ABSTRACT
OBJECTIVE: To study the efficacy, tolerance and safety in primary care of the cryotherapy technique using nitrous oxide. Design. Descriptive, observational and transversal study. SETTING: Mariñamansa-A Cuña Health Centre, Ourense. PARTICIPANTS: All the patients who consulted for cutaneous lesions caused by cryotherapy between March and April 2000 (n=130). MAIN MEASUREMENTS: Age, sex, diagnosis, location, size of lesion, duration of application of the cryogenic agent, previous treatment, side-effects observed, and evolution of the lesion. RESULTS: Mean age was 36.65 (95% CI, 32.57-40.74), of whom 53.8% (95% CI, 44.80-62.50) were women. The most common lesions were common warts (68.5%), actinic Keratosis (12.3%) and plantar warts (7.7%). We found that most lesions were located on an upper limb (50.8%). The mean size of lesions was 8.65 mm2 (95% CI, 4.50-12.80). 69.7% of warts were scraped prior to cryotherapy; and 16.2% received prior keratolysis. We found no side-effects in 32.3% of the patients; the commonest side-effect detected was blisters. Mean number of cryotherapy sessions was 2.82 (95% CI, 2.39-3.29). The technique was tolerated well in 83.8% of cases. We found total cure in 87.7%. Most of the cutaneous lesions that failed were common warts. CONCLUSIONS: Nitrous oxide is effective in most lesions caused by cryotherapy. The technique is tolerated well, can be handled easily and can be used in primary care.
Subject(s)
Cryotherapy , Nitrous Oxide , Skin Diseases/therapy , Adult , Cross-Sectional Studies , Female , Humans , Male , Primary Health CareABSTRACT
Objetivo. Estudiar la eficacia, tolerancia y seguridad de la técnica de crioterapia con óxido nitroso en atención primaria. Diseño. Estudio descriptivo observacional, transversal. Emplazamiento. Centro de Saúde Mariñamansa-A Cuña, Ourense. Participantes. Todos los pacientes que consultaron por lesiones cutáneas subsidiarias de crioterapia entre marzo y abril de 2000 (n = 130).Mediciones principales. Edad, sexo, diagnóstico, localización, tamaño de la lesión, tiempo de aplicación del agente criogénico, tratamiento previo, secundarismos observados y evolución de la lesión. Resultados. La edad media fue de 36,65 años (IC del 95 per cent, 32,57-40,74); un 53,8 per cent (IC del 95 per cent, 44,80-62,50) eran mujeres. Las lesiones más frecuentes fueron verrugas vulgares (68,5 per cent), queratosis actínica (12,3 per cent) y verrugas plantares (7,7 per cent).Observamos que la mayoría de las lesiones se localizó en miembro superior (50,8 per cent). El tamaño medio de las lesiones fue de 8,65 mm2 (IC del 95 per cent, 4,50-12,80). Se realizó raspado previo a la crioterapia en el 69,7 per cent de las verrugas y un 16,2 per cent recibió queratolítico previo. No observamos secundarismos en el 32,3 per cent de los pacientes; de los secundarismos detectados el más frecuente fue la ampolla. La media de sesiones de crioterapia fue de 2,82 (IC del 95 per cent, 2,39-3,29). La técnica fue bien tolerada en el 83,8 per cent de los casos. Obtuvimos una curación global de un 87,7 per cent; las lesiones cutáneas que fracasan son sobre todo verrugas vulgares. Conclusiones. El óxido nitroso es eficaz en la mayoría de los lesiones subsidiarias de crioterapia y es una técnica bien tolerada y de fácil manejo que puede aplicarse en atención primaria (AU)
Subject(s)
Adult , Male , Female , Humans , Cryotherapy , Nitrous Oxide , Skin Diseases , Primary Health Care , Cross-Sectional StudiesABSTRACT
OBJECTIVE: To assess the effect of stressful life events (SLE) on the monitoring of patients with essential hypertension. DESIGN: Observational and prospective. SETTING: Primary care. PARTICIPANTS: 236 hypertense patients selected by systematic randomised sampling. MEASUREMENTS: Age, sex, marital status, cultural level, kind of family, presence of SLE, social support, blood pressure, severity of hypertension, tobacco consumption, alcohol, presence of diabetes, hypercholesterolaemia, body mass index, compliance with hypertension treatment. RESULTS. Mean age was 63.51 (62.05; 64.96), with 66.1% being women and 33.9% men. 48.7% of the patients referred to some SLE during the follow-up. These reached a mean of 47.65 (33.16; 62.15) life change units (LCU). Patients with high-impact SLE (>150 LCU) had a significant increase of 10.91 mm Hg (0.43; 21.40) in their systolic blood pressure and of 9.48 beats per minute (3.78; 15.19) in their heart rate, after monitoring for possible factors of confusion. We observed a similar trend for diastolic pressure, but this did not reach statistical significance. CONCLUSION: The presence of SLE has a negative effect on systolic blood pressure in hypertense patients.
Subject(s)
Adaptation, Psychological/physiology , Cardiovascular Physiological Phenomena , Cardiovascular System/physiopathology , Hypertension/physiopathology , Life Change Events , Stress, Psychological/physiopathology , Aged , Female , Heart Rate/physiology , Humans , Male , Middle Aged , Prospective StudiesABSTRACT
Objetivo. Valorar el efecto de los acontecimientos vitales estresantes (AVE) sobre el control de pacientes con hipertensión arterial esencial. Diseño. Observacional y prospectivo. Emplazamiento. Atención primaria. Participantes. Un total de 236 hipertensos seleccionados por muestreo aleatorio sistemático. Mediciones. Edad, sexo, estado civil, nivel cultural, tipo de familia, presencia de AVE, apoyo social, presión arterial, gravedad de la hipertensión, consumo de tabaco, alcohol, presencia de diabetes, hipercolesterolemia, índice de masa corporal y cumplimiento del tratamiento antihipertensivo. Resultados. La media de edad fue de 63,51 años (62,05-64,96), siendo la mayoría mujeres (66,1 por ciento). Un 48,7 por ciento de los pacientes refirieron algún AVE durante el seguimiento, y éstos alcanzaron una media de 47,65 (33,16-62,15) unidades de cambio vital (LCU). Los pacientes con AVE de alto impacto (>150 LCU) presentaron un incremento significativo de 10,91 mmHg (0,43-21,40) en la presión arterial sistólica y de 9,48 lat/min (3,78-15,19) en la frecuencia cardíaca, tras controlar por los posibles factores de confusión. Asimismo, observamos una tendencia similar respecto de la presión arterial diastólica, pero sin alcanzar significación estadística. Conclusiones. La presencia de AVE empeora el control de la presión arterial sistólica en pacientes hipertensos (AU)
Subject(s)
Middle Aged , Aged , Male , Female , Humans , Cardiovascular Physiological Phenomena , Life Change Events , Stress, Psychological , Prospective Studies , Cardiovascular System , Adaptation, Psychological , Hypertension , Heart RateSubject(s)
Cholesterol/blood , Reagent Strips , Capillaries , Evaluation Studies as Topic , Humans , Reproducibility of ResultsABSTRACT
OBJECTIVE: Evaluation of the chronometry test as a screening procedure for hypoacusia compared with tonal audiometry, in patients over 65 years. DESIGN: Cross-sectional study. SETTING: Mariañamansa health area (Ourense). PATIENTS: The first 49 patients over 65 who came to the medical consultations in June and July 1992 were selected, irrespective of the reasons for their visit; there were 17 males and 32 females, with and average age of 72.4 +/- 4.6 and 71.9 +/- 4.5. Only one patients consulted directly about loss of hearing. MEASUREMENTS AND MAIN RESULTS: A statistically significant association was found between the chronometry test and the audiometry test (gold-standard), significant at p < 0.005 for the left ear and p < 0.05 for the right ear. The test achieved a sensitivity of 0.85 and specificity of 0.76 in the case of the left ear, and 0.84 (sensitivity) and 0.56 (specificity) for the right ear. The kappa rate was 0.55 for the right ear and 0.67 for the left ear, showing agreement that went well beyond chance. CONCLUSIONS: In our view, the chronometry test constitutes an cheap, effective, simple, and replicable procedure for the detection of hypoacusia in patients aged over 65, and one which can usefully be used when no audioscope is available.
