Acarbosa y propofol: ¿una peligrosa combinación? / Acarbose and propofol: A dangerous combination?

La hepatotoxicidad es una complicación infrecuente tras el empleo de propofol, que puede ser potencialmente grave en caso de no realizarse un diagnóstico precoz. El propofol es un fármaco cada vez más empleado en la práctica diaria no solo en cirugía sino también en la sedación de procedimientos invasivos ambulatorios tales como la endoscopia. Acarbosa es un fármaco clásico en el tratamiento de la diabetes tipo 2 en estadios iniciales que puede causar de forma infrecuente hepatitis tóxica. Se presenta el caso de una paciente que sufrió una hepatitis aguda secundaria al empleo de propofol como anestesia oftalmológica, hepatitis probablemente potenciada por el uso previo de acarbosa. El cuadro se diagnosticó de forma precoz y se resolvió sin complicaciones. El conocimiento de esta complicación en el ámbito de la anestesiología se revela cada vez más importante para mejorar la valoración preanestésica de los pacientes que vayan a ser sedados con propofol y así evitar en lo posible su aparición (AU)

Hepatotoxicity is a rare complication following the use of propofol and can be potentially serious if an early diagnosis is not made. Propofol is being increasingly used in daily practice, not only in surgery, but also in outpatient sedation procedures, such as endoscopy. Acarbose is a well-known drug used in type 2 diabetes treatment, particularly in the early phase. A case is reported on a patient who suffered an acute hepatitis secondary to the use of propofol in ophthalmology surgery, a hepatitis probably enhanced by prior use of acarbose, a drug that also can cause hepatotoxicity. An early diagnosis and it was resolved without complications. This case could contribute to improve pre-anesthetic evaluation of patients who will be undergoing sedation with propofol in order to avoid the possible appearance of hepatitis (AU)

[Parasitosis (I). Imported heart and lung lesions]. / Parasitosis (I). Lesiones cardiacas y pulmonares importadas.

Imported parasitoses are an uncommon condition in our setting, although recently, the increase of migratory flow has been leading to an increase in the detected cases of these diseases. This fundamentally occurs in immigrants from tropical zones where these conditions are generally endemic. However, imported parasitoses are being increasingly diagnosed in Western persons who have lived in the tropics for different reasons. When examining a subject with cardiovascular syndromes with a possible parasitic origin, it could be useful to classify the possible geographic zone of origin in order to perform disease screening. Then, if the problem is mainly respiratory, it would be well to first rule out the existence of tuberculosis in the case of long stays and to individual the diagnosis according to the geographic area, season of the year, type of exposure and symptoms presented, in the case of shorter stays.

[Acarbose and propofol: a dangerous combination?]. / Acarbosa y propofol: ¿una peligrosa combinación?

Hepatotoxicity is a rare complication following the use of propofol and can be potentially serious if an early diagnosis is not made. Propofol is being increasingly used in daily practice, not only in surgery, but also in outpatient sedation procedures, such as endoscopy. Acarbose is a well-known drug used in type 2 diabetes treatment, particularly in the early phase. A case is reported on a patient who suffered an acute hepatitis secondary to the use of propofol in ophthalmology surgery, a hepatitis probably enhanced by prior use of acarbose, a drug that also can cause hepatotoxicity. An early diagnosis and it was resolved without complications. This case could contribute to improve pre-anesthetic evaluation of patients who will be undergoing sedation with propofol in order to avoid the possible appearance of hepatitis.

[Prevalence of metabolic syndrome in the province of Albacete (Spain)]. / Prevalencia del síndrome metabólico en la provincia de Albacete.

OBJECTIVE: The primary objective of this study was to determine the prevalence of Metabolic Syndrome (MS) in people between 40-70 years of age in the province of Albacete (Spain). PATIENTS AND METHODS: A population-based, cross-sectional study was made of people between 40-70 years of age in three representative municipalities of the province of Albacete. A total of 425 subjects were included, with a mean age of 53.1 years (95% CI: 52.3-54). Women represented 50.4% of the series and males 49.6%. All participants were subjected to general laboratory testing, physical examination and the measurement of anthropometric parameters. MS was defined according to the ATP-III criteria. Prevalence of MS and its distribution according to the different epidemiological characteristics were calculated. RESULTS: Total prevalence of MS was 20.9% (88/421), with a mean age of 57 years (95% CI: 55.1-59). Prevalence was seen to increase with age, reaching up to one-third of all subjects over 60 years. Significant differences were observed in relationship to a background of ischemic heart disease, ultrasensitive C-reactive protein elevation and the detection of microalbuninuria in MS subjects. Arterial hypertension and abdominal obesity were the most prevalent criteria in MS subjects. CONCLUSIONS: Taking into consideration the important co-morbidity of MS, knowledge of the prevalence and characteristics of the syndrome in our setting and its early identification and intervention targeted to the different factors underlying MS will contribute to reduce the number of cardiovascular events associated with the syndrome.

Prevalencia del síndrome metabólico en la provincia de Albacete / Prevalence of metabolic syndrome in the province of Albacete (Spain)

Objetivo. El objetivo principal del estudio es determinar la prevalencia del síndrome metabólico (SM) en personas entre 40 y 70 años en la provincia de Albacete. Pacientes y métodos. Se trata de un estudio transversal poblacional en personas entre 40 y 70 años en tres municipios representativos de la provincia de Albacete. La participación total del estudio fue de 425 individuos. La edad media de la muestra fue de 53,1 años (intervalo de confianza [IC] 95%: 52,3-54), con un 50,4% de mujeres y un 49,6% de hombres. A todos los participantes se les realizó una analítica general y una exploración física con medición de parámetros antropométricos. El SM se definió según los criterios del Adult Treatment Panel-III (ATP-III). En el análisis estadístico se calculó la prevalencia del SM, así como su distribución según sus características epidemiológicas. Resultados. La prevalencia total del SM fue del 20,9% (88/421), con una edad media de 57 años (IC 95%: 55,1-59). Su prevalencia aumenta con la edad, siendo de hasta un tercio de la población mayor de 60 años. Por otra parte, se han encontrado diferencias significativas con antecedentes de cardiopatía isquémica, elevación de la proteína C reactiva ultrasensible y la detección de microalbuminuria en los pacientes con SM. La hipertensión arterial y la obesidad abdominal fueron los criterios más prevalentes en los pacientes con SM. Conclusiones. Teniendo en cuenta la importante comorbilidad que este síndrome conlleva, el conocimiento de su prevalencia y sus características en nuestro medio, así como su identificación y la intervención precoz sobre los distintos factores que la componen, contribuirían a una disminución de eventos cardiovasculares que se relacionan con este síndrome

Objective. The primary objective of this study was to determine the prevalence of Metabolic Syndrome (MS) in people between 40-70 years of age in the province of Albacete (Spain). Patients and methods. A population-based, cross-sectional study was made of people between 40-70 years of age in three representative municipalities of the province of Albacete. A total of 425 subjects were included, with a mean age of 53.1 years (95% CI: 52.3-54). Women represented 50.4% of the series and males 49.6%. All participants were subjected to general laboratory testing, physical examination and the measurement of anthropometric parameters. MS was defined according to the ATP-III criteria. Prevalence of MS and its distribution according to the different epidemiological characteristics were calculated. Results. Total prevalence of MS was 20.9% (88/421), with a mean age of 57 years (95% CI: 55.1-59). Prevalence was seen to increase with age, reaching up to one-third of all subjects over 60 years. Significant differences were observed in relationship to a background of ischemic heart disease, ultrasensitive C-reactive protein elevation and the detection of microalbuninuria in MS subjects. Arterial hypertension and abdominal obesity were the most prevalent criteria in MS subjects. Conclusions. Taking into consideration the important co-morbidity of MS, knowledge of the prevalence and characteristics of the syndrome in our setting and its early identification and intervention targeted to the different factors underlying MS will contribute to reduce the number of cardiovascular events associated with the syndrome