ABSTRACT
AIM: The number of primary care paediatricians is decreasing in Europe without a justifiable reason. We aimed to compare the clinical practice of paediatricians and family doctors attending children and adolescents in primary care. METHODS: MEDLINE, Embase, CENTRAL, TRIP and Google Scholar were searched from December 2008 to February 2018. No language or study design restrictions were applied. Three reviewers assessed eligibility of the studies. Seven pairs of reviewers performed the data extraction and assessed the methodological quality independently. Discrepancies were resolved by consensus. RESULTS: Fifty-four, out of 1150 studies preselected, were included. We found that paediatricians show more appropriate pharmacology prescription patterns for the illness being treated; they achieve higher vaccination rates and have better knowledge of vaccines and fewer doubts about vaccine safety; their knowledge and implementation of different screening tests are better; they prescribe psychoactive drugs more cautiously and more in line with current practice guidelines; their evaluation and treatment of obesity and lipid disorders follow criteria more consistently with current clinical practice guidelines; and they perform fewer diagnostic test, show a more suitable use of the test and request fewer referrals to specialists. CONCLUSION: According to published data, in developed countries, paediatricians provide higher quality care to children than family doctors.
Subject(s)
Primary Health Care , Quality of Health Care , Adolescent , Child , Europe , Humans , Pediatricians , VaccinationABSTRACT
BACKGROUND: The undercarboxylated form of osteocalcin (ucOC) is an emerging marker of cardiovascular disease. It is unknown if ucOC in related to common cardiovascular risk markers in children. In offspring of families with and without metabolic syndrome (MetS+ and MetS- families), we assessed whether ucOC was related to a continuous metabolic syndrome score (MetS score) and to carotid intima-media thickness (cIMT). METHODS: ucOC and total OC, MetS score and cIMT were assessed in 203 asymptomatic prepubertal children (age 7.6 ± 0.1 yr; 49% girls), of whom 99 were from MetS+ families. RESULTS: In children from MetS+ families, percent ucOC was higher than in children from MetS- families (p < 0.01). In offspring from MetS+ families, higher ucOC and especially higher percent ucOC was independently associated with both the MetS score and cIMT (both p ≤ 0.01). CONCLUSIONS: The undercarboxylated form of OC is related to common cardiovascular risk markers in children at risk for cardiovascular disease.
Subject(s)
Cardiovascular Diseases/etiology , Metabolic Syndrome/complications , Osteocalcin/blood , Carotid Intima-Media Thickness , Child , Child, Preschool , Female , Humans , Male , Osteocalcin/metabolism , Risk FactorsSubject(s)
Humans , Polymyalgia Rheumatica/epidemiology , Primary Health Care/methods , Age of OnsetSubject(s)
Polymyalgia Rheumatica/epidemiology , Aged , Female , Humans , Male , Prevalence , Primary Health CareSubject(s)
Abortion, Induced , Contraception, Postcoital , Abortion, Legal , Female , Humans , Pregnancy , Pregnancy, Unwanted , SpainABSTRACT
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Humans , Contraception/methods , Emergency Medicine/methods , Contraceptive Agents/therapeutic use , Contraceptive Agents, Female/therapeutic use , Contraceptive Devices , Abortion, Induced/methods , Abortion, Induced/trends , Contraceptives, Postcoital/administration & dosage , Contraceptives, Postcoital/therapeutic use , Contraceptives, Oral/therapeutic useSubject(s)
Fibromyalgia/complications , Cross-Sectional Studies , Female , Humans , Male , Primary Health CareABSTRACT
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Humans , Comorbidity , Fibromyalgia/complications , Fibromyalgia/epidemiology , Mental Disorders/epidemiology , Rheumatic Diseases/epidemiologySubject(s)
Marijuana Abuse/epidemiology , Adolescent , Adult , Age Factors , Cross-Over Studies , Data Interpretation, Statistical , Female , Humans , Male , Prevalence , Sex Factors , Spain/epidemiology , Surveys and Questionnaires , Time FactorsABSTRACT
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Subject(s)
Humans , Marijuana Smoking/epidemiology , Marijuana Abuse/epidemiology , Primary Health Care/statistics & numerical data , Epidemiology, DescriptiveABSTRACT
Fundamentos: Los accidentes constituyen una patología poco estudiada en el ámbito de la Atención Primaria. Son una de las consultas más frecuentes en los servicios de urgencias y los Centros de Atención Primaria realizan la primera asistencia a la mayoría de los accidentados. Conocer la incidencia y las características clínico-epidemiológicas de los accidentes atendidos en una Área Básica de Salud puede aportar información sobre cuáles pueden ser susceptibles de actividades de prevención. Métodos: Diseño: estudio descriptivo. Emplazamiento: atención primaria. Muestra: todos los pacientes (389) que fueron atendidos por accidente en el Centro de Atención Primaria, entre octubre-98 y mayo-99. Variables: edad, sexo, lugar del accidente, tipo de lesión, localización, agentes implicados, intencionalidad, pruebas complementarias, tratamiento y derivación. Análisis estadísticos: estimación de medias, desviación estándar, estimación de proporciones e intervalos de confianza del 95 per cent. Resultados: Incidencia: 4,1 per cent (IC95 per cent: 3,7-4,5 per cent). Sexo: varones 59 per cent (IC95 per cent:54,2-64 per cent) y mujeres 40,9 per cent (IC95 per cent: 36-45,8 per cent). Edad: menores de 20 años, el 50,4 per cent (IC95 per cent:45,4-55,4 per cent);.Actividad de mayor accidentalidad: ocio 24,4 per cent (IC95 per cent: 20,2-28,7 per cent). Lugar: hogar 36,2 per cent (IC95 per cent: 31,5-41 per cent). Lesión más frecuente: contusiones 39,6 per cent (IC95 per cent:34,7-44,4 per cent).Localización más frecuente: extremidad superior 37,5 per cent (IC95 per cent: 32,7-42,3 per cent); Agente mayoritariamente implicado: herramientas y máquinas: 15,9 per cent (IC95 per cent:12,3-19,6 per cent). El 92,2 per cent (IC95 per cent: 89,3-94,7 per cent) fueron casuales. Tipo de visita: el 83,3 per cent (IC95 per cent: 79,6-87 per cent) fueron atendidos con carácter urgente; el 79,5 per cent (IC95 per cent:75,4-83,5 per cent) recibió tratamiento con cura y/o fármacos. El 9,8 per cent (IC95 per cent:6,8-12,7 per cent) requirió derivación hospitalaria, Un 13,3 per cent (IC95 per cent: 0-16,7 per cent) requirió pruebas complementarias. Conclusiones: El mayor porcentaje de accidentalidad se da en población joven, por lo que se evidencia la necesidad de incorporar intervenciones de educación sanitaria para la prevención de accidentes dirigidas a dicha población (AU)
