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Miró Ò, Llorens P, Aguiló S, Alquézar-Arbé A, Fernández C, Burillo-Putze G, Marcos NC, Marañón AA, Oms GS, Del Castillo JG. Epidemiological aspects, clinical management and short-term outcomes in elderly patients diagnosed with acute heart failure in the emergency department in Spain: results of the EDEN-34 study. Rev Clin Esp 2024; 224:204-216. [PMID: 38423386 DOI: 10.1016/j.rceng.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
OBJECTIVE To estimate the incidence of acute heart failure (AHF) diagnosis in elderly patients in emergency departments (ED), diagnostic confirmation in hospitalized patients, and short-term adverse events. METHODS All patients aged ≥65 years attended in 52 Spanish EDs during 1 week were included and those diagnosed with AHF were selected. In hospitalized patients, those diagnosed with AHF at discharge were collected. As adverse events, in-hospital and 30-day mortality, and combined adverse event (death or hospitalization) at 30 days post-discharge were collected. Adjusted odds ratios (OR) for association of demographic variables, baseline status and constants at ED arrival with mortality and 30-day post-discharge adverse event were calculated. RESULTS We included 1,155 patients with AHF (annual incidence: 26.5 per 1000 inhabitants ≥65 years, 95% CI: 25.0-28.1). In 86% the diagnosis of AHF was known at discharge. Overall 30-day mortality was 10.7% and in-hospital mortality was 7.9%, and the combined event in 15.6%. In-hospital and 30-day mortality was associated with arterial hypotension (adjusted OR: 74.0, 95% CI: 5.39-1015. and 42.6, 3.74-485, respectively and hypoxemia (2.14, 1.27-3.61; and 1.87, 1.19-2.93) on arrival at the ED and requiring assistance with ambulation (2.24, 1.04-4.83; and 2.48, 1.27-4.86) and age (per 10-year increment; 1.54, 1.04-2.29; and 1.60, 1.13-2.28). The combined post-discharge adverse event was not associated with any characteristic. CONCLUSIONS AHF is a frequent diagnosis in elderly patients consulting in the ED. The functional impairment, age, hypotension and hypoxemia are the factors most associated with mortality.
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Affiliation(s)
- Ò Miró
- Área de Urgencias, Hospital Clínico, IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - P Llorens
- Servicio de Urgencias, Corta Estancia y Hospitalización a Domicilio, Hospital General Dr. Balmis, Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Universidad Miguel Hernández, Alicante, Spain.
| | - S Aguiló
- Área de Urgencias, Hospital Clínico, IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - A Alquézar-Arbé
- Servicio de Urgencias, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - C Fernández
- Servicio de Urgencias, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, Spain
| | - G Burillo-Putze
- Servicio de Urgencias, Hospital Universitario de Canarias, Tenerife, Spain
| | - N C Marcos
- Área de Urgencias, Hospital Clínico, IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - A A Marañón
- Área de Urgencias, Hospital Clínico, IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - G S Oms
- Área de Urgencias, Hospital Clínico, IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - J G Del Castillo
- Servicio de Urgencias, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, Spain
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Espinosa B, Burillo-Putze G, Fernández C. Notes on acute poisoning treated in an emergency department. Rev Clin Esp 2023; 223:250-251. [PMID: 36842659 DOI: 10.1016/j.rceng.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Affiliation(s)
- B Espinosa
- Servicio de Urgencias, Unidad de Estancia Corta y Hospitalización a Domicilio, Hospital Doctor Balmis de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain.
| | - G Burillo-Putze
- Servicio de Urgencias, Hospital Universitario de Canarias, Facultad de Ciencias de la Salud, Universidad Europea de Canarias, Tenerife, Spain
| | - C Fernández
- Servicio de Urgencias, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, Spain
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Espinosa B, Burillo-Putze G, Fernández C. Apuntes sobre las intoxicaciones agudas atendidas en un servicio de urgencias. Rev Clin Esp 2023. [DOI: 10.1016/j.rce.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
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Jiménez S, Miró Ò, Llorens P, Martín-Sánchez F, Burillo-Putze G, Piñera P. Incidence, risk factors, clinical characteristics and outcomes of deep venous Thrombosis in patients with COVID-19 attending the emergency department: Results of the UMC-19-S8. J Vasc Surg Venous Lymphat Disord 2021. [PMCID: PMC8360812 DOI: 10.1016/j.jvsv.2021.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Alquézar-Arbé A, Miró Ò, Piñera P, Jacob J, Martín A, Agra Montava I, Llorens P, Jiménez S, Burillo-Putze G, García-Lamberechts EJ, Martín-Sánchez FJ, González Del Castillo J, Siesta RDI. [Analysis of the evolution of patients attended in Spanish emergency departments during the first wave of the pandemic]. An Sist Sanit Navar 2021; 44:243-252. [PMID: 34142985 PMCID: PMC10019547 DOI: 10.23938/assn.0957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND To describe the number of visits (total and per COVID-19) attended by the Spanish hospital emergency departments (EDs) during the first wave of the pandemic (March-April 2020) compared to the same period in 2019, and to calculate the quantitative changes in healthcare activity and investigate the possible influence of hospital size and COVID-19 seroprevalence. METHOD Cross-sectional study that analyzes the number of visits to Spanish public EDs, reported through a survey of ED chiefs during the study periods. Changes in healthcare activity were described in each autonomous community and com-pared according to hospital size and the provincial impact of the pandemic. RESULTS A total of 187 (66?%) of the 283 Spanish EDs participated in the study. The total number of patients attended de-creased to 49.2?% (<?30?% in the Castilla-La Mancha region), with a 60?% reduction in non-COVID-19 patients (reduction <?50?% in the regions of Asturias and Extremadura). While there were no differences in changes of healthcare activity according to the size of the hospital, there were differences in relation to the provincial impact of the pandemic, with a direct correla-tion related to the decrease in non-COVID-19 activity (the greater the impact, the greater the decrease; R2?=?0.05; p?=?0.002) and an inverse correlation to the overall activity (the greater the impact, the lesser the decrease; R2?=?0.05; p?=?0.002). CONCLUSION There was a very significant decrease in the number of ED visits during the first pandemic wave, although this decrease cannot be explained solely by the local incidence of the pandemic.
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Affiliation(s)
- A Alquézar-Arbé
- Servicio de Urgencias. Hospital de la Santa Creu i Sant Pau. Barcelona. España..
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Burillo-Putze G, Climent-Díaz B. Increase and change in the profile of poisonings in the elderly. Rev Clin Esp 2021; 221:473-475. [PMID: 34059491 DOI: 10.1016/j.rceng.2020.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 11/28/2022]
Affiliation(s)
- G Burillo-Putze
- Departamento de Medicina Física y Farmacología, Facultad de Ciencias de la Salud, Universidad de La Laguna, Tenerife, Spain; Fundación Española de Toxicología Clínica (FETOC), Spain.
| | - B Climent-Díaz
- Fundación Española de Toxicología Clínica (FETOC), Spain; Unidad de Toxicología Clínica, Servicio de Medicina Interna, Consorcio Hospital General Universitario, Valencia, Spain
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Miró Ò, Alquézar-Arbé A, Llorens P, Martín-Sánchez FJ, Jiménez S, Martín A, Burillo-Putze G, Jacob J, García-Lamberechts EJ, Piñera P, Del Castillo JG. [Comparison of the demographic characteristics and comorbidities of patients with COVID-19 who died in Spanish hospitals based on whether they were or were not admitted to an intensive care unit]. Med Intensiva 2020; 45:14-26. [PMID: 33158594 PMCID: PMC7522623 DOI: 10.1016/j.medin.2020.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/02/2020] [Accepted: 09/17/2020] [Indexed: 12/22/2022]
Abstract
Objetivo Describir las características demográficas y de comorbilidad de los pacientes con COVID-19 fallecidos en hospitales españoles durante el brote pandémico de 2020 y compararlas según si ingresaron o no en una Unidad de Cuidados Intensivos (UCI) antes del fallecimiento. Métodos Análisis secundario de los pacientes de la cohorte SIESTA (formada por pacientes COVID de 62 hospitales españoles) fallecidos durante la hospitalización. Se recogieron sus características demográficas y comorbilidades, individuales y globalmente, estimadas mediante el índice de comorbilidad de Charlson (ICC). Se identificaron los factores independientes relacionados con ingreso en UCI, y se realizaron diversos análisis de sensibilidad para contrastar la consistencia de los hallazgos del análisis principal. Resultados Se incluyeron los 338 pacientes de la cohorte SIESTA fallecidos; de ellos, 77 (22,8%) accedieron a una UCI previamente al fallecimiento. En el análisis multivariable, tres de las 20 características basales analizadas se asociaron independientemente con ingreso en UCI de los pacientes fallecidos: demencia (no hubo pacientes fallecidos con demencia que ingresasen en UCI; OR = 0, IC 95% = no calculable), cáncer activo (OR = 0,07, IC 95% = 0,02-0,21) y edad (< 70 años: OR = 1, referencia; 70-74 años: OR = 0,21, IC 95% = 0,08-0,54; 75-79 años: OR = 0,21, IC 95% = 0,08-0,54; ≥ 80 años: OR = 0,02, IC 95% = 0,01-0,05). La probabilidad de ingreso en UCI de los pacientes que fallecieron disminuyó significativamente al aumentar el ICC, incluso tras ajustarla por edad (ICC 0 puntos: OR = 1, referencia; ICC 1 punto: OR = 0,36, IC 95% = 0,16-0,83; ICC 2 puntos: OR = 0,36, IC 95% = 0,16-0,83; ICC > 2 puntos: OR = 0,09, IC 95% = 0,04-0,23). Los análisis de sensibilidad no mostraron diferencias destacables respecto al análisis principal. Conclusiones El perfil de los pacientes COVID fallecidos sin ingresar en UCI se ajustó a lo observado en la práctica médica habitual antes de la pandemia, y las características basales que limitaron su ingreso fueron la edad y la carga de comorbilidad global, especialmente la demencia y el cáncer activo.
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Affiliation(s)
- Ò Miró
- Servicio de Urgencias, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, España.
| | - A Alquézar-Arbé
- Servicio de Urgencias, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - P Llorens
- Servicio de Urgencias, Hospital General Universitario de Alicante, Universidad Miguel Hernández, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, España
| | - F J Martín-Sánchez
- Servicio de Urgencias, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, España
| | - S Jiménez
- Servicio de Urgencias, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, España
| | - A Martín
- Servicio de Urgencias, Hospital Universitario de Móstoles, Madrid, España
| | - G Burillo-Putze
- Servicio de Urgencias, Hospital Universitario de Canarias, Tenerife, España
| | - J Jacob
- Servicio de Urgencias, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
| | - E J García-Lamberechts
- Servicio de Urgencias, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, España
| | - P Piñera
- Servicio de Urgencias, Hospital General Universitario Reina Sofía, Murcia, España
| | - J González Del Castillo
- Servicio de Urgencias, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, España
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Ibrahim-Achi D, Pérez-Carrillo M, Expósito-Rodriguez M, Burillo-Putze G. Intoxicaciones agudas en hospitales comarcales. Rev Clin Esp 2020; 220:388-389. [DOI: 10.1016/j.rce.2019.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 12/29/2019] [Indexed: 10/24/2022]
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Hernández-Ramos I, Parra-Esquivel P, López-Hernández Á, Burillo-Putze G. [Spontaneuos pneumomediastinum secondary to cannabinoid hyperemesis syndrome]. An Sist Sanit Navar 2019; 42:227-230. [PMID: 31133765 DOI: 10.23938/assn.0635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Cannabinoid hyperemesis syndrome (CHS) is little known amongst clinicians and is characterised by abdominal pain and cyclical vomiting, after intense consumption of cannabis over several years. It does not respond to treatment with antiemetics, but does respond to showers in very hot water. We present the case of a 24-year-old patient whose antecedents included cannabis consumption since the age of 14 and an episode of spontaneous idiopathic pneumomediastinum (PM) the previous month, which presented an association of CHS and secondary pneumomediastinum with the intense, repeated vomiting of the CHS. He was given topical capsaicin and 5 mg of intravenous haloperidol, and was kept for 48 hours in the in A and E Short Stay Unit. This isolated clinical observation appears to indicate the need to rule out CHS as the cause of PM in young patients and, similarly, to consider the presence of PM in the clinical exploration of young people with CHS and in patients with pathologies whose aetiology might be influenced by an increase in intrathoracic pressure.
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Affiliation(s)
- I Hernández-Ramos
- Servicio de Urgencias. Hospital Universitario de Canarias. La Laguna. Tenerife..
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Báez-Ferrer N, Gironés-Bredy C, Domínguez-Rodriguez A, Burillo-Putze G. Aumento del tiempo para cesar la reanimación cardiopulmonar en la parada cardiaca extrahospitalaria. Med Intensiva 2018; 42:395-396. [DOI: 10.1016/j.medin.2017.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 06/12/2017] [Accepted: 06/15/2017] [Indexed: 10/19/2022]
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Dominguez-Rodriguez A, Avanzas P, Burillo-Putze G, Abreu-Gonzalez P. Influencia del tratamiento con morfina en la mortalidad intrahospitalaria de pacientes con insuficiencia cardíaca aguda. Med Intensiva 2017; 41:382-384. [DOI: 10.1016/j.medin.2016.05.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 05/03/2016] [Accepted: 05/09/2016] [Indexed: 10/20/2022]
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Dominguez-Rodriguez A, Avanzas P, Burillo-Putze G, Abreu-Gonzalez P. Influence of morphine treatment on in-hospital mortality among patients with acute heart failure. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.medine.2017.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Burillo-Putze G, López Briz E, Climent Díaz B, Munné Mas P, Nogue Xarau S, Pinillos MA, Hoffman RS. [Emergent drugs (III): hallucinogenic plants and mushrooms]. An Sist Sanit Navar 2015; 36:505-18. [PMID: 24406363 DOI: 10.4321/s1137-66272013000300015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
An increase in the consumption of vegetable substances with a hallucinogenic effect has been observed. Some of these substances are associated with ancestral religious ceremonies, while many of them are legal or are partially regulated. Salvia divinorum is a powerful kappa receptor agonist, with dissociative and hallucinogenic properties, which start quickly and have a short duration. Kratom (Mytragyna speciosa) has mitragynine as its principal alkaloid, with stimulating effects at low doses (coke-like effect), and sedative effects (opiate-like effect) at high doses. Several deaths from its consumption have been detected. The consumption of hallucinogenic mushrooms appears in cyclic form, although there has been increase in their online offer. They are consumed in search of their hallucinogenic effects, above all those belonging to the family of psilocybes, which contain tryptamines with a hallucinogenic effect similar to LSD. Peyote (Lophophora psilocybes), a cactus rich in mescaline (trimetoxifeniletilamina), produces hallucinations of the five senses, and forms part of the religious culture of the North American Indians. Daturas, which are ubiquitous, produce anticholinergic symptoms and effects on the central nervous system (delirium, hallucinations, etc.), due to their high atropine and scopolamine content. Other substances used for their hallucinogenic effects include the drink known as ayahuasca, and seeds for preparing infusions like Ololiuqui, Morning Glory (Ipomoea violacea), Hawaian Baby Woodrose (Argyreia nervosa), Syrian Rue (Peganum harmala) and Iboga Rootbark (Tabernanthe iboga).
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Affiliation(s)
- G Burillo-Putze
- Servicio de Urgencias, Hospital Universitario de Canarias, Spain,
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Darias Acosta A, Gironés Bredy C, Benito Lozano M, Burillo-Putze G. Diagnóstico de sospecha de cáncer en los servicios de urgencias. An Sist Sanit Navar 2015. [DOI: 10.4321/s1137-66272015000100014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Darias Acosta A, Gironés Bredy C, Benito Lozano M, Burillo-Putze G. [Diagnosis of cancer in hospital emergency services]. An Sist Sanit Navar 2015; 38:133-134. [PMID: 25963466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Cremades Pallas R, Burbano P, Valcárcel de La Iglesia M, Burillo-Putze G, Martín-Sánchez F, Miró Ò. Impacto de la inclusión de artículos escritos en inglés en revistas biomédicas españolas de edición multilingüe. An Sist Sanit Navar 2013; 36:467-70. [DOI: 10.4321/s1137-66272013000300011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Burillo-Putze G, Aldea-Perona A, Rodríguez-Jiménez C, García-Sáiz MM, Climent B, Dueñas A, Munné P, Nogué S, Hoffman RS. [Emergent drugs (II): the Pharming phenomenon]. An Sist Sanit Navar 2013; 36:99-114. [PMID: 23648497 DOI: 10.4321/s1137-66272013000100010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The use of medicines, with or without medical prescription, for recreational ends by the young population has received little attention from doctors. In the USA, one in five adolescents has used medicines for recreational purposes, and consultations in Emergency Departments for medicine abuse have exceeded those for illegal drugs. Although few data are available in Spain, such consumption is situated between 3.1 and 8.6% according to surveys. The medicines most used are dextromethorphan and methylphenidate. The former, on sale without prescription, presents a varied symptomatology, dosage and dependent metabolic action, ranging from euphoria to hallucinations. Methylphenidate, taken orally, nasally or intravenously, is used as a stimulant in substitution for cocaine and is one of the medicines most diverted onto the illicit market at the world level. In principle, other substances like modafinil and propofol present a limited incidence of non-medical use, but they have a probable abuse potential that should be borne in mind, above all in the health context. Finally, opiates like fentanyl, oxycodone and buprenorphine, with new pharmaceutical presentations, have recently become generalized in the therapeutic arsenal of many medical specialities; they are giving rise to phenomena of abuse, dependence and diversion towards the illicit market. Demands for detoxification treatment, their mixture with illegal substances, and cases of death should alert us to the abuse of these medicines.
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Affiliation(s)
- G Burillo-Putze
- Universidad Europea de Canarias, Facultad de Ciencias de Salud, Servicio de Urgencias, Hospital Universitario de Canarias, Tenerife, España.
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Burillo-Putze G, Hernández Sánchez M, Climent García B, Pinillos Echeverría M. Nuevas formas de consumo de alcohol. An Pediatr (Barc) 2012; 77:419-20. [DOI: 10.1016/j.anpedi.2012.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 03/20/2012] [Indexed: 11/17/2022] Open
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Burillo-Putze G, Climent B, Echarte JL, Munné P, Miró Ó, Puiguriguer J, Dargan P. Drogas emergentes (I): las «smart drugs». An Sist Sanit Navar 2011; 34:263-74. [DOI: 10.4321/s1137-66272011000200012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Burillo-Putze G, García BC, González AMDV. [New cannabinoids use (Spice) and their detection in emergency departments]. An Pediatr (Barc) 2010; 73:287-8. [PMID: 20817626 DOI: 10.1016/j.anpedi.2010.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Revised: 07/19/2010] [Accepted: 07/20/2010] [Indexed: 10/19/2022] Open
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Miró O, Sesma J, Burillo-Putze G. [Research in urgent and emergency medicine]. An Sist Sanit Navar 2010; 33 Suppl 1:215-227. [PMID: 20508691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Health research is consubstantial with clinical excellence, a fact that is also inherent in urgency and emergency medicine (UEM). Besides, the specific characteristics of the Spanish health CARE system and the organisation of hospital emergency CARE offer a probably unique scenario, offering unique opportunities for their scientific analysis and study. Although the indices of Spanish scientific production in UEM were traditionally below those registered for researchers of other medical specialties, as well for UEM researchers of other countries, there has been a dynamic of continuous growth since 1995: it is the highest with respect to the former and second amongst our European colleagues. Besides, there is a great deal of low level scientific activity (papers presented to conferences). To increase scientific production in UEM there is a need to solve some aspects that hinder this task, such as: the lack of a scientific culture, doubtless united to the lack of a recognised specialty; the limited training in research methodology; the lack of explicit recognition of scientific work; the limited scientific infrastructure; the practically 100% dedication to the work of care tasks; the scarce participation in national grants for research projects; and the absence in Spain of an indexed journal specialising in UEM. Besides, we believe that it is necessary to promote and interrelate the research groups of different hospitals and emergency medical systems, both locally and amongst the different autonomous communities, so that they work in a coordinated way and thus obtain the necessary critical mass that will enable the formation of a thematic network of cooperative research.
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Affiliation(s)
- Oscar Miró
- Area de Urgencias, Hospital Cínic, Barcelona 08036, Spain.
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Burillo-Putze G, Nogué-Xarau S, Pérez-Castrillón JL, Dueñas-Laita A. [Cyanide and carbon monoxide in intoxication by smoke in a fire]. Rev Neurol 2009; 48:335-336. [PMID: 19291665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Suárez-Peláez J, Burillo-Putze G, Lubillo-Montenegro S, Ramos-Gómez L. Pre-hospital fluid therapy in the critically injured patient: need for clinical studies. Injury 2007; 38:130-1; author reply 131-2. [PMID: 16996064 DOI: 10.1016/j.injury.2006.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2006] [Accepted: 05/25/2006] [Indexed: 02/02/2023]
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León-Quintana C, Ayala-Rodrigo A, Domínguez-Suárez M, Castro-Conde JR, Burillo-Putze G. [Acute confusional state due to intoxication]. Rev Neurol 2006; 42:703-4. [PMID: 16736406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
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Burillo-Putze G, Munné Mas P, Pérez Carrillo MA, Hoffman RS. Errores respecto a la intoxicación por paracetamol en menores de 6 años. An Pediatr (Barc) 2006; 64:498-9; author reply 499. [PMID: 16756898 DOI: 10.1157/13087884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Burillo-Putze G, Miró O, Nogué Xarau S, Munné P. Golosinas del siglo XXI, ¿una nueva amenaza toxicológica? Aten Primaria 2004. [DOI: 10.1157/13058050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Burillo-Putze G, Miró O, Nogué Xarau S, Munné P. Golosinas del siglo XXI, ¿una nueva amenaza toxicológica? Aten Primaria 2004; 33:167. [PMID: 14987508 PMCID: PMC7675997 DOI: 10.1016/s0212-6567(04)79385-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Munné P, Saenz Bañuelos JJ, Izura JJ, Burillo-Putze G, Nogué S. [Acute pharmacologic poisoning (II). Analgesics and anticonvulsants]. An Sist Sanit Navar 2003; 26 Suppl 1:65-97. [PMID: 12813479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
In this second chapter on Acute Drugs Poisoning we deal with two groups of substances of great transcendence from the point of view of their use and morbidity/mortality. Within the group of analgesic-anti-inflammatory drugs we consider paracetamol and the salicylates, which are easily available to the population. With respect to the anticonvulsants, although they are barely involved in the ensemble of acute drug poisonings, their effects can be serious. We concentrate on four drugs: valproic acid, phenobarbitol, carbamacepine, and phenytoin. Finally, a section is dedicated to isoniazid, a drug that, with the renewed incidence of tuberculosis, is of toxicological interest.
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Affiliation(s)
- P Munné
- Servei dacute;Urgencias, Unitat de Toxicologia Clinica, Hospital Clinic, C/ Villarroel 170,08036 Barcelona, Spain.
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Gainza I, Nogué S, Martínez Velasco C, Hoffman RS, Burillo-Putze G, Dueñas A, Gómez J, Pinillos MA. [Drug poisoning]. An Sist Sanit Navar 2003; 26 Suppl 1:99-128. [PMID: 12813480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
A review is made of acute poisoning by opiates and its treatment in the emergency services, bearing in mind the progressive decline in the number of cases presented with the arrival of new forms of their administration, as well as the presence of new addictive drugs that have resulted in a shift in consumption habits. Reference is also made to the way in which the different types of existing substances originated, with the aim of achieving a better understanding of their use and in order to administer the most suitable treatment when poisoning occurs. Cocaine poisoning is discussed, with reference to its clinical picture, diagnosis and treatment. The consumption of illegal drugs in our country has undergone a notable change in recent years, with heroin being relegated and the incorporation of cocaine, amphetamine derivatives such as "ecstasy" (MDMA), "liquid ecstasy" (GHB) and, to a lesser extent, ketamine. A review is made of cannabis and its derivates, from the history of its consumption and the preparations employed to the effects produced in the different bodily systems. A brief explanation is also given of its metabolites and its principal mechanisms of action. Finally, we comment on the effects of LSD and hallucinogenic mushrooms.
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Affiliation(s)
- I Gainza
- Servicio de Psiquiatría, Hospital de Navarra, 31008 Pamplona Spain
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Osés I, Burillo-Putze G, Munne P, Nogué S, Pinillos MA. [Acute pharmacologic poisoning (I). Psychotropic and antiarrhythmic drugs]. An Sist Sanit Navar 2003; 26 Suppl 1:49-63. [PMID: 12813478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
In the evaluation of Acute Drug Poisoning (ADP) in patients seriously ill with a potentially non-toxic dose of the drug that is theoretically responsible, it is important to insist on anamnesis in the coingestion of other drugs or toxics. Initially attention is given to life support measures, oxygenation, protection of the airway and expanding the volemia. The ECG is a diagnostic tool of the first order in ADPs, above all for tricyclic antidepressants (TAD) and cardio-vascular drugs. In the majority of cases continuous monitoring is usually necessary during the first 12-24 hours. The benzodiazepines do not usually give rise to serious poisoning. The use of flumazenil will be reserved for cases of respiratory depression, deep coma or where the cause is undetermined. They can give rise to convulsions, above all in the case of mixed poisonings with anti-depressants and abstinence syndrome. The TADs have an enormous potential seriousness, as they can cause mortal arrhythmias. The therapeutic range of lithium is very narrow; it can produce signs of basically digestive and neurological toxicity. In the case of poisoning by digoxin, the use of anti-digital anti-bodies will be considered in cases of serious bradyarrhythmias, AV blocks or PCR. Glucagon is the antidote for serious poisoning by beta-blockers and for refractory hypotension in cases of calcioantagonists.
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Affiliation(s)
- I Osés
- Servicio de Medicina Intensiva, Hospital de Navarra, Irunlarrea 3, 31008 Pamplona, Spain
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Garcés Redolat E, Parra Hernández A, Munné Mas P, Burillo-Putze G. [Liquid paracetamol intoxication in the under-6s: changes in the toxic dose]. Aten Primaria 2003; 32:434-5. [PMID: 14622558 PMCID: PMC7669019 DOI: 10.1016/s0212-6567(03)70764-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Munné P, Saenz Bañuelos J, Izura J, Burillo-Putze G, Nogué S. Intoxicaciones medicamentosas (II): Analgésicos y anticonvulsivantes. An Sist Sanit Navar 2003. [DOI: 10.4321/s1137-66272003000200005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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García Marín N, Burillo-Putze G, Osuna Peña JM, García Marín V. Síndrome de latigazo cervical y pruebas radiológicas. Aten Primaria 2003; 32:438-9; author reply 439. [PMID: 14622562 PMCID: PMC7669162 DOI: 10.1016/s0212-6567(03)70769-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Burillo-Putze G, Duarte IH, Alvarez Fernandez JA. Helicopter emergency medical service in Spain. Air Med J 2001; 20:21-3. [PMID: 11331822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
No studies had been conducted about Spanish HEMS programs, so we conducted a nationwide survey by phone from January to June 1999. We identified 18 HEMS programs in 13 regions, which transported 4870 patients in 1998. The primary/interhospital missions ratio was 51.25/48.75. In 78% of responding programs, the medical crew was a physician and a nurse. Only 33% of HEMS had standard medical equipment; most lacked noninvasive blood pressure monitors, and one-third of the medical personal were correctly protected with flight helmets and flight suits. It is necessary to study the cost-effectiveness of the Spanish model of HEMS.
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Affiliation(s)
- G Burillo-Putze
- Emergency Department, Hospital Universario de Canarias, University of La Laguna, Tenerife, Canary Islands, Spain.
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Riquelme Rodríguez A, Burillo-Putze G, Jiménez Sosa A, Hardisson De La Torre A. [General epidemiology of acute intoxication in a health área]. Aten Primaria 2001; 28:506. [PMID: 11718648 PMCID: PMC7677949 DOI: 10.1016/s0212-6567(01)70430-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Abstract
This is a report on our first 2 years' experience of operating a helicopter emergency medical service in the Canary Islands, Spain. The two advanced life-support helicopters are staffed full time by a physician and a nurse. For the transport protocol, inter-hospital transport patients (secondary missions) were classified into three groups: group A, minor illnesses or injuries; group B, modified or middle critical condition; and group C, critical condition. On-scene patients (primary missions) were also divided into critical and non-critical condition. Cardiovascular and respiratory stabilization were necessary before transport. One thousand and fifty-four patients were transported, 19% of whom were primary missions and 81% of whom were secondary missions. Thirty per cent of the first group were in critical condition. The distribution of secondary missions was group A 16%, group B 44% and group C 40%. In group C, 60% of patients were mechanically ventilated, 70% needed cardiovascular drug support and 84% needed stabilization before transport. Thirty-two per cent were trauma patients and 12% neonates. The overall mortality rate was 0.8%. The cost per mission was US$2300. In the interests of safety and rationalization of the use of resources, transport of non-critical patients should be reduced. The presence of a trained physician and nursing crew and stabilization before transport could be responsible for the low mortality rate.
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Affiliation(s)
- S Lubillo
- Critical Care, Hospital Universitario Ntra. Sra. del Pino, Universidad de Las Palmas de Gran Canaria, Spain
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