[Use of topical non-steroidal anti-inflammatory agents in an urban health center. Comparison with the current evidence]. / Uso de antiinflamatorios tópicos en un centro de salud urbano. Estudio comparativo con la evidencia actual.

OBJECTIVE: To describe the prescribing of topical non-steroidal anti-inflammatory drugs (NSAIDs) in an urban health center (Zaragoza, Spain). PATIENTS AND METHODS: A cross-sectional descriptive study was conducted on subjects who belonged to an urban center and were studied during the year 2010. The sample size with a confidence level of 95%, was calculated, a total of 843 prescriptions were analyzed. The sample was single random, and 150 cases were selected. The prevalence and confidence intervals were calculated. The statistical package STATA 9.1 was used for the calculations. RESULTS: The most used drug was diclofenac, in 27.33% (95% CI: 20.65-34.88). NSAIDs were most used in females. In 18% of the cases the area of application was the knee, followed by the 15% in the lower back area (95% CI: 10,22-21,78). There were no adverse reactions. CONCLUSIONS: Frequent use is made of topical NSAIDs in a basic health area. Current recommendations support the use in the knee and in the hand, but not in the back, where its use is common. The use of topical NSAIDs decreases side effects and drug interactions, therefore their use is recommended in patients on multiple drug therapy and in the elderly.

Uso de antiinflamatorios tópicos en un centro de salud urbano. Estudio comparativo con la evidencia actual / Use of topical non-steroidal anti-inflammatory agents in an urban health center. Comparison with the current evidence

Objetivo. Descripción de la prescripción de antiinflamatorios no esteroideos (AINE) tópicos en un centro de salud urbano (Zaragoza). Pacientes y métodos. Estudio transversal realizado en un centro de salud durante el año 2010. Se incluyó a 843 pacientes que tenían prescrito un AINE. Se calculó el tamaño muestral para un nivel de confianza del 95%, seleccionándose aleatoriamente 150 historias clínicas. Se calcularon prevalencias de uso y sus intervalos de confianza. Se utilizó el programa estadístico STATA 9.1. Resultados. El fármaco más utilizado fue el diclofenaco con el 27,33% (IC 95%: 20,65-34,88) del total de prescripciones. Su uso resultó más frecuente en el sexo femenino. En el 18% de los casos la zona de aplicación fue la rodilla (IC 95%: 12,46-24,76), seguida de la región lumbar con un 15,33% (IC 95%: 10,22-21,78). No se registraron reacciones adversas. Existen fallos en el registro, sobre todo en la dosificación y la duración de los episodios. Conclusiones. El uso de AINE tópicos en la zona básica de salud estudiada es frecuente. Las recomendaciones actuales avalan su utilización en el dolor leve o moderado de rodilla, mano y codo, pero no en la espalda, para donde se prescribe de forma frecuente. El uso de AINE tópicos presenta menos efectos secundarios e interacciones farmacológicas que la vía oral, por lo que su uso es recomendable en pacientes polimedicados y de edad avanzada (AU)

Objective. To describe the prescribing of topical non-steroidal anti-inflammatory drugs (NSAIDs) in an urban health center (Zaragoza, Spain). Patients and methods. A cross-sectional descriptive study was conducted on subjects who belonged to an urban center and were studied during the year 2010. The sample size with a confidence level of 95%, was calculated, a total of 843 prescriptions were analyzed. The sample was single random, and 150 cases were selected. The prevalence and confidence intervals were calculated. The statistical package STATA 9.1 was used for the calculations. Results. The most used drug was diclofenac, in 27.33% (95% CI: 20.65-34.88). NSAIDs were most used in females. In 18% of the cases the area of application was the knee, followed by the 15% in the lower back area (95% CI: 10,22-21,78). There were no adverse reactions. Conclusions. Frequent use is made of topical NSAIDs in a basic health area. Current recommendations support the use in the knee and in the hand, but not in the back, where its use is common. The use of topical NSAIDs decreases side effects and drug interactions, therefore their use is recommended in patients on multiple drug therapy and in the elderly (AU)

Retención de orina en un paciente inmunocompetente: mielitis transversa aguda / Urinary retention in immunocompetent patient: acute transverse myelitis

La diabetes MODY-5 es un tipo de diabetes monogenica infrecuente, causada por mutación en el gen del factor de transcripción nuclear hepático 1-beta (HNF-1¦Â). Esta mutación puede ser de tipo puntual o bien corresponder a delecciones grandes, y a su vez, puede aparecer de novo por mutación espontanea o bien ser transmitida de forma hereditaria con caracter autosomicodominante. Está asociada con un alto riesgo de complicaciones microvasculares de aparición temprana en las personas afectas, así como con alteraciones renales características del tipo quistes y anomalías del tracto genital, que estan presentes incluso antes del nacimiento. Por ello, está justificado hacer pruebas de detección para las mutaciones de HNF-1 en diabíticos no obesos, sobre todo, cuando existen alteraciones renales o genitales asociadas, sin tener en cuenta los antecedentes familiares (AU)

MODY-5 diabetes is an infrequent type of monogenic diabetes, caused by mutation in the gene of the nuclear hepatic transcription factor 1-beta (HNF-1¦Â).This mutation can be of a momentary type or it might correspond to big deletions, and, in its turn, it can appear due to spontaneous de novo mutation or it can be transmitted by hereditary with an autosomal dominant character. It is associated with a high risk of microvascular complications that appear early in affected people, as well as with characteristic renal alterations of the cyst type, and anomalies of the genital tract, which are present even before birth. That is why it is justified to carry out detection tests for HNF-1¦Â mutations in non-obese diabetics, above all when there are associated renal or genital alterations, without consideration of family antecedents (AU)

[An analysis of the effect of tobacco on glucose metabolism]. / Análisis de la influencia del tabaco sobre el metabolismo de la glucosa.

BACKGROUND: The nicotine contained in tobacco smoke produces an elevation of the plasmatic catecholamines which, in turn, may be the cause of the increase in basal glycemia by several mechanisms. The aim of this study was to investigate the relation between cigarette consumption and the increase in glucose in smokers and non smokers. METHODS: Basal glycemia and glucosylate hemoglobin (HbA1c) were determined in 74 males, 38 smokers and 36 non smokers who were consulted and included in the prevention activities program of the center. RESULTS: Significantly greater fasting glycemia was found in smokers than in nonsmokers. However, upon analyzing the values of glucosylate hemoglobin no significant differences were observed between the two groups. CONCLUSIONS: These data suggest that nicotine contained in tobacco smoke produces a transitory hyperglycemia.