[Volume and demand of rheumatologic problems and their management at a primary health care center]. / Estudio del volumen y la demanda de problemas reumatológicos y su manejo en un centro de atención primaria.

The present study was carried out as a part of the elaboration process of the Program of Rheumatologic Diseases of the health center of Chapela. The following rates are reported: the volume of patients affected by these problems (14.5%), the generated care demand (6.9% of the overall demand), the age and sex distribution, their importance as a reason of disability (14.4% of the overall number of sick leaves), and the different specific diagnoses. To evaluate how these patients were managed by the team, a series of indicators were used, such as the number of identified patients, the quality of the documentation, the types of complementary investigations, the referral of patients to the secondary level, and the adequacy of therapies. As conclusions, a significant volume of rheumatologic consultations and work disabilities was found, with a high use rate of radiological studies and a low use rate of laboratory investigations, the use of basically NSAI drugs in the therapy, and the need for a specifically oriented clinical record to be used in the diagnosis and follow up of these conditions.

[Dystonia and carbamazepine (author's transl)]. / Distonía por carbamacepina. A propósito de cuatro observaciones en el niño.

Appearance of dystonic movements in four epileptics children, while carbamazepine administration, is the object of this publication. Human material is formed by four patients in pediatric ages of 4.5, 5, 6 and 7 years old, which presented dystonia after the administration of carbamazepine. Clinical, neuroradiological, psychometric and bioelectric explorations were performed, also serum determinations of anticonvulsant levels. Three of the children presented serious psychomotor retardation. The electroencephalograms showed no uniform changes. Serum levels of carbamazepine were in therapeutics limits. From this personal experience and bibliography data it is deduced that dystonia is not a toxic phenomena, establishing the possibility of an interaction between carbamazepine and dopaminergic system.