ABSTRACT
Objetivo Describir las características clínicas y epidemiológicas de los sujetos incluidos en el Registro Nacional de Paget. Sujetos y método Registro de pacientes con enfermedad ósea de Paget (EOP), confirmada radiológicamente, de 25 centros participantes. Se recogieron datos clínico epidemiológicos (edad, sexo, fecha y manifestaciones al diagnóstico y tratamientos), calidad de vida (CV) (cuestionario EuroQol de 5 dimensiones), estado de salud, factores ambientales (profesión, antecedentes de sarampión, contacto con animales, consumo de lácteos, condiciones de la vivienda, lugar de nacimiento y domicilio) y familiares (historia de EOP, procedencia de los ascendientes y número de hijos). Se realizó una descripción estadística de los datos. Resultados El registro incluyó a 602 sujetos con edad media de 62 ± 11 años con predominio de varones (55%). El 79% de los sujetos presentaba síntomas en el momento del diagnóstico, fundamentalmente dolor (83%). El 82% de los sujetos había recibido tratamiento, principalmente bisfosfonatos, con más de un fármaco en el 47% de los casos. A pesar del tratamiento, una proporción importante tenía limitación de la CV, especialmente relacionada con dolor (64%), movilidad (47%) y ansiedad junto con malestar (33%). La mayor parte de los sujetos habían estado expuestos a situaciones que se consideran factores de riesgo. El 14% de los sujetos tenía historia familiar de EOP y el 1,5% de los sujetos tenía hijos con EOP. Los ascendientes de los casos familiares procedían con más frecuencia de Ávila, Salamanca, Málaga y La Coruña. Conclusiones El dolor y la limitación de la movilidad disminuyen la CV del sujeto con EOP a pesar del tratamiento. Son frecuentes los antecedentes de exposición a factores de riesgo (AU)
Objectives To describe the clinical and epidemiological characteristics of patients included in the National Register of Paget's disease. Methods A Register of patients with Paget disease (PD), radiologically confirmed, and pertaining to 25 hospitals was analysed. Clinical and epidemiological data were collected, including age, sex, date and presentations at time of diagnosis, treatment, quality of life (QL) (EuroQol 5D) and perceived health, environmental factors (profession, history of measles, contact with animals, dairy consumption, housing conditions, place of birth and address) and family history (PD history, origin of the ancestors, number of children). We conducted a statistical description of the data. Results The register included 602 patients with an average age of 62±11 years and a predominance of male (55%). Of the patients included, 79% showed symptoms at the time of diagnosis, mainly pain (83%); 82% had received treatment, mainly bisphosphonates (47% more than one drug). Despite treatment, a significant proportion had limitations in their QL, especially related to pain (64%), mobility (47%) and anxiety/depression (33%). Most of the patients had been exposed to situations which were considered as risk factors. Of the patients included, 14% had family history of PD and 1.5% had children with PD. The ancestors of the familial cases came more frequently from Avila, Salamanca, La Coruña and Malaga. Conclusions The pain and the limitation of mobility decrease the QL of patients with PD despite treatment. Frequently, patients have a history of exposure to risk factors (AU)
Subject(s)
Humans , Osteitis Deformans/epidemiology , Spain/epidemiology , Diseases Registries , Genetic Predisposition to Disease , Risk FactorsABSTRACT
OBJECTIVES: To describe the clinical and epidemiological characteristics of patients included in the National Register of Paget's disease. METHODS: A Register of patients with Paget disease (PD), radiologically confirmed, and pertaining to 25 hospitals was analysed. Clinical and epidemiological data were collected, including age, sex, date and presentations at time of diagnosis, treatment, quality of life (QL) (EuroQol 5D) and perceived health, environmental factors (profession, history of measles, contact with animals, dairy consumption, housing conditions, place of birth and address) and family history (PD history, origin of the ancestors, number of children). We conducted a statistical description of the data. RESULTS: The register included 602 patients with an average age of 62±11 years and a predominance of male (55%). Of the patients included, 79% showed symptoms at the time of diagnosis, mainly pain (83%); 82% had received treatment, mainly bisphosphonates (47% more than one drug). Despite treatment, a significant proportion had limitations in their QL, especially related to pain (64%), mobility (47%) and anxiety/depression (33%). Most of the patients had been exposed to situations which were considered as risk factors. Of the patients included, 14% had family history of PD and 1.5% had children with PD. The ancestors of the familial cases came more frequently from Avila, Salamanca, La Coruña and Malaga. CONCLUSIONS: The pain and the limitation of mobility decrease the QL of patients with PD despite treatment. Frequently, patients have a history of exposure to risk factors.
ABSTRACT
BACKGROUND AND OBJECTIVE: We aimed to assess the influence of correct blood pressure (BP) measurement, following the recommendations of the Spanish Guideline of Hypertension 2005 (SGH), on the diagnostic decisions in hypertensive patients. PATIENTS AND METHOD: Prospective, longitudinal, observational, multicenter study conducted in hypertensive patients with stable pharmacologic therapy in primary care units. 4040 patients were included, in whom BP was measured following current clinical practice at the first visit (visit 1). After 7 days no therapeutic changes could be made and BP was measured following the criteria of good BP measurement from the SGH (visit 2). Control rate was assessed both, following the investigators opinion and the SGH algorithm, at visits 1 and 2. Differences in therapeutic recommendations between visits were assessed. RESULTS: 3436 patients were evaluable (48.9% women), with mean age (standard deviation) of 63.4 (11.4) years. Decreases in systolic/diastolic BP of 4.8 mmHg (95% confidence interval [CI], 4.5-5.1) and 2.8 mmHg (95% CI, 2.6-3.0) between visits were observed. The control rate following the investigators opinion was of 59.1% (95% CI, 57.4-60.8%) at visit 1 and 76.4% (95% CI, 75.0-77.9%) at visit 2, and the one following the criteria of the SGH was 32.2% (95% CI, 30.6-33.7%) at visit 1 and 46.6% (95% CI, 44.9-48.3%) at visit 2. The rate of patients in which therapeutic recommendations were changed was of 54.1% (95% CI, 52.4-55.7%). CONCLUSIONS: Applying the recommendations of the SHG for correct BP measurement led to increased control rate in relation to a previous measurement, prompting changes in the therapeutic attitude.
Subject(s)
Blood Pressure Determination/standards , Hypertension/diagnosis , Female , Humans , Male , Middle Aged , Prospective StudiesABSTRACT
FUNDAMENTO Y OBJETIVO: El propósito del estudio ha sido cuantificar la influencia de la correcta medida de la presión arterial (PA), siguiendo las recomendaciones de la Guía Española de Hipertensión2005 (GETHA), sobre la toma de decisiones diagnósticas en hipertensos. PACIENTES Y MÉTODO: Se ha realizado un estudio prospectivo, longitudinal, observacional y multicéntrico en hipertensos con tratamiento farmacológico estable, en el ámbito de atención primaria. Se incluyó a 4.040 pacientes, a quienes se efectuaron 2 mediciones de la PA: la primera según la práctica habitual (visita 1) y la segunda al cabo de 7 días, sin ninguna modificación terapéutica, aplicando los criterios de la GEHTA sobre la medición correcta de la PA (visita 2). Se calculó la tasa de control según criterio de los investigadores y aplicando el algoritmo de la GEHTA, y se evaluaron las diferencias entre las recomendaciones terapéuticas efectuadas tras las visitas 1 y 2.RESULTADOS: Fueron valorables 3.436 pacientes (un 48,9% mujeres), con una edad media (desviación estándar) de 63,4 (11,4) años. Se observaron descensos de la PA sistólica y de la PA diastólica de 4,8 mmHg (intervalo de confianza [IC] del 95%, 4,5-5,1) y de 2,8 mmHg (IC del95%, 2,6-3,0), respectivamente, entre las visitas 1 y 2. A criterio de los investigadores, el porcentaje de control fue del 59,1% (IC del 95%, 57,4-60,8%) en la visita 1 y del 76,4% (IC del95%, 75,0-77,9%) en la visita 2 (p < 0,001), mientras que al aplicar los criterios de la GEHTA el grado de control fue del 32,2% (IC del 95%, 30,6-33,7%) y del 46,6% (IC del 95%, 44,9-48,3%), respectivamente (p < 0,001). El porcentaje de pacientes a los que se modificaron las recomendaciones terapéuticas fue del 54,1% (IC del 95%, 52,4-55,7%).CONCLUSIONES: La aplicación de las recomendaciones para la medida correcta de la PA incrementó el porcentaje de control respecto a una medida previa, lo que dio lugar a una modificación en la conducta terapéutica
BACKGROUND AND OBJECTIVE: We aimed to assess the influence of correct blood pressure (BP) measurement, following the recommendations of the Spanish Guideline of Hypertension 2005(SGH), on the diagnostic decisions in hypertensive patients. PATIENTS AND METHOD: Prospective, longitudinal, observational, multicenter study conducted in hypertensive patients with stable pharmacologic therapy in primary care units. 4040 patients were included, in whom BP was measured following current clinical practice at the first visit(visit 1). After 7 days no therapeutic changes could be made and BP was measured following the criteria of good BP measurement from the SGH (visit 2). Control rate was assessed both, following the investigators opinion and the SGH algorithm, at visits 1 and 2. Differences in therapeutic recommendations between visits were assessed. RESULTS: 3436 patients were evaluable (48.9% women), with mean age (standard deviation) of63.4 (11.4) years. Decreases in systolic/diastolic BP of 4.8 mmHg (95% confidence interval [CI],4.5-5.1) and 2.8 mmHg (95% CI, 2.6-3.0) between visits were observed. The control rate following the investigators opinion was of 59.1% (95% CI, 57.4-60.8%) at visit 1 and 76.4% (95%CI, 75.0-77.9%) at visit 2, and the one following the criteria of the SGH was 32.2% (95% CI,30.6-33.7%) at visit 1 and 46.6% (95% CI, 44.9-48.3%) at visit 2. The rate of patients in which therapeutic recommendations were changed was of 54.1% (95% CI, 52.4-55.7%).CONCLUSIONS: Applying the recommendations of the SHG for correct BP measurement led to increased control rate in relation to a previous measurement, prompting changes in the therapeutic attitude