[Cytomegalovirus pneumonitis in immunocompetent adults: report of a case]. / Neumonitis por citomegalovirus en pacientes adultos inmunocompetentes: a propósito de un caso.

Cytomegalovirus produces congenital and acquired infections most of them asymptomatic. The percentage of clinical cases with visceral affection increases in patients suffering from a deficiency cellular immunity, showing the great importance of this defensive system in the control of the infection. This case presents an infection by Cytomegalovirus with visceral affection in an immunocompetent adult host. This is a mean duration of fever as the only symptom with lymphocytosis, biochemical hepatic changes and an interstitial pulmonary radiologic image. We think this case is a matter of considerable interest because it is a challenge in the study of the pathogenic mechanisms of this infection.

[Communication between primary care and specialists]. / Comunicación entre atención primaria y atención especializada: análisis de los contenidos de los documentos de derivación y retorno de enfermos reumatológicos.

OBJECTIVE: To assess how well referral and referral-back documents for rheumatology patients going back and forth between a health area's Primary Care and the specialist clinics are filled in. DESIGN: A descriptive retrospective study. Sevilla Central Health area. PATIENTS: These were the 233 patients with a referral document in their Clinical Notes, who were sent from Primary Care (both Health Centres (HC) and out-patient clinics (OC)) to the Rheumatology Service during 1991 (233 cases). MEASUREMENTS AND MAIN RESULTS: Out of the total, 69.96% (163) came from General Practitioners in out-patient clinics and 30.04% (70) from HC Family or General doctors. In HC the referral document was completed better than in OC, in the areas of clinical history, physical investigation and laboratory data. How well the referral-back document was filled in was independent of where the patient was referred from. 30.67% of the OC referrals and 15.71% of the HC ones were suggested by Area Specialists, without any significant differences existing. CONCLUSIONS: Patients coming from HC have their referral document better completed than those referred from out-patient clinics. The return document the HC patients take back is no better filled in by the rheumatologists. A high percentage of rheumatology referrals are suggested by Area Specialists but processed through Primary Care.