[Effectiveness of serotonergic agonists in the treatment of obese patients]. / Efectividad de los agonistas serotoninérgicos en el tratamiento de pacientes obesos.

OBJECTIVE: To compare the effectiveness of two interventions in the treatment of obese patients: hypocaloric diet and hypocaloric diet plus serotoninergic medication. DESIGN: Randomised clinical trial. SETTING: Primary Care. Out-patient Endocrinology clinic. PATIENTS: The trial included 60 obese adults, assigned at random to two groups of 30 each. Both groups were comparable for sex, age, weight and Body Mass Index. Weight controls were performed at 2, 4 and 6 months. RESULTS: There were no significant differences in weight losses at the times studied (2, 4 and 6 months) between the Control (Hypocaloric diet) and Study (Hypocaloric diet plus medication) groups. There were significant weight losses in both groups analysed between 2 and 4 months, with a Body Mass Index which went down from 36.2 to 34.12 and from 35.52 to 33.57 (p < 0.001) in the Control and Study groups, respectively. CONCLUSIONS: No significant differences were observed in the results obtained for obese patients between a hypocaloric diet supplemented by serotoninergic medication and a hypocaloric diet.

[Adequacy of medical referrals to hospital emergency service]. / Adecuación de las derivaciones médicas a un servicio de urgencias hospitalario.

OBJECTIVE: To assess the correctness and diagnostic concordance in referrals of patients to hospital Casualty Departments (CD); and the possible differences between rural and urban health centres (HC) as well as between general practitioners (GP) and family and community medicine (FCM) specialists. DESIGN: Observational study of a crossover nature. SETTING: Health area 1 in the province of Badajoz. PATIENTS AND OTHER PARTICIPANTS: 800 patients, referred to their local hospital Casualty Department. MEASUREMENTS AND MAIN RESULTS: 50.5% of all referrals were considered justified. 15.1% of the patients referred were admitted to hospital. 50.7% of referrals from GPs were found to be correct, against 47% from FCM specialists; and 49% of those referred from rural HCs were correct, as against 45.9% of those referred from urban HCs (no significant differences). Only 54% of referrals had a diagnostic hypothesis, with diagnostic concordance at 50%. There was diagnostic concordance in 28.1% of GP referrals, against 33.3% of FCM specialists; and in 27.5% of those from rural HCs against 26.1% from urban HCs (no significant differences). CONCLUSIONS: We found no differences in the correctness of referrals or diagnostic concordance of patients seen in the CD of our city's health area, neither between patients referred from rural and urban HCs, nor between patients referred by GPs and FCM specialists.