Gaceta Medica de Bilbao最新文献

In the last few years, the utility of procalcitonin (PCT) as a marker of severity of sepsis has been studied. PCT values may be useful in differentiating septic stages and in predicting postoperative complications. The principal objectives of our study were to demonstrate that PCT is a useful and early marker in the diagnosis and differentiation of sepsis in surgical patients and to assess PCT levels in the diagnosis of postoperative infectious complications.

We performed a prospective study to evaluate a diagnostic test in 75 patients from March to July 2009 by establishing two groups: the first group consisted of patients with infectious diseases (acute cholecystitis, acute diverticulitis, mesenteric ischemia and gastrointestinal perforations) and the second group comprised patients with non-infectious diseases who developed infectious complications (urinary tract infection, catheter-associated bacteremia, pneumonia, intraabdominal abscess, surgical wound infection and anastomotic dehiscence) during the postoperative period.

The results showed that PCT values were elevated in septic processes. Moreover, the higher these values, the greater the severity of the process.

Laburpena

Azken urteotan, prokalzitonina (PCT) sepsiaren larritasunaren adierazle modura erabiltzeko aukera ikertu da, bere balioak fase septikoen bereizkuntzari lotuz eta baita operazio ondoko zailtasunen igarle gisa ere. Gure azterketaren helburu nagusiak dira, batetik, prokalzitonina patologia kirurgikoko pazienteengan sepsia bereizteko eta diagnostikatzeko adierazle erabilgarri eta goiztiarra dela erakustea, eta, bestetik, operazio ondoko konplikazio infekziosoen diagnostikoan prokalzitonina mailak ebaluatzeko modua erakustea.

Ikerketa Deskriptibo Prospektibo bat egin zen 2009ko uztailetik martxora, 75 pazienteen proba diagnostikoa ebaluatzeko, eta bi talde bereizi ziren: lehenengoan, patologia infekziosoa zuten pazienteak zeuden (kolezisititis akutua, dibertikulitis akutua, iskemia mesenterikoa eta urdai eta hesteetako zulaketak), eta, bigarren taldean, berriz, patologia ez-infekziosoagatik operatuak izan ziren eta gero konplikazio infekziosoak izan zituzten pazienteak, hala nola gernu hodiaren infekzioa, kateterrari lotutako bakteriemia, pneumonía, abdomen-barneko abszesua, infekzioa zauri kirurgikoan eta anastomosiko dehiszentzia.

Lortutako emaitzek agerian utzi dute prozesu septiko baten aurrean prokalzitoninaren balioak igotzen direla, eta, gainera, balioak are gehiago igotzen direla prozesuaren larritasuna areagotu ahala.

Objective

To determine the characteristics of prescribers and consumers of osteoporosis drugs.

Design

Cross-sectional study.

Setting

34 primary care areas for the county of West Gipuzkoa (Spain).

Participants

People older than 13 years, randomly selected from 1673 persons consuming osteoporosis drugs for 1 year.

Intervention

A questionnaire completed through clinical interview and data from the medical record.

Main measurements

Risk factors, drugs, bone mineral density (BMD), prescribers, fracture risk.

Results

We studied 512 persons (90.6% women), with a mean age of 68.9 years, taking 898 drugs for osteoporosis. A total of 24.6% had a history of fracture before the age of 50 years and 21.5% of women were fertile for less than 30 years. BMD was available in 50.4%; of these, 52.8% were osteoporotic. One in three BMD scans performed were not justified. The most widely prescribed drug was calcium, with or without vitamin D (53.4%), followed by biphosphonates (33.95%). Prescriptions were issued by rheumatologists (29.2%), traumatologists, gynecologists and primary care physicians (12.4%). One-third (30.6%) were not based on the best evidence. According to the Black scale, 23.8 ± 3.9% had a high risk of fracture (37.8% primary care, 0% gynecology).

Conclusions

Osteoporosis drugs are being used when not warranted by BMD, risk factors or fracture risk. Specialists prescribe these drugs as much or more than primary care physicians. Standardization of criteria for the rational management of this disease is imperative.

Anaphylactic reactions due to muscle relaxants and other drugs that induce IgE-mediated sensitivity are highly prevalent. Because of false-positive and false-negative results in skin tests and the lack of provocation tests with some drugs (e.g., general anesthetics), diagnosis is often difficult. An alternative is to assay leukotrienes, which are chemical mediators that also contribute to inflammation in asthma and allergic rhinitis. In this brief report, we describe the cellular antigen stimulation test (CAST), a quick and easy to perform assay for peptide-sulfido-leukotrienes and compare this test with traditional in vitro assays.

Objective

To study trends in the cardiovascular risk factors analyzed during the Arteriosclerosis and Cardiovascular Disease Prevention Weeks held in Bilbao from 2000 to 2008.

Material and methods

All participants completed a questionnaire on their history of cardiovascular disease and daily habits and underwent clinical and laboratory tests.

Results

Results were obtained from a total of 4,695 persons with a mean age of 65.22 ± 12.16 years. Over the study period, hypertension and cholesterol values decreased, with a steady and significant increase in treatments for high blood pressure and hypercholesterolemia. There was almost no change in body mass index, but there was a steady increase in moderate and intense exercise, as well as a decrease in smoking.

Conclusions

The results obtained confirm that the Arteriosclerosis and Cardiovascular Disease Prevention Weeks appear to have been effective, given the substantial reductions detected in the prevalence of cardiovascular risk factors.