RESUMO
Objetivos Determinar la prevalencia de la solicitud del perfil lipídico como ayuda diagnóstica de primera línea en pacientes con impresión clínica de vértigo periférico, así como un análisis de la relación costo-beneficio de dicha solicitud. Métodos Estudio de tipo corte transversal retrospectivo. Revisión de 201 historias de pacientes atendidos en la consulta externa tanto de especialistas como de médicos generales de la Clínica Universitaria Teletón y Casa chía, con diagnóstico de vértigo periférico, en el periodo comprendido entre enero de 2005 y julio de 2008. Resultados Las edades de los pacientes oscilaron entre 6 y 87 años, el 36 % de sexo masculino y el 64 % femenino. El perfil lipídico fue solicitado como prueba diagnóstica inicial para el manejo de vértigo a un 76 % de los pacientes. Los perfiles lipídicos hallados fueron normales en el 80 % de los pacientes a quienes se les solicitó. Se presenta el análisis de la relación costo-beneficio de esta prueba. Conclusiones Existe una alta prevalencia de solicitud de perfil lipídico como estudio de primera línea en el abordaje de pacientes con vértigo periférico, aunque no existe evidencia que avale esta solicitud, se requiere retroalimentación al cuerpo médico tanto de atención primaria como especialistas.
Objective Determining the prevalence of requesting lipid profile as a first-line diagnostic method in patients having a clinical impression of peripheral vertigo and also determining such request's cost- benefit ratio. Methods This was a retrospective cross-sectional study of 201 clinical charts regarding patients diagnosed as having peripheral vertigo at the Teletón teaching hospital's outpatient services in Chía between January 2005 and July 2008. Clinical charts drawn up by both general practitioners and medical specialists at first-time visit were compiled and analyzed Results The patients were aged 6 to 87 years old; 36 % were males and 64 % females. Lipid profile was requested for 76 % of the patients as initial diagnostic method; it was found that 80 % of the results revealed no abnormality. Conclusion Although a high prevalence regarding a request for lipid profile first-line study was found for patients having peripheral vertigo, there was no scientific evidence supporting such requirement. Ordering this kind of study not only increases unnecessary costs concerning diagnostic methods but also involves unjustified treatment. Feedback is needed for both doctors and first attention staff to ensure that this type of practice becomes changed.
Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Testes Diagnósticos de Rotina , Lipídeos/sangue , Padrões de Prática Médica , Procedimentos Desnecessários , Vertigem/sangue , Colômbia/epidemiologia , Comorbidade , Análise Custo-Benefício , Estudos Transversais , Testes Diagnósticos de Rotina/economia , Dislipidemias/sangue , Dislipidemias/diagnóstico , Dislipidemias/economia , Dislipidemias/epidemiologia , Medicina Geral , Hospitais Universitários/economia , Medicina , Ambulatório Hospitalar/economia , Padrões de Prática Médica/economia , Estudos Retrospectivos , Procedimentos Desnecessários/economia , Vertigem/economia , Vertigem/epidemiologiaRESUMO
OBJECTIVE: Determining the prevalence of requesting lipid profile as a first-line diagnostic method in patients having a clinical impression of peripheral vertigo and also determining such request's cost- benefit ratio. METHODS: This was a retrospective cross-sectional study of 201 clinical charts regarding patients diagnosed as having peripheral vertigo at the Teletón teaching hospital's outpatient services in Chía between January 2005 and July 2008. Clinical charts drawn up by both general practitioners and medical specialists at first-time visit were compiled and analyzed. RESULTS: The patients were aged 6 to 87 years old; 36 % were males and 64 % females. Lipid profile was requested for 76 % of the patients as initial diagnostic method; it was found that 80 % of the results revealed no abnormality. CONCLUSION: Although a high prevalence regarding a request for lipid profile first-line study was found for patients having peripheral vertigo, there was no scientific evidence supporting such requirement. Ordering this kind of study not only increases unnecessary costs concerning diagnostic methods but also involves unjustified treatment. Feedback is needed for both doctors and first attention staff to ensure that this type of practice becomes changed.
Assuntos
Testes Diagnósticos de Rotina/estatística & dados numéricos , Lipídeos/sangue , Padrões de Prática Médica/estatística & dados numéricos , Procedimentos Desnecessários/estatística & dados numéricos , Vertigem/sangue , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Colômbia/epidemiologia , Comorbidade , Análise Custo-Benefício , Estudos Transversais , Testes Diagnósticos de Rotina/economia , Dislipidemias/sangue , Dislipidemias/diagnóstico , Dislipidemias/economia , Dislipidemias/epidemiologia , Feminino , Medicina Geral , Hospitais Universitários/economia , Humanos , Masculino , Medicina , Pessoa de Meia-Idade , Ambulatório Hospitalar/economia , Padrões de Prática Médica/economia , Estudos Retrospectivos , Procedimentos Desnecessários/economia , Vertigem/economia , Vertigem/epidemiologia , Adulto JovemRESUMO
OBJECTIVES: To evaluate the relation between creatine kinase-MB (CK-MB) and benign paroxysmal vertigo in childhood (BPV). STUDY DESIGN: We prospectively evaluated and followed serum CK-MB in 22 children with BPV diagnosed between 1998 and 2003. RESULTS: The average age of debut for BPV was 1.7 years, and follow-up time was 2.8 years. The CK-MB values were elevated in all children. CK-MB values were persistently increased (mean, 6.0 microg/L) during the study period and were not related to duration of BPV, time since last attack, or frequency of attacks. CK-MB became normal in 7 children who recovered during the study period. After the initial increased CK-MB value, CK, aspartate aminotransferase, and cardiac troponin I (in 16 children) were measured as markers of muscular disease. CK was slightly increased in 7 (31.8%) and aspartate aminotransferase in 14 (63.6%) of the children. Cardiac troponin I was normal in all children. CONCLUSIONS: In this study, serum CK-MB levels were associated with BPV. These findings indicate a possible muscular involvement in BPV. Further studies will be needed to determine if CK-MB is useful as a diagnostic test for BPV.