ABSTRACT
AIM: To investigate the incidence rate of diagnosed coeliac disease among the paediatric population in the province of Cáceres and the changes over the years. METHODS: The incidence rate of diagnosed coeliac disease between the years 1981 and 1999, age at diagnosis and clinical presentation form were investigated. The study was carried out over two periods: A (1981 to 1990) and B (1991 to 1999). RESULTS: The incidence rate for period A was 6.87/100,000 (CI 95%: 5.26-8.83) and for period B 16.04/100,000 (CI 95%: 12.99-19.59) (p < 0.0001). The relative risk of receiving a diagnosis of coeliac disease during the first four years of life was 2.31% (CI 95%:1.61-3.31) greater in period B than in period A. The mean age at diagnosis was 37.4 +/- 47.4 mo and 43.9 +/- 43.7 mo in A and B, respectively (p = 0.0058). The typical clinical pattern was the most frequent (83.6% in A and 58.3% in B). The mean age of introduction of gluten to the diet was 4.6 +/- 2.0 mo and 6.9 +/- 1.7 mo, for period A and B, respectively (p < 0.0001). CONCLUSION: The incidence rate of coeliac disease has increased during the two periods studied. In recent years, the relative risk of receiving a diagnosis of coeliac disease during the first four years of life has increased. The atypical clinical presentation has also increased, although the typical clinical form is still the most frequent in younger children.
Subject(s)
Celiac Disease/diagnosis , Celiac Disease/epidemiology , Adolescent , Age Factors , Age of Onset , Celiac Disease/diet therapy , Child , Child, Preschool , Female , Humans , Incidence , Infant , Infant, Newborn , Male , Retrospective Studies , Socioeconomic Factors , Spain/epidemiology , Time FactorsABSTRACT
In this second article on subcutaneous venous access implants, the authors make an in depth presentation on how to handle these devices. The main topics which are covered include: nomenclature, indications, complications, how to set or implant this device and nursing treatment. Under the nursing treatment section, the authors explain care and maintenance, general regulations, what procedure to follow if one confronts an unusual resistance during an injection, fibrinolithic treatment, and the intraspinal system.
Subject(s)
Catheters, Indwelling , Catheterization/methods , Catheterization/nursing , Equipment Design , HumansABSTRACT
Chemotherapy treatment or the administering parenteral feeding requires permanent venous access during weeks, months or perhaps years. To have available an adequate venous access while treating gravely ill patients is fundamental in order to guarantee the perfusion of fluids blood transfusions administration of medicines, to supply intravenous feeding, to draw blood samples, etc. In this article, which will have a follow-up which concentrates on proper handling, the authors expose the reasons why subcutaneous venous access implants and used as well as how to deal with one of their main complications; extravasation. A bibliography will accompany the follow-up article.
Subject(s)
Catheterization, Central Venous , Catheters, Indwelling , HumansABSTRACT
The authors present a brief historical summary of the use of oxygen therapy in a patient's home from its start in 1970 to the present time, analyzing the controversies which have developed and the interest in oxygen therapy in a patient's home. For a review of the indications, initial evaluation, requirements and dose of this treatment, one should consult the article written by these authors published in Revista Rol de Enfermeria 2000; 23(4):257-261. In continuation, the authors explain the main nursing care which a patient receiving oxygen therapy at home requires, the circumstances which can compromise its efficiency, its secondary effects and complications, and the follow-up that is necessary to carry out on patients using this therapy.
Subject(s)
Community Health Nursing/organization & administration , Home Care Services/organization & administration , Oxygen Inhalation Therapy/methods , Oxygen Inhalation Therapy/nursing , Aftercare , Humans , Oxygen Inhalation Therapy/adverse effects , Risk FactorsABSTRACT
At the present time, it has been clearly demonstrated that at home oxygen therapy either on a long term basis or on a continuous basis brings important benefits for a patient: his/her physical and neuro-psychological conditions improve and his/her quality of life increases. However, given that this is some controversy about its indications, therapeutic effects and manner to administrate it, the authors review all these aspects, drawing from very up-to-date bibliographical references. At a later date, in another article, these same authors will evaluate nursing treatment corresponding directly to at home oxygen therapy.
Subject(s)
Home Care Services/organization & administration , Oxygen Inhalation Therapy/methods , Oxygen Inhalation Therapy/nursing , Humans , Lung Diseases, Obstructive/psychology , Lung Diseases, Obstructive/therapy , Oxygen Inhalation Therapy/adverse effects , Oxygen Inhalation Therapy/psychology , Patient Compliance/psychologyABSTRACT
BACKGROUND: To ascertain the use of drugs among the non-institutionalised elderly population, the factors related to polypharmacy and pinpointing the relationship thereof with chronic diseases. METHODS: Cross-sectional epidemiological study by means of door-to-door survey. The population systematically selected totalled 960 individuals age 65-93. The questionnaire included demographic data, self-assessed health condition, quantitative and qualitative aspects of the use of medications, chronic diseases and assessment of functional ability. RESULTS: 91.62% of those surveyed were taking medication, a greater number of females (p < 0.002) than males. The medications taken to the greatest extent were blood pressure drugs (42.4%), analgesics (38.7%) and heart drugs (24.8%). Drugs were used to a greater extent among the oldest age group (p < 0.0001), those having the lowest educational level (p < 0.001), those with impaired eyesight and hearing (p < 0001), those having the lowest social status (p < 001), more contacts with the health care services (p < 0001), worse self-assessed health condition (p < 0001), a greater number of chronic diseases (p < 0.0001) and depressive disorders (p = 0.004). The linear regression analysis revealed a positive relationship between the number of medications taken and the number of chronic diseases (r = 0.518; p < 0.0001). Females report worse health conditions (p < 0.05). The variables analyzed with regard to polypharmacy by means of logistic regression are age (over age 75; OR = 1.1478), three or more chronic diseases (OR = 1.83) and poor self-assessed health condition (OR = 1.22). CONCLUSIONS: Physical checkups on the elderly must include a review of the medications being taken, especially among those over age 75 who have a worse self-assessed health condition and a larger number of chronic diseases.
