ABSTRACT
Eclampsia is one of the most dangerous complications of pregnancy and has a high incidence in developing countries. It is characterized by coma and the occurrence of generalized tonic-clonic seizures in pregnant women with hypertension. Deep bites on the tongue and other orofacial injuries have been described as consequences of these seizures. We present a case of death associated with eclampsia in which the bite during the seizure episode caused almost total amputation of an enlarged tongue (macroglossia). The medico-legal value of this finding and the situation due to antecedent pathological conditions and lack of routine screening in pregnant women who may migrate legally or illegally to give birth with better medical care are discussed.
ABSTRACT
El objetivo de este trabajo es analizar la evolución del gasto en farmacia en Andalucía y en la provincia de Jaén, entre los años 1991 y 1999, comparándolo con el resto de las Comunidades Autónomas, y el total nacional, estudiando los factores que pudieron influir en el mismo, entre ellos el papel de los farmacéuticos que trabajan en las estructuras de Atención Primaria como elemento racionalizador de dicho gasto. La evolución del gasto farmacéutico se va a ir conociendo a través de los informes retrospectivo que de forma sistemática elaboran desde hace más de diez años el Servicio Andaluz de Salud y eI INSALUD, entre otros. Los resultados indican un incremento interanual del gasto farmacéutico diferente para cada servicio de salud con un rango que oscila entre el 20,28% (Servicio Vasco. Salud, año 1991) Y el 1,14% (INSALUD, año 1993). Entre las conclusiones resaltar que la incorporación de los farmacéuticos a los Distritos de Primaria permite mejorar el conocimiento de este gasto, así como el asesoramiento al personal sanitario y de forma especial a los Directores de los Distritos cuando estos se implican directamente en su control, observándose, entonces, los menores incrementos interanuales (AU)
The objective of this study is to analyze the evolution of pharmaceutical expenditure in Andalucía and in Jaén Province between 1991 and 1999, comparing them to the rest of the Autonomous Communities, and the national total, studying the factors that could influence them, mainly the role of the pharmacists that work in Primary Care structures as a rationalizing factor of this expenditure. The evolution of pharmaceutical expenditure will be shown through the retrospective reports that Andalussian Health Service and INSALUD, among others, have systematically elaborated for more than ten years. The results indicate an inter-annual increase in pharmaceutical expenditure, different for each Service, with a range oscillating between 20-28% (Bosque Health Service 1991) and 1,14% (INSALUD, 1993). Among the conclusions the incorporation of pharmacists to primary care districts allowing improvement in knowledge of this expenditure stands out, likewise the assessment of health personnel and in particular the District Directors when they are directly implicated in its control, less inter-annual increases, being therefore observed (AU)
