Analyzing complications and implementing solutions in a pediatric inguinal hernia cooperation program in Equatorial Guinea: a prospective cohort study.

Background: Few studies have evaluated the efficacy of short-term medical missions. This study was aimed to evaluate complication rates and determine the effects of protocol changes in a pediatric inguinal hernia campaign in Equatorial Guinea and analyze post-operative follow-up capacity. Methods: In this prospective observational cohort study, we evaluated two patient cohorts (group A, 2017-2018; group B, 2019) treated during campaigns in Equatorial Guinea for congenital inguinal pathology (hernia, hydrocele, and cryptorchidism). Patients aged < 18 years treated in referral campaigns were included. Complications occurring up to 6 months post-operatively were evaluated. Two stages were defined: Stage 1, wherein, complication rate in group A was compared to that in a control group from a tertiary hospital in Spain (with a case-control ratio of 1:2, paired according to age, sex and diagnosis); stage 2, wherein, complication rates between groups A and B were compared. Group B received a single dose of prophylactic amoxicillin-clavulanic acid. Follow-up capacity was assessed through follow-up appointments. Results: In stage 1, complication and surgical site infection (SSI) rates were 21.3% and 7.4% in group A (n = 94), and 5.8% (p < 0.001) and 0.5% (p = 0.012) in the control group, respectively. Group A had 20.2% loss-to-follow-up. In group B (n = 62), 6-month postoperative follow-up could not be assessed owing to restrictions due to the COVID-19 pandemic, so only early complications were considered in stage 2, were complication and surgical site infection rates were 18.1% and 7.4% in group A and 11.3% (p = 0.350) and 1.6% (p = 0.150) in group B. Conclusion: Our results showed higher than expected complication rates. Pre-operative prophylactic antibiotic could not show to reduce SSI. Further studies are needed to reduce complication rates in these campaigns. Patient loss-to-follow-up ratio warrants considering new strategies.

Mejora de la calidad de vida de pacientes con dolor crónico no oncológico por el seguimiento farmacoterapéutico desde la farmacia comunitaria / No disponible

No disponible

[Trend in platelet antiaggregants utilization in the autonomous community of Valencia, Spain (2000-2005)]. / Tendencia en la utilización de antiagregantes en la comunidad Valenciana (2000-2005).

BACKGROUND: Platelet antiaggregants are basic drugs for preventing ischemic arterial diseases. This study is aimed at ascertaining the trend in their use in Primary Care in the Autonomous Community of Valencia during the 2000-2005 period. METHODS: Descriptive study of the use of platelet antiaggregants (ATC code: B01AC) dispensed charged to the National Health System in the Autonomous Community of Valencia in Primary Care. Data given in defined daily doses (DDD) per 1000 inhabitants per day. RESULTS: In 2005, three drugs totalled 98% of all those prescribed overall (acetyl salicylicacid (ASA) 66%, clopidogrel 23% and triflusal 9%). Oral antiaggregant use rose by 23% within the 2000-2005 period (from 29.6 to 36.5 DDD/1000 inhab./day). Clopidogrel showed a 218% increase, whilst ASA was the most used drug, with quite a stable percentage of use throughout said time period (nearing 70%). The expense generated by this group of drugs doubled, clopidogrel having been the highest-cost drug/DDD (2.14 EUROS), its use having totalled 23% of all antiaggregants yet the expense thereof having totalled 76% of the total expenditure. CONCLUSIONS: The use of antiaggregants increased in the Autonomous Community of Valencia during the time period under study. The utilization of ASA remained stable, whilst clopidogrel increased its market share despite the treatment guide recommendations and the restrictions on its use. The consumption of clopidogrel noticeably contributed to the drug spending for this group.

Tendencia en la utilización de antiagregantes en la Comunidad Valenciana (2000-2005) / Trend in platelet antiaggregants utilization in the autonomous Community of Valencia, Spain (2000-2005)

Fundamento: Los antiagregantes plaquetarios son fármacos básicos para la prevención de enfermedades isquémicas arteriales. El objetivo de este trabajo es conocer la evolución de su utilización en Atención Primaria en la Comunidad Valenciana durante el periodo 2000-2005. Métodos: Estudio descriptivo del consumo de los antiagregantes plaquetarios (código ATC: B01AC) dispensados con cargo al Sistema Nacional de Salud en la Comunidad Valenciana en el ámbito de Atención Primaria. Datos expresados en dosis diarias definidas (DDD) por 1.000 habitantes y día. Resultados: En 2005 tres fármacos representaron el 98% de la prescripción global (ácido acetilsalicílico (AAS) 66%, clopidogrel 23% y triflusal 9%). El consumo de antiagregantes orales se incrementó en un 23% entre 2000 y 2005 (desde 29,6 DDD/1.000 hab y día hasta 36,5). El clopidogrel mostró un incremento del 218%, mientras que el ácido acetilsalicílico fue el principio de mayor consumo con una cuota de utilización bastante estable durante todo el periodo (próxima al 70%). El gasto generado por este grupo de fármacos se duplicó, el clopidogrel fue el fármaco con mayor coste/DDD (2,14t), en 2005 su utilización constituyó un 23% del total de antiagregantes pero su gasto representó el 76% del total. Conclusiones: En este periodo se incrementó el consumo de antiagregantes en la Comunidad Valenciana. El AAS mantuvo estable su utilización, mientras que el clopidogrel aumentó su cuota de mercado pese a las recomendaciones de las guías terapéuticas y las restricciones para su uso. El consumo del clopidogrel contribuyó de forma notable al gasto farmacéutico de este grupo

Background: Platelet antiaggregants are basic drugs for preventing ischemic arterial diseases. This study is aimed at ascertaining the trend in their use in Primary Care in the Autonomous Community of Valencia during the 2000-2005 period. Methods: Descriptive study of the use of platelet antiaggregants (ATC code: B01AC) dispensed charged to the National Health System in the Autonomous Community of Valencia in Primary Care. Data given in defined daily doses (DDD) per 1,000 inhabitants per day. Results: In 2005, three drugs totalled 98% of all those prescribed overall (acetyl salicylicacid (ASA) 66%, clopidogrel 23% and triflusal 9%). Oral antiaggregant use rose by 23% within the 2000-2005 period (from 29.6 to 36.5 DDD/1,000 inhab./day). Clopidogrel showed a 218% increase, whilst ASA was the most used drug, with quite a stable percentage of use throughout said time period (nearing 70%). The expense generated by this group of drugs doubled, clopidogrel having been the highest-cost drug/DDD (2.14 EUROS), its use having totalled 23% of all antiaggregants yet the expense thereof having totalled 76% of the total expenditure. Conclusions: The use of antiaggregants increased in the Autonomous Community of Valencia during the time period under study. The utilization of ASA remained stable, whilst clopidogrel increased its market share despite the treatment guide recommendations and the restrictions on its use. The consumption of clopidogrel noticeably contributed to the drug spending for this group