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Objetivo. Determinar las características sociodemográficas, clínicas y psicopatológicas de un grupo de pacientes hiperfrecuentadores comparándolo con otro grupo de normofrecuentadores en tres centros de atención primaria. Método. La muestra está compuesta por 232 hiperfrecuentadores (definidos por un número de consultas igual o superior a 12 en el último año) y 93 normofrecuentadores. Los instrumentos utilizados son: un cuestionario de elaboración propia para la evaluación de las características sociodemográficas y clínicas y el Cuestionario de Salud General de Goldberg en su versión de 28 ítems (GHQ-28).Resultados. La regresión logística muestra que el aumento de edad, un nivel educativo bajo, la presencia de enfermedad crónica (diabetes e hipertensión), un diagnóstico psiquiátrico y presencia de sintomatología psicopatológica «menor» establecen diferencias significativas en el grupo de hiperfrecuentadores frente al grupo de normofrecuentadores. No existen diferencias significativas entre hombres y mujeres. Conclusión. Los pacientes hiperfrecuentadores presentan altas tasas de quejas físicas, mentales y sociales. La edad, determinadas enfermedades crónicas y la psicopatología son los factores más importantes en relación a la hiperfrecuentación (AU)

Objective. To determine the sociodemographic and clinical characteristics of frequent attenders and compare them with another group of routine attenders in three primary care centers. Method. The sample is composed by 232 frequent attenders (defined by number of consultations in the last year of 12 or more) and 93 routine attenders. The instruments used are: a questionnaire for the evaluation of the sociodemographic and clinical characteristics and the 28-item Goldberg General Health Questionnaire (GHQ-28).Results. The logistic regression shows that increase of age, low level of education, presence of chronic disease, psychiatric diagnosis and presence of psychopathological «minor» symptomatology establish significant differences in the group of frequent attenders in relation to the routine attenders group. There are no significant differences between men and women. Conclusion. Frequent attenders present higher rates of physical, mental and social complaints. Age, some chronic conditions and psychopathology are the most important factors for frequent attendance (AU)

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OBJECTIVE: To determine the sociodemographic and clinical characteristics of frequent attenders and compare them with another group of routine attenders in three primary care centers. METHOD: The sample is composed by 232 frequent attenders (defined by number of consultations in the last year of 12 or more) and 93 routine attenders. The instruments used are: a questionnaire for the evaluation of the sociodemographic and clinical characteristics and the 28-item Goldberg General Health Questionnaire (GHQ-28). RESULTS: The logistic regression shows that increase of age, low level of education, presence of chronic disease, psychiatric diagnosis and presence of psychopathological <> symptomatology establish significant differences in the group of frequent attenders in relation to the routine attenders group. There are no significant differences between men and women. CONCLUSION: Frequent attenders present higher rates of physical, mental and social complaints. Age, some chronic conditions and psychopathology are the most important factors for frequent attendance.

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AIM: To evaluate the factors involved in the impairment of health-related quality of life (HRQOL) in patients with celiac disease. METHODS: A multicenter, cross-sectional prospective study was performed in patients with celiac disease who completed two HRQOL questionnaires: the gastrointestinal quality of life index (GIQLI) and the EuroQol-5D (EQ). RESULTS: Three hundred and forty patients (163 controlled with a gluten-free diet, and 177 newly diagnosed with a normal diet) were included. The GIQLI score was significantly better in patients on a gluten-free diet (GFD) than in non-treated patients on their usual diet, both in terms of the overall score (3.3 vs 2.7, respectively; P < 0.001), as well as on the individual questionnaire dimensions. Both the preference value of the EQ as the visual analogue scale were significantly better in treated than in non-treated patients (0.93 vs 0.72 P < 0.001 and 80 vs 70 P < 0.001, respectively). Variables significantly associated with a worse HRQOL score were female gender, failure to adhere to a GFD, and symptomatic status. CONCLUSION: In untreated celiac disease, the most important factors that influence patient perception of health are the presence of symptoms and a normal diet. HRQOL improves to levels similar to those described in the general population in celiac disease patients well controlled with a GFD.

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The effect of six mixtures with 50% molar substitution of KCl (0-50%) and potassium lactate (0-50%) as NaCl substitutes in small calibre fermented sausages on some sensory parameters and on the acceptability was studied. Also, the relationship between sensory profile and consumer acceptability using external preference mapping was investigated. The results showed that as the K-lactate substitution increased, pH, sweetness, crumbliness and pastiness also increased, and piquantness, hardness, cohesiveness, ripened flavour, acid taste and saltiness decreased. However, the treatments prepared with a high level of salt substitution by KCl showed scores of sensory attributes similar to those of the control. Consumer segmentation showed differences in acceptability between genders, place of residence, educational level and age group. Consumers rejected fermented sausages with high K-lactate substitution but not those with a high KCl substitution. External preference mapping split consumers up into four clusters with different preference patterns. According to these results and from a sensory point of view, it is possible to achieve a reduction of 50% of NaCl in small calibre fermented sausages and to obtain a product acceptable to most consumers.

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Lowering salt content in meat products is possible from a technological and sensorial point of view, although little information is available about the consumers' attitude and acceptance of these products. Attitude towards low salt meat products, following the Theory of Planned Behaviour (TPB) proposed by Ajzen, was evaluated by 392 consumers. Acceptability of small calibre fermented sausages with 50% molar substitution of NaCl by six different mixtures of KCl (0-50%) and K-lactate (0-50%) and the control (22g NaCl/kg) was determined by 98 consumers. The preference of the previous best two treatments was compared to the batch control by 279 consumers. In general consumers had a positive attitude towards low salt meat products, being higher for women than for men. Women showed stronger ideas and higher Perceived Control on the Behaviour towards reduced sodium meat products than men. Smokers showed lower intense beliefs than non-smokers. Consumers with a basic level of education were more affected by what other people important for them thought they should do. The final model obtained using the Theory of Planned Behaviour showed a good predictive capacity (R(2)=0.60) and a good internal consistency. Regarding the acceptability study, batches with substitution levels of 50% and 40% by K-lactate, showed lower overall acceptance than the control batch. Significant differences in acceptability were found regarding the gender and place of residence of the consumers. The preference study showed no differences between the batch control and batches with 50% KCl and 40% KCl + 10% of K-lactate substitution levels. According to these results and from a sensorial point of view, it is possible to reduce NaCl content in small calibre fermented sausages by 50% and obtain a product acceptable for consumers.

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BACKGROUND: Inflammatory bowel disease impairs patients' perception of health and has a negative impact on health-related quality of life (HRQOL). Most studies include patients from a single hospital. This may bias limit results through the use of small patient samples and/or samples within a restricted disease spectrum. METHODS: HRQOL was measured in patients with ulcerative colitis (UC) and Crohn's disease (CD) from 9 hospitals located in different geographical areas in Spain using 2 questionnaires: the Spanish version of the Inflammatory Bowel Disease Questionnaire (IBDQ) and the EuroQol. Results are expressed as medians. RESULTS: The study included 1156 patients (528 patients with UC and 628 with CD; median age, 35 yr; slight predominance of women, 617 versus 539). HRQOL worsened in parallel with disease severity to a similar extent in both UC (IBDQ scores of 6.1, 4.7, and 4.0 for the 3 disease severity groups, respectively) and CD (IBDQ scores of 6.1, 5.0, and 4.1, respectively). A similar inverse relation between clinical activity and quality of life was observed when EuroQol preference values were used. All 5 dimensions of the IBDQ showed significantly lower scores in patients with active UC and CD than in patients in remission. The pattern of scores by IBDQ dimensions differed between patients in relapse (who scored worse on the digestive symptoms dimension) and patients in remission. Variables related with disease activity, time of evolution since diagnosis and female sex, were significantly associated with having a worse perception of HRQOL. The type of disease or geographical area of residence did not influence results on the IBDQ. CONCLUSIONS: UC and CD impair patients' HRQOL, and the degree of impairment depends on disease activity but is independent of the type of disease and place of residence.

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The reduction of added NaCl in fermented meat products has been proposed to decrease the amount of sodium in the diet. The effect of substituting NaCl by KCl, potassium lactate (K-lactate) or glycine (0-40%) in some sensory, microbiological and physicochemical characteristics of fermented sausages was evaluated. The sensory effects of substituting NaCl by mixtures of glycine and KCl or glycine and K-lactate was also evaluated. The partial substitution of NaCl by KCl, K-lactate and glycine had little effect on microbiological stability. However, flavour and/or textural defects were detected by sensory analysis with substitution levels of 40% by KCl, 30% with K-lactate and 20% with glycine. The partial substitution (above 40%) of NaCl with different mixtures of KCl/glycine and K-lactate/glycine showed important flavour and textural defects which did not permit an increase in the level of substitution compared to those obtained with the individual components.

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Salt is essential in the elaboration of dry meat products, contributing to their texture and flavour development. The effect brought about by substituting NaCl with KCl (0-60%), potassium lactate (0-100%) and glycine (0-100%) on the texture, flavour and colour characteristics of fermented sausages and dry-cured pork loins was evaluated. Texture profile analysis and a sensory analysis were performed. Important flavour defects were detected with substitutions above 40% for the three substituents in both products, and with substitutions above 30% for glycine in dry-cured loin. A loss of cohesiveness was detected by the sensory analysis in fermented sausages at substitution levels higher than 30% with potassium lactate (K-lactate) and higher than 50% with glycine. Although the instrumental analysis detected texture changes in dry-cured loin, the sensory analysis did not detect any substitution effect on texture.

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A goat herd severely affected by arthritis was studied. The most representative clinical signs consisted of articular swelling, mainly of the carpal joints, and the subsequent locomotor disorders. Some goats also showed signs of central nervous system involvement. Examinations of joint fluid revealed an increased number of mononuclear blood cells, mostly lymphocytes. Gross and microscopic articular lesions were of inflammatory and degenerative types. Periarticular connective tissue, synovial bursae, tendons and tendon sheaths were predominantly affected. Inflammatory lesions were those of a chronic hyperplastic tenosynovitis with fibrosis of the connective tissue components. Degenerative changes consisted mainly of necrosis and mineralisation of articular-related structures. Histological lesions in the central nervous system were those of a nonpurulent encephalitis initially located in periventricular areas, but in one case extensive encephalomalacia was also seen. Of the 80 animals sampled 82.5 per cent showed seropositive reactions against an ovine progressive pneumonia virus antigen. None was seropositive to brucella and titres to chlamydia were low. Attempts to isolate chlamydia and mycoplasma from affected joints and several organs failed. Different bacteria were recovered from a few samples but did not seem significant. Syncytium-forming viral particles were isolated from several organs, mainly the lungs, synovial membranes and lymphoid tissue of almost all the slaughtered animals. These particles were identified as lentiviruses by electron microscopy. The clinical signs, lesions serological results and microbiological findings, led to a diagnosis of caprine arthritis-encephalitis. This syndrome has not been recognised in Spain previously.

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