[The potability of the water in a region with a high level of natural radiation]. / Potabilidad del agua en una región de alto nivel de radiación natural.

BACKGROUND: The recent Spanish legislation on drinkable waters for public use includes a paragraph establishing the requirements to be fulfilled by waters in relation with their radioactivity and the methods to be used to measure it. As water radioactivity depends on the radioactive content of the grounds and rocks where it flows, it is possible to expect high levels in those zones whose characteristic is their high level of natural radiation. METHODS: For this reason, we have organized two measurement campaigns with the objective of characterizing the drinkable waters in an Spanish area, where the radioactive elements concentration in the ground is high. The methodology used is as described in legislation, using a low-bottomed proportional counter. RESULTS: The results we have obtained indicate that the zone, where measurements have been made, shows lower radioactivity levels than the legally established limits, nevertheless, at same time, there appear several points, where the radioactivity levels are high, showing values exceeding in great measure the legal limit for drinkable waters. CONCLUSIONS: With the results, we have obtained, its seems necessary that a greater attention is paid to drinkable waters in those points, where the radioactivity levels are high including corrective measures.

[The multiple-admissions patient in internal medicine as a special type of hospital readmission]. / El paciente multingresado en medicina interna como tipo especial de readmisión hospitalaria.

A considerable number of patients treated in hospitals register several readmissions, this being special cause for concern, not only from a clinical point of view but also in respect of the management of resources. This article analysed the clinical, epidemiological and resources variable associated with patients classified as "multiadmitted". The aim of the study is determine the possible factors which predispose the multiadmission. Multiadmitted patients are defined as those who are admitted twice in a period of 12 months or those admitted 3 times in 5 years. The type of the study carried out involved control cases. We selected 1099 admissions during a period of a year at an internal medicine department of a third-level hospital. Among the various results, we would highlight the fact that 34% of the patients were multiadmitted. The main characteristics were: mean age of 8 years older than the others, patients afflicted with chronic diseases of high prevalence (most of them of the respiratory, cardiovascular, gastrointestinal or endocrine systems). The most frequent diseases were COLD (Chronic Obstructive Lung Disease), cardiomyopathies, and chronic liver disease).

[Appropriateness of admissions to an internal medicine service at a tertiary hospital]. / Adecuación de los ingresos en un servicio de medicina interna de un hospital de tercer nivel.

In the present study, clinical, epidemiological and management factors influencing the appropriateness of the 1076 admissions to a general Internal Medicine Section during one year are evaluated. 184 admissions (17%) corresponded to patients who did not meet the AEP (Appropriateness Evaluation Protocol) criteria for appropriateness. A remarkable finding was the low incidence of patients with inadequate admission in spite of social pressure, which we interpret as a consequence of an excessive demand for care and the subsequently low availability of hospital beds. Inadequate admission was more common in the younger age group than in patients over 64 years. Cardiovascular and respiratory disorders were more common among adequate admissions, whereas infective, neoplastic, and poorly defined conditions were more common among inadequate admissions. There were no differences in hospital stay between both groups. The patients who had been previously admitted had more commonly adequate admissions. A reduction in the inadequacy index could be achieved if diagnostic investigations were more speedily performed and a temporal hospitalization unit previous to admission were available.

[A morbidity study in a general internal medicine service in a third-level hospital]. / Estudio de la morbilidad en un servicio de medicina interna general en un hospital de tercer nivel.

This study carried out at a type "C" hospital, analyses the actual pathology of 1,052 patients attended to at the internal medicine department during a period of one year. The sex distribution did not show any differences. The median age (64 years) was significantly superior in women. The more frequent diseases were from group VII (cardiovascular: 512 cases) and group VIII (respiratory: 471 cases) according to the 9th edition of the who international diseases classification. The most frequent causes for admission were: respiratory infection (19.5%), cardiac insufficiency (13.8%) and CVA (10.6%). The most frequent baseline diseases were cardiomyopathy (20.4%), chronic obstructive airways syndrome (16%), malignant neoplasia (8.5%) and hepatopathy (7.6%). The risk factors and toxic habits observed were: Chronic bronchitis (19.6%), blood hypertension (15.5%), diabetes (13.5%) and high alcohol intake (10%).

[Mortality at an internal medicine department of a tertiary hospital]. / Mortalidad en medicina interna de un hospital de tercer nivel.

The clinical and epidemiological variables as well as conduct parameters, attributable to death cases of the 1,052 patients cared for during one year in an Internal Medicine Department are analyzed. The mortality rate was 11.6%. We may point out in our results the elevated mean age (75.5 +/- 11.2 years) and the high incidence of repeated admissions (46%) among death cases. The mean and median hospital stay values were lower in the patients who died than in those that survived. The more frequent basic causes of death were stroke (27%), chronic obstructive pulmonary disease (15%) and neoplasias (14%). When analyzing the different conditions within one patient, cardiovascular diseases were most often found amongst those who died (73%). Gastrointestinal and infectious diseases were on the contrary associated to a low mortality rate.