Prevalencia por áreas sanitarias de enfermedad renal crónica en la población diabética de Extremadura durante los años 2012, 2013 y 2014. Un estudio observacional / Prevalence by health areas of chronic kidney disease in diabetic population of Extremadura during the years 2012, 2013 and 2014. An observational study

Antecedentes y objetivo: La diabetes mellitus es la principal causa de enfermedad renal crónica (ERC) en nuestro país. El objetivo fue estimar la prevalencia global y por áreas sanitarias de ERC en la población diabética de Extremadura. Pacientes y métodos: Estudio observacional, longitudinal, retrospectivo en la población diabética atendida en el Sistema Extremeño de Salud durante el periodo 2012-2014. Se incluyeron 90.709 pacientes ≥ 18 años. El cálculo del filtrado glomerular estimado (FGe) se realizó mediante la ecuación CKD-EPI (derivada de la ecuación desarrollada por la Chronic Kidney Disease Epidemiology Collaboration) y se calculó el cociente albúmina/creatinina en orina (CAC). Se consideró paciente con ERC a todo aquel que en su última analítica tenía un FGe<60 mL/min/1,73 m2 y/o un CAC ≥ 30 mg/g, confirmados en una determinación previa separada al menos por tres meses. Resultados: La prevalencia global de ERC fue del 15,6% (17,5% en mujeres y 13,7% en varones) y fue mayor en la provincia de Cáceres (17%) que en la de Badajoz (14,8%, p<0,001), encontrándose la menor prevalencia en el área sanitaria de Navalmoral de la Mata (13%) y la mayor en la de Plasencia (17,8%, p < 0,001). La prevalencia de ERC definida sin necesidad de confirmación de la sostenibilidad del daño renal o del FGe disminuido fue del 26,1% (29,3% en mujeres y 22,9% en varones), lo que supone una sobreestimación de la prevalencia del 67%. Conclusiones: La prevalencia de ERC en población diabética extremeña es menor a la referida habitualmente y difiere significativamente entre sus áreas sanitarias. (AU)

Background and objective: Diabetes mellitus is the leading cause of chronic kidney disease (CKD) in our country. The objective was to estimate the global prevalence and by health areas of CKD in the diabetic population of Extremadura. Patients and methods: Observational, longitudinal retrospective study in the diabetic population attended in the Extremadura Health System in 2012–2014. A total of 90,709 patients ≥ 18 years old were studied. The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI). The presence of CKD was defined as follows: an eGFR<60 mL/min/1.73 m2 in a time period of greater than three months or the presence of renal damage, as evaluated by an urine albumin-creatinine ratio (UACR) ≥ 30 mg/g, with or without reduced eGFR, also in a time period of greater than three months. Results: The overall prevalence of CKD was 15.6% (17.5% in women and 13.7% in men) and it was higher in the province of Cáceres (17%) than in Badajoz (14.8%, p<0.001), with the lowest prevalence in the Navalmoral de la Mata health area (13%) and the highest in Plasencia (17.8%, p<0.001). The prevalence of CKD defined without the need for confirmation of the sustainability of kidney damage or decreased eGFR was 26.1% (29.3% in women and 22.9% in men), which represents an overestimation of the prevalence of 67%. Conclusions: The prevalence of CKD in Extremadura's diabetic population is lower than usually referred to and differs significantly between its health areas. (AU)

Prevalence by health areas of chronic kidney disease in the diabetic population of Extremadura in 2012, 2013 and 2014. An observational study.

BACKGROUND AND OBJECTIVE: Diabetes mellitus is the leading cause of chronic kidney disease (CKD) in our country. The objective was to estimate the global prevalence and by health areas of CKD in the diabetic population of Extremadura. METHODS: Observational, longitudinal retrospective study in the diabetic population attended in the Extremadura Health System in 2012-2014. A total of 90,709 patients ≥18 years old were studied. The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI). The presence of CKD was was defined as follows: an eGFR <60ml/min/1.73m2 in a time period≥of three months or the presence of renal damage, as evaluated by an urine albumin-creatinine ratio (UACR) ≥30mg/g, with or without reduced eGFR, also in a time period ≥ of three months. RESULTS: The overall prevalence of CKD was 15.6% (17.5% in women and 13.7% in men) and it was higher in the province of Cáceres (17.0%) than in Badajoz (14.8%, p<0.001), with the lowest prevalence in the Navalmoral de la Mata health area (13.0%) and the highest in Plasencia (17.8%, p<0.001). The prevalence of CKD defined without the need for confirmation of the sustainability of kidney damage or decreased eGFR was 26.1% (29.3% in women and 22.9% in men), which represents an overestimation of the prevalence of 67%. CONCLUSIONS: The prevalence of CKD in Extremadura's diabetic population is lower than usually referred to and differs significantly between its health areas.

[Prevalence and degree of control of cardiovascular risk factors in patients with ischemic cardiopathy of an urban health center.] / Prevalencia y grado de control de los factores de riesgo cardiovascular en pacientes con cardiopatía isquémica adscritos a un centro de salud urbano.

OBJECTIVE: Compliance with the therapeutic objectives recommended in the clinical practice guidelines on cardiovascular prevention and changes in lifestyle, such as smoking cessation, reduce the morbidity and mortality of patients with ischemic heart disease. The objective of this study was to analyze the prevalence and degree of control of the main cardiovascular risk factors in patients with ischemic heart disease. METHODS: A total of 200 patients with ischemic heart disease randomly selected between the years 2008-2018. The degree of control of the cardiovascular risk factors and the achievement of the recommended objectives in secondary cardiovascular prevention were analyzed during a mean follow-up of 5 years. A descriptive and inferential analysis of the data was performed with the SPPS version 22.0 program. RESULTS: 77.9% of patients (mean age 65.6 years, 63.2 men and 70.5 women, p<0.01) had high blood pressure, 69.3% dyslipidemia, 48.2% obesity and 32.3% diabetes. 34.8% were smokers (39.2% of men versus 25.4% of women, p=0.06). During the follow-up, a slight decrease in smoking was observed (from 34.8% to 21.6%, p<0.01), with a greater percentage reduction in men versus women (42.9% versus 21.3%, p<0.01). In the follow-up, he also highlighted the decrease in blood pressure, total cholesterol and LDL-cholesterol. Optimal compliance with therapeutic objectives was achieved in 21.7% of patients. CONCLUSIONS: The objectives of secondary cardiovascular prevention are reached in a low percentage of patients with ischemic heart disease, with a lower rate of smoking cessation in women.

OBJETIVO: El logro de objetivos terapéuticos recomendados en las guías de práctica clínica sobre prevención cardiovascular y los cambios en estilos de vida, como abandono del tabaco, disminuyen la morbimortalidad de los pacientes con cardiopatía isquémica. El objetivo de este estudio fue analizar la prevalencia y grado de control de los principales factores de riesgo cardiovascular en pacientes con cardiopatía isquémica. METODOS: La muestra la conformó un total de 200 pacientes con cardiopatía isquémica seleccionados aleatoriamente entre los años 2008-2018. Se analizó el grado de control de los factores de riesgo cardiovascular y el logro de los objetivos recomendados en prevención secundaria cardiovascular, durante un seguimiento medio de 5 años. Se realizó un análisis descriptivo e inferencial de los datos con el programa estadístico SPPS versión 22.0. RESULTADOS: Un 77,9% de los pacientes (edad media 65,6 años; 63,2 años los varones y 70,5 las mujeres, p<0,01) presentaban hipertensión arterial, un 69,3% dislipemia, un 48,2% obesidad y un 32,3% diabetes. El 34,8% eran fumadores (el 39,2% de los varones frente al 25,4% de las mujeres, p=0,06). Durante el seguimiento destacó el discreto descenso del tabaquismo (del 34,8% al 21,6%, p<0,01), con una mayor caída porcentual en los varones frente a las mujeres (42,9% versus 21,3%, p<0,01). También destacó la disminución de las cifras de presión arterial, colesterol total y LDL-colesterol. El cumplimiento óptimo de los objetivos terapéuticos se logró en el 21,7% de los pacientes. CONCLUSIONES: Los objetivos de prevención secundaria cardiovascular se alcanzan en un bajo porcentaje de los pacientes con cardiopatía isquémica, con una menor tasa de abandono del tabaquismo en mujeres.

Leucoplasia oral / Oral leukoplakia

No disponible

Exantema fijo medicamentoso por etoricoxib / Fixed drug eruption induced by etoricoxib

No disponible

Estudio descriptivo de validez y aplicabilidad de la regla nemotécnica POUNDing en pacientes con migraña / Validity and applicability of the mnemonic POUNDing rule in patients with migraine. A descriptive study

INTRODUCCIÓN: En la valoración inicial de un paciente con cefalea, el médico se plantea con frecuencia si el dolor se corresponde con una migraña y si el paciente precisa pruebas de neuroimagen. El objetivo del trabajo fue valorar la validez y aplicabilidad de la regla nemotécnica POUNDing en pacientes diagnosticados de migraña. PACIENTES Y MÉTODOS: Estudio descriptivo, de aplicación de la regla POUNDing en pacientes con diagnóstico de migraña y con realización de alguna prueba de imagen cerebral (tomografía computarizada o resonancia magnética), en un centro de salud urbano y en una consulta de Neurología del Hospital Universitario de Badajoz. RESULTADOS: Se incluyó a 116 pacientes (edad media 45,6 años; 79,3% mujeres; 70 procedentes de consultas de Neurología y 46 del centro de salud). Destacaron en las comparaciones los elevados valores predictivos positivos: 90,9% (IC 95%: 57,1-99,5%); 100% (IC 95%: 73,2-99,3%) y 96,0% (IC 95%: 77,7-99,8%), en los pacientes de la consulta de Neurología, del centro de salud y en la población total, respectivamente, y sus bajos valores predictivos negativos: 6,8% (IC 95%: 2,2-17,3%); 3,1% (IC 95%: 0,2-18,0%) y 5,5% (IC 95%: 2,0-12,9%), también respectivamente en los pacientes de la consulta de Neurología, del centro de salud y en la población total. CONCLUSIONES: La regla POUNDing presenta un alto valor predictivo positivo y podría ser de gran ayuda en la aceptación o rechazo de un diagnóstico de migraña, al facilitar un uso más eficiente de las pruebas de neuroimagen

INTRODUCTION: In assessing the patient with headache, clinicians are often faced with 2 important questions: Is this headache a migraine? Does this patient require neuroimaging? The aim of this study was to assess the validity and applicability of the mnemonic POUNDing rule in patients diagnosed with migraine. PATIENTS AND METHODS: A descriptive, validation study of the POUNDing rule in patients with a diagnosis of migraines and with a brain imaging test (computed tomography or magnetic resonance imaging), in an urban health centre and a neurology clinic of the University Hospital of Badajoz. RESULTS: A total of 116 patients were included (mean age 45.6 years; 79.3% women, 70 from the neurology clinics, and 46 from the health centre). The best validity parameters of the POUNDing rule were its positive predictive values: 90.9% (95% CI: 57.1-99.5%), 100% (95% CI: 73.2-99.3%), and 96.0% (95% CI: 77.7-99.8%) in the patients of the neurology clinic, the health centre and in the total population, respectively, and its low negative predictive values: 6.8% (95% CI: 2.2-17.3%), 3.1% (95% CI: 0.2-18.0%), and 5.5% (95% CI: 2.0-12.9%), also respectively in the patients of the neurology clinic, the health centre and in the total population. CONCLUSIONS: The POUNDing mnemonic rule has a high positive predictive values and can be a great help in accepting or rejecting a diagnosis of migraine, facilitating a more efficient use of neuroimaging tests

Herpes zóster oftálmico / Herpes zoster ophthalmicus

No disponible

Ojo rojo grave: glaucoma agudo / Severe red eye: Acute glaucoma

No disponible

[Validity and applicability of the mnemonic POUNDing rule in patients with migraine. A descriptive study]. / Estudio descriptivo de validez y aplicabilidad de la regla nemotécnica POUNDing en pacientes con migraña.

INTRODUCTION: In assessing the patient with headache, clinicians are often faced with 2 important questions: Is this headache a migraine? Does this patient require neuroimaging? The aim of this study was to assess the validity and applicability of the mnemonic POUNDing rule in patients diagnosed with migraine. PATIENTS AND METHODS: A descriptive, validation study of the POUNDing rule in patients with a diagnosis of migraines and with a brain imaging test (computed tomography or magnetic resonance imaging), in an urban health centre and a neurology clinic of the University Hospital of Badajoz. RESULTS: A total of 116 patients were included (mean age 45.6 years; 79.3% women, 70 from the neurology clinics, and 46 from the health centre). The best validity parameters of the POUNDing rule were its positive predictive values: 90.9% (95% CI: 57.1-99.5%), 100% (95% CI: 73.2-99.3%), and 96.0% (95% CI: 77.7-99.8%) in the patients of the neurology clinic, the health centre and in the total population, respectively, and its low negative predictive values: 6.8% (95% CI: 2.2-17.3%), 3.1% (95% CI: 0.2-18.0%), and 5.5% (95% CI: 2.0-12.9%), also respectively in the patients of the neurology clinic, the health centre and in the total population. CONCLUSIONS: The POUNDing mnemonic rule has a high positive predictive values and can be a great help in accepting or rejecting a diagnosis of migraine, facilitating a more efficient use of neuroimaging tests.