[Detection of alpha-1 antitrypsin deficiency: A study on patients diagnosed with chronic obstructive pulmonary disease in primary health care]. / Detección del déficit de alfa-1 antitripsina: estudio en pacientes con enfermedad pulmonar obstructiva crónica diagnosticados en atención primaria.

The prevalence of chronic obstructive pulmonary disease (COPD) in Spain is 10.2%. Although tobacco is the main aetiological factor, biomass smoke exposure and alpha-1 antitrypsin deficiency (AATD) have also been related to its development. AATD is a genetic condition which could be causing 2-3% of COPD cases. The aim of this cross-sectional descriptive study was to exclude the existence of AATD in a population of COPD patients from CS Culleredo, A Coruña. The thick blood drop test on blotting paper, as well as the analysis of the mutations PI*S and PI*Z of the gene SERPINA 1 by the analysis of denaturing gradients after simultaneous amplification related to PCR (polymerase chain reaction). The study population included 80 patients between 40-80 years old, of whom 30% were carriers of a deficient allele (heterozygous), and 80% of them were the allele PiS. Only one PiSZ (1.25%) individual and no PiZZ was detected. This represents an allelic frequency of 3.1% (PiZ), and 13.1% (PiS). The detected allelic frequencies are higher than previously reported in the Spanish population. Severe AATD has been excluded in 98.75% of the study population. The Pi*SZ patient has been diagnosed in an early stage of the disease. We have also achieved one of the quality indicators recommended by GesEPOC. Our area has shown a high PiS and PiZ frequency, thus our study could be used as a reference for further research in the Galician population.

Factors leading to the removal of the intrauterine implant Gynefix.

OBJECTIVE: The objective of this study was to determine the incidence of expulsion of the Gynefix intrauterine implant, to analyze the variables associated with the above and to examine the efficacy of this intrauterine contraceptive model in users at the Municipal Family Planning Center-SERGAS in A Coruña, Spain. METHODS: A prospective observational study was performed on all women (n = 358) who had a Gynefix implant inserted from March 1998 to September 2000. RESULTS: The accumulated incidence of implant expulsion was 6.7% (95% confidence interval (CI) 4.4-9.9) with a pregnancy rate of 0.6% (95% CI 0.09-2.2). The probability of implant removal decreases with the rise in the number of implants that have been inserted by the professional. A multivariate analysis adjusted for age, number of implants and uterine position showed that the position of the uterus was the variable that independently determined the probability of removal. CONCLUSIONS: It is concluded that retroflexion of the uterus increases the probability of removal.

The importance of the removal of the intrauterine device in genital colonization by actinomyces.

OBJECTIVE: To determine whether, in addition to treatment with antibiotics, it is necessary to remove the intrauterine device (IUD) to eliminate genital colonization by Actinomyces. METHODS: A randomized clinical trial was carried out. Patients were divided into two groups. The intervention group did not have their IUDs removed, while the control group did. Both groups were treated with trimethoprim and sulfamethoxazole. A total of 43 patients were included. RESULTS: The patients from the intervention group and the control group proved to be comparable. The post-intervention cytology smear tested negative for Actinomyces in 100% of the patients whose IUD had been removed and in 66.7% of those whose IUD had not been removed (p = 0.005). The probability that colonization by Actinomyces will continue if the IUD is not removed is greater the longer the patient has been exposed to the IUD. After 24 months, relative risk (RR) = 2, after 36 months RR = 2.16 and after 48 months RR = 2.66. CONCLUSIONS: The removal of the IUD has been effective in genital colonization by Actinomyces. The protective effect exerted by the removal of the IUD was found to be greater in proportion to the length of time the patient had used it.

Eight years with the same IUD.

The purpose of this study was to determine the efficacy of the TCu380A (GYNET 380 IUD) in long-term users for periods of > 5 years and to obtain the incidence of Actinomyces as related to length of use and reasons for removal. The report is a retrospective descriptive study of all the clinical cases (n = 370 patients) at the Municipal Family Planning Centre-SERGAS A Coruña, Spain, of women who had a TCu380A IUD inserted during the period 1988-1989 with a September 1997 cutoff date for data analysis. A total of 271 (73.5%) patients had been using the TCu380A IUD for > 5 years with 100% efficacy. The accumulated incidence of Actinomyces was 5.9% (CI 95%: 3.8-8.9). The highest incidence was found between the second and third year of use. There was no increase in the incidence of Actinomyces after 5 years of use. The most common reason for removal of the IUD was the duration of use of 8 years with the same device (32.3%).

PIP: A retrospective study was carried out to determine the efficacy of the long-term use of TCu380A (GYNET 380 IUD) for a period of 5 years. The study also aimed to obtain the incidence of Actinomyces as it related to length of use and reasons for removal. Data were obtained from 370 clinical cases of patients who had been inserted with a TCu380A IUD (GYNET 380) between 1988 and 1989 at the Family Planning Centre-SERGAS A Coruna, Spain. Results revealed that a total of 271 patients had been using the TCu380A IUD for 5 years with 100% efficacy. The accumulated incidence of Actinomyces was 5.9%. Highest incidence was found between the 2nd and 3d year of use. There was no increase in the incidence of Actinomyces after 5 years of use. The duration of use--8 years with the same device--was the most common reason for removal of the IUD (32.3%).