[Zinc and chronic obstructive pulmonary disease]. / Cinc y enfermedad pulmonar obstructiva crónica.

BACKGROUND: To evaluate the zinc organic concentration in the chronic obstructive pulmonary disease (COPD) in relation to a control group. Also, to analyze if the serum zinc levels are related with zinc concentration in erythrocyte, nail and hair. PATIENTS AND METHODS: Forty patients of COPD have been studied, all males, average age 62 +/- 7 years and body mass index (BMI) of 27 +/- 4. Forty patients were included in the control group, with average age 57 +/- 9 years and BMI of 24 +/- 5. The patients with concomitant disease or booth treatment that could increase the zinc excretion were excluded. In all patients clinical history and examination, hematology and biochemistry tests, hepatic and lipid parameters, and nail, plasma, hair and erythrocyte zinc levels by atomic absorption spectrophotometry were done. Variance analysis and Pearson test were done. RESULTS: Blood, intraerythrocyte and nail zinc were similar in healthy subjects and patients; however, the median concentration of zinc in hair was significantly lower in patients (156 +/- 46 micrograms/g versus control group (185 +/- 64 micrograms/g) (p < 0.05). No differences were found between smokers and no smokers, and drinkers and no drinkers in relation with body concentration of zinc. CONCLUSION: The zinc concentration in hair can be a good method to evaluate the chronic deficiency in the human body. The COPD patients could be susceptible to develop zinc deficiency; the situation increases the possibility of infection diseases.

[Influence of the organizational model on user satisfaction]. / Influencia del modelo organizativo en la satisfacción de los usuarios.

OBJECTIVE: To identify in Health Centres (HC), doctors' offices and out-patient clinics the variables among the use, the doctor and organisation, which most affect satisfaction of the Primary Care (PC) user. DESIGN: A descriptive crossover study. SETTING: PC level in three Andalusian cities. PATIENTS AND OTHER PARTICIPANTS: A sample of groups of 460 users of out-patient clinics and doctors' offices and 400 from HCs, all in an urban environment. MEASUREMENTS AND MAIN RESULTS: Three questionnaires were used to gather the independent variables of organisation, doctor and use, and also the dependent variable, or satisfaction, in three dimensions: professional competence, personal qualities and accessibility. The reliability of the scale of satisfaction was analysed using Crombach's alpha; and discriminative capacity, using the Edwards test. The effect of the variables of doctor, user and organisation on HCs and doctors' offices / out-patient clinics was analysed separately with multiple regression. The determination coefficient of the variables for the user at doctors' offices / out-patient clinics was higher than the same variables in HCs (p < 0.0001), age being the variable which most affected satisfaction, both in HCs and doctors' offices / out-patient clinics. The determination coefficients for the regressions of the variables of doctor and organisation were higher in HCs than in doctors' offices / outpatient clinics (p < 0.001) in both cases - with the use of the clinical records being the primary variable in both organisations. CONCLUSIONS: It appears that the organisational model of HCs offers more possibilities of increasing user satisfaction by modifying determined features of the doctor and the organisation.

[Consumer satisfaction with 2 models of primary care in operation in Andalucia]. / La satisfacción de los usuarios con los dos modelos de asistencia primaria vigentes en Andalucia.

A study was completed to investigate if any differences are observed in user satisfaction with health care centres, polyclinics and solo-practice, furthermore to identify user, organizational characteristics and doctors as variables that relate to user satisfaction in health care. A sample of users was chosen from the Andalusian cities of Granada, Málaga and Sevilla with an alpha = 5%, beta = 10% and d = 11%. The variables were collected trough the use of three questionnaires. Greater satisfaction was found between health care centre users than with polyclinics and solo-practice, with values being 62.4, 58.2 and 60.6 with a p < 0.001. The variables more strongly associated with user satisfaction in health care centres are those related with doctors and organization characteristics. Therefore several are capable of improvement in order to increase user satisfaction. On the contrary in polyclinics and solo-practice the most influential variables are those related with the user characteristics, which are not modifiable by the health services intervention.

[Adverse reactions caused by drugs in pediatrics]. / Reacciones adversas causadas por medicamentos en pediatría.

The present study describes the results obtained in a screening program aimed at detecting adverse reactions to medication in children aged 1-8 years admitted to the Pediatrics Service of the University of Granada Hospital (Spain). The program is based on monitoring the patients for a period of 12 months. Of a total of 597 patients, adverse reactions were recorded in 4.4%. Within this group the reactions were classified as confirmed in 33.3%, probable in 30% and possible in 36.6%. Based on organs and systems, the CNS was most frequently affected (40%), followed in decreasing order by the digestive (37%) and cardiovascular systems (10%), skin (10%) and endocrine system (3%). The drugs most frequently involved were bronchodilators (40%), antibiotics (30%) and antiepileptics (20%). Among risk factors, polytherapy, hospitalization time and type of drug administered were the most important.

[Comparison in changes in blood coagulation tests during use of oral contraceptives. First symposium - sexual steroids]. / Comparacion de la modificacion en algunas pruebas de coagulacion por el uso de tres anticonceptivos orales. Primer simposio - esteroides sexuales

PIP: 284 women using 3 types of oral contraceptives were studied for 1 year. The drugs used were: SH-70840, containing 0.050 mg of ethinyl estradiol and 1 mg of ethinyl nortestosterone acetate; SH-70876, containing 0.075 mg of ethinyl estradiol and 1 mg of ethinyl nortestosterone acetate; and SH-70850, containing 0. 050 mg of ethinyl es tradiol and 0.50 mg of norgestrel. The average results were within normal limits. Of the 3 groups, 2 (using SH-70840 and 70876) showed a slight increase in blood coagulation. The tests, conducted with properly selected patients, showed no cases of thrombosis.^ieng

[Endometrial study made during the continuous administration of microdoses of 30 micrograms of d-norgestrel]. / Estudio endometrial en la administraction continua de microdosis de 30 microgramos de d-Norgestrel.

PIP: 171 endometrium biopsies taken from 61 patients before and during treatment with daily doses of 30 mcg of d-norgestrel were studied. It was found that continuous treatment with this drug produces a number of changes in the endometrial mucus membrane, although they are less marked than those found during treatment with oral contraceptives of the combination type. The progestational effect appeared to take place earlier, and secretion began earlier, as shown by the appearance of subnuclear vacuoles. An atrophied endometrium was found in only 1 case, but this may be due to the fact that biopsies were not taken from patients showing amenorrhea. Considerable edema was frequently found in biopsies taken at all stages in the cycle. Despite the earlier appearance of the progestational effect, the development of the endometrium appeared to be less complete than in the case of normal patients without treatment. These changes may be related to the contraceptive action of d-norgestrel.^ieng