Adverse drug reactions (ADR) are one of the ten main causes of mortality in the world, as a cause of hospital admissions or prolongation hospitalizations days created an important health and economic ...impact. This study aimed to detect incidence and characterize ADRs that occurred during hospitalization and associated with admission in Internal Medicine service.
Observational and prospective study of intensive RAM monitoring patients admitted in Internal Medicine services in a third level hospital over a twelve months period in 2014. The assessment consisted of a complete and protocol collecting information about the patients and related to suspected ADRs during hospitalization. Statistical analysis was performed using SPSS v.20.0.
The study included 253 patients and in 54 (21,34%) ADR were detected, the risk of experiencing an ADR was associated with the age (p=0.012). ADR-related hospitalizations incidence were 7,11%, and fatal ADR incidence were 1,97%. With regard to severity 81,2% were severe. Gastrointestinal disorders represented the most common ADRs followed by metabolism and nutrition disorders and vascular disorders. The drugs most frequently associated with ADRs were cardiovascular agents, antiinfective drugs and central nervous system agents. 72.2% of the patients who suffered ADR had polypharmacy.
In our study incidence of adverse drug reactions in hospitalized patients was 21,34%, this data and ADR´s related to admission to hospital or fatal ADR´s are mainly suffered by pluripathology and polymedicated elderly patients with worst renal function values. In these patients a more careful prescription should be made.
Background and Aims: Schizotypical personality disorder (PD) is difficult to diagnose due to the overlapping symptoms with other clinical entities. Objectives: To illustrate this difficulty with a ...clinical case and to recover the term schizotypy in a well-argued manner.Methods: We present the case of a 30-year-old male who consults for excessive social anxiety secondary to diffuse paranoid fears that make him have fantasies of escaping from his usual environment and that cause difficulties in interpersonal relationships and difficulty in getting a job once he has gotten rid of cannabis. Reactive to this anguish has had escapes to other cities or countries in the past that have meant for him to be maintained street situation for months or the need to prostitute himself consuming cannabis in high dose. He alternates with these escapes, incomes in therapeutic communities, cannabis consumption and hospitalizations by diffuse psychotic clinic and obsessive ruminations mainly of sexual content. The last admission was three years ago where he was diagnosed with polymorphous psychotic disorder and unspecified PD.Results: He is diagnosed of schizotypal PD and starts a treatment with olanzapine 2.5mg and being refer to a day hospital, where progressive improvement is observed. After 9 months he is asymptomatic and has recovered the family bond and works.Conclusions: The differential diagnosis of psychotic symptoms is not always simple but has prognostic implications. Schizotypy, a disused term, raises schizophrenia and schizotypal PD as part of a continuum, which is closer to clinical practice.
