SEARCH · Search PubMed

Results for “Mail Distribution”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 937 records · Page 52Linked to original sources

PubMed1996

Relationship between hospital pharmacists' job satisfaction and involvement in clinical activities.

Job satisfaction among hospital pharmacists employed by a national hospital pharmacy management company was measured by using a mail questionnaire. A previously validated survey that measured pharmacists' job satisfaction was adapted for use in this study. Additional questions determined the pharmacist's clinical pharmacy training and participation in clinical pharmacy services. Questionnaires were mailed to all full-time hospital pharmacists employed by the pharmacy management company. Of the 606 mailed, deliverable questionnaires, 354 usable responses were returned, for a response rate of 58.4%. The respondent hospital pharmacists' level of job satisfaction showed a positive association with clinical pharmacy involvement. Of the nine items in the questionnaire that measured the pharmacists' involvement in clinical pharmacy services, seven items showed a positive relationship between involvement in that clinical activity and job satisfaction. Mean job satisfaction increased as the percentage of time spent performing clinical pharmacy activities increased. Job satisfaction decreased as time spent performing distributive functions increased. The percentage of time hospital pharmacists were engaged in clinical activities was significantly associated with job satisfaction.

Adult↗

PubMed1997

Conditions at conception and risk of menstrual disorders.

In a case-control study, we evaluated the association of the risk of menstrual disorders with four periconceptional factors: short preceding interpregnancy interval (< 6 months), low (< or = 19 years) or high (> or = 40 years) maternal age at conception, and month of conception. We divided 919 women who had visited a fertility clinic between 1991 and 1995 into three categories: cases (with mean menstrual cycle length > or = 42 or < or = 21 days, or a variation of > or = 14 days between cycles, or amenorrhea, N = 294), controls (with cycles within a range of 25-35 days and variation < or = 7 days, N = 520), and intermediates (N = 105). A self-administrable questionnaire was mailed, asking for information about maternal reproductive history and age, and potential confounders such as smoking, exercise, and level of education. Response (77%) differed little among cases, intermediates, and controls. We found elevated risks for short pregnancy intervals [adjusted odds ratio (OR) = 2.04; 95% confidence interval (CI) = 1.04-4.02] and advanced maternal age (OR = 3.24; 95% CI = 1.27-8.30) but not for low maternal age (OR = 0.58; 95% CI = 0.11-3.14) (cases vs controls). We found similar effects for intermediates vs controls. The distribution of month of conception did not differ much from controls for both cases and intermediates. The results indicate that conception after short pregnancy intervals or at advanced maternal age increases the risk of menstrual disorders in daughters. The precise etiology is unclear, but it may lie in the quality of the oocyte at conception.

Adolescent↗

PubMed2002

The profile of level I trauma center directors.

BACKGROUND: No data are available regarding the characteristics of the trauma directors of Level I trauma centers. METHODS: Questionnaires were mailed to 102 directors of Level I trauma centers. Data were analyzed in a blinded fashion. RESULTS: Seventy-two directors responded. All were men, with a mean age of 48 +/- 6 years. Fifty-eight percent of directors were fellowship trained. Directorship was assumed 7.3 +/- 6.1 years after training and the average time on the job was 8.6 +/- 6.1 years. Directors work in urban (93%), university-affiliated (67%) institutions that admit 1,000 to 2,000 patients annually (50%). Practice time distribution is as follows: trauma clinical care, 33%; general surgery, 20%; administrative work, 18%; critical care delivery, 17%; and research, 11%. Directors take 6.6 +/- 2.2 night calls per month, with half of them taking in-house call. Eighty-eight percent of directors are involved in research. Seventy-eight percent of directors earn $200,000 to $325,000 per year, with the largest group making $225,000 to $250,000. Salary is derived from clinical revenues (42%) and hospital (37%) or university (20%) support. Compensation is higher in community hospitals and tends to be higher in the Midwest. CONCLUSION: The profile of the trauma director at a Level I trauma center was described. This may be important in trauma career and systems development.

Adult↗

PubMed2002

Year 2000 Oncology Nursing Society Research Priorities Survey.

PURPOSE/OBJECTIVES: To determine the Oncology Nursing Society's (ONS's) research priorities for 2001-2005 for oncology nursing across the entire scope of cancer care, including prevention, detection, treatment, and palliative care. DESIGN: A cross-sectional, mailed survey. SAMPLE: Stratified by the general member group (i.e., a random sample of 1,850 ONS members) and researcher group (i.e., census of 150 ONS researchers). 788 responded for an overall response rate of 39%. MAIN RESARCH VARIABLES: 113 topics that were identified from the 1994 ONS Research Priority Survey questionnaire and earlier ONS Research Priority Surveys, with the addition of 20 new items to existing questionnaire categories and one new category area: health services research. FINDINGS: Top 20 research priorities were distributed across six of eight questionnaire categories, and the number of top 20 priorities within categories differs. Compared to the 1994 survey, 9 topics were common to both top 20 lists; 8 were new to the top 20, and 11 dropped out of the top 20. When the researcher group and adjusted total sample group top 20 priority ratings were compared, nine topics were common to both groups. CONCLUSIONS: Examining research priorities affords different perspectives to guide practice, education, research, management, and administration. IMPLICATIONS FOR NURSING: ONS Research Priority Survey results provide an important foundation for developing future research across the entire scope of oncology nursing.

Cross-Sectional Studies↗

PubMed2003

Variability in interventions with pulmonary artery catheter data.

OBJECTIVES: To determine if intensivists given PAC data from critically ill patients make uniform management choices. DESIGN: Cross-sectional survey of board-certified intensivists. SETTING: Medical intensive care unit. PARTICIPANTS: Board-certified intensivists who are members of the American College of Chest Physicians and Society of Critical Care Medicine. INTERVENTIONS: A survey questionnaire containing three medical intensive care clinical vignettes was mailed to critical care physicians. Each vignette contained PAC data and one-half of the surveys contained echocardiographic (Echo) information. Every respondent was asked to select one of six interventions for each vignette. MEASUREMENTS: There were 126 evaluable surveys returned. In vignette 1 an intervention (none of the above) was selected by more than 50% of respondents. In vignettes 2 and 3, the most frequent selection was chosen only 44 and 37% of the times, respectively. There was a significant difference in the distribution of management choices between te Echo and the non-Echo subgroups. CONCLUSIONS: There is a significant heterogeneity in selecting an intervention based on PAC data among intensivists. The presence of Echo information may change the intervention selected but does not reduce heterogeneity. Any randomized trial evaluating efficacy of PAC's will have to have strict treatment protocols.

Attitude of Health Personnel↗

PubMed2006

Internet-based self-help with therapist feedback and in vivo group exposure for social phobia: a randomized controlled trial.

Sixty-four individuals with social phobia (social anxiety disorder) were assigned to a multimodal cognitive-behavioral treatment package or to a waiting list control group. Treatment consisted of a 9-week, Internet-delivered, self-help program that was combined with 2 group exposure sessions in real life and minimal therapist contact via e-mail. Results were analyzed on an intention-to-treat basis, including all randomized participants. From pre- to posttest, treated participants in contrast to controls showed significant improvement on most measured dimensions (social anxiety scales, general anxiety and depression levels, quality of life). The overall within- and between-groups effect sizes were Cohen's d = 0.87 and 0.70, respectively. Treatment gains were maintained at 1-year follow-up. The results from this study support the continued use and development of Internet-distributed, self-help programs for people diagnosed with social phobia.

Adult↗

PubMed2002

Genotype-phenotype correlations with personality traits of healthcare professionals: a new use for the Human Genome Project.

OBJECTIVE: To describe the genetic basis of various personality traits. DESIGN: Prospective, blinded cohort study comparing questionnaire-reported personality traits with candidate genes for temperament, as revealed by genetic mapping in the Human Genome Project. Non-supervised questionnaires were mailed to MJA subscribers. DNA extracted from newborn screening blood samples of all New South Wales participants was used to perform mutation analysis for candidate personality genes. SETTING: Tertiary medical care in New South Wales, 1 April 2000 to 1 April 2001. PARTICIPANTS: Healthcare professionals who admitted to reading the MJA on at least a semi-regular (monthly) basis. MAIN OUTCOME MEASURES: Correlations between occupation, personality and gene mutations were sought using a LOD score in comparison with a classic Poisson d'avril distribution. RESULTS: Mutations were identified that suggested the existence of genes determining several personality traits. Genes coding for belligerence (bel), charisma (lub), cynicism (dub), housekeeping (vac and uum), lack of personality (dul-1), obsessive-compulsive behaviour (pic-e) and gullibility (suk-r) are described. These were found to be selectively represented in certain members of the healthcare profession. CONCLUSIONS: The seven most important healthcare personality genes have now been described for posterity.

Genotype↗

PubMed1978

Diagnosis of twin zygosity by mailed questionnaire.

A deterministic questionnaire method for zygosity determination is developed for use in epidemiological studies of adult twins. It is based on the answers of both members of a twin pair to two questions on similarity and confusion in childhood. The algorithm of the method is used to determine the zygosity status of a twin pair at two different levels of certainty. The validity of the method is tested by making blood marker determinations of 11 polymorphic marker systems fro a random sample of 104 twin pairs. The agreement between questionnaire and blood marker diagnosis was 100%, but the stricter level of certainty left 8.7% in the nonclassified group. The genetical representativeness of the sample is tested by the allele distribution of the markers as compared to the Finnish population data as well as by the distribution of the number of intra-pair differences in blood markers.

Blood Group Antigens↗

PubMed1998

Evaluative laboratory testing practices of United States rheumatologists.

OBJECTIVE: Several laboratory tests can be used to monitor disease activity in patients with rheumatic diseases. We sought to learn how rheumatologists use evaluative laboratory tests in the care of patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. METHODS: We surveyed United States rheumatologists by mailed questionnaire. Of the 976 rheumatologists who received the questionnaire, 575 responded, for a response rate of 59%. RESULTS: Eighty-six percent of the respondents reported using either the erythrocyte sedimentation rate (ESR) or C-reactive protein level to monitor patients with RA, 92% used either the anti-DNA antibody level or complement C3 level to monitor patients with SLE, and 95% used either the ESR or ANCA levels to monitor patients with ANCA-associated vasculitis. The frequency of testing was distributed over a broad range, but testing was common. Testing on 50% of the visits or more was reported by 52% of respondents for RA, 59% of respondents for SLE, and 64% of respondents for ANCA-associated vasculitis. Between 7% and 11% of respondents reported testing patients on every visit, regardless of clinical disease activity. The majority of respondents reported not altering the treatment of clinically stable patients based on these test results. CONCLUSION: Evaluative laboratory testing is common, and is rarely used as an independent guide for treatment.

Antibodies, Antineutrophil Cytoplasmic↗

PubMed1996

[Autologous blood transfusion in the Federal Republic of Germany--results of a questionnaire in 1993. 2. The use of autologous transfusion in the old and new federation].

In 1993, we conducted a postal survey to assess the use of autologous blood transfusion (ABT) in the Federal Republic of Germany after reunification. The results of this survey have already been reported in a previous paper, but without differentiation between the "old" and "new" states (former West Germany and former German Democratic Republic, respectively). In the present study, the data of our 1993 survey were further analysed to see if there were differences in the use of ABT between the "old" and "new" states. METHODS. The study is based on data of a 1993 postal survey of German hospitals. Details concerning the performance of the survey have been reported in a previous paper. Briefly, questionnaires were mailed to the anaesthesia departments of 400 randomly selected hospitals in the "old" states and 284 hospitals in the "new" states of the Federal Republic of Germany. The questionnaires contained 36 questions related to general information on the hospital and the use of ABT; 305 completed questionnaires were returned from the "old" states and 197 from the "new" states, response rates of 76% and 69%, respectively. For the present investigation, the responses of the hospitals of the "old" and "new" states were analysed separately. Frequency distributions of categorical variables were analysed by the chi-square test. Because of multiple testing, statistical significance was attained only at the 0.05% level (P < or = 0.0005). RESULTS. There were no significant differences between the "old" and "new" states with respect to hospital size by number of beds, percentage of general and specialised hospitals, and percentage of operations requiring blood transfusion. In both the "old" and "new" states, 9% of the responding hospitals maintained a hospital-based transfusion service, while the other depended on regional blood banks. Preoperative autologous blood donation (PABD) was performed at least "rarely" in 85% and 71% (P = 0.0001), and "mostly" in 20% and 10% (P = 0.0014) of the hospitals in the "old" and "new" states, respectively. Uniformly, the principal uses of PABD were for orthopaedic and cardiac surgery. In 62% and 27% (P < 0.0001) of those hospitals that reported performing PABD, the autologous blood service was run by the anaesthesia department. Preoperative plasmapheresis was performed in 14% and 8% (P = 0.008), and isovolaemic haemodilution in 82% and 56% (P < 0.0001) of the hospitals in the "old" and "new" states, respectively. Automated autotransfusion devices (cell savers) were available in 38% and 19% (P < 0.0001) of the hospitals, respectively. Simple collection devices for perioperative blood salvage were used in 17% and 15% (P = 0.24) of the hospitals in the "old" and "new" states, respectively. CONCLUSION. We conclude that ABT is more widely used in the "old" than the "new" states of the Federal Republic of Germany. ABT is regarded as a desirable alternative to homologous blood transfusion, and in the interest of equal standards of medical care throughout the nation, the use of ABT should be further promoted, especially in the "new" states of the Federal Republic of Germany.

Blood Transfusion, Autologous↗

PubMed2004

Treatment of panic disorder: live therapy vs. self-help via the Internet.

A randomized trial was conducted comparing 10 individual weekly sessions of cognitive behaviour therapy for panic disorder (PD) with or without agoraphobia with a 10-module self-help program on the Internet. After confirming the PD diagnosis with an in-person structured clinical interview (SCID) 49 participants were randomized. Overall, the results suggest that Internet-administered self-help plus minimal therapist contact via e-mail can be equally effective as traditional individual cognitive behaviour therapy. Composite within-group effect sizes were high in both groups, while the between-group effect size was small (Cohen's d=16). One-year follow-up confirmed the results, with a within-group effect size of Cohen's d=0.80 for the Internet group and d=0.93 for the live group. The results from this study generally provide evidence to support the continued use and development of Internet-distributed self-help programs.

Adult↗

PubMed2005

Application of a propensity score approach for risk adjustment in profiling multiple physician groups on asthma care.

OBJECTIVES: To develop a propensity score-based risk adjustment method to estimate the performance of 20 physician groups and to compare performance rankings using our method to a standard hierarchical regression-based risk adjustment method. DATA SOURCES/STUDY SETTING: Mailed survey of patients from 20 California physician groups between July 1998 and February 1999. STUDY DESIGN: A cross-sectional analysis of physician group performance using patient satisfaction with asthma care. We compared the performance of the 20 physician groups using a novel propensity score-based risk adjustment method. More specifically, by using a multinomial logistic regression model we estimated for each patient the propensity scores, or probabilities, of having been treated by each of the 20 physician groups. To adjust for different distributions of characteristics across groups, patients cared for by a given group were first stratified into five strata based on their propensity of being in that group. Then, strata-specific performance was combined across the five strata. We compared our propensity score method to hierarchical model-based risk adjustment without using propensity scores. The impact of different risk-adjustment methods on performance was measured in terms of percentage changes in absolute and quintile ranking (AR, QR), and weighted kappa of agreement on QR. RESULTS: The propensity score-based risk adjustment method balanced the distributions of all covariates among the 20 physician groups, providing evidence for validity. The propensity score-based method and the hierarchical model-based method without propensity scores provided substantially different rankings (75 percent of groups differed in AR, 50 percent differed in QR, weighted kappa=0.69). CONCLUSIONS: We developed and tested a propensity score method for profiling multiple physician groups. We found that our method could balance the distributions of covariates across groups and yielded substantially different profiles compared with conventional methods. Propensity score-based risk adjustment should be considered in studies examining quality comparisons.

Adult↗

PubMed2001

Preexisting histologic evidence of prostatitis is unrelated to postimplant urinary morbidity.

The presence and extent of prostatitis on the patients' preimplant biopsy slides was correlated with their postimplant course to determine if any relationship exists between histological prostatitis and postimplant morbidity. Biopsy slides from 56 patients treated with I-125 (144 Gy, TG-43), Pd-103 (125 Gy, NIST-1999), or Pd-103 plus supplemental external beam radiation (20-44 Gy) were studied. As part of ongoing prospective protocols, treatment-related morbidity is monitored by mailed questionnaires at 1, 3, 6, 12, and 24 months postimplant, using standard American Urologic Association (I-PSS) and Radiation Therapy Oncology Group criteria. Patient's preimplant biopsies, stained with standard hematoxylin and eosin, were retrieved for review by one uropathologist (LT). Separate evaluations of the degree and extent of inflammation in biopsy cores free of cancer and in cancerous biopsy cores were undertaken. Infiltrates were classified as periglandular if they were within 50 microns of a glandular structure. They were otherwise classified as stromal. Distribution of the inflammation was reported as focal, multifocal, or diffuse. The intensity of inflammation was separately graded as mild if there were fewer than 10 inflammatory cells per high-power field, moderate if there were 10-200 cells per high-power microscopic field, or severe if there were more than 200 cells per field. In all cases the great majority of inflammatory cells were mononuclear, predominantly lymphocytes. Periglandular inflammation was most common, with 18% of patients having focal periglandular and 20% having multifocal periglandular inflammation on their preimplant biopsies. Cancer-related infiltrates were the second most common, with 23% of patients having focal, 13% multifocal, and 13% diffuse cancer-related inflammation on their preimplant biopsies. Eight of the 55 patients developed postimplant urinary retention, requiring catheterization for 2 to 8 days. The overall incidence of postimplant urinary retention was low and there was no obvious relationship between the presence of inflammation on preimplant biopsy and the likelihood of postimplant urinary retention. AUA score changes at 1 and 6 months postimplant were highly variable and unrelated to the presence or severity of periglandular or cancer-related inflammation. Considering the apparent lack of relationship between histological findings and clinical outcomes in the patients reported here, the authors conclude that histologic evidence of prostatitis is not a contraindication to brachytherapy.

Biopsy↗

PubMed1996

Comparison of Department of Veterans Affairs pharmacy services in 1992 and 1994 with strategic-planning goals.

Data were collected from Department of Veterans Affairs (VA) medical center pharmacies in 1992 and 1994 to measure progress toward implementation of the VA 1990 strategic plan. A questionnaire was pretested and mailed to pharmacy chiefs at all 173 VA medical centers (VAMCs) with pharmacies in 1992. The same questionnaire, with slight modifications consistent with revision of the strategic plan, was mailed in 1994. Usable responses were received from more than 80% of VAMCs in both years. The number and types of activities, services, and staffing at VAMC pharmacies varied with respect to automation, procurement, drug accountability, image, participation in professional organizations, professional role, pharmaceutical care activities, technicians, and research and education. Compared with the 1992 results, the 1994 results indicated greater pharmacist involvement in patient-education activities, expanded roles for pharmacists in monitoring anticoagulation therapy and in pharmacokinetic services, and less use of pharmacists for distributive functions. In 1994, more facilities reported having an open pharmacy concept in place to encourage direct patient care initiatives. VAMCs reported greater involvement in pharmacy education in 1994 than in 1992, with more VAMCs having affiliations with pharmacy schools and clerkship and residency training programs. Responses indicated considerable variation among VAMC pharmacies in the number and types of services provided.

Hospitals, Veterans↗

PubMed2003

ASHP national survey of pharmacy practice in hospital settings: dispensing and administration--2002.

Results of the 2002 ASHP national survey of pharmacy practice in hospital settings that pertain to dispensing and administration are presented. A stratified random sample of pharmacy directors at 1101 general and children's medical-surgical hospitals in the United States were surveyed by mail. SMG Marketing Group, Inc., supplied data on hospital characteristics; the survey sample was drawn from SMG's hospital database. The response rate was 46.7%. During 2002, both inpatient and outpatient hours of service increased compared with 2001. Paradoxically, there was an 8.5% decrease in pharmacy staffing and a 7% vacancy rate, suggesting that pharmacists are busier. Most hospitals (80%) had a centralized inpatient dispensing system, but 44% were planning to become more decentralized. Automated dispensing cabinets were used by 58% of hospitals with decentralized drug distribution systems. Most hospitals (81.4%) dispensed more than three quarters of oral doses as unit doses and 63.3% of injectable doses to non-critical care patients, increases from 1999. A large percentage of hospitals (89%) repackaged both oral and injectable medications. More hospitals were repackaging medications than three years ago, primarily because of lack of commercial availability. Approximately 20% of pharmacies either partially or completely outsourced drug preparation activities. Nurses administered medications in virtually all hospitals (99.7%). Despite widespread recommendations to use bar-code technology to check and document doses administered, only 1.5% of hospitals used this technology, an increase from 1.1% in 1999. Nearly two thirds of hospitals used computer-generated medication administration records. While pharmaceutical services are expanding, workforce issues continue to challenge pharmacists trying to maintain and enhance safe medication systems. Safe systems continue to be in place in most hospitals, but the adoption of new technology to improve safety is slow.

Documentation↗

PubMed2007

A comparison of factors used by physicians and patients in the selection of antidepressant agents.

OBJECTIVES: Involving patients in treatment decisions may reduce premature antidepressant treatment terminations and improve clinical and health economic outcomes. However, a first step is to determine what information to provide to patients to facilitate their decision making. The authors therefore identified, valued, and ranked factors of antidepressant treatment selection that are relevant to patients and compared them with the opinions of general practitioners. METHODS: Matching surveys were developed for patients and physicians with feedback from focus groups. In the patient group, participation was requested from consecutive patients at four family practice sites in Nova Scotia, Canada. Surveys were mailed to 247 randomly selected general practitioners. RESULTS: Surveys were completed by 127 patients and 110 physicians, representing return rates of 70% and 46%, respectively. The most valued of the 12 differentiating factors when selecting an antidepressant, ranked first by both patients and physicians, was common side effects. Also ranked highly by both groups were precautions with antidepressant use, physician antidepressant experience, and discontinuation problems. Groups differed in their ranking of uncommon serious side effects, time since antidepressants were marketed, cost, and dosing schedule. The ranking distributions were significantly different for six of 12 factors between patients and general practitioners (Wilcoxon ranked-sum test). Patient experience with antidepressants did not influence factor value. CONCLUSIONS: The data demonstrate moderate disagreement between patients and general practitioners regarding the relative value of antidepressant selection factors. The effect of this disagreement on treatment adherence and other outcomes requires further investigation, as improving patient-physician concordance regarding antidepressant choices may lead to improved treatment acceptance.

Antidepressive Agents↗

PubMed2006

A survey-based assessment of the prevalence and severity of chronic hand dermatitis in a managed care organization.

Although studies conducted outside of the United States have found a 7% to 12% prevalence of chronic hand dermatitis, no US general population-based estimates have been reported. The objective of this study was to quantify the prevalence of chronic hand dermatitis in a US managed care organization population. A 13-item self-assessment questionnaire was developed and validated, with 85% sensitivity and 95% specificity. The questionnaire was mailed to 2 random member samples from a Massachusetts managed care organization: 502 general members and 878 members with dermatitis. The questionnaire had a 36.74% overall response rate, with a chronic hand dermatitis point prevalence of 17.49% and 33.33% in the general and dermatitis populations, respectively. Among the general population, the questionnaire results identified 16.94% members who had chronic hand dermatitis but had not sought dermatitis-related medical services. After direct standardization to the 2000 US Census population with respect to age, gender, and race distributions, the projected point prevalence was estimated at 16.36% in the US general population. In conclusion, we found a higher prevalence of chronic hand dermatitis than previously reported. Approximately 1 in 6 members did not seek medical attention, suggesting that chronic hand dermatitis may be underdetected and untreated and may require more awareness and effective management.

Adult↗

PubMedDate not supplied

[Streptococcal infection in a primary school population. Study during the academic year].

One hundred and seventy four children from the "República de Checoslovaquia" National School of the Centro Habana-Norte municipality were investigated during the 1976-1977 academic course months. The method of mail interview of parents was used. Every month the history of oropharyngeal infection and antibiotic administration was obtained, and bacteriology of pharyngeal exudates was performed. Antistreptolysin or AELO titers were determined at three-month intervals. Cardiovascular physical examinations were made and electrocardiograms obtained during the last month. 19,22% of exudates were positive for hemolytic streptococci. 46,56% of streptococcal strains isolated corresponded to the group A. Hemolytic streptococci isolation ranged between 10,4% in October, 1976 and 36,1% in April, 1977. The monthly distribution of the different serological groups of isolated hemolytic streptococci disclosed statistically significant differences. 78,26% of the 667 AELO reactions corresponded to titers of 200 or more Todd units. Average titers in the four stages of the serological study are between 382,42 and 463,92 Todd units. Significative differences between the results of bacteriology and serology and the physical state of oropharynx or the history of clinical manifestations were not evidenced. Manifestations of carditis or rheumatic fever were not found.

Child↗