ABSTRACT
We conducted a prospective evaluation of drug-induced severe hyponatremia (adverse drug reaction (ADR)) through the Prospective Pharmacovigilance Program from Laboratory Signals at Hospital over a period of 10 years. Cases of serum sodium (Na(s)) < 116 mM were recorded from July 2007 to June 2017 (first period). Also cases of Na(s) 116-122 mM were recorded from July 2012 to June 2017 (second period). Drugs were the primary cause of severe hyponatremia. The incidence rate of Na(s) < 116 mM by drugs was increased threefold over the decade. Compared with other causes of hyponatremia, patients with adverse drug reaction-serum sodium (ADR-Na(s)) in the first period were older (79 years (interquartile range (IQR) 68.6-89 vs. 65 years (IQR 48-81); P < 0.001) and were more often women (70.8% vs. 48.9% men, P < 0.001); in the second period were also older (79 years (IQR 65.3-89) vs. 63 years (IQR 46-80.6); P < 0.001) and were more often women (70% vs. 53%, P = 0.002), and ADR-Na(s) occurred more often in summer. The most frequent therapeutic groups of culprit drugs were the cardiovascular system and nervous system. The 65.3% in the first period and 71.2% in the second period of the ADR-Na(s) cases responded to hydration and had been diagnosed with hypovolemic hyponatremia.
Subject(s)
Analgesics, Opioid/adverse effects , Anticonvulsants/adverse effects , Cardiovascular Agents/adverse effects , Cholinergic Antagonists/adverse effects , Hyponatremia/chemically induced , Psychotropic Drugs/adverse effects , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Anti-Bacterial Agents/adverse effects , Antineoplastic Agents/adverse effects , Bolivia/epidemiology , Child , Child, Preschool , Female , Gastrointestinal Agents/adverse effects , Humans , Hypoglycemic Agents/adverse effects , Hyponatremia/epidemiology , Infant , Infant, Newborn , Male , Middle Aged , Pharmacovigilance , Prospective Studies , Seasons , Severity of Illness Index , Young AdultABSTRACT
We evaluated the risk for the Spanish Olympic Team acquiring Zika virus in Rio de Janeiro, Brazil, during 2016. We recruited 117 team members, and all tested negative for Zika virus. Lack of cases in this cohort supports the minimum risk estimates made before the Games.
Subject(s)
Sports , Travel , Zika Virus Infection/epidemiology , Zika Virus Infection/virology , Zika Virus , Anniversaries and Special Events , Athletes , Brazil , Disease Outbreaks/prevention & control , Global Health , Humans , Risk Assessment , SpainABSTRACT
The aim of the present study is to describe the clinical and epidemiological characteristics, complications and outcome of patients with haemophilia and acute head injury (AHI) at the emergency department (ED), and develop a protocol to prevent early and late complications. This is a retrospective cohort study including all patients with haemophilia and AHI admitted to the ED. We identified 26 patients with AHI. A computed tomography scan was carried out on all patients at admission, and again on two patients (with neurosurgical complications) 48 h later. The discharge diagnosis was as follows: 3.8% subdural haematoma, 3.8% cerebellar epidural haematoma and 92.3% uncomplicated AHI. We propose the following protocol: a computed tomography scan upon arrival and another within 48 h post-AHI, unless there is an absence of clinical symptoms. In addition, all patients must self-administer a clotting factor as soon as possible and be observed in the ED for at least 48 h.