ABSTRACT
Entre los simples vómitos gestacionales y la HG existe una multitud de cuadros con grados de intensidad intermedios, sin que se observen claras diferencias etiopatogénicas. Las náuseas y vómitos de la gestación (NVG) son una situación fisiológica frecuente en la embarazada. Suelen ser esporádicos, preferentemente matutinos, con capacidad de alterar la calidad de vida de la gestante pero sin repercusión en su estado metabólico. Cuando el cuadro se agrava presentando vómitos continuos e intensos que imposibilitan la correcta alimentación de la gestante nos encontramos ante una hiperemesis gravídica (HG), que puede llevar a un cuadro de deshidratación, deficiencias nutricionales y alteración metabólica, requiriendo en muchas ocasiones tratamiento hospitalario para corregir las alteraciones hidroelectrolíticas presentes y múltiples complicaciones tanto digestivas como neurológicas(AU)
Nausea and vomiting in pregnancy is a common physiological condition in pregnant women. It is usually sporadic, often in the morning, which can affect the quality of life of the pregnant woman without any change in her metabolic state. When the condition is aggravated, with continuous and intense vomiting which makes it impossible to follow a correct diet, we are faced with a hyperemesis gravidarum (HG) which can lead to dehydration, nutritional deficiencies and metabolic changes. On many occasions this may require hospital treatment to correct the water and electrolyte changes and the multiple digestive tract and neurological complications. There is a multitude of conditions between simple gestational vomiting and HG with intermediate levels of intensity, without any clear differences in pathological origin(AU)
Subject(s)
Humans , Female , Pregnancy , Education, Continuing/methods , Signs and Symptoms/methods , Signs and Symptoms , Morning Sickness/complications , Hyperemesis Gravidarum/complications , Dehydration/complications , Dehydration/diagnosis , Quality of Life , Antiemetics/therapeutic use , Evidence-Based Medicine/methods , Morning Sickness , Hyperemesis Gravidarum/therapy , Hyperemesis Gravidarum/diagnosis , Morning Sickness/diagnosisABSTRACT
AIM: To describe the clinical practice in antithrombotic therapy to prevent stroke in older patients with atrial fibrillation (AF). DESIGN: Cross-sectional study. SETTING: Ourense's area with 95,840 inhabitants over 65 years. PARTICIPANTS: Patients over 65 with non rheumatic AF, chronic or paroxistic; 411 cases, 69.6% older than 75 year. MAIN MEASUREMENTS: Demographic characteristics, personal history, stroke risk, diagnostic characteristics of AF, antithrombotic treatment, and its adequacy. RESULTS: Only 33% high risk patients received oral anticoagulation (OCA) with warfarin at diagnosis. Some features were found to be significant independent risk factors for OCA: age (older than 75 vs 65-74 years; odds ratio =0.32; 95% confidence interval, 0.18-0.59), and prior stroke (odds ratio =2.02; 95% confidence interval, 1.16-3.55). CONCLUSIONS: Warfarin prophylactic is insufficiently prescribed, especially in older than 75 years (with high baseline risk of stroke and no counter-indications). There was inadequate prescription in 73.4% cases.
Subject(s)
Anticoagulants/therapeutic use , Atrial Fibrillation/complications , Stroke/prevention & control , Warfarin/therapeutic use , Administration, Oral , Age Factors , Aged , Anticoagulants/administration & dosage , Atrial Fibrillation/drug therapy , Confidence Intervals , Cross-Over Studies , Data Interpretation, Statistical , Drug Prescriptions , Humans , Hypertension/complications , Odds Ratio , Risk Factors , Warfarin/administration & dosageABSTRACT
Objetivo. Analizar las pautas de profilaxis antitrombótica en pacientes con fibrilación auricular (FA) mayores de 65 años y su adecuación a la evidencia. Diseño. Estudio transversal. Emplazamiento. Área de salud de Ourense, con 95.840 habitantes mayores de 65 años. Participantes. Personas mayores de 65 años con FA no reumática, crónica o paroxística (411 casos; un 69,6% mayor de 75 años). Mediciones principales. a) Variables sociodemográficas, antecedentes personales y riesgo de accidente cerebrovascular (ACV), y b) características diagnósticas de la FA, tratamiento antitrombótico prescrito y adecuación a la evidencia científica. Resultados. En el momento del diagnóstico se prescribió anticoagulación oral (ACO) al 33% de los casos con riesgo alto. La probabilidad de recibir ACO se modificó por la edad (mayores de 75 años frente al grupo de 65-75 años; odds ratio, 0,32; intervalo de confianza del 95%, 0,18-0,59) y por la presencia de ACV previo (odds ratio, 2,02; intervalo de confianza del 95%, 1,16-3,55). Conclusiones. Resulta insuficiente la prescripción de ACO profiláctica, sobre todo en los mayores de 75 años con riesgo alto de ACV y baja frecuencia de contraindicaciones; el porcentaje de inadecuación es del 73,4% en este grupo
Aim. To describe the clinical practice in antithrombotic therapy to prevent stroke in older patients with atrial fibrillation (AF). Design. Cross-sectional study. Setting. Ourense's area with 95 840 inhabitants over 65 years. Participants. Patients over 65 with non rheumatic AF, chronic or paroxistic; 411 cases, 69.6% older than 75 year. Main measurements. Demographic characteristics, personal history, stroke risk, diagnostic characteristics of AF, antithrombotic treatment, and its adequacy. Results. Only 33% high risk patients received oral anticoagulation (OCA) with warfarin at diagnosis. Some features were found to be significant independent risk factors for OCA: age (older than 75 vs 65-74 years; odds ratio =0.32; 95% confidence interval, 0.18-0.59), and prior stroke (odds ratio =2.02; 95% confidence interval, 1,16-3,55). Conclusions. Warfarin prophylactic is insufficiently prescribed, especially in older than 75 years (with high baseline risk of stroke and no counter-indications). There was inadequate prescription in 73.4% cases
