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Collado-González B, Ferrero-García-Loygorri C, Escobar-Castellanos M, Barrera-Brito V, Salvador-Rodríguez M, Marañón R, Mora-Capín A. [Evolution of the perception of the safety culture of healthcare professionals in a pediatric emergency department]. J Healthc Qual Res 2024; 39:41-49. [PMID: 38123402 DOI: 10.1016/j.jhqr.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/14/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND AND AIM Safety culture (SC) is a fundamental tool for minimizing adverse events and improving safety and quality of care. Our objective, therefore was to analyze the evolution of the SC of healthcare professionals in a pediatric emergency department (PED) after the implementation of a risk management system for patient safety based on the UNE:EN:ISO 179003 Standard and the execution of new safe practices for Joint Commission International accreditation. At the same time describe the current strengths and weaknesses. METHODS Quasi-experimental, single-center study. All PED professionals participated in the study. An initial measurement of SC was performed through the Hospital Survey on Patient Safety Culture (HSOPS) questionnaire of the Agency for Healthcare Research and Quality adapted to Spanish in 2014. Pro-patient safety strategies were implemented between 2015 and 2022. A subsequent measurement was performed in 2022. RESULTS The response rate in 2014 was 55% and 78% in 2022. On both occasions the group with the highest participation was nurses with 35.1% and 34.8%, respectively. Five dimensions improved after the interventions: frequency of adverse events (25.2%, p<0.001), organizational learning (25%, p<0.001), feedback and communication about errors (22.3%, p<0.001), non-punitive response to errors (6.5%, p = 0.176), and management support (4%, p = 0.333). CONCLUSIONS The actions carried out had a positive influence on organizational learning and the frequency of adverse events reported and communication within the team. In contrast, the perception of SC did not increase.
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Affiliation(s)
| | | | | | - V Barrera-Brito
- Hospital General Universitario Gregorio Marañón, Madrid, España
| | | | - R Marañón
- Hospital General Universitario Gregorio Marañón, Madrid, España
| | - A Mora-Capín
- Hospital General Universitario Gregorio Marañón, Madrid, España
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Rivas-García A, Míguez-Navarro MC, Ferrero-García-Loygorri C, Marañón R, Vázquez-López P. Burnout syndrome in paediatricians working in paediatric emergency care settings. Prevalence and associated factors: a multilevel analysis. An Pediatr (Barc) 2023; 98:119-128. [PMID: 36737361 DOI: 10.1016/j.anpede.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/20/2022] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION The aim of our study was to describe the prevalence of burnout syndrome (BOS) in paediatricians working in paediatric emergency care settings and to analyse its association with potential risk factors. MATERIAL AND METHODS Multicentre cross-sectional study through a survey of paediatricians working in paediatric emergency care settings in hospitals affiliated to the Research Network of the Spanish Society of Paediatric Emergency Medicine (SEUP) between September 2019 and January 2020. We analysed the association between social/family-related, demographic, occupational and satisfaction factors and the presence of BOS by means of multivariate and multilevel mixed-effects logistic regression models. RESULTS The estimated prevalence of BOS was 36.5% (95% confidence interval [CI], 31.7 %-41.2%). In the multivariate analysis, lacking a stable group of friends (OR, 2.57; 95% CI, 1.10-5.97), problems in and out of the work setting (OR, 3.06; 95% CI, 1.60-5.88) and a work experience of 9 years or less (OR, 2.31; 95% CI, 1.37-3.90) were identified as individual factors that increased the risk of SBO, while feeling acknowledged by coworkers (OR, 0.48; 95% CI, 0.30-0.79) and acknowledged by one's supervisor (OR, 0.62; 95% CI, 0.41-0.93) were protective factors. In relation to the hospital, the paediatric emergency unit being a subdepartment of the Department of Paediatrics (OR, 3.81; 95% CI, 1.85-7.85), the presence of an on-call emergency medicine specialist around the clock (OR, 3.53; 95% CI,1.62-7.73) and a volume of 28 or more paediatric emergency encounters a day to be managed per on-call physician (OR, 2.05; 95% CI, 1.01-4.16) were identified as independent risk factors for SBO. There was no variability in the prevalence of BOS attributable to differences between hospitals and autonomous communities, save for the described situations. CONCLUSIONS The prevalence of SBO among these providers is high. There are modifiable factors that we can intervene on to address BOS, independently of the hospital or region.
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Affiliation(s)
- Arístides Rivas-García
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| | | | - Clara Ferrero-García-Loygorri
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Rafael Marañón
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Paula Vázquez-López
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
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- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
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Jové-Blanco A, Toledano-Revenga J, Rivas-García A, Vazquez-López P, Lorente-Romero J, Marañón R. Inhaler technique in a pediatric emergency department: Impact of an education intervention among healthcare professionals. Pediatr Pulmonol 2023; 58:441-448. [PMID: 36226385 DOI: 10.1002/ppul.26205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 08/24/2022] [Accepted: 10/09/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Inhaler technique (IT) knowledge among healthcare providers is poor. The aim was to improve Pediatric Emergency Department (PED) healthcare providers' IT technique by carrying out an education intervention and sustain it for 6 months. METHODS Open-label, quasi-experimental, prospective, and unicentric study. Healthcare professionals working at the PED were enrolled. The study was developed in three phases: baseline evaluation and education intervention (P1) and reevaluation 1 month (P2) and 6 months (P3) after the education intervention. Participants fulfilled an eight-question theoretical test. Practical skills were evaluated by demonstrating IT in all three phases. The education intervention consisted in a verbal explanation of IT followed by a demonstration of IT with metered-dose inhaler using a mannequin. RESULTS A total of 84 healthcare providers (medical residents, nurses, and nursing assistants) were involved. In the theoretical questionnaire, the mean score at baseline was 4.4/8 (SD 1.7) improving to 6.3/8 (SD 1.2) in P2 and 6.47/8 (SD 1.1) in P3. In the IT evaluation for children <7 years old, the score improved from 5.7/7 (SD 1.3) to 6.5/7 in P2 and 6.7/7 in P3 (p < 0.001). For children >7 years old, the mean score of IT at baseline was 3.1/10 (SD 4), which improved to 7.4/10 (SD 3) and 8.2/10 in P2 and P3, respectively (p < 0.001). Only professional category influenced results at baseline. CONCLUSION Healthcare providers' theoretical knowledge and practical skills on IT are low. The education intervention performed is a useful strategy to ameliorate IT among healthcare providers.
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Affiliation(s)
- Ana Jové-Blanco
- Department of Pediatric Emergency, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Health Investigation Institute Gregorio Marañón, Madrid, España
| | | | - Arístides Rivas-García
- Department of Pediatric Emergency, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Health Investigation Institute Gregorio Marañón, Madrid, España
| | - Paula Vazquez-López
- Department of Pediatric Emergency, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Health Investigation Institute Gregorio Marañón, Madrid, España
| | - Jorge Lorente-Romero
- Department of Pediatric Emergency, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Health Investigation Institute Gregorio Marañón, Madrid, España
| | - Rafael Marañón
- Department of Pediatric Emergency, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Health Investigation Institute Gregorio Marañón, Madrid, España
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Rivas-García A, Míguez-Navarro MC, Ferrero-García-Loygorri C, Marañón R, Vázquez-López P. Síndrome de burnout en pediatras con actividad asistencial en urgencias. Prevalencia y factores asociados. Análisis multinivel. An Pediatr (Barc) 2023. [DOI: 10.1016/j.anpedi.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Castro-Rodríguez C, Lorente-Romero J, Rivas-García A, García-Loygorri CF, Vázquez-López P, Marañón R. Acute Alcohol Intoxication in Pediatric Emergencies. Pediatr Emerg Care 2022; 38:e1523-e1528. [PMID: 35876736 DOI: 10.1097/pec.0000000000002808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Alcohol intoxication in pediatrics is a growing problem in our environment. The objectives of this study are to define the prevalence of acute alcohol intoxication in the pediatric emergency department (PED) and to describe the associated symptoms and their relationship with potential risk factors. METHODS AND MATERIAL This cross-sectional study includes patients younger than 16 years with a diagnosis of acute alcohol intoxication between March 2010 and October 2018 in the PED of a tertiary hospital. Patients with concomitant intoxication by other substances were excluded. The association between qualitative variables was determined using the χ 2 or Fisher exact test and quantitative with the Student t , Mann-Whitney U test, and simple linear regression. RESULTS There were 136 episodes of alcohol intoxication, which represents a prevalence of 24.1/100,000 emergencies. After excluding 10 patients because of positive screening for other drugs, 126 patients with a mean age of 14.5 years (SD, 1.2 years) were included, 57.9% of whom were women. A total of 25.4% of the patients were younger than 14 years. Ethanolemia was determined in 88.9%, and its mean concentration was 195.7 mg/dL (SD, 56.5 mg/dL), with potentially serious levels (>300 mg/dL) being found in 3.6% of the patients. A relationship was found between the Glasgow Coma Scale score and ethanolemia ( B = -12.7; 95% confidence interval, -8.1 to -17.4; P < 0.001), as well as with potassium ( B = -31, 9; 95% confidence interval, -6.6 to -57.3; P = 0.014). No patient had seizures or hypoglycemia. A total of 10.3% of the patients required admission. CONCLUSIONS Alcohol intoxication is a rare consultation reason in the PED. They usually present with mild and self-limited symptoms, being the decrease in the level of consciousness and hypokalemia the most frequent symptom and analytical alteration.
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Affiliation(s)
- Cristina Castro-Rodríguez
- From the Pediatric Emergency Department, General University Hospital Gregorio Marañón, Madrid, Spain
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Míguez MC, Ferrero C, Rivas A, Lorente J, Muñoz L, Marañón R. Retrospective Comparison of Intranasal Fentanyl and Inhaled Nitrous Oxide to Intravenous Ketamine and Midazolam for Painful Orthopedic Procedures in a Pediatric Emergency Department. Pediatr Emerg Care 2021; 37:e136-e140. [PMID: 30925568 DOI: 10.1097/pec.0000000000001788] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To compare the efficacy and adverse events of 2 pharmacological strategies: intranasal fentanyl and nitrous oxide (FN) inhaled against intravenous ketamine and midazolam (KM) as procedural sedation and analgesia (PSA) in painful orthopedic procedures in the pediatric emergency department (ED). METHODS This is an observational retrospective cohort study. Patients were included that submitted to PSA for carrying out a painful orthopedic procedure in the ED of a tertiary hospital over a period of 2 years. The main outcome variable was efficacy and adverse events of the PSA procedure. RESULTS Eighty-three patients were included. Fifty-two patients received FN and 31 KM. The PSA strategy was considered efficacious in 82.7% of the patients in the KM group and 80.6% in the FN cohort. No differences between both strategies were found (P = 0.815). Seventeen children showed early adverse events, 2 in the FN cohort and 15 in the KM group (relative risk of the KM strategy, 23.48; 95% confidence interval (CI), 3.24-169.99). The average of satisfaction obtained by the families was of 10 (CI, 10-10) in the KM cohort and of 9 (CI, 8-9.5) in the FN group (P = 0.152). The length of stay in the ED was longer in the KM cohort (P < 0.001). Hospital admission rate differences were not statistically different (9.6% vs 22.6%, P = 0.144) in the KM versus FN cohort. CONCLUSIONS Both PSA strategies presented similar efficacy. The FN strategy was associated with a lower risk of adverse events and shorter ED length of stay than KM in this ED setting.
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Affiliation(s)
- Ma Concepción Míguez
- From the Emergency Pediatrician, Sección de Urgencias de Pediatría, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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García-Moreno FJ, Escobar-Castellanos M, Marañón R, Rivas-García A, Manrique-Rodríguez S, Mora-Capín A, Fernández-Llamazares CM. [Adecuacy of pediatric antimicrobial prescribing in the Emergency Department at discharge]. An Pediatr (Barc) 2021; 96:S1695-4033(20)30507-5. [PMID: 33583763 DOI: 10.1016/j.anpedi.2020.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 11/12/2020] [Accepted: 11/18/2020] [Indexed: 10/22/2022] Open
Abstract
INTRODUCTION In January 2019, Community of Madrid's Health Department published a guide about the use of antimicrobials in outpatient children. Taking this regional Guide as reference, this study was aimed at estimating the adequacy of the antimicrobial stewardship at discharge from a pediatric Emergency Department (ED). Secondarily, the differences in adequacy according to the diagnosis and the prescriber were studied, and the agreement between this Guide and the protocols of the ED was assessed. MATERIAL AND METHODS An observational, descriptive, retrospective study was conducted on patients under 16 years old, with a diagnosis included in the regional Guide who were discharged from a pediatric ED between March of 2018 and February of 2019. Prescription was considered adequate when the indication, the antibiotic and the posology (dosage, dosing interval, length of treatment and route of administration) were correct. RESULTS 165 out of 648 (25,5%) infectious diseases processes analyzed received antimicrobial treatment. In 23 processes treated with antimicrobial, the adequacy could not be evaluated due to the absence of data necessary to assess any aspect of posology. Therapy was considered appropriate in 550/625 processes (88.0%). When antimicrobial treatment was prescribed, 70/142 (49.3%) were appropriate and no statistically significant differences in adequacy were found between prescribers. Posology was the worst handled point of the prescription (26.3%). Tract urinary infection, conjunctivitis and otitis media were the pathologies with the lowest adecuacy (44.4%; 50.0% and 52.2%) and presented the highest discrepancy between the Guide and the center protocols (k=0.308; k=0.000; k=0.586). CONCLUSIONS The adequacy of the management of infectious processes to the reference Guide in our pediatric ED was high, but it was below 50% when antimicrobial treatment was required. The degree of adequacy to the local protocols of the center was greater than to the regional Guide. This reveals a discrepancy between the 2documents that should be analyzed and corrected according to the available scientific evidence.
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Affiliation(s)
- Félix Jesús García-Moreno
- Servicio de Farmacia, Hospital General Universitario Gregorio Marañón, Madrid, España; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España
| | | | - Rafael Marañón
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España; Sección de Urgencias de Pediatría, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - Arístides Rivas-García
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España; Sección de Urgencias de Pediatría, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - Silvia Manrique-Rodríguez
- Servicio de Farmacia, Hospital General Universitario Gregorio Marañón, Madrid, España; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España; RETIC SAMID Carlos III (RD16/0022/0004), Madrid, España
| | - Andrea Mora-Capín
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España; Sección de Urgencias de Pediatría, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - Cecilia M Fernández-Llamazares
- Servicio de Farmacia, Hospital General Universitario Gregorio Marañón, Madrid, España; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España; RETIC SAMID Carlos III (RD16/0022/0004), Madrid, España
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Lorente Romero J, Marañón R, Jové Blanco A. [Obtaining a urine sample through the perineal bag without replacement: Analysis of the contamination rate]. An Pediatr (Barc) 2021; 94:272-273. [PMID: 33436312 DOI: 10.1016/j.anpedi.2020.11.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 11/16/2020] [Indexed: 11/26/2022] Open
Affiliation(s)
| | - Rafael Marañón
- Urgencias Pediátricas, Hospital Gregorio Marañón, Madrid, España
| | - Ana Jové Blanco
- Urgencias Pediátricas, Hospital Gregorio Marañón, Madrid, España
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Castro-Rodríguez C, Solís-García G, Mora-Capín A, Díaz-Redondo A, Jové-Blanco A, Lorente-Romero J, Vázquez-López P, Marañón R. Briefings: A Tool to Improve Safety Culture in a Pediatric Emergency Room. Jt Comm J Qual Patient Saf 2020; 46:617-622. [DOI: 10.1016/j.jcjq.2020.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 08/10/2020] [Accepted: 08/10/2020] [Indexed: 10/23/2022]
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de Lucas N, Maconochie I, Van de Voorde P, Rodríguez-Nuñez A, López E, Labarre A, Breinig S, Clerigué N, Sotoca J, Er A, Aleo E, Duran I, Barrera E, Romero E, Canduela V, Marañón R, Rodrigo R, Gelman A, Domínguez JAR, Trastoy J, Centelles I, Mencía S. Effect of bicarbonate administration on outcome in children in cardiac arrest. Resuscitation 2020. [DOI: 10.1016/j.resuscitation.2020.08.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Marañón R, Solís-García G, Ignacio Cerro C, Díaz Redondo A, Romero Martínez AI, Mora Capín A. [Evaluation of effectiveness of corrective measures arising from incident notifications in a paediatric emergency department]. J Healthc Qual Res 2019; 34:242-247. [PMID: 31713520 DOI: 10.1016/j.jhqr.2019.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/03/2019] [Accepted: 05/13/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To analyse the effectiveness of corrective measures arising from the analysis of safety incident notifications in the Paediatric Emergency Unit. METHODS A quasi-experimental, prospective, and single-centre study was carried out between 2015 and 2018. In the first phase, incidents notified throughout one year were analysed. Corrective measures were then implemented for 5 specific kinds of incidents. These incidents were finally compared to those notified within 12 months after the implementation of those measures. Results were expressed as relative risk and relative risk reduction. RESULTS A total of 1587 safety incidents were notified (0.9% of patients treated) between January 2015 and December 2017. After implementation of corrective measures, there was a decrease in all kinds of incidents notifications analysed. The incidents related to patient identification were reduced by 60.9% (RR 0.39, 95% CI; 0.25-0.60), and those regarding communication between professionals were reduced by 74.5% (RR 0.25, 95% CI; 0.12-0.55). Incidents related to sedation and analgesic procedures totally disappeared. No significant reduction was found in incidents concerning the triage system, or in those related to rapid intravenous rehydration procedures. CONCLUSIONS The implementation of improvement actions arising from the analysis of voluntary notification of incidents is an effective strategy to improve patient effective strategy to improve.
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Affiliation(s)
- R Marañón
- Unidad de Urgencias de Pediatría, Hospital General Universitario Gregorio Marañón, Madrid, España.
| | - G Solís-García
- Unidad de Urgencias de Pediatría, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - C Ignacio Cerro
- Unidad de Urgencias de Pediatría, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - A Díaz Redondo
- Servicio de Medicina Preventiva, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - A I Romero Martínez
- Unidad de Urgencias de Pediatría, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - A Mora Capín
- Unidad de Urgencias de Pediatría, Hospital General Universitario Gregorio Marañón, Madrid, España
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de Lucas N, Van de Voorde P, Rodríguez-Núñez A, López-Herce J, Maconochie I, Sotoca J, Er A, Marañón R, Clerigué N, Pérez-Gay L, Lobato Z, Aleo E, Romero E, Pino A, Fernández R, Arribas JF, Pitti JA, Oliveras AP, Plana M. What makes the difference in children with unexpected good outcome 6 months after cardiac arrest? Resuscitation 2019. [DOI: 10.1016/j.resuscitation.2019.06.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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García-Morin M, López-Sangüos C, Vázquez P, Alvárez T, Marañón R, Huerta J, Cela E. Lactate Dehydrogenase: A Marker of the Severity of Vaso-Occlusive Crisis in Children with Sickle Cell Disease Presenting at the Emergency Department. Hemoglobin 2017; 40:388-391. [DOI: 10.1080/03630269.2016.1275677] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Fernández Lafever S, López R, Marañón R. Infección de orina como manifestación de un absceso pélvico. An Pediatr (Barc) 2011; 75:212-3. [DOI: 10.1016/j.anpedi.2011.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Revised: 03/02/2011] [Accepted: 03/04/2011] [Indexed: 10/17/2022] Open
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Santos M, Marañón R, Miguez C, Vázquez P, Sánchez C. Use of racecadotril as outpatient treatment for acute gastroenteritis: a prospective, randomized, parallel study. J Pediatr 2009; 155:62-7. [PMID: 19394033 DOI: 10.1016/j.jpeds.2009.01.064] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2008] [Revised: 11/05/2008] [Accepted: 01/21/2009] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare the efficacy of therapy with racecadotril plus oral rehydration versus oral rehydration alone in children with gastroenteritis in an outpatient setting care. STUDY DESIGN Prospective, randomized, open and parallel study performed in a Pediatric Emergency Service of a tertiary care hospital. The study included 189 patients, ages 3 to 36 months, with acute gastroenteritis: 94 were administered an oral rehydration solution (OR), 94 received oral rehydration solution plus racecadotril (OR + R). The principal variable studied was the number of bowel movements in 48 hours after initiating treatment. RESULTS The groups were comparable clinically and epidemiologically at enrollment. No significant differences were found in the number of bowel movements between the 2 groups 48 hours after initiating treatment (4.1 +/- 2.7 bowel movements in the OR group vs 3.8 +/- 2.4 bowel movements in the OR + R group). No differences were found in the average duration of gastroenteritis (4.7 +/- 2.2 days in the OR group, 4.0 +/- 2.1 days in the OR + R group; P = .15). The incidence of adverse events was similar in both groups (19 patients [20.2%] in the OR group, 18 patients [19.1%] in the OR + R group). CONCLUSIONS In our study group, the use of racecadotril did not improve the symptoms of diarrhea compared with standard rehydration therapy.
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Affiliation(s)
- Mar Santos
- Department of Pediatrics, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
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García Fernández EJ, Marañón R, Maroto C, Maroto E, Seriñá C, Delcán JL. [Pulmonary valvuloplasty in children with cyanotic cardiopathy]. Rev Esp Cardiol 1991; 44:115-8. [PMID: 2068356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We present 5 patients with cyanotic congenital heart disease in whom a pulmonary valvuloplasty was performed as palliative therapy. The patients symptoms were hypoxemic spells, very low oxygen saturation and no weight gain. The oxygenation improved and symptoms disappeared. We believe that in properly selected patients this technique represents a good therapeutic modality.
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