Consumo de infusiones y su relación con la incontinencia urinaria / Herbal tea consumption and its relationship to urinary incontinence

El objetivo de este estudio fue evaluar la relación entre el consumo de infusiones de plantas medicinales y la presencia de incontinencia urinaria (IU), así como establecer cuáles son las plantas más frecuentemente utilizadas y si existe alguna asociación entre éstas y los distintos tipos de IU. Se diseñó un estudio descriptivo, transversal, multicéntrico en cinco Centros de Salud Urbanos del área metropolitana de Barcelona. Participaron 392 mujeres, elegidas sistemáticamente a partir de la consulta diaria. Las variables de estudio fueron: edad, antecedentes patológicos y farmacológicos y actividad física. Se utilizó un cuestionario autoadministrado de frecuencia de consumo de infusiones y un cuestionario validado para evaluar presencia y tipo de incontinencia. Resultados: un 33,6%% de las mujeres participantes en el estudio padecía IU, de ellas un 29,7% presentaban IU de esfuerzo, IU de urgencia un 32,8% e IU mixta un 31,3%. La infusión más consumida fue la de manzanilla (44,9%). La ingesta de café fue superior en las mujeres incontinentes pero no alcanzó significación estadística. El consumo de infusiones se asoció significativamente con la IU (44,3% frente a 24,9%, p<0,0001). La IU más frecuente entre las consumidoras fue la de urgencia. Se encontró una relación entre la frecuencia de consumo de poleo y la presencia de IU, mientras que con la salvia aparecía una relación inversa. El análisis multivariante mostró que el consumo de infusiones y el número de plantas distintas fueron los factores más relacionados con la presencia de IU (OR de toma de infusiones: 2,7; IC95%:1,69; 4,40). Conclusiones: La manzanilla es la infusión más utilizada. El consumo de infusiones se asocia con mayor frecuencia de incontinencia. El consumo de poleo y tila aumenta la frecuencia de incontinencia, mientras que el de salvia la disminuye. El tipo de IU más relacionado con la toma de infusiones de plantas medicinales es la IU de urgencia (AU)

The aim of this study was to evaluate the relationship between the consumption of herbal teas and the presence of urinary incontinence (UI), and establish which plants are most frequently used and whether any association exists between them and the different types of UI. A descriptive, cross-sectional, multicenter study was performed in five urban Health Centers of greater Barcelona. Participants were 392 women, systematically selected from daily practice. The study variables were: age, pathological and pharmacological history and physical activity. A self-administered questionnaire on herbal tea consumption frequency and a validated questionnaire to assess the presence and type of incontinence were used. Results: 33.6% of the women in the study suffered from IU, of which 29.7% was stress UI, 32.8% urge UI and 31.3% mixed UI. The most consumed herbal tea was chamomile (44.9%). Coffee intake was higher in incontinent women but did not reach statistical significance. Tea consumption was significantly associated with UTI (44.3 % vs. 24.9%, p <0.0001). Urge UI was the most common UI among herbal tea consumer women. A relationship between the frequency of pennyroyal consumption and the presence of UI was found, while an inverse relationship was found the case of sage. Multivariate analysis showed that herbal tea consumption and the number of different plants were the factors most related to the presence of UI (OR for herbal tea consumption: 2.7; 95% CI: 1.69; 4.40). Conclusions: Chamomile tea is the most widely used. Herbal tea consumption is associated with to an increased frequency of UI. Pennyroyal and lime flower consumption increases UI frequency, whereas sage decreases it. Urge UI is the UI type most associated with herbal tea consumption (AU)

Medida de la presión arterial en consulta y automatizada (BPTru®) para evaluar el efecto de bata blanca / Measurement of blood pressure in consultation and automated mesurement (BPTru ®) to evaluate the white coat effect

Fundamento y objetivo: El efecto de bata blanca (EBB) es uno de los principales sesgos que pueden modificar la medida de la presión arterial (PA) en consulta, por lo que se debe considerar para evitar errores diagnóstico-terapéuticos en los pacientes hipertensos. La utilización de aparatos automatizados en consulta podría disminuir dicho efecto. Método: Se diseñaron 2 estudios con el objetivo de evaluar las diferencias entre la medida rutinaria en consulta y la obtenida por el aparato automatizado de medida de PA en consulta, BPTru®, así como su influencia en el EBB. El primero de los estudios, TRUE-ESP, incluyó pacientes normotensos e hipertensos atendidos en consultas especializadas de Cardiología, Nefrología, Medicina Interna, Endocrinología y Medicina Familiar. El segundo, TRUE-HTA, incluyó pacientes hipertensos atendidos en una Unidad de HTA, protocolizada, con personal entrenado. Resultados: El estudio TRUE-ESP incluyó 300 pacientes, 76% hipertensos. Se observó una diferencia significativa entre la medida clínica y la medida BPTru® (media [DE] de PA sistólica/PA diastólica [PAS/PAD] de 9,8 [6,11]/3,4 [7,9] mmHg, p<0,001). El porcentaje de pacientes que cumplió criterios de EBB fue del 27,7%. El estudio TRUE-HTA incluyó 101 pacientes hipertensos. Se observó una diferencia significativa entre la medida clínica y la medida mediante BPTru® (media [DE] de PAS/PAD de 5,7 [3,9]/2,1 [3,5] mmHg, p<0,001) y la medida del período de actividad de la monitorización ambulatoria de la PA (MAPA) (media [DE] de PAS/PAD de 8,5 [6,7]/3,5 [2,5] mmHg, p<0,001). El porcentaje de pacientes que cumplió criterios de EBB fue del 32,1%. Conclusiones: El empleo de aparatos automatizados de medida de PA en consulta, como el BPTru®, puede colaborar a disminuir el EBB y mejorar la precisión de la medida de la PA en consulta (AU)

Background and objective: White coat effect (WCE) is one of the main bias that can affect office blood pressure (BP) measurement. Therefore, it is a factor must be considered in hypertensives to avoid mistakes in diagnosis and/or treatment. Employment of automated office BP (AOBP) devices could diminish that effect. Methods: Two studies were designed with the objective of evaluating differences between routinely office and AOBP measurements. WCE was also assessed. First, the TRUE-ESP study included normotensive and hypertensive patients attending specialized consultations at Cardiology, Nephrology, Internal Medicine, Endocrinology and Family Practice. Second, the TRUE-HTA study included hypertensives attending a protocoled Hypertension Unit, with a trained staff. Results: TRUE-ESP study included 300 patients, 76% being hypertensives. A significant difference between office BP and AOBP measurement (SBP/DBP 9.8±11.6/3.4±7.9mmHg, P<.001) was observed. Percentage of patients gathering WCE criteria was 27.7%. TRUE-HTA study included 101 hypertensive patients. A significant difference between office BP and AOBP measurement (SBP/DBP 5.7±9.3/2.1±5.3mmHg, P<.001) and activity period-ABPM (SBP/DBP 8.5±6.7/3.5±2.5mmHg, P<.001) was observed. Percentage of WCE patients was 32.1%. Conclusions: Use of AOBP devices can contribute to decrease WCE and to improve accuracy of office BP measurement (AU)

[Measurement of blood pressure in consultation and automated mesurement (BPTru(®)) to evaluate the white coat effect]. / Medida de la presión arterial en consulta y automatizada (BPTru®) para evaluar el efecto de bata blanca.

BACKGROUND AND OBJECTIVE: White coat effect (WCE) is one of the main bias that can affect office blood pressure (BP) measurement. Therefore, it is a factor must be considered in hypertensives to avoid mistakes in diagnosis and/or treatment. Employment of automated office BP (AOBP) devices could diminish that effect. METHODS: Two studies were designed with the objective of evaluating differences between routinely office and AOBP measurements. WCE was also assessed. First, the TRUE-ESP study included normotensive and hypertensive patients attending specialized consultations at Cardiology, Nephrology, Internal Medicine, Endocrinology and Family Practice. Second, the TRUE-HTA study included hypertensives attending a protocoled Hypertension Unit, with a trained staff. RESULTS: TRUE-ESP study included 300 patients, 76% being hypertensives. A significant difference between office BP and AOBP measurement (SBP/DBP 9.8±11.6/3.4±7.9 mmHg, P<.001) was observed. Percentage of patients gathering WCE criteria was 27.7%. TRUE-HTA study included 101 hypertensive patients. A significant difference between office BP and AOBP measurement (SBP/DBP 5.7±9.3/2.1±5.3 mmHg, P<.001) and activity period-ABPM (SBP/DBP 8.5±6.7/3.5±2.5 mmHg, P<.001) was observed. Percentage of WCE patients was 32.1%. CONCLUSIONS: Use of AOBP devices can contribute to decrease WCE and to improve accuracy of office BP measurement.

Self-audit y la acreditación de tutores / Self-audit and tutor accreditation

ObjetivoDescribir la experiencia de utilización del self audit (SA) como criterio de acreditación de los tutores de medicina familiar y comunitaria, analizar el conocimiento que tienen los tutores de esta metodología de autoevaluación y recoger su opinión respecto a este método.DiseñoEstudio descriptivo retrospectivo y análisis de un cuestionario de opinión.EmplazamientoUnidades docentes (UU.DD.) de medicina familiar y comunitaria de Cataluña.ParticipantesTutores de las UU.DD. de medicina familiar y comunitaria de Cataluña (julio de 2001 a julio de 2008).IntervencionesFormación de los tutores en la metodología SA, creación de un grupo de referencia y circuito de corrección. Corrección por pares de los SA realizados por los tutores según unos criterios determinados previamente y envío posterior de un informe-feedback. Encuesta de opinión autoadministrada a un grupo de tutores de las UU.DD.Mediciones y resultados principalesSe realizaron 673 SA. El tema más frecuentemente escogido fue la diabetes mellitus (27,9% de los casos). La valoración global de los SA desde un punto de vista metodológico fue correcta en el 44,5% de los casos, mejorable en el 45,3% y deficiente en el 10,2%.Mediciones y resultados principalesEn relación con los cuestionarios de opinión, se enviaron 300. El índice de respuesta fue de 151/300 (50,3%). Ante la pregunta sobre la utilidad del SA para la práctica profesional, un 12% lo consideraba muy útil; un 56%, bastante útil y un 32%, poco o nada útil.Mediciones y resultados principalesRespecto de si era un buen criterio para la reacreditación y acreditación de tutores, un 63% opinaba que no...(AU)

ObjectiveTo describe the experience of using self-audit (SA) as a means of accrediting family and community medicine tutors, to analyse the knowledge that the tutors have on this self-assessment methodology, and to record their opinions on this method.DesignRetrospective descriptive study and analysis of an opinion questionnaire.SettingFamily and community medicine teaching units (TU) in Catalonia.ParticipantsTutors from family and community medicine TU in Catalonia (July 2001–July 2008).MethodsTraining of the tutors in SA methodology, creation of a reference group and a correction cycle. Correction by peers of the SAs performed by the tutors according to previously determined criteria and subsequent issue of a report-feedback. Self-administered questionnaire by a group of TU tutors.Measurements and main outcomesA total of 673 SA were performed. The most frequent topic selected was diabetes mellitus in 27.9% of cases. The overall evaluation of the SA from a methodological point of view was correct in 44.5% of cases, improvable in 45.3%, and deficient in 10.2%.Measurements and main outcomesA total of 300 opinion questionnaires were issued. The response rate was 151/300 (50.03%). On the question about the usefulness of the SA in professional practice, 12% considered it very useful, 56% adequate, and 32% of little use or not useful.Measurements and main outcomesAs regards whether it was a good means for the re-accreditation or accreditation of tutors, 66% considered that it was not.ConclusionsA high percentage of the SAs analysed are not carried out correctly, which indicates that tutors do not know this self-assessment method very well. They consider that SAs are a useful tool for improving clinical practice, but not a good means for accreditation and re-accreditation(AU)

[Self-audit and tutor accreditation]. / Self-audit y la acreditación de tutores.

OBJECTIVE: To describe the experience of using self-audit (SA) as a means of accrediting family and community medicine tutors, to analyse the knowledge that the tutors have on this self-assessment methodology, and to record their opinions on this method. DESIGN: Retrospective descriptive study and analysis of an opinion questionnaire. SETTING: Family and community medicine teaching units (TU) in Catalonia. PARTICIPANTS: Tutors from family and community medicine TU in Catalonia (July 2001-July 2008). METHODS: Training of the tutors in SA methodology, creation of a reference group and a correction cycle. Correction by peers of the SAs performed by the tutors according to previously determined criteria and subsequent issue of a report-feedback. Self-administered questionnaire by a group of TU tutors. MEASUREMENTS AND MAIN OUTCOMES: A total of 673 SA were performed. The most frequent topic selected was diabetes mellitus in 27.9% of cases. The overall evaluation of the SA from a methodological point of view was correct in 44.5% of cases, improvable in 45.3%, and deficient in 10.2%. A total of 300 opinion questionnaires were issued. The response rate was 151/300 (50.03%). On the question about the usefulness of the SA in professional practice, 12% considered it very useful, 56% adequate, and 32% of little use or not useful. As regards whether it was a good means for the re-accreditation or accreditation of tutors, 66% considered that it was not. CONCLUSIONS: A high percentage of the SAs analysed are not carried out correctly, which indicates that tutors do not know this self-assessment method very well. They consider that SAs are a useful tool for improving clinical practice, but not a good means for accreditation and re-accreditation.

[Is the action taken by Catalonian primary care doctors adequate in view of the insufficient reduction in blood pressure levels in hypertensive patients? DISEHTAC-2001 study]. / Es adecuada la actitud que adoptan los médicos de atención primaria en Cataluña ante la insuficiente reducción de cifras de presión arterial en los pacientes hipertensos? Estudio DISEHTAC-2001.

OBJECTIVE: To determine the attitude to therapy of primary care staff in view of the lack of reduction in blood pressure. To describe the most commonly used antihypertensives. DESIGN: Descriptive, longitudinal, retrospective study during the year 2001. SETTING: Primary care, Spain. PARTICIPANTS: We analysed 990 hypertensive patients from 12 health centres picked from the 31 participants in the DISEHTAC-1996 study. METHODS: Age, sex, weight, and height were analysed, along with blood pressure values throughout the year 2001, therapeutic attitude (increase/replacement/combination) with poor control (more than 2 consecutive visits with blood pressure>139 and/or 89 mm Hg), screening and prevalence of cardiovascular risk factors (CVRF), and drugs used. RESULTS: There were 58.9% females; mean age: 65.4 (13.01) years, and 43.8% received 2 or more antihypertensives. The most common antihypertensives prescribed were diuretics (47.6%), and angiotensin-converting enzyme (ACE) inhibitors plus diuretics was the most used combination (22.1%). When there was poor control, some change in treatment was made in 76.8% (95% confidence interval [CI], 73.6-80) of cases. The most common was a combination of drugs (49.6%). The expected action was more frequent in those over 65 years and with a grade I of arterial hypertension (systolic blood pressure [SBP] between 140-150 and diastolic blood pressure [DBP] between 90-99 mm Hg (P<.001). CONCLUSIONS: Combined therapy is used in almost half of hypertensive patients, with the most common action being a drug combination.