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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Hemos le&#237;do el art&#237;culo de Soc&#237;as Mir et al&#46; en el que analizan la evoluci&#243;n temporal de los ingresos por intoxicaci&#243;n en las unidades de cuidados intensivos espa&#241;olas &#40;UCI&#41;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a>&#46; Llama la atenci&#243;n que entre los 10 t&#243;xicos m&#225;s frecuentes haya varias drogas &#40;descontando etanol y benzodiazepinas&#41; en el periodo 2002-2006 que suman el 26&#44;7&#37; de los casos &#40;coca&#237;na 9&#37; casos&#44; an&#225;logos opioides 9&#37;&#44; hero&#237;na 5&#37; y metadona 3&#37;&#41;&#44; y que dicha prevalencia haya disminuido a menos de la mitad &#40;13&#44;2&#37;&#41; en el periodo 2013-2014&#44; con un cambio en la representaci&#243;n de las drogas m&#225;s prevalentes &#40;an&#225;logos opioides 6&#37;&#44; <span class="elsevierStyleItalic">cannabis</span> 4&#37; y coca&#237;na 4&#37;&#41;&#46; Aunque con un porcentaje peque&#241;o&#44; tambi&#233;n es destacable en el segundo periodo&#44; la presencia del <span class="elsevierStyleItalic">cannabis</span> como droga de ingreso en la UCI&#44; lo cual probablemente se relaciona con su progresivo aumento de potencia agonista sobre receptores CB1 y CB2&#44; su mayor prevalencia de consumo y el incremento de efectos secundarios a ello<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Dado que los servicios de urgencias hospitalarios &#40;SUH&#41; constituyen una buena atalaya para monitorizar estos cambios&#44; pues la mayor&#237;a de pacientes con eventos adversos de relevancia cl&#237;nica que ocurren en relaci&#243;n al consumo de drogas consultan a dichos servicios<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2&#44;3</span></a>&#44; desear&#237;amos comentar 2 registros multic&#233;ntricos en los que participamos&#44; donde se incluyeron prospectivamente pacientes intoxicados por drogas&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">En la red europea EuroDEN-Plus&#44; participan 2 hospitales espa&#241;oles &#40;Hospital Cl&#237;nic de Barcelona y Hospital Son Espases de Palma de Mallorca&#41;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a>&#46; Durante el periodo 2014-2018 se recogieron 43&#46;633 casos&#44; de los que 2&#46;982 proced&#237;an de estos centros&#46; Sesenta y un pacientes &#40;2&#44;0&#37;&#41; ingresaron en la UCI y 13 pacientes &#40;0&#44;44&#37;&#41; fallecieron&#46; Por otro lado&#44; la red REDUrHE es una red espa&#241;ola formada por 11 SUH de 6 comunidades aut&#243;nomas&#44; la cual registr&#243; 4&#46;526 pacientes atendidos por una urgencia generada por drogas entre 2017 y 2019<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a>&#44; de los que 90 &#40;2&#44;0&#37;&#41; ingresaron en la UCI y 12 &#40;0&#44;27&#37;&#41; fallecieron en el hospital&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> figuran las drogas implicadas en los casos de ingreso en la UCI y de fallecimiento&#44; y la frecuencia relativa con la que cada droga condujo a dichas situaciones&#46; Como indican Soc&#237;as Mir et al&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a>&#44; la mortalidad observada es muy elevada &#40;aunque disminuye al 6&#44;06&#37; en el periodo 2013-2014&#41;&#44; pudiendo inferir con las limitaciones obvias&#44; que la mortalidad en pacientes que ingresan en la UCI por una intoxicaci&#243;n por drogas es muy inferior a la mortalidad general por intoxicaciones&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Por otro lado&#44; en cuanto a la observaci&#243;n que realizan Soc&#237;as&#44; Mir et al&#46; sobre la probable presencia de pautas de consumo peligrosas&#44; como el etanol&#44; nuestro grupo hall&#243; en el registro REDUrHE&#44; en 3&#46;925 pacientes en los que se registr&#243; el consumo de alcohol et&#237;lico&#44; con una co-ingesta en el 58&#44;3&#37;&#44; que esta no influ&#237;a en la necesidad de ingreso en la UCI &#40;OH<span class="elsevierStyleSup">&#43;</span> 2&#44;2 vs&#46; OH<span class="elsevierStyleSup">&#8722;</span> 1&#44;9&#37;&#59; OR&#58; 1&#44;103&#59; IC 95&#37;&#58; 0&#44;688-1&#44;770&#41;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">En resumen&#44; no resulta frecuente que los pacientes atendidos en los SU por eventos adversos derivados del consumo de drogas precisen actualmente ingreso en la UCI&#44; y en caso de hacerlo&#44; la mortalidad es baja&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financiaci&#243;n</span><p id="par0030" class="elsevierStylePara elsevierViewall">Estudio financiado por la Delegaci&#243;n del Gobierno para el Plan Nacional sobre Drogas&#44; Secretar&#237;a de Estado de Sanidad&#44; Ministerio de Sanidad&#44; ref 2016&#47;072&#46;</p></span></span>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N&#46;&#176; ingreso UCI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Porcentaje ingreso UCI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N&#46;&#176; exitus&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Porcentaje exitus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Coca&#237;na&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;358&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;164&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Cannabis</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">968&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2&#46;011&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">24&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Anfetam&#237;nicos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">745&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">1&#44;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">294&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;48&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Benzodiazepinas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Frecuencias absolutas y relativas&#44; detalladas por grupos de drogas&#44; de pacientes que requirieron ingreso en unidad de cuidados intensivos y que fallecieron en los dos registros revisados</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:5 [
            0 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evoluci&#243;n de las intoxicaciones en las unidades de cuidados intensivos espa&#241;olas&#58; comparaci&#243;n de dos periodos"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Soc&#237;as Mir"
                            1 => "S&#46; Nogu&#233; Xarau"
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