[Analysis of repeat prescriptions in chronic treatments at a health center]. / Análisis de la prescripción repetida para tratamientos crónicos en un centro de salud.

OBJECTIVES: To describe the social-health profile of the population attending for the renewal of prescriptions for long-term treatments; to quantify the possible pharmacological interactions; to measure cognitive function in a sample of this population. DESIGN: Crossover study. SETTING: Urban Health Centre. PARTICIPANTS: All the patients (359) who were seen during a one month period at any of the centre's nursing stations for the renewal of long-term treatment prescriptions. MEASUREMENTS AND RESULTS: All the social-health data of every patient were collected on a form. Cognitive function was assessed in one of every three cases by means of Folstein's Minimental test. Average age was 64 +/- 0.76; 37% were men and 63% women. The mean number of chronic diagnoses per patient was 3.2 +/- 0.08 and of medicines per patient 2.9 +/- 0.09. 15% medicated themselves. Pharmacological interactions were possible in 41% of the patients who took more than one medicine. 8% were illiterate and 16% only knew how to read or write. 24.54% displayed overall cognitive deterioration and 48%, lapses in memory. CONCLUSIONS: Patients seen at our Centre for renewal of prescriptions were an elderly population group, with pluripathology, taking several medicines, with a low cultural level and deterioration in their cognitive functions. The risk of pharmacological interactions is very high. Repeat prescriptions for long-term treatments should not just be an administrative function: it should be performed by trained health staff.

[Microvascular angina (syndrome X). Presentation of 4 cases]. / Angina microvascular (síndrome X). Presentación de cuatro casos.

OBJECTIVE: To revise diagnostic, therapeutic and evolutive specifications of Microvascular Angina. To improve the knowledge about this syndrome among family doctors. DESIGN: Descriptive and transversal study. SETTING: Outpatients belonging to a Primary Care Centre in the metropolitan area of Madrid. PATIENTS AND OTHER PARTICIPANTS: Four patients (2 male and 2 female) aged over 50, diagnosed to have Microvascular Angina. MEASUREMENTS AND MAIN RESULTS: The clinical histories of the patients diagnosed to have Microvascular Angina were used. This syndrome was defined as a typical chest pain starting by an effort, normal electrocardiogram, ischemic ST-segment depression in exercise stress test and angiographically normal coronary arteries. The clinical and electrocardiographic specifications were similar in four cases. A positive exercise stress test and the existence of normal coronary arteries was confirmed in all the patients. All of them were treated with betablokers and/or calcium channel blokers with an effective response in three of them. CONCLUSIONS: It is important to know the existence of Microvascular Angina in Primary Care, first because it is one cause of chest pain and second because it has a good prognosis with few complications in the future.

[Syringomas. Presentation of 7 cases]. / Siringomas. Presentación de siete casos.

OBJECTIVE: To further knowledge of syringoma and its importance within the overall condition of the patient, with a view to making it relevant in the differential diagnosis of other conditions such as xanthomata or milium cysts. DESIGN: A descriptive study of a crossover type. SETTING: Primary care and the dermatology clinic of a health centre in the metropolitan area of Madrid. PATIENTS AND OTHER PARTICIPANTS: The records of patients with syringomas confirmed by histological tests during 1990-1993 were examined. Patients with only a clinical diagnosis were discarded. The different diagnoses on referral by the primary care doctor were also studied. MEASUREMENTS AND MAIN RESULTS: Seven patients (5 women, two men) were confirmed by histological tests as suffering Syringomas. They were between 16 and 52 years old. Four had lesions only on the eyelids; in the other three they were widespread. All of them were asymptomatic, had been over three years without lesions and had no special previous history. None of them wanted to undergo treatment. The referral diagnoses cited xanthomata in five cases and milium cysts in the others. CONCLUSIONS: The primary care doctor must become better informed about syringoma, given its frequent confusion with other conditions (xanthomata and milium cysts). This confusion gives rise to unnecessary additional examinations and discomfort for the patients. These lesions should be verified histologically, as it is an nonaggressive method.