Prevalence of Abdominal Aortic Aneurysm in Men Aged 65-74 Years in a Metropolitan Area in North-East Spain.

BACKGROUND: A declining prevalence of AAA and a shift in the distribution towards the older population have been observed during the last decade in Europe. The aim was to estimate the current screening prevalence of AAA in men aged 65-74 years in a metropolitan area in north-east Spain and to identify associated risk factors. METHODS: A cross sectional prevalence study in men registered in L'Hospitalet Primary Healthcare Services (Barcelona, Spain) was performed. There were 619 randomly selected subjects (expected prevalence of aneurysm, 5%; accuracy of estimation, ±2%; loss to follow up, 30%). Exclusion criteria were life expectancy <1 year, limited quality of life, previous diagnosis of AAA, prior aorto-femoral surgery, and non-Caucasian. The following were measured: internal diameter of the infrarenal abdominal aorta using ultrasound, cardiovascular risk factors, personal (heart disease, stroke, peripheral vascular disease) and family history (AAA), physical examination, and blood tests. We estimated the prevalence and 95% confidence interval of AAA, and used logistic regression analysis to identify risk factors for AAA. RESULTS: Among the 651 individuals included in the analysis the prevalence of aneurysm was 2.30% (95% CI, 1.30-3.77%). In the regression analysis, AAA was associated with smoking (0-10, 11-20, or >20 cigarettes/day), diagnosis of myocardial infarction, and being taller than the median (165 cm). CONCLUSIONS: The current screening prevalence of AAA among men aged 65-74 years in a metropolitan area in north-east Spain is similar to that in northern Europe. Smoking, myocardial infarction, and height were associated with the presence of AAA.

[Infectious diseases in primary care]. / Patología infecciosa en atención primaria.

OBJECTIVE: To find the frequency and seasonal variability of the infectious diseases detected over a year. DESIGN: Observational prospective study. SETTING: Primary care centre. PATIENTS: Simple multi-stage random sampling of the patients over 14 seen on demand at general medical clinics and the Casualty department between June 1991 and May 1992. MEASUREMENTS AND MAIN RESULTS: Out of 49,193 attendances during the study period, the attendance sample was 2,523, of which 474 (18.8%; CI: 17.3-20.3%) were for infectious conditions. Average age of these 474 was 39 (SD: 19.17); 55% were women. Frequency of respiratory infections was 64.1% (CI: 59.8-68.5%). The correlation coefficient between respiratory infections and the total number of infections was 0.94 (R2 = 0.89). The frequency of infections oscillated between 29% (CI: 23-35%) in February and 10% (CI: 5.8-14.5%) in May. CONCLUSIONS: Infectious conditions account for a considerable percentage of the total number of primary care attendances. There is a seasonal variation in infections, which is mainly due to respiratory infections.

[Are antibiotics correctly prescribed in primary care?]. / Se prescriben correctamente los antibióticos en atención primaria?

OBJECTIVE: To identify the antibiotic prescriptions and evaluate their suitability for the infectious conditions treated at a Primary Care Centre. DESIGN: A prospective observation study. SETTING: La Mina Primary Care Centre. Sant Adrià de Besòs (Barcelona). PATIENTS AND OTHER PARTICIPANTS: The on-demand visits of patients over 14 to the General Medicine and Emergency clinics between June 1991 and May 1992 provided the data through a simple multi-stage random sample. MEASUREMENTS AND MAIN RESULTS: On the basis of the clinical notes, these variables were recorded: age, gender, diagnosis, the antibiotic prescribed and its manner of administration. The indication and choice of treatment was assessed in line with previously established criteria, as well as whether the antibiotic was first-choice in Primary Care. Infections treated in hospital or by specialists, non-bacterial cutaneous infections and Conjunctivitis were excluded. Out of 2,523 people examined, 474 presented infectious conditions (18.8%); the most common of these were infections of the upper respiratory tract (46.4%) and acute Bronchitis (17.3%). An antibiotic was prescribed in 206 cases (43.3%). The most used antibiotics were: Amoxicillin (41.5%), Penicillin (19.0%), Cloxacillin (11.2%), Erythromycin (10.2%) and Pipemidic Acid (7.8%). They were orally taken in 89.4% of cases. 92.3% of the antibiotics were first-choice. Overall fitness of treatment was 86.3% (56.5% unnecessary and non-prescribed treatment; and 29.7% necessary and using the recommended antibiotic). The least suitable treatment was observed for cases of acute Bronchitis without any risk factors. CONCLUSIONS: Prescriptions are adjusted to the recommendations on antibiotic policy in Primary Care, although less suitable treatment was observed for acute Bronchitis. The importance of applying a methodology based on objective criteria, in order to make a qualitative analysis in studies on the use of medication, is highlighted.