Juan Carlos Orengo Valverde

PubMed2002

[Knowledge about PSA among primary care physicians].

OBJECTIVE: The use of prostate-specific antigen as a tumor marker has led to an important advancement in the diagnosis of prostate cancer. Primary care physicians have started to request this test over the last 5 or 6 years. However, an inadequate use of this tumor marker has been observed. This study analyzes the primary care physicians' knowledge about PSA. METHODS: A cross-sectional and observational study was conducted. A questionnaire with 12 closed questions on PSA was sent out to 350 primary care physicians in the Canary Islands (Spain) The study was confidential and the following variables were analyzed: absolute frequencies, percentages and comparison of percentages (95% CI). RESULTS: We received 186 questionnaires (53.1%). To the question on whether the physician had sufficient knowledge about the test, 36% (67) answered 'yes' and 64% 'no'. The items that showed a higher percentage of correct answers were: "with the use of PSA, the utility of DRE has dropped (91.9%), "PSA can increase in prostate cancer (88.7%)", "a PSA level < 4 ng/ml indicates no prostate cancer (88.2%)" and "PSA > 4 ng/ml indicates prostate cancer" (86.6%). The percentages of correct answers for the remaining questions were less than 70%. CONCLUSIONS: The study shows that primary care physicians' knowledge about PSA is insufficient and a continuing education program is necessary.

Clinical Competence↗

PubMedDate not supplied

Oral surgery in patients undergoing oral anticoagulant therapy.

UNLABELLED: There is an evident need for procedural protocol for oral surgery patients who undergo oral anticoagulant treatment (OAT) because of: 1) the possible severity of complications and 2) the growing demand for OAT, which in some cases may be as much as 8% of the oral surgery patients that are referred to the hospital from primary care centers. In this study, the authors define the parameters for creating a proto- col applicable to this group of patients. The conclusion is that it is not necessary to suspend OAT before surgery; rather, these procedures should be performed under multidisciplinary medical control. OBJECTIVE: The authors demonstrate that it is possible to perform oral surgery on OAT patients, without having to sus- pend treatment beforehand. STUDY DESIGN: A longitudinal study was performed in OAT patients that required some type of oral surgical procedures. After an INR control, the patient underwent surgery and afterwards the patient was given tranexamic acid as a mouth rinse. Postoperative hemorrhage was classified as slight when it lasted less than 5 minutes, moderate when it lasted longer than five minutes, and severe when it required blood transfusion. RESULTS: The study was performed over a 5-year period (1996-2000), by the maxillofacial surgery department. In that time period, 125 patients with OAT were treated; 90 of them were males and 35 were females. Tooth extraction was per- formed in 229 sessions and a total of 367 teeth were extracted, with an average of 1.6% per session. With regards to postoperative hemorrahage, it was slight in 210 cases (91.7%), moderate in 18 (7.9%) and severe only in one case (0.4%). All the variables were compared and no statistically significant differences were found. CONCLUSIONS: We believe that OAT should not be suspended before oral surgery, but it surgery should be performed under multidisciplinary control-especially in the case of the elderly (over 65) or with those patients that have other concomitant illnesses such as renal insufficiency or anemia or other medical treatments.

Administration, Oral↗