Cirugía y traumatología menor, ¿podemos?, ¿podremos? / Surgery and minor traumatology. Can we? Will we be able to?

No disponible

[Effectiveness of dermatologic minor surgery in the office of the family physician and patient satisfaction in relation with ambulatory surgery]. / Efectividad de la cirugía menor dermatológica en la consulta del médico de familia y satisfacción del paciente en relación con la cirugía ambulatoria.

BACKGROUND: The minor surgery by family physicians increase the primary care competences. The purpose of this work is to prove patients' satisfaction and minor surgery effectiveness practiced by family physicians in health centers with respect to ambulatory's general surgeon. MATERIAL AND METHODS: Case-control retrospective study, comparing dermatological surgical procedures performed by 4 family physicians and 8 3rd-year Family Physician residents with surgical procedures wade made by a surgeon over one a year period. Variables analysed include: descriptive samples homogeneity, surgery effectiveness (waiting time, esthetic results, healing time and number of visits, and histopathologic correlation) and patients' satisfaction (with the waiting time, with the results of surgery and with the physician). RESULTS: Minor surgical procedures carried out by 146 family physicians and 61 general surgeons were compared, in congruence with the analyzed descriptive homogeneity's parameters. Family physicians average waiting time was the lower, with a mean of 45 days less than the surgeon. Patient's satisfaction with the physician was higher when family physician were involved (p < 0.001); the same could be applied for the waiting time (p < 0.001). There were no significant differences over the effectiveness and patients' satisfaction. CONCLUSION: The dermatologic minor surgery by family physician is effective, satisfactory for patients, and has less waiting time. This results justify the introduction of minor surgery in the family physicians office.

[Minor surgery in the family physician's office. Description of one year's experience]. / Cirugía menor en la consulta del médico de familia. Descripción de un año de experiencia.

OBJECTIVE: To describe the first results from minor surgery (MS) performed by the family doctor (FD) and to analyse the concordance between presurgical diagnosis and anatomical pathology. DESIGN: Prospective study. SETTING: Health centre and hospital anatomical pathology service. PARTICIPANTS: Interventions over a year by 4 FD and 8 third-year family medicine interns. MEASUREMENTS AND MAIN RESULTS: Descriptive variables for all the interventions were analysed. There were: age and gender; place, size and diagnosis of the lesion; reason for the MS; type of intervention; waiting time; and histological findings. The prior diagnosis was compared with the anatomical pathology for simple agreement. There were 243 interventions. Complete data were obtained for 229 (124 female and 105 male, aged between 4 and 79). The most common reason for MS was aesthetic, followed by fear of malignity and pain. The techniques used most often were: surgical exeresis (56.3%) and cryotherapy (36.2%). Most problems treated were naevi (72 cases), verrucas (83) and epidemic-sebaceous cysts (23). All the substances extracted (140) were sent to Pathology and there was 84.1% agreement between the Laboratory report and doctor's diagnosis. Average waiting time for the intervention was 15 days. CONCLUSIONS: Performing MS in primary care is feasible, as long as the FD is correctly trained. In our unit there is little waiting time and high histopathologic concordance.

[Determination of theophylline blood levels by a rapid immunoenzyme method ( "Accu-Level"): results in 83 cases]. / Determinación de teofilinemias por método rápido inmunoenzimático ("Accu-Level"): resultados en 83 casos.

We report the results of the use of the "Accu-level" method for the rapid measurement of theophylline blood levels in a health center, so as to evaluate it for the routine practice of family doctors. The study included 83 patients receiving sustained effect theophylline preparations from May to September 1988. The accuracy of the method in the interassay evaluation (repetitivity) showed a variation coefficient of 7.92%, whereas in the intraassay evaluation (reproducibility) the coefficients were lower than 5%. The correlation study with the EMITT method showed a correlation coefficient of r = 0.9967. The present results, the easy use of the assay by the family doctor and the small technical equipment which is required support the use of this method for the monitorization of blood theophylline levels in outpatients.