Baena Parejo M.I.,Provincial Delegate of the Ministry of Health |
Borrego A.M.J.,Hospital Santa Creu i Sant Pau |
Ruiz J.A.,Fundacio Sant Hospital |
Monjo M.C.,Hospital Son Espases |
And 10 more authors.
Journal of Emergency Medicine | Year: 2015
Background: Medication errors lead to morbidity and mortality among emergency department (ED) patients. An inaccurate medication history is one of the underlying causes of these errors. Objectives: This study was performed to determine the prevalence of patients with discrepancies between the medical list information contained in the clinical history compiled on admission to the ED and the list of medications patients are actually taking, to characterize the discrepancies found, and to analyze whether certain factors are associated with the risk of discrepancies. Methods: We conducted a cross-sectional, descriptive, observational, multicenter study with an analytic component in the EDs of 11 hospitals in Spain. We compared pharmacist-obtained medication lists (PML) with ED-obtained medication lists (EDML). Discrepancy was defined as one or more differences (in drug or dosage or route of administration) between the EDML and PML. The endpoints were the proportion of patients with discrepancies in their home medical lists, and the prevalence of certain factors among patients with discrepancies and those without. Results: We detected 1476 discrepancies in 387 patients; no discrepancies were found in 20.7%. The most frequent discrepancies involved incomplete information (44.2%) and omission (41.8%). In the bivariate analysis, age, number of medications, and Charlson comorbidity score were significantly associated with discrepancy. In the multivariate analysis, number of medications and hospital were the variables associated with discrepancy. Conclusions: The EDML differed from the list of medications patients were actually taking in 79.3% of cases. Incomplete information and omission were the most frequent discrepancies. Age, number of medications, and comorbidities were related to the risk of discrepancies. © 2015 Elsevier Inc. Source
Ruiz A.S.,University of Granada |
Peralta-Ramirez M.I.,University of Granada |
Garcia-Rios M.C.,University of Granada |
Munoz M.A.,University of the Balearic Islands |
And 2 more authors.
Journal of Cyber Therapy and Rehabilitation | Year: 2010
The Trier Social Stress Test (TSST; Kirschbaum et al., 1993) is currently the most commonly used psychosocial stressor to generate a response of the axes involved in stress. The TSST has proven effective in the activation of the hypothalamic-pituitary-adrenal axis. In addition, new technologies, such as virtual reality (VR), are being integrated into stress research protocols (Kelly et al., 2007). To determine whether TSST as applied to VR leads to the sympathetic and neuroendocrine activation in a group of healthy individuals. Also, this study aims to connect this response with different psychological variables regarding stress vulnerability, psychopathology, and personality. Twenty-one university students (6 male and 15 female) were exposed to a modified version of the TSST adapted to a virtual environment (VE), in which they have to deliver a speech. Electrodermal activity and salivary cortisol secretion were simultaneously registered at different instances. After the task, sympathetic activation was observed in all participants, as well as increase in the cortisol secretion in 14 of the students. This increase was statistically significant in the moment prior to the speech and the moment after in the responder group. In the same fashion, statistically significant differences were found in the responder group only regarding obsession and compulsion scales and extroversion, which were higher in the responder group. Our findings support the use of the TSST paradigm in VR as an experimental situation appropriate to research designs in laboratory aiming to study the modulation of the axes implied in response to stress. © Virtual Reality Medical Institute. Source
Alvarez-Cubero M.J.,University of Granada |
Entrala C.,LORGEN GP |
Fernandez-Rosado F.,LORGEN GP |
Martinez-Gonzalez L.J.,University of Granada |
And 4 more authors.
Prostate Cancer and Prostatic Diseases | Year: 2012
BACKGROUND: We would like to compare the different RNASEL genotypes with the stage of the cancer using parameters such as PSA levels, Gleason score and T-stage, and to develop a clinical protocol for the monitoring of the disease for trying a better evolution of the patient. METHODS: A total of 231 patients with sporadic prostate cancer and 100 of controls were genotyped in RNASEL gene by sequencing the exons 1 and 3. A survey of clinical information was collected by a specialist following the Helsinki protocol. All patients and controls were interviewed by a researcher and signed their informed consent to participation in the study, which was approved by Ethics Committee of the hospital. The genetic information was processed and collected with an ABI PRISM Genetic Analyser 3130 using SeqScape software v.2.6. All the patients were analysed by comparing the genetic and clinical data. χ 2-tests, Monte Carlo, Fisher tests and contigency tables were performed using SPSS v.15.0 and ARLEQUIN v.3.5 software on patient population. RESULTS: Significant differences were found only between patients and controls in D541E, R461Q and I97L genotypes, the remainder of the variants did not seem relevant to our population in contrast to other populations, such as north-Caucasians, Afro Americans and Ashkenazi Jews. The genotypes associated with the worst prognoses are G/G in D541E, A/A in R462Q and A/G in I97L. The controls were included in our study to determine an approximation of the genotype in our population compared with the patients, but they did not account for the statistical process. CONCLUSIONS: The genetic profile of patients with this cancer combined with other parameters could be used as a prognosis factor in deciding to give more radical and frequent treatments, depending on personal genotype. © 2012 Macmillan Publishers Limited All rights reserved. Source