[Study of effectiveness of craving control with topiramate in patients with substance dependence disorders]. / Estudio de la efectividad del control del craving con topiramato en pacientes con trastornos por dependencia de sustancias.

INTRODUCTION: Effectiveness and tolerability of topiramate at 3 and 6 months was assessed in patients requesting dehabituation programs. METHODS: Observational, prospective, national and multicenter study of 6 months, in patients on treatment with topiramate, who fulfilled criteria for dependence of opiates according to ICD-10 participating in therapeutic programs of dehabituation, without concomitant psychiatric illnesses and any responsible relative. Main measures of effectiveness were retention rates, alcohol consumption and other illicit drugs by urine tests (opiates, cannabis, cocaine) and treatment needs by EuropASI scale. Other parameters were HAM-D, DAS-SV and SF-36. RESULTS: Patients with consumption by urine tests decreased from 94.1 % (n = 64) at baseline to 39.6 % (n = 19) after 6 months of treatment, as was seen by means of the mean score in EuropASI scale, for all substances except methadone. No consumption was accompanied by a low rate of relapse of 33.3 % at 6 months. Twenty one patients had adverse reactions (28 %). The most frequent adverse reactions were somnolence (n = 9; 12 %), paraesthesia (n = 5; 6.7 %) and depression (n = 4; 5.3 %). CONCLUSIONS: In real clinical practice, topiramate showed a good response with a relevant decrease of percent of patients with abuse or consumption, and a satisfactory tolerability profile for the treatment of patients with dependence on heroine, cocaine, and other opiates, showing better outcomes than those obtained in previous trials.

Estudio de la efectividad del control del craving con topiramato en pacientes con trastornos por dependencia de sustancias / Study of effectiveness of craving control with topiramate in patients with substance dependence disorders

Introducción. En la práctica clínica habitual se ha evaluado de eficacia y tolerabilidad d etopiramato a los 3 y 6 meses en pacientes que solicitaron programas de deshabituación. Métodos. Estudio observacional prospectivo, multicéntrico, topiramato, en pacientes con criterios de dependencia de opiáceos según la CIE-10 en programas terapéuticos de deshabituación, si otra patología psiquiátrica concomitante y con algún familiar responsable. Medidas principales de eficacia han sido: tasas de retención, consumo de alcohol y otras drogas de abuso en orina y necesidad de tratamiento del cuestionario EuropASI. Otros parámetros han sido las escalas HAM-D, DAS-SV y SF-36. Resultados. El número de pacientes consumidores según controles de orina descendió del 84,1% (n=64) basal al 39,6% (n=19) a los 6 meses de seguimiento, descenso que se reflejó también a partir de la puntuación media en el cuestionario EuropASI para todas las sustancias excepto la metadona. Esta alta tasa de no consumo se acompañó de una baja tasa de recaídas, del 33,3• a los 6 meses. Se registraron 21 pacientes con reacciones adversas (28%), siendo las reacciones adversas más frecuentes la somnolencia (n=9; 12%), las parestesias (n=5; 6,7%) y la depresión (n=4; 5,3%). Conclusiones. El topiramato mostró en condiciones asistenciales reales una buena respuesta, con una importante disminución del porcentaje de pacientes consumidores y un satisfactorio perfil de tolerabilidad en el tratamiento de pacientes con dependencia de heroína, cocaína y/u otros derivados opiáceos, mejorando los resultados obtenidos en ensayos clínicos previos (AU)

Introduction. Effectiveness and tolerability to topiramate at 3 and 6 months was assessed in patients requesting dehabituation programs. Methods. Observational, prospective, national and multicenter study of 6 months, in patients on treatment with topiramate, who fulfilled criteria for dependence of opiates according to ICD-10 participating in therapeutic programs of dehabituation, without concomitant psychiatric illnesses and any responsible relative. Main measures of dehabituation, without concomitant psychiatric illnesses and any responsible relative. Main measures of effectiveness were retention rates, alcohol consumption and other illicit drugs by urine test (opiates, cannabis, cocaine) and treatment needs by EuropASI scale, Other parameters were HAM-D, DAS-SV and SF-36. Results. Patients with consumptions by urine test decreased from 94.1% (n=64) at baseline to 39,6% (n=19) after 6 months of treatment, as was seen by means of the mean score in EuropASI scale, for all substances except methadone. No consumption was accompanied by a low rate of relapse of 33.3% at 6 months. Twenty one patients had adverse reactins (28%). The most frequent adverse reactions were somnolence (n=9, 13%), paraesthesia (n=5 6.7%) and depression (n=4; 5.3%). Conclusions. In real clinical practice, topiramate showed a good response with a relevant decrease of percent of patients with abuse or consumption, and a satisfactory tolerability profile for the treatment of patients with dependence on heroine, cocaine and other opiates, showing better outcome than those obtained in previous trials (AU)

Topotecan asociado a ciclofosfamida como tratamiento de tumores sólidos pediátricos avanzados / Topotecan associated to cyclophosphamide as treatment of advanced pediatric solid tumors

Se presenta un estudio retrospectivo de la utilización de topotecan y ciclofosfamida como terapia de rescate en niños con tumores solidos refractarios ó recidivados que habían recibido previamente terapia intensiva, incluyendo en dos de ellos megaterapia con rescate hematopoyetico. Se incluyeron 19 pacientes (seis sarcomas de partes blandas, cuatro neuroblastomas, tres sarcomas de Ewing, tres tumores neuroectodermicos primitivos, dos retinoblastomas bilaterales y un meduloblastoma. La dosis total por ciclo fue de 1.250 mg de ciclofosfamida y 3,75 mg de topotecan. Los ciclos se repitieron cada 28 días. Se administraron un total de 79 ciclos. Se observaron 3 remisiones completas (dos rabdomiosarcomas y un sarcoma sinivial) y 6 remisiones parciales (dos neuroblastomas, un meduloblastoma, un retinoblastoma y un tumor desmoplasico) lo que significa un 47 por ciento de casos con respuesta objetiva al tratamiento. La principal toxicidad observada fue la mielosupresion (tras el 20 por ciento de los ciclos) (AU)

[Acute poisoning by I.M. iron. Report of a fatal case (author's transl)]. / Intoxicación aguda por hierro administrado por vía parenteral. A propósito de un caso de evolución fatal.

The case of a five months-old child who received 44 mg/Kg of Fe-sorbitol I.M. by mistake is reported. That dose is about ten times the usual standard dosage. After an initial vague symptomatology, followed by transitory improvement, she developed a serious metabolic acidosis, renal and hepatic failure and generalized convulsions. The clinical picture could not be controlled by general supportive treatment, desferroxamine administration and exanguino-transfusion.