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This study aimed to know the importance of the antimicrobial spectrum and the bacterial resistances for the antibiotic choice in the extrahospitalary pediatric area, at the same time that establish the relationship with others therapeutics parameters.Cross-sectional, observational study within the MUSA (Improvement of Use of Antimicrobial Agents in Primary Health Care) Project made by personal interview of 210 pediatrician doctors randomly selected with national representation. This target is included in a bigger universe (855 doctors) representative of the most doctors responsible of the antibiotic prescriptions in the extrahospitalary area (sample error of the 3.3% for a 95% confidence interval and maximum response dispersion: p=q=50). The results of the pediatric study were subjected to a comparative analysis with the results of a similar study made ten years ago and with the global results of the general study. The questionnaire used for the interview had two clearly different parts: in the first part, the questions were open with the objective to get spontaneous answers from the participants; the second part had questions with suggested answers.Clinical efficacy is the most spontaneously valued issue by the Spanish pediatricians when it comes to choosing an antimicrobial agent; efficacy is followed by tolerance/safety and posology. Antimicrobial spectrum is mentioned by one out of 4-5 pediatricians that have participated in the study (21.9%), while the bacterial resistances are only mentioned by a 3.8%. In a suggested level, clinical efficacy is still the most valued parameter, being identified by 7 out of 10 interviewed with the bacterial eradication. In this case, the antimicrobial spectrum is the following parameter on significance, appearing as a synonym of "activity against specific microorganisms" in 2 out of 3 cases. In relation to his own evaluation, 3 out of 4 pediatricians say they take "a lot" of the bacterial resistances into consideration, who are mostly understood as "global rate" for 5-6 out of 10 interviewed, whether the resistance showed by the pneumococcal is what worried the most to 4 out of 10 of them. This importance given to the bacterial resistances at the second part of the study contrasts with the low consideration showed when it is compared with other parameters and the valoration is treated in a spontaneous way. In relation to a similar study realized on 1997 (Urano Proyect), we observe that clinical efficacy has replaced tolerance/safety as a parameter to bear in mind, probably as a consequence of more experience and confidence with the most important antimicrobial agents in the antibiotic prescriptions in podiatry. On the other hand, the bacterial resistances still being left out on the pediatricians spontaneous consideration, a fact that is shared with the majority of the collectives participating on the general study. The rest of the parameters stay in a similar way.Is necessary to emphasize at the importance of bacterial resistances in the antimicrobials rational use on the pediatric patient. As the antimicrobial tolerance profile has been improving in the last ten years, clinical efficacy, understood as "bacterial eradication" has became the most determining parameter when choosing antimicrobial agents.

This study analyzed the consumption of systemic antibiotics in the province of Avila, Spain, and its Basic Health Areas (ZBS) during 2005. It was a retrospective observational study of the consumption of systemic antibiotics (ATC class J01) during 2005 using the data collected by the Concylia program. The study population was identified from the 2005 Medical Card Register database. Consumption data was expressed in defined daily doses (DDD) per 1,000 inhabitants per day (DID), calculated in relation to the contribution of the user at the time of acquiring the prescription. It was found that antibiotic consumption in the province of Avila in 2005 was 26.91 DHDAj. There was a considerable difference between rural (36.63) and urban areas (15.44) with a large variability among the different Basic Health Areas. The areas with a smaller number of inhabitants per town or city and per doctor, used more antibiotics, which could be due to more severe pathology, absence of self-medication or lack of diagnostic resources, among other factors. There is no relation between greater consumption and workload. It was concluded that the consumption of antibiotics in the province of Avila is high due to their use in rural areas. A high variability in the consumption of antibiotics was observed between the different areas, which was related to the smaller number of inhabitants per city or town and per doctor, but had no relation to workload.

The aim of this study was to determine the incidence of automedication with antibiotics in Spain, analyzing the magnitude, importance and possible consequences of this problem.A quantitative study was carried out in the pharmacies by personal interview with people who had acquired a pharmaceutical speciality. The study was performed according to territorial distribution proportional to the population of different autonomic communities and urban and rural environments. The questionnaires were done over one year with four cut offs, each coinciding with one of the annual seasons.Automedication with antibiotics was observed in 32.1% of the people who had acquired an antibiotic in a pharmacy, being 28.8% with pharmaceutical specialities acquired. In 20% of the cases (18.1% of the specialities), automedication was produced by direct request of the user, while in 12.1% of the cases (10.7% of the specialities) this was by recommendation by the pharmacist/ pharmaceutical auxillary. Of the people obtaining an antibiotic by self-medication, two out of three acquired a wide-ranging semisynthetic penicillin, while 23% acquired a macrolide. The remaining therapeutic subgroups acquired were tetracyclins (3.3%) and cephalosporins, quinolones and cotrimoxazoles being 1.6% each. Automedication was most frequent in people from 30 to 39 years of age (36.1%) followed by those from 40 to 49 years (29.5%). Men showed a slightly greater incidence than women with 39% of the women acquiring an antibiotic directly doing so for someone other than themselves. Pharyngoamigdalitis was the most frequent process for which an antibiotic was acquired by automedication (34.5% of the cases). The most frequent therapeutic schedule was three times a day for one week. There was little correspondence between the dosage schedule and length of treatment and the number of doses contained in the drug acquired.Antibiotic automedication is a widespread practice in Spain, specially in the treatment of infectious respiratory and bucal processes. Together with therapeutic unfulfillment and storage of antibiotics in the homes, automedication is currently one of the most serious problems in antibioticotherapy since it is frequently accompanied by bad usage. Health care education programs should be developed with the aim of making the public aware of the negative effects of automedication and orienting patients as to the rational use of antibiotics.

To study the demand for laboratory test from a sample of Primary Care doctors.A crossover observational study.Primary care medical clinics in Spain and Andorra.Volunteer doctor with primary care practices.The study was based on: a) a questionnaire to the doctors taking part, on their clinical consultations, b) recording of the age and gender of patients seen during four consecutive weeks, and c) the logging of the laboratory tests requested during these four weeks.82 doctors took part. They had 37,383 clinical consultations, asking for 1,965 analytical studies with 7,248 tests; i.e., they generated 5.25 requests for analysis per hundred consultations. The doctors who requested most analyses had less consultations/day and less consultations/inhabitants/year. When the distance to the laboratory increased, the analyses per consultation lessened and the analyses per inhabitant went up. The most common reason for requesting analysis was the follow-up of an already-known pathology.A request for analysis is made in 5.25% of primary care consultations. The most common reason is to follow up an already-known pathology.

To show the impact of these consensus meetings on health-workers.A descriptive study using a postal survey. SITE. The Province of Avila.Registered doctors and nurses in the Province of Avila, in the month of March, 1991.19.2% of the doctors and 13% of the nurses answered the survey. The consensus meetings were known to 29.6% of the doctors and 13.5% of the nurses. Out of these, 70.3% of the doctors and 54.5% of the nurses refer to a modification in their behaviour. Nevertheless, the majority of the health-workers saw well-monitored hypertense patients monthly and believe that the entire population's level of cholesterol should be determined. This runs against the recommendations of the consensus meetings. There were no differences on this between those who knew of the meetings and those who did not.The results and recommendations of the consensus meetings were inadequately publicized. They have little or no effect on healthworkers' behaviour.

We measured the alexithymia by the Kleiger-Kinsman scale in 36 patients with D.U.D. We employed 34 patients with irritables Bowel Syndrome and 30 patients with chronic organic pathologia as control groups. Our results show two possible conclusions: 1) The absence alexithymia's specificity in our ulcerous patients and/or the incapacity of this M.M.P.I.'s subescale to discriminate this feature in the psichosomatic diseases.

We measure aggressivity in 36 patients with DUD (duodenal ulcer disease). We use two control groups as sample: normal population and other group of chronic organic pathologies. The results denote that the autoaggression-inhibition factor is the best discriminate variable to our group of duodenal ulcer patients of both sexes.

The dynamic demography of the village of Aldeavieja (Avila) from 1900 to 1985 was evaluated with several indicators. A reduction in mortality rate was found, stabilizing around 10% since 1950, with a greater reduction in mortality rates in children. From 1900 to 1985 the Swarop index rose from 34.55% to 92.86%, and life expectancy from 30.13 to 77.5 years. The most common causes of death were infectious diseases during the first decades of the period, being now replaced by tumors and chronic diseases. There was a great demographic loss and the population became older (17.59% are now older than 65 years). It was concluded that a knowledge of dynamic demography is needed for a rational planning and an adequate resource allocation based on needs.