Presenter of 2 Presentations
THE POWER OF AN ELECTROCARDIOGRAM - A CASE REPORT
Abstract
Abstract Body
Background and purpose:
Eletrocardiogram(EKG) is a very informative, cheap and widespread tool that can diagnose heart problems. Every phsysician should know how to read an EKG, however, in Portugal, in ambulatory setting they are reported by cardiologists. The aim of this case report is to highlight the importance of carefully analyzing all the exams that are requested in daily practice.
Methods:
Case study. The information was retrieved from the electronic medical record.
Results:
A 62-years-old patient, diagnosed with cholecystitis in an emergency department(ED), was supposed to be submitted to elective cholecystectomy, however, during pre-procedure routines the patient was found to have an abnormal EKG. It revealed excessive supraventricular extrassystoles, and an observation by cardiology was advised in order to decide if the surgery could be performed. The patient’s condition worsened and had to return to the ED. An urgent surgery was advised, however it was not performed given the abnormal EKG. The patient was discharged home on analgesics and antibiotics. The following day, we saw the patient in our health center and after looking at the EKG, we realized that it had been incorrectly interpreted and it was normal. The timing intervals settings were not correct and it was shorter than the usual interval. The patient ended up doing the surgery and recovered well.
Conclusions:
This case highlights the importance of analyzing all the exams that are requested in daily practice, and, despite their report, the physician should be critical and analyze them to the best of his knowledge.
OSTEOPOROSIS DIAGNOSIS IN PRIMARY CARE – THE REALITY OF TWO HEALTH CENTERS
Abstract
Abstract Body
Background and Purpose
Osteoporosis is characterized by low mineral bone density and increases the risk of fracture. It affects 10% of the Portuguese population, mainly women. It can be a silent disease, and its diagnostic can be established using Dual Energy X-ray Absorptiometry(DEXA) and the risk of fracture can be stratified using FRAX. With this study we intend to review the diagnostic methods used to diagnosis osteoporosis in a primary care setting.
Methods
Transverse, observational study that includes all the patients with the diagnosis of osteoporosis in two primary care institutions.
Results
From a total of 16500 patients 762 were diagnosed with osteoporosis. This represents a prevalence of 4,61%, of which 95% are women and 5% are men, with an average age of 75 years SD±10. In these patients, the diagnosis was established using DEXA in 32,3%, RX in 8% and FRAX in 0,5%, and in 59,2% the method was unknown. From the latter, 37,2% performed a DEXA and to 1,8% FRAX was applied later on. From those diagnosed using RX, 21,6% ended up performing a DEXA and to 1,6% FRAX was applied later.
Conclusions
Osteoporosis is a challenging diagnosis for the general practitioner(GP), and is greatly underdiagnosed. Although a third of these diagnosis are correctly established using a DEXA, many of them were wrongly established using only X-ray’s. Therefore, it is essential to educate the GP about the correct diagnostic algorithms and teach them how to use newly developed and inexpensive methods like FRAX, in order to improve the quality of healthcare they provide.