Pub Date : 2011-01-01DOI: 10.1016/j.gmb.2011.02.001
A. Alberte Castiñeiras , Ángel San Miguel Hernández , M.J. Rodríguez Barbero , C. Alberte Pérez , P. Pérez Pascual
Knowledge of the antibiotic resistance in a specific healthcare area is essential for suitable application of the antibiotic policy, which can be understood as the use of recommendations for the application and consumption of antimicrobial agents, as well as for education and continual surveillance to achieve the most effective, rational and least expensive antibiotic therapy possible.
We performed a study of antimicrobial susceptibility between 2000 and 2005 in the Health Area of the West of Valladolid (Spain) corresponding to the Rio Hortega University Hospital, with a catchment area of approximately 235,0000 inhabitants.
The microorganisms tested were obtained from isolates of distinct samples from patients with infectious processes. The agents were considered causal. The most frequently isolated agents were described.
The antibiotics tested were those that showed acceptable in vitro and in vivo activity against each isolated species. The criteria considered were clinical effectiveness, the prevalence of resistance, a low possibility of developing resistance, indications for clinical use and being the first treatment choice or alternative. The results were expressed in percentages of susceptibility or sensitivity to the antibiotics analyzed.
The sensitivity criteria of the National Committee on Clinical Laboratory Standards (USA) were followed. The category of SENSITIVE to a given antibiotic implies that the infection caused by the isolated bacterium can suitably be treated with the routine dosage of this antibiotic. The RESISTANT category implies that isolated bacteria are not inhibited with the routine dosage of this antibiotic.
The antibiotic types studied followed general lines and the following agents were taken as representative of their class: Ampicillin (ampicillin and amoxicillin derivatives), Amoxicillin/clavulanic acid(ampicillin/sulbactam), Cefalotin (cefazolin, cefaclor, cephradine, cefalexin, etc), Cefoxitin (cefmetazole), Cefotaxime (ceftriaxone, imipenem, meropenem), Gentamicin (netilmicin, tobramycin), Ciprofloxacin (ofloxacin), Ofloxacin (levofloxacin). In Enterococci: Gentamicin synergy (gentamicin, tobramycin, netilmicin and amikacin). Streptomycin synergy (streptomycin).
The results obtained in the study were grouped in different antibiotic activities:
1.
Antibiotic activity against Gram-positive bacteria: a. Antibiotic activity against to Staphylococcus aureus. b. Antibiotic activity against S epidermidis. c. Antibiotic activity against Enterococcus faecalis d. Antibiotic activity against E. faecium. e. Antibiotic activity against Streptococcus agalactiae.
2.
Antibiotic activity against Gram-negative bacteria. a. Antibiotic activity against Enterobacteriaceae. Antibiotic activity against Escherichia coli. Antibiotic activity against
{"title":"Estudio de la actividad antibacteriana en un hospital terciario. Evolución durante el período 2000-2005","authors":"A. Alberte Castiñeiras , Ángel San Miguel Hernández , M.J. Rodríguez Barbero , C. Alberte Pérez , P. Pérez Pascual","doi":"10.1016/j.gmb.2011.02.001","DOIUrl":"https://doi.org/10.1016/j.gmb.2011.02.001","url":null,"abstract":"<div><p>Knowledge of the antibiotic resistance in a specific healthcare area is essential for suitable application of the antibiotic policy, which can be understood as the use of recommendations for the application and consumption of antimicrobial agents, as well as for education and continual surveillance to achieve the most effective, rational and least expensive antibiotic therapy possible.</p><p>We performed a study of antimicrobial susceptibility between 2000 and 2005 in the Health Area of the West of Valladolid (Spain) corresponding to the Rio Hortega University Hospital, with a catchment area of approximately 235,0000 inhabitants.</p><p>The microorganisms tested were obtained from isolates of distinct samples from patients with infectious processes. The agents were considered causal. The most frequently isolated agents were described.</p><p>The antibiotics tested were those that showed acceptable <em>in vitro</em> and <em>in vivo</em> activity against each isolated species. The criteria considered were clinical effectiveness, the prevalence of resistance, a low possibility of developing resistance, indications for clinical use and being the first treatment choice or alternative. The results were expressed in percentages of susceptibility or sensitivity to the antibiotics analyzed.</p><p>The sensitivity criteria of the National Committee on Clinical Laboratory Standards (USA) were followed. The category of SENSITIVE to a given antibiotic implies that the infection caused by the isolated bacterium can suitably be treated with the routine dosage of this antibiotic. The RESISTANT category implies that isolated bacteria are not inhibited with the routine dosage of this antibiotic.</p><p>The antibiotic types studied followed general lines and the following agents were taken as representative of their class: Ampicillin (ampicillin and amoxicillin derivatives), Amoxicillin/clavulanic acid(ampicillin/sulbactam), Cefalotin (cefazolin, cefaclor, cephradine, cefalexin, etc), Cefoxitin (cefmetazole), Cefotaxime (ceftriaxone, imipenem, meropenem), Gentamicin (netilmicin, tobramycin), Ciprofloxacin (ofloxacin), Ofloxacin (levofloxacin). In Enterococci: Gentamicin synergy (gentamicin, tobramycin, netilmicin and amikacin). Streptomycin synergy (streptomycin).</p><p>The results obtained in the study were grouped in different antibiotic activities:</p><ul><li><span>1.</span><span><p>Antibiotic activity against Gram-positive bacteria: a. Antibiotic activity against to <em>Staphylococcus aureus</em>. b. Antibiotic activity against <em>S epidermidis</em>. c. Antibiotic activity against <em>Enterococcus faecalis</em> d. Antibiotic activity against <em>E. faecium.</em> e. Antibiotic activity against <em>Streptococcus agalactiae</em>.</p></span></li><li><span>2.</span><span><p>Antibiotic activity against Gram-negative bacteria. a. Antibiotic activity against Enterobacteriaceae. Antibiotic activity against <em>Escherichia coli</em>. Antibiotic activity against <em>","PeriodicalId":35686,"journal":{"name":"Gaceta Medica de Bilbao","volume":"108 1","pages":"Pages 15-29"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gmb.2011.02.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137332186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-01-01DOI: 10.1016/j.gmb.2011.02.006
Juan Simó Miñana
Objective
To determine the growth and distribution of public expenditure on health among health sectors in the Basque Country from 1995 to 2008 and compare them with those in the 17 autonomous regions in Spain as a whole.
Method
Public expenditure on health in the Basque Country among health sectors and its annual growth were determined and compared with average expenditure in Spain's 17 autonomous regions through a retrospective longitudinal study. Demographic variables such as regional income (GDP per capita) and population aging were also analyzed.
Results
Between 2002 and 2008, the per capita public expenditure on health in the Basque Country was 10% higher than the average in the autonomous regions and growth was 1.3% higher. Per capita pharmaceutical expenditure in the Basque Country was 2% lower than the regional average, growth was 27% higher than this average, and its weight in public expenditure on health grew 0.950% annually. The annual growth of hospital expenditure in the Basque Country was 15% higher than that in primary care (3.571% vs. 3.097%) and the weight of primary care in public expenditure on health decreased 2.6 times more than that of hospital care. On average during the period, both sectors exceeded the regional average of per capita expenditure by 16-17%. However, per capita expenditure on hospital staff in the Basque Country was 20-30% higher than the regional average while that on primary care staff was 10-15% higher than this average.
Conclusions
Between 1995 and 2008, Basque hospital and primary care maintained their budgetary superiority over the regional average. In hospital staff, this budgetary superiority was double that in primary care compared with the regional average. Pharmaceutical expenditure was within the regional average.
{"title":"El gasto sanitario público en el País Vasco, 1995-2008: comparación con el conjunto de las comunidades autónomas","authors":"Juan Simó Miñana","doi":"10.1016/j.gmb.2011.02.006","DOIUrl":"10.1016/j.gmb.2011.02.006","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the growth and distribution of public expenditure on health among health sectors in the Basque Country from 1995 to 2008 and compare them with those in the 17 autonomous regions in Spain as a whole.</p></div><div><h3>Method</h3><p>Public expenditure on health in the Basque Country among health sectors and its annual growth were determined and compared with average expenditure in Spain's 17 autonomous regions through a retrospective longitudinal study. Demographic variables such as regional income (GDP per capita) and population aging were also analyzed.</p></div><div><h3>Results</h3><p>Between 2002 and 2008, the per capita public expenditure on health in the Basque Country was 10% higher than the average in the autonomous regions and growth was 1.3% higher. Per capita pharmaceutical expenditure in the Basque Country was 2% lower than the regional average, growth was 27% higher than this average, and its weight in public expenditure on health grew 0.950% annually. The annual growth of hospital expenditure in the Basque Country was 15% higher than that in primary care (3.571% vs. 3.097%) and the weight of primary care in public expenditure on health decreased 2.6 times more than that of hospital care. On average during the period, both sectors exceeded the regional average of per capita expenditure by 16-17%. However, per capita expenditure on hospital staff in the Basque Country was 20-30% higher than the regional average while that on primary care staff was 10-15% higher than this average.</p></div><div><h3>Conclusions</h3><p>Between 1995 and 2008, Basque hospital and primary care maintained their budgetary superiority over the regional average. In hospital staff, this budgetary superiority was double that in primary care compared with the regional average. Pharmaceutical expenditure was within the regional average.</p></div>","PeriodicalId":35686,"journal":{"name":"Gaceta Medica de Bilbao","volume":"108 1","pages":"Pages 7-14"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gmb.2011.02.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83745315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-01-01DOI: 10.1016/j.gmb.2011.02.004
Juan Gérvas
{"title":"Morir en casa con dignidad. Una posibilidad, si hay apoyo y cuidados de calidad","authors":"Juan Gérvas","doi":"10.1016/j.gmb.2011.02.004","DOIUrl":"10.1016/j.gmb.2011.02.004","url":null,"abstract":"","PeriodicalId":35686,"journal":{"name":"Gaceta Medica de Bilbao","volume":"108 1","pages":"Pages 3-6"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gmb.2011.02.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74732509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-01-01DOI: 10.1016/j.gmb.2011.02.007
Juan Goiria
{"title":"Discurso leído en la entrega del Premio Ilustre de Bilbao a la Academia","authors":"Juan Goiria","doi":"10.1016/j.gmb.2011.02.007","DOIUrl":"10.1016/j.gmb.2011.02.007","url":null,"abstract":"","PeriodicalId":35686,"journal":{"name":"Gaceta Medica de Bilbao","volume":"108 1","pages":"Pages 1-2"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.gmb.2011.02.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"111102681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Medalla Europea “Eguzkilore 2009” de la Sociedad Vasca de Hipertensión Arterial y Riesgo Cardiovascular","authors":"Julen Ocharan-Corcuera, Jesús Iturralde-Iriso, Gregorio Mediavilla-Tris","doi":"10.1016/S0304-4858(10)70034-2","DOIUrl":"10.1016/S0304-4858(10)70034-2","url":null,"abstract":"","PeriodicalId":35686,"journal":{"name":"Gaceta Medica de Bilbao","volume":"107 4","pages":"Pages 136-137"},"PeriodicalIF":0.0,"publicationDate":"2010-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0304-4858(10)70034-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56308096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-10-01DOI: 10.1016/S0304-4858(10)70033-0
Jon Kepa Balparda-Arias
Priapism is defined as a clinical entity in which there's a sustained penile erection, not related to any sort of sexual stimulation. It may represent a true urologic emergency, taking into account that the low flow variant has been strongly related to permanent sexual dysfunction. Treatment will depend on whether the disease is of the ischemic or the non ischemic variant, with the therapeutics of the first including cavernosal aspiration, intracavernosal injection with constrictive agents and surgical management.
Laburpena
Priapismoa, hain zuzen, sexu-kitzikapenarekin loturarik ez duen zakilaren erekzio iraunkorra da. Urologia-arazo larria izan daiteke; izan ere, Fluxu Baxua izeneko aldagaiak zuzeneko harremana dauka sexu-disfuntzio iraunkorrarekin. Tratamendu egokia zein den erabakitzeko, oro har, aldagai iskemikoa eta ez-iskemikoa bereizi behar dira. Lehenengoari aurre egiteko tratamendua, beraz, leizeetako xurgapenean, sendagai basokontriktoreen instilazioan eta kirurgia-terapeutikan oinarritutakoa izan liteke.
{"title":"Priapismo: concepciones clínicas, diagnósticas y de tratamiento","authors":"Jon Kepa Balparda-Arias","doi":"10.1016/S0304-4858(10)70033-0","DOIUrl":"10.1016/S0304-4858(10)70033-0","url":null,"abstract":"<div><p>Priapism is defined as a clinical entity in which there's a sustained penile erection, not related to any sort of sexual stimulation. It may represent a true urologic emergency, taking into account that the low flow variant has been strongly related to permanent sexual dysfunction. Treatment will depend on whether the disease is of the ischemic or the non ischemic variant, with the therapeutics of the first including cavernosal aspiration, intracavernosal injection with constrictive agents and surgical management.</p><p><strong>Laburpena</strong></p><p>Priapismoa, hain zuzen, sexu-kitzikapenarekin loturarik ez duen zakilaren erekzio iraunkorra da. Urologia-arazo larria izan daiteke; izan ere, Fluxu Baxua izeneko aldagaiak zuzeneko harremana dauka sexu-disfuntzio iraunkorrarekin. Tratamendu egokia zein den erabakitzeko, oro har, aldagai iskemikoa eta ez-iskemikoa bereizi behar dira. Lehenengoari aurre egiteko tratamendua, beraz, leizeetako xurgapenean, sendagai basokontriktoreen instilazioan eta kirurgia-terapeutikan oinarritutakoa izan liteke.</p></div>","PeriodicalId":35686,"journal":{"name":"Gaceta Medica de Bilbao","volume":"107 4","pages":"Pages 128-135"},"PeriodicalIF":0.0,"publicationDate":"2010-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0304-4858(10)70033-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56307921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-10-01DOI: 10.1016/S0304-4858(10)70031-7
Serafín García Mata
Computed tomography-guided radiofrequency ablation was performed under general anesthesia and in outpatient surgery. Symptoms resolved within 0–5 days. Pain resolved in all patients without complications. There were no recurrences during a follow-up of between 9 months and 3 years. No physeal involvement was observed, even when the lesion was close to the physis.
{"title":"Tratamiento percutáneo del osteoma osteoide mediante ablación por radiofrecuencia guiada por TC, en niños y adolescentes","authors":"Serafín García Mata","doi":"10.1016/S0304-4858(10)70031-7","DOIUrl":"10.1016/S0304-4858(10)70031-7","url":null,"abstract":"<div><p>Computed tomography-guided radiofrequency ablation was performed under general anesthesia and in outpatient surgery. Symptoms resolved within 0–5 days. Pain resolved in all patients without complications. There were no recurrences during a follow-up of between 9 months and 3 years. No physeal involvement was observed, even when the lesion was close to the physis.</p></div>","PeriodicalId":35686,"journal":{"name":"Gaceta Medica de Bilbao","volume":"107 4","pages":"Pages 115-122"},"PeriodicalIF":0.0,"publicationDate":"2010-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0304-4858(10)70031-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75750006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-10-01DOI: 10.1016/S0304-4858(10)70038-X
Carmen de la Hoz Torres
{"title":"In memoriam al Prof. Dr. José María Rivera-Pomar","authors":"Carmen de la Hoz Torres","doi":"10.1016/S0304-4858(10)70038-X","DOIUrl":"10.1016/S0304-4858(10)70038-X","url":null,"abstract":"","PeriodicalId":35686,"journal":{"name":"Gaceta Medica de Bilbao","volume":"107 4","pages":"Pages 143-144"},"PeriodicalIF":0.0,"publicationDate":"2010-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0304-4858(10)70038-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"105553416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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