Prevención de errores de medicación en la farmacia ambulatoria del hospital

Prevenció; Errors de medicació; Farmàcia ambulatòriaPrevención; Errores de medicación; Farmacia ambulatoriaPrevention; Medication errors; Outpatient pharmacyArticle que parla sobre la prevenció d’errors en el tractament amb medicaments hospitalaris de dispensació ambulatòria (MHDA); quins són els errors més freqüents així com les mesures per disminuir-ne el risc

Resolution test of GOCE satellite data applied to density anomalies at crustal and upper mantle levels

The GOCE satellite mission was devised by the European Space Agency to study the Earthâs gravity field with an unprecedented accuracy using gravity gradient data. The goal of this study is to analyze the resolution in terms of shape, minimum size, and density contrast of anomalous bodies related to geological structures that can be identified from GOCE data. A parametric study is performed by calculating the gravity gradients associated with rectangular prisms with fixed aspect ratio of 9:3:1 and varying the size, burial depth, and density contrast, selecting those structures showing amplitudes and wavelength variations comparable to the accuracy of GOCE data. Results show that the minimum size for crustal anomalies to be resolved is 270 x 90 x 30km for a Dr = 500kg/m3, burial depth of 0km, and a computation height of 255km. A minimum size of 585 x 195 x 65km is required for a body with Dr = 50kg/m3 and 200km burial depth. In addition, the application to the 3D case of a passive continental margin than resembles, in its main general trend, the crustal structure of the NW-Iberia shows that the signal of all gravity gradient components is dominated by the crustal thinning associated with the passive continental margins and the corresponding isostatic response

Interval cancers in a population-based screening program for colorectal cancer in Catalonia, Spain

Objective. To analyze interval cancers among participants in a screening program for colorectal cancer (CRC) during four screening rounds. Methods. The study population consisted of participants of a fecal occult blood test-based screening program from February 2000 to September 2010, with a 30-month follow-up (n = 30,480). We used hospital administration data to identify CRC. An interval cancer was defined as an invasive cancer diagnosed within 30 months of a negative screening result and before the next recommended examination. Gender, age, stage, and site distribution of interval cancers were compared with those in the screen-detected group. Results. Within the study period, 97 tumors were screen-detected and 74 tumors were diagnosed after a negative screening. In addition, 17 CRC (18.3%) were found after an inconclusive result and 2 cases were diagnosed within the surveillance interval (2.1%). There was an increase of interval cancers over the four rounds (from 32.4% to 46.0%). When compared with screen-detected cancers, interval cancers were found predominantly in the rectum (OR: 3.66; 95% CI: 1.51-8.88) and at more advanced stages (P = 0.025). Conclusion. There are large numbers of cancer that are not detected through fecal occult blood test-based screening. The low sensitivity should be emphasized to ensure that individuals with symptoms are not falsely reassured

From the surface Topography to the Upper mantle beneath Central-Iberian-Zone. The ALCUDIA Seismic Experiments

American Geophysical Union, Fall Meeting 15-19 December, 2014, San FranciscoMulti-seismic experiments acquired across the central and southern part of the Iberian Peninsula provide a new insight into the structure and nature of the lithosphere beneath these areas. Normal incidence and wide-angle seismic reflection data acquired in the area resolve the internal architecture and constrain the distribution of the physical properties along an almost 280 km long transect that samples the major tectonic domains of the Central Iberian Zone (CIZ) and the associated suture (e.g., the Central Unit, CU). A high quality image, ~230 km long, down to 45 km depth (~15 s TWTT) is provided by the normal incidence data set. Based on the reflectivity characteristics, the image can be divided into an upper and mid-lower crust, ~13 km and ~18 km thick, respectively. The wide-angle seismic transect extended the crustal section towards the north across the Madrid Basin. This, latter data set also sample the CIZ until the CU. This is ~280 km long profile which provides very strong constraints on the distribution of physical properties (P wave and S wave velocities, Poisson's ratio) of the upper lithosphere. The PiP and PmP seismic phases constrain two discontinuities: the brittle to ductile discontinuity at ~13-19 km and the Moho boundary at ~31-35.5 km. Currently both appear to act as decoupling surfaces and are interpreted to represent levels of lithological/rheological variations. The internal structure of the Moho is further discussed taking into account the characteristics of the PmP reflections. Furthermore, low fold wide-angle P and S wave stacks reveal a marked crust-mantle transition which is most probably 5-6 km thick and relatively complex structure. The geometrical relationships of this structure with the crustal fabrics of the normal incidence image suggest that the Moho is most probably a result of the re-equilibration and/or other lithospheric processes active after the Variscan collision

The Crust beneath Morocco: From the surface topography to the upper mantle a 700 km long seismic section across Morocco.

The most characteristic topographic features of Morocco are the Atlas Mountains and the Rif Coordillera. These two orogenic belts are the response of different geodynamic processes acting at lithospheric scale caused by a complex plate interaction. Both are located within the diffuse plate boundary zone separating Africa and Europe. The boundary zone is characterized by a relatively broad zone of deformation that includes mountain chains in southern Iberia, the Betics and in Morocco, the Rif Cordillera, separated by the Alboran basin. The zone delineates an arcuate arc system known as the Gibraltar arc. The area is characterized by a relatively large amount of earthquake activity at various depths and with a broad spectra of focal mechanisms. Within the last decade a large international effort have been devoted to the area. The topic has fostered a strong collaborations between Spanish and international research teams form Europe and USA. Key multi-seismic projects have been developed that aim to constrain the structure, composition and tectonic scenario from south of the Atlas to the Betics, across the Rif cordillera and the Alboran basin. The multidisciplinary research program included: natural source (earthquakes) recording with temporal deployments of broad band (BB) instrumentation and, controlled source seismic acquisition experiments where, spatially dense recording of wide-angle seismic reflection shot gathers were acquired. The natural source experiments consisted on a transect from Merzouga across the Gibraltar Arc and into the Iberian Peninsula (until south of Toledo) and, a nearly regular grid of BB. The controlled source data-sets were able to constrain the crustal structure and provide seismic P-wave propagation velocity models from the coast across the Rif and the Atlas. From south to north the crust features a relatively moderate crustal root beneath the Middle Atlas which can reach 40 km clearly differing from the 35 km thickness value observed at both sides of this root. Travel time inversion results position the crustal root just south of the High Atlas defining a thrusted mantle wedge and, also a limited crustal imbrication is suggested in the Middle Atlas. The most surprising feature is a prominent and unexpected crustal root (over 50 km) located beneath the external Rif and identified by both the wide-angle data and receiver function studies. To the east of this feature the crust thins rapidly by 20 km across the Nekkor fault zone, suggested to be related to the sharp change in crustal thickness. On shore-offshore recording of marine shots reveal further complexities in the transition to the Alboran basin. The low values of the Bouguer gravity anomalies beneath the Rif Cordillera are consistent with the crustal models derived from the new seismic data. The detailed knowledge on the crustal structure achieved by this high resolution imaging geophysical techniques is an asset to evaluate the earthquake and potential tsunami hazard for the coasts of North Africa and western Europe.This work has been primarily funded by the Spanish MEC project CGL2007–63889. Additional funding was provided by projects CGL2010–15416, CSD2006-00041, and CGL2009–09727 (Spain), CGL2008–03474-E, 07- TOPO_EUROPE_FP-006 (ESF Eurocores) and EAR-0808939 (US, NSF).Peer Reviewe

Trends in mortality in septic patients according to the different organ failure during 15 years

Background The incidence of sepsis can be estimated between 250 and 500 cases/100.000 people per year and is responsible for up to 6% of total hospital admissions. Identified as one of the most relevant global health problems, sepsis is the condition that generates the highest costs in the healthcare system. Important changes in the management of septic patients have been included in recent years; however, there is no information about how changes in the management of sepsis-associated organ failure have contributed to reduce mortality. Methods A retrospective analysis was conducted from hospital discharge records from the Minimum Basic Data Set Acute-Care Hospitals (CMBD-HA in Catalan language) for the Catalan Health System (CatSalut). CMBD-HA is a mandatory population-based register of admissions to all public and private acute-care hospitals in Catalonia. Sepsis was defined by the presence of infection and at least one organ dysfunction. Patients hospitalized with sepsis were detected, according ICD-9-CM (since 2005 to 2017) and ICD-10-CM (2018 and 2019) codes used to identify acute organ dysfunction and infectious processes. Results Of 11.916.974 discharges from all acute-care hospitals during the study period (2005-2019), 296.554 had sepsis (2.49%). The mean annual sepsis incidence in the population was 264.1 per 100.000 inhabitants/year, and it increased every year, going from 144.5 in 2005 to 410.1 in 2019. Multiorgan failure was present in 21.9% and bacteremia in 26.3% of cases. Renal was the most frequent organ failure (56.8%), followed by cardiovascular (24.2%). Hospital mortality during the study period was 19.5%, but decreases continuously from 25.7% in 2005 to 17.9% in 2019 (p < 0.0001). The most important reduction in mortality was observed in cases with cardiovascular failure (from 47.3% in 2005 to 31.2% in 2019) (p < 0.0001). In the same way, mean mortality related to renal and respiratory failure in sepsis was decreased in last years (p < 0.0001). Conclusions The incidence of sepsis has been increasing in recent years in our country. However, hospital mortality has been significantly reduced. In septic patients, all organ failures except liver have shown a statistically significant reduction on associated mortality, with cardiovascular failure as the most relevant