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Objective: To study fragile elderly people in the population, their characteristics and their distribution according to fragility markers., Design: Cross-sectional, descriptive study using a survey., Setting: Primary care. Elderly people living in Guadalajara in January 2002., Participants: 434 people were interviewed (1.24% of population). There were 157 losses (26.6%)., Interventions: The questionnaire contained social and demographic variables (age, sex, setting), care variables (medication, pathologies, home care) and evaluative scales (Barthel, Folstein, Yesavage, Diaz-Palacios)., Main Measurements: Fragility markers: 3 or more pathologies, 6 or more drugs, dementia, and/or positive on one of the four scales used., Results: Subjects lived in rural areas more (56.7%; CI, 52-61.3), but there were not more women. Fragile elderly, n=257 (59.2%; CI, 54.6-63.8), were more women (OR=1.8; CI, 1.5-2.2) and over 70 (OR=80-84, 5.2; CI, 3.7-7.5; OR=85-89, 8.2; CI, 5.3-12.8). Prevalence of markers was: 3 or more pathologies, 30.2% (95% CI, 25.8-34.5); cognitive deterioration, 22.6% (95% CI, 18.7-26.5); social risk, 20.8% (95% CI, 16.3-23.8); multi-medication, 18.7% (95% CI, 15-22.3); Barthel incapacity, 11.7 (95% CI, 8.7-14.8); depression, 5.3% (95% CI, 3.2-7.5); and dementia, 3.2% (95% CI, 1.6-4.9). Women suffered cognitive deterioration more. The over-80s suffered cognitive deterioration, social risk and incapacity more., Conclusions: There was high prevalence of fragility with cognitive deterioration, multi-medication and social risk; and lower presence of dementia. Women and the most elderly people were most affected.

The existence of multiple primary tumors of the upper aerodigestive tract, esophagus, and lung (UADT-E-L) is related with a common etiopathogenic factor (alcohol-tobacco association). In a review of 43 patients, 6.75% with a UADT-E-L tumor developed another neoplasm, 3.25% at the same site. Nine percent (8.59%) of the tumors were synchronic and 10.85% were metachronic. The most frequent association was larynx-lung. Another neoplasm was detected by physical examination and/or radiology in 44.18% of cases, with a time lapse of less than 3 years in 50%. The most frequent treatment was surgery with/without complementary radiotherapy. The most common stage was T1-T2 (62.06%) and N0-N1 (68.96%). The survival rate was 31% at 2 years and 25% at 3 years.

Objectives: To estimate the prevalence of tuberculosis infected children in the first grades of Primary Education and to analyse the distribution of infected people among social class groups and other previous circumstances., Methods: Cross-sectional study with diagnostic test application and questionnaire survey, in a representative sample of the school population of the province of Guadalajara, Spain (two stages sampling design). Tuberculin skin tests with 2 I.U. of P.P.D. RT-23 and the Sokal method for lecture were used. For occupational classification and social class definition were used the criteria of the last report of Spanish Epidemiology Society., Results: A total of 1,093 children (50.8% males) between 6 and 9-year-old were studied. The overall prevalence of infected children was 1.64 (I.C.:1-2.3). The distribution of infection did not show significant differences between urban/rural population, previous disease, family antecedent, social class, dwelling area and occupational activities of parents. The prevalence increased in the older upper school years and among the older children. Prevalence ranged from 0.4% (CI: 0.01-1.3) in the first year to 3.53% (CI: 2.4-4.6) in the last year. Children born in 1988 had a 3.23% prevalence (CI: 1.2-5,1), while those born in 1989; 1990 and 1991 had a prevalence of 0.73 (CI: 0-1.77), 1.88% (CI: 0.2-3.51) and 0.4% (0-1.2), respectively., Conclusions: Tuberculosis infection is less prevalent at school ages than other areas of Spain. In spite of the increase prevalence per school year, the low frequency and sample size did not allow to test for other associations.

Background: The purpose of this study is to describe the social-demographic and clinical profile of hospitalised leprosy patients and to check whether typology has changed during the history of the centre., Methods: Descriptive and retrospective study, performed by means of reviewing a sample of the patient records registered at the Centre since it was founded in 1943 until 1995. 366 cases were chosen by means of a systematic random sample and questionnaires completed on social-demographic and clinical variables., Results: Most of the patients were male (71.9%, IC: 67.3-76.4), young (39.6 years of age, IC: 37.9-41.4), single (46.2%, IC: 41-51.3%) with low levels of education (illiteracy: 54.1%, IC: 40-69) with occupations relating to farming (35.5%, IC: 30.6-40.4) from Southern Spanish regions (patients from Andalucía 52.8%, IC: 45.8-54). The disease showed a family background in 31.1% of cases (IC: 26.4-35.9) and serious multibacillary forms (Lepromatose Leprosy 66.1%, IC: 61.2-71), which affected lower limbs in 72.1% of cases, heads in 63.1% and upper limbs in 64.4%. Global mortality of people admitted to hospital was 31.1% (IC: 26.4-35.9). During the surveyed period, patient age increased, and symptoms and mortality decreased. In general, hospital stays were for long periods (7.1 years, IC: 6.1-8.1), although at the end of the surveyed period, stays decreased considerably, in accordance with the duration of treatment (2.2 years)., Conclusions: A Young male, in a precarious financial situation living in the South of Spain appear to be the patient profile which, with severe initial anatomical symptoms and later favourable results may represent the disease in a country with an autocuthonous endemy and characteristic epidemiology, which is in the pre-eradication phase.