[Evaluation of infiltrations performed in primary care]

OBJECTIVES

To describe the evolution of the pain and the functional impotence in the articular and periarticular pathology after to infiltrate with local corticosteroid and anaesthetic; to analize the number of discharge certificates that maybe to give in the patients with employment transitory incapacity (ETI) during the first week post-infiltration.

DESIGN

Intervention without control group.

SETTING

Semiurban primary care physician's practices (ABS Piera).

PARTICIPANTS

Men and women elder than 18 years old, with articular and periarticular pathology.

INTERVENTION

Were infiltrated with local triamcinolone acetonid and bupivacain 2% 65 patients.

MAIN MEASUREMENTS

Were gathered socio-demographic factors, diagnostic, response, number of infiltrations for patient, secondary effects, and number of discharge certificates that were given in the patients in ETI situation during the first week post-infiltration.

RESULTS

Were infiltrated predominantly men (57%) with 31-65 years old (67.7%), employed (70.7%) in manual works (78.4%). Rotary joint tendinitis (46.2%) and epicondylitis (27.7%) were the most common diagnostics. Mean and CI (95%) obtained in the VAS for pain were: initially, 8.8 (7.4-9.8); week, 1.4 (1-1.8); 3 months, 2.2 (1.3-3.1), and year, 2.3 (1.1-3.5). Mean and CI (95%) found for functional impotence were: initially, 8.2 (6.7-9.7); week, 0.9 (0.7-1.1); 3 months, 1.2 (0.9-1.5), and year, 1.6 (1.4-1.8). The number of infiltrations for patient was 1.6. Hadn't important secondary effects. Were given 19 discharge certificates in 25 patients with ETI in the first week post-infiltration.

CONCLUSIONS

The patients diminished the pain and the functional impotence in the articular and periarticular pathology after of the infiltration, allowing to give an elevate number of discharge certificates during the first week post-infiltration.

[Screening and effectiveness evaluation of a brief intervention in risk drinkers seen in primary health care]

AIMS

To evaluate the screening, the effectiveness of an antialcoholic brief intervention for risk drinkers, the acceptation level to participate in this study, and the analytical parameters evolution associated to the alcohol consumption after of the intervention.

DESIGN

Longitudinal prospective intervention study of 1 year of duration.

SETTING

5 urban primary care physician's practices.

PARTICIPANTS

Of an aleatory pattern of 681 patients, men and women of 18-65 years old, were selected 78 risk drinkers. Patients with exclusion criteria (n=10), didn't wanted to participate (n=24) and had suspicion of alcoholic dependence syndrome (ADS) (n=11), didn't participated in this intervention.

INTERVENTIONS

Were offered antialcoholic brief counselling with written supporter and were followed with alcohol consumption rate and analytical control at 2 and 12 months.

MAIN MEASURES

Was estimated the prevalence of risk drinkers, the acceptation level to participate in this study, alcohol consumption and risk drinkers decreased at 2 and 12 months, analytical parameters evolution after of the intervention.

RESULTS

Prevalence of risk drinkers: 11.5% (95% confidence interval [CI], 8.3%-14.7%). Acceptation level to participate in this study: 64.7%. Significative alcohol consumption decreased at 2 and 12 months (P<.05). Risk drinkers decreased: at 2 months were 57.6% (95% CI, 50.3%-64.9%; P=.01) and at 12 months were 42.4% (95% CI; 35.9%-48.9%) (P=.003). GGT, MCV, cholesterol, and triglycerides significative decreased.

CONCLUSIONS

Low prevalence of risk drinkers without suspicion of ADS in our setting; high effectiveness of antialcoholic brief counselling and high acceptation level to participate in this study; reduction of the GGT, MCV, cholesterol, and triglycerides after of the intervention.