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)

[Usefulness of transesophageal echocardiography in the diagnosis of coronary anomalies]. / Utilidad de la ecocardiografía transesofágica en el diagnóstico de anomalías coronarias.

BACKGROUND: Although rare, anomalous coronary arteries are associated with myocardial ischemia and sudden death. Identification is made by angiography but its true course is difficult to determine even with this invasive procedure. OBJECTIVES: The purpose of this study is to determine the role of transesophageal echocardiography (TEE), Doppler and color flow Doppler, in identifying the origin and course of anomalous coronary arteries. MATERIAL AND METHODS: Six patients with angiographically confirmed anomalous coronary arteries were studied by TEE, Doppler and color flow Doppler. RESULTS: The abnormal origin was confirmed in all six patients. In three, the left main originated from the right sinus of Valsalva. In one the right coronary artery from the left sinus of Valsalva. One was a single right coronary artery from the right sinus of Valsalva, and one, had a fistula between the coronary artery and the right ventricle. In four, the TEE was able to demonstrate clearly the course in relation to the great vessels, two were interarterial and one posterior. Color flow Doppler was obtained in four patients. In one patient, there was increase in diastolic flow velocity due to proximal coronary obstruction. One had increase of the systolic flow velocity. CONCLUSIONS: TEE is useful test for diagnosing the origin of anomalous coronary arteries and confirming its course in relation to the great vessels. Doppler flow Doppler is useful in localization the vessel.

[Pericardial effusion simulating a tumor. The value of Doppler color echocardiography for its differentiation]. / Derrame pericárdico que simula un tumor. Valor de la ecocardiografía Doppler a color para su diferenciación.

We describe the case of a patient aged 64 with aortic valve disease and pericardial effusion. Echocardiographic evaluation showed an intrapericardial mass of about 7 cm of diameter with clotted appearance, adhered to the visceral leaf, at the level of the atrio-ventricular function. Because of this finding we performed color codified Doppler echocardiography, observing that this mass acquired a blue hue during diastole and mosaic hue at the end of the systole, realizing that this phenomenon was due to fluid retention. There are many publications about the value of echocardiography for the identification of pericardial masses and some of them show how an effusion can hide a tumor. The interest of this particular case lies in that the effusion simulated a tumor and by means of the color codified Doppler we could demonstrate that it corresponded to the stream of the pericardial fluid. During the surgical procedure the absence of the mass was corroborated.

[Influence of left ventricular hypertrophy on its function in essential arterial hypertension. Analysis by Doppler echocardiography]. / Influencia de la hipertrofia del ventrículo izquierdo sobre su función en la hipertensión arterial esencial, análisis por ecocardiografia Doppler.

In order to evaluate the influence of left ventricular hypertrophy (LVH) on the function of this ventricle, twenty patients with essential arterial hypertension (EAH) were studied using Doppler echocardiography. Patients with diastolic blood pressure greater than 91 mmHg were included. Antihypertensive treatment was stopped 2 weeks before the study. None of them had any concomitant coronary artery disease nor kidney involvement. Left ventricular diameters, left ventricular mass (LVM), stroke volume, fractional shortening, mean velocity of circumferential shortening (Vcfr), mean velocity of circumferential relaxation, mean velocity of aortic flow and mean E and A velocities of mitral flow as well as the ratio of these velocities (E/A) were measured or calculated. With those values from the entire group, arithmetic means were calculated and the population was divided into two groups: those with values greater than the mean and those with values below the mean for each variable for comparative purposes. The relationship of the individual values was also calculated. The interventricular septum thickness and the left ventricular end diastolic diameter were proportional with diastolic blood pressure (p less than 0.05). The LVM values shown an inverse relationship to the fractional shortening (p less than 0.01), Vcfr (p less than 0.05) as well as end diastolic diameter of left ventricle (r = -0.889, p less than 0.01) and with the stroke volume (r = -0.861, p less than 0.01). The E/A ratio was proportional to the fractional shortening (p less than 0.05) and to Vcfr (r = 0.903). The A velocity of the mitral Doppler flow showed an inverse proportion to the Vcfr (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

[Exercise test with cold water intake. Preliminary results]. / Prueba de esfuerzo con ingestión de agua fría. Resultados preliminares.

Thirty healthy individuals with no history of cardiovascular disease were studied to determine the electrocardiographic effects of maximal exercise immediately followed by ingestion of ice water. The subjects were subgrouped according to their training into (A) high (N = 5), (B) moderate (N = 14) and (C) low (N = 11) levels. Electrocardiograms (ECGs) were taken at rest and at rest with ingestion of ice water followed by maximal stress tests. Maximal stress tests were repeated followed by ingestion of ice water at the beginning of and at 2, 3, 6 and 9 minutes of recuperation. The stress test combining maximal effort and ice water ingestion was positive in all members of Group A, in 4 from Group B and in 1 from Group C. A stress test associating maximal effort with ice water ingestion is a useful method of detecting subjects susceptible to changes in ECG which appear to be secondary to coronary spasm. It has a low cost it is simple to perform and represents minimal risk.

[Echocardiographic diagnosis of pulmonary atresia with intact interventricular septum and associated Ebstein anomaly]. / Diagnóstico ecocardiográfico de la atresia pulmonar con septum interventricular intacto y malformación de Ebstein asociada.

Pulmonary atresia with intact ventricular septum is an uncommon congenital cardiac anomaly which very often present varying degrees of downward displacement and dysplasia of the tricuspid valve. We describe a case of pulmonary atresia and intact ventricular septum associated with Ebstein's malformation of the tricuspid valve first diagnosed with echocardiography and confirmed by angiocardiography and anatomic studies.