Efectos extrapiramidales como posible reacción adversa a domperidona / Extrapyramidal effects as a possible adverse reaction to domperidone

Domperidona se presentó inicialmente como un fármaco antiemético libre de efectos extrapiramidales al no pasar la barrera hematoencefálica.Desde su aparición, sin embargo, se ha comunicado un reducido número de casos en los que sí han aparecido estos efectos. Presentamos el caso de un niño de nueve años que presentó efectos extrapiramidales tras recibir tratamiento con domperidona por un cuadro de vómitos. Se revisa la literatura al respecto y se concluye que debe valorarse cuidadosamente el riesgo-beneficio que supone el uso de antieméticos en niños (AU)

[Preoperative preparation and nutrition in colorectal cancer]. / Preparación preoperatoria y nutrición en el cáncer colorrectal.

Pre-operative nutrition in patients with colon/rectum cancer is important in ensuring that they are suitably prepared for the operation. Two pre-operative methods for preparation on the colon were compared: the first is that we normally use, of five days of residue-free hospital meals, cleansing enemas, laxatives and three litres of polyethylene glucol solution. The new method we describe is easy enough to be implemented by the patient at home, and combines enhanced nutrition with an excellent level of intra-colon cleaning: it involves the exclusive administration for four days of Ensure HN (a complete, defined, pre-prepared low-fibre diet, in a variety of flavours) and the application of two cleansing enemas the evening prior to the operation. Eighteen parameters were assessed, on the entry of each patient to the study, on the day of the operation, and six days following the operations; the parameters obtained after the trial show statistically significant differences (p < 0.05-p < 0.001) in favour of the second method for 17 of the parameters, following preparation; when each group was compared within itself prior to and following preparation. The values for all but two parameters were seen to drop, notably proteins, by 28.37% (p < 0.01), weight by 8.17%, albumin by 3.43% and hemoglobin by 17.72%, in the first group while, in the second, there were rises in proteins (3.72%), albumin (7.26%), hemoglobin (5.48%), leukocytes, calcium and triglycerides. The level of cleansing of the intestine continued to be excellent, without significant differences between the two methods.(ABSTRACT TRUNCATED AT 250 WORDS)

[Aluminum contamination of pediatric parenteral nutrition solutions]. / Contaminación por aluminio de las soluciones de nutrición parenteral pediátrica.

The main clinical manifestations of aluminum toxicity include progressive encephalopathy, osteomalacia, microcytic hypochromic anemia, and cholestasis. The premature newborn receiving IV therapy are at high risk of such aluminium intoxication: two conditions predispose them to an aluminum overdose-parenteral exposure and their reduced kidney function. The amount of aluminum present as contaminant was calculated for each of the i.v. solutions used in the preparation of the parenteral nutrition units in pediatrics, along with that for three prepared nutritions. This was done using atomic absorption spectrophotometry. The calcium salts (5.18 +/- 2.88(5)ppm), phosphorus salts (3.96 +/- 3.52(5)ppm) and trace elements (1.52 +/- 0.92(4) ppm) were the most contaminated components, the amount of aluminum being similar to that found by other authors showing bone and liver accumulations. The great variability between the solutions of different manufacturers and of different batches suggests that the contamination takes place during manufacture, so that it could in many cases be prevented by establishing adequate controls.