[Epidemiology of drug poisoning in the Ramón y Cajal University Hospital during a year]. / Epidemiología de las intoxicaciones medicamentosas durante un año en el Hospital Universitario Ramón y Cajal.

BACKGROUND: In recent years, there has been an increase of drugs poisoning cases seen in the Emergency Department. This study has aimed to evaluate the characteristics of these cases in the Ramón and Cajal Hospital in Madrid. MATERIALS AND METHODS: A descriptive analysis about the drug poisonings diagnosed in 2004 was performed, using a retrospective search in the database of the electronic clinical records. The studied variables were gender, age, intention, drugs, admission into the hospital and relapse. RESULTS: There were 566 drug poisoning (47%) with a cumulative incidence of 0.1%, in which women (62.3%) were found to predominate, and the average patient age was 42.46+/-19.97 years (range 14-100 years). In 64.31% of the cases (566), only one kind of drug was used, benzodiazepine being the most common. This appeared at least once in 62% of the cases. Furthermore, 83% were cases of voluntary poisoning. Of the involuntary poisonings, digoxin was the most common drug with a frequency of 58.4%. A total of 28.6% of the cases were admitted into hospital, while the total number of patients who suffered a relapse in this period was 10%. DISCUSSION: Voluntary drug intoxications are caused mostly by psychoactive drugs, likely due to a high prevalence of underlying psychiatric disease in these patients. However, unintentional intoxications are mainly found in patients under chronic treatment with drugs such as digoxin and antiepileptics. More studies should be carried out to analyze which kind of preventive actions could reduce or avoid the high number of relapses.

Epidemiología de las intoxicaciones medicamentosas durante un año en el Hospital Universitario Ramón y Cajal / Epidemiology of drug poisoning in the Ramón y Cajal University Hospital during a year

un aumento de las intoxicaciones medicamentosasatendidas en los servicios de Urgencias. El objetivode este trabajo fue evaluar las características deéstas en el Hospital Ramón y Cajal de Madrid.Material y métodos. Se realizó un análisisdescriptivo de las intoxicaciones medicamentosasdiagnosticadas en el año 2004, a través de unabúsqueda retrospectiva, en la base de datos de lahistoria clínica electrónica. Las variables estudiadasfueron sexo, edad, intencionalidad, tipo de fármaco,ingreso hospitalario y reincidencia.Resultados. Se recogieron 566 intoxicacionesmedicamentosas con una incidencia acumulada del0,1%, en las cuales existía un predominio de mujeres(62,3%), y la media de edad de los pacientes fue de42,46±19,97 años (rango 14-100 años). En un64,31% de los casos se utilizó un solo tipo defármaco. Las benzodiacepinas, presentes en el 62%de los casos, fueron las de mayor frecuencia. Además,un 83% fueron voluntarias. En las intoxicaciones novoluntarias la digoxina fue el fármaco que apareciócon más frecuencia (58,4%). Un 28,6% del totalrequirieron ingreso hospitalario, mientras que lareincidencia en este periodo fue del 10%.Discusión. Los intentos autolíticos medicamentososson producidos en su mayoría por fármacospsicoactivos, debido probablemente a una altaprevalencia de patología psiquiátrica subyacente enestos pacientes. Las intoxicaciones no voluntarias,sin embargo, se presentan fundamentalmente enpacientes con tratamiento crónico, mediantefármacos como la digoxina o los antiepilépticos. Sedeberán realizar estudios para analizar qué tipo demedidas de prevención pueden disminuir o evitar elgran número de reincidencias

Background. In recent years, there has been anincrease of drugs poisoning cases seen in theEmergency Department. This study has aimed toevaluate the characteristics of these cases in theRamón and Cajal Hospital in Madrid.Materials and methods. A descriptive analysisabout the drug poisonings diagnosed in 2004 wasperformed, using a retrospective search in thedatabase of the electronic clinical records. Thestudied variables were gender, age, intention, drugs,admission into the hospital and relapse.Results. There were 566 drug poisoning (47%) witha cumulative incidence of 0.1%, in which women(62.3%) were found to predominate, and theaverage patient age was 42.46±19.97 years (range14-100 years). In 64.31% of the cases (566), onlyone kind of drug was used, benzodiazepine being themost common. This appeared at least once in 62%of the cases. Furthermore, 83% were cases ofvoluntary poisoning. Of the involuntary poisonings,digoxin was the most common drug with a frequencyof 58.4%. A total of 28.6% of the cases wereadmitted into hospital, while the total number ofpatients who suffered a relapse in this period was10%.Discussion. Voluntary drug intoxications are causedmostly by psychoactive drugs, likely due to a highprevalence of underlying psychiatric disease in thesepatients. However, unintentional intoxications aremainly found in patients under chronic treatmentwith drugs such as digoxin and antiepileptics. Morestudies should be carried out to analyze which kindof preventive actions could reduce or avoid the highnumber of relapses

[Inhaled insulin. General characteristics. Repercussion on lung function]. / Insulina inhalada. Características generales. Repercusión sobre la función pulmonar.

Inhaled insulin satisfies the unsuccessful search for non-injectable insulin pathways for the chronic treatment of diabetes. Its use will allow insulin-dependent patients to even receive a single daily injection of basal insulin or early insulinization in patients with type 2 diabetes and poor glycemic control, many of whom maintain the treatment with oral antidiabetics due to aversion to the subcutaneous route (sc). Current data indicate that this insulin is at least as effective as the sc in regards to glucose control. However, clinical experience will clarify its true efficacy and the presence of possible side effects in the long term, especially on the lung function. In this sense, it has been observed that inhaled insulin leads a non-significant small decrease in forced expiratory volume in one second (FEV1). This appears early and does not progress during the first 2 years of treatment, being reversible after its withdrawal.

Insulina inhalada. Características generales. Repercusión sobre la función pulmonar / Inhaled insulin. General characteristics. Repercussion on lung function

La insulina inhalada satisface la búsqueda infructuosa de vías no inyectables de insulina para el tratamiento crónico de la diabetes. Su uso permitirá a pacientes insulinodependientes recibir incluso un solo pinchazo diario de insulina basal, o una insulinización precoz en enfermos con diabetes tipo 2 y mal control glucémico, a muchos de los cuales se les mantiene el tratamiento con antidiabéticos orales por aversión a la vía subcutánea (sc). Los datos actuales indican que dicha insulina es, al menos, igual de eficaz que la sc en cuanto al control glucémico, aunque la experiencia clínica nos esclarecerá su verdadera eficacia y la presencia de posibles efectos secundarios a largo plazo, especialmente sobre la función pulmonar. En este sentido, se ha observado que la insulina inhalada provoca un pequeño descenso del volumen espiratorio forzado en el primer segundo (FEV1) no clínicamente significativo, que aparece de forma temprana y no progresa durante los 2 primeros años de tratamiento, siendo reversible tras la retirada del mismo

Inhaled insulin satisfies the unsuccessful search for non-injectable insulin pathways for the chronic treatment of diabetes. Its use will allow insulin-dependent patients to even receive a single daily injection of basal insulin or early insulinization in patients with type 2 diabetes and poor glycemic control, many of whom maintain the treatment with oral antidiabetics due to aversion to the subcutaneous route (sc). Current data indicate that this insulin is at least as effective as the sc in regards to glucose control. However, clinical experience will clarify its true efficacy and the presence of possible side effects in the long term, especially on the lung function. In this sense, it has been observed that inhaled insulin leads a non-significant small decrease in forced expiratory volume in one second (FEV1). This appears early and does not progress during the first 2 years of treatment, being reversible after its withdrawal