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Fundamento y objetivo Los objetivos de este trabajo fueron: a) describir la neutropenia febril (NF) inducida por quimioterapia en pacientes afectados de neoplasia solida (NS); b) validar la escala de la Asociacion Multinacional de Tratamiento de Soporte en Cancer (MASCC), y c) evaluar si el uso de esta escala es util para disminuir el coste economico derivado de esta urgencia oncologica y mejorar la calidad de vida. Pacientes y metodo Estudio prospectivo de incidencia de NF desde diciembre de 2005 hasta noviembre de 2006. Calculo de la sensibilidad y especificidad de la escala y comparacion de diversos parametros antes y despues (periodos 1 y 2) de la inclusion de la escala de MASCC. Resultados Se incluyeron 80 episodios. El 48,8% fueron de bajo riesgo. La sensibilidad y la especificidad de la escala fueron del 86,3 y el 62%, respectivamente. Dieciseis pacientes pudieron abandonar el hospital tempranamente (en un plazo inferior a 3 dias). Se comprobo una reduccion significativa del coste economico durante el periodo 2. Conclusiones La escala de MASCC es un instrumento seguro para estratificar el riesgo de pacientes con NS y NF inducida por quimioterapia. Sin embargo, una mayor especificidad permitiria una reduccion mayor del coste hospitalario y una mejora en la calidad de vida de estos enfermos.

We aimed to describe chemotherapy-induced neutropenic fever (NF) in patients with solid neoplasms (SN), to validate the Multinational Association of Support Treatment in Cancer (MASCC) scale, and to evaluate whether the use of the MASCC scale was useful for reducing hospital costs for this oncologic emergency and improving the quality of life.We performed a prospective study on the incidence of chemotherapy-induced NF from December 2005 to November 2006 and calculated the sensitivity and specificity of the MASCC scale. We compared different parameters before and after (periods 1 and 2) the inclusion of the MASCC scale.We included 80 episodes of NF, 48.8% being of low risk. The sensitivity and the specificity of the MASCC scale were 86.3% (19/22) and 62% (26/58), respectively. 16 patients were discharged early (3 days). Hospital costs were significantly lower during period 2.The MASCC scale is a safe tool for stratifying the risk of cancer patients and chemotherapy-induced NF. However, greater specificity would allow a greater reduction in hospital costs and improve the quality of life of these patients.

Bloodstream infections have probably decreased in HIV patients since highly active antiretroviral therapy (HAART) usage.Hematogenous infections, including mycobacteria and fungi in HIV patients, stratified into two periods (I: 1995-1996 and II: 1997-1998) were included to evaluate changes attributable to HAART.226 episodes were attended (incidence: 38.8 in period I and 15.3 in period II; p0.01). A significant decrease was observed in immunosuppression related microorganisms. HAART usage increased from 6.4% in period I to 31.2% in period II. Immunological parameters of HIV patients significantly improved in period II.Hematogenous infections have significantly decreased in HIV patients since the use of HAART.