Dolor abdominal y parada cardíaca. Una presentación inusual de hematoma de los rectos

Spontaneous hematoma of the rectus abdominis sheath is a cause of infrequent abdominal pain. Most common form of presentation is abdominal pain of sudden onset, followed by the finding of an abdominal mass. In the case of large bruises these can cause symptoms and signs derived from hypovolemia. Anticoagulant therapy is considered the most frequent risk factor, especially if the patients are elderly women whose onset of symptoms appeared after a coughing attack. We present a case of a spontaneous straight hematoma sheath presenting as a sudden cardiac arrest that ultimately caused the death of the patient.El hematoma espontáneo de la vaina del recto abdominal es una causa de dolor abdominal infrecuente. Su forma más común de presentación es dolor abdominal de inicio súbito, seguido del hallazgo de una masa abdominal. En el caso de hematomas grandes, éstos pueden causar síntomas y signos derivados de la hipovolemia. La terapia anticoagulante se considera el factor de riesgo más frecuente, especialmente si los pacientes son mujeres de edad avanzada y los síntomas aparecieron después de un ataque de tos. Presentamos un caso de hematoma espontáneo de la vaina del recto cuya presentación fue un paro cardíaco repentino que, finalmente, causó la muerte del paciente

Attitudes towards anti-smoking legislation and prevalence of tobacco consumption in Spanish primary healthcare personnel

Introduction Our aim was to ascertain how the anti-smoking legislation of 2005/2010 has affected the behavior of primary healthcare center (PHC) personnel (medical and nonmedical) with respect to their attitudes towards tobacco, its consumption and the legislative changes. Methods The sample consisted of 2040 PHC employees (1578 women, 77.4%). Never smokers, ex-smokers, and smokers represented 46.7%, 37.8%, and 15.5% of the sample, respectively. Tobacco prevalence amongst physicians and nurses was 12.3%. Following the introduction of the antismoking legislation, a decrease in consumption was observed. Most of the participants considered that tobacco consumption affected health, was an addictive illness, and passive smoking had an impact on the health of non-smokers. Whilst 91.6% agreed with the current legislation, only 25% felt that it encouraged cessation. Results The sample was made up of 2040 PHC employees (1578 women; 77.4%). Never smokers, ex-smokers, and smokers represented 46.7%, 37.8%, and 15.5%, respectively. Tobacco prevalence amongst physicians and nurses was 12.3%. Following the introduction of the anti-smoking legislation a decrease in consumption was observed. Most of the participants considered that tobacco affected health, was an addictive illness, and passive smoking had an impact on the health of non-smokers. Whilst 91.6% agreed with the current legislation, only 25% felt that it encouraged cessation. Conclusions Spanish primary healthcare professionals have a relatively low prevalence of smoking compared to the general population. It is necessary to implement more legislative measures to improve and maintain this outcome