Jordi Galimany-Masclans

Influence of nursing interventions on adherence to treatment with antituberculosis drugs in children and young people: research protocol

AIM To evaluate the efficacy of nursing interventions on adherence to antituberculosis medication in a paediatric cohort (aged 0-18 years) and to identify the risk factors for non-compliance. BACKGROUND After primary infection, children have a higher risk of developing tuberculosis and the severity of the disease is worse in children. Adherence to treatment is essential to control both latent infection and tuberculosis disease. DESIGN Phase 1: retrospective descriptive analysis (n = 270) in children and young people receiving antituberculosis treatment. Phase 2: quasi-experimental, longitudinal, prospective study (n = 100). The results of the two phases will be compared. METHODS Phase 1: in children followed up during the period 2011-2013 (non-intervention group), the level of adherence and its associated epidemiological, sociocultural and clinical risk factors will be analysed. Phase 2: educational (written information in the childs mother tongue and follow-up telephone calls) and monitoring (Eidus-Hamilton test and follow-up questionnaire) nursing interventions will be implemented. The results of the two phases will be compared. The definitive Nurse-led Follow-up Programme will then be designed. This project was funded in October 2013. DISCUSSION The risk factors for poor adherence to antituberculosis therapy need to be identified to optimize treatment success in latent tuberculosis infection and disease in children and young people. Simultaneous application of several educational and monitoring methods in nurse-led follow-up shall improve adherence in children and adolescents in our setting. These results may also be applicable in other settings, where tuberculosis is more prevalent and directly observed treatment strategies are not available.

Reacciones adversas a los medios de contraste yodados en radiología

OBJECTIVE The aim of the study is to determine the incidence of adverse reactions to iodinated contrast media and to characterise them in a group of outpatients, inpatients and emergency patients in a private hospital in Barcelona. METHOD A retrospective cohort study was carried out over a 60 months period, from February 2002 to February 2007, analysing the patients who underwent to iodinated contrast radiological examinations. Adverse reactions were evaluated from the manual record format developed following the requirements of the Quality Assurance Program in Radiology. Study variables were, administration route, contrast media dose, adverse reaction type, and signs and symptoms. Statistical analysis was descriptive. RESULTS A total of 68 (0.3 %) of adverse reaction were registered of which 64 were mild (94.1%), 4 moderate (5.9%) and none severe. On the basis of the administration route (intravenous or oral) adverse reaction were 67 (94%) and 1 (6%) respectively. With a 40-80ml contrast media dose by injection, mild adverse reactions were 87.5%, moderate 12.5% and severe 0%. With a 90-150ml contrast media dose by injection, mild adverse reaction were 94.9% and moderate 5.1%. CONCLUSIONS The number of adverse reaction using iodinated contrast media is low and are they are generally mild; however the nurse must be ready to recognise and treat them.