription use and adaptation studies.

[Breast feeding: knowledge, attitudes and sociocultural ambiguity]. / Lactancia materna: conocimientos, actitudes y ambigüedad sociocultural.

OBJECTIVES: Found sociocultural attitude with regard to breast-feeding (BF) between the sanitary (SP) and no sanitary personnel (NSP) of health centers. DESIGN: Descriptive, cross-sectional study. SETTING: 4 health centres and 3 hospitals of Valencia. PARTICIPANTS: 442 workers of these centres. INTERVENTION: Structured questionnaire. MAIN RESULTS: 88% of SP and 76% of NSP (p < 0.05) believed that BF has many advantages comparing with artificial-feeding in a developed country. SP said more advantages of BF than NSP (p < 0.0001). Most renowned advantages were immunological, affective relationship and comfort. Main inconveniences were dependence, work reasons, aesthetic nature and insecurity in the ingested amount. 56% of SP and 86% of NSP (p < 0.0001) believed milk's analysis necessary. 56% women and 38% men (p < 0.001) didn't see correct give BF in public. Men were more concerned than women (p < 0.05) for local problems of chest, aesthetic results, milk's quality and transmission of illnesses. CONCLUSIONS: It's necessary to support knowledge and re-evaluating the trust in the nutritious capacity of maternal milk between the personnel of health centers and hospitals. Generic ambiguity toward functions of feminine breast exists and public'BF isn't acceptable. It's necessary recover socioculturally the image of BF and keep in mind the existent ambiguity upon designing campaigns of promotion.

[Health examination of children from the Democratic Sahara Republic (North West Africa) on vacation in Spain]. / Examen de salud de niños de la República Arabe Saharaui Democrática (noroeste de Africa) de vacaciones en España.

OBJECTIVE: We present results of a global health evaluation of groups of children from the Democratic Sahara Republic who came to Spain for vacation. PATIENTS AND METHODS: Clinical and analytical tests of 242 Sahara children from refugee camps in Tindouf (Algeria) that were adopted temporarily by Spanish families between July 1993 and July 1997 are reported. We have used standard groups graphics from the World Health Organization. RESULTS: The results were as follows: sex, 53% girls; mean age, 11.1 +/- 1.6 years and age range, 7-16 years (mode 11). Sixty percent of the children had a weight lower than the 10th percentile and 28% less than the 3rd percentile. Fifty-one percent of the children had a height lower than the 10th percentile and 32% less than the 3rd percentile. The corporal mass was lower than the 10th percentile in 19% and less than the 3rd percentile in 8%. The mean hemoglobin was 12.7 +/- 1.2 gr/dl (17% Hb < 12), iron 66 +/- 32 micrograms/dl (23% Fe < 40), and ferritin 28 +/- 24 ngr/ml (26% Fe < 12). Between 1 and 3 intestinal parasites were found in 75% of the children. Isolated were: Entamoeba coli (38%), Blastocystis hominis (22%), Lamblia (18%), Endolimax nana (17%), Hymenolepis nana (11%), and Oxiuros (5%). Sixteen percent of the children had dental caries and 54% dental malocclusion. Ophthalmological problems were found in 28%, generally myopia. Mantoux > 9 mm was found in 5%. Other pathologies included: 5 kyphoscoliosis, 2 cardiopathies, 2 poliomyelitis sequels, 1 gastric ulcer, 1 epilepsy, 1 spherocytosis and 1 euthyroid goiter. Those with weight in p < 3 and/or functional murmur had Hb < 12 in 61% of the cases and Fe < 40 in 48%. CONCLUSIONS: Anamnesis is difficult because of ignorance of the pathological antecedents and date of birth. For physical exploration and collection of parasites they were extremely modest. Feeding and conditions of life would explain low weight and height percentiles, ferropenic anemia and intestinal parasite rates. It would be better to give anti-parasite drugs and systematic ferroprofilaxis as routine and perform blood tests only in those with weight p < 3.

[Medical responsibilities concerning maternal breast-feeding]. / Los cargos sanitarios ante la lactancia materna.

OBJECTIVE: The objective of this study was to determine the knowledge of high ranking officers in Servei-Valencià-Salut (SVS) about breast-feeding (BF) and national and international regulation related to it, in addition to determining what sanitary policies were undertaken by them to promote BF. PATIENTS AND METHODS: A survey was sent by mail to all high ranking officers (HO) of SVS and all pediatric chief staff services (PC) in our community. To analyze data between both groups a Chi square test and odds ratio in the qualitative variables and variance in the quantitative. RESULTS: Of the surveys sent, 100% were answered by the PC and 44% the HO. Breast-feeding was ranked as superior to artificial feeding by 100% of PC and 73% of HO (p < 0.05). Both groups believed in the necessity of carrying out policies to promote BF in developed countries. Only two PC seemed to know the 1981 OMS's code. All PC carried out policies of BF promotion in their area of influence, while in the HO the percentages varied from 64% to 0% according to their position in the health service organization. CONCLUSIONS: It is necessary to spread the knowledge of and to apply the OMS/UNICEF normatives and to involve al HO with real decision-making power in the development of sanitary policies.