Nefritis intersticial aguda por omeprazol. A propósito de un caso / Omeprazole induced acute interstitial nephritis. A case report

La nefritis intersticial aguda es una importante causa de fallo renal agudo reversible (1-3% de éstos). En la mayoría de las ocasiones está causada por fármacos, siendo los antiinflamatorios, las penicilinas y las sulfonamidas los más frecuentemente implicados en la actualidad. Las manifestaciones clínicas de la nefritis intersticial aguda han variado con el paso del tiempo y con el uso masivo de nuevos fármacos. El omeprazol es un inhibidor de la bomba de protones prescrito ampliamente para el tratamiento del reflujo gastroesofágico y de la úlcera péptica. Aunque el omeprazol es generalmente bien tolerado, puede producir efectos adversos importantes como fallo renal agudo por nefritis intersticial. A continuación presentamos el caso de un paciente que presenta nefritis intersticial aguda secundaria a la toma de omeprazol

Acute interstitial nephritis is an important cause of acute, reversible renal failure (1%-3% of these). Most of them are due to drugs, the most frequently involved at present being anti-inflammatory drugs penicillins and sulfonamides. The clinical manifestations of acute interstitial nephritis have varied over time and with the massive use of new drugs. Omeprazole is a proton pump inhibitor that has been widely described for the treatment of gastroesophageal reflux and peptic ulcer. Although omeprazole is generally well tolerated, it may produce serious side effects such as acute renal failure due to interstitial nephritis. In the following, we present the case of a patient who had acute interstitial nephritis secondary to taking omeprazole

[Referral to specialists by pediatric clinics at an urban health center]. / Derivaciones a especialistas de consultas pediátricas de un centro de salud urbano.

OBJECTIVE: To find the characteristics of paediatric referrals to the referral hospital. DESIGN: An epidemiological study of a crossover type. SETTING: Two paediatric clinics at an urban Health Centre. PATIENTS AND OTHER PARTICIPANTS: A consecutive sample of 384 referrals during 1992. MEASUREMENTS AND MAIN RESULTS: 3.94% of patients were referred. Nursing babies were the most commonly referred group. The commonest diagnostic groups were: congenital anomalies (25.5%), Neurology and sense organs (24%) and Respiratory Pathology (15.9%). The clinics to which patients were most commonly referred were: Traumatology (25.5%), Ophthalmology (21.4%) and ENT (21.4%). 80.6% of the Traumatology referrals were for congenital anomalies. 72.9% were referred for confirmation of the diagnosis. 56.8% came from on-demand consultations and 43.2% from appointments. 84.6% were of a normal character. In 27.3% there was a written report from the specialist. CONCLUSIONS: Congenital anomalies made by the most frequently referred diagnostic group; and Traumatology the most consulted specialty. There was a low instance of referral at the patient's own request. There was a high number of patients referred from among patients with appointments. There was scant information from the specialist to the Paediatrician.

[Health problems managed at the programmed pediatric consultation of a health center]. / Problemas de salud atendidos en la consulta programada de pediatría de un centro de salud.

OBJECTIVE: To assess the scheduled Paediatrics programme through the health problems cared for and the characteristics of care, evolution and follow-up. DESIGN: Descriptive study of a crossover type. SETTING: Two Paediatrics clinics in the "Soria Norte" Health Centre. PATIENTS: A non-probabilistic consecutive sample of 143 children under 10 during 1992. MAIN RESULTS: Average age was 3.69 +/- 2.97 years old. The commonest diagnostic groups were: Groups XVI (26.9%), III (18%), IX (9.6%), V and X (both 8.4%). 83% of the children were not following a procedure, 23% were being monitored by a specialist at the same time and 8% were referred. 36% of those with problems were following a treatment and 51% evolved for the better. CONCLUSIONS: The commonest problems are those which are badly defined and endocrine-metabolic ones. The problems where procedures were observed and the patients who followed through some treatment both made up low percentages. It is therefore important both to watch out for problems and to follow procedures more strictly.