También es una dislipemia / It is also a dyslipidemia

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[Analysis of the control of cardiovascular risk factors in patients with peripheral arterial disease]. / Análisis del control de factores de riesgo cardiovascular en pacientes con enfermedad arterial periférica.

INTRODUCTION: The objective was to determine the percentage of patients with peripheral arterial disease (PAD) with good control of their cardiovascular risk factors (CVRF) (LDL cholesterol, blood pressure and smoke cessation). MATERIAL AND METHODS: Cross-sectional multicentre study. The location was Primary Care and other clinics that typically treat patients with peripheral arterial disease (Internal Medicine, Vascular Surgery, Cardiology, Endocrinology and Nephrology). The first 10 patients with peripheral arterial disease were systematically selected by 440 researchers from all regions. RESULTS: The study included 4087 patients. Blood pressure was controlled in 29.5% of the cases. The frequency of patients with optimal control was significantly better in primary care (p<.01). There was an optimal control of LDL-C levels in 30.4% of patients. Factors associated with optimal control of LDL-C was, being diabetic, stage I of La Fontaine, and being seen by a doctor that was not the primary care physician. Control was worse in women and in smokers. CONCLUSIONS: Primary care physicians better manage patients with hypertension. Patients seen in by a specialist as opposed to primary care are more likely to achieve optimal control of CVRF. The situation is far from the ideal, only 6% achieved optimal control of all CVRF.

Análisis del control de factores de riesgo cardiovascular en pacientes con enfermedad arterial periférica / Analysis of the control of cardiovascular risk factors in patients with peripheral arterial disease

Introducción. El objetivo del presente estudio es determinar el porcentaje de pacientes con enfermedad arterial periférica (EAP) con un control óptimo de sus factores de riesgo cardiovascular (FRCV) (colesterol unido a las lipoproteínas de baja densidad [c-LDL], presión arterial [PA] y abandono de tabaco). Material y métodos. Estudio descriptivo transversal multicéntrico, realizado en consultas de atención primaria (AP) y de otras especialidades que habitualmente atienden a pacientes con EAP, medicina interna, cirugía vascular (CV), cardiología, endocrinología y nefrología. Selección sistemática de los 10 primeros pacientes con EAP de las consultas de 440 investigadores pertenecientes a todas las comunidades autónomas. Resultados. Se incluyeron en el estudio a 4.087 pacientes. Tenían controlada la PA el 29,5% de los pacientes. La frecuencia de pacientes con control de la PA fue significativamente mejor en consultas de AP (p<0,01). Se observó un control óptimo de los niveles de c-LDL en un 30,4% de los pacientes. Los factores asociados con un control óptimo de este factor fueron el hecho de ser diabético, el encontrarse en estadio I de La Fontaine y el ser atendido por un médico que no fuese de AP, y se controlaba peor en mujeres y en fumadores activos. Conclusiones. Los médicos de AP manejan mejor al paciente hipertenso. Sin embargo, los pacientes atendidos en especialidad frente a AP tienen mayor probabilidad de conseguir un control óptimo de los FRCV. La situación dista de ser la idónea, ya que solo en un 6% se consiguió el control óptimo de todos los FRCV(AU)

Introduction. The objective was to determine the percentage of patients with peripheral arterial disease (PAD) with good control of their cardiovascular risk factors (CVRF) (LDL cholesterol, blood pressure and smoke cessation). Material and methods. Cross-sectional multicentre study. The location was Primary Care and other clinics that typically treat patients with peripheral arterial disease (Internal Medicine, Vascular Surgery, Cardiology, Endocrinology and Nephrology). The first 10 patients with peripheral arterial disease were systematically selected by 440 researchers from all regions. Results. The study included 4087 patients. Blood pressure was controlled in 29.5% of the cases. The frequency of patients with optimal control was significantly better in primary care (p<.01). There was an optimal control of LDL-C levels in 30.4% of patients. Factors associated with optimal control of LDL-C was, being diabetic, stage I of La Fontaine, and being seen by a doctor that was not the primary care physician. Control was worse in women and in smokers. Conclusions. Primary care physicians better manage patients with hypertension. Patients seen in by a specialist as opposed to primary care are more likely to achieve optimal control of CVRF. The situation is far from the ideal, only 6% achieved optimal control of all CVRF(AU)

[Contraceptive methods used by immigrant populations and conditions that influence the choice in a health area in Zaragoza]. / Métodos anticonceptivos utilizados por población inmigrante y condicionantes que influyen en su elección en un área sanitaria de Zaragoza.

BACKGROUND: The percentage of women immigrants in Spain has increased in these last years, resulting in the emergence of specific needs related to sexual and reproductive health. The objective of this article was to define the contraceptive methods used by immigrant women and the determining factors that influence their choice. To estimate the use of emergency post-coital contraception and prevalence of abortion. METHODS: A descriptive cross-sectional study using a survey was carried out in the first quarter of 2011 at the "Centro de Salud Delicias Sur" in Zaragoza, Spain. The target population were immigrant women of childbearing age between 15 and 45 years who attended the clinic. Non probability sampling was used. RESULTS: The mean age was 29.35 years (95% confidence interval (CI) = 27.95 to 30.75 years). The majority country of origin was Ecuador. Almost half the women were single and worked in paid employment. The educational level was considered as average. The average duration of residence in Spain was 5.68 years (95% CI = 4.99 to 6.37 years) and 42% of them (95% CI = 32.62 to 51.83) did not use any contraceptive method. The most used contraceptive method was the condom, followed by oral hormonal contraceptives. More than half of the women had been informed in Primary Care. Almost one third (32%) (95% CI = 23.42 to 41.60) of the women had a history of abortion. More than 19% of women (95% CI = 12.46 to 28.10) had used the emergency contraceptive method. CONCLUSION: Contraceptive methods were not used by 42% of women. The alert indicators on the failure of preventive measures in sexual health are still too high.

Métodos anticonceptivos utilizados por población inmigrante y condicionantes que influyen en su elección en un área sanitaria de Zaragoza / Contraceptive methods used by immigrant populations and conditions that influence the choice in a health area in Zaragoza

Introducción. En los últimos años el porcentaje de mujeres inmigrantes ha aumentado provocando el surgimiento de necesidades específicas referentes a su salud sexual y reproductiva. El objetivo fue conocer los métodos anticonceptivos utilizados por ellas y los condicionantes que influyen en su elección. Estimar como indicadores de alerta: uso de píldora poscoital y prevalencia de abortos. Material y métodos. Estudio descriptivo transversal, mediante encuesta realizada en el primer trimestre del año 2011 en el Centro de Salud Delicias Sur (Zaragoza). La población diana fueron mujeres inmigrantes en edad fértil (15-45 años) que acudieron al centro, previo consentimiento informado. Muestreo accidental por cuotas. Resultados. La edad media fue de 29,35 años (IC al 95% = 27,95-30,75 años). El país de origen mayoritario fue Ecuador. Casi la mitad de las mujeres estaban solteras y trabajaban por cuenta ajena, y su nivel de instrucción era medio. La media de años de residencia en España fue de 5,68 años (IC al 95% = 4,99-6,37 años). Un 42% de las mujeres (IC al 95% = 32,62-51,83) no utilizaba ningún método anticonceptivo. El método más utilizado fue el preservativo, seguido de la píldora. Más de la mitad de las mujeres habían sido informadas en atención primaria. Un 32% (IC al 95% = 23,42-41,60) de ellas tenían un antecedente de aborto. Respecto al uso de la píldora poscoital (PPC), había recurrido a ella el 19,39% (IC al 95% = 12,46-28,10). Conclusiones. El 42% no utilizaba ningún método anticonceptivo y los indicadores de alerta sobre el fracaso de medidas preventivas en salud reproductiva son elevados (AU)

Background. The percentage of women immigrants in Spain has increased in these last years, resulting in the emergence of specific needs related to sexual and reproductive health. The objective of this article was to define the contraceptive methods used by immigrant women and the determining factors that influence their choice. To estimate the use of emergency post-coital contraception and prevalence of abortion. Methods. A descriptive cross-sectional study using a survey was carried out in the first quarter of 2011 at the "Centro de Salud Delicias Sur" in Zaragoza, Spain. The target population were immigrant women of childbearing age between 15 and 45 years who attended the clinic. Non probability sampling was used. Results. The mean age was 29.35 years (95% confidence interval (CI) = 27.95 to 30.75 years). The majority country of origin was Ecuador. Almost half the women were single and worked in paid employment. The educational level was considered as average. The average duration of residence in Spain was 5.68 years (95% CI = 4.99 to 6.37 years) and 42% of them (95% CI = 32.62 to 51.83) did not use any contraceptive method. The most used contraceptive method was the condom, followed by oral hormonal contraceptives. More than half of the women had been informed in Primary Care. Almost one third (32%) (95% CI = 23.42 to 41.60) of the women had a history of abortion. More than 19% of women (95% CI = 12.46 to 28.10) had used the emergency contraceptive method. Conclusion. Contraceptive methods were not used by 42% of women. The alert indicators on the failure of preventive measures in sexual health are still too high (AU)

Tratamiento antirresortivo tras fractura proximal de fémur / Antiresorptive treatment after proximal femur fracture

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Revisión de los antiagregantes plaquetarios y sus indicaciones en atención primaria. Ocho años después / Review of plasma anti-aggregants and their indications in primary care. Eight years later

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Abordaje de la hiperplasia benigna de próstata. ActuaciónAtención Primaria-Especializada / Bening prostatic hyperplasia approaching Primary Health Care-Especialized Care

Las manifestaciones clínicas de la hiperplasia benigna de próstata (HBP) se presentan preferentemente a partir de los 50 años. Diferenciar la sintomatología según sean sus características " irritativas" (componente dinámico) u "obstructivas" (componente estático) dirigirá la instauración individualizada hacia uno u otro tratamiento farmacológico (alfabloqueantes-hormonoterapia). La valoración de la clínica y de la calidad de vida, mediante el cuestionario (I-PSS-L), la realización de tacto rectal y la cuantificación de los niveles del antígeno prostático específico (PSA) son elementos necesarios para que el médico de Atención Primaria (AP) decida qué paciente es tributario de atención en ese medio o debe ser derivado. Se propone un es quema de actuación consensuado como guía ante este tipo de patología (AU)