[Toxic shock syndrome associated with nasal packing]. / Shock tóxico estafilocócico asociado a cirugía nasal.

Staphiloccocal Toxic Shock Syndrome is a potentially fatal multisystem disease associated to nasal packing, catheter insertion, retention of foreign materials and uneffective sterile techniques. It is usually developed in the immediate postoperative period (first 48 hours) with hypotension, skin rash, fever, multisystemic failure and shock. We report a case in a 24-year-old man secondary to nasal surgery.

[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.

[Approximation to the detection of drug adverse reactions among doctors at the primary health care level]. / Aproximación a la detección de reacciones adversas a medicamentos entre los facultativos de atención primaria.

OBJECTIVE: To try to find the pattern of adverse reactions to drugs (ARD), as observed by Primary Care doctors, and the opinion of these on control of drugs. DESIGN: This was a descriptive, crossover study carried out by means of a postal questionnaire filled in by the interviewee. SITE. The Province of Córdoba. PARTICIPANTS: Primary Care doctors in the province of Córdoba. MAIN MEASUREMENTS AND RESULTS: 403 doctors (rate of reply: 31.6%) answered the questionnaire. The most commonly observed ARDs are those connected with digestive conditions (dyspepsia, 19.4%; diarrhea, 10.9%; nausea and vomiting, 10.4%), followed by dermatological complaints. 36.6% of doctors suspect at least one ARD a week. The therapeutic groups most frequently responsible are analgesic/antiinflammatory drugs, followed by antibiotics/chemotherapies. 49.7% were ignorant of the "Yellow Card" programme, although 86.6% showed a favorable attitude to being notified. CONCLUSIONS: The level of awareness of the possibility of ARD among the doctors polled is high. The "Yellow Card" programme is still little known. It is well worth circulating information, especially in view of Primary Care professionals' high level of motivation.

[The approach to the etiological diagnosis of hyperlipemias in primary care]. / Aproximación al diagnóstico etiológico de las hiperlipemias en atención primaria.

OBJECTIVE: To perform etiological diagnosis of hyperlipidemia (HL) brought to light in family medical (general practice) consultations. DESIGN: Retrospective descriptive study. SITE. A basic health zone (ZBS). PATIENTS: 231 patients diagnosed as having HL by their doctors. MAIN MEASUREMENTS AND RESULTS: Lipidic levels (average figures): total cholesterol (CT): 280; C-LDL: 201; C-HDL: 49 and triglycerides (TGL): 198. Distribution by phenotypes: IIa: 178 patients, IIb: 42, IV:5, with 6 doubtful cases. Distribution according to etiological diagnosis: 79% primary HL (83% polygenic and 17% family) 15% secondary HL, with 6% having both types in association. CONCLUSIONS: Diagnosis of HL in the visits to the family doctor reveals probability-predictable patterns based, above all, on the the overall assessment made by the doctor of his/her patient. The survey and the family study are very limited in our circles. The predominating type of HL is primary polygenic where prescribing of special diets will be sufficient in most cases.