Reanimación cardiopulmonar extracorpórea: caso clínico de paro cardiaco extra hospitalario / Extracorporeal cardiopulmonay resuscitation: case report on an out-of-hospital cardiopulmonary arrest

Out-of-hospital cardiopulmonary arrest (OHCA) is highly lethal. Although overall survival is increasing, hospital discharge with good neurological prognosis remains low and highly variable. In some countries, protocols are being implemented, which include techniques in cardiopulmonary resuscitation, allowing a better neurological prognosis for those patients who undergo an OHCA. Following these new techniques and the incorporation of these new protocols already accepted in the guidelines of advanced cardiopulmonary resuscitation, we report a 54 years old male who presented an OHCA and received advanced cardiopulmonary by a professional team in situ. He was transferred to the emergency department, where optimal advanced resuscitation was continued, until the connection to extracorporeal cardiopulmonary support, with the aim of reestablishing blood flow, a technique known as cardiopulmonary resuscitation (ECPR: extracorporeal cardiopulmonary resuscitation). The patient was discharged from the hospital 25 days later.

Prescripción de opioides al alta de un servicio de urgencia / Prescription of opioids at the moment of discharge from an emergency department

Background There is a worrisome increase in opioid prescription worldwide. Their use and overuse may cause adverse outcomes. Aim To determine incidence and characteristics of opioid prescription at discharge at an emergency department (ED). Material and Methods A prospective observational study in a random sample of adult patients attended at an ED of a teaching hospital. We reviewed medical records prescriptions for each patient to collect information about drugs prescribed, reason and medical indication of use (doses and duration). Results A total of 1,001 patients aged 50 ± 20 years (61% women) were studied. Seven percent of patients received an opioid prescription at discharge from the ED, mainly to treat renal and back pain. The dose, duration of treatments or both were incompletely described in 54% of prescriptions. The dose of tramadol in drops was incomplete in 96% of prescriptions. Conclusions Seven percent of patients discharged from an ED received an opioid prescription, mainly to treat non-oncological acute pain. The lack of information detected in the prescriptions affected quality, safety and effectiveness of the treatment, especially when pharmaceutical formulations were drops.

Traumatismos dentales en dentición permanente / Dental trauma in permanent dentition

Los traumatismos dentales en los últimos años han mostrado una alta predominancia reportada en estudios poblacionales, siendo la edad principalmente comprometida entre los 8 y 12 años, afectando mayormente al sexo masculino, por lo que representa actualmente un serio problema de salud pública. Se clasifican en fracturas coronarias, luxaciones y avulsiones Estos traumatismos son causadas en su mayoría por caídas y actividades deportivas como el ciclismo, siendo las fracturas coronarias no complicadas las lesiones más frecuentes. El manejo de estas lesiones es difícil para el clínico, por lo que el objetivo de la presente revisión fue brindar información actualizada del diagnostico, tratamiento y pronostico de las lesiones traumáticas en la dentición permanente.

Dental injuries in recent years have shown a high prevalence reported in population studies, where age is mainly committed between 8 and 12 years, affecting mostly male, so it now represents a serious public health problem. Crown fractures are classified, dislocations and avulsions these injuries are mostly caused by falls and sports activities like cycling; being the uncomplicated crown fractures the most common injuries. The management of these lesions is difficult for the clinician, so the objective of this review is to provide updated information on diagnosis, treatment and prognosis of traumatic injuries in permanent teeth.