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Biomedical subjects

S Lou Arnal

Publications and source records attributed to S Lou Arnal.

13 recordsLinked to original sources
PubMed2005

[Blood pressure measurement devices used in primary care office].

OBJECTIVE: To know different blood pressure (BP) measurement devices used in primary care (PC). DESIGN: Cross-sectional study, multilocated, with a non probabilistic sample of consecutive cases selection, all over the country. SETTING: Primary care practices from all the country. PARTICIPANTS: PC patients treated and they all were of age. METHODS: Two consecutive BP measures were made and measurement devices used in this process by physicians were booked. RESULTS: In this study participated 3592 PC physicians, BP were measured to 14,137 subjects. To a 69.8% of subjects BP were measured with a mercury sphygmomanometer; 16.5% with an electronic device; 11.8% with an aneroid manometer; and a 1.9% were measured with more than one measurement method. In rural environmental, electronic devices and aneroid manometer were used more, and some differences were noted in the different self ruled community in our country. There were differences in BP values in order to measurement methods, a third measurement was made often by physicians who managed electronic devices, and utilization of digits 0 and 5 was higher when measurement method was not an electronic device. CONCLUSIONS: In PC office, mercury sphygmomanometer is being used preferably and that aneroid manometers are still in use. Their utilization involves important bias in measurement process, so that electronic devices should be promoted.

Blood Pressure Determination↗
PubMed2005

[Primary care physicians behaviour in inadequate blood pressure control].

PURPOSE: To investigate the behaviour of primary care (PC) physicians on inadequate hypertension control. DESIGN: Cross-sectional and multicentric study. SETTING: PC clinics in the whole of Spain. PATIENTS: Patients > or =18 years old who followed pharmacological antihypertensive treatment since at least 3 months before, selected by a consecutive sampling. MEASUREMENTS: Blood pressure measured by family doctors. The therapeutic diagram used before and after the visit was registered, and in those cases in which some kind of modification was adopted, the reasons why. RESULTS: 12,754 hypertensive patients were included. The average age was 63.3+/-10.9 years (57.3% women). A 65% lived in urban areas and the 35% in semi-urban o rural areas. The 63.9% (95% confidence interval, 63.1%-64.8%) showed a bad control of hypertension. The majority of the patients followed a therapeutic regimen of monotherapy (56%) being the ACE inhibitors the most prescribed drug (34.8%), followed by the calcium antagonist (21.3%), and angiotensin II antagonists (17.4%). The percentage of patients with inadequate control of the blood pressure, in which the therapeutic behaviour was modified was 18.3% (95% confidence interval, 17.5%-19.1%) (a change of drug in 47%, association in 34.7% and an increase in the dose in 18.3%). The main reasons for which the therapeutic behaviour was modified was because no drug efficacy (63.7%) and the presence of adverse events (5.5%). The price of the therapy originated 1.2% of the modifications. CONCLUSIONS: PC physicians behaviour was conservative in uncontrolled hypertension cases. Amongst the doctors who modified their behaviour, by inadequate blood pressure control, the change of drug was the decision most adopted.

Aged↗
PubMed1994

[Self health care when faced with acute pathology in childhood].

OBJECTIVE: To quantify and describe the self-care practices for children up to 14 seeking care because of an acute pathology. DESIGN: An observation study carried out by means of a questionnaire administered to the person accompanying the patient. SETTING: Primary Care: an urban Health Centre. PATIENTS AND OTHER PARTICIPANTS: The total number of cases of acute pathology treated during April and May 1993 in the Centre's paediatric clinics. MEASUREMENTS AND MAIN RESULTS: 248 cases were studied (53% boys and 47% girls, with an average age of 5.3 +/- 3.85). Self-care (self-medication, 84.6%; non-pharmacological measures, 11.5%; both of these, 3.9%) was practised in 61.3% of cases (CI 95%: 55.2-67.4). The most common drugs were: antipyretics-analgesics (60%), antitussives (9.6%) and antibiotics (8.1%). Self-care was practised most often on patients presenting respiratory symptoms (69.6%) (p < 0.001), with self-medication predominant (91.2%) (p < 0.001). The number of days occurring between the appearance of symptoms and the medical consultation was greater among those who did not practise self-care (4.5 +/- 5.2 as against 2.1 +/- 1.8) (p < 0.001). CONCLUSIONS: Self-care is a very common practice among people seeking paediatric treatment. Self-medication, especially for respiratory trouble, is the most common form. Patients who practise self-care tend to be earlier in seeking a medical consultation.

Acute Disease↗
PubMed1993

[A serum cholesterol study in a consulting population and its implications in clinical practice].

OBJECTIVE: To investigate serious cholesterol levels in the population seeking medical attention, utilising HOTH (How Often That High) graphs, and to look at implications these results have for recording of cholesterol incidence. DESIGN: This was a non-longitudinal, retrospective, observational study. SETTING: Carried out at the general practice level, in the Valdefierro Basic Health Area (Zaragoza Province). PATIENTS: 742 subjects aged between 18 and 65 years with no previous history of dyslipemia. MEASUREMENTS AND MAIN RESULTS: After obtaining the figures on cholesterolemia, the HOTH graph was drawn from which, for a given cholesterol value, the percentage of the population with a given value can be seen. The mean cholesterol value was 201 mg/dl. A total of 54% of male subjects and 40% of female subjects were situated above the threshold figure of 200 mg/dl. Furthermore, 15% of male subjects and 10% of female subjects were situated above 250 mg/dl. CONCLUSIONS: The application of recording procedures for cholesterol, based on a globally discriminatory score, reveals a startling number of patients who need tests and treatment. We suggest a strategy based on the different levels according to age, sex, bloodstream cholesterol level, and the existence or otherwise of other cardiovascular risk factors. Lastly, we would mention the usefulness of the HOTH graphs in improving our knowledge of the cholesterol levels in a population.

Adolescent↗
PubMed1993

[Validation of a method for calculating the cardiovascular risk in primary care].

OBJECTIVE: To design a simple method to calculate overall cardiovascular risk (CVR), which could be used in Primary Care (PC). DESIGN: A descriptive study to correlate and validate our method (called CVR-PC) using the Framingham, the British Regional Heart study and the Spanish Society to fight against Arterial Hypertension methods. SETTING: Urban health centre. PATIENTS: 670 patients of both sexes chosen at random in clinics, to apply a programme of preventive measures. MEASUREMENTS AND MAIN RESULTS: The age, gender, blood pressure, tobacco consumption, Cholesterolaemia and Glycaemia were determined for each patient. A multiplicative memory method was designed to obtain the index of cardiovascular risk without recourse to electronic support. Figures obtained were correlated with those from the equation of the Framingham study. The Pearson r values were: 0.85 for the series total (0.85 for men and 0.83 for women). The cut-off point for high/low-moderate risk was identified. From this 76.3% sensitivity and 95.7% specificity were obtained. CONCLUSIONS: The method studied shows adequate correlation as well as high sensitivity and specificity when compared with the Framingham method. It can be useful in Primary Care clinic for identifying individuals at high cardiovascular risk.

Adult↗
PubMed1992

[Single oral dose of phosphomycin trometamol versus pipemidic acid and norfloxacin in treating uncomplicated low-level urinary tract infections].

OBJECTIVE: To make an assessment of the effectiveness and safety of a single oral dose compared with the conventional way of treating low-level Urinary Infections presenting no complications. DESIGN: This was an investigative and prospective study, using a control, a simple blind and randomised sample. SITE. Health Centres in Oviedo and Zaragoza. PATIENTS OR OTHERS PARTICIPANTS: We looked at 150 patients and included 106 females between the ages of 16 and 75 in the study. Their clinical symptoms were compatible with low-level urinary infections presenting no complications. INTERVENTIONS: 49 patients were given Trometamol Phosphomicine (TP) in a single oral dose; 36 took Pipemidic Acid (PA) and 21 Norfloxacine (NFX), both of these in a dose of 400 mg twice a day for 5 to 7 days. MAIN MEASUREMENTS AND RESULTS: Clinical and bacteriological assessments of the results were made 3, 7, and 28 days after treatment. A total of 75 gems were isolated: E. coli was the most common (68%). In all three groups, the main symptoms rapidly disappeared after the start of the treatment. CONCLUSIONS: Having considered the bacteriological and clinical findings, as well as tolerance levels, we are able to conclude that a single oral dose of Trometamol Phosphomicine is a good alternative to conventional therapy for the treatment of low-level Urinary Infections Which present no complications.

Administration, Oral↗
PubMed1991

[Quality control of a computer system for repeat prescriptions].

The results of a quality control of a computer system of repeated prescription (RPS) and its basic features are reported. The selected quality criteria were the following: reduction of the bureaucratic index in the visit, correct fulfillment of the treatment order, health attention circuits of the RPS, and compliance of the patient with the treatment. The record of activities and a random sample of treatment orders (TO) were used as sources of data. Quality indexes near the optimal standard (OS) were achieved: bureaucratic index 12.8% (OS = 15%), fulfillment of the TO 94% (OS = 100%), specified dosages 86% (OS = 100%), prescriptions in out-of-date orders 7% (OS = 0%), use higher than calculated 1% (OS = 0%), and use lower than calculated 36% (OS = 25%). Finally, the corrective measures for the detected quality problems are proposed, and the advantages of the computer RPS are discussed.

Algorithms↗
PubMed1990

[An epidemiological study on mental health in a health area].

To identify the prevalence of psychological abnormalities in the adult population of the Valdefierro Health Area, we carried out an epidemiological study following the methodology of the cross sectional two-phase study. A random sample of 400 individuals, stratified for age and sex, was selected from the population over 15 years of age. In a first phase, the GHQ positive individuals underwent the semistructured interview Clinical Interview Schedule (CIS). The prevalence of psychological distress detected by the GHQ questionnaire was 13.4%. There was a significant association between psychological distress and female gender, educational level, working status, marital status and use of health care services. 42 of the 51 GHQ positive cases (82%) were considered as psychiatric conditions by the CIS. This represents a 11% prevalence of psychiatric disorders in the evaluated sample.

Adolescent↗
PubMed1990

[Results and evaluation of a pilot study for the implementation of a program of preventive activities in primary health care].

Following the guidelines for preventive and health promoting activities in Primary Health Care presented by the S.E.M.F.Y.C., we developed a study to evaluate the adequacy of the parallel nurse clinic for their implementation. 209 individuals (94 males and 115 females, mean age 36,4 +/- 13 years) were included in the study. The results showed a remarkably high prevalence of risk factors in the study series and a good acceptance of the program by the users. The opportunistic screening by means of a referral to a nurse clinic was shown to be an adequate strategy for the development of the program, with a multimplicator effect on the whole of nursing activities to be evaluated at the time of planning their implementation rate.

Adolescent↗
PubMed1990

[Vaccination coverage in a pediatric population attended by a primary health care center].

It is hereby presented a quality control study of a systematic vaccination program developed in an urban primary care center. Target population were children between 0 and 8 years attended in the center. They were considered as having a correct vaccination coverage those cases in which it was possible to verify documented accomplishment of the local vaccination schedule. Out of the 538 children included in our study, 168 (31%) were founded not to have appropriate vaccination coverage evidenced in their clinical records, and their families were requested for an interview: 126 (75%) attended de appointment. In 93 of them it was founded a recording mistake, and 33 cases were verified as no correctly covered. Vaccination coverage rate was 86%, being inverse relationship between age and coverage rate. They are discussed corrective actions derived from the quality control.

Child↗