the main mechanisms of injury among the combat casualties treated in the Spanish Role 2 in Herat, although the casualties
with gunshot wounds presented more severe injuries. Our results regarding the distribution of the mechanisms of injury are
similar to those published in other series; however, a consensus has not been found in the current literature in which the injury
severity of combat casualty has been related to the mechanisms of injury.
KEYWORDS: combat casualty, mechanisms of injury, injury severity score, Role 2, Spanish Medical Corps, Afghanistan.
198 Daptomycin prescription-indication study in Hospital Central de la Defensa «Gómez Ulla»
Carvajal-Fernández A., Fernández-García M., Aparicio-Hernández RM., García-Luque A.
SUMMARY: Introduction: Daptomycin is a bactericidal antimicrobial, active against gram-positive bacteria; indicated by
summary product characteristics (SmPC) in the treatment of complicated skin and soft tissue infections, right infective endocarditis
caused by S. aureus, and S. aureus bacteremia if it is associated with one of them. However, daptomycin is also
prescribed in other indications, or other doses than those approved, arising the need to analyze its use. Patients and methods:
Design: drug utilization study of the type prescription-indication, retrospective; in Hospital Central de la Defensa “Gómez
Ulla”, from July 15 to October 31, 2019. Objective: to know indications and the use of daptomycin. Sampling and sample size:
consecutive non-probabilistic, N = 30. Ad hoc preparation of the data collection logbook, including clinical, demographic
and pharmacological characteristics. Karch and Lasagna’s modified algorithm to determine the causal relationship of adverse
drug reactions suspicion. Descriptive statistical analysis with SPSS 25.0 program. Results: In 87% (26/30) of the cases the indication
was adapted to SmPC; complicated skin and soft tissue infections and bacteremia were the most prevalent indications.
Despite the recommendations in the SmPC, 17% (5/30) of the patients had a creatinine clearance less than 30 ml/min, but
there was no renal adjustment of the dose regimen, and in 64% (19/30) of the cases there was no CPK control. There was one
case of an increase in CPK with a “probable” causality relationship. Conclusions: Absence of significant deviations from the
indications of daptomycin. The need for informative intervention regarding safety is objectified: a) adjustment according to
the patient’s renal function and b) control of CPK levels before and during treatment.
KEYWORDS: Daptomycin, drug utilization study-daptomycin, Staphylococcus aureus-daptomycin, Central Defense Hospital
«Gómez Ulla»-daptomycin, renal failure-daptomycin, CPK-daptomycin.
SHORT COMMUNICATION
203 From primary care to hospital emergency: on the subject of a case
Mora-Martínez H., Serrano-Moreno A.C., Alcalde-López S., Lou-Calvo E., Sánchez-Casas S.
SUMMARY: Some serious pathologies can go unnoticed depending on the perception of each person. Many times patients
conceive disease differently depending on their background or their own health determinants, which can make illness to be
overlooked until it is too late.
Mediastinitis is a serious and infrequent infection, which presents unspecific symptoms for the patient. However, it can end up
affecting vital structures and having a poor prognosis if it is not diagnosed and treated in time.
For all this, a comprehensive and directed anamnesis, as well as individualized patient care and knowledge of their background
and characteristics are essential for the doctor when guiding, diagnosing and treating each person.
Only in this way will we be able to discern the severity in each situation, regardless of whether it may seem futile at first to both
the doctor and the patient himself.
KEY WORDS: Disease, seriousness, background, mediastinitis, health determinants.
207 Patent foramen ovale closure in a military patient: Case presentation and revision of the literature
Marschall A., Martí-Sánchez D., López-Soberón E., Goncálvez-Sánchez F., Álvarez-Antón S., Navarro-Suay R.
SUMMARY: Currently, the most prevalent indication in order to close a patent foramen ovale is cryptogenic stroke. However,
in the military environment, several special circumstances (tactical, medical and legal) may generate the need for a treatment
outside the cryptogenic stroke context. We present a case of a patent foramen ovale closure in a military member.
KEYWORDS: Patent foramen ovale, cardiology, military.
TECHNICAL NOTE
211 Positive assessment of drugs: from March, April, May, June and July of 2021
Silva-Cuevas M.A., Aparicio-Hernández RM., Sánchez-López P., Prats-Oliván P.
SUMMARY: The drugs assessed by the Spanish Agency for Medicines and Health Products or European Medicines Agency
made public from March to July of 2021, and considered of interest to the healthcare professional, are reviewed. These are
positive technical reports prior to the authorization and placing on the market of the product.
KEYWORDS: avalglucosidasa alfa (nexviadyme®); azacitidina (onureg®); azatioprina (jayempi®); duvelisib monohidrato
(copiktra®); elivaldogen autotemcel (skysona®); estetrol/drospirenona (drovelis y lydisilka®); evinacumab (evkeeza®); hidrocortisona
(efmody®); idecabtagene vicleucel (abecma®); imatinib (imatinib koanaa®); mesilato de tirbanibulina (klisyri®);
odevixibat (bylvay®); pitolisant (ozawade®); ponesimod (ponvory®); relugolix/estradiol/acetato de noretisterona (ryeqo®);
roxadustat (evrenzo®); satralizumab (enspryng®); selumetinib (koselugo®); setmelanotida (imcivree®); tafasitamab (minjuvi®);
tralokinumab (adtralza®); vericiguat (verquvo®); vosoritida (voxzogo®).
REPORT
218 1.er Congreso de Sanidad Militar de la Unión Europea. Una apuesta de éxito
Pérez-Romero, A, Zamanillo-Sainz, A.
SUMMARY: Between the 6th and the 8th of October 2021, at the facilities of the Spanish National Defence Studies Centre
(CESEDEN), the 1st EU Congress on Military Health Services was held. International Congress designed with the aim of
analysing the role of the EU Military Health Services in support of civilian authorities during the pandemic, operational
176 Sanid. mil. 2021; 77 (4)