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El consumo moderado de alcohol no mejora la salud cardiaca 23 Jul 2014


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Los resultados de un polémico macroestudio en el que ha intervenido un centenar de científicos de instituciones de Europa, América, Oceanía y Asia, contradicen la creencia ampliamente extendida de que un consumo moderado de alcohol es más beneficioso para la salud cardiaca que no tomar nada de alcohol. Los nuevos resultados ponen en entredicho las conclusiones de estudios anteriores que sugerían que tomarse una copa al día promueve la salud cardiovascular.

Alcohol coraz√≥nEn realidad, a juzgar por los resultados del macroestudio, presentados p√ļblicamente a trav√©s de la revista acad√©mica brit√°nica BMJ (British Medical Journal) (doi: org/10.1136/bmj.g4164.), editada por la British Medical Association (Asociaci√≥n M√©dica Brit√°nica), reducir la cantidad de alcohol consumido, incluso para quienes beben muy poco o de forma moderada, puede mejorar la salud cardiovascular, incluyendo un riesgo menor de enfermedad cardiaca coronaria, un √≠ndice de masa corporal m√°s bajo y una presi√≥n sangu√≠nea inferior.

El macroestudio se basa en una revisión de evidencias aportadas por más de 50 estudios que enlazaron los hábitos de bebida y la salud cardiovascular para más de 260 000 personas.

El equipo del Dr. Michael Holmes, de la Escuela Perelman de Medicina en la Universidad de Pensilvania en Filadelfia, Estados Unidos, Juan Pablo Casas, de la Facultad de Epidemiolog√≠a y Salud P√ļblica en la Escuela de Higiene y Medicina Tropical de Londres, Reino Unido, y m√°s de cien coautores, han constatado que los individuos portadores de un gen espec√≠fico que normalmente lleva a un consumo m√°s bajo de alcohol a lo largo del tiempo, tienen, en promedio, una mejor salud cardiovascular. En concreto, los resultados muestran que las personas que consumen un 17 %¬† menos de alcohol por semana tienen en promedio un riesgo de enfermedad cardiaca coronaria un 10 % menor,¬† una tensi√≥n arterial m√°s baja y un √≠ndice de masa corporal tambi√©n m√°s bajo.

‚ÄúLos nuevos resultados son muy importantes para nuestra comprensi√≥n de c√≥mo afecta el alcohol a las enfermedades del coraz√≥n. Al contrario de lo que informes previos afirmaban, parece ahora que cualquier exposici√≥n al alcohol tiene un impacto negativo sobre la salud cardiaca‚ÄĚ, argumenta el Dr. Holmes. ‚ÄúDurante alg√ļn tiempo, estudios observacionales han sugerido que s√≥lo el beber mucho era perjudicial para la salud cardiovascular, y que el consumo bajo pod√≠a incluso ser beneficioso. Esto ha llevado a algunas personas a beber moderadamente bas√°ndose en la creencia de que ello disminuir√≠a su riesgo de enfermedad cardiaca. Sin embargo, lo que estamos viendo con este nuevo estudio es que un menor consumo de alcohol, incluso para quienes lo beben en cantidades moderadas o muy bajas, puede suponer una salud cardiovascular mejor‚ÄĚ.

En el nuevo estudio, los investigadores examinaron la salud cardiovascular de individuos que poseen una variante gen√©tica del gen ‚Äúalcohol deshidrogenasa 1B‚ÄĚ, que se sabe hace descomponerse al alcohol a un ritmo m√°s r√°pido. Esta r√°pida descomposici√≥n causa s√≠ntomas molestos, incluyendo n√°useas y enrojecimiento facial, y ha propiciado menores niveles de consumo de alcohol con el tiempo. Usando este marcador gen√©tico como indicador razonablemente fiable de un consumo m√°s bajo de alcohol, el equipo de investigaci√≥n pudo identificar las conexiones entre estas personas y una mejor salud cardiovascular.
julio 14/ 2014 (NCYT)

Caroline E Dale, Luisa Zuccolo, Richard J Silverwood, Yiran Guo, Zheng Ye, David Prieto-Merino.Association between alcohol and cardiovascular disease: Mendelian randomisation analysis based on individual participant data. BMJ 2014; 349, 10 Jul 2014

La cirugía de cataratas resulta beneficiosa para las personas con demencia 23 Jul 2014


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Adem√°s de mejorar la visi√≥n, la cirug√≠a de cataratas podr√≠a ralentizar el deterioro mental en las personas con alzh√©imer y otros tipos de demencia, seg√ļn un estudio reciente.

cataratasUna mejor visión también mejora su calidad de vida, dijeron los investigadores.

“Estos resultados preliminares indican que mejorar la visi√≥n puede tener una variedad de beneficios para las personas con demencia y sus seres queridos, tanto visuales como no visuales”, afirm√≥ el Dr. Alan Lerner, de la Universidad Case Western Reserve y del Centro M√©dico Case de los Hospitales Universitarios en Ohio.

La cirug√≠a de cataratas consiste en la extracci√≥n de las lentes naturales de los ojos cuando est√°n empa√Īadas y reemplazarlas por unas lentes artificiales claras.

El estudio contó con 20 pacientes de demencia que se sometieron a una cirugía de cataratas y con un grupo de control de 8 pacientes a los que no se realizó ese procedimiento.

Seis meses después de la cirugía, los pacientes del grupo de la cirugía experimentaron una mejora significativa de la vista y la calidad de vida, un menor deterioro de la memoria y pensamiento y una mejora mayor de la conducta que los del grupo de control, hallaron los investigadores.

Los cuidadores de los pacientes que se sometieron a una cirug√≠a de cataratas tambi√©n reportaron una mejora de la calidad de vida, seg√ļn el estudio. El reporte fue presentado en la reuni√≥n anual de la Asociaci√≥n del Alzheimer (Alzheimer’s Association) en Copenhague, Dinamarca.

“Nuestros hallazgos tienen que ser verificados por un estudio de mayor tama√Īo, pero sugieren la necesidad de abordar de forma agresiva las comorbilidades relativas a la demencia, como las cataratas que dificultan la visi√≥n, al mismo tiempo que se busca un equilibrio entre la seguridad y los riesgos m√©dicos”, a√Īadi√≥ Lerner en un comunicado de prensa de la asociaci√≥n.

“Si los resultados se mantienen, afectar√°n significativamente al modo en que tratamos las cataratas en los individuos con demencia. Otras intervenciones para compensar la p√©rdida sensorial (incluyendo la vista y el o√≠do) podr√≠an ayudar a mejorar la calidad de vida de las personas con demencia y de sus cuidadores”, dijo Lerner.

Una vocera de la Asociación del Alzheimer dijo que el estudio respalda la opinión de la organización de que las personas con demencia se benefician de un tratamiento de atención médica completo.

“Las actitudes demasiado habituales como: ‘No hace falta un cuidado adicional’ o ‘¬ŅPor qu√© hacerlos pasar por todo eso?’ no est√°n justificadas y son una pr√°ctica m√©dica mala”, dijo Mar√≠a Carrillo, vicepresidenta de relaciones m√©dicas y cient√≠ficas de la asociaci√≥n.

“A la hora de pensar en realizar una cirug√≠a u otros procedimientos a personas con alzh√©imer u otra demencia es necesario meditarlo y poner l√≠mites de forma adecuada”, dijo Carrillo. “Sin embargo, no deber√≠amos dar por hecho que los procedimientos m√©dicos no deben tenerse en cuenta o que son demasiado arriesgados”.

Estos resultados muestran que mejorar las habilidades sensoriales puede ser beneficioso de varias maneras, para las personas con alzh√©imer y tambi√©n para sus cuidadores, a√Īadi√≥.

Los datos y conclusiones presentados en reuniones normalmente son considerados como preliminares hasta que se publiquen en una revista médica revisada por profesionales.
julio 13/2014 (Medlineplus)

Un nuevo sistema detecta las reca√≠das en pacientes con mieloma m√ļltiple 23 Jul 2014


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El Instituto de Investigaci√≥n Biom√©dica de Salamanca (IBSAL) y el Hospital 12 de Octubre de Madrid han desarrollado un nuevo sistema que permitir√° diferenciar a los pacientes de mieloma m√ļltiple que sufrir√°n reca√≠das de los que no para ajustar los tratamientos en funci√≥n de esta posibilidad. La tecnolog√≠a de secuenciaci√≥n masiva, que hasta ahora est√° restringida a los laboratorios, se traslada a la pr√°ctica cl√≠nica en un art√≠culo recogido por la revista Blood (doi: 10.1182/blood-2014-01-550020.).

Mieloma‚ÄúLos pacientes de mieloma responden muy bien al tratamiento de forma inicial pero casi todos recaen al cabo del tiempo y este es uno de los principales retos de la enfermedad‚ÄĚ, explica Ram√≥n Garc√≠a Sanz, investigador de la Universidad de Salamanca y de la Unidad de Biolog√≠a Molecular del Hospital Universitario y miembro del Instituto de Investigaci√≥n Biom√©dica de Salamanca (IBSAL).

A medida que se van logrando avances en los tratamientos, la respuesta de los pacientes mejora pero ‚Äúhasta ahora no √©ramos capaces de diferenciar los que recaen de los que no‚ÄĚ. Sin embargo, gracias a la nueva tecnolog√≠a de secuenciaci√≥n profunda o masiva, los investigadores han desarrollado una metodolog√≠a para encontrar c√©lulas tumorales despu√©s de los tratamientos aunque solo haya una entre miles, lo que se conoce enfermedad m√≠nima residual, que puede provocar la reca√≠da.

‚ÄúPodemos hallar seis secuencias tumorales entre un mill√≥n de c√©lulas normales‚ÄĚ, apunta el investigador. De la misma forma, tambi√©n es posible comprobar si la enfermedad ha desaparecido por completo. La t√©cnica amplifica el ADN tumoral de los pacientes para poder distinguirlo del ADN de las c√©lulas normales.

Esta tecnolog√≠a se estaba utilizando solo en los laboratorios para identificar nuevos genes o la predisposici√≥n a sufrir enfermedades y la gran novedad es que se aplique ahora en la investigaci√≥n cl√≠nica y as√≠ realizar un mejor pron√≥stico en pacientes. ‚ÄúEs una metodolog√≠a absolutamente nueva para el campo de la monitorizaci√≥n de los pacientes‚ÄĚ, afirma Ram√≥n Garc√≠a Sanz. ‚ÄúEn Europa se ha hecho alg√ļn estudio semejante en leucemia aguda linfobl√°stica, pero para enfermedad m√≠nima residual no hay nada m√°s en secuenciaci√≥n profunda‚ÄĚ, agrega.

El estudio se realiz√≥ con 133 pacientes de m√°s de 80 hospitales que colaboran con los investigadores del Grupo Espa√Īol de Mieloma (GEM) con resultados que permit√≠an distinguir claramente entre los pacientes que pueden recaer y los que no. Por lo tanto, ‚Äúes un hito muy novedoso ya que antes no pod√≠amos definir los que estaban curados de los que no‚ÄĚ.

Consecuencias futuras

En opini√≥n de los investigadores, este estudio es un ejemplo de c√≥mo una estrategia molecular se puede aplicar a pacientes para el control de la enfermedad a largo plazo y lo m√°s interesante es que a partir de ahora se podr√°n dise√Īar nuevas estrategias de tratamiento. Lo habitual es que a todos los pacientes de mieloma m√ļltiple se les aplique ‚Äúun poco a ciegas‚ÄĚ un tratamiento de mantenimiento que consiste en tomar una pastilla de poca toxicidad pero cuyo coste llega a los 10 000 euros al mes.

‚ÄúAhora podr√≠amos plantearnos interrumpir el tratamiento si los niveles de enfermedad residual m√≠nima negativa as√≠ lo aconsejan‚ÄĚ, apunta el experto del IBSAL, algo que ya se est√° haciendo en el caso de la leucemia mieloide cr√≥nica. Adem√°s del beneficio para el paciente, que no tendr√° que seguir con el tratamiento si no es necesario, supondr√° un importante ahorro para el sistema de salud. En el caso de los pacientes que responden mal a las terapias, se podr√≠a mantener la estrategia actual o probar nuevas estrategias a trav√©s de ensayos cl√≠nicos como los que lleva a cabo el propio Hospital Universitario de Salamanca.

En Espa√Īa se detectan cinco casos de mieloma m√ļltiple por cada 100 000 habitantes y a√Īo, es decir, cerca de 2000 nuevos cada a√Īo, as√≠ que este avance puede resultar muy importante. Los investigadores a√ļn necesitan optimizar la metodolog√≠a pero creen que en el plazo de un a√Īo podr√≠a estar disponible en Salamanca y en el 12 de Octubre de Madrid.
julio 14/2014 (SNIC)

Martinez-Lopez J, Lahuerta JJ, Pepin F, González M, Barrio S, García-Sanz R. Prognostic value of deep sequencing method for minimal residual disease detection in multiple myeloma. Blood ;123(20):3073-9. 15 May  2014

La genética puede aumentar el riesgo de parálisis cerebral 23 Jul 2014


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Una nueva investigaci√≥n sugiere que los genes podr√≠an tener un papel en la par√°lisis cerebral, la causa m√°s habitual de discapacidad f√≠sica en los ni√Īos.

parálisisLas investigaciones anteriores han identificado varios factores de riesgo relacionados con el embarazo, incluyendo el parto prematuro, el crecimiento anómalo, la exposición a la infección y la carencia de oxígeno al nacer. También se ha encontrado un posible vínculo familiar con la parálisis cerebral, pero no se ha confirmado.

La par√°lisis cerebral afecta a la capacidad de movimiento, y altera el equilibrio y la postura.

En este estudio, los investigadores analizaron los datos de m√°s de 2 millones de nacimientos en Noruega entre 1967 y 2002. Identificaron m√°s de 3600 casos de par√°lisis cerebral, o 1.8 casos por cada 1000 ni√Īos nacidos en ese per√≠odo.

La tasa era m√°s alta entre gemelos (5.1 por cada 1000 ni√Īos) que entre los ni√Īos sin hermanos gemelos (1.7 por cada 1000 ni√Īos). Si un gemelo ten√≠a par√°lisis cerebral, el otro gemelo ten√≠a un riesgo 15 veces mayor de tener esa afecci√≥n.

Si un ni√Īo de una familia ten√≠a par√°lisis cerebral, los hermanos de padre y madre que nac√≠an despu√©s ten√≠an un riesgo entre 6 y 9 veces m√°s alto, y los hermanos de solo de padre o madre ten√≠an un riesgo hasta 3 veces mayor. Los ni√Īos nacidos de padres con una par√°lisis cerebral ten√≠an 6.5 veces m√°s probabilidades de tener la afecci√≥n que los nacidos de padres que no la ten√≠an.

Incluso los primos hermanos de personas con par√°lisis cerebral ten√≠an un riesgo 1.5 veces m√°s alto, seg√ļn los hallazgos publicados en la revista The BMJ (doi: org/10.1136/bmj.g4294). Es el primer estudio que examina la par√°lisis cerebral en un rango tan amplio de v√≠nculos familiares.

“Nuestros datos sugieren que la par√°lisis cerebral incluye un componente gen√©tico, con una recurrencia mayor entre parientes con una relaci√≥n gen√©tica m√°s cercana”, escribieron los investigadores.

Cuando un ni√Īo nace con una par√°lisis cerebral, los padres desean saber si hicieron algo que provocara la afecci√≥n, y si puede volver a suceder en otros hijos o nietos, anot√≥ el Dr. Peter Rosenbaum, pediatra, en un comentario acompa√Īante.

Coment√≥ que la investigaci√≥n de las causas de la par√°lisis cerebral “dista mucho de haberse terminado”, pero a√Īadi√≥ que incluso los familiares que tienen un riesgo 15 veces mayor tienen un riesgo real bajo de la enfermedad.

“Esta informaci√≥n deber√≠a aportar alguna tranquilidad a las familias que ya tengan alg√ļn caso de par√°lisis cerebral”, concluy√≥ Rosenbaum.
julio 15/2014 (Medlineplus)

Mette C Tollånes, Rolv T Lie, Dag Moster.Familial risk of cerebral palsy: population based cohort study. BMJ ;349:g4294.2014 Jul 15

Miden el cansancio de un médico tras una guardia mediante el movimiento de sus ojos 23 Jul 2014


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La velocidad de los movimientos sacádicos, los movimientos rápidos del ojo, es un excelente instrumento para medir de forma objetiva el cansancio de un médico. Un estudio internacional confirma su utilidad para evaluar a los médicos tras una guardia.

mov ocularUn equipo internacional de científicos, entre los que se encuentran investigadores de la Universidad de Granada (UGR), ha demostrado por primera vez que es posible detectar de manera objetiva, a través de los movimientos de sus ojos, el cansancio que tienen los médicos residentes después de una guardia.

En su trabajo se revela que la velocidad de los movimientos sacádicos (movimientos rápidos del ojo, fundamentalmente voluntarios, que utilizamos para dirigir la mirada a un objeto que nos llama la atención) es un excelente índice para medir de forma objetiva el cansancio de estos profesionales.

En un art√≠culo publicado en Annals of Surgery ( doi: 10.1097/SLA.0000000000000260. ), los cient√≠ficos llevaron a cabo la evaluaci√≥n de los m√©dicos residentes del Servicio de Traumatolog√≠a del St. Joseph‚Äôs Hospital and Medical Center de Phoenix (EE UU) antes y despu√©s del llamado “call-day” (d√≠a de guardia en el que permanecen 24 horas de trabajo sin dormir).

A todos ellos se les midió la velocidad de los movimientos sacádicos del ojo antes y después de la guardia. Además, tuvieron que realizar pruebas simuladas de laparoscopia (también antes y después de este periodo de 24 horas trabajando).

Percepción subjetiva de fatiga

Los resultados demostraron que después de tantas horas de trabajo, la velocidad de los movimientos sacádicos efectivamente disminuyó y, además, aumentó su percepción subjetiva de fatiga. Sin embargo, en las pruebas simuladas de laparoscopia después de la guardia, la ejecución no se vio perjudicada de manera significativa por el cansancio.

Es decir, afortunadamente para los pacientes, el tiempo previo de trabajo no tuvo un impacto negativo sobre la pr√°ctica quir√ļrgica. Esto apoya la hip√≥tesis de que el cansancio de los profesionales de la salud no es la fuente √ļnica de los errores m√©dicos. Aunque las guardias impliquen trabajo sin descanso, los m√©dicos, en su ejercicio profesional, despliegan siempre todos los recursos a su alcance para obtener los mejores resultados. As√≠, se resalta la compleja relaci√≥n entre los cuidados continuos, la seguridad del paciente, factores econ√≥micos y los propios profesionales fatigados.

‚ÄúTambi√©n es cierto que esos otros recursos de la competencia profesional poco podr√°n hacer ante un exceso de horas de trabajo, por lo que estos resultados son fundamentales para ayudar a la regulaci√≥n de turnos y horarios, bas√°ndose en datos objetivos de fatiga y rendimiento‚ÄĚ, apuntan Leandro Luigi Di Stasi, investigador Fulbright en el Barrow Neurological Institute (Phoenix, EE UU), y Andr√©s Catena Mart√≠nez, director del Centro de Investigaci√≥n Mente, Cerebro y Comportamiento de la UGR.

Hace m√°s de una d√©cada, el Instituto Nacional de Medicina del Gobierno de EE UU public√≥ un informe titulado To Err Is Human: Building a Safer Health System, en el que se estim√≥ que los errores m√©dicos causaban, solo en aquel pa√≠s, entre 44 000 y 98 000 muertes y m√°s de un mill√≥n de lesiones y da√Īos cada a√Īo.

Aunque haya controversia alrededor de estas estimaciones de mortalidad, es evidente que los errores m√©dicos y los da√Īos accidentales ocurren demasiado frecuentemente. En particular, los errores consecuencia de la fatiga han sido identificados como uno de los factores que m√°s contribuyen a la ocurrencia de accidentes laborales. Recientemente, se ha estimado que los costes de estos accidentes (solo en EE UU) ascienden a 31,1 billones de d√≥lares.

Evitar los errores

En Espa√Īa, se estima que alrededor del 10% de los pacientes ingresados en hospitales sufren alg√ļn evento adverso como consecuencia de la atenci√≥n sanitaria, y alrededor del 50 % de estos errores podr√≠an ser evitados aplicando pr√°cticas cl√≠nicas m√°s seguras.

‚ÄúPor consiguiente, todas aquellas estrategias cuyo objetivo sea conocer los factores que disminuyen la seguridad del paciente est√°n en la agenda de diversas organizaciones internacionales, incluyendo la Organizaci√≥n Mundial de la Salud‚ÄĚ, apuntan Di Stasi y Catena.

Debido a que la existencia de turnos de trabajos muy prolongados y el uso de horas extraordinarias es cada vez m√°s habitual, especialmente entre los residentes, ‚Äúel estudio de la fatiga como un factor que contribuye a la posible prevenci√≥n de errores en el sistema sanitario se ha convertido en uno de los principales temas en la gesti√≥n de riesgos en este contexto‚ÄĚ.

Los resultados de este art√≠culo abren tambi√©n el debate sobre el n√ļmero de horas que los residentes pueden trabajar sin perjudicar la seguridad del paciente. Por ejemplo, en EE UU los residentes trabajan casi el doble de los residentes espa√Īoles o franceses (80 horas semanales frente a 40).

Además, los resultados de este estudio también tendrán aplicaciones en otras disciplinas similares a la Medicina en cuanto a gran volumen de conocimientos, la complejidad en la toma de decisiones y la complejidad técnica (como, por ejemplo, la aviación civil y militar).
julio 18/2014 (SNIC)

Leandro L. Di Stasi, Michael B. McCamy, Stephen L. Macknik, James A. Mankin, Nicole Hooft, Susana Martinez-Conde. Saccadic Eye Movement Metrics Reflect Surgical Residents’ Fatigue. Ann Surg. 2014 Apr;259(4):824-9. Abril 2014

Las medidas de los medicamentos para los ni√Īos pueden llevar a errores 23 Jul 2014


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Usar una cucharadita o una cucharada para administrar los medicamentos a los ni√Īos con frecuencia puede llevar a errores con la dosis del f√°rmaco, informa un estudio reciente.

coughLas indicaciones de los fármacos basadas en cucharadas o cucharaditas duplicaron las probabilidades de un padre de medir de forma incorrecta la dosis indicada, y también duplicaron el riesgo de no seguir la receta del médico con precisión, hallaron los autores del estudio.

“Usar preferentemente los mil√≠metros en las indicaciones sobre las dosis para los medicamentos l√≠quidos podr√≠a reducir la confusi√≥n de los padres y reducir los errores con los medicamentos, sobre todo para los grupos que est√°n en riesgo de cometer errores, como los que tienen pocos conocimientos b√°sicos sobre la salud y las personas que no hablan ingl√©s”, coment√≥ la autora l√≠der del estudio, la Dra. Shonna Yin, profesora asistente de pediatr√≠a de la Facultad de Medicina de la NYU en la ciudad de Nueva York.

Los hallazgos del estudio aparecen en la revista Pediatrics (doi: peds.2014-0395).

Cada a√Īo, hay m√°s de 10 000 llamadas a los centros de control de intoxicaciones debido a administrar a un ni√Īo la dosis incorrecta de medicamentos orales l√≠quidos, seg√ļn la informaci√≥n de respaldo incluida en el estudio.

Varios grupos han sugerido que los pediatras y los farmaceutas cambien a las dosis en milímetros para los pacientes jóvenes, entre ellos la Academia Americana de Pediatría (American Academy of Pediatrics), los Centros para el Control y la Prevención de Enfermedades (CDC) de EE. UU. y el Instituto para las Prácticas Farmacológicas Seguras (Institute for Safe Medication Practices).

Para averiguar si esto ayudaría, Yin y sus colaboradores observaron a 287 padres que suministraban un medicamento a sus hijos.

Los investigadores hallaron que, en general, el 39 % de los padres midieron de forma incorrecta la dosis deseada, y en √ļltima instancia, el 41 % cometieron un error al medir lo que su m√©dico hab√≠a recetado.

Los padres que usaron medidas en cucharadas o cucharaditas ten√≠an 2.3 veces m√°s probabilidades de servir la dosis incorrecta, y 1.9 veces m√°s probabilidades de no seguir la receta de forma precisa, se√Īalaron los investigadores.

Casi una tercera parte de los padres a los que se dieron indicaciones con dosis en cucharadas o en cucharaditas eligieron una cuchara de cocina, lo que hizo que hubiera 2.5 veces más probabilidades de que administraran la dosis errónea, advirtió el Dr. Ian Paul, vicepresidente asociado de investigación del departamento de pediatría del Colegio de Medicina de la Universidad Estatal de Pensilvania.

“Cuando se observa una cuchara de cocina, la cantidad que en realidad habr√° en la cuchara tiene menos probabilidades de ser exactamente la deseada”, dijo Paul. “Es menos probable que se vierta la cantidad adecuada en esa cuchara y que luego se administre a la boca del ni√Īo”.

La inexactitud de las cucharas de cocina se hace incluso m√°s preocupante dado que los f√°rmacos se recetan a los ni√Īos seg√ļn su peso, para asegurar que reciban una dosis precisa, coment√≥ Heather Free, farmaceuta de Washington D.C., y vocera de la Asociaci√≥n Americana de Farmaceutas (American Pharmacists Association).

Los ni√Īos son m√°s sensibles que los adultos a muchos f√°rmacos, y que la dosis sea incluso ligeramente err√≥nea puede conducir a problemas.

“Tan solo una cantidad min√ļscula, un mil√≠metro de m√°s, puede aumentar los niveles de toxicidad o no dar una dosis suficiente al paciente”, coment√≥ Free.

Algunos padres también tienen problemas para distinguir entre una cucharadita y una cucharada, o entre las abreviaciones cdta. (tsp., en inglés) y cda. (tbsp), apuntó Paul.

“No es tan f√°cil saber que la abreviaci√≥n quiere decir cucharadita, no cucharada, sobre todo para los padres con unos conocimientos b√°sicos de salud pobres”, plante√≥ Paul.

Para evitar los errores en la dosificación, algunas cadenas farmacéuticas emiten ahora las recetas pediátricas con instrucciones de dosificación en milímetros, y dan a los padres jeringas orales para medir cada dosis de forma precisa, dijo Free.

Free utiliza las dosis en mil√≠metros al emitir recetas para los ni√Īos, e incluso marca la dosis recetada en la jeringa oral de forma que los padres no tengan que intentar determinar la cantidad correcta con la mirada cada vez.

Los padres no deben tener miedo de pedirle al médico o farmaceuta que haga que la receta de su hijo sea más fácil de administrar, enfatizó Yin.

“Los padres deben pedir al m√©dico o al farmaceuta que les d√© la dosis en mil√≠metros en lugar de cucharaditas y cucharadas”, aconsej√≥. “Los padres tambi√©n deben asegurarse de usar un dispositivo para las dosis, como una jeringa oral, un gotero o una cuchara de dosificaci√≥n, en lugar de una cuchara de cocina, para medir la dosis”.

Las farmacias tienen dispositivos precisos para dosificar a mano, y deben proveerlos si se les piden, aseguró Free.

“Si el farmaceuta no lo provee, exhorto a los padres a pedirle al farmaceuta una de sus jeringas orales desechables, y asegurarse de saber bien c√≥mo usarla”, plante√≥.
julio 14/2014 (Medlineplus)

Yin HS, Dreyer BP, Ugboaja DC, Sanchez DC, Paul IM, Moreira HA.Unit of Measurement Used and Parent Medication Dosing Errors.Pediatrics. 2014 Jul 14.

 
 
 
Clínica Central Cira García
IPK (Instituto de Medicina Tropical)
IPK (Instituto de Medicina Tropical)
INOR
Instituto Nacional de Oncológica y Radiobiologia
Ciren
CIREN(Centro Internacional de Restauración Neurológica).
Centro de Salud La Pradera
Centro Internacional de Salud La Pradera
 
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