0．1％他克莫司治疗浆细胞性龟头炎

背景：浆细胞性龟头炎或Zoon龟头炎（BZ）是成年男性的一种常见疾病，皮肤损害多位于龟头，也可累及包皮，其病因尚不明确。目的：报道采用0．1％他克莫司软膏治疗两例BZ患者的经验，并与其他局部疗法对比。患者和方法：两例未曾行包皮环切术的高加索成年男性均患BZ，局部外用0．1％他克莫司软膏，2次／d。结果：分别随访1年和10个月，发现两例患者的皮肤损害均显著改善。结论：局部外用0．1％他克莫司软膏治疗BZ安全有效。     

Los problemas de salud también explican la utilización de servicios sociales en atención domiciliaria

ObjectiveTo identify which social and health variables are associated with receiving social services in patients included in home care programmes with the implementation of the Dependence Law.DesignCross-sectional study.Setting72 primary health care teams in Catalonia.PatientsPatients over 64 years old with chronic diseases in home care programmes in Catalonia.MeasurementsHealth status variables: Charlson, Barthel, Pfeiffer, Braden and Gijon, data from their carer (Zarit), self perception of health (SF-12), health professional visits, as well as: emergency visits, temporary admissions, and final results such as death or definitive admission in a nursing home or a hospital.ResultsA total of 1068 patients were included, 46.8% of the patients received some kind of social service, public or private. We observed that the variables related to receive some kind of social services are: high dependence (Barthel test), pressure sores and home care rehabilitation. Barthel test is highly associated with having social problems (Gijon test), living without an informal carer, more than 2 GP visits and having additional private health care.ConclusionsTo be more fair, the evaluation of the provisions of the Dependence Law should also consider the health status of the patient. With the implementation of this law we can observe difficulties in access to social services for middle class patients. These patients do not have access to public social assistance and cannot pay for a private one. Social services are still an alternative to family care.     

Plasma cell balanitis treated with tacrolimus 0.1%

BACKGROUND: Plasma cell balanitis or balanitis of Zoon (BZ) is a frequent diagnosis in mature men and lesions are generally localized on the glans but may involve the prepuce; its aetiology remains unknown. OBJECTIVES: To present our experience with tacrolimus 0.1% ointment in the treatment of two patients with BZ refractive to other topical treatments. PATIENTS AND METHODS: Two uncircumcised mature caucasian males were seen, both presenting with BZ; topical tacrolimus 0.1% ointment twice daily was prescribed in each case. RESULTS: Marked improvement of the lesions in both patients has been observed, with follow-up of 1 year and 10 months, respectively. CONCLUSIONS: Topical tacrolimus 0.1% ointment is an effective and safe treatment for BZ.     

Nursing workload predictors in Catalonia (Spain): a home care cohort study

Objective

To identify the characteristics of chronic patients and their environment in order to predict the nursing workload required 1 year after their inclusion in a home care program.

Methods

A longitudinal study was carried out in 72 primary health care teams in Catalonia (Spain) with a 1-year follow-up of 1,068 home care patients over 64 years old. The variables collected from each patient included data on health and social status (Charlson and Barthel indexes and the Pfeiffer, Braden and Gijon scales), carer overburden (Zarit scale), hospital admissions, use of emergency services, self-perceived health (SF-12) and the number of health worker visits.

Results

Patients received 7.2 (SD 10.4) visits per year from their nurse-in-charge, out of a total of 8.7 (SD 13.1) nursing visits per year. Risk factors for receiving more nursing visits at home were male gender (IRR = 1.42, 95%CI: 1.20-1.67), dependency for daily activities (IRR = 1.65, 95%CI: 1.29-2.13), decubitus ulcers (IRR = 4.03, 95%CI: 2.27-7.14) and receiving emergency medical care at home (IRR = 1.65, 95%CI: 1.31-2.07). In contrast, patients with major cognitive impairment (IRR = 0.78, 95%CI: 0.63-0.98) had a lower probability of receiving nursing visits at home.

Conclusions

Workload can be predicted by patients’ clinical characteristics. The positive correlation of workload with variables related to disease severity and the negative correlation with variables related to cognitive impairment show that home care nursing in Catalonia is basically demand-oriented.