RESUMO
BACKGROUND: Venous thromboembolism (VTE) affects millions of patients worldwide and is responsible for thousands of hospitalisations annually. AIMS: To evaluate the awareness regarding VTE among Mexican internists. METHODS: We designed a cross-sectional survey using a questionnaire applied to Mexican internists mainly during academic meetings. RESULTS: We collected 1220 questionnaires. VTE was considered a potential complication for medical inpatients by 85% of the respondents, whereas 69% and 63%, respectively, considered pulmonary embolism to be a complication of deep vein thrombosis (DVT) and a cause of death. Awareness of some VTE risk factors was adequate, and 85% of those physicians surveyed routinely observed patients for these risk factors, although only 58% performed global risk stratification. Only 12% of the respondents considered length of hospital stay as a risk factor, and 58% assumed that the risk decreases after hospital discharge; 64% and 49% responded that the risk is higher, and VTE risk factors are more frequent in surgical versus medical inpatients respectively. VTE diagnosis was reported as easy or very easy for 59% of the respondents, but only 41% regarded phlebography as the gold standard for diagnosing DVT, although 85% of the respondents reported that d-dimer + Doppler ultrasound was an alternative. Pulmonary arteriography or helical computed tomography CT scan was the gold standard for diagnosing pulmonary embolism for 60% of the physicians, but 55% responded that electrocardiogram, arterial gasometry and chest X-ray are also useful. CONCLUSIONS: Awareness regarding VTE risk factors and the degree of diagnostic skills among Mexican internal medicine specialists are low.
Assuntos
Competência Clínica , Hospitalização , Medicina Interna/educação , Tromboembolia Venosa/diagnóstico , Adulto , Estudos Transversais , Feminino , Humanos , Tempo de Internação , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Fatores de Risco , Tomografia Computadorizada Espiral , Tromboembolia Venosa/diagnóstico por imagem , Tromboembolia Venosa/epidemiologia , Adulto JovemRESUMO
In order to evaluate captopril effectiveness in the treatment of glomerular albuminuria in nondiabetic patients, an initial study was carried out in 16 patients with proteinuria greater than 1 gr/1, administering captopril, 50 mg/day during a 4 month follow-up period. During that time, urinary albumin levels significantly descended (p < 0.001), with a concomitant rise in serum albumin. We conclude that captopril can be effective as a part of the treatment of albuminuria associated with nephropathy of non diabetic origin.