Consumo de psicofármacos y exposición a toxinas bacterianas vehiculizadas por alimentos: una asociación peligrosa / Consumption of psychoactive drugs and exposure to bacterial toxins carried by food: a dangerous association

Objetivo: Describir y analizar desde el punto de vista clínico y epidemiológico un brote de toxiinfección alimentaria en una institución de enfermos psiquiátricos de Granada, en 2015, y examinar si el tratamiento con psicofármacos constituye un factor de riesgo para desarrollar una toxiinfección alimentaria, analizando los grados de susceptibilidad según el grupo terapéutico consumido. Método: Estudio ambispectivo de cohortes. La unidad de análisis fueron los residentes. Se realizó búsqueda activa de casos, encuesta alimentaria y búsqueda de otros riesgos, e inspección alimentaria. Se estudiaron variables de persona, lugar y tiempo. Análisis descriptivo (frecuencias absolutas y relativas), cálculo de las tasas de ataque por pabellón y por menú. Análisis bivariado (ji al cuadrado, t de Student) y riesgo relativo como medida de la fuerza de asociación. Análisis multivariado mediante regresión logística para el análisis de riesgos de la medicación. Resultados: Se contabilizaron 18 casos con diarrea sin fiebre (periodo de incubación de 6-16 horas), de carácter leve y autolimitado. Las manifestaciones clínicas, la agrupación temporal de casos y las características de los alimentos ingeridos centraron la sospecha en una toxina bacteriana. A igualdad en el resto de variables, los grupos terapéuticos N03AF y N03AG confirieron mayor riesgo de enfermar (odds ratio [OR]: 8,626; intervalo de confianza del 95% [IC95%]: 2,050-36,308; p=0,003; y OR: 14,516; IC95%: 3,155-66,784; p=0,001, respectivamente). Conclusión: La disminución del tránsito intestinal causada por la administración de antiepilépticos puede aumentar el tiempo de exposición de la mucosa intestinal a la toxina, aumentando el riesgo de enfermar y de padecer complicaciones. Debe realizarse un esfuerzo higiénico suplementario en este tipo de instituciones para prevenir estas afecciones

Objective: To describe and analyse from a clinical and epidemiological point of view, a food borne outbreak in a psychiatric institution in Granada, in 2015, and to examine whether treatment with psychoactive drugs constitutes a risk factor for the development of a food borne disease, analysing the degree of susceptibility according to the therapeutic group consumed. Method: Ambispective cohort study. Residents were the unit of analysis. Our group carried out an active case search and a food survey. A search for other risks was developed as well as a food inspection. Location, time and individual variables were studied. A descriptive analysis was conducted (absolute and relative frequencies). Calculation of attack rates by building and by menu was made. Bi-variant analysis (Chi-square test, t-Student test) and relative risk were used as a measure of strength of association. For risk analysis of medication, a multivariate analysis using logistic regression was carried out. Results: 18 cases with diarrhoea without fever were found (incubation period from 6 to 16hours). Cases were mild and self-limiting. The clinical manifestations, the temporal grouping of cases and the characteristics of the ingested foods, focussed suspicion on a bacterial toxin. Being equal in the rest of variables, the N03AF, and N03AG therapeutic groups confer greater risk of disease (odds ratio [OR]: 8.626; 95% confidence interval [95%CI]: 2.050-36.308; p=0.003; and OR: 14.516; 95%CI: 3.155-66.784; p=0.001, respectively). Conclusion: Decreased intestinal transit, caused by the administration of anticonvulsants, may increase exposure time of the intestinal mucosa to the toxin, increasing the risk of disease and suffering from complications. An additional hygienic effort should be made in this type of institution to prevent these pathologies

[Consumption of psychoactive drugs and exposure to bacterial toxins carried by food: a dangerous association]. / Consumo de psicofármacos y exposición a toxinas bacterianas vehiculizadas por alimentos: una asociación peligrosa.

OBJECTIVE: To describe and analyse from a clinical and epidemiological point of view, a food borne outbreak in a psychiatric institution in Granada, in 2015, and to examine whether treatment with psychoactive drugs constitutes a risk factor for the development of a food borne disease, analysing the degree of susceptibility according to the therapeutic group consumed. METHOD: Ambispective cohort study. Residents were the unit of analysis. Our group carried out an active case search and a food survey. A search for other risks was developed as well as a food inspection. Location, time and individual variables were studied. A descriptive analysis was conducted (absolute and relative frequencies). Calculation of attack rates by building and by menu was made. Bi-variant analysis (Chi-square test, t-Student test) and relative risk were used as a measure of strength of association. For risk analysis of medication, a multivariate analysis using logistic regression was carried out. RESULTS: 18 cases with diarrhoea without fever were found (incubation period from 6 to 16hours). Cases were mild and self-limiting. The clinical manifestations, the temporal grouping of cases and the characteristics of the ingested foods, focussed suspicion on a bacterial toxin. Being equal in the rest of variables, the N03AF, and N03AG therapeutic groups confer greater risk of disease (odds ratio [OR]: 8.626; 95% confidence interval [95%CI]: 2.050-36.308; p=0.003; and OR: 14.516; 95%CI: 3.155-66.784; p=0.001, respectively). CONCLUSION: Decreased intestinal transit, caused by the administration of anticonvulsants, may increase exposure time of the intestinal mucosa to the toxin, increasing the risk of disease and suffering from complications. An additional hygienic effort should be made in this type of institution to prevent these pathologies.

Osteoporosis posmenopáusica y ultrasonidos. Réplica / Post-menopausal osteoporosis and ultrasound treatment. Response

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