"NASCI case of the month: left ventricular apical hypoplasia"

Left ventricular apical hypoplasia is a rare congenital condition. It can cause nonspecific symptoms and can be accompanied by cardiac conduction system alterations such as bundle branch block, atrial flutter (AF) or atrial fibrillation. The diagnosis mostly is made by imaging.

Urinary incontinence in gynaecological consultations. Do all women with symptoms wish to be treated?

OBJECTIVE

To determine the prevalence and symptom severity of urinary incontinence (UI) in women who attend primary care gynaecological consultations, as well as the proportion of women with UI symptoms who wish to be studied and treated.

MATERIALS AND METHODS

A multicentre, observational, descriptive cross-sectional study was conducted of women who visit the 8 specialised consultations for sexual and reproductive health (SRH) in the 4 Catalan provinces for any reason (except UI, pregnancy and postpartum). We employed the ICQ-UI-SF questionnaire to detect UI symptoms. Women with UI symptoms (ICI-Q-SF>0) were asked whether they wanted specific care for their UI problem. Those who answered "no" were asked why.

RESULTS

The study included 2840 women, 41.8% of whom reported urine losses, especially mild to moderate symptoms. Some 53.62% of the women with UI responded that they did not wish to be treated. Of these, 75% had mild symptoms, 45% had moderate symptoms, and only 16% and 5% had severe or very severe symptoms, respectively. Fifty-three percent of the women did not want treatment because the UI was not a significant problem for them.

CONCLUSIONS

Almost half of the women who attended a specialised consultation for SRH for any reason reported UI symptoms, especially mild and moderate. More than half of the patients with UI symptoms did not want to start a diagnostic and treatment process for their problem. Symptom severity is associated with the willingness to be treated.

[Epidemiology of human hydatidosis in the IX Region of la Araucania, Chile 1991-1998]

In the region of la Araucania, located in the south of Chile (37 degrees 24'-39 degrees 34' South lat.), the economy is based in cattle raising and agriculture. The cases of human hydatidosis, mortality and notification registered in la Araucania 1991-1998 are reviewed. The rate for hydatid disease is 38.5 per 100,000 population. Liver (47.1%) and lung (40.7%) were the most affected viscera. Days in hospital, 11-20 the 56.1%. Disease in female is 51.1%. The mortality rate is 0.8 per 100,000, the most frequently affected county is Imperial. The age group 15-44 years is the most affected. The notification rate is 8.74 per 100,000 population. The rate for hydatid disease is higher than the rate of notification, then necessarily there exist a subnotification. We think that it is necessary to investigate the serological prevalence of hydatidosis in the population of the IX Region Araucania.

Special characteristics of osteoid osteoma in the proximal phalanx

We report two cases of osteoid osteoma in the proximal phalanx. This is an uncommon location for the lesion and it has special clinical and radiological features. Both cases were successfully treated when an 'en bloc' excision of the lesion, including the nidus, was performed. Four operations were required in the first case.

[Seroepidemiological investigation of various tissue helminthiasis, by means of indirect hemagglutination test, in Lonquimay County, Chile]

In order to have a present perspective on the prevalence on the epidemiology of some tissue helminthiasis in Lonquimay County, southern Chile, in 1993 a seroepidemiological survey, by means of an indirect hemagglutination test (IHAT) for hydatidosis, cysticercosis and trichinosis was undertaken. In 11 (1.2%), 10 (1.1%) and 6 (0.6%) out of 945 examined persons, most of them from rural areas, the corresponding IHAT resulted positive. Additionally, radiographic and ecotomographical studies for thorax and abdomen respectively were performed to the 11 individuals with serology positive for hydatidosis: whereas all the thoracic radiographies resulted negative, liver hydatic cysts were detected in five persons, who latter on were submitted to surgery. Prevalence rates of hydatidosis in Lonquimay are among the highest regional and national values.

[Ischemic cardiopathy in primary care. A descriptive study]

A descriptive study of ischemic heart disease in a primary care center is reported. From the recording systems 112 patients with IHD (9 of them dead) were identified. The calculated incidence and prevalence rates were 1.9/1000 and 10.9/1000, respectively. There were remarkably high rates of cardiovascular risk factors. The most common forms of presentation were myocardial infarction in males and angina in females. The physicians of the primary care center played a role in the diagnosis in 17% of patients. In addition, the disease was exclusively managed in the primary care center in 29% of patients, most of them over 65 years of age. The role of the primary care physician in the diagnosis and control of this condition is emphasized.