[GPs' self-perception of their own role compared with hospital, ambulatory, academic, and health organisation physicians]. / Auto-percezione del ruolo professionale in medicina generale nel confronto con il medico specialista.

Aim of the present study was to explore how the 76 general practitioners (GPs) - serving Carpi district (90,000 residents) - value their own role compared with the hospital, ambulatory, academic, and health organisation physicians'. GPs had a positive self-image only in comparison with health organisation doctors (7 vs 7 grades). GPs disappointed with themselves when comparing their role with ambulatory (-1.6 grades), academic (-1.9 grades) and hospital doctors (-2.2 grades). Secondarily, GPs perceived patients' valuing their professional role mostly 'subordinate' to the other physicians', except health organisation colleagues'.

Non-HDL cholesterol predicts coronary heart disease in primary prevention: findings from an Italian 40-69 year-old cohort in general practice.

OBJECTS: Non-HDL cholesterol is now recommended as an index of risk associated with combined dyslipidemia, and it has also been found useful in predicting coronary heart disease (CHD) risk in patients with diabetes. We studied the association between known CHD risk factors, enclosed non-HDL cholesterol, and a "high CHD risk condition", i.e. a "5-years CHD risk >15%" in general practice. METHODS: We studied 4,085 40-69 year-old diabetic (no. 489) and non-diabetic (no. 3,596) individuals from an opportunistic cohort. Cross-sectional descriptive statistics, and age- and gender-adjusted multiple logistic exponential betas have been calculated. RESULTS: About 12% of the participants had diabetes. Age- and gender-adjusted comparison showed that all the study variables were significantly worse in diabetic vs. non-diabetic individuals (except cigarette smoking, total blood cholesterol and the ratio of total to HDL cholesterol). They had a mean "5-year CHD-risk" significantly higher than non-diabetic individuals (18.8+/-11.9% vs 7.5+/-6.9%, P<0.01), and a four-fold prevalence of "5-years CHD risk >15%" (55.4% vs 11.1%, P<0.01). As to diabetic individuals, the study variables associated to a "high CHD risk condition" were cigarette smoking, systolic blood pressure, and non-HDL blood cholesterol levels. As to non-diabetic individuals cigarette smoking, systolic blood pressure, and HDL (inversely) and non-HDL blood cholesterol levels were associated to a "high CHD risk condition". CONCLUSIONS: Non-HDL cholesterol--and cigarette smoking and systolic blood pressure--strongly predicted a "high CHD risk condition" both in diabetic and non-diabetic individuals.

[Relationship between the assessment of coronary risk using the Italian chart and the assessment with the New Zealand chart]. / Relazione tra la valutazione del rischio coronarico calcolato con la carta italiana e quella neozelandese.

OBJECTIVE: To describe the distribution of coronary risk in primary prevention using both the New Zealand and Italian charts, and to assess whether there is a relationship between the two scales built on data from populations at different natural coronary risk. DESIGN: Descriptive study. SETTING: Carpi's district, Territorial Health Authority in Modena province. PARTICIPANTS: Population between 40 and 69 years old without any background of cardiovascular disease. MAIN MEASURES: The variables studied corresponded to the Jackson's New Zealand table and the Italian Progetto Cuore's one. Concordance was assessed with the kappa coefficient. RESULTS: We studied 1850 men and 2235 women with an average age of 56 years. The percentage of 'high' coronary risk men and women at the New Zealand's chart was 27% and 8% respectively. Ten percent of 'high' risk men and no woman were found at the Italian chart. The kappa coefficient to evaluate the agreement on high risk men between the two charts was 'moderate' (kappa = 0.403). No estimation was allowed for women. CONCLUSION: There was moderate agreement between the New Zealand and the Progetto Cuore charts.