RESUMO
A district-wide epilepsy audit in general practice showed that levels of seizure frequency recording were too low to evaluate the quality of control of epilepsy. A repeat audit after multi-faceted interventions showed an improvement in seizure frequency recording of 13.2% (CI = 8.9 to 17.6) from 54.7% to 68%. This illustrates the difficulties of evaluating quality of care using routine records and the problems of implementing changes in general practice.
Assuntos
Epilepsia/terapia , Auditoria Médica , Atenção Primária à Saúde/normas , Qualidade da Assistência à Saúde , Gerenciamento Clínico , Humanos , Prontuários Médicos/normas , Índice de Gravidade de DoençaRESUMO
In the present study we have estimated the current prevalence of actinic skin disease in young and middle-aged adults in Queensland, Australia by surveying a representative community. It was found that 4.6% of persons aged 20 to 69 years had skin cancer, mostly basal cell carcinoma, and 40% had solar keratoses. The age distribution and site distribution of actinic lesions in this population were not as classically described; persons below age 40 years exhibited substantial sun-related skin damage, and a large proportion of actinic lesions occurred on sites other than the head, backs, of hands, or forearms. Allowing for age and sex, the strongest risk factors for skin cancer and solar keratoses were fair skin, as assessed by a dermatologist, and clinical signs of solar damage such as solar lentigines, facial telangiectasia, and actinic elastosis of the neck. Associations with self-reported tendencies toward sunburn, frequent painful sunburns, occupational sun exposure, and a previous history of skin cancer were confirmed.
Assuntos
Neoplasias Cutâneas/epidemiologia , Adulto , Fatores Etários , Idoso , Carcinoma Basocelular/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Ceratose/epidemiologia , Masculino , Pessoa de Meia-Idade , Queensland , Luz Solar/efeitos adversosAssuntos
Ceratose/terapia , Automedicação/métodos , Neoplasias Cutâneas/terapia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Plantas Medicinais , QueenslandAssuntos
Cnidários , Dermatite de Contato/etiologia , Adulto , Biópsia , Dermatite de Contato/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pele/patologiaAssuntos
Citosina/análogos & derivados , Dermatomicoses/terapia , Flucitosina/administração & dosagem , Dermatoses da Mão/terapia , Imidazóis/administração & dosagem , Miconazol/administração & dosagem , Esporotricose/terapia , Administração Oral , Adulto , Anfotericina B/administração & dosagem , Cauterização , Criocirurgia , Curetagem , Estudos de Avaliação como Assunto , Griseofulvina/administração & dosagem , Humanos , Masculino , Iodeto de Potássio/administração & dosagemRESUMO
The fate of over 1,500 patients treated for malignant melanoma in Queensland, Australia, between 1963 and 1969 has been followed by the Queensland Melanoma Project (QMP). Aspects which have been studied and reported include yearly incidence (16 per 100,000), sex incidence (females 55%, males 45%), size of melanomas (73% less than 2.0 cm), prognosis related to sex, site and histological features, multiple primary cutaneous melanomas (more than 1 in 4.8% of patients), hereditary and immunological aspects and value of frozen section diagnosis in management. Continued education of the public and medical practitioners is essential to insure early diagnosis and appropriate management of patients with melanoma.
