Objective: To describe the experience with upper gastrointestinal bleeding (UGIB) in two major Latin American hospitals, its main causes, treatment and prognosis, while exploring some risk factors associated with death. Design: Prospective cohort study. Patients and Methods: We included 464 patients older than 15 years of age from two reference centers. We studied some demographic variables, history, clinical presentation, treatment and mortality. We explored the association between those variables and death. Results: The mean age was 57.9 years, and the male: female ratio was 1.4:1. Three hundred and fifty-nine patients (77.4%) were seen for gastrointestinal bleeding (outpatient bleeding) and 105 patients (22.6%) were inpatients seen for UGIB. A total of 71.6% of patients admitted with the diagnosis of upper GI bleeding underwent upper GI endoscopy (EGD) within 24 hours. The main causes of bleeding were peptic ulcer (190 patients, 40.9%), erosive disease (162 patients, 34.9%) and variceal bleeding (47 patients, 10.1%). Forty-four patients died (9.5%). Patients who presented with bleeding due to other causes during hospitalization had a higher mortality risk than those whose complaints were related to gastrointestinal bleeding (RR 2.4, 95% CI 1.2-4.6). An increasing number of comorbidities, such as those described in the Rockall score, were also associated with a higher risk of mortality (RR 2.5, 95% CI 1.1-5.4). Conclusion: Intrahospital upper GI bleeding and the presence of comorbidities are risk factors for a fatal outcome. Identifying patients with a higher risk would help improve the management of patients with UGIB.

The plasma levels of beta-Thromboglobulin (beta-TG) and Platelet Factor 4 (PF4) were measured in patients during the normal obstetrical period and in pre-eclampsia. A significant increase was observed in the two proteins with respect to the non-pregnant control group but no difference was seen between pregnancy and puerperium in either the normal or pre-eclamptic cases. The one significant variation in the concentration of the two proteins was a sharp rise during parturition. There was no correlation between beta-TG, PF4 and either the platelet count or creatinine but urea and uric acid did show a slight correlation with the two platelet proteins.

BackgroundBefore October 2015, the dispensing procedure in the Home Care Service (HCS) was manual where medication for each patient was sent from the pharmacy service (PS) weekly in an individual bag. This procedure required high economic, time and human resources. For any treatment start or change, an individual order was requested as a pro re nata (PRN) medicine. Occasionally a global return of accumulated drugs was made.PurposeIn October 2015, the PS implemented an automated dispensing cabinet linked to an electronic prescribing programme (ADCLEP), Omnicell, in the HCS. PS replaced drugs automatically 2 days a week and staff from HCS placed them into the ADCLEP. The aim of this study was to evaluate the consequences of such implementation in the dispensing procedure evaluating the economic, time and human resources.Material and methodsData were obtained from our electronic prescribing programme e-Osabide and our management computer programme SAP. A comparison between a period of 2 months (from 1 January to 29 February) was made in 2015 and 2016. The items registered were: number of PRN medicines; economic cost (€); and dispensing time and staff resourcesResults 2015 2016 No of PRN medicines 24757 Dispensing time (min) 1920640 Dispensing staff 8 pharmacy assistants + 1 pharmacist2 pharmacy assistant + 1 pharmacist Cost (€) 50 26340 377ConclusionThe number of PRN medicines decreased by79%, dispensing time by 67%, dispensing staff resources by 67% and economic cost by 20%. Eliminating individual preparation and minimising the number of PRNs have had a great impact on PS care work. The main reason why the number of PRNs decreased is that the ADCLEP contains most of the medicines used by HCS.Economic cost was reduced due to more accurate and better adaptation to the patient’s needs. Even though it has not been measured, prescriptions were updated more accurately and this could have led to less medication errors.Other advantages detected were no delay in the disposition of medicines and improvement in control of narcotics (book is generated automatically).We had no way of measuring the number of returns but the perception was that they decreased to almost none. ADCLEP is an efficient system and could be exported to other services.No conflict of interest

new trend implies a change in the demographic pattern and disease that most commonly affects the elderly. In addition, there has been an increase in certain diseases in old age and a direct relationship of oral disease with systemic diseases of aging own. The objectives of this study are to know the state of oral health in institutionalized geriatric population and assess the impact of systemic diseases and drug therapy in the level of oral health. Material and Method: We performed a cross-sectional, descriptive and observational study in a group of patients institutionalized in a geriatric center of Santiago de Compostela. Patients were randomly selected, all over 65 and resident in the center. Patients with impaired physical, emotional or cognitive, which would prevent carrying out the research protocol were excluded. Each of the patients included in the study has made them an oral examination, as well as a review of their medical histories, pharmacological data and their systemic diseases. Results: They will be presented during the Congress. Conclusions: They will be presented during the Congress.

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