[Pancreatic disease in patients with HIV treated with didanosine (DDI)]. / Afectación pancreática en pacientes VIH tratados con didanosina (DDI).

Pancreatic involvement has been studied in 70 HIV infected patients, in diverse stages, that were treated with didanosine (ddI), both as monotherapy or associated to zidovudine; 38% of patients presented adverse reaction that obliged to withdraw the medication: pancreatitis (4%), hyperamylasemia (21%) and abdominal pain and/or diarrhea (12%). The possible causes in presentation of adverse effects were evaluated: route of infection, stage of HIV infection, use of pentamidine or trimethoprim-sulfamethoxazole for preventing Pneumocystis carinii pneumonia, administration of ddI in monotherapy or in combined form with zidovudine, time of treatment and level of CD4 lymphocytes. The outcome of adverse effects is related significantly only with the most advanced stage of HIV infection.

[A proposal for the development of the program of family and community medicine]. / Una propuesta para el desarrollo del programa de medicina familiar y comunitaria.

We present a methodological innovation for the Teaching Unit of Family and Community Medicine in Valencia, consisting in a stage of the first year residents in the Health Centers during the first week after their incorporation to the teaching program. At the same time, we attempt to evaluate the level of clinical knowledge of these residents about common problems in primary care; to assess their knowledge about organization, information systems, health programs, etc.; to evaluate their degree of preference for the specialty and to analyze how such an experience may be helpful for the education of the family physicians. The mean number of correct answers to a test-type examination about common clinical problems in that level of care was 31.6%. The mean level of knowledge about primary care was self-rated as poor. Only 2 out of 22 residents had freely chosen this specialty, and only as a third choice. At the end of the stage, 74.7% of the residents evaluated it as useful or highly useful. We propose some recommendations which might improve the structure and implementation of the teaching.