Síndrome de vena cava superior en varón de 93 años / Superior vena cava syndrome in a 93-year-old man

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Meningitis por Streptococcus gallolyticus y su asociación con la enfermedad inflamatoria intestinal: a propósito de un caso / The association of Streptococcus gallolyticus meningitis and inflammatory bowel disease: Apropos of a case

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Endocarditis infecciosa, una entidad que precisa de los niveles asistenciales geriátricos / Endocarditis; an entity that requires geriatric care models

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Pancitopenia en el curso de infección por SARS-CoV-2 / Pancytopenia during SARS-CoV-2 infection

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Infarto de omento: una causa inusual de abdomen agudo / Omental infarction: an unusual cause of acute abdomen

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Apatía postictus / Post-stroke apathy

La apatía es un trastorno de la motivación consistente en una reducción cuantitativa de la conducta dirigida a objetivos. Los pacientes muestran una pérdida de motivación, preocupación, interés y respuesta emocional, lo que se traduce en una disminución de la iniciativa, de la interacción con el entorno y de la actividad social. La apatía no solo es frecuente tras el ictus sino que su presencia afecta negativamente a pacientes y cuidadores, incluyendo una peor recuperación funcional, pérdida de la autonomía social y mayor sobrecarga del cuidador. Es necesario disponer de una definición precisa y de unos criterios diagnósticos consensuados de apatía para mejorar la valoración e individualizar el plan de tratamiento del paciente. Así como las terapias de modificación de conducta han demostrado su utilidad, son escasos los ensayos clínicos dirigidos a evaluar la eficacia del tratamiento farmacológico de pacientes con apatía postictus (AU)

Apathy is a motivational disturbance that can be defined as a quantitative reduction of goal-directed behaviour. Patients present with loss of motivation, concern, interest, and emotional response, resulting in a loss of initiative, decreased interaction with their environment, and a reduced interest in social life. Apathy not only appears to be common in stroke patients, but it has also been related to a wide range of negative consequences for the patients and their caregivers, including poor functional recovery, loss of social independence, and caregiver distress. Clear definition and consensus diagnostic criteria for apathy are needed to accomplish an accurate assessment and an individualised treatment plan. Although there have been reports of successful behavioural therapy treatment of apathetic states, there is a paucity of controlled clinical trials on the efficacy of apathetic behaviours using pharmacotherapy (AU)

[Post-stroke apathy]. / Apatía postictus.

Apathy is a motivational disturbance that can be defined as a quantitative reduction of goal-directed behaviour. Patients present with loss of motivation, concern, interest, and emotional response, resulting in a loss of initiative, decreased interaction with their environment, and a reduced interest in social life. Apathy not only appears to be common in stroke patients, but it has also been related to a wide range of negative consequences for the patients and their caregivers, including poor functional recovery, loss of social independence, and caregiver distress. Clear definition and consensus diagnostic criteria for apathy are needed to accomplish an accurate assessment and an individualised treatment plan. Although there have been reports of successful behavioural therapy treatment of apathetic states, there is a paucity of controlled clinical trials on the efficacy of apathetic behaviours using pharmacotherapy.

Inhibidores de la bomba de protones: estudio de prescripción en una Unidad de Recuperación Funcional / Proton bomb inhibitors: a study of the prescription in a Functional Recovery Unit

Introducción. Desde su introducción, el consumo de los inhibidores de la bomba de protones (IBP) se ha incrementado exponencialmente. Sin embargo, surgen dudas sobre su adecuada prescripción, efectos secundarios potenciales, especialmente en el anciano frágil, y costes de tratamiento. El objetivo del estudio es evaluar la frecuencia y adecuación del uso de los IBP en mayores de 65 años ingresados en la Unidad de Recuperación Funcional (URF) de un hospital de media estancia. Material y métodos. Estudio retrospectivo sobre la prescripción de los IBP en pacientes hospitalizados en la URF del Hospital de la Fuenfría, seleccionando a aquellos pacientes mayores de 65 años ingresados a lo largo de 2011. Se recogió información relativa a la frecuencia, tipo y adecuación de la prescripción de los IBP antes del ingreso y en el momento del alta tanto del hospital de agudos como de la URF. Resultados. Doscientos noventa y seis pacientes cumplieron los criterios de inclusión (edad media: 78,8 años, 70,6% mujeres). Un total de 45,3, 79,1 y 75,5% de los pacientes tomaban IBP antes del ingreso y en el momento del alta del hospital de agudos y de subagudos, respectivamente. No se identificó una indicación para su uso en el 62,7, 30,8 y 54,2% de los pacientes. El omeprazol fue el IBP más prescrito. Conclusiones. Los resultados sugieren un uso de los IBP extendido e inapropiado en los pacientes hospitalizados. Son precisos planes de actuación para reducir la prescripción inapropiada, evitando efectos secundarios e interacciones farmacológicas (AU)

Introduction. The use of proton pump inhibitors (PPI) has increased exponentially since they were introduced. However concerns have been raised regarding the appropriateness of these prescriptions, and the potential side effects, particularly in frail elderly people, as well as the cost of this treatment. The aim of this study was to assess the extent and appropriateness of PPI prescribing in a group of patients over 65 years old admitted to the functional recovery unit of a medium-stay hospital. Materials and methods. A retrospective review of inpatient prescribing of PPI was carried out in a functional recovery unit in Hospital de la Fuenfría, selecting those older than 65 years, who were admitted during 2011. Data obtained from medical records included, prescription of a PPI before admission and at the time of discharge from hospital (both acute care hospital and Hospital de la Fuenfría), type of PPI, and indications for their prescription. Results. Inclusion criteria were met by 296 patients (mean age 78.8 years, 70.6% females). A total of 45.3, 79.1 and 75.5% of patients were on PPIs before admission, and at the time of being discharge from acute care hospital, and Hospital de la Fuenfría, respectively. A valid indication for therapy was not apparent in 62.7, 30.8 and 54.2% of them. Omeprazole was the most widely prescribed PPI.ConclusionsThere appears to be a widespread and inappropriate use of PPIs in hospital practice. Interventions are needed to curtail this inappropriate prescribing practice, avoiding side effects and drug interactions (AU)

[Proton bomb inhibitors: a study of the prescription in a functional recovery unit]. / Inhibidores de la bomba de protones: estudio de prescripción en una Unidad de Recuperación Funcional.

INTRODUCTION: The use of proton pump inhibitors (PPI) has increased exponentially since they were introduced. However concerns have been raised regarding the appropriateness of these prescriptions, and the potential side effects, particularly in frail elderly people, as well as the cost of this treatment. The aim of this study was to assess the extent and appropriateness of PPI prescribing in a group of patients over 65 years old admitted to the functional recovery unit of a medium-stay hospital. MATERIALS AND METHODS: A retrospective review of inpatient prescribing of PPI was carried out in a functional recovery unit in Hospital de la Fuenfría, selecting those older than 65 years, who were admitted during 2011. Data obtained from medical records included, prescription of a PPI before admission and at the time of discharge from hospital (both acute care hospital and Hospital de la Fuenfría), type of PPI, and indications for their prescription. RESULTS: Inclusion criteria were met by 296 patients (mean age 78.8 years, 70.6% females). A total of 45.3, 79.1 and 75.5% of patients were on PPIs before admission, and at the time of being discharge from acute care hospital, and Hospital de la Fuenfría, respectively. A valid indication for therapy was not apparent in 62.7, 30.8 and 54.2% of them. Omeprazole was the most widely prescribed PPI. CONCLUSIONS: There appears to be a widespread and inappropriate use of PPIs in hospital practice. Interventions are needed to curtail this inappropriate prescribing practice, avoiding side effects and drug interactions.