[Results of pulmonary embolism treatment in a tertiary hospital short stay unit. Is this the right place?]. / Resultados del tratamiento médico de la embolia de pulmón en una unidad de corta estancia de un hospital de tercer nivel: ¿es el lugar adecuado?

OBJECTIVES: To determine the mean stay (MS) of patients with pulmonary embolism (PE) in a thrombosis unit (TU) with a short stay unit (SSU) in a tertiary hospital. To compare the data collected with those of other hospitals in the same region, of other regions (Autonomous Communities [AACC]), and within the same hospital in the year before the SSU opened. MATERIAL AND METHODS: A descriptive retrospective observational study that included patients with a diagnosis of PE in the University Hospital Virgen de la Arrixaca (HCUVA) in 2012. These data were classified by hospital department, and used for calculating the mean stay. This was then compared with that of other hospitals in our region, with the rest of the regions, and with the data in 2007 (the last year without a TU). RESULTS: A total of 113patients with PE were included, 60 (53%) in the TU with an MS of 4.39, in Oncology, 7.45, and Internal Medicine (IM), 15.38days. There were no deaths in the TU and only 3 (5%) readmissions. Published data showed that the MS in all hospitals in our region was 8.25, 5.18 in our hospital, and higher in the rest of hospitals. The best AACC was the Basque Country with an MS of 6.85days. In 2007, there were 70patients with PE in the HCUVA, 34 (49%) in IM, with an MS of 8.50, Oncology 11 (31%) with an MS 9.64, and Chest Diseases 3 (4.3%) with an MS 19days, and with an overall mortality of 11% and a rate of readmissions in IM of 6%. CONCLUSION: The mean stay for a PE in the SSU of a TU was lower than in the rest of the hospital departments, lower than the rest hospitals of our region, lower than the rest of the regions, and lower than any department of our hospital before the SSU existed, without increasing the readmission or mortality rate.

[Reasons for anxiety in primary care professionals. A resident-tutor comparison]. / Motivos de ansiedad en los profesionales de atención primaria. Comparación residentes-tutores.

OBJECTIVES: 1) To find the reasons for PC professionals' anxiety when going about their normal work. 2) To check whether training and experience affect the assessment of the reasons of Family Doctors for anxiety. DESIGN: A descriptive study using a questionnaire. SETTING: PC health centres with second-year family and community medicine (FCM) residents from the Murcia Teaching Unit. PARTICIPANTS: All second-year FCM residents from the Teaching Unit (28) in December 1995 and their tutors. MEASUREMENTS: Open questionnaire based on three points: Causes of anxiety in on-demand consultations; causes of anxiety in scheduled consultations; other reasons for anxiety connected with the Health Centre. RESULTS: The three most anxiety-producing causes in relation to each question were: a) on-demand consultation: residents (R)--unfinishable consultations, lack of time, clinical problems; tutors (T)--unfinishable consultations, a lot of patients waiting outside, manipulative patients. b) Scheduled consultation: R--clinical problems, consultation too long, difficulties in reaching a solution; T--consultation too long, patients without an appointment and interruptions in the middle of the consultation. c) Other reasons for anxiety: R--not being off the day after being on call, having to do research work, and emergency calls; T--emergency calls, research work and temperature problems. CONCLUSIONS: Clinical problems are the causes of anxiety with the greatest difference between tutors and residents. Regulated training in the health centre and professional experience seem to act positively on some of the causes of anxiety.

[Research in action. How to assist the integration of residents of family and community medicine in health centers]. / Investigación en la acción. Cómo facilitar la incorporación de los residentes de MFyC al centro de salud.

OBJECTIVES: To find the causes of worry in second-year family and community medicine (FCM) residents on their arrival at health centres. DESIGN: A descriptive study. A survey with 4 questions on difficulties found in the on-demand clinic, in consultations by appointment, other causes of anxiety and problems foreseen a priori. SETTING: Health centres in the Murcia Region with second-year FCM residents. PARTICIPANTS: All the second-year FCM residents (28) on their arrival at health centres in November, 1995. RESULTS: The three points of most concern to residents were: 1. On-demand clinic: unfinishable consultations, lack of time and clinical problems. 2. Consultations by appointment: clinical problems, over-long consultations and difficulties in resolving the consultations. 3. Other causes of anxiety: not having the day off after being on call, research work and emergencies. 4. Problems foreseen a priori: a lot of patients in a short time, not creating problems for the tutor and unemployment at the end of the residency. CONCLUSIONS: The short time to attend each patient and clinical problems are what cause most difficulty. This was the first time the difficulties residents had to integrate into Health Centres were surveyed. The initiative was greatly appreciated by them.