[Complications of intestinal transporting of cocaine packets. Study of 215 cases]. / Complicaciones en transportadores intestinales de paquetes con cocaína. Estudio de 215 casos.

BACKGROUND: To analyse clinical manifestations, diagnosis and management in the "body packer syndrome". MATERIAL AND METHODS: We collected 215 patients who had ingested packets of cocaine. RESULTS: Bowel obstruction, haemorrhagic complications and seizures were observed in 5.1, 4.2 and 2.3%, respectively. Toxic manifestations of cocaine occurred in 4 patients. CONCLUSIONS: Radiographs of abdomen are necessary for diagnosis and follow-up. Close surveillance in necessary to identify intestinal obstruction or acute intoxication by cocaine.

[Alcohol withdrawal syndrome: clinical and analytical manifestations and treatment]. / Síndrome de abstinencia alcohólica: manifestaciones clínicas, analíticas y tratamiento.

BACKGROUND: The aim of this study was to analyze clinical manifestations and treatment aspects of alcohol withdrawal syndrome. MATERIAL AND METHODS: A retrospective study of 212 clinical records. RESULTS: The commonest withdrawal effects were tremulousness (68.7%) 7 agitation (67.3%) and hallucinations (46%). Most patients were male. The 64% recognize a period of relative or absolute abstinence less than two days, and a 67.8% have been previous incident of withdrawal syndrome. The commonest complications during hospital stay were rhabdomyolysis (26%). Time of symptoms were three days and mean of hospitalization were 14 days. The treatment used was the correction of fluid and electrolyte imbalance (93%) and B vitamins (98%). In relation to the use of drugs, in 84% of our patients we used benzodiazepines with longer-acting, and clomethiazole in 50% of cases. Mortality were 0.9%. CONCLUSIONS: Patient with alcohol withdrawal syndrome was a male, previously drinker, with a period of abstinence less than two days. In addition to tremulousness and agitation, in our series, we wish to emphasize higher frequency of hallucinations, and the incidence of complications as rhabdomyolysis, despite of such response of treatment is good and mortality is low.

[Infectious pathology in diabetic patients cared for in an emergency department]. / Patología infecciosa en pacientes diabéticos atendidos en un departamento de urgencias.

OBJECTIVE: We study the influence of diabetes in the incidence of infectious diseases attended in an emergency department (ED). PATIENTS AND METHODS: 2,500 adult patients attended in the ED of a general hospital were examined. We value prospectively: clinical data, diagnosis in ED and rate of admissions, comparing two groups: Group A (175 diabetic patients), Group B (350 non diabetic control patients, with the same age and sex). We used the glycated Hb and the glucose levels to make a difference in A Group: patients with good control (A1 = Hb A1c < 8), patients with poor control (A2 = HbA1c > 8), patients with low glucose levels (A3 = glucose < 200 mg/dl) and high glucose levels (A4 = glucose > 200 mg/dl). RESULTS: Infectious disease are more frequent in diabetic patients than no diabetic (Group A = 13.1% vs Group B = 3.2%), certain amount pneumonia and urinary tract infection. Also the infectious diseases are more frequent in diabetic patients with high glucose levels (Group A4) than diabetic patients with low glucose levels (Group A3), but there were no significant differences between A1 and A2 groups. CONCLUSIONS: The presence of diabetes was bound up with a higher frequency of infectious diseases, above all pneumonia and urinary tract infection, in an ED. The importance of metabolic control in relation with infectious diseases is not definite in our study.