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Biomedical subjects

M Arenas

Publications and source records attributed to M Arenas.

At least 19 recordsLinked to original sources
PubMed1997

[Clinical assessment systems in the diagnosis of pulmonary thromboembolism].

We proposed developing two symptom-based systems for assessing the presence of pulmonary thromboembolism (TEP) in our practice, using a standardized questionnaire and multivariate models. Data were collected from September 1993 through November 1994 (case reports, physical examination findings and complementary test results) of patients admitted to our ward with a suspicion of TEP. The calculated odds ratio for each of the variables recorded were used as weights to determine their relevance or not for the group at risk for TEP. The yield of the two systems developed (a weights system and a logistical model) were studied by plotting ROC curves. Eighty-two patients (40 women and 42 men, mean age 60.94 +/- 14.39 years) were admitted. The questionnaire had a sensitivity of 88% and a specificity of 75%, a positive predictive value of 94% and a negative predictive value of 60%. The logistical regression model had a sensitivity of 96.3% for a diagnosis of TEP with inclusion of the following variables: female sex, disease-related immobility, presence of deep venous thrombosis (DVT) in the lower extremities and the appearance of unexplained dyspnea. Neither system was clearly superior to the other for arriving at a clinical diagnosis of TEP.

Aged↗
PubMed1997

[Evolution of pulmonary scintigraphy in the follow-up of pulmonary embolism. Effect of anticoagulant treatment and other associated factors].

We performed a prospective study to determine the evolution of perfusion defects 6 months after pulmonary thromboembolism (PTE), to identify associated factors and to evaluate the incidence of subclinical recurrence. Seventy patients diagnosed of PTE were enrolled. Perfusion pulmonary scintiscans were performed 6 months after the acute PTE episode and the results were compared with initial defects. We looked for significant relations between several course profiles and factors such as age, sex, anticoagulation therapy and patient history. Defects revealed by the initial scintiscan remained the same 6 months later in 15 (21%), decreased in 35 (53%) and disappeared in 16 (23%) of the 70 patients. New defects were identified in 2 patients. A significant relation was found between a favorable outcome as shown by follow-up scintiscans and compliance with anticoagulation therapy (p = 0.0024). Other statistically significant relations were observed between favorable outcome and a history of surgical intervention during the acute episode (p = 0.004) and between unfavorable outcome and a history of venous thromboembolic disease (p = 0.004).

Adult↗
PubMed1994

[An opinion/satisfaction survey on 2 models of clinical histories used in primary care].

OBJECTIVE: We aimed to discover the opinion of primary care doctors regarding the structure, usefulness and problems when using two models of clinical records employed consecutively in the same health centres. DESIGN: A double crossover study. An opinion poll (with 22 closed questions and one open), filled out in 1988 (evaluating the type A clinical record) and then in 1992 (for type B), was used. Chi squared statistical analysis with Yates corrections and Fisher test. SETTING AND PARTICIPANTS: Staff doctors and third-year family and community medicine interns at their teaching centres in Alicante province. In 1988, 49 doctors took part, and in 1992, 68: 70 and 75% respectively of the target group. RESULTS: The new record was an improvement over the earlier one. It was broader and corresponded more closely to the actual case. But problems of completion and legibility persisted, as did the difficulties in filling out socio-economic data and work/school history. Model B favoured use by all the team members. It was better for new patients and when doing later checks, although it did not avoid the accumulation of inactive documentation. The need for specific documents for preventive activities was detected. Computerisation would improve manageability. For both models lack of time was the main reason for under-recording. CONCLUSIONS: The new model is better than the earlier one but is lacking in the areas of manageability and difficulty in retrieving information. The methodology employed shows its use for evaluating health-care innovations and detecting insufficiencies, as well as allowing user-satisfaction to be more easily identified.

Attitude of Health Personnel↗