ABSTRACT
INTRODUCCIÓN: La eritrodermia es un síndrome inflamatorio cutáneo infrecuente caracterizado por compromiso eritematoso generalizado y descamación, de más del 90% de superficie cutánea total. OBJETIVO: Caracterizar clínica e histopatológicamente a los pacientes con eritrodermia en un hospital universitario chileno. METODOLOGÍA: Estudio retrospectivo, realizado en el Hospital Clínico Universidad de Chile, basado en revisión de fichas clínicas e informes histopatológicos de pacientes con eritrodermia, entre 2005 y 2018. Se evaluó edad, sexo y variables clínicas (co-morbilidades, síntomas, días de evolución, ingreso hospitalario, informe histopatológico, diagnóstico y evolución). RESULTADOS: Total de 28 pacientes, 18 hombres (64%), edad promedio 59 años. Causa más frecuente de eritrodermia fue dermatosis pre-exis-tentes, con 15 casos (54%), que incluyen: psoriasis 9 (32%), dermatitis de contacto 3 (11%), PRP 2 (7%), dermatitis atópica 1 (4%). A estas le siguen: reacción adversa medicamentosa 6 (21%), idiopática 6 (21%) y Síndrome de Sezary 1 (4%). CONCLUSIÓN: El presente estudio corresponde a la primera serie de eritrodermias realizada en Chile. Destacan las dermatosis preexistentes como la principal causa, lo que se correlaciona con la literatura.
INTRODUCTION: Erythroderma is an infrequent cutaneous inflammatory disorder characterized by generalized erythematous compromise and desquamation, of more than 90% of total cutaneous surface. OBJECTIVE: Clinical and histopathological cha-racterization of patients with erythroderma in a Chilean university hospital. METHODOLOGY: Retrospective study, performed at the University of Chile Clinical Hospital, based on review of clinical records and histopatho-logical reports of patients with erythroderma, between 2005 and 2018. Age, sex and clinical variables were evaluated (co-morbidities, symp-toms, days of evolution, hospital admission, histopathological report, diagnosis and evolu-tion). RESULTS: A total of 28 patients, 18 were men (64%), average age 59 years. Most frequent cause of erythroderma was pre-existing dermatosis, with 13 cases (52%), which included: psoriasis 9 (32%), contact dermatitis 3 (11%), PRP 2 (7%), atopic dermatitis 1 (4%). These are followed by adverse drug eruption 6 (21%), idiopathic 6 (21%) and Sezary syndrome 1 (4%). CONCLUSION: The present study corresponds to the first series of erythrodermas performed in Chile. The pre-existing dermatoses were the main cause of erythroderma, which coincides with other reports.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Dermatitis, Exfoliative/etiology , Dermatitis, Exfoliative/pathology , Dermatitis, Exfoliative/epidemiology , Psoriasis/complications , Psoriasis/epidemiology , Clinical Evolution , Chile , Cross-Sectional Studies , Retrospective Studies , Drug Eruptions/complications , Drug Eruptions/epidemiology , Dermatitis, Atopic/complications , Dermatitis, Atopic/epidemiology , Dermatitis, Contact/complications , Dermatitis, Contact/epidemiologyABSTRACT
Background: The use of herbal medicines is justified empirically using ethnopharmacological knowledge, which has limitations. Reports of adverse events (AE) may contribute for safety, quality, and effectiveness assessment. Objectives: This study aimed to develop an instrument to allow detection and evaluation of the causal likelihood of AE related to herbal medicines. Methods: A quantitative methodological development research intervention was performed with primary care health professionals. Two cases were distributed in an interval of one week in order to allow for completion of the proposal form. The within-rater reliability was calculated and classified into satisfactory, regular, and unsatisfactory, according to essential, necessary, and recommended items reported. Results: Fifty-seven professionals were enrolled. A high degree of the within-rater reliability was observed for the most essential, necessary, and recommended fields. The instrument contributed to assessment of definite causal association, once the duration of reactions including evolution, withdrawal, and reposition items showed high reliability. Most fields poor and weak filled were related to quality defects, such as popular name and appearance. Conclusions: Data suggest the instrument is adequate to report AE arising from herbal medicines. Owing to information regarding to organoleptic characteristics, the instrument is different from drug instruments. Therefore, it is intended to improve AE reports related to herbal medicines and contribute for appropriate use.
Antecedentes: Hierbas medicinales son utilizadas empíricamente con la base en el conocimiento etnofarmacobotánico, los cuales tienen limitaciones. Los informes de los eventos adversos (EA) pueden contribuir a la seguridad, la calidad y la evaluación de la eficacia de estos productos. Objetivos: El objetivo del estudio fue desarrollar un formulario para permitir la detección y evaluación de la probabilidad causal de EA relacionado al uso de plantas medicinales e fitoterápicos. Métodos: Investigación cuantitativa, de desenvolvimiento se llevó a cabo con los profesionales sanitarios de atención primaria. Dos casos fueran distribuidos, en un intervalo de una semana, con el fin de ser llenado en el formulario propuesto. La fiabilidad inter-observadores del instrumento fue evaluada y los resultados fueran clasificados en satisfactorio, regular e insatisfactorio, según los datos esenciales, necesarios y recomendados que fueran rellenados en el formulario de notificación. Resultados: Cincuenta y siete profesionales fueran elegibles. Se observó alto grado de fiabilidad entre observadores para la mayoría de los campos esenciales, necesarios y recomendados. El formulario contribuyó para la evaluación de la asociación causal definitiva, una vez que los campos de duración de las reacciones; evolución, retirada y re- exposición tuvieran alta fiabilidad. La mayoría de los campos flacamente llenados estaban relacionados con defectos de calidad, tales como: nombre popular y apariencia. Conclusiones: Los datos sugieren que el formulario propuesto es adecuado para reportar EA derivados de hierbas medicinales. Por la información relativa a las características organolépticas, el instrumento es diferente de lo instrumento para notificación de medicamentos. Por lo tanto, se pretende mejorar los informes de EA relacionados con los productos naturales y contribuir para el uso apropiado.
Subject(s)
Humans , Plants, Medicinal , Drug-Related Side Effects and Adverse Reactions , Product Surveillance, Postmarketing , Risk Assessment , PharmacovigilanceABSTRACT
Se efectuó un estudio descriptivo y transversal, con vistas a identificar las reacciones adversas a medicamentos en el Hospital Provincial Docente Clinicoquirúrgico Saturnino Lora Torres de Santiago de Cuba, durante el 2014. Se notificaron 107 reacciones adversas, 73 (68,2 por ciento) por los licenciados en enfermería y 29 (27,1 por ciento) por los médicos; entre ellas sobresalieron: escalofríos, ansiedad y tos. El sexo femenino y las enfermedades concomitantes condicionaron la aparición de dichas reacciones. Primaron los antibacterianos y antihipertensivos como los grupos farmacológicos principales, el factor de crecimiento y el captopril como los medicamentos con mayor incidencia y árnica como remedio homeopático(AU)
A descriptive and cross-sectional study was carried out, aimed at identifying the adverse reactions to drugs in Saturnino Lora Torres Teaching Clinical Surgical Provincial Hospital in Santiago de Cuba, during 2014. One hundred and seven adverse effects were notified, 73 (68.2 percent) by the Licentiates in Nursing and 29 (27.1 percent) by the doctors; among them chills, anxiety and cough highlighted. The female sex and the concomitant diseases conditioned the emergence of these reactions. The antibacterial and antihypertensive prevailed as the main pharmacological groups, the growth factor and captopril as the drugs with higher incidence and arnica as homeopathic remedy(AU)
Subject(s)
Humans , Male , Female , Drug-Related Side Effects and Adverse Reactions , Secondary Care , Pharmaceutical Preparations , Pharmacovigilance , Epidemiology, Descriptive , Cross-Sectional StudiesABSTRACT
Se efectuó un estudio descriptivo y transversal, con vistas a identificar las reacciones adversas a medicamentos en el Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora Torres" de Santiago de Cuba, durante el 2014. Se notificaron 107 reacciones adversas, 73 (68,2 %) por los licenciados en enfermería y 29 (27,1 %) por los médicos; entre ellas sobresalieron: escalofríos, ansiedad y tos. El sexo femenino y las enfermedades concomitantes condicionaron la aparición de dichas reacciones. Primaron los antibacterianos y antihipertensivos como los grupos farmacológicos principales, el factor de crecimiento y el captopril como los medicamentos con mayor incidencia y árnica como remedio homeopático.
A descriptive and cross-sectional study was carried out, aimed at identifying the adverse reactions to drugs in "Saturnino Lora Torres" Teaching Clinical Surgical Provincial Hospital in Santiago de Cuba, during 2014. One hundred and seven adverse effects were notified, 73 (68.2%) by the Licentiates in Nursing and 29 (27.1%) by the doctors; among them chills, anxiety and cough highlighted. The female sex and the concomitant diseases conditioned the emergence of these reactions. The antibacterial and antihypertensive prevailed as the main pharmacological groups, the growth factor and captopril as the drugs with higher incidence and arnica as homeopathic remedy.
Subject(s)
Pharmaceutical Preparations , Drug-Related Side Effects and Adverse Reactions , Pharmacovigilance , Secondary CareABSTRACT
Objetivo: verificar ocorrência das reações adversas da mucosite, síndrome mão-pé e neuropatia periférica em pacientes tratados com quimioterapia. Método: estudo descritivo, retrospectivo, com coleta de dados em prontuários de adultos com câncer. O projeto obteve aprovação do Comitê de Ética em Pesquisa, protocolo n. 560.065. Resultados: foram analisados 244 prontuários; destes, 28 apresentaram alteração na mucosa oral, variando de Grau 1 a 3; 10 pacientes apresentaram sintomas de síndrome mão-pé, variando de Grau 1 a 4 e 14 neuropatia periférica, Graus 1 a 3. Conclusão: as três reações, embora abaixo da estatística apresentada na literatura, são relevantes e cabe à enfermagem identificá-las. Essas reações caracterizam conceitos complexos, que exigem intervenções de enfermagem voltadas para a mensuração, prevenção e restauração destas manifestações.(AU)
Objective: to verify the occurrence of the following drug adverse reactions mucositis, hand-foot syndrome and peripheral neuropathy in patients treated with chemotherapy. Method: a descriptive, retrospective study, with data collection from medical records of patients diagnosed with cancer. The project was approved by the Ethics Committee, under the protocol 560,065. Results: we have analyzed 244 medical records; of these, 28 have shown alterations in the oral mucosa, ranging from grades 1 to 3; 10 patients have sown symptoms of the hand-foot syndrome, ranging from grades 1 to 4 and 14 have presented peripheral neuropathy, grades 1-3. Conclusion: the three drug adverse reactions, although below the statistics presented in the literature are relevant and it is up to nursing staff to identify them. These reactions characterize complex concepts that require nursing interventions for the measurement, prevention and restoration of such events.(AU)
Objetivo: verificar la aparición de reacciones adversas mucositis, síndrome mano-pie y neuropatía periférica en los pacientes tratados con quimioterapia. Método: estudio descriptivo, retrospectivo, con la recogida de datos en los registros de adultos con cáncer. El proyecto fue aprobado por el Comité Ético de Investigación, Protocolo. 560.065. Resultados: se analizaron 244 historias clínicas; de éstos, 28 mostraron alteraciones en la mucosa oral, que van desde grado 1 a 3; 10 pacientes mostraron síntomas del síndrome mano-pie, que van desde el grado 1 a 4:14 neuropatía periférica, los grados 1 a 3. Conclusión: las tres reacciones, aunque ellos por debajo de las estadísticas presentadas en la literatura son relevantes y corresponde a la enfermería de identificar. Estas reacciones se caracterizan conceptos complejos que requieren intervenciones de enfermería para la medición, la prevención y restauración de dichos eventos.(AU)
Subject(s)
Humans , Male , Female , Adult , Oncology Nursing , Paraneoplastic Polyneuropathy , Mucositis , Hand-Foot Syndrome , Neoplasms/drug therapy , Antineoplastic Agents/adverse effects , Antineoplastic Agents/therapeutic use , Medical Records , Epidemiology, Descriptive , Retrospective StudiesABSTRACT
Cytomegalovirus infection is common in cardiac transplant patients. Foscarnet is used, with limited evidence, as second-line treatment after ganciclovir failure in these patients. We describe the case of a paediatric cardiac transplant patient who developed electrolyte disturbances during foscarnet treatment for cytomegalovirus infection. The infection resolved after 6 weeks of treatment. Low ionized calcium and magnesium levels were observed during the drug infusion, which were treated with supplements. The serum levels reverted to normal after drug withdrawal.
Subject(s)
Antiviral Agents/therapeutic use , Calcium/blood , Cytomegalovirus Infections/blood , Cytomegalovirus Infections/drug therapy , Foscarnet/therapeutic use , Magnesium/blood , Child, Preschool , Humans , MaleABSTRACT
BACKGROUND AND OBJECTIVE: Roflumilast is a recently marketed drug, indicated for maintenance treatment of severe chronic obstructive pulmonary disease associated with chronic bronchitis in adult patients with a history of frequent exacerbations as add on to bronchodilator treatment. MATERIAL AND METHODS: The safety data of this drug have always been subjected to controversy and concerns. The Food and Drug Administration rejected the drug after the first evaluation, asking the company to clarify the adverse reactions during the investigation process, the European Medicines Agency approved the drug including a Risk Management Plan, designed to promote a safe use of the drug. RESULTS: During the first months after the marketing process, the Spanish Pharmacovigilance System has already been acquainted of several adverse events notifications; therefore, these patients may be closely monitored, mainly because of digestive and psychiatric disorders. CONCLUSIONS: Here we report the case of a female patient who showed a serious digestive clinical profile and a severe weight loss, more than 25% of her initial weight, when a treatment with roflumilast was started. The suspicion of a side effect as the cause of the reported clinical profile and its resolution required 3 hospital admissions.
Subject(s)
Aminopyridines/adverse effects , Benzamides/adverse effects , Diarrhea/chemically induced , Phosphodiesterase Inhibitors/adverse effects , Pulmonary Disease, Chronic Obstructive/drug therapy , Aged , Aminopyridines/pharmacokinetics , Aminopyridines/therapeutic use , Animals , Anorexia/chemically induced , Benzamides/pharmacokinetics , Benzamides/therapeutic use , Bronchitis/complications , Comorbidity , Cyclopropanes/adverse effects , Cyclopropanes/pharmacokinetics , Cyclopropanes/therapeutic use , Drug Evaluation, Preclinical , Female , Gastrointestinal Tract/drug effects , Hallucinations/chemically induced , Hospitalization , Humans , Patient Readmission , Phosphodiesterase Inhibitors/pharmacokinetics , Phosphodiesterase Inhibitors/therapeutic use , Polypharmacy , Product Surveillance, Postmarketing , Sleep Apnea Syndromes/complications , Vomiting/chemically induced , Weight LossABSTRACT
Se realizó un estudio analítico prospectivo con el propósito de evaluar el uso del jarabe de aloe y el mielito de eucalipto como terapia alternativa para el tratamiento del asma bronquial, en el municipio Jaruco, provincia Mayabeque, en el período comprendido entre los meses de octubre 2005 hasta octubre de 2006. El universo estuvo conformado por el total de pacientes vistos en consultorios médicos del casco urbano, como muestra los pacientes asmáticos en edades comprendidas de 15 a 50 años, de ambos sexos. Las variables utilizadas fueron: edad, sexo, evolución clínica con el jarabe de Aloe y mielito de eucalipto, aparición de reacciones adversas. Se confeccionó un modelo de historia clínica a los 100 pacientes que constituyeron la muestra, donde predominaron las edades entre 15 y 20 años, sexo masculino. A partir de los 60 días hubo mejoría clínica en la mayor parte de los pacientes, el tratamiento con jarabe de aloe resultó más económico. Ambos tratamientos ocasionaron poca cantidad de reacciones adversas (AU)
It was performed a prospective analytical study to evaluate the use of aloe syrup and honey and eucalyptus syrup as an alternative therapy for the treatment of bronchial asthma, in Jaruco municipality, in the months of October 2005 - October 2006. The totals of patients seen at urban family doctors offices were taken as universe, as sample the asthmatic patients aged 15 to 50 years of both sexes. The variables used were age, sex, clinical progress with aloe syrup and honey and eucalyptus syrup, appearance of adverse reactions. A medical record model was produced for the 100 patients that constituted the sample, in which predominated ages between 15 and 20 years old, male sex. After 60 days there was clinical progress in the majority of patients, treatment with aloe syrup was cheaper. Both treatments resulted in a small amount of adverse reactions (AU)
Subject(s)
Phytotherapy , Aloe , Plant Preparations/therapeutic useABSTRACT
Las plantas medicinales, por sus innumerables propiedades terapéuticas (antioxidante, antiinflamatoria, anticancerígeno y antiinfecciosa, entre otras) han mostrado ser sumamente eficaces en todas las civilizaciones. Con el desarrollo de las investigaciones actuales en esta materia, existen en Cuba grandes posibilidades de obtener nuevos fitofármacos con bajo potencial de reacciones adversas. A tales efectos se realizó una revisión bibliográfica con vistas a exponer los avances en la caracterización farmacotoxicológica de la planta Curcuma longa Linn para completar así la información disponible en las bases de datos nacionales al respecto(AU)
For their countless therapeutic properties (anti-oxidative, anti-inflammatory, anti-carcinogenic and anti-infective, among others), herbal medicines have shown to be extremely effective in all civilizations. With the development of the current researches on this topic, there are in Cuba great possibilities of obtaining new herb medicines with low potential of adverse reactions. For this purpose, a literature review was carried out aimed at exposing the advances in the pharmacological and toxiciological characterization of the herbal medicine Curcuma longa Linn, so as to complete the available information in the national databases on this respect(AU)
Subject(s)
Humans , Curcuma , Plant Poisoning , Curcuma/toxicity , Phytotherapeutic Drugs , Phytotherapy/adverse effectsABSTRACT
Se realizó un estudio analítico prospectivo con el propósito de evaluar el uso del jarabe de aloe y el mielito de eucalipto como terapia alternativa para el tratamiento del asma bronquial, en el municipio Jaruco, provincia Mayabeque, en el período comprendido entre los meses de octubre 2005 hasta octubre de 2006. El universo estuvo conformado por el total de pacientes vistos en consultorios médicos del casco urbano, como muestra los pacientes asmáticos en edades comprendidas de 15 a 50 años, de ambos sexos. Las variables utilizadas fueron: edad, sexo, evolución clínica con el jarabe de Aloe y mielito de eucalipto, aparición de reacciones adversas. Se confeccionó un modelo de historia clínica a los 100 pacientes que constituyeron la muestra, donde predominaron las edades entre 15 y 20 años, sexo masculino. A partir de los 60 días hubo mejoría clínica en la mayor parte de los pacientes, el tratamiento con jarabe de aloe resultó más económico. Ambos tratamientos ocasionaron poca cantidad de reacciones adversas
It was performed a prospective analytical study to evaluate the use of aloe syrup and honey and eucalyptus syrup as an alternative therapy for the treatment of bronchial asthma, in Jaruco municipality, in the months of October 2005 - October 2006. The totals of patients seen at urban family doctors offices were taken as universe, as sample the asthmatic patients aged 15 to 50 years of both sexes. The variables used were age, sex, clinical progress with aloe syrup and honey and eucalyptus syrup, appearance of adverse reactions. A medical record model was produced for the 100 patients that constituted the sample, in which predominated ages between 15 and 20 years old, male sex. After 60 days there was clinical progress in the majority of patients, treatment with aloe syrup was cheaper. Both treatments resulted in a small amount of adverse reactions
Subject(s)
Aloe , Asthma/therapy , Phytotherapy , Plant Preparations/therapeutic useABSTRACT
Introducción: Piper auritum Kunth (caisimón de anís) es una de las plantas más utilizadas tradicionalmente en Cuba por sus propiedades antiinflamatorias, analgésicas y cicatrizantes. Objetivos: reportar un caso clínico que sufrió una reacción adversa por automedicación de hojas de Piper auritum. Métodos: se revisó la literatura y la historia clínica de una paciente femenina atendida en el servicio del Hospital Universitario Dr Miguel Enríquez, Servicio de Cirugía Plástica y Caumatología. Resultados: se presentó el caso de una paciente que sufrió lesiones por quemaduras hipodérmicas y sus consecuencias al aplicar hojas de P auritum de forma incorrecta sobre la piel de las mamas, que necesitaron autoinjertos de piel laminar de espesor parcial medio con resultados satisfactorios. Conclusiones: es importante la orientación por personal especializado para el uso de las plantas medicinales(AU)
Introduction: Piper aurifum Kunth (caisimón de anis) is one of the most used plants traditionally in Cuba because of its anti-inflammatory, analgesic and healing properties. Objectives: to report a clinical case suffering from an adverse reaction caused by self-medication with Piper aurifum leaves. Methods: the medical literature and the medical history of a female patient, who was seen at Dr Miguel Enríquez university hospital plastic surgery and burn treatment service, were reviewed. Results: the case of a patient who suffered lesions from hypodermic burns caused by the wrong application of P aurifum leaves on the breast skin was presented. It was necessary to use laminar skin autografts of average partial thickness to cure the lesions, with satisfactory results. Conclusions: it is important that specialists provide appropriate instructions about the use of medicinal plants(AU)
Subject(s)
Burns , Piper/adverse effects , NecrosisABSTRACT
Introducción: Piper auritum Kunth (caisimón de anís) es una de las plantas más utilizadas tradicionalmente en Cuba por sus propiedades antiinflamatorias, analgésicas y cicatrizantes. Objetivos: reportar un caso clínico que sufrió una reacción adversa por automedicación de hojas de Piper auritum. Métodos: se revisó la literatura y la historia clínica de una paciente femenina atendida en el servicio del Hospital Universitario Dr Miguel Enríquez, Servicio de Cirugía Plástica y Caumatología. Resultados: se presentó el caso de una paciente que sufrió lesiones por quemaduras hipodérmicas y sus consecuencias al aplicar hojas de P auritum de forma incorrecta sobre la piel de las mamas, que necesitaron autoinjertos de piel laminar de espesor parcial medio con resultados satisfactorios. Conclusiones: es importante la orientación por personal especializado para el uso de las plantas medicinales
Introduction: Piper aurifum Kunth (caisimón de anis) is one of the most used plants traditionally in Cuba because of its anti-inflammatory, analgesic and healing properties. Objectives: to report a clinical case suffering from an adverse reaction caused by self-medication with Piper aurifum leaves. Methods: the medical literature and the medical history of a female patient, who was seen at Dr Miguel Enríquez university hospital plastic surgery and burn treatment service, were reviewed. Results: the case of a patient who suffered lesions from hypodermic burns caused by the wrong application of P aurifum leaves on the breast skin was presented. It was necessary to use laminar skin autografts of average partial thickness to cure the lesions, with satisfactory results. Conclusions: it is important that specialists provide appropriate instructions about the use of medicinal plants