Hipotensión grave y prolongada tras sobredosis de candesartán y amlodipino por intento autolítico: primer caso comunicado en la literatura / Severe and prolonged hypotension after overdose of candesartan and amlodipine from attempted suicide: first case

La asociación de varios hipotensores para el tratamiento de la hipertensión arterial suele ser una práctica frecuente y útil, aunque en ocasiones puede dificultar el manejo de una sobredosificación o de posibles efectos adversos. Se presenta el caso de un paciente joven que requirió cuidados intensivos por hipotensión grave y prolongada con hipoperfusión y acidosis metabólica, tras la ingesta estimada de 1280 mg de candesartán y 500 mg de amlodipino por intento autolítico, suponiendo la primera citación en la literatura de una sobredosis por esta combinación terapéutica. Se describe la situación clínica y analítica del enfermo durante las primeras 25 horas de su evolución y el tratamiento al que fue sometido, haciendo especial énfasis en la fisiopatología provocada por las características farmacológicas de ambos medicamentos (AU)

The combination of several antihypertensives drugs for the treatment of hypertension is common and useful, though sometimes difficult to deal with a possible overdose or adverse effects. We report the case of a young patient who required intensive care for severe and prolonged hypotension with hypoperfusion and metabolic acidosis after the estimated ingestion of 1280 mg of candesartan and 500 mg of amlodipine for attempted suicide, assuming the first citation in the literature of an overdose by this therapy. We describe the clinical and laboratory status of the patient during the first 25 hours of evolution and the treatment applied, with special emphasis on the pathophysiology caused by the pharmacological characteristics of both drugs (AU)

Natural and sexual selection in a wild insect population.

The understanding of natural and sexual selection requires both field and laboratory studies to exploit the advantages and avoid the disadvantages of each approach. However, studies have tended to be polarized among the types of organisms studied, with vertebrates studied in the field and invertebrates in the lab. We used video monitoring combined with DNA profiling of all of the members of a wild population of field crickets across two generations to capture the factors predicting the reproductive success of males and females. The factors that predict a male's success in gaining mates differ from those that predict how many offspring he has. We confirm the fundamental prediction that males vary more in their reproductive success than females, and we find that females as well as males leave more offspring when they mate with more partners.

GABA immunoreactivity in the olfactory bulbs of the adult sea lamprey Petromyzon marinus L.

The distribution of gamma-aminobutyric acid (GABA) immunoreactivity in the olfactory bulbs of the adult sea lamprey was studied using an antibody against this transmitter. Five types of GABA-immunoreactive (GABAir) cells were observed. Medium-sized GABAir cells (periglomerular cells) were located around the olfactory glomeruli and occasionally within them. In the inner cellular layer of the bulbs and around the olfactory ventricles, two types of GABAir perikarya were present: some medium-sized GABAir cells and numerous small GABAir cells (granules). In the walls of the olfactory ventricle, some medium-sized GABAir cells of cerebrospinal fluid-contacting type were observed. At the entrance of the olfactory nerves, medium-sized GABAir bipolar cells were present, mostly located between the olfactory nerve and the glomerular layer or close to the meninges, but some in the intracranial portion of the olfactory nerve. GABAir processes were present in all layers of the olfactory bulb. In addition there were also GABAir cells in the dorsal interbulbar commissure. The distribution of GABA observed in the olfactory system of lampreys indicates that this transmitter plays a major role in the modulation of bulbar circuits. The presence of granular and periglomerular cells in lampreys indicates that these two intrinsic GABAergic neurons of the olfactory bulbs are shared by most vertebrates, although lampreys have additional GABAir cell types.

Gestión sanitaria y satisfacción del usuario: experiencia en la descentralización del control de pacientes con anticoagulación oral / Health care management and user satisfaction: an experience in the decentralisation of control of patients who use oral anticoagulants

No disponible