ABSTRACT
The incidence of acute poisonings has increased in recent years and constitutes approximately 2% of the services provided by the Emergency Department currently. The objective of this study is to describe the frequency and characteristics of the intoxications treated at the Central University Hospital of Asturias during 2015 from biochemical-analytical, epidemiological and medical-legal perspectives. We conducted a retrospective study and a descriptive analysis of the clinical and sociodemographic variables included in the acute intoxication (AI) protocol at the national level. This hospital treated 2,478 cases of acute poisoning, representing 2.3% of the emergencies treated and corresponding to an incidence of 764 cases/100,000 inhabitants/year with an age ranging from under 1 year to over 80 years. The average age of the patients was 43.6 (SD = 16.6) years. Of these patients, 59.4% were males with an average age of 44 (SD = 16.8) years, and women represented 43.1% with an average age of 42.8 (SD = 16.5) years. These intoxications have a frequency of 47.2% during the weekend, while 37.4% occur between June and September. Acute voluntary intoxication is the most frequent intentionality, corresponding to 83.2% of the cases. We must point out that the medical records register 16.8% of the cases as suicide attempts. Ethanol and benzodiazepines are the most commonly-used toxics. These intoxications are treated in the Emergency Department without requiring hospitalization and have a very low mortality rate.
La incidencia de las intoxicaciones agudas ha aumentado en los últimos años, y actualmente constituye aproximadamente el 2% de las atenciones sanitarias llevadas a cabo por los Servicios de Urgencias. El objetivo de este estudio es describir la frecuencia y características de las intoxicaciones atendidas en el Hospital Universitario Central de Asturias durante el año 2015 desde la perspectiva bioquímica-analítica, epidemiológica y médico-legal. Se realizó un estudio retrospectivo y un análisis descriptivo de las variables clínicas y sociodemográficas incluidas en el protocolo de intoxicación aguda a nivel nacional. Este hospital atendió 2478 casos de intoxicaciones agudas representando el 2,3% de las urgencias atendidas y que corresponde a una incidencia de 764 casos/100000 habitantes/año con un rango de edad de menores de 1 año a mayores de 80 años. La edad media de los pacientes atendidos fue de 43,6 (DE = 16,6) años. El 59,4% de los pacientes eran varones con una edad media de 44 (DE = 16,8) años, las mujeres representaban el 43,1% y su edad media era de 42,8 (DE = 16,5) años. El 47,2% de estas intoxicaciones ocurren durante el fin de semana y el 37,4% se dan entre junio y septiembre. La intencionalidad más frecuente es la intoxicación aguda voluntaria correspondiente al 83,2% de los casos. Cabe destacar que el 16,8% de los casos están referenciados en su historia clínica como intentos de suicidio. Los tóxicos más empleados son el etanol y las benzodiacepinas. Estas intoxicaciones son resueltas en el Servicio de Urgencias sin requerir ingreso hospitalario y poseen una tasa de mortalidad muy baja.
Subject(s)
Benzodiazepines/poisoning , Ethanol/poisoning , Poisoning/epidemiology , Substance-Related Disorders/epidemiology , Acute Disease , Adult , Emergencies , Female , Humans , Male , Middle Aged , Poisoning/etiology , Poisoning/therapy , Retrospective Studies , Seasons , Spain/epidemiology , Suicide, Attempted/statistics & numerical data , Time FactorsABSTRACT
Endoscopic full-thickness resection (EFTR) is a new technique for the resection of colonic lesions with limitations for other techniques such as endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) due to fibrosis, the location of the lesion or invasion depth. In addition, techniques such as ESD require a long learning curve and unfortunately they are not fully implemented in Western countries. EFTR has numerous indications, which are expanding daily. The Full-Thickness Resection Device® (FTRD) is a promising tool, although it has many limitations and is associated with some risks. One of the main limitations of this resection device is the size of the lesion and it is not recommended for the resection of lesions > 30 mm. Furthermore, tumor size is directly related to the "en bloc" resection rate. On the one hand, this case report suggests that neoadjuvant chemotherapy can modify the lesion size and larger lesions become candidates for EFTR in a second attempt. On the other hand, the concomitant use of systemic anticancer therapy could be a contraindication for the use of FTRD® as it may be associated with late perforations. It is necessary to establish the time between the use of chemotherapy and the use of FTRD® in order to avoid complications. These considerations must be analyzed in future prospective studies.
Subject(s)
Adenocarcinoma/surgery , Colonic Neoplasms/surgery , Endoscopic Mucosal Resection/methods , Adenocarcinoma/drug therapy , Adenocarcinoma/pathology , Chemotherapy, Adjuvant , Colon, Descending , Colonic Neoplasms/drug therapy , Colonic Neoplasms/pathology , Colonoscopy , Endoscopic Mucosal Resection/instrumentation , Female , Humans , Lung Neoplasms/drug therapy , Lung Neoplasms/pathology , Middle Aged , Neoplasms, Multiple Primary/drug therapy , Neoplasms, Multiple Primary/pathology , Tumor Burden/drug effectsABSTRACT
Clear Cell «sugar tumor¼ of the lung is a rare nosological entity of which around 60 cases have been published in the scientific literature. Considered to be of mesenchymal origin, it presents a typical histochemical - immunohistochemical profile, positive PAS and melanic markers, which allows it to be differentiated from other more frequent neoplasms with worse prognosis. We present the case of a 56-year-old man with a clear cell lung tumor. Radiological, macro-microscopic and histochemistry - immunohistochemical characterization, as well as a brief review of the literature.
Subject(s)
Lung Neoplasms , Neuroendocrine Tumors , Perivascular Epithelioid Cell Neoplasms , Humans , Lung/pathology , Lung Neoplasms/diagnosis , Lung Neoplasms/pathology , Male , Middle Aged , Perivascular Epithelioid Cell Neoplasms/diagnosis , Prognosis , SugarsABSTRACT
La incidencia de las intoxicaciones agudas ha aumentado en los últimos años, y actualmente constituye aproximadamente el 2% de las atenciones sanitarias llevadas a cabo por los Servicios de Urgencias. El objetivo de este estudio es describir la frecuencia y características de las intoxicaciones atendidas en el Hospital Universitario Central de Asturias durante el año 2015 desde la perspectiva bioquímica-analítica, epidemiológica y médico-legal. Se realizó un estudio retrospectivo y un análisis descriptivo de las variables clínicas y sociodemográficas incluidas en el protocolo de intoxicación aguda a nivel nacional. Este hospital atendió 2478 casos de intoxicaciones agudas representando el 2,3% de las urgencias atendidas y que corresponde a una incidencia de 764 casos/100000 habitantes/año con un rango de edad de menores de 1 año a mayores de 80 años. La edad media de los pacientes atendidos fue de 43,6 (DE = 16,6) años. El 59,4% de los pacientes eran varones con una edad media de 44 (DE = 16,8) años, las mujeres representaban el 43,1% y su edad media era de 42,8 (DE = 16,5) años. El 47,2% de estas intoxicaciones ocurren durante el fin de semana y el 37,4% se dan entre junio y septiembre. La intencionalidad más frecuente es la intoxicación aguda voluntaria correspondiente al 83,2% de los casos. Cabe destacar que el 16,8% de los casos están referenciados en su historia clínica como intentos de suicidio. Los tóxicos más empleados son el etanol y las benzodiacepinas. Estas intoxicaciones son resueltas en el Servicio de Urgencias sin requerir ingreso hospitalario y poseen una tasa de mortalidad muy baja
The incidence of acute poisonings has increased in recent years and constitutes approximately 2% of the services provided by the Emergency Department currently. The objective of this study is to describe the frequency and characteristics of the intoxications treated at the Central University Hospital of Asturias during 2015 from biochemical-analytical, epidemiological and medical-legal perspectives. We conducted a retrospective study and a descriptive analysis of the clinical and sociodemographic variables included in the acute intoxication (AI) protocol at the national level. This hospital treated 2,478 cases of acute poisoning, representing 2.3% of the emergencies treated and corresponding to an incidence of 764 cases/100,000 inhabitants/year with an age ranging from under 1 year to over 80 years. The average age of the patients was 43.6 (SD = 16.6) years. Of these patients, 59.4% were males with an average age of 44 (SD = 16.8) years, and women represented 43.1% with an average age of 42.8 (SD = 16.5) years. These intoxications have a frequency of 47.2% during the weekend, while 37.4% occur between June and September. Acute voluntary intoxication is the most frequent intentionality, corresponding to 83.2% of the cases. We must point out that the medical records register 16.8% of the cases as suicide attempts. Ethanol and benzodiazepines are the most commonly-used toxics. These intoxications are treated in the Emergency Department without requiring hospitalization and have a very low mortality rate
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , Poisoning/epidemiology , Substance-Related Disorders/epidemiology , Emergency Service, Hospital/statistics & numerical data , Retrospective Studies , Seasons , Age and Sex Distribution , Suicide, Attempted/statistics & numerical data , Poisoning/therapy , Substance-Related Disorders/therapy , Spain/epidemiology , Hospitals, University/statistics & numerical data , IncidenceABSTRACT
Endoscopic full-thickness resection (EFTR) is a new technique for the resection of colonic lesions with limitations for other techniques such as endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) due to fibrosis, the location of the lesion or invasion depth. In addition, techniques such as ESD require a long learning curve and unfortunately they are not fully implemented in Western countries. EFTR has numerous indications, which are expanding daily. The Full-Thickness Resection Device(R) (FTRD) is a promising tool, although it has many limitations and is associated with some risks. One of the main limitations of this resection device is the size of the lesion and it is not recommended for the resection of lesions > 30 mm. Furthermore, tumor size is directly related to the "en bloc" resection rate. On the one hand, this case report suggests that neoadjuvant chemotherapy can modify the lesion size and larger lesions become candidates for EFTR in a second attempt. On the other hand, the concomitant use of systemic anticancer therapy could be a contraindication for the use of FTRD(R) as it may be associated with late perforations. It is necessary to establish the time between the use of chemotherapy and the use of FTRD(R) in order to avoid complications. These considerations must be analyzed in future prospective studies
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