European Journal of Internal Medicine - EUR J INTERN MED. 01/2003; 14.
Anales de medicina interna (Madrid, Spain: 1984) 02/2001; 18(1):47-8.
Anales De Medicina Interna - AN MED INTERNA. 01/2001; 18(1).
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ABSTRACT: Anaemia especially iron deficiency anaemia (IDA) is a worldwide health problem and the most frequent nutritional lack in developing countries. The epidemiology of anaemia in hospitalized patients in Internal Wards is not well-known.
On a retrospective basis we studied 105 patients with haemoglobin levels below 115 g/L. Symptoms, type of anaemia, causing disease, diagnostic procedures, pathologic findings and transfusional schedule were analyzed.
Mean haemoglobin was 77.8 (SD 17.9) g/L. Anaemia degree was deeper in women (p < 0.05) and IDA comparatively with chronic disease (CDA) (p < 0.01) and it did not show relation with therapeutic agents which potentially induce anaemia. IDA was the most frequent followed by haemorrhagic anaemia (HA) and CDA. The diagnostic procedure which discovered an underlying disease in most of the cases was upper digestive tract endoscopy, and CDA needed the highest number of diagnostic procedures. There was not relationship between the sort of anaemia and symptoms due to upper digestive tract and endoscopic findings, however low digestive tract symptoms (bleeding and abnormal finger rectal examination) and pathologic findings in colonoscopy had a straight relation (p < 0.05).
IDA is the anaemia most frequently diagnosed in an Internal Medicine Department followed by HA and ACD. Clinical symptoms and the type of anaemia have poor correlation. In IDA upper digestive endoscopy as well as lower digestive tract examination is mandatory. We propose colonoscopy in patients aged more than 50-years whereas barium enema could be employed in younger people.
Sangre 12/1999; 44(6):418-23.
Anales de medicina interna (Madrid, Spain: 1984) 11/1999; 16(10):544-5.
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ABSTRACT: The amount and quality of drugs prescribed after hospitalization in Internal Medicine and the factors which influence them have been rarely evaluated in Spain.
We study prospectively drugs prescribed in patients hospitalized in Internal Medicine analyzing amount of drugs before admission (BAD), on discharge (DD), end drugs after temporal drugs were removed (ED), drugs prescribed as chronic treatment (CTD), symptomatic drugs (SD), acute-use drugs (AUD) and low therapeutic utility drugs (LTUD). We also evaluated the sort of drugs and the factors implicated in increase or decrease of prescription volume.
Two hundred and eighty-five patients were evaluated [164 males, 121 females, mean age 68.08 (SD 15.27)]. They had mean BAD 3.42(SD 2.67)7 DD 3.92 (SD 2.36) (p < 0.001) and ED 3.65 (SD 2.30) (No differences with BAD). The amount of drugs were higher in patients 65 years old and elder (p < 0.001). LTUD were decreased from 62(22%) patients on admission to 21 (7%) on discharge (p < 0.001). Compounded drugs were reduced from 36 (13%) patients to 17 (6%) (p < 0.05). Age older 65, length of stay greater 7 days, need for intravenous administration of drugs, comorbidities and complications during hospitalization all caused increase in prescription volume on discharge. Logistic-regression analysis showed that CTD and AUD were the main causes of increase of drugs while BAD and LTUD were protective. Drugs reduced in higher proportion were mucolytics (p < 0.005) drugs to treat plant-based hyperplasia benign of prostate (p < 0.05), brain vasodilators (p < 0.001) and peripheral vasodilators (p < 0.01).
Hospitalization in Internal Medicine results in an increase of prescription volume though it is short-term. The higher number of drugs is accumulated in elderly. Factors implicated in increasing are length of stay, need for intravascular access, complications during inpatient, drugs to treat acute diseases and chronic use drugs. Low therapeutic utility drugs are used before admission in outpatients.
Anales de medicina interna (Madrid, Spain: 1984) 02/1999; 16(1):25-30.
Anales de medicina interna (Madrid, Spain: 1984) 10/1998; 15(9):501-5.
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ABSTRACT: To evaluate the epidemiology of delays in patients hospitalized in a department of internal medicine in a hospital of third level (high technology, end-stem of Spanish health system), its influences in hospital length of stay and the leading reasons which we named Gap Days.
We studied all patients admitted through emergency ward for internal medicine during Oct 93-June 94. Gap Day was defined as the day passed as inpatient in which no intravenous route, isolation, artificial feeding, fever, impairing of clinic steady-state were needed or waited and any diagnostic tools were used. We counted Gap Day from the second day and from de third day for histopathology that we ordered the explorations. In a nonselected group days of delay to arrive written data were measured while the results were known for personal request.
144 patients had a mean length of stay of 9.52 (SD 5.41) days. Gap Days occurred in 97 (67%) patients (Mean 3.85 SD 2.80) with a mean length of stay 10.71 SD 5.09 days, while patients without Gap Days had a mean length of stay of 7.14 SD 5.29 days (p < 0.001). Patients with higher Gap Days were those with symptoms related to hematological system (p = 0.002), nephrourological system (p = 0.011) and a hematological diagnostic (p = 0.003) on admission. On discharge patients with hematological diagnostic had also higher Gap Days (p = 0.017). They had higher Gap Days also patients with two symptoms or more on admission (3.63 SD 2.96, p = 0.016), patients who lived alone (5.33 SD 3.42, p = 0.050) and patients with no concordance between diagnostic on admission and discharge (4.06 SD 3.41, p < 0.01). In 37 patients written data arrived 2.14 SD 1.06 days later after to know the results for personal request.
Gap Days are an important factor to prolong the length of stay in internal medicine. They are influenced by number of symptoms on admission, concordance between diagnostics on admission and discharge, hematological diagnostics and some social and functioning hospital factors.
Anales de medicina interna (Madrid, Spain: 1984) 05/1997; 14(4):179-83.