[Effectiveness of medical counseling for alcoholic patients and patients with excessive alcohol consumption seen in primary care]. / Efectividad del consejo médico a pacientes alcohólicos y bebedores excesivos atendidos en consultas de atención primaria.

AIM: To determine the effectiveness of medical counseling for alcohol abuse, when it is provided in primary care centers. DESIGN: Quasi-experimental, open, multicenter before-after study.Setting. 14 primary care physician's practices (7 rural, 7 urban) in the province of Córdoba (Spain). PARTICIPANTS: 306 patients of both sexes, recruited with a case-finding strategy, who consumed >=35 (men) or >=21 (women) IU per week, or who had alcohol dependence syndrome (ADS) (MALTS score O>=11). Interventions. All patients were offered brief counseling to reduce drinking, and all were followed to evaluate their status 3 months, 1 year and 2 years later. MAIN MEASURES: The response variable was self-reported alcohol consumption together with normal GGT values or confirmation of alcohol consumption by a relative. The results were subjected to intention-to-treat analysis. RESULTS: Of the 306 patients included in the study, 95.1% were men and 78.4% had ADS. After 2 years 38.89% (95% CI, 32.2%-44.3%) had attained their treatment goal: 23.85% were in complete abstinence, and 15.0% consumed moderate amounts of alcohol below the limit considered to indicate risk. Starting excessive consumption at less than 16 years of age (odds ratio [OR], 3.0885), living in a slum (OR, 3.2103), smoking (OR, 1.7187), and a positive CAGE test (OR, 1.9949) were associated with failure of the intervention (P<.05). CONCLUSIONS: Counseling provided by the family doctor was highly effective under the usual conditions of general practice, both for patients with excessive alcohol consumption and for patients with con ADS.

Efectividad del consejo médico a pacientes alcohólicos y bebedores excesivos atendidos en consultas de atención primaria / Effectiveness of medical counseling for alcoholic patients and patients with excessive alcohol consumption seen in primary care

Objetivo. Comprobar la efectividad del consejo médico antialcohólico que se da en las consultas de atención primaria. Diseño. Estudio cuasi-experimental de tipo 'antes-después', abierto, multicéntrico. Emplazamiento. Catorce consultas médicas de atención primaria (7 rurales y 7 urbanas) de la provincia de Córdoba (España).Participantes. Un total de 306 pacientes de ambos sexos, captados mediante búsqueda de casos, que presentaban un consumo de alcohol 35 (varones) y 21 (mujeres) U a la semana, y/o síndrome de dependencia alcohólica (SDA) (MALTS-O>= 11).Intervenciones. A todos se les ofreció consejo médico breve antialcohólico y se les hizo un seguimiento para valoración de su estado a los 3 meses, 1 y 2 años.Mediciones principales. La variable de respuesta fue la suma del consumo autorreferido, más valores normales de GGT, y la confirmación del familiar. El análisis del estudio fue por 'intención de tratar'. Resultados. De los 306 pacientes incluidos, en un 95,1 por ciento de los casos se trataba de varones y un 78,4 por ciento presentaba SDA. Al cabo de 2 años, el 38,89 por ciento (IC del 95 por ciento, 32,2-44,3 por ciento) había alcanzado el objetivo terapéutico: un 23,85 por ciento se encontraba en abstinencia total y el 15,0 por ciento presentaba un consumo moderado de alcohol, por debajo del límite de riesgo. El comienzo del consumo excesivo antes de los 16 años (odds ratio [OR], 3,0885), vivir en un barrio marginal (OR, 3,2103), consumir tabaco (OR, 1,7187) y un test de CAGE positivo (OR, 1,9949) se asociaron al fracaso de la intervención (p < 0,05).Conclusiones. Se demuestra la alta efectividad del consejo antialcohólico impartido por el médico de familia en condiciones habituales de consulta, tanto en bebedores excesivos como en aquellos con SDA. al cabo de 2 años, el 38,89 por ciento (IC del 95 por ciento, 32,2-44,3 por ciento) había alcanzado el objetivo terapéutico: un 23,85 por ciento se encontraba en abstinencia total y el 15,0 por ciento presentaba un consumo moderado de alcohol, por debajo del límite de riesgo. El comienzo del consumo excesibo antes de los 16 años (odds ratio [OR], 3,0885), vivir en un barrio marginal (OR, 3,2103), consumir tabaco (OT, 1,7187) y un test de CAGE positivo (OR, 1,9949) se asociaron al fracaso de la intervención (p<0,05). Conclusiones. Se demuestra la alta efectividad del consejo antialcohólico impartido por el médico de familia en condiciones habituales de consulta, tanto en bebedores excesivos como en aquellos con SDA (AU)

[Tobacco consumption among the student population. Related factors]. / Consumo de tabaco entre la población escolar. Factores relacionados.

OBJECTIVE: To know smoking prevalence among schoolchildren and factors related with this habit. METHODS: A cross-sectional study. 548 school-children in their 6th and 8th years of primary studies at schools from an area of Córdoba (Spain) were interviewed. INTERVENTIONS: Autoadministered questionnaire. RESULTS: Tobacco was tried in 22% (CI 95%: 18.7-25.8) school-children. The average age for starting with this habit was 11.6 (SD)(CI 95%: 11.4-11.8). 12.1% smoked regularly and 1.3% smokers every day. The tobacco consumption in children was related with age (OR = 2.96; CI 95%: 1.12-7.82), cough medicines consumption (OR = 3.15; CI 95%: 1.32-7.48), to have a smokers sister (OR = 2.53; CI 95%: 1.06-6.00) and best friend (OR = 4.42; CI 95%: 1.85-10.60) and drinking beer (OR = 3.68; CI 95%: 1.15-11.7). CONCLUSIONS: The prevalence of smoking in our school-children is very close to that reported by others. Among the factors accounted with the tobacco consumption in schoolchildren, highlight the presence of this habit in the eldest sister and the best friend.

[Alcohol consumption and environmental influence among school children]. / Consumo de alcohol e influencia del entorno entre escolares de E.G.B.

OBJECTIVE: The objective of this study was to know the attitude towards alcohol and its consumption among schoolchildren. We also studied the influence of the immediate environment. PATIENTS AND METHODS: Participants were a random sample of sixth and eight grade schoolchildren during the 1995 school year from our rural area (n = 14,537). Data were collected from a confidential and anonymous survey about attitude and alcohol consumption. RESULTS: We found that 63% of children had tried alcohol occasionally. Forty-seven percent of them drank on a regular basis. Furthermore, 8% of this group consumed beer daily. Among frequent drinkers, 20.4% had gotten drunk at some time and this was more frequent among boys (p < 0.01) and older students. Forty percent of children did not think alcohol was a drug. Regarding family environment, 37% of fathers consumed alcohol daily in contrast to 4% of mothers. Logistic-regression analyses showed an independent association between alcohol consumption and smoking habits. CONCLUSIONS: A great number of schoolchildren and consumed alcohol occasionally. Boys and older students had gotten drunk more frequently than girls. Moreover, they believe that alcohol is not a drug and cannot perceive it as a harmful substance.

[Influence of socioeconomic factors on the course and monitoring of pregnancy]. / Influencia de factores socioeconómicos en la evolución y seguimiento del embarazo.

OBJECTIVE: To analyse variations in monitoring the pregnancy programme (PP) and in the programme's development in three population groups distinguished by their socio-demographic characteristics. DESIGN: An observational, descriptive and retrospective study. SETTING: "Occidente" Health District, Córdoba. PARTICIPANTS: Women who finalised their pregnancy in 1994 or 1995 (n = 415) and who lived in three zones distinguished geographically and socially: an Urban Area (UA), with an average population socially and economically and urban environment; a Marginal Area (MA) with a low social and economic level, high rates of unemployment and drug addiction, and a mixed population (gypsy and latin); and a Rural Area (RA), which had a rural productive way of life. MEASUREMENTS: The area of residence was related to the socio-demographic variables, history, drug consumption, PP monitoring and identified pathology. RESULTS: PP coverage reached 73.8% (CI 69.2-77.8), Pregnant women living in the MA were younger (p < 0.001), and included more adolescents (p < 0.001) and more single women (p < 0.001). CONCLUSIONS: Poorer monitoring and adherence to the PP by the MA population could be confirmed.

[Yield of active search of tuberculosis in a marginal population]. / Rentabilidad de la búsqueda activa de tuberculosis en una población marginal.

OBJECTIVES: A prevalence study on tuberculosis infection among school-children in our area. A study of the family, contacts and teachers of infected children. An analysis of the level of compliance with diagnostic and therapeutic procedures. DESIGN: Observational and descriptive. Clinical-epidemiological. SETTING: An urban Basic Health Area with 18,000 inhabitants. PATIENTS AND OTHER PARTICIPANTS: 393 people were included in the study: 162 school-children doing first-year EGB [c. six years old], 199 family members and contacts of the infected children and 32 EGB teachers. MEASUREMENTS AND MAIN RESULTS: Mantoux intradermoreaction. Application of the study procedure. Following of the evolution and monitoring of the treatment. We found 6 infected children (3.7% of the school-children), all of whom came from the same marginalised area. Among the 231 family members, contacts and teachers studied, we found 30 cases of active Tuberculosis (13%) and 71 cases of infection (30.7%). Antituberculous treatment was indicated for all cases of illness and secondary Chemoprophylaxis for 49 cases. The study could not be completed in 62 cases. CONCLUSIONS: The prevalence of tuberculous infection among school-children from the marginalised area is high. Examination of the infected childrens' contacts showed a high level of tuberculous infection. Follow-up of the diagnostic and therapeutic procedures was incomplete for a significant percentage of those under study.