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To assess the hospitalisation requirements for medical specialties (MS), admissions to a district hospital were studied during two subsequent years. Of the 196,800 inhabitants, 3% (6,089) were admitted which resulted in 7,841 admissions during this period. Four hundred and forty two different main diagnosis were performed but only 14 led to 50% of admissions and these same entities were also involved in any of the diagnosis associated (comorbidity). Mean age of the total group was 61 +/- 18 years being women patients three years older than men. More men than women were admitted. Pathology complexity was usually due to comorbidity, rather than a specific entity. Therefore we consider that the relationship between primary, general medicine and specialty attention should be reviewed and the involvement of MS in district hospitals should be revised so that the service may be efficient as well as improving cost-effectiveness ratio and thus achieving a remarkable economical saving.

A study of 5 patients diagnosed as having pulmonary tuberculosis during a period of 14 months is presented. 3 of them are members of the same family of 7 and the other 2 are closely related. This study calls our attention to the need for carrying out contacts evaluation, relative or not, and for chemoprophylaxis. The presentation of microepidemyes in relation to the decrease of the prevalence was also observed.

The causes of the maintained endemia of tuberculosis in the area of the "Hospital Arnau de Vilanova", Valencia, were studied in 162 cases treated over a 6 year period. The social conditions of the area, predisposition factors and the rare clinical and radiological first manifestations are factors influencing the maintained endemia. The introduction of invasive diagnosis techniques to confirm the disease, brought about the diagnoses of cases that with the standard techniques would have been impossible, giving the false impression of a higher incidence. We concluded that it is necessary to keep the disease in mind in the differential diagnosis of risk groups, maintaining the required epidemiological measures.