[Benzodiazepine prescription at a health center: prevalence, its use and user characteristics]. / Prescripción de benzodiacepinas en un centro de salud: prevalencia, cómo es su consumo y características del consumidor.

OBJECTIVES: To find the prevalence of prescription of benzodiazepines (BDZ) in 1997 at a health centre (HC), and the characteristics of both their consumption and the takers. DESIGN: Crossover, observational study. SETTING: Primary care urban centre. PATIENTS: From a total of 7356 patients over 14 with clinical records and belonging to four lists, a random sample stratified by lists was selected. INTERVENTION: A form was used to gather social and demographic data, educational level, family context, linked pathologies, number of visits to HC per year, BDZ prescription and variables defining the kind of consumption. MAIN RESULTS: The prevalence of BDZ prescription was 7.7% (CI, 6-10%). Consumption profile: 33% long BDZ, 31% intermediate and 33% short. 44% consumed BDZ occasionally or for less than 2 weeks, and 42% had been taking it for over a year. For 56% (95% CI, 40-70) their G.P. was the origin of the prescription. The reason for the prescription was not specified in 42% of cases. The variables which defined the profile of the consumers, included in the logistic regression, were: sex, number of visits and linked pathologies, whose OR were: 1.57 (CI, 1.08-2.03), 1.11 (CI, 1.06-1.17) and 1.61 (CI, 1.04-2.05). CONCLUSIONS: The prevalence of BDZ prescription during 1997 in the population seen at our clinics was very similar to the figures found in other studies, with higher annual consumption averages and without the reason for taking it being specified in half the cases. The profile of BDZ takers was: mainly women, people with linked pathologies, and as a function of the number of attendances.

Prescripción de benzodiacepinas en un centro de salud: prevalencia, cómo es su consumo y características del consumidor / Prescription of benzodiazepines at a health centre: prevalence, how they are taken and characteristics of the taker

Objetivos.Prevalencia de prescripción de benzodiacepinas (BDZ) en 1997 en un centro de salud (CS), cómo es el consumo y características del consumidor. Diseño. Estudio observacional transversal. Emplazamiento.Centro urbano de atención primaria. Pacientes. Entre un total de 7.356 pacientes mayores de 14 años con historia clínica pertenecientes a 4 consultas, se seleccionó una muestra aleatoria estratificada por consultas de 667. Intervención. Hoja de recogida de datos sociodemográficos, nivel de instrucción, entorno familiar, patologías asociadas, n.º visitas/año, prescripción de BDZ y variables que definen el tipo de consumo. Resultados principales. Prevalencia de prescripción de BDZ: 7,7 por ciento (IC del 95 por ciento, 6-10 por ciento). Perfil de consumo: 33 por ciento BDZ de vida media larga, 31 por ciento de intermedia y 33 por ciento de corta.El 44 por ciento las consume de forma ocasional o menos de 2 semanas y un 42 por ciento lleva más de un año consumiéndolas; en un 56 por ciento (IC del 95 por ciento, 40-70) el origen de la prescripción es el médico de cabecera y no consta el motivo de la prescripción en el 42 por ciento de los casos. Las variables que definen el perfil del consumidor, incluidas al aplicar la regresión logística, fueron: sexo, n.º de visitas y patologías asociadas, cuyas OR fueron 1,57 (IC del 95 por ciento, 1,08-2,03), 1,11 (IC del 95 por ciento, 1,06-1,17) y 1,61 (IC del 95 por ciento, 1,04-2,05), respectivamente. Conclusiones. La prevalencia de prescripción de BDZ durante 1997 en la población atendida en nuestras consultas fue muy similar a la encontrada en otros estudios, con medias de consumo superiores al año y sin que conste el motivo de la prescripción en la mitad de los casos, recayendo la misma sobre todo en mujeres, con patología asociada y en función del n.° de visitas (AU)

Liver transplantation for Echinococcus granulosus hydatid disease.

The authors report their experience with 6 patients requiring liver transplantation who suffered with liver infestation by Echinococcus granulosus. One patient presented with acute Budd-Chiari syndrome because obstruction of hepatic veins was produced during the first operation; the other 5 patients received liver transplants for terminal chronic liver disease (2 secondary sclerosing cholangitis, 2 secondary biliary cirrhosis, and 1 postnecrotic cirrhosis of the liver). All the patients had been operated previously on for hydatidosis and were at the end of liver functional disorder. Some of the patients had undergone many operations, making the transplantation procedure even more difficult. One patient required a second transplant for primary graft failure; he died 40 days later from cerebrovascular accident. Another patient died 7 months after transplant from pulmonary embolism. The other 4 patients are alive and in optimal condition 37-65 months after transplantation. Hepatic hydatidosis--in principle, a benign disease--can cause hepatic complications that eventually require liver transplantation. The transplantation procedure is more difficult than usual in these cases. Although postoperative complications are frequent, most patients achieve prolonged survival and a good quality of life.

Cholecyst-thoracic fistula. A rare complication of lithiasic cholecystitis.

A 64-year-old male patient was studied for repeated right basal pneumonia of long duration. A computed tomography scan showed a cholecystitis of concealed evolution. Surgery revealed fistulization toward the thorax, with the passage of multiple calculi of a biliary origin to the chest cavity. We report the first described case to our knowledge of cholecyst-thoracic fistula secondary to cholecystitis of long evolution.