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1.
Rev Esp Salud Publica ; 942020 01 16.
Artigo em Espanhol | MEDLINE | ID: mdl-31942868

RESUMO

OBJECTIVE: There are few epidemiological studies on acute poisonings from pesticides, industrials and household products in Spain. The objective of this work is to describe the epidemiological and clinical profile of acute poisonings by chemical products in our country, and analyze their annual evolution. METHODS: The Spanish Toxicovigilance System (SETv) is a prospective registry that includes 32 Emergency Departments and Intensive Care Units in Spain. An observational descriptive study of acute poisoning by chemical agents (excluding pharmacological products and illicit drugs) was carried out, within 1999-2014. Statistical analysis was performed using Chi-square or exact Fisher's tests. Non-parametric continuous variables were compared using the Mann-Whitney U test. P-value less than 0.05 were considered significant. RESULTS: The 10,548 cases studied had a mean age of 38.41 (±22.07) years, being significantly higher in women (p=0.0001). 67.7% of the poisonings occurred at home, and the most frequent routes of exposure were respiratory (48.3%), digestive (35.3%) and ocular (13.1%). The most frequent toxic groups were toxic gases (31%), caustics (25.6%) and irritant gases (12.1%). Of the patients that required treatment (76.2%), antidotes were used in 27.2%. 20.6% of the patients were admitted at Hospital, with a median stay of 32 (±151.94) days, with significant differences for pesticides and solvents (p=0.02). Sequelae were presented at discharge in 2.1% of patients. Mortality was 1.4% (146 patients) with a mean age of 62.08 years (±19.58) (p=0.0001). CONCLUSIONS: The reduction of chemical poisonings should be prevented in the domestic environment, taking into account the sources of exposure to carbon monoxide and the handling of household cleaning products, both caustic liquids and the generation of irritating gases when mixed.

2.
Nefrología (Madrid) ; 39(1): 35-43, ene.-feb. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-181907

RESUMO

Objetivos: Conocer la incidencia de casos de acidosis láctica por metformina durante el periodo enero de 2014 y marzo de 2017 en el Área Sanitaria III de Aragón. Analizar los factores clínicos y analíticos asociados y la mortalidad. Resultados: Treinta y un casos (61,3% varones). Incidencia: 79,76 casos/100000 pacientes-año; edad media 75,39 ± 9,34 años; 23 de ellos con niveles séricos de metformina (21,91 ± 15,52 mcg / mL); miligramos/día de metformina ingeridos: 1790,32 ± 499; 96,8% de casos en el contexto de fracaso renal agudo; 11 casos con antecedentes de enfermedad renal crónica (35,5%); 12 requirieron UCI (38,7%); 13 requirieron tratamiento depurador (41,9%; 3 hemodiafiltración, 10 hemodiálisis) Existió correlación significativa entre: miligramos diarios ingeridos de metformina y niveles del fármaco; niveles de metformina y: creatinina pico, pH y lactato. La mortalidad fue del 25,8%. Solo hubo diferencias significativas entre los fallecidos y los supervivientes respecto a la duración de la estancia y la creatinina final. La regresión logística multivariante no detectó ninguna variable del estudio asociada con la mortalidad. Conclusiones: La incidencia en nuestra área sanitaria es más elevada que en otras series, con 25,8% de mortalidad. Prácticamente todos los casos en el contexto de fracaso renal agudo de origen prerrenal. En un 29% de los casos hubo sobredosificación. Es necesario advertir a los pacientes de las situaciones más frecuentes potencialmente inductoras de acidosis láctica, especialmente la deshidratación, si siguen tomando el fármaco durante las mismas


Objectives: To determine the incidence of metformin-induced lactic acidosis during the period January 2014 to March 2017 in Aragon Healthcare Area III. To analyse the associated clinical and analytical factors and mortality. Results: A total of 31 cases (61.3% males). Incidence: 79.76 cases/100,000 patients-year; mean age 75.39±9.34 years; 23 of them with levels of serum metformin (21.91 ± 15.52 mcg/ ml); milligrams/day of metformin ingested: 1790.32 ± 499; 96.8% of cases in the context of acute kidney failure; 11 cases with a history of chronic kidney disease (35.5%); 12 required intensive care (38.7%); 13 required purification treatment (41.9%; 3 haemodiafiltration, 10 haemodialysis). There was a significant correlation between daily milligrams of metformin ingested and drug levels; levels of metformin; and peak creatinine, pH and lactate. Mortality was 25.8%. There were only significant differences between the deceased and survivors regarding the duration of stay and final creatinine. Multivariate logistic regression did not detect any study variables associated with mortality. Conclusions: The incidence in our healthcare area is higher than in other series, with a 25.8% mortality rate. Virtually all cases were in the context of prerenal acute kidney failure. In 29% of cases, there was an overdose. Patients must be warned about the most common lactic acidosis-inducing situations, especially dehydration, if they continue taking the drug at such times


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Acidose Láctica/induzido quimicamente , Acidose Láctica/mortalidade , Metformina/efeitos adversos , Atenção Terciária à Saúde , Fatores de Risco , Espanha/epidemiologia , Incidência
3.
Nefrologia ; 39(1): 35-43, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30060893

RESUMO

OBJECTIVES: To determine the incidence of metformin-induced lactic acidosis during the period January 2014 to March 2017 in Aragon Healthcare Area III. To analyse the associated clinical and analytical factors and mortality. RESULTS: A total of 31 cases (61.3% males). Incidence: 79.76 cases/100,000 patients-year; mean age 75.39±9.34 years; 23 of them with levels of serum metformin (21.91±15.52 mcg/ ml); milligrams/day of metformin ingested: 1790.32±499; 96.8% of cases in the context of acute kidney failure; 11 cases with a history of chronic kidney disease (35.5%); 12 required intensive care (38.7%); 13 required purification treatment (41.9%; 3 haemodiafiltration, 10 haemodialysis). There was a significant correlation between daily milligrams of metformin ingested and drug levels; levels of metformin; and peak creatinine, pH and lactate. Mortality was 25.8%. There were only significant differences between the deceased and survivors regarding the duration of stay and final creatinine. Multivariate logistic regression did not detect any study variables associated with mortality. CONCLUSIONS: The incidence in our healthcare area is higher than in other series, with a 25.8% mortality rate. Virtually all cases were in the context of prerenal acute kidney failure. In 29% of cases, there was an overdose. Patients must be warned about the most common lactic acidosis-inducing situations, especially dehydration, if they continue taking the drug at such times.


Assuntos
Acidose Láctica/induzido quimicamente , Hipoglicemiantes/efeitos adversos , Metformina/efeitos adversos , Acidose Láctica/epidemiologia , Acidose Láctica/mortalidade , Acidose Láctica/terapia , Idoso , Feminino , Humanos , Hipoglicemiantes/administração & dosagem , Incidência , Modelos Logísticos , Masculino , Metformina/administração & dosagem , Distribuição por Sexo , Espanha/epidemiologia , Centros de Atenção Terciária
7.
Toxicol Lett ; 186(1): 2-8, 2009 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-19027838

RESUMO

The relationship between basic research and its potential clinical applications is often a difficult subject. Clinical toxicology has always been very dependent on experimental research whose usefulness has been impaired by the existence of huge differences in the toxicity expression of different substances, inter- and intra-species which make it difficult to predict clinical effects in humans. The new methods in molecular biology developed in the last decades are furnishing very useful tools to study some of the more relevant molecules implied in toxicokinetic and toxicodynamic processes. We aim to show some meaningful examples of how recent research developments with genes and proteins have clear applications to understand significant clinical matters, such as inter-individual variations in susceptibility to chemicals, and other phenomena related to the way some substances act to induce variations in the expression and functionality of these targets.


Assuntos
Pesquisa Biomédica/métodos , Medicina Clínica/métodos , Toxicogenética/métodos , Xenobióticos/toxicidade , Animais , Variação Genética , Humanos , Valor Preditivo dos Testes , Especificidade da Espécie , Xenobióticos/farmacocinética
8.
Environ Int ; 34(3): 330-44, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-17467799

RESUMO

The consequences of exposure of people to highly chlorinated polychlorodibenzo-p-dioxins (PCDDs) are much less known than those of TCDD. We report on levels of PCDDs (and PCDFs) in 13 members of two families poisoned by contaminated cooking oil. Originally, all persons displayed chloracne as an early symptom. Persisting hexa- and higher chlorinated PCDDs could be analysed many years after exposure. Highest values found in blood lipids were: OCDD 660,000 pg/g; HpCDD 58,000 pg/g; HxCDDs: 3500 pg/g. None of the participants exhibited increased TCDD levels at the time of study. During a period of 6 years, HpCDD and OCDD disappeared from the blood lipids much faster in persons exposed as children or young adults, than from lipids of their parents. Surface receptors on blood lymphocytes of the members of the two families and the proliferative capacity of these blood cells in the presence of typical stimulants were analysed. Even in family members with the highest body burdens of hexa- to octachlorinated PCDDs we could not detect pronounced changes from a reference population with respect to the immunological markers. Minor deviations of levels of some receptors in a few, but not all, highly exposed persons suggested a similar trend to those reported in previous studies of persons with body burdens of > or =3000 pg TCDD/g blood lipids. An increase in the number of total blood lymphocytes in some subjects exposed as children may have similarity with highly TCDD-exposed children in Seveso.


Assuntos
Sistema Imunitário/efeitos dos fármacos , Dibenzodioxinas Policloradas/análogos & derivados , Adolescente , Adulto , Antígenos CD/análise , Análise Química do Sangue , Carga Corporal (Radioterapia) , Criança , Cloracne , Gorduras Insaturadas na Dieta , Saúde da Família , Feminino , Humanos , Linfócitos/química , Linfócitos/imunologia , Masculino , Pessoa de Meia-Idade , Dibenzodioxinas Policloradas/sangue , Dibenzodioxinas Policloradas/toxicidade , Receptores Imunológicos/análise , Espanha
9.
Rev. toxicol ; 17(1): 33-35, ene.-abr. 2000. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-31051

RESUMO

Se presentan los resultados de un trabajo que pretende verificar la correlación existente entre la concentración de etanol en suero y sangre medidas mediante la técnica enzimática de la alcohol deshidrogenasa en 283 muestras, aplicando un modelo simple de regresión lineal. Se ha comprobado la existencia de una buena correlación entre las concentraciones de etanol en ambos medios (r2 = 0,9739) con un intervalo de confianza al 95 por ciento de: +/-0,17 gr/litro (AU)


Assuntos
Humanos , Intoxicação Alcoólica/fisiopatologia , Etanol/sangue , Estudos de Casos e Controles , Intervalos de Confiança , Soro/análise
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