Prevalence of drug interactions in hospital healthcare

Aim of the review To study the prevalence of drug interactions in hospital healthcare by reviewing literature. Method A review was carried out of studies written in Spanish and English on the prevalence of drug interactions in hospital care published in Pubmed between January 1990 and September 2008. The search strategy combined free text and MeSH terms, using the following keywords: ??Drug interaction??, ??prevalence?? and ??hospital??. For each article, we classified independent variables (pathology, age of population, whether patients were hospitalized or not, geographical location, etc.) and dependent variables (number of interactions per 100 patients studied, prevalence of patients with interactions, most common drug interactions, and others). Results The search generated 436 articles. Finally, 47 articles were selected for the study, 3 provided results about drug interactions with real clinical consequences, 42 about potential interactions, and 2 described both. The prevalence of patients with interactions was between 15 and 45?% and the number of interactions per 100 patients was between 37 and 106, depending on the group of studies analyzed. There was a considerable increase in these rates in patients with heart diseases and elderly persons. Conclusion There is a large number of studies on the prevalence of drug interactions in hospitals but they report widely varying results. The prevalence is higher in patients with heart diseases and elderly people.     

Bone and joint tuberculosis

Introduction

Bone and joint tuberculosis has increased in the past two decades in relation with AIDS epidemics.

Material and methods

A literature review of bone and joint tuberculosis, focusing on Pott’s disease.

Results

Bone and joint TB comprises a group of serious infectious diseases whose incidence has increased in the past two decades, especially in underdeveloped countries, in part due to the AIDS epidemic. Tuberculous spinal infections should be suspected in patients with an insidious, progressive history of back pain and in individuals from an endemic area, especially when the thoracic vertebrae are affected and a pattern of bone destruction with relative disc preservation and paravertebral and epidural soft tissue masses are observed. Atypical tuberculous osteoarticular manifestations involving the extraspinal skeleton, a prosthetic joint, or the trochanteric area, and nontuberculous mycobacterial infections should be considered in favorable epidemiological contexts. Surgery combined with prolonged specific antituberculous chemotherapy is mainly indicated in patients with neurological manifestations or deformities, and provides satisfactory results in most cases.

Conclusions

Spinal tuberculosis is still a relative common extra spinal manifestation of spinal tuberculosis that requires a high degree of suspicion in order to avoid neurological complications and need of surgery.

     

Assessing the ecotoxicological effects of long-term contaminated mine soils on plants and earthworms: relevance of soil (total and available) and body concentrations

The interactions and relevance of the soil (total and available) concentrations, accumulation, and acute toxicity of several essential and non-essential trace elements were investigated to determine their importance in environmental soil assessment. Three plant species (T. aestivum, R. sativum, and V. sativa) and E. fetida were simultaneously exposed for 21 days to long-term contaminated soils collected from the surroundings of an abandoned pyrite mine. The soils presented different levels of As and metals, mainly Zn and Cu, and were tested at different soil concentrations [12.5, 25, 50, and 100 % of contaminated soil/soil (w/w)] to increase the range of total and available soil concentrations necessary for the study. The total concentrations in the soils (of both As and metals) were better predictors of earthworm uptake than were the available concentrations. In plants, the accumulation of metals was related to the available concentrations of Zn and Cu, which could indicate that plants and earthworms accumulate elements from different pools of soil contaminants. Moreover, Zn and Cu, which are essential elements, showed controlled uptake at low concentrations. The external metal concentrations predicted earthworm mortality, whereas in plants, the effects on growth were correlated to the As and metal contents in the plants. In general, the bioaccumulation factors were lower at higher exposure levels, which implies the existence of auto-regulation in the uptake of both essential and non-essential elements by plants and earthworms.