ABSTRACT
OBJETIVOS. Se intenta ver el grado de control de pacientes con diabetes mellitus tipo 2 (DM2) en el momento de inclusión en el programa de DM2 y en el momento actual. También se analizan la evolución de los factores de riesgo cardiovascular asociado, las complicaciones y la evolución de los tratamientos pautados. MÉTODOS. Es un estudio retrospectivo bietápico realizado en un centro de salud urbano. De un total de 751 pacientes hemos obtenido una muestra de pacientes con un seguimiento mínimo de 1 año. Realizamos un estudio descriptivo en donde se ha visto el grado de control inicial y en el momento actual según los criterios del Grupo Cardiovascular de la Sociedad Española de Diabetes, así como las complicaciones en el tiempo de seguimiento y el tratamiento puesto. También se han analizado los factores de riesgo cardiovascular asociados a DM2. RESULTADOS. Nos encontramos una escasa mejoría de los parámetros sometidos a control a pesar del incremento de tratamientos puestos. Vemos además un aumento de las complicaciones. CONCLUSIONES. Hay que valorar la eficacia de los tratamientos disponibles frente a la DM2 y establecer criterios de su adecuado uso. Se deben evaluar también los resultados, no sólo el proceso (como ocurre actualmente). Es conveniente orientar la Atención Primaria hacia el control de patologías crónicas que son las que más morbimortalidad y gasto de recursos generan
OBJECTIVES. An attempt is made to see the degree of control of patients with type 2 diabetes mellitus (DM2) on enrolment in the DM2 program and at present. The evolution of the associated cardiovascular risk factors, complications and evolution of the treatments prescribed are also analyzed. METHODS. It is a retrospective bi-stage study conducted in an urban health care center. We have obtained one sample of patients with a minimum follow-up of 1 year out of a total of 751 patients. We performed a descriptive study in which the degree of initial and current control was seen according to the criteria of the Cardiovascular Group of the Spanish Society of Diabetes and the complications in follow-up time and treatment given. Cardiovascular risk factors associated to DM2 have also been analyzed. RESULTS. We found a limited improvement of the parameters subjected to control in spite of increase of treatments given. We also see an increase in complications. CONCLUSIONS. It is necessary to evaluate the efficacy of the treatments available for the treatment of DM2 and establish criteria for their adequate use. The results should also be evaluated, not only the disease (as presently occurs). It is necessary to orient the Primary Care towards control of chronic diseases that are those which generate more morbidity-mortality and use of resources
Subject(s)
Male , Female , Adult , Aged , Middle Aged , Aged, 80 and over , Humans , Diabetes Mellitus/therapy , Cardiovascular Diseases/etiology , Cardiovascular Diseases/prevention & control , Follow-Up Studies , Retrospective Studies , Risk Factors , Cross-Sectional StudiesABSTRACT
INTRODUCTION: The damage caused to the central nervous system by lightning can be immediate or delayed. Cerebrovascular accidents are usually an infrequent complication of lightning strikes. CASE REPORT: We report the case of a patient who was hit by lightning and then developed an acute bilateral intraparenchymatous haemorrhage in the basal ganglia and the left internal capsule. DISCUSSION: Few cases of intracranial haemorrhages secondary to lightning strikes have been reported. We carry out a review and analysis of the literature currently available on the subject. A number of theories have been put forward that attempt to explain the mechanism behind these haemorrhages in patients who have been hit by lightning. The reason why there is a predilection for the basal ganglia is unknown, although it could be linked to the particular features of the vascularisation of the area.
Subject(s)
Intracranial Hemorrhages/etiology , Lightning Injuries/complications , Basal Ganglia/pathology , Humans , Intracranial Hemorrhages/pathology , Lightning Injuries/pathology , Male , Middle Aged , Trauma, Nervous System/etiology , Trauma, Nervous System/pathologyABSTRACT
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