[Clinical processes in a high resolution clinic of specialist outpatient clinics].

Objectives: The high resolution clinic (HRC) is an outpatient care process by which treatment and diagnosis are established, recorded, and completed in a single day. The aim of this study was to assess the extent to which patients with medical conditions may benefit from a single consultation system.

Material And Methods: A descriptive study of 795 first visit events, randomly selected as high-resolution consultations in cardiology, gastroenterology, internal medicine, and chest diseases.

Is time to search the Wells Score 4.0?

Background: Wells score for deep vein thrombosis presents problems for implementation in the hospital emergencies, mainly due to the complexity of its enforcement.

Objective: To assess whether the inclusion of D-dimer as a predictor might lead to a simplification of this clinical decision rule.

Patients And Methods: A database of deep vein thrombosis patients was studied by logistic regression model in which the 10 predictors in the Wells score and the dimer D were included.

[Do women demand to be assisted at medical clinics more often than men?].

Background: Different features of the users of the Spanish Public Health System have been previously assessed, specially in General Practice and Hospital Emergency Departments. Nevertheless, the epidemiological characteristics of those patients who attend to specialised clinics have not been so thoroughly evaluated.

Patients And Methods: The referee of the demand, the place of residence, the age and the sex of patients were all analysed for the ,first visits, at the Medical Department clinics (Internal Medicine, Cardiology, Gastroenterology, Pneumology) in our hospital, during 2002.

[Impact of automatized systems in a high resolution model of outpatients clinics].

Objective: To analyse the impact of computerised systems in Radiology and Laboratory Departments on the reduction in the waiting time of the patients attending to an Internal Medicine outpatient consultation organised in a high resolution model.

Methods: For one year, we studied the delay in diagnostic explorations (laboratory test, simple radiology, ultrasonic diagnostics and brain scanner) that were all applied for and performed in a single day. We compared the traditional organization (n = 312 explorations), in which the results were handed in by hospital auxiliary staff, to a computerised method (n = 457 explorations), which was implemented via our intranet.

[Referrals to a gastroenterology outpatient clinic: differences according to patients' geographical origin].

Introduction: The characteristics of users of the Spanish public health system have been evaluated in multiple studies. However, these studies usually refer to users of primary care and emergency services and less frequently to users of specialized services. Some studies have described differences according to patients' geographical origin.

[Comparative analysis of antioxidant defense during on-pump and off-pump cardiac surgery].

Introduction And Objectives: The transient myocardial ischemia that occurs during cardiac surgery leads to oxidative stress and the production of free radicals. The resulting damage can be reduced if cardiopulmonary bypass is avoided. We obtained indirect measures of the oxidative damage occurring during cardiac surgery by monitoring the glutathione system and we studied the influence of cardiopulmonary bypass.

[Candida parapsilosis endocarditis after prolonged antibiotic therapy].

Infective endocarditis is still a very serious disease whose prognosis has improved in recent years, even though advanced technologies have brought a greater number of cases attributable to increased growth of fungi in more virulent forms. We describe a case of endocarditis caused by Candida parapsilosis on a previously healthy aortic valve in a man who had received prolonged intravenous antibiotic treatment a few months earlier. The initial presentation included acute arterial ischaemia of the lower limbs.

[Therapeutic approaches in symptomatic hypertrophic obstructive cardiomyopathy].

Hypertrophic cardiomyopathy is a complex and heterogeneous disease. Although most patients experience just a few symptoms, and have a good prognosis, there are others whose symptoms are severe and progressive, determined by different pathophysiological elements such as diastolic dysfunction, myocardial ischemia, arrhythmias and subaortic obstruction. Approximately 20-30% of hypertrophic cardiomyopathy patients develop an intraventricular dynamic gradient, which in some cases, is responsible for severe symptoms which are ameliorated once the obstruction is reduced.