ABSTRACT
OBJECTIVE: To find the work-load involved in caring for a displaced part of the population and its social/health characteristics. DESIGN: Descriptive study lasting a year. SETTING: General medical clinics at an urban Primary Care Centre in Alcorcón (Madrid). PATIENTS: Those users over 14 not registered at the Centre who were attended by the General Practitioners and nursing staff during the study period. MEASUREMENTS AND MAIN RESULTS: During the sampling days 263 non-registered patients were attended in on-demand medical consultations, this being 5.58% of the total. 301 home notices were sent out during the year, of which 12.95% were generated by displaced patients. The medical consultations by appointment for this group were 2.3% of the total within the Centre and 15.3% at home. There were no significant differences between the registered and displaced populations regarding the number of referrals to laboratory, radiology or specialists. 21.86% of nurses' pre-arranged home visits were due to the follow-up of displaced patients. The patients in our sample were mostly elderly (82.4%), women (68.6%) and staying for extended periods within our catchment area. A third of them attended for bureaucratic reasons (prescriptions). 58.23% of the remaining consultations were due to chronic pathologies. 18.07% brought with them medical reports or long-treatment booklets. CONCLUSIONS: Caring for the non-registered population causes a considerable work-load for the Primary Care team, both because of the number of people and their social/health characteristics. It should be made a requirement that the patient brings medical reports when he/she moves from their customary residence.
Subject(s)
Appointments and Schedules , Community Health Services/organization & administration , Primary Health Care , Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Spain , Urban HealthABSTRACT
Progressive external ophthalmoplegia is a myopathic alteration of slow progression which affects the extrinsic ocular muscles; ptosis of the eyelid being the most characteristic sign. Nowadays, it is included as type of muscular dystrophy. Even though mitochondrial changes have been described, they are not specific to this disease. 2 cases are described in this paper, commenting on clinical, electromyographic and pathological aspects.
Subject(s)
Ophthalmoplegia/diagnosis , Adult , Biopsy , Blepharoptosis/classification , Blepharoptosis/diagnosis , Blepharoptosis/pathology , Electromyography , Female , Humans , Middle Aged , Muscles/pathology , Ophthalmoplegia/classification , Ophthalmoplegia/pathologyABSTRACT
Two patients affected by thrombotic thrombocytopenic purpura (TTP) are treated with plasmapheresis, fresh frozen plasma infusion, steroid and inhibitors of platelet aggregation with an impaired final stage: the first patient died during a plasmapheresis session and the other had a good evolution, obtaining complete recovery, maintained a year later. We discuss the clinical features and highlight the needs for early treatment with all the latest therapies.
