Farmacovigilancia de las vacunas frente a COVID-19 en farmacias comunitarias. Resultados tras la primera dosis / Pharmacovigilance of vaccines against COVID-19 in community pharmacies. Results with the first dose

Objetivos: detección, notificación y seguimiento de sospechas de reacciones adversas (RA) tras la administración de la primera dosis de la vacuna frente a la COVID-19 en usuarios de las farmacias comunitarias y su repercusión sobre la salud y vida diaria. Métodos: diseño: observacional prospectivo. Sujetos: personas vacunadas frente a la COVID-19, mayores de edad, que firmaron el consentimiento informado. Variables: número y porcentaje de participantes que presentaban al menos una RA. Número, tipo y frecuencia de posible reactividad. Repercusión en su vida diaria. El estudio fue aprobado por el CEIm-G (Exp. 2021-007).Resultados: colaboraron 10 farmacias de Pontevedra y 2 de Ourense. 781 casos, 488 (62,5 %) mujeres. Edad 56,8 (DE=17,9) años. 389 (49,8 %) en grupo de riesgo.495 (63,4 %) vacunados, 321 mujeres (65,8 %) y 174 (59,4 %) hombres refirieron al menos una RA: 236 (53,0 %) frente a Comirnaty®, 157 (82,6 %) a Vaxzevria®, 69 (66,3 %) a Spikevax® y 33 (80,5) a Janssen®.Se registraron 1.367 RA, 1,8 por persona vacunada. Las más prevalentes (el % es sobre el total de pacientes): dolor en punto de inyección 375 (48,0 %), cansancio/fatiga 170 (21,8 %), escalofríos 118 (15,1 %), cefalea 117 (15,0 %), dolor muscular 112 (14,3 %) y fiebre 98 (12,5 %). De los 495 encuestados con RA, necesitaron ayuda profesional 77 (15,6 %): del médico de familia 30 (39,0 %), 9 (11,7 %) en servicio de urgencias, 1 (1,3 %) en hospital y 37 (48,1 %) en la farmacia. A 118 (15,1 %) les impidió desarrollar su actividad diaria.Se comunicaron las RA que refirieron 264 vacunados (53,3 %).Conclusiones: el número de vacunados que manifestaron haber sufrido RA fue alto. Dolor en el punto de inyección fue la RA más prevalente. La mitad fueron atendidos en la farmacia. Aunque fueron en general leves, afectaron notablemente a su vida diaria. (AU)

Efectos adversos de las vacunas frente al SARS-CoV-2 en farmacéuticos comunitarios de Pontevedra / Adverse effects of SARS-CoV-2 vaccines in community pharmacists of Pontevedra

Objetivo: analizar los registros de sospechas de efectos adversos (EA) de las vacunas frente al SARSCoV-2 administradas a farmacéuticos comunitarios (FC) y personal auxiliar.Métodos. Diseño: estudio observacional transversal, en febrero-abril de 2021. Sujetos: farmacéuticos, técnicos y auxiliares de la provincia de Pontevedra que ejercen en contacto con los pacientes, vacunados con la primera dosis frente al SARS-CoV-2.Variables: número, tipo y frecuencia de EA, características demográficas.Procedimiento: se habilitó un formulario en la web del Colegio de Farmacéuticos de Pontevedra. Se anunció a los FC colegiados de la provincia su existencia y la conveniencia de cumplimentarlo.Resultados: 167 participantes, de los que 153 manifestaron síntomas compatibles con reactividad a la vacuna, 122 (93,1 %) mujeres y 31 (86,1 %) hombres. 146 (95,4 %) habían recibido Vaxzevria®, 116(79,4 %) mujeres y 30 (20,6 %) hombres, y 7 (4,6 %) Comirnaty®, 6 (85,7 %) mujeres y 1 (14,3 %) hombre. Se comunicaron 823 EA, 811 (5,3 DE=2,8 EA, 0-12 por paciente) con Vaxzevria® y 12 (0,9 DE=1,0 EA, 0-3 por paciente) con Comirnaty®. EA más frecuentes: dolor en punto de inyección, 128 (87,7 %); escalofríos, 107 (73,3 %); dolor muscular, 106 (72,6 %). En los tres casos, mayor proporción de mujeres (p<0,01). El número máximo de EA manifestados por un participante fue 12. 132 (86,3 %) vacunados que refirieron EA, 106 (86,9 %) mujeres y 26 (83,9 %) hombres, necesitaron medicamentos para aliviar los síntomas. 77 (46,1 %) no pudieron desarrollar sus actividades diarias y 47 (28,1 %) no pudieron trabajar el día siguiente. Conclusiones: el número de EA comunicados por farmacéuticos y personal auxiliar vacunados fue alto. Aunque no fueron graves, afectaron de manera considerable a su actividad diaria y laboral. (AU)

Percepción de los usuarios de la farmacia comunitaria sobre la COVID-19 al final de la alarma y comparación con la situación al inicio / Community pharmacy users' perception of COVID-19 comparingthe beginning and ending situation of the lockdown

OBJETIVOS: evaluar la percepción de los usuarios de las farmacias sobre la repercusión de la COVID-19 en su salud al final del confinamiento y comparar los resultados con los obtenidos al inicio. MATERIAL Y MÉTODOS: estudio observacional transversal aleatorizado, en farmacias de Pontevedra y Ourense, del 10 al 25 de junio de 2020. SUJETOS: ≥ 18 años que acuden en demanda de medicamentos y/o material de protección. Procedimiento: el usuario cumplimentaba un cuestionario anónimo, depositándolo en una bandeja desinfectada diariamente. RESULTADOS: 839 encuestas. 492 (58,6 %) mujeres, edad media 54,6 (DE =1 7,4 años). 144 (17,2 %) viven solos. 771 (91,9 %) creen que la COVID-19 es más peligrosa que la gripe, 233 (27,7 %) desconocen estar en algún grupo de riesgo. 137 (16,4 %) dicen sentirse mal/muy mal con el aislamiento. Aspectos más afectados: familiar 429 (51,1 %) y emocional 377 (44,9 %). La afectación de los aspectos físico 210 (25,0 %) y laboral 183 (21,8 %) mejoraron significativamente en fase final. En 2020/21 piensan vacunarse de la gripe 376 (44,4 %), en 2019/20 lo hicieron 243 (34,4 %). 541 (64,5 %) se vacunarán frente a la COVID-19 cuando exista vacuna. Aumentan los que se vacunarán, aunque no esté financiada: 511 (60,9 %) / 280 (39,7 %). CONCLUSIONES: no ha variado significativamente la percepción sobre la peligrosidad de la COVID-19 y la repercusión en su salud. Los aspectos del bienestar más afectados siguen siendo el familiar y el emocional. Aumenta el número de los que se sintieron mal/muy mal con el confinamiento y el de mayores afectados por la soledad. Aumenta la intención de vacunarse del SARS-CoV-2, aunque no sea financiada

AIM: Assess the perception of pharmacy users about the impact of COVID-19 on their health at the end of confinement and compare the results with those obtained at the beginning. MATERIAL AND METHODS: Randomized cross-sectional observational study, in pharmacies in Pontevedra and Ourense, from 10 to 25 June 2020.Subjects: 18 years of age who come on demand for medicines and/or protective material. PROCEDURE: the user completed an anonymous questionnaire, depositing it in a daily dis-infected tray. RESULTS: 839 surveys. 492 (58,6%) women, an average age of 54.6 (DE-17.4) years. 144 (17,2%) they live alone. 771 (91,9%) COVID-19 is more dangerous than influenza, 233 (27.7%) they don't know how to be in some risk group. 137 (16,4%) say they feel bad/very bad with isolation. Most affected aspects: family 429 (51.1%) emotionally 377 (44.9%). Affecting physical aspects 210 (25.0%) 183 (21.8%) significantly improved in the final phase. In 2020/21 they plan to be vaccinated with influenza 376 (44.4%), in 2019/20 they did so 243 (34.4%). COVID-19 will be vaccinated when there is a vaccine. Those who will be vaccinated increase even if 511(60.9%)/280 (39.7%) is not funded. CONCLUSIONS: The perception of the danger of COVID-19 and the impact on its health has not changed significantly. The aspects of well-being that are most affected remain familiar and emotional. Increases the number of those who felt bad/very bad with confinement and that of adults affected by loneliness. It increases the intention to get vaccinated from SARS-CoV-2, even if it is not funded

Factores de riesgo de diabetes en una población adolescente de Cangas de Morrazo (Galicia) (RIVACANGAS) / Diabetes risk factors in adolescent population from Cangas de Morrazo (Galicia) (RIVACANGAS)

Objetivos: Identificar factores de riesgo de desarrollar diabetes (DM) en una muestra de escolares. Material y método: Estudio epidemiológico, transversal, multicéntrico en alumnos de la ESO (12-17 años) de 4 centros escolares de Cangas do Morrazo (Pontevedra). Variables: edad, sexo, antecedentes personales y familiares de DM, peso, estatura, perímetro de cintura (PC), índice cintura/talla (ICT), índice de masa corporal (IMC), presión arterial. Cuestionario de riesgo de DM para niños y adolescentes (Findrisc-A) (modificado), características de la dieta (Kidmed) y de la actividad física (PAQ-A). Resultados: 630 escolares, 628 sin diabetes: 294 niñas (46,8%) y 334 niños (53,2%), media de edad 13,8±1,4 años. El 7,1% hipercolesterolemia; 1,7% ECV, 0,8% HTA y 0,3% DM. El 5,6% antecedentes familiares de 1er grado de DM. Antecedentes de 2º grado de DM el 18,6%. Sobrepeso el 23,3%. El 7,5% con obesidad central (PC >P90). El 21,0 % ICT >0,5. El 63,9% PAS >P90 y 23,7% PAD >P90. La puntuación media del Kidmed fue de 5,0±2,2. 21,7% con adherencia baja (<3 puntos) y 11,8% con adherencia alta (>8 puntos). Puntuación media PAQ-A de 2,6±0,7, mayor en niños (2,8±0,7 vs 2,5±0,7; p<0,001), con actividad física baja 1,6% y con actividad física alta el 19,4%. Puntuación media Findrisc-A 6,0±3,4. Relación directa entre Findrisc-A y PAS, PAD, PC, IMC e ICT. Inversa con Kidmed y PAQ-A. Conclusiones: El riesgo medio de diabetes resultó bajo, aunque más del 10% presentaba riesgo alto o muy alto. Uno de cada cuatro tiene exceso de peso y uno de cada diez, obesidad (AU)

Objectives: To identify risk factors of developing diabetes (DM) in a sample of students. Materials and methods: It was carried out an epidemiological, cross-sectional and multicenter study with students from 12 to 17 years of four schools from Cangas do Morrazo (Pontevedra). Variables: age, sex, personal and family history of DM, weight, height, waist circumference (WC), waist/height index (WHI), body mass index (BMI), blood pressure, cholesterol levels, presence of central obesity (PC>P 90). It was applied the Risk of DM questionnaire for children and adolescents (Findrisc-A) (modified). The characteristics of the diet were evaluated with the Kidmed Index (low adherence if result < 3 points and high if > 8 points) and the physical activity too (PAQ-A). Results: 628 students were included in the study: 294 girls (46.8%) with an average age of 13,8±1,4 years. The proportion of risk factors was: 7.1% hypercholesterolemia; 1.7% CVD, hypertension 0.8%. 5.6% had 1 rst degree family history of DM. 2 nd degree family history of DM, 18.6%. 23.3% were overweight. 7.5% had central obesity. 21.0% WHI>0.5. 63.9% SBP>P90 and 23.7% DBO>P90. The average of the Kidmed score was 5.0±2.2. 21.7% with low adherence and 11.8% with high adherence. PAQ-A average score was 2.6±0.7, higher in boys (2.8±0.7 vs 2.5±0.7; p<0.001), with low physical activity 1.6% and 19.4% with high physical activity. Findrisc average score 6.0±3.4. There was found a direct relationship between Findrisc-A and SBP, DBP, WC, BMI and WHI. On the other hand, an inverse correlation between Findrisc results and the Kidmed and PAQ-A values was shown. Conclusions: The average diabetes risk was low, but more than 10% had high or very high risk. One of every four students was overweight and one of every ten had obesity (AU)

Plasma levels of microparticle-associated tissue factor activity in patients with clinically suspected pulmonary embolism.

INTRODUCTION: Microparticles (MPs) carrying active tissue factor (TF) have been detected in the plasma of cancer patients in particular in those presenting with acute deep vein thrombosis (DVT) or pulmonary embolism (PE). Experimental studies in mice have revealed that circulating MPs carrying TF contribute to thrombus formation. AIM: To study whether unselected patients with an acute confirmed PE have elevated TF activity in the MP fraction (MP-TF activity). MATERIALS AND METHODS: Plasma MP-TF activity was measured in 159 non-selected patients with clinically suspected PE and in 48 healthy controls as previously described. Blood was collected at time of inclusion. The diagnosis of acute PE was confirmed in 54 patients and excluded in 105 patients. RESULTS: Median MP-TF activity in 159 patients with clinically suspected PE was 72 fM Xa/min [range 32-6657] fM Xa/min and higher than in healthy controls (66 [range 28-183] fM Xa/min; P<0.05). There was no significant difference (P=0.169) in MP-TF activity between patients with confirmed PE (median 84.5 fM Xa/min [range 36-2149]) and patients without PE (72 fM Xa/min [range 32-6657]) fM Xa/min). In the 159 patients with clinically suspected PE we observed in an exploratory analysis higher MP-TF activity levels in patients with active cancer (median 137 fM Xa/min [range 36-6657]) and cardiovascular disease (median 131.5 fM Xa/min [range 45-2149]) than in patients without these disorders (P=0.0004 and P=0.014, respectively). CONCLUSION: In patients presenting with clinically suspected PE plasma MP-TF activity was not associated with confirmed PE.

Análisis de la utilización de medicamentos por pacientes diabéticos en la provincia de Pontevedra / Analysis of the use of medication for diabetic patients in the province of Pontevedra

Objetivos: a) Determinar las características demográfi cas y el perfi l de utilizaciónde los medicamentos de la población usuaria de hipoglucemiantes en la provincia dePontevedra, y b) analizar las eventuales diferencias en la utilización de esos medicamentosen función de la edad, el sexo y la residencia de los pacientes (interior ocosta). Estudio descriptivo retrospectivo de consumo (dispensación) de hipoglucemiantesen las ofi cinas de farmacia de la provincia de Pontevedra durante 2007.Variables analizadas: Dosis diaria por 1.000 habitantes y número de recetas porpaciente. Resultados: Se estudió a un total de 41.202 pacientes (un 4,35% de lapoblación total, que llega al 20% a partir de 80 años); un 51,67% eran mujeres.Los grupos de hipoglucemiantes más consumidos fueron, entre las insulinas, lasmixtas (40,36%), y entre los hipoglucemiantes orales las biguanidas (51,61%) y lassulfonilureas (29,52%). La glibenclamida la utilizan en mayor medida los pensionistasque los no pensionistas (el 17,88 frente al 13,88%; p= 0,07). La utilización dehipoglucemiantes, inhibidores de la enzima conversora de la angiotensina/antagonistasdel receptor de la angiotensina II, antiagregantes y estatinas no se ajusta a lasrecomendaciones de las guías terapéuticas actuales. El mayor consumo de ansiolíticosy antidepresivos en las mujeres es estadísticamente signifi cativo. El consumode hipoglucemiantes por paciente es mayor entre los residentes en la costa(AU)

Objectives: a) To determine the demographic features and profile of use ofmedicines by the population who takes hypoglycemic agents in the provinceof Pontevedra, and b) to analyze any differences in the use of these drugs accordingto age, sex and residence (interior or coast). A retrospective descriptivestudy of consumption of hypoglycemic agents in community pharmaciesfrom Pontevedra during 2007. Analysed variables: The daily dose per thousandin habitants and the number of prescriptions per patients. Results:41,202 patients (4.35% of total population, to over 20% for aged 80):51.67% were women. More consumed hypoglycemic groups were: amonginsulins, the premixed insulins: 40.36%, and among the oral hypoglycaemicagents: biguanides 51.61% and sulfonylureas 29.52%. Glibenclamide wasused to a greater extent by pensioners than by nonpensioners (17.88 vs13.88%; p= 0.07). The use of hypoglycemic agents, angiotensin-convertingenzymeinhibitors/angiotensin II receptor antagonists, antiagreggants and statinsare not consistent with the recommendations of current treatment guidelines.Among women, the consumption of anxiolytics and antidepressants wasstatistically significant. Hypoglycemic drugs consumption per patient is higheramong residents on the coast(AU)

Atomic force microscopy: a novel approach to the detection of nanosized blood microparticles.

BACKGROUND: Microparticles (MPs) are small vesicles released from cells of different origin, bearing surface antigens from parental cells. Elevated numbers of blood MPs have been reported in (cardio)vascular disorders and cancer. Most of these MPs are derived from platelets. OBJECTIVES: To investigate whether atomic force microscopy (AFM) can be used to detect platelet-derived MPs and to define their size distribution. METHODS: Blood MPs isolated from seven blood donors and three cancer patients were immobilized on a modified mica surface coated with an antibody against CD41 prior to AFM imaging. AFM was performed in liquid-tapping mode to detect CD41-positive MPs. In parallel, numbers of CD41-positive MPs were measured using flow cytometry. Mouse IgG1 isotype control was used as a negative control. RESULTS: AFM topography measurements of the number of CD41-positive MPs were reproducible (coefficient of variation=16%). Assuming a spherical shape of unbound MPs, the calculated diameter of CD41-positive MPs (dsph) ranged from 10 to 475 nm (mean: 67.5+/-26.5 nm) and from 5 to 204 nm (mean: 51.4+/-14.9 nm) in blood donors and cancer patients, respectively. Numbers of CD41-positive MPs were 1000-fold higher than those measured by flow cytometry (3-702x10(9) L(-1) plasma vs. 11-626x10(6) L(-1) plasma). After filtration of isolated MPs through a 0.22-microm filter, CD41-positive MPs were still detectable in the filtrate by AFM (mean dsph: 37.2+/-11.6 nm), but not by flow cytometry. CONCLUSIONS: AFM provides a novel method for the sensitive detection of defined subsets of MPs in the nanosize range, far below the lower limit of what can be measured by conventional flow cytometry.

[Should hydration and artificial nutrition be accepted as a palliative care?]. / Se considera la hidratación y la nutrición artificial como un cuidado paliativo?

BACKGROUND: Ethical considerations are becoming more and more common in clinical practice. There is no unanimous agreement on which measures should be deemed as basic care, specially regarding hydration and artificial nutrition. AIM: To know the opinion of lay people and health professionals, stratified according to their university degree, about which palliative measures, including hydration and artificial nutrition, should be judged as palliative care. METHODS: A descriptive transversal study has been designed to know the opinion of 256 subjects: 91 users of the National Health System (NHS), 80 nurses, 47 pharmacists and 38 physicians. A questionnaire examined which of the following measures should be considered as palliative care: hygiene, analgesia, pressure ulcer care, position change, sedation, oxygen administration, urinary catheter, hydration, enteral and parenteral nutrition. RESULTS: More than 50% of the participants think that all the proposed measures can be considered as a palliative care, except parenteral nutrition. There is unanimous agreement to accept analgesia, pressure ulcer care, position change and enteraL nutrition as basic care, but there is disagreement in relation to hygiene (p = 0.000), sedation (p = 0.005), oxygen administration (p = 0.007), urinary catheter (p = 0.011) and parenteral nutrition (p = 0.000). There were not differences of opinion after adjusting for age, sex, religious beliefs, and length of professional experience among the individuals that answered the questionnaire. CONCLUSION: There is no agreement on which measures should be considered as palliative care. Opinions differ regarding hygiene, sedation, oxygen administration, urinary catheterisation and parenteral nutrition. In comparison to enteral nutrition, many responders believe that parenteral nutrition is a therapeutic option. The opinions shown in this questionnaire were independent from the demographic characteristics of the subjects that answered it.

¿Se considera la hidratación y la nutrición artificial como un cuidado paliativo? / Should hydration and artificial nutrition be accepted as a palliative care?

Fundamento: Cada vez son más frecuentes los dilemas éticos en la práctica clínica. No existe acuerdo unánime, en especial en lo relativo a la hidratación y nutrición artificial, sobre que medida debe ser considerada como un cuidado básico. Objetivo: Conocer la opinión del personal sanitario, diferenciando la titulación universitaria, sobre que medidas de cuidado paliativo, incluyendo la hidratación y la nutrición artificial, deben ser consideradas como cuidado paliativo. Material y metodos: Se ha diseñado un estudio de campo descriptivo transversal, en el que se analiza la opinión de 256 individuos mediante las respuestas a un cuestionario: 91 usuarios del Sistema Nacional de Salud, 80 enfermeras, 38 médicos y 47 farmacéuticos sobre qué medida de las siguientes debe ser considerada como cuidado paliativo: higiene, analgesia, cuidado de las escaras, cambios posturales, sedación, oxigenoterapia, sondaje urinario, hidratación intravenosa, nutrición enteral y nutrición parenteral. Resultados: Más del 50% de los encuestados valora todas las medidas interrogadas como paliativas, a excepción de la nutrición parenteral. Entre los diversos grupos no existen diferencias en considerar a la analgesia, cuidado de escaras, cambios posturales, sueroterapia y administración de nutrición enteral como un cuidado básico, pero sí existen diferencias de opinión sobre la higiene (p = 0,000), sedación (p = 0,005), oxigenoterapia (p = 0,007), sondaje urinario (p = 0,011) y nutrición parenteral (p = 0,000). La edad, sexo, creencia religiosa y años de experiencia profesional en el ámbito sanitario del encuestado no influyen los resultados obtenidos. Conclusiones: No existe unanimidad entre los individuos, en qué medida debe ser considerada como cuidado paliativo. Se discrepa en relación a la higiene, la sedación, la oxigenoterapia, el sondaje urinario y la nutrición parenteral. Esta última medida se considera más como una opción terapéutica que la nutrición enteral. La opinión no depende de las características sociodemográficas de la población estudiada (AU)

Background: Ethical considerations are becoming more and more common in clinical practice. There is no unanimous agreement on which measures should be deemed as basic care, specially regarding hydration and artificial nutrition. Aim: To know the opinion of lay people and health professionals, stratified according to their university degree, about which palliative measures, including hydration and artificial nutrition, should be judged as palliative care. Methods: A descriptive transversal study has been designed to know the opinion of 256 subjects: 91 users of the National Health System (NHS), 80 nurses, 47 pharmacists and 38 physicians. A questionnaire examined which of the following measures should be considered as palliative care: hygiene, analgesia, pressure ulcer care, position change, sedation, oxygen administration, urinary catheter, hydration, enteral and parenteral nutrition. Results: More than 50% of the participants think that all the proposed measures can be considered as a palliative care, except parenteral nutrition. There is unanimous agreement to accept analgesia, pressure ulcer care, position change and enteraL nutrition as basic care, but there is disagreement in relation to hygiene (p = 0.000),sedation (p = 0.005), oxygen administration (p = 0.007), urinary catheter (p = 0.011) and parenteral nutrition (p = 0.000). There were not differences of opinion after adjusting for age, sex, religious beliefs, and length of professional experience among the individuals that answered the questionnaire. Conclusion: There is no agreement on which measures should be considered as palliative care. Opinions differ regarding hygiene, sedation, oxygen administration, urinary catheterisation and parenteral nutrition. In comparison to enteral nutrition, many responders believe that parenteral nutrition is a therapeutic option. The opinions shown in this questionnaire were independent from the demographic characteristics of the subjects that answered it (AU)

[Use of maintenance fluid therapy in surgery]. / Utilizacíon de fluidterapia de maintenimiento en cirurgía.

OBJECTIVE: To analyze the use of various maintenance fluid therapy regimens, as well as their adequacy to hospital recommendations, in adult in-patients admitted to a general surgery ward during 1 year. MATERIAL AND METHODS: Data on solution type and volume, fluid therapy regimen, and duration in days were retrospectively collected for each administered solution from computerized medical orders within the Unit-Dose Drug Distribution Area. A database was developed including the composition of available solutions within our hospital, so that electrolytes, glucose and volumes administered may be calculated. RESULTS: Out of 354 patients undergoing fluid therapy 125 were selected to receive maintenance regimens. Fluid therapy was administered for more than 5 days in 31% of patients. The most commonly supplied fluids were 5% glucose (43%) and 0.9% saline + 1500 mL of 5% glucose + 60 mEq potassium chloride (CIK). Amongst patients receiving the recommended volume/day (84%) 50% received sodium and potassium more than twice as much the recommended amount, and 70% received glucose amounts not covering minimal daily requirements. Potassium was administered according to recommendations in 85% of patients. CONCLUSIONS: There is an excessive use of 0.9% saline and 5% glucose to the detriment of 1/3 glucosaline and 10% glucose, which translates as an excessive daily sodium and defective daily glucose provision. In our hospital we have recommended maintenance fluid therapy regimens, as well as fluids more appropriate for postoperative electrolyte replacement; however, their use is still deficient.

La imagen corporal en pacientes con deformidades dentofaciales tratados mediante cirugía ortognática / Body image in patients with dentofacial deformities treated by orthognatic surgery

Objetivo: Las posibles repercusiones psicológicas de las deformidades dentofaciales y los efectos que su tratamiento puede ejercer sobre la imagen corporal provocan importantes controversias. En este estudio, que forma parte de una investigación prospectiva más amplia sobre distintos aspectos psicológicos de los pacientes adultos con deformidades dentofaciales graves susceptibles de cirugía ortognática, se evalúa la imagen corporal de una muestra de pacientes antes y en distintos momentos después de su tratamiento quirúrgico. Método: En una muestra de pacientes (N= 58) con diversos tipos deformidades faciales se evaluaron las puntuaciones de imagen corporal mediante las dos subescalas, general y oclusal-facial, del test de Secourd y Jourard modificado en cuatro momentos sucesivos: una semana antes de la cirugía (T0) y un mes (T1), seis meses (T6) y un año (T12) después de la misma. Resultados: A pesar de la gravedad de la deformidad, antes de la cirugía no se observaron diferencias entre los individuos de la muestra y la población general en ninguna de las dos subescalas de imagen corporal. En T6 se observó un aumento significativo respecto la población general en las puntuaciones de ambas subescalas (p< 0,001). En T6 también se observó un incremento significativo respecto a T0 tanto en la escala general (p< 0,05) como en la facialoclusal (p< 0,001). En T12 se mantenían las diferencias significativas en ambas subescalas respecto a la población general, pero en relación a T0 sólo en la subescala facial oclusal (p< 0,001). No se observaron diferencias significativas entre las determinaciones en T6 y T12. Conclusión: En este estudio se confirma el efecto positivo de la cirugía ortognática sobre la imagen corporal a medio plazo, pero es necesario un seguimiento mayor para evaluar la persistencia de estos resultados y sus eventuales cambios (AU)

[Body image in patients with dentofacial deformities treated by maxillofacial surgery]. / La imagen corporal en pacientes con deformidades dentofaciales tratados mediante cirugía ortognática.

OBJECTIVE: Considerable controversies exist about the psychological impact of dentofacial deformities and the effects of treatment on body image. This research, which is a part of a longitudinal prospective study about a number of psychological aspects of adult patients with severe dentofacial deformities treated by orthognatic surgery, assesses the body image of a sample of patients before and after treatment. METHOD: Two subscales, general and facial-oclusal, of the modified Secord and Jourard test were used to evaluate body image of a sample of orthognatic surgery patients (N = 58). The questionnaires were completed at four time points: one week before surgery (T0), and one (T1), six (T6) and twelve months (T12) after surgery. RESULTS: Despite the severity of dentofacial deformity, presurgical mean scores of both subscales of body image test were normal. T6 scores were significantly higher than normative levels in both subscales (p < 0.001). T6 scores were also significantly higher than T0 in both general (p < 0.05) and facial-oclusal subscales (p < 0.001). T12 measurements showed significant differences in both subscales with respect to normative levels but significant differences between T12 and T0 were only found in facial oclusal subscale (p < 0.001). No differences were found between T12 and T6 scores. CONCLUSION: The positive effect of orthognatic surgery on body image is encouraging, but longer follow up is needed to evaluate the persistence of results and the eventual occurrence of any late change.

[Effective response to risperidone treatment in manic syndrome secondary to neurocysticercosis]. / Buena respuesta a risperidona en fase maniaca secundaria a neurocisticercosis.

This study presents a clinical case about a patient suffering a manic syndrome secondary to neurocysticercosis and no responding to traditional neuroleptic treatment. We administrated the risperidone treatment, that was effective.

[Spontaneous rupture of multiple cysts into the excretory tract in a case of cysts of the hilar sinus]. / Rotura quística múltiple espontánea en la vía excretora en un caso de hiliosinuquistosis.

We report a case of spontaneous rupture of renal cysts into the excretory tract, an uncommon complication in cystic disease and a rare finding in cysts of the hilar sinus. We discuss the different hypotheses on its etiopathogenesis. The possible mechanism of multiple spontaneous rupture in this case is described and the diagnostic possibilities are discussed.