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Biomedical subjects

M Vernet Vernet

Publications and source records attributed to M Vernet Vernet.

9 recordsLinked to original sources
PubMed2004

[Functional thyroid pathology in the elderly].

OBJECTIVE: To describe the prevalence of functional thyroid pathology (FTP) and pathologies associated with it in an elderly population. DESIGN: Descriptive, cross-sectional study. SETTING: Urban primary care centre. PATIENTS: Representative sample of the entire population attended that was 60 years old or over. MAIN MEASUREMENTS: Demographic variables, clinical history of thyroid pathology and pathology associated with it, Body Mass Index, small tests for diagnosing depression and anxiety, the mini-mental test, electrocardiogram, determination of total cholesterol and LDL cholesterol, and of free thyrotrophin and thyroxin if it is disturbed. RESULTS: 192 people were studied, 56% women, 53% between 60 and 69 and 12% over 79 years old. 10% had a history of previous FTP. Prevalence of active FTP was 13% (10.41% sub-clinical hypothyroidism, 0.52% clinical hypothyroidism, 1.56% sub-clinical hyperthyroidism, and 0.52% clinical hyperthyroidism). Prevalence of new diagnoses of FTP was 4.1% (7 with hypothyroidism and 1 with hyperthyroidism, all sub-clinical). During the study the following pathology was detected in hypothyroidism sufferers: 43% anxiety disorder, 38% depressive syndrome, 28.5% cognitive deterioration, 9.5% dementia, 26% electrocardiographic disturbances, 47.6% obesity, and 28.5% with total cholesterol > or =250 mg/dL. In hyperthyroidism, 50% with depressive syndrome, 25% with cognitive deterioration, 25% with electrocardiographic disturbances, and 50% with obesity were detected. CONCLUSIONS: FTP is more prevalent among the elderly than in the population as a whole, with predominance of hypothyroidism, subclinical pathology and among women. In terms of pathology traditionally linked to thyroid malfunction, few differences were found between the population affected with FTP and those not affected. Primary care doctors are important in reducing under-diagnosis.

Aged↗
PubMed2003

[Application of a method for the early detection of diabetic retinopathy in Primary Health Care].

PATIENTS AND METHODS: An ophthalmic examination was performed in 1,495 diabetic patients by means of a photographic method with a non-mydriatic retinal (Ffo-CNM) camera (with inclusion of 81.5% of the total diabetic population in our area attended in three primary care centers in Terrasa, Barcelona. RESULTS: The prevalence of diabetic retinopathy known prior to the study was 15% (n = 218). With the application of the Ffo-CNM method the prevalence increased up to 28% (p = 0.0001). The diagnoses obtained were: normal fundoscopic appearance (bilateral), 61% (n = 908), DR without maculopathy, 22% (n = 334); DR with maculopathy, 5% (n = 75); severe DR or preproliferative DR, 0.1% (n = 1), and proliferative DR, 0.7% (n = 10). The fundus was not visible in 11% (n = 167) of patients, mainly because of darkness refractory miosis (48%) and media opacity (43%). Thirty-nine percent of examined patients were referred to the referral Ophthalmology department either because DR or non-visible eye fundus. CONCLUSIONS: The use of Ffo-CNM enhances the ophthalmoscopic examination in the diabetic population given the simplicity of the technique and its accessibility with the corresponding increase in the number of diagnoses of DR. Likewise, it improves the care quality to the diabetic patient and also the reationalization of patient referral to the ophthalmologic centers.

Cross-Sectional Studies↗
PubMed2002

[Socio-demographic and clinical characteristics of a patient population with diabetes mellitus].

OBJECTIVES: To describe sociodemographic and clinical characteristics of a diabetic population. To relate sociodemographic and clinical evolutionaries variables. DESIGN: Descriptive transversal study. SETTING: Three urban Primary Health Centers (PHC). Participants. Diabetic patients attended in these PHC.Measurements. VARIABLES: sociodemographic and clinical through an individualized survey and a medical record review. RESULTS: 1495 patients were studied from whom 96% were diabetic type 2. Age: 66 years old (SD 12). Sex: 56% were women. Education level: 62 didn't have finished their primary studies. Family: 71% live together with a partner. Years of evolution: Diabetes (DM) < 10 years: 47% in type 1; 64% in type 2. RISK FACTORS: DM 1: smokers 40%; hypertension (HTA) 7%; DM 2: smokers 12%; HTA 51%; obesity 26%; hypercholesterolemia 28%; hypertriglyceridemia 17%. Chronic complications: DM 1: retinopathy (DR) 26%; nephropathy (Nf) 3.5%; ischemic heart disease (IHD) 3.5%; periferic arteriopathy (PA) 7%; Cerebrovascular accident (CVA) 2%; peripheric neuropathy (PN) 5%. DM 2: DR 14%; Nf 13%; IHD 12%; PA 9%; CVA 5%; PN 4%; autonomic neuropathy 3%. Metabolic control DM 2: 67% HbA1c 7.5. Best metabolic control in DM with less years of evolution (p = 0.001). Treatment DM 2: 32% diet, 51% oral treatment, 13% insulin, 4% mixed. No relation with cultural level and family situation with metabolic control. In chronic complications only DR were more prevalent in patients with less cultural level (p = 0.037). CONCLUSIONS: Less cultural level doesn't influence neither metabolic control nor appearance chronic complications, except DR. The knowledge of diabetic population attended has allowed to detect the need of reinforce the intervention for decrease smoking and increase chronic complications detection.

Adolescent↗
PubMed2000

[Intervention of the family physician in the diagnosis of cancer].

OBJECTIVE: To find the intervention of family doctors (FD) in diagnosing tumour pathology. DESIGN: Retrospective descriptive study. SETTING: Urban primary care centre. PATIENTS: Patients over 14 diagnosed with cancer. MEASUREMENTS: Selection of patients from the computerised records between November 1989 and March 1997. Review of clinical histories, analysing: 1. Personal details, 2. Type of cancer, 3. Intervention of the FD in the diagnosis, 4. Symptom of initial consultation, 5. Further tests requested by FD, 6. Interval between consultation and diagnosis, 7. Survival and 8. interval between diagnosis and death. FD intervention in diagnosis was evaluated: 1. Impossible intervention, 2. No intervention, with suspect signs not valued (SSNV) or with suspect signs valued (SSV), 3. Diagnostic intervention, incomplete (Iin) or complete (Ico). RESULTS: 438 tumours were detected: in 256 men (59%) and 171 women (41%). The most common kind in men was lung cancer (46 cases, 17%), and in women breast cancer (59 cases, 34%). In 233 cases (53%) the intervention of the FD was impossible. In 29 cases (6.5%) the FD's intervention was nil (15 cases with SSNV, 14 cases with SSV). Of the 174 cases (39.6%) in which the FD intervened, full diagnosis was made in 40% (69 cases). The mean of the interval between the first consultation and the diagnosis was significantly less when FD intervention existed, at 1.95 months (CI, 0.63-1.06) in Ico and 2.9 months (CI, 0.51-2.19) in Iin, than when there was no intervention, with delays of 5.58 months (CI, 1.46-3.53) with SSNV and 10.5 months (CI, 8.45-12.54) with SSV (p = 0.000). CONCLUSIONS: The family doctor can play an important part in cancer diagnosis. His/her active intervention can reduce the interval between consultation and diagnosis.

Adult↗
PubMed2000

[Intervention for alcoholism control among chronic drinkers in primary care].

OBJECTIVE: To evaluate the evolution of alcohol consumption in chronic drinkers after a primary care alcohol intervention over two years. DESIGN: Prospective intervention study. SETTING: Urban primary care centre. PATIENTS: Males between 20 and 60 years old who consumed 100 or more grams of alcohol per day for at least the previous two years. MEASUREMENTS AND MAIN RESULTS: Detoxification (out-patient or hospital according to the degree of dependency) and habit-breaking, which consisted of psychological support (techniques of brief counselling, brief motivating interview) and/or referral to the care and observance centre (COC) for individual and/or group psychotherapy, took place. A minimum of eight visits were programmed and consumption was assessed in gr/day at the start and at one (1 m), three (3 m), six (6 m), twelve (12 m), eighteen (18 m) and twenty-four months (24 m). 64 out of 129 (49.5%) responded to the appointment. Control visits: nil observance (0 visits) 6 patients (9%), and excellent observance (> or = 9 visits) 21 patients (33%). INTERVENTIONS: Psychotherapy treatment: psychological support 55 patients (86%), referral to the COC 4 (6%), group psychotherapy 2 (3%), and non-treatment 6 (9%). Data on mean consumption: start 131 g/day (SD = 52), 12 m 31 (SD = 41), and 24 m 38 (SD = 42). Mean reduction of consumption at 24 months according to the observance: insufficient -19%, acceptable -71.1%, excellent -83.9% (p = 0.001). CONCLUSIONS: Low response to appointments. Evolution of alcohol consumption was similar to that in other studies. Clear relationship between number of visits and consumption at the end of the study. Given the positive findings, we think a primary care intervention on alcohol is essential.

Adult↗
PubMed2000

[Analysis of indications and diagnosis of the gastroscopies requested by primary care physicians].

OBJECTIVES: To analyse the pathology diagnosed on the basis of the gastroscopies requested from a primary care centre (PCC). Assessment and treatment of Helicobacter pylori (HP) infection. DESIGN: Retrospective and descriptive. SETTING: Urban PCC. PATIENTS: Those over 14 who had a gastroscopy for a diagnostic purpose, requested by their primary care doctor during 1997. MEASUREMENTS: Review of clinical records and gastroscopy reports analysing: personal data, reasons for request, prior treatment, diagnoses, treatment to eradicate HP, later referral to the digestion specialist and waiting-time for the gastroscopy. RESULTS: 206 gastroscopies were performed, 139 for epigastralgia (67%) and 73 for heartburn (35%). 161 patients (78%) had had previous treatment, with alkalines used in 94 cases (45%). The most common diagnoses were: 54 normal (26%), 60 hiatus hernias (30%), 43 oesophagitis (21%), 18 duodenal ulcers (9%) and 4 gastric ulcers (2%). The Helicobacter pylori study was positive in 67 cases, with triple treatment (amoxycillin, clarithromycin and omeprazole) to eradicate it given for 7 days in 36 cases (54%). Referral to the specialist of 3% of the patients. Waiting-time for the performance of the gastroscopy: 60 days (SD: 35). CONCLUSIONS: Gastroscopy is a diagnostic method habitually used in our PCC. The pathology diagnosed is mainly treated in primary care. Given the current controversy about actions at determined clinical entities, standardisation of criteria used by professionals at different care levels is very important. This standardisation should affect the indications of the examinations, and the treatment and follow-up of the pathologies. The reduction in waiting-time for a gastroscopy could possibly modify the prescription and duration of the prior treatment.

Amoxicillin↗
PubMed1994

[Nephropathy in patients with type II diabetes and arterial hypertension].

OBJECTIVE: To evaluate the degree of renal affectation in a group of patients diagnosed as having diabetes mellitus (DM) type II and high arterial blood pressure (HABP), related to the control of arterial blood pressure (ABP) and the type of hypotensor treatment utilised. DESIGN: Cross-sectional study. SETTING: Terrassa Nord Primary Care Centre. PATIENTS: Sample of 54 patients with DM type II and HABP. MEASUREMENTS AND SPECIAL RESULTS: The renal study comprised the determination of levels of microalbuminuria, proteinuria and plasmatic creatinine. The microalbuminuria was in excess of 30 micrograms/minute in 12 cases (22%), six of whom had proteinuria in excess of 0.5 g/24 h (11%). Two patients had kidney failure (3.7%). The hypotensors most used were the diuretics (45%) and inhibitors of the angiotensin-converting enzyme (IACE) (40%). The microalbuminuria level of patients with a good control of diastolic ABP (arterial blood pressure) was lower than those with poor control (p = 0.02), while there was no difference between the type of hypotensor treatment used. CONCLUSIONS: We would stress the importance of detection of diabetes patients with preclinical renal injury in Primary Health Care, to be able to apply measures that will modify the development of nephropathy, specifically, with good control of ABP.

Aged↗
PubMed1980

[Massive pulmonary embolism due to hydatid vesicles. Report of a case (author's transl)].

A patient with hepatic and peritoneal hydatidosis suffered acute episodes of restrictive bronchial disease for the last 2 years. The patient was admitted during the course of one of this acute episodes with clinical symptoms of pulmonary embolism. Supportive therapeutic measures were prescribed, but the patient died 12 hours latter. Autopsy revealed hepatic, peritoneal and pulmonary hidatidosis as well as multiple pulmonary thromboembolisms due to hydatid vesicles. Literature on this subject is reviewed, and different clinical forms and therapeutic possibilities are discussed. The importance of small therapeutic possibilities are discussed. The importance of small recurrent hydatid embolisms in the pathogenesis of acute or subacute cor pulmonale in patients with liver hydatidosis is stressed.

Acute Disease↗