Buprenorfina-naloxona: lo nuevo de 2009 / No disponible

No disponible

Curso de la red de trastornos adictivos de casos clínicos en el tratamiento de las adicciones, segunda edición* / No disponible

No disponible

Síndrome de respuesta inflamatoria sistémica (SRIS) y cirugía cardiaca bajo circulación extracorpórea (Parte I) / Systemic inflammation reaction and extracorporeal circuit in cardiac surgery

La cirugía cardiaca bajo circulación extracorpórea (CEC) produce un síndrome de respuesta inflamatorio sistémico (SRIS) debido a una activación del sistema inmune desencadenado por el contacto de la sangre con superficies extrañas, el trauma quirúrgico, la lesión isquemia-reperfusión y la endotoxemia. Este SRIS produce un aumento de la morbimortalidad en los pacientes sometidos a estos procedimientos quirúrgicos. En esta primera parte, revisamos la activación de las células endoteliales, la cascada de la coagulación, y el sistema complemento (AU)

Cardiac surgery with extracorporeal circulation causes a systemic inflammatory response syndrome (SIRS) due to the activation of the immune system triggered by: the contact of the blood with foreign surfaces, the surgical trauma, the ischemiareperfusion lesion and the endotoxemia. This SIRS results in an increase in the morbidity-mortality in patients undergoing these surgical procedures. In this first part, the activation of the endothelial cells, the coagulation cascade and the complementary system are reviewed (AU)

Joven con consumo de alcohol y cannabis y accidente de tráfico / Youth with alcohol and cannabis consumption in traffic accident

Objetivo. Examinar el caso clínico de un joven de 23 años que acude a urgencias por un accidente de tráfico después de haber consumido alcohol y cannabis. Material y métodos. Se analiza el caso clínico de un joven de 23 años que acude a un servicio de urgencias por accidente de tráfico con un importante estado de nerviosismo y agitación. Se explora el consumo de sustancias por el paciente. Resultados. El paciente conducía bajo los efectos del alcohol y del cannabis; se comenta la prevalencia de consumo de alcohol y cannabis, sobre todo entre la juventud, analizando el deterioro que puedan producir esas drogas en las capacidades para conducir un vehículo. Conclusión. Según datos de las encuestas realizadas por el Plan Nacional Sobre Drogas, el alcohol y el tabaco, seguidos del cannabis, son las drogas más consumidas en España. El uso combinado de cannabis y alcohol produce un serio deterioro en la aptitud para conducir y aumenta el riesgo de que el conductor sea responsable de un accidente comparado con conductores libres de drogas

Objective. To examine the case of a youth attending accident & emergency (A&E) following a traffic accident after consuming both alcohol and cannabis. Material and methods. A case of a 23 year old youth attending A&E following a traffic accident and in an extreme state of nervousness is analysed. The consumption of substances by the patient is explored. Results. The patient was driving under the influence of alcohol and cannabis. The prevalence of the consumption of these substances, especially among young people, is commented on, analysing the deterioration these drugs can cause in the capacity to drive a motor vehicle. Conclusions. According to data from surveys carried out by the National Plan on Drugs, alcohol and tobacco, followed by cannabis, are the most commonly consumed drugs in Spain. The combined use of alcohol and cannabis produces a serious deterioration in fitness to drive and increases the risk of the driver being responsible for an accident, as compared with drivers not under the influence of drugs

Casos clínicos en el tratamiento de las adicciones: un programa de teleformación de la Red de Trastornos Adictivos, Red RTA / Case reports in drug addiction: a programme from the Spanish Thematic Network of Addictive Disorders

No disponible

Varón dependiente del alcohol / Alcohol dependent male

Objetivo: Analizar el caso clínico de un varón de 38 años, dependiente del alcohol en sus vertientes de diagnóstico, consejo para el tratamiento y tratamiento del problema. Material y métodos: El caso clínico analizado corresponde al de un paciente varón, se registran las pautas de consumo de alcohol así como la problemática social, laboral, familiar y de tráfico que ese consumo le ha producido. Resultados: Se analizan los pasos dirigidos al diagnóstico sistematizado (criterios DSM-IV, cuestionarios diagnósticos de dependencia del alcohol y marcadores biológicos) y el tratamiento realizado en dicha patología, tanto farmacológico como psicosocial. Conclusiones: La dependencia del alcohol es un problema médico que se presenta frecuentemente en los servicios de urgencias y en atención primaria, patología que en muchos casos deberá ser tratada por servicios especializados, tanto en sus formas iniciales (síndrome de abstinencia) como posteriormente en tratamientos de deshabituación y rehabilitación

Objectives: To analyse a clinical case of an alcohol dependent male in the aspects of diagnosis, advice for treatment and treatment of the problem. Material and methods: The case analysed is that of a 38 year old male patient. The pattern of alcohol consumption, as well as the social, labour, family and traffic problems produced by this consumption are registered. Results: We analyse the steps taken for a systematic diagnosis (DSM-IV criteria, diagnostic surveys of alcohol dependence and biological markers) and the treatment given for the said pathology, both pharmacological and psychosocial. Conclusions: Alcohol dependence is a medical problem that is frequently seen in primary care and A&E services. In many cases, it is a pathology that should be treated by specialised services, both in its initial forms (abstinence syndrome) and later treatment for habit loss and rehabilitation

[Mortality related to alcohol consumption in Spain: 1981-1990]. / Mortalidad relacionada con el consumo de alcohol en España: 1981-1990.

OBJECTIVE: The aim of this study was to assess the overall contribution of alcohol to Spanish mortality during 1981 to 1990, as well as the impact on the premature death. METHODS: To this purpose we have used the sources of data furnished by the 'Movimiento Natural de la Población' that provides data of causes of death. Figures of proportional mortality, adjusted mortality and years of potential life lost were calculated, as well as trend analysis. RESULTS: 6.3% (mean in the ten years period) of the mortality was due to alcohol. This mortality was higher among males than females. Adjusted mortality show a light increase during the period. The most important category referring to years of potential life lost was unintentional injuries. In this category, motor vehicle accidents were responsible for the majority of premature death. CONCLUSION: This study shows the importance of alcohol related mortality in our country and the large premature death.

[The presence of pathological processes among spanish drivers: its relevance to road safety]. / Presencia de procesos patológicos en los conductores españoles: su relevancia en el campo de la seguridad vial.

BACKGROUND: The presence of pathological processes is considered to be a risk factor in road traffic accidents. The Council Directive 91/439 (29 July 1991) and the legislation prevailing in our country (RD 1467/1983 and 13/1992) specify the different diseases or deficiencies which can affect the ability to drive appropriately. The aim of this study is to assess the presence of pathological processes among spanish drivers. METHODS: A sample of Spanish drivers were selected and a self questionnaire was sent to them. 1500 questionnaires were considered to be valid. RESULTS: The health state of the majority of the drivers was shown to be good (61.8%) or very good (35.3%). 15.3% of those surveyed suffered some pathological process, of which 52.0% were considered capable of affecting their ability to drive without any danger (7.9% among all surveyed). 6.6% of the drivers with pathological processes considered that their ability to drive had decreased because of that reason, and 3.1% had stopped driving. CONCLUSIONS: The presence of incapacitating pathological processes among Spanish drivers is frequent. Health care workers should be aware of this and should inform their patients of the possible effect of a pathological process and other risk factors concerning driving ability.

[Anticholinergic action of neuroleptics and antidepressives on the guinea pig ileum. Comparison with atropine and pirenzepine]. / Action anticholinergique des neuroleptiques et des antidépresseurs sur l'iléon de cobaye. Comparaison avec l'atropine et la pirenzépine.

All the drugs studied here present anticholinergic antimuscarinic dose-dependent activity reversible in front of acetylcholine whether exogenous or released by electrically stimulated Guinea-pig ileum. The classification in decreasing order of anticholinergic power is as follows: atropine, pirenzepine, trimipramine, clozapine, clotiapine , thiotixene , trazodone. Atropine, pirenzepine and probably trazodone act as competitive antagonists, while the other ones have an antagonistic non-competitive action. The action mainly occurs at a postsynaptic level and only trazodone would present a high component of presynaptic action. Our results bear out the hypotheses denying any relation between anticholinergic power and extrapyramidal effects in neuroleptics and between anticholinergic action and antidepressive effect in antidepressants.