Adverse drug events in an intensive care unit of a university hospital

Purpose Adverse drug events (ADEs) are harmful and occur with alarming frequency in critically ill patients. Complex pharmacotherapy with multiple medications increases the probability of a drug interaction (DI) and ADEs in patients in intensive care units (ICUs). The objective of the study is to determine the frequency of ADEs among patients in the ICU of a university hospital and the drugs implicated. Also, factors associated with ADEs are investigated. Methods This cross-sectional study investigated 299 medical records of patients hospitalized for 5 or more days in an ICU. ADEs were identified through intensive monitoring adopted in hospital pharmacovigilance and also ADE triggers. Adverse drug reactions (ADR) causality was classified using the Naranjo algorithm. Data were analyzed through descriptive analysis, and through univariate and multiple logistic regression. Results The most frequent ADEs were ADRs type A, of possible causality and moderate severity. The most frequent ADR was drug-induced acute kidney injury. Patients with ADEs related to DIs corresponded to 7% of the sample. The multiple logistic regression showed that length of hospitalization (OR = 1.06) and administration of cardiovascular drugs (OR = 2.2) were associated with the occurrence of ADEs. Conclusion Adverse drug reactions of clinical significance were the most frequent ADEs in the ICU studied, which reduces patient safety. The number of ADEs related to drug interactions was small, suggesting that clinical manifestations of drug interactions that harm patients are not frequent in ICUs.

Body composition and quality of life (QoL) of the elderly offered by the ""University Third Age`` (UTA) in Brazil

The investigation of the factors that interfere in the well-being of the elderly and their QoL can provide theoretical and methodological subsidies in structuring actions and policies in the health area, in order to fulfill the needs of that population. In this descriptive transversal study, body composition and QoL of elderly women at the UTA program in Piracicaba (Sao Paulo, Brazil) were verified. The participants were 81 women from UTA, and the general levels of physical activity were evaluated, as well as body weight (BW), height, and bodymass index (BMI). The waist circumference (WC) was measured at the level of the umbilical scar and the body composition by impedance (BIA 310e). QoL was verified by means of WHOQOL-Bref and statistical analysis developed with the SAS program. The decrease of weight, height, BMI, and fat-free mass (FFM) was observed among the several age groups, although with no significant difference. The average levels of the general QoL scores and physical, psychological and environmental domains decreased in higher age groups, but social domains showed the opposite result. This fact can be a particular characteristic of the UTA group, and factors the influence such behavior are yet to be studied. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

Clonal transmission of ESBL-producing Klebsiella spp. at a university hospital in Brazil

The present study was designed to determine the prevalence and extended-spectrum beta-lactamase (ESBL) types in clinical isolates of Klebsiella spp. at a university hospital located in the Brazilian southern region (Ribeirao Preto, Sao Paulo) as well as their antibiotic susceptibility and genetic profiles. This study included 147 non-repeat Klebsiella spp. isolates collected from January to June 2000, of which 23 K. pneumoniae and 8 K. oxytoca were selected as ESBL producers by using the Oxoid combination disk method and Etest ESBL strip. beta-lactamases were characterized by IEF, PCR and sequencing assays using primers for ESBL genes. Antibiotic susceptibility was evaluated by MicroScan system. Dissemination of two major clones of ESBL-producing Klebsiella spp. occurred in the hospital. According to the results obtained in this study there was a clonal spread of CTX-M-producing K. oxytoca in five clinics and dissemination of ESBL-producing K. pneumoniae in the nursery and pediatrics wards.

Northern wing, General Purpose North 3, University of Queensland, St Lucia

As seen from Blair Road.

Northern wing, General Purpose North 3, University of Queensland, St Lucia

As seen from Balir Road.

West elevation, General Purpose North 3, University of Queensland, St Lucia

Formal elevation facing University of Queensland entrance roads.

Eastern edge, General Purpose North 3, University of Queensland, St Lucia

As seen from informal courtyard; Duhig Tower beyond.

West elevation, General Purpose North 3, University of Queensland, St Lucia

Formal elevation facing University of Queensland entrance roads.

West elevation, General Purpose North 3, University of Queensland, St Lucia

Formal elevation facing University of Queensland entrance roads.

West elevation, General Purpose North 3, University of Queensland, St Lucia

Formal elevation facing University of Queensland entrance roads.

Amphitheatre entry court, Collaborative Workshop, University of Queensland, St Lucia

Entry from landscaped amphitheatre area.

Gutter detail, Collaborative Workshop, University of Queensland, St Lucia

Open-ended folded sheet metal gutter.

Amphitheatre entry court, Collaborative Workshop, University of Queensland, St Lucia

Entry from landscaped amphitheatre area.

Catalogue of manuscripts from the Hayes Collection in the University of Queensland Library

Index to correspondence and manuscript material on literary and historical matters, mostly in Queensland and New South Wales, Australia held in the Fryer Library, University of Queensland - UQFL2. Authors and subjects include J.H.M. Abbott, Archer Family, E. Armitage, R. Bedford, H.S. Bloxome, E.J. Brady, 'Broadside', F. Broomfield, A.H. Chisholm, C.B. Christesen, R.H. Croll, Z. Cross, F.W.S. Cumbrae-Stewart, E. Dark, D. Deamer, C.J. Dennis, J. Devaney, E.M. England, P. Fitzgerald, R.D. Fitzgerald, Dame Mary Gilmore, C. Gittins, A.L. Gordon (criticism), P. Grano, M. Haley, W.A. Horn, R.G. Howarth, J. Howlett Ross, E.H. Lane, H. Lane, F.J. McAuley, D. McConnel, G. McCrae, K. (S) Mackenzie, P. Miles, J.K. Moir, C.P. Mountford, A. Muir, D.A. O'Brien, J.H. O'Dwyer, W.H. Ogilvie, M. Potter, T. Playford, H. Power, Queensland Authors' and Artists' Association, I. Southall, W. Sowden, A.G. Stephens, P.R. Stephensen, H. Tyron, A.J. Vogan, B. Vrepont, T. Welsby, H.R. White and Duke of Windsor. Also personal papers of Father Hayes, relating to his activities as parish priest.