PubMed Health⌕ Search

Biomedical subjects

J Ribas Sala

Publications and source records attributed to J Ribas Sala.

6 recordsLinked to original sources

[Do physicians know the cost of the treatments and tests they prescribe?].

OBJECTIVE: To determine the degree of knowledge among physicians regarding the cost of diagnostic tests and commonly used drugs. INDIVIDUALS AND METHODS: An interview was obtained with a representative sample of 164 physicians from a total of 338 (accuracy +/- 3.55), distributed in interns/residents (n:119) and staff members (n:45) from the divisions of Surgery (n:81) and Medicine (n:83) at Hospital Clinic i Provincial, Barcelona. The questionnaire included 15 questions, 10 regarding drugs and 5 diagnostic tests, with 5 possible answers. An arbitrary scoring system was used (correct answer: 5 points; approximate; 3 points; mistake: 1 point) and the percentage of right answers (correct and approximate answers) was also evaluated versus mistakes. The Student "t" test, the analysis of variance and the chi 2 test were used to compare the results. RESULTS: The overall score reached was 2.72 +/- 0.41. Differences between residents vs staff and medicine vs surgery were not significant. The score in questions regarding diagnostic tests was significantly higher than that obtained for drug cost among all group. The percentages of right answers (correct and approximate answers) were 58.8%-61.7% (drugs) and 58.3-60.8% (tests), with no differences among groups. Differences regarding year of residence were also not significant. CONCLUSIONS: The knowledge degree on costs of some drugs and diagnostic tests among physicians is deficient. It is necessary to find standards that contribute to increase the level of information regarding costs derived from the health care delivery process among health care professionals.

Costs and Cost Analysis↗

[Drotrecogin alfa (activated): specific treatment for serious sepsis].

Severe sepsis is a high prevalent disease at Intensive Care Units with no specific treatment till recently. Several clinical trials show low serum levels of activated protein C in this kind of patients. Recently, drotrecogin alfa (activated), a recombinant human activated protein C, has been approved in Spain for severe sepsis treatment in addition to the best patient care. Protein C (activated) has antithrombotic, profibrinolitic an antiinflamatory properties. So far, Prowess (phase 3 trial) is the most important clinical trial conducted with drotrecogin alfa (activated) at the moment. It demonstrates not only its efficacy and safety, but also a 19.4% reduction in the relative risk of death. Nevertheless, it is difficult to decide which patients would be candidate for this new therapy due to its lack of experience, high cost and the risk-benefit relationship. This review attempts to provide an overview about this new hospital drug.

Sepsis↗

[Desensitization to cotrimoxazole, rifampicin and penicillin G in nine patients with prior hypersensitivity].

OBJECTIVE: To present a protocol for the administration and development technique of the desensitization regimens for cotrimoxazole, rifampicin and penicillin G hypersensibility. METHOD: A review of the available desensitization protocols for these antibiotics and a retrospective study of desensitization processes undertaken in the center from 1998. A development technique of the antibiotic dosages was designed. RESULTS: Desensitization regimens for cotrimoxazole, rifampicin and penicillin G undertaken in the center in 9 patients came from a protocol by Glucksteins et al., Holland et al. and Wendal et al., respectively. After the literature review and the satisfactory results that allowed subsequent antibiotic administration in the 9 cases, these regimens were established as protocols of the center. CONCLUSIONS: Dosage development and patient administration have a practical application and can help to decrease the potential mistakes related to the complexity of the process.

Anti-Infective Agents↗