[Association between ischemic heart disease and peptic ulcer. A case-control study]. / Asociación entre cardiopatía isquémica y ulcus péptico. Estudio de casos y controles.

AIM: To determine whether patients with ischemic heart disease (IHD) are at higher risk for peptic ulcer (PU). MATERIAL AND METHODS: We performed a case-control study. The patients were selected by simple random sampling of clinical histories. CASES: 310 patients with IHD (angina pectoris, myocardial infarct or both). CONTROLS: 310 patients without IHD, paired by age, sex and tobacco consumption. Data were obtained by review of the patients' clinical histories. Response variable: diagnosis of peptic ulcer by endoscopy, esophagogastroduodenal transit or surgery. The odds ratio (OR) was determined by logistic regression, adjusting for the effect of confounding variables and risk for PU. RESULTS: The mean age of the patients was 72.7 years (SD 8.6) and 70% were men. PU was found in 18.7% of the patients and in 12.3% of the controls with an adjusted OR of 1.77 (95% CI: 1.12-2.77; p = 0.01). This effect was produced at the expense of duodenal ulcer with an adjusted OR of 2.22 (95% CI: 1.29-3.74; p = 0.003). The adjusted OR of gastric ulcer was 1.13 (95% CI: 0.45-2.82; p = 0.8). CONCLUSIONS: After adjusting for the effect of confounding variables and risk factors for the development of PU, this disease was more frequent in the group of patients with IHD.

[Description of the structure of and demand for a social security service for displaced persons]. / Descripción de la estructura y demanda de un servicio de desplazados de la Seguridad Social.

We have evaluated the structure and demand of care in a Social Security center for the attention to patients out of their dwelling place during de months of July and August, 1987. We had a single office, with two doctors and one nurse and no auxiliary staff. Data were recovered from the daily morbidity sheet. There were overall 4354 visits with a daily mean of 42 patients/doctor. 63.8% attended only to repeat prescriptions, and only 1.07% justified their demands with a written report. The leading cause for medical consultation were respiratory diseases followed by dermatological diseases. Remarkably, 22.6% of consultations were not made by the patient in person. The most common type of interconsultation was the referral to the emergency room of the reference hospital. We have compared these data with other morbidity studies, and we conclude that a better attention of the administration to the clinics for patients out of their dwelling place is required. Another urgent need is the implementation of the prolonged therapy card.