Encuesta sobre conocimiento en cigarrillo electrónico y nuevos productos de consumo de nicotina en el personal sanitario / Survey on knowledge of electronic cigarettes and new nicotine consumer products among health personnel

Introducción.La irrupción de los cigarrillos electrónicos (e-cig) y nuevos productos de consumo de tabaco ha supuesto un desfase en el conocimiento del tabaquismo entre el personal sanitario. Los escasos estudios sobre su eficacia y la intromisión de la industria tabaquera no ayudan a dirimir la controversiaexistente entre su uso como ayuda para la cesación/reducción de daños frente a su asimilación al resto de labores del tabaco. Sujetos y métodos: Se realiza una encuesta dirigida a personal sanitario a nivel de toda España tratando de constatar el conocimiento sobre los e-cig, sus potenciales daños, empleo en la clínica, papel de la industria y legislación actual en España. Para ello, a través de un entorno online, se distribuye un cuestionario a responder entre los días 12 y 26 de agosto de 2019. Resultados: Se reciben 266 encuestas, la mayoría de mujeres (3:1), médicas (73,3 %) y con 11 años o más de experiencia (54,5%). Un 30,5% no conoce ningún tipo de e-cig y el 78,6 % no se siente capacitado ni para informar ni para tratar a los consumidores. Ven riesgos de cronificar la cesación (77,8%) y normalizarel consumo de nicotina en lugares ya libres de humo (62,8%), aunque hasta el 44% cree que pueden tenerun papel como herramienta de cesación en determinados pacientes, siendo asumida la ausencia de estudios que los avalen (38,3%). El 62% ve una actitud engañosa de las tabaqueras y el 51,9% en su regulación como productos de consumo sin existir una legislaciónespecífica. Comparadas las respuestas entre profesionales médicos y no médicos, por años de experiencia ygrupos de edad, destacan diferencias estadísticamente significativas (p < 0,05) en la percepción de daños,el papel de las tabaqueras y en el conocimiento más específico de los dispositivos entre el personal másjoven y/o con menos años de experiencia. (AU)

Introduction: The appearance of electronic cigarettes (E-cig) and new products of use of tobacco have entailed a lag in the knowledge of smoking habit among health care personnel. The scarce studies on its efficacy and the meddling of the tobacco industry have not helped to solve the controversy existing between its use as an aid for smoking cessation/reduction of harm against its assimilation to the remaining tobacco products.Subjects and methods: A survey addressed to the health care personnel in Spain was carried out. It aimed to determine the knowledge on the E-cig, their potential harm, use in the clinical practice, role of the industry and current legislation in Spain. To do so, a questionnaire to be answered was distributed onlinebetween 12 and 26 of August 2019. Results: A total of 266 surveys were received, most of which were from women (3:1), doctors (73.3%) and with 11 years of more of experience (54.5%). Of these, 30.5 % did not know any type of E-cig and 78.6 % did not feel qualified to inform or to treat the users. They see risks of the smoking cessation becoming chronic (77.8%) and making the use of nicotine normal in sites that are already smoke free (62.8%), although up to 44% believe that they canhave a role as a tool to quit smoking in some patients, the absence of studies that support being assumed (38.3%). 62% consider that the tobacco companies have a misleading attitude and 51.9% in their regulation as products of use without the existence of specific legislation. When comparing the answersbetween the medical and non-medical professionals, there are statistically significant differences by years of experience and age groups (p < 0.05) in the perception of harm, the role of the tobacco companies and in the most specific knowledge of the devices among the younger personnel and/or those with fewer years of experience. (AU)

Relación entre la dislipidemia y otros factores de riesgo cardiovasculares conocidos con la presencia de enfermedad cardiovascular en pacientes con enfermedad pulmonar obstructiva crónica de las Islas Canarias / Dyslipidaemia and other cardiovascular risk factors in relation to manifest cardiovascular disease in patients with chronic obstructive pulmonary disease in the Canary Islands

INTRODUCCIÓN: La enfermedad cardiovascular tiene un impacto negativo en el pronóstico vital de los pacientes con enfermedad pulmonar obstructiva crónica (EPOC), siendo la dislipidemia (DLP) y la hipertensión arterial (HTA) los factores de riesgo más prevalentes. El objetivo del estudio fue: 1) evaluar la relación existente entre el diagnóstico de DLP y la presencia de enfermedad cardiovascular en pacientes con EPOC, y compararlo con otros factores conocidos de riesgo cardiovascular; y 2) determinar la relación entre las diferentes comorbilidades cardiovasculares y los grupos de gravedad según la clasificación GOLD 2017. MÉTODOS: Estudio observacional transversal de 454 pacientes con EPOC en seguimiento ambulatorio. Se calculó la prevalencia de cada una de las comorbilidades cardiovasculares y el riesgo de que cada uno de los factores de riesgo cardiovascular se presentase conjuntamente con una enfermedad vascular (RRij). RESULTADOS: El 66,7% de los pacientes eran dislipidémicos. La DLP mostró una mayor relación con la presencia de accidentes cerebrovasculares (ACV) (RRij 1.36; p = 0,0054), enfermedad renal crónica (ERC) (RRij 1.34; p = 0,00023) y arteriopatía periférica (AP) (RRij 1.38; p = 0,00015); la HTA se relacionó mayormente con ACV (RRij 1,41; p = 0,0014) y ERC (RRij 1,42; p < 0,0001); la DMT2 con AP (RRij 1,90; p = 0,0001), insuficiencia cardiaca (IC) (RRij 1,74; p = 0,0002) y ERC (RRij 1,76; p < 0,0001); la obesidad con IC (RRij 1,60; p = 0,0009) y ERC (RRij 1.54; p = 0,0001). CONCLUSIÓN: La DLP se relacionó con la presencia de ACV, ERC y AP. La HTA y DMT2 se relacionaban mayoritariamente con IC y ACV

INTRODUCTION: Cardiovascular disease has a negative impact on the vital prognosis of patients with chronic obstructive pulmonary disease (COPD), where dyslipidaemia (DLP) and arterial hypertension (AHT) are considered the most prevalent risk factors. The objective of this study was 1) to assess the relationship between diagnosed DLP and cardiovascular disease in COPD patients and compare it with other known cardiovascular risk factors and 2) to determine the relationship between the different cardiovascular comorbidities and the severity groups according to the GOLD 2017 classification. METHODS: A cross-sectional, observational study was performed in 454 outpatients with COPD during their follow up. We calculated the prevalence of each of the cardiovascular comorbidities and the probability of each of the cardiovascular risk factors to occur jointly with a vascular disease (RRij). RESULTS: A total of 66.7% of the patients had DLP, whereby DLP was related to cerebrovascular accidents (CVA) (RRij 1.36, P=.0054), chronic kidney disease (CKD) (RRij 1.34, P=.00023), and peripheral arterial disease (PAD) (RRij 1.38, P=.00015). AHT was mostly related to CVA (RRij 1.41, P=.0014) and CKD (RRij 1.42, P<.0001). Type 2 diabetes mellitus (T2DM) correlated with PAD (RRij 1.90, P=.0001), heart failure (HF) (RRij 1,74, P=.0002), and CKD (RRij 1.76, P<.0001), and obesity was associated with HF (RRij 1.60, P=.0009) and CKD (RRij 1.54, P=.0001). CONCLUSION: DLP was related to CVA, CKD, and PAD. AHT and T2DM are the conditions that mostly relate to HF and CVA

Dyslipidaemia and other cardiovascular risk factors in relation to manifest cardiovascular disease in patients with chronic obstructive pulmonary disease in the Canary Islands. / Relación entre la dislipidemia y otros factores de riesgo cardiovasculares conocidos con la presencia de enfermedad cardiovascular en pacientes con enfermedad pulmonar obstructiva crónica de las Islas Canarias.

INTRODUCTION: Cardiovascular disease has a negative impact on the vital prognosis of patients with chronic obstructive pulmonary disease (COPD), where dyslipidaemia (DLP) and arterial hypertension (AHT) are considered the most prevalent risk factors. The objective of this study was 1) to assess the relationship between diagnosed DLP and cardiovascular disease in COPD patients and compare it with other known cardiovascular risk factors and 2) to determine the relationship between the different cardiovascular comorbidities and the severity groups according to the GOLD 2017 classification. METHODS: A cross-sectional, observational study was performed in 454 outpatients with COPD during their follow up. We calculated the prevalence of each of the cardiovascular comorbidities and the probability of each of the cardiovascular risk factors to occur jointly with a vascular disease (RRij). RESULTS: A total of 66.7% of the patients had DLP, whereby DLP was related to cerebrovascular accidents (CVA) (RRij 1.36, P=.0054), chronic kidney disease (CKD) (RRij 1.34, P=.00023), and peripheral arterial disease (PAD) (RRij 1.38, P=.00015). AHT was mostly related to CVA (RRij 1.41, P=.0014) and CKD (RRij 1.42, P<.0001). Type 2 diabetes mellitus (T2DM) correlated with PAD (RRij 1.90, P=.0001), heart failure (HF) (RRij 1,74, P=.0002), and CKD (RRij 1.76, P<.0001), and obesity was associated with HF (RRij 1.60, P=.0009) and CKD (RRij 1.54, P=.0001). CONCLUSION: DLP was related to CVA, CKD, and PAD. AHT and T2DM are the conditions that mostly relate to HF and CVA.

Hipertensión venosa epiescleral idiopática como causa de glaucoma de ánguala abierto unilateral (HVEI) / Idiopathic episcleral venous hypertension as a cuase of unilateral open-angle glauca

Caso clínico. Presentamos el caso de vasos epiesclerales dilatados y glaucoma de ángulo abierto. Mujer de 40 años que acude a consulta por ojo derecho (OD) rojo de 7 años de evolución. En la exploración destaca marcada dilatación de los vasos epiesclerales e hiperemia conjuntival, una presión intraocular (PIO) de 30mmHg, con un escotoma arciforme superior en el campo visual (C.V.) y una pérdida de fibras nerviosas en los sectores superior e inferior en la OCT. La gonioscopia mostró un ángulo abierto y sangre en el trabeculum y en la fundoscopia se observa una excavación papilar de 0.4. Se consigue control de la PIO con tratamiento hipotensor. Al persistir la dilatación epiescleral venosa solicitamos estudio tiroideo y resonancia magnética nuclear craneal, que resultaron normales. Se realizó una angiografía cerebral también normal. Por exclusión se diagnosticó de HVEI unilateral como causa de glaucoma de ángulo abierto. Discusión. Debemos resaltar que la HVEI es una causa de glaucoma rara que cursa con dilatación de los vasos epiesclerales y PIO alta y que su diagnóstico se hace tras haber descartado patologías intracraneales e intraorbitarias (AU)

Case report. We report a case of dilated episcleral vein with unilateral secondary open angle glaucoma. A 40-year-old female presented with redness of right eye without any prior systemic history. Her ocular examination revealed dilated episcleral veins and a high intraocular pressure (IOP) of 30 mmHg in the right eye, with a superior arciform scotom in the visual field and a decrease of retinal nerve fiber layer (RNFL) in superior and inferior sectors. Gonioscopy showed open angle with blood in Schlemm’s. Dilated fundus examination showed cup to disc ratio (CDR) to be 0.4. We achieved a control of IOP with hypotensive treatment. Systemic examination was negative for carotid cavernous fistula, low-grade dural arteriovenous fistula and dysthyroid ophthalmopathy. She was diagnosed by exclusion of idiopathic venous episcleral hypertension. Discussion. We want to highlight that this is a rare condition of glaucoma , presented by dilated episcleral veins and high IOP and its diagnosis is a diagnosis of exclusion (AU)

[Usefulness of urine cytology for bladder carcinoma diagnosis: comparative study with biopsy]. / Utilidad de la citología de orina para el diagnóstico del carcinoma vesical: estudio comparativo con biopsia.

OBJECTIVES: Traditionally, urine cytology has been considered as the gold standard for bladder cancer screening. However, new methods are playing new roles in these cases. In order to assess the value of cytology of voided urine we performed one comparative study between cytology and biopsy. METHODS: We retrospectively analyzed the results of urine cytology and biopsy follow-up in 109 patients. All cytologies were from voided urine. They were cytocentrifuged and stained with Papanicolaou stain. RESULTS: We found 70 true positive cases and 24 true negative cases. Sensitivity was calculated to be 97% and specifity 96-100%. 12 cases had the first cystoscopy test and biopsy negative, as the cancer was diagnosed in the second biopsy. CONCLUSIONS: Patients with clearly positive urine cytology, which was not confirmed in a first cystoscopic study, should be carefully followed up to identify a possible bladder or upper urinary tract cancer. The urine cytology still has a significant role as the gold standard for bladder cancer screening.

Utilidad de la citología de orina para el diagnóstico del carcinoma vesical: estudio comparativo con biopsia / Usefulness of urine cytology for bladder carcinoma diagnosis: comparative study with biopsy

Objetivo: La citología de orina se ha considerado la técnica de elección para el cribado de carcinoma vesical. La existencia de otros métodos diagnósticos adicionales, han puesto en duda su utilidad. Aportamos un estudio comparativo cito-histológico para comprobar su valor. Método: Hemos realizado un estudio retrospectivo de 109 biopsias vesicales en relación con los diagnósticos citológicos previos. Todas las citologías eran de micción espontánea, procesadas por citocentrifugación y teñidas con Papanicolaou. Resultados: Encontramos 70 casos verdaderos positivos, y 24 casos verdaderos negativos, consiguiendo una sensibilidad del 97% y una especificidad del 96-100%. Destacando que 12 casos positivos tenían la primera cistoscopia y biopsia negativa, diagnosticándose la neoplasia en la segunda biopsia. Conclusiones: Los pacientes con citologías de orina claramente positivas, que no se confirman en una primer estudio citoscópico, deben ser seguidos, para identificar una posible neoplasia vesical o de vías urinarias altas. La citología de orina puede seguir considerándose como una técnica de elección para el cribado y control de neoplasia vesical (AU)

Objectives: Traditionally, urine cytology has been considered as the gold standard for bladder cancer screening. However, new methods are playing new roles in these cases. In order to assess the value of cytology of voided urine we performed one comparative study between cytology and biopsy. Methods: We retrospectively analyzed the results of urine cytology and biopsy follow-up in 109 patients. All cytologies were from voided urine. They were cytocentrifuged and stained with Papanicolaou stain. Results: We found 70 true positive cases and 24 true negative cases. Sensitivity was calculated to be 97% and specifity 96-100%. 12 cases had the first cystoscopy test and biopsy negative, as the cancer was diagnosed in the second biopsy. Conclusions: Patients with clearly positive urine cytology, which was not confirmed in a first cystoscopic study, should be carefully followed up to identify a possible bladder or upper urinary tract cancer. The urine cytology still has a significant role as the gold standard for bladder cancer screening (AU)