[Adequacy of the pharmacologic treatment to the recommendations of a performance protocol in hypercholesterolemia in primary care]. / Adecuación del tratamiento farmacológico a las recomendaciones de un protocolo de actuación ante la hipercolesterolemia en atención primaria.

OBJECTIVE: To evaluate whether hypolipaemiant treatment in patients with hypercholesterolaemia (HC) corresponds to the recommendations in a primary care diagnosis and treatment protocol. DESIGN: Descriptive observational study. SETTING: Primary care centre. PATIENTS: 304 patients whose long-term prescription records recorded hypolipaemiant drugs. RESULTS: Average age was 62.7 and 198 were women. 176 presented simple HC and 125 mixed dyslipaemia. 46 had a history of ischaemic cardiopathy. Pre-treatment LDL-cholesterol (LDL-c) was recorded for 224; 168 of them had 2 or more cardiovascular risk factors. Of the 202 who had a record of post-treatment LDL-c, 163 were at level III of risk, which went down to 47 at 6 months. The values before and after medication were as follows: total cholesterol (TC) 290.3 mg/dl and 246.2 mg/dl; LDL-c 207.8 mg/dl and 166.0 mg/dl; HDL-cholesterol 50.5 mg/dl and 53.1 mg/dl; and triglycerides (TG) 156.1 mg/dl and 133.6 mg/dl. Mean reduction of TC and LDL-c was greater in the patients treated with statins that in those treated with fibrates. Decrease in TG was greater with fibrates. CONCLUSIONS: Treatment was initiated when LDL-c figures were over the limit specified in the protocol. In most cases this was because of the accumulation of cardiovascular risk factors.

[A tumor registry at a primary care center]. / Registro de tumores en un centro de asistencia primaria.

AIM: We analysed the data obtained from a tumor register kept in a Primary Care Centre (PCC) to find out the variables which contribute to the diagnostic and therapeutic evolution of our patients. DESIGN: Retrospective study on every Neoplasia registered in the Centre. PATIENTS: 293 malignant Neoplasias were recorded in the period between June 1984 and June 1990 (184 in males--62.8%; and 109 in women--37.2%). MEASUREMENTS AND MAIN RESULTS: The intervals between symptom and consultation (ISC), between consultation and referral (ICR), between referral and diagnosis (IRD) and between diagnosis and treatment (IDT) were evaluated. The average age at the moment of diagnosis was 59 (SD:13). There were 3.9% double neoplasias. The most frequent type was lung cancer with 41 cases (14%). This also occupied first place among men, whereas breast cancer did so among women. 10 tumours were diagnosed by screening: 4 breast, 5 cervix and 1 endometrium, which represent 16%, 50% and 14.3% respectively of these cancers. For all neoplasias taken together, the average time of ISC was 44.09 days (SD 73.48) and of IDT 25.75 days (SD:61.55). Given the wide variations, we assessed the most common types of tumour. CONCLUSIONS: The usefulness of keeping a tumour register in a Primary Care Centre, which could identify the factors which affect diagnostic delays and find possible corrective measures to reduce the delays, was appraised.