RESUMO
El reumatismo de partes blandas es una patología muy frecuente en Atención Primaria, susceptible en determinadas circunstancias de tratamiento mediante infiltraciones locales. Se trata de una técnica sencilla y fácil de aprender, que comporta importantes gratificaciones tanto para el paciente como para el médico y escasas complicaciones. El resultado terapéutico dependerá del conocimiento de la misma y de su correcta indicación, así como de la utilización del fármaco adecuado. En este artículo revisaremos dichos apartados, comentando la técnica, las vías de acceso de las patologías más frecuentes, los efectos adversos, las contraindicaciones, los fármacos utilizados, proponiendo un protocolo de actuación en Atención Primaria basado en nuestra propia experiencia sobre el tema. La patología del aparato locomotor aguda, crónica, traumática, degenerativa, inflamatoria e incluso tumoral es susceptible en determinadas circunstancias de tratamiento local mediante técnicas de infiltración (AU)
Assuntos
Humanos , Injeções Intra-Articulares , Injeções Intra-Articulares/métodos , Injeções Intra-Articulares/efeitos adversosRESUMO
OBJECTIVE: To compare the percentage of tobacco consumers obtained by checking Primary care clinical notes (PCCN) with the percentage obtained by a telephone poll of the same people. To compare the record of tobacco counselling in the PCCN with that discovered by polling. DESIGN: Crossover and descriptive study. SETTING: Two urban health districts. PATIENTS: Random sample of 450 with PCCN and between 15 and 75 years-old. MEASUREMENTS AND RESULTS: A telephone questionnaire with data on tobacco consumption and smokers' perceptions of anti-tobacco counselling. Data obtained from checking the PCCN were: age, gender, basic care unit, number of attendances, pathologies and related risk factors, tobacco consumption and counselling. Tobacco consumption did not figure in 51% of the PCCN. Out of the 108 smokers identified by telephone polling, only 61 had this fact in their PCCN. 55 of these smokers said they had been counselled, which was only recorded on 11 occasions in the PCCN. The probability of receiving counselling increased when patient was over 45, when there were pathologies or related risk factors, with frequency of attendance and with each daily cigarette smoked. CONCLUSIONS: The PCCN substantially under-record tobacco consumption and, especially, counselling. The smokers who receive most counselling are those have already, most probably, smoked for a long time.
Assuntos
Aconselhamento/estatística & dados numéricos , Inquéritos Epidemiológicos , Prontuários Médicos/estatística & dados numéricos , Prevenção do Hábito de Fumar , Adolescente , Adulto , Fatores Etários , Idoso , Estudos Cross-Over , Feminino , Humanos , Masculino , Rememoração Mental , Pessoa de Meia-Idade , Fumar/epidemiologia , TelefoneRESUMO
A case-control study was designed to assess the relationship between passive exposure of children to smoking and the development of respiratory diseases with ronchi and wheezing detected by the primary care physician. The clinical records of 530 children in whom at least one episode of ronchi and/or wheezing had been recorded during the four years of activity of the Family and Community Unit of Cornellà were considered as cases. All the remaining children from the same age group were considered as controls. There were no significant differences in the proportion of smoking families between cases and controls (70.5% vs 71.9, chi 2 = 0.018, p = 0.89, NS). The mean number of cigarettes per family and day was not different either. It is a concluded that, in this age group, passive exposure to smoking does not result in an increase of respiratory diseases associated with ronchi and wheezing.
