Background and importance Consumption of complementary and alternative medicine (CAMs) has increased among human immunodeficiency virus (HIV) patients. CAMs are of questionable safety and efficacy and may interact with antiretroviral treatment (ART). There are no data about the frequency of CAMs consumption in the Spanish HIV population. Aim and objectives This study aimed to explore CAMs consumption and drug-drug interactions (DDI) in a cohort of HIV patients. Material and methods Cross-sectional multicentre study conducted between June and November 2018 in nine Spanish hospitals. Data collected: demographics, current ART, adherence (patients' self-report), CAMs consumption, virological and immunological current status. A structured questionnaire was used to assess CAMs consumption. Identification of DDI was performed using the University of Liverpool database and classified in three categories: no clinically significant interaction, potential interaction requiring close monitoring/change (moderate) and contraindication (severe). Results 420 patients were included; 347 (82.6%) male, aged 47(±10.4) years; 337 (80.2%) Caucasian, 209 (49.8%) taking 86 different CAMs. Table 1 shows the characteristics of patients taking CAMs and the most consumed CAMs. Ninety (21.4%) patients took ≥3 CAMs and 34 (8.1%) took ≥5 CAMs. At least one DDI was identified in 34 (16.3%) patients, all being moderate. Most frequent CAMs involved in DDI were magnesium (n=8), multivitamins (n=7) and cat's claw (n=3). In 68 (79.1%) CAMs no information was found. View this table: Abstract 4CPS-255 Table 1 Conclusion and relevance A high frequency and variety of CAMs consumption was observed in the Spanish HIV population, with green tea, black tea, red tea, fish oil and ginger being the most consumed products. In 16% of patients a DDI with the ART requiring close monitoring/treatment change was detected. However, in almost 80% of CAMs no information about potentials DDI was found. These results highlight the need to provide adequate information about these products to HIV patients as part of their pharmaceutical care due to their unawareness of potential drug interactions. Conflict of interest No conflict of interest

ObjetivoEvaluar los resultados de la colocación de catéteres doble J con anestesia local para el manejo de distintas patologías ureterales.MétodosEstudio retrospectivo de 45 cateterismos ureterales consecutivos con anestesia local desde enero de 2015 hasta julio de 2016. Se incluyeron pacientes hemodinámicamente estables con una obstrucción o fístula urinaria o para la identificación ureteral durante una cirugía abdominopélvica. Cinco minutos antes del procedimiento se instilaron 10ml de gel-lidocaína y 50ml de suero-lidocaína en la vejiga. Se colocaron catéteres 4,8Fr mediante un cistoscopio flexible de 15,5Fr y escopia. Se analizaron las características y resultados de los procedimientos.ResultadosSe realizaron 45 procedimientos (33 colocaciones, 12 recambios) en 37 pacientes, de los cuales 40 (89%) fueron exitosos. Con una edad media de 58,6 años (±17,5), se intervinieron 10 hombres (27%) y 27 mujeres (73%). Las principales indicaciones fueron litiasis (37,8%), compresiones extrínsecas del uréter (28,9%) y la localización intraoperatoria ureteral (22,2%). Los intentos infructuosos fueron debidos a la incapacidad para ascender la guía/catéter en 4 casos (8,8%) o para identificar el meato ureteral en uno (2,2%). Ocho pacientes (17,8%) presentaron alguna complicación postoperatoria (7 Clavien I, uno Clavien IIIa). Ningún procedimiento se interrumpió por dolor. El análisis estadístico no encontró ningún factor predictor de éxito. El régimen ambulatorio fue 4 veces más barato.ConclusionesLa colocación de catéteres ureterales se puede realizar de forma eficaz y segura bajo anestesia local en el gabinete de cistoscopias. Este procedimiento podría ahorrar tiempo operatorio, reducir costes y minimizar los efectos secundarios de la anestesia general.

OBJECTIVE:To assess the outcomes of ureteral stent placement under local anesthesia for the management of multiple ureteral disorders. METHODS:Retrospective study of 45 consecutive ureteral stents placed under local anesthesia from January 2015 to July 2016. Inclusion criteria were hemodynamically stable patients with urinary obstruction, urinary fistula or for prophylactic ureteral localization during surgery. Five minutes before the procedure, 10ml of lidocaine gel and 50ml of lidocaine solution were instilled in the bladder. A 4.8Fr ureteral stent was placed using a 15.5Fr flexible cystoscope under fluoroscopic control. Characteristics of procedures and outcomes were analysed. RESULTS:A total of 45 procedures (33 placement, 12 replacements) were attempted in 37 patients, of which 40 (89%) were successful. There were 10 male (27%) and 27 female patients (73%) with a mean age of 58.6 years (±17.5). Main indications for stent placement were stones (37.8%), extrinsic ureteral compression (28.9%) and surgery ureteral localization (22.2%). The reasons for failing to complete a procedure were the inability to pass the guidewire/stent in 4 cases (8.8%) or to identify the ureteral orifice in 1 (2.2%). Postoperative complications occurred in 8 patients (17.8%) (7 Clavien I, 1 Clavien IIIa). No procedure was prematurely terminated due to pain. Statistical analysis did not find significant successful predictors. The outpatient setting provided a fourfold cost decrease. CONCLUSIONS:Ureteral stent placement can be safely and effectively performed under local anesthesia in the office cystoscopy room. This procedure could free operating room time, reduce costs and minimize side effects of general anesthesia.

Antibiotic dosing for patients with acute renal failure receiving continuous renal replacement therapy (CRRT) is a clinical challenge. The aim of this study was to investigate the pharmacokinetics of meropenem (M) during CRRT.

ObjetivosLa disfunción eréctil (DE) es un estado muy común entre la población. Está en clara relación con la hipertensión arterial (HTA), la diabetes mellitus (DM), la dislipemia (DLP) y el síndrome metabólico (SM). El objetivo del presente estudio es esclarecer si la presencia y severidad de la DE están en relación con el número de factores de riesgo cardiovascular (FRCV).Material y métodosAnalizamos retrospectivamente las características de 242 varones derivados a nuestro centro para la realización de biopsia prostática entre septiembre de 2007 y diciembre de 2009. Se recogieron prospectivamente las siguientes variables: edad, altura, peso, índice de masa corporal (IMC), HTA, DM, DLP y obesidad (IMC<30kg/m2). Para describir la función eréctil utilizamos el cuestionario Erection Hardness Score. Analizamos la relación entre la presencia y severidad de DE y la presencia de HTA, DM, DLP y obesidad. Analizamos las variables clínicas en función de la presencia o ausencia de DE y en relación con su severidad.ResultadosLa presencia de DE se relaciona con HTA (OR: 1,805 [1,128-2,887]; p=0,013), DM (OR: 3,585 [1,613-7,966]; p=0,001) y DLP (OR: 1,928 [1,062-3,500]; p=0,029). La función eréctil no se relacionó con obesidad (OR: 0,929 [0,522-1,632]; p=0,795). Los pacientes con DE eran más susceptibles de tener más FRCV (p=0,009) y la severidad de la DE se encontró en relación con HTA (p<0,001), DM (p<0,001), DLP (p=0,001) y el número FRCV (p<0,001).ConclusionesLa presencia y severidad de la DE se encuentra en relación con la HTA, la DM, la DLP y el número de FRCV.

Aim: Erectile dysfunction (ED) is a very common condition in the general population. ED is closely related to Hypertension (HT), Diabetes Mellitus (DM), Dyslipidemia (DLP) and Metabolic Syndrome (MS). This study has aimed to clarify whether the presence and severity of ED are related to the presence and number of cardiovascular risk factors (CVRF).Material and methods: We retrospectively analyzed the characteristics of 242 males referred to our center for a prostate biopsy from September 2007 to December 2009. The following variables were collected prospectively: age, height, weight, body mass index (BMI), AHT, DM, DLP and obesity (BMI < 30 kg/m(2)). The Erection Hardness Score Questionnaire was used to assess erectile function. We analyzed the relation between the presence and severity of ED and the presence of HT, DM, DLP and obesity. We analyzed the clinical variables based on the presence or absence of ED and in relationship to its severity.Results: The presence of ED was related to HT (OR: 1.805 [1.128-2.887]; p = 0.013), DM (OR 3.585 [1.613-7.966]; p = 0.001) and Dyslipidemia (OR: 1.928 [1.062-3.500]; p = 0.029). Erectile function was not related to Obesity (OR: 0.929 [0.522-1.632]; p = 0.795). Patients with ED were more likely to have more CVRF (p = 0.009) and the severity of ED was related to the presence of HT (p < 0.001), DM (p < 0.001), DLP (p = 0.001) and the number of CVRF (p < 0.001).Conclusions: The presence and severity of ED correlate with the presence of HT, DM, Dyslipidemia and the number of DVRF. (C) 2011 AEU. Published by Elsevier Espana, S.L. All rights reserved.

Testosterone deficiency syndrome (TDS) is a clinical and biochemical entity related to sexual and cardiovascular health. Hypertension, diabetes mellitus (DM), dyslipidemia and overweight are four clinical factors strongly related to cardiovascular illnesses. The aim of our study was to determine if the presence and number of cardiovascular risk factors was related to total testosterone levels and the presence of biochemical TDS. We retrospectively analyzed 384 patients referred to our center for prostate biopsy between September 2007 and December 2009. Variables age, height, weight, body mass index (BMI), tobacco use, alcohol intake, hypertension, DM, dyslipidemia (hypercholesterolemia/hypertriglyceridemia) and overweight (BMI>25) were recorded prospectively. Hormonal profile was determined as part of our clinical protocol. We used 231 and 346 ng dl −1 as total testosterone cut-points (8–12 nmol l −1 ) for diagnosis of biochemical TDS, following ISA-ISSAM-EAU Guidelines. We analyzed the relationship between testosterone levels and the presence of hypertension, DM, dyslipidemia and overweight, and with the number of these cardiovascular risk factors. Mean age was 66±8 years. Prevalence of TDS was 6.5% within the 231 ng ml −1 cutoff point and 28.4% for the 346 ng dl −1 cutoff point. Levels of testosterone were related to hypertension ( P =0.007), dyslipidemia ( P =0.013), overweight ( P =0.036) and the number of cardiovascular risk factors ( P =0.018). The prevalence of TDS in our population is comparable to data from international studies. Testosterone levels decrease as the number of cardiovascular risk factors rise.