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Biomedical subjects

B Santos Ramos

Publications and source records attributed to B Santos Ramos.

6 recordsLinked to original sources
PubMed2000

Costs related to inappropriate use of albumin in Spain.

BACKGROUND: Albumin has been used in various treatments for > 50 years, but, recently, its use in clinical practice has become very controversial. OBJECTIVE: To assess the use of albumin in clinical practice in the public hospital setting in Andalucía, Spain, focusing on the economic repercussions of the inappropriate use of albumin. METHODS: Multicentered observational study in 22 public hospitals in which all patients receiving albumin (from start to conclusion of treatment) were assessed during a five-month period on three predetermined, nonconsecutive days. The clinical indications for albumin were evaluated on the basis of Guidelines, a consensus document created by a multidisciplinary team for dissemination by the Governmental Health Authority to all hospitals within its purview. The data were abstracted from the patient case report forms by the pharmacist selected to compile the data in each of the participating hospitals. RESULTS: A total of 242 forms reporting the use of 62,282 g of albumin were evaluated. The most frequent prescribing motives were nutritional intervention (23%), paracentesis in cirrhotic patients (19%), and radical surgery (11%). Only 59 prescriptions (24%), corresponding to 14,539 g of albumin (23%), were considered appropriate. The total cost of albumin therapy for the 242 cases was $183,796 (US$); $42,905 (23%) of this figure was the cost of appropriate use of albumin and $140,891 (77%) was the amount related to inappropriate use. CONCLUSIONS: Evaluated against model guidelines, the use of most of the albumin, deemed clinically necessary by the prescribers, was considered unnecessary or inappropriate. Hence, institutions need to define and implement guidelines that focus on responsible use of such agents in an increasingly cost-conscious healthcare environment.

Adolescent↗
PubMed1998

[Evaluation of drug treatment of myocardial infarction in public hospitals of Andalusia. GAUME (Andalusian Group for performance of Studies on Drug Utilization)].

BACKGROUND: The management of patients with acute myocardial infarction (AMI) has changed over the last decade. The aim of this study was to evaluate the pharmacologic treatment of AMI in the clinical practice, with special emphasis in thrombolytic therapy. MATERIAL AND METHODS: Prospective drug utilization survey, collecting data from 26 hospitals belonging to the Andalusian Health Service, Spain, during one month period. Pharmacologic treatment in the first 24 h was obtained. RESULTS: Out of 379 patients recruited, 52.8% received thrombolytic therapy, although another 19% could have obtained some benefit from that therapy. Alteplase was the most frequently used thrombolytic (65.5%). The regimen prescribed was mainly that followed in GUSTO Study (45.8%) or double bolus (43.5%). In a high percentage of patients the thrombolytic selection was not made according to the results of the literature. Women and patients older than 75 years were less likely to receive thrombolytic therapy. There was a high utilization of aspirin (89.7%), nitrates (84.4%) and heparin (83.6%). CONCLUSIONS: Thrombolytic therapy was prescribed in a higher percentage of patients than is reported in other trials. In spite of that, thrombolytics should have been used in more patients. As alteplase does not have a definitive benefit over streptokinase, protocol is needed when selecting a thrombolytic agent.

Age Factors↗
PubMed1993

Decision analysis applied to the selection of angiotensin-converting enzyme inhibitors.

Decision analysis is applied to the group of angiotensin-converting enzyme inhibitors, in order to select those which should be included in the hospital formulary and to establish a research method which allows the reproduction of the process with new, related drugs. Captopril, enalapril and lisinopril were the alternatives considered. Evaluation criteria were efficacy, clinical experience, safety, dosage interval, hepatic bioactivation, interactions, dosage forms and cost. A relative weight was assigned through a survey among the hospital's staff. Each alternative was evaluated in relation to all criteria. Sensitivity analysis was applied to validate the method. Enalapril obtained the highest score, followed by lisinopril and captopril. The sensitivity analysis confirms this result. Enalapril is selected for the hospital formulary due to its higher score, although the differences between the three are very small.

Angiotensin-Converting Enzyme Inhibitors↗
PubMedDate not supplied

[Interstitial cystitis: drug therapy].

The present job reviews the etiology, clinical presentation, diagnostic and treatment of interstitial cystitis. An exhaustive revision is made of all the possibilities of pharmacological treatment with a special mention to the two major drugs: dimethylsulfoxide and pentosampolysulphate. A critical judgement of existing clinical trials is made. The conclusion indicates the need of more controlled experimental work in the future to allow a more objective determination of the most appropriate and effective therapy for these patients.

Cystitis↗
PubMedDate not supplied

[An evaluation of the effect of light on a commercial solution of amino acids for parenteral nutrition].

There are few studies on the stability of amino acids in solutions prior to mixing for parenteral nutrition, and even few studies which evaluate the contribution of light to their deterioration. The present study was carried out with the aim of becoming familiar with this parameter of stability in the working conditions of our Pharmacy Service. Two batches of Aminoplasmal L-10 were taken, one of which was subjected to direct low intensity sunlight and the other was maintained in the dark, as a control batch, for between 3-6 months. At the end of this time, complete aminograms were performed by ionic interchange chromatography. The measurements of concentrations of each amino acid were obtained for each batch. A Student T test was used to show that there were no significant differences between them after both 3 and 6 months. It was therefore concluded that the amino acid solution we had tested was maintained stable under the light exposure conditions of our Service after 6 months.

Amino Acids↗