Semergen
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To design and validate a triage system for emergency services in primary care. ⋯ The triage system shows good interobserver agreement results, has a good correlation with the referral hospital, and there was no disagreement with the opinion of professionals.
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Sarcoidosis is a multisystem chronic disease characterised by the accumulation of inflammatory cells into the affected tissue, secondary to excessive cellular immune response. It can occur in any organ, although the most common is the lung. The skin lesions of sarcoidosis are only present in 25-30% of patients, and have a highly variable clinical expression. ⋯ Due to the presence of dyspnea a chest x-ray was requested, which showed changes in the parenchyma and hilum. A skin and transbronchial biopsy was subsequently performed, which confirmed the diagnosis of sarcoidosis. The skin and lung lesions subsided after prolonged treatment with oral adrenal cortex hormones.
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The benefit of acetylsalicylic acid and other antiplatelet drugs in secondary prevention is well established, however it use in primary prevention continues to be controversial. On the one hand, the benefit obtained is very near the potential damage arising from its use (mainly gastrointestinal bleeding), and on the other, the net benefit is less, given that its aim is to prevent the occurrence of vascular events in situations with a lower baseline risk. Antiplatelet treatment with aspirin in primary prevention has been evaluated in clinical trials and several meta-analyses, comparing its efficacy with a placebo, and with results noted for their heterogeneity. The mechanisms of action of different antiplatelet drugs, as well as the existing evidence with aspirin in primary prevention, the directions for its use by different Scientific Societies, and the cost/benefit of the intervention are reviewed.
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Primary Care Physicians are usually the first to see patients with neuropathic pain. The aim of this study is to assess the prevalence of neuropathic pain, its therapeutic management, and to clinically characterize these patients. ⋯ Neuropathic pain according to NP4 test is highly prevalent in Spanish Primary Care settings. The management of these patients with NSAIDs and non-opioid analgesics is not appropriate, as they are not recommended for this kind of pain. Although they were being treated with more than 2 analgesics, they still referred to high pain intensity, interference in daily activities, and a low general opinion of the treatment.
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One of the principal characteristics of a good pharmacological combination is drug synergism. A new analgesic combination of ibuprofen, a non-steroidal anti-inflammatory drug, used frequently in clinical practice due to good quotient of efficacy and safety, and codeine, a minor opiate used very much as second analgesic step in combination, has recently come on the market. We have conducted a review in MEDLINE of the principal studies published in the medical literature as regards the efficacy and safety of both drugs separately and finally, a review of the clinical experience showed in studies with analgesic combinations in general and on the hypothesis of a possible drug synergism between NSAIDs and Opiates.