[Psychological malaise and the sociodemographic and familial characteristics of the over-user of primary care]. / Malestar psíquico y características sociodemográficas y familiares del hiperfrecuentador en atención primaria.

OBJECTIVES: To find the social, demographic and family characteristics, the psychological malaise and reasons for consultation of normal and hyper-attenders at a primary care practice. DESIGN: Crossover study with a control. SETTING: Primary care. PATIENTS: 127 hyper-attenders (they attended the practice as often as, or more often than, the mean number of visits, stratified by sex and age) and 120 normal attenders chosen by stratified random sampling. INTERVENTIONS: Questionnaire with characterisation data, family demography, psychological malaise (Goldberg general health questionnaire) and reasons for consultation. RESULTS: To be considered a hyper-attender, the number of attendances per year ranged from > or = 8 (in 15 to 44-year olds) to > or = 20 (in men over 65). Hyper-attenders were about 12% of almost all groups, except in men between 45 and 64 and women over 64, in whom it was around 18%. We found no relevant differences between normal and hyper-attenders as to demography or perception of family function. In almost 60% of hyper-attenders and 34% of normal attenders (p < 0.001), psychological malaise was detected. CONCLUSIONS: If the definition of hyper-attenders is stratified by age and sex, their social and demographic characteristics are very different from in other studies, even though there are a similar number of them. However, these demographic and/or family characteristics are similar in normal and hyper-attenders.

[Serologic study of vertically transmitted infections in pregnant women attending 3 health centers in Jaén]. / Estudio serológico de las infecciones de transmisión vertical en las mujeres embarazadas controladas en tres centros de salud de Jaén.

BACKGROUND: Studying serological tests into syphilis, German measles, toxoplasma and hepatitis B requested as part of the monitoring of pregnant women and analysing the different activities in the face of the findings. METHODS: A descriptive study. A systematic random process was used to select (1/3) 299 cases of women whose pregnancy had been monitored between 1991 and 1993 in three health centres in Jaen (capital of the province of the same name), which have a catchment population of 66,423 inhabitants. We analyse the differences between the centres using the Chi squared test. RESULTS: A serology of syphilis (R.P.R.) was conducted on 269 pregnant women (90% Standard Error (S.E.): 1.7) all of which proved negative; German measles (ELISA Immunoglobulin (Ig) G, toxoplasm (FIAX IgG and IgM) and (HBsAg in 92% (S.E.: 1.6) German measles antibodies being found in 98% (S.E.: 0.8), the HBsAg proving negative in 99% (S.E.: 0.6) and immunity to toxoplasm existing in 13% (S.E.:2). When the data were analysed, being broken down into the different health centres, notable differences were observed (p > 0.04) in the case of German measles. In the five cases were German measles proved negative, the serology was not repeated once, and on two occasions it was the second pregnancy. They do not appear in the history of preventive medicine. Treatment with spiromycine was initiated for toxoplasmosis, and it lasted for 10 to 21 days for five of the cases, but the infection was not confirmed once, and for two of these it was only determined serologically. CONCLUSIONS: Both the percentage of requests for the first serology and the prevalence are consistent with literature on the subject, with the exception of toxoplasm, whose immunity prevalence was much lower than in other zones. The actions taken in the face of certain results were rather inadequate.