MR in trichloroethane poisoning

We present a case of acute trichloroethane intoxication caused by inhalation of typewriter correction fluid. CT and MR findings revealed lesions in the basal ganglia and cortex similar to those observed in patients with methanol and carbon monoxide poisoning.

[Analysis of direct costs of controlling arterial hypertension]

OBJECTIVE

To analyse the number of attendances and the direct cost of pharmaceutical prescription arising from a year-long monitoring of hypertense patients.

SETTING

Health Centre.

DESIGN

A prospective observation study.

PATIENTS

220 hypertense patients, undergoing arterial pressure (AP) monitoring, were chosen by means of systematic random sampling.

MEASUREMENTS AND MAIN RESULTS

The variables of age, gender, cardiovascular risk factors, AP, monitoring level (criterion AP < 160-90 mmHg), attendances and treatment used were analysed. The pharmaceutical cost was calculated in line with the dosages and according to the 1990 Vademecum. The monitoring level was 43.6%. The total number of attendances per patient were 12.8 +/- 6.43 and those for hypertension, 7.9 +/- 3.5. Diabetics attended more for hypertension (8.8 vs 7.5, p < 0.05). Pharmaceutical treatment was prescribed for 183 people (83.2%). The number of drugs was correlated with the severity of the hypertension and the number of attendances. Overall drug cost was 429,571 pesetas per month. Average monthly cost per patient was 2,348.69 +/- 2,318.92 pesetas (range 90.5-12,856.5). Angiotensin enzyme conversion inhibitors (AECI) made for the greatest monthly mean cost per patient (4,352.9 pesetas) and diuretics, the least (322.2 pesetas).

CONCLUSION

Frequency of attendance is related to the presence of diabetes and the number of drugs prescribed. The introduction of AECI and Calcium antagonists into first-line treatment represents an important increase in the cost of controlling Hypertension.

[Control of arterial hypertension: analysis of visit and time factors]

OBJECTIVE

To analyse the frequency of attendance and the time elapsed between the diagnosis of Arterial Hypertension (AHT) and the control of Arterial Pressure (AP); and to analyse the different ways of presenting the level of control of AHT.

DESIGN

Retrospective study.

SETTING

Teaching Health Centre.

PATIENTS

103 hypertense patients diagnosed since 1986: 44 men (42.7%) and 59 women (57.3%), with an average age of 52.6 +/- 1. Their initial AP was 164.4 +/- 17.1/102.1 +/- 7.4 mmHg. The criterion of AHT control was Diastolic Arterial Pressure (DAP) < 90 mmHg.

MEASUREMENTS AND MAIN RESULTS

AP at the end of the first year was 150.1 +/- 20.6/90.7 +/- 9.6 mmHg (p < 0.001 in comparison with the initial AP). The average attendances for AHT and per patient in the first year was 8.7 +/- 5 (1-26). Patients with more severe forms of AHT and/or with associated risk factors visited more often (p < 0.05). During the first year 76 patients (73.7%) presented on at least one attendance a controlled DAP. At the end of the first year 46 patients (44.6%) were under control. The average time per patient until AP was controlled was 28.6 +/- 31.6 weeks (1-168). Males and under-65s took more time to control their AP (p < 0.05).

CONCLUSIONS

There are gender and age differences in the time required to bring AP under control. Frequency of attendance is related to the severity of AHT and the presence of other pathologies and risk factors. The level of control of AHT, expressed in different ways, is not constant.