Prevalencia de IACS en el HIGA San Roque de Gonnet : Otra medida de la calidad de atención

Las infecciones asociadas a los cuidados de la salud (IACS) son un grave problema de salud pública y uno de los indicadores de la calidad de la asistencia. Todos reconocemos que hoy es de vital importancia su vigilancia y prevención. En el HIGA San Roque de Gonnet se implementan dos herramientas para evaluar los índices de riesgo de IACS. Desde el 2005 el hospital realiza vigilancia continua en áreas críticas (UTIUCIN) y cirugías limpias de Traumatología y Neurocirugía. Desde el 2010 se incorpora al Estudio Nacional de Prevalencia de Infecciones Hospitalarias de Argentina (ENPIHA) que se realiza anualmente en el mes de agosto. Este instrumento de vigilancia permite proporcionar datos homogéneos y comparables para nuestra Institución. Son esperables según la bibliografía tasas entre 3 y 9 % ; los datos obtenidos en nuestra institución son imprescindibles para gestionar las actividades del Comité de Control de Infecciones y son una evidencia de la calidad de atención que se ofrece a nuestros pacientes.Facultad de Ciencias Médica

Evaluation and follow-up of anti-retroviral treatment adherence of HIV positive patients assisted at a hospital in La Plata, Argentina

The HZGA San Roque Hospital (an Acute Hospital at La Plata, Argentina) assists 40 HIV patients. The present study was carried out due to the lack of adherence to the High Activity Anti-Retroviral Therapy (HAART) because of the late withdrawal of medication. The present work was implemented on HIV patients who withdraw medication from the Pharmacy Department at the Hospital. Research period lasted 12 months. The aims of this work were to quantify the degree of adherence to the treatment, to assist patients by means of pharmaceutical care so that they reach a 90 % of adherence to the treatment, to analyse the relationship between the understanding of the treatment and its administration and the degree of adherence, and, finally, to analyse the relationship between viral load (VL) and adherence. The study showed that containment and information help to raise the level of patients' adherence to HAART in 29 %. The patients' responsibility and commitment to the treatment also increased, as well as CD4 values; VL, on the other hand, decreased with respect to the beginning of the study. The interrupt far TIMID (less than 0.10) shows an improvement of 15.8 % in the number of patients who interrupted their treatment is also reflected in the survey of adherence where we have an increase of 26.2 %.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Chagas, ten years of study in a public hospital

Background: Epidemiological study of chagasic patients in a public hospital between 2007 and 2017 Methods & Materials: All patients were evaluated with serological confirmation with two/three techniques (ELISA, TIF, HAI), cardiovascular(ECG, echocardiography, chest x-ray) and gastroenterological studies. The analyzed data were sex, age, place of birth, clinical staging, type of transmission, pregnancy condition, treatment and drug toxicity Results: Of 154 diagnosed, 34(22%) were males and 120(78%) were females, 68(56,6%) were pregnant at the time of diagnosis and 12(7,8%) they had been infected by mother-child transmission. The average age of infected women was 37.3(range 15-66) and in men was 55,8(range 13-73). Of all diagnosed, 29(19%) had cardiovascular and 6(3,9%) gastrointestinal diseases. Almost half are from bordering countries(Bolivia, Paraguay) Of our country, Chaco was the one that more number of cases contribute. They received treatment in accordance with the recommendations of the Ministry of Health 62 (40,3%) and 11(17,8%) of them evidenced drug toxicity. Conclusion: More women than men were diagnosed. Almost 60% during pregnancy. The cardiovascular affectation was diagnosed five times more than the gastrointestinal disease. Only 40% of those diagnosed were included in the treatment criteria.Facultad de Ciencias Médica

Experience of a rapid test center for HIV in a public hospital

Background: The implementation of rapid tests for HIV allows to improve the accessibility to the diagnosis and favors the incorporation of the people to the health system. Methods & Materials: A prospective epidemiological study between 01 April and 30 September 2017 of the people studied with quick method of HIV at General Hospital San Roque in La Plata was performed. During the 6-month period, 172 people, 80 women and 92 men between 7 and 72 years of age were studied. In all cases a pre-test interview was conducted and the results were delivered with counseling. Extraction of venous blood was drawn by puncture of digital fingertip lancing. The HIV antibody screening was performed by reactive immunochromatographic strips (Quick Test Determine HIV). People with preliminary positive results were referred to the hospital laboratory for confirmation. We used the diagnostic algorithm recommended by the Ministry of Health of the Nation. ELISA (Architect) and viral load (Roche Cobas ampliprep) were carried out in the Reference Laboratory of the “Tomas Perón” Biological Institute.Facultad de Ciencias Médica

International Nosocomial Infection Control Consortiu (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module

We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care–associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line–associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN

Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome

BACKGROUN

Alirocumab and cardiovascular outcomes after acute coronary syndrome

BACKGROUN