Habilidades y competencias en genética clínica para el médico de familia español / Skills and competencies in clinical genetics for Spanish family doctor

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Virus Zika. ¿Alarma excesiva o riesgo real? / Zika virus. Excessive alarm or real risk?

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Prevalencia de dolor como motivo de consulta y su influencia en el sueño: experiencia en un centro de atención primaria / Frequency of pain as a reason for visiting a primary care clinic and its influence on sleep

ObjetivosDeterminar la frecuencia de dolor como motivo de visita en una consulta de atención primaria y conocer su influencia en el sueño.DiseñoEstudio descriptivo transversal.ÁmbitoCentro de Atención Primaria urbano de Hospitalet de Llobregat.ParticipantesPacientes que acudían al centro con cita previa, los 5 primeros diarios. Se catalogaron como casos aquellos que consultaban por dolor, y como controles el resto.Mediciones principalesVariables sociodemográficas, antecedentes patológicos, uso de coanalgésicos, cuestionario Índice de Calidad del Sueño de Pittsburgh (puntuación>5: «malos dormidores»). Para los casos, se evaluó, además, cronología del dolor, tipo, intensidad, sistema afectado y tratamiento.Resultados206 pacientes incluidos y 31 excluidos. La edad media fue de 50 años, 56% mujeres. El 39% casos (de éstos, 78% dolor agudo, 80% nociceptivo, 75% episódico y 71% musculoesquelético). La intensidad del dolor con la escala VAS fue de 4,9. El 62% recibían tratamiento analgésico con primer escalón de la OMS. El 45% de los pacientes cumplían criterios de «buen dormidor». En el análisis multivariante en hombres el dolor agudo (p=0,022) y la intensidad del mismo (p=0,035) aparecieron como factores independientes de mal descanso nocturno; en mujeres ninguna variable fue significativa.ConclusionesEn nuestro estudio un elevado porcentaje de pacientes consultan por dolor agudo, especialmente musculoesquelético. Los hombres presentan una relación entre mala calidad del sueño, intensidad del dolor y dolor agudo. Se requieren estudios posteriores para profundizar en el tema y así mejorar el dolor y la calidad del sueño de nuestros pacientes(AU)

ObjectivesTo determine the frequency of pain as a reason to visit a Primary Care doctor and to investigate the influence of pain on sleep disturbances.DesignCross-sectional descriptive study.SettingUrban Primary Health Care Centre.ParticipantsThe first five patients who came to the primary health care centre with an appointment were included. Those who came with pain were labelled as cases, the others as controls.Main measurementsSocio-demographic variables, background, use of co-analgesics, Pittsburgh Sleep Quality Index (a global PSQI score greater than 5 indicated “poor sleepers”). For the cases, pain intensity was also assessed, chronology and kind of pain, the system affected and treatment.ResultsA total of 206 patients were included and 31 excluded. The mean age was 50 years and 56% were women. Pain was the reason for consultation in 39% of the patients, of whom 78% had acute pain, 80% nociceptive, 75% incidental and 71% musculoskeletal. The average VAS score was 4.98. A total of 62% were receiving treatment according to the first step of the WHO pain ladder. Forty-five per cent of patients were categorized as “good sleepers”. The multivariate analysis showed that acute pain (P=.022) and pain intensity (P=.035) in men appeared as independent factors of sleep disturbances; in women there were no statistically significant variables.ConclusionsIn our study, a high percentage of patients came to the primary health care centre for pain, mainly musculoskeletal. In men, there is a clear relationship between sleep disturbances, pain intensity and acute pain. Further research is needed to study this topic in depth, in order to alleviate pain and improve the sleep quality in our patients(AU)

[Frequency of pain as a reason for visiting a primary care clinic and its influence on sleep]. / Prevalencia de dolor como motivo de consulta y su influencia en el sueño: experiencia en un centro de atención primaria.

OBJECTIVES: To determine the frequency of pain as a reason to visit a Primary Care doctor and to investigate the influence of pain on sleep disturbances. DESIGN: Cross-sectional descriptive study. SETTING: Urban Primary Health Care Centre. PARTICIPANTS: The first five patients who came to the primary health care centre with an appointment were included. Those who came with pain were labelled as cases, the others as controls. MAIN MEASUREMENTS: Socio-demographic variables, background, use of co-analgesics, Pittsburgh Sleep Quality Index (a global PSQI score greater than 5 indicated "poor sleepers"). For the cases, pain intensity was also assessed, chronology and kind of pain, the system affected and treatment. RESULTS: A total of 206 patients were included and 31 excluded. The mean age was 50 years and 56% were women. Pain was the reason for consultation in 39% of the patients, of whom 78% had acute pain, 80% nociceptive, 75% incidental and 71% musculoskeletal. The average VAS score was 4.98. A total of 62% were receiving treatment according to the first step of the WHO pain ladder. Forty-five per cent of patients were categorized as "good sleepers". The multivariate analysis showed that acute pain (P=.022) and pain intensity (P=.035) in men appeared as independent factors of sleep disturbances; in women there were no statistically significant variables. CONCLUSIONS: In our study, a high percentage of patients came to the primary health care centre for pain, mainly musculoskeletal. In men, there is a clear relationship between sleep disturbances, pain intensity and acute pain. Further research is needed to study this topic in depth, in order to alleviate pain and improve the sleep quality in our patients.