Epidemiological changes in diagnosed coeliac disease in a population of Spanish children.

AIM: To investigate the incidence rate of diagnosed coeliac disease among the paediatric population in the province of Cáceres and the changes over the years. METHODS: The incidence rate of diagnosed coeliac disease between the years 1981 and 1999, age at diagnosis and clinical presentation form were investigated. The study was carried out over two periods: A (1981 to 1990) and B (1991 to 1999). RESULTS: The incidence rate for period A was 6.87/100,000 (CI 95%: 5.26-8.83) and for period B 16.04/100,000 (CI 95%: 12.99-19.59) (p < 0.0001). The relative risk of receiving a diagnosis of coeliac disease during the first four years of life was 2.31% (CI 95%:1.61-3.31) greater in period B than in period A. The mean age at diagnosis was 37.4 +/- 47.4 mo and 43.9 +/- 43.7 mo in A and B, respectively (p = 0.0058). The typical clinical pattern was the most frequent (83.6% in A and 58.3% in B). The mean age of introduction of gluten to the diet was 4.6 +/- 2.0 mo and 6.9 +/- 1.7 mo, for period A and B, respectively (p < 0.0001). CONCLUSION: The incidence rate of coeliac disease has increased during the two periods studied. In recent years, the relative risk of receiving a diagnosis of coeliac disease during the first four years of life has increased. The atypical clinical presentation has also increased, although the typical clinical form is still the most frequent in younger children.

[A health study of older persons in Extremadura: drug taking and the most frequent chronic diseases]. / Estudio de salud de las personas mayores en Extremadura: consumo de fármacos y patologías crónicas más frecuentes.

BACKGROUND: To ascertain the use of drugs among the non-institutionalised elderly population, the factors related to polypharmacy and pinpointing the relationship thereof with chronic diseases. METHODS: Cross-sectional epidemiological study by means of door-to-door survey. The population systematically selected totalled 960 individuals age 65-93. The questionnaire included demographic data, self-assessed health condition, quantitative and qualitative aspects of the use of medications, chronic diseases and assessment of functional ability. RESULTS: 91.62% of those surveyed were taking medication, a greater number of females (p < 0.002) than males. The medications taken to the greatest extent were blood pressure drugs (42.4%), analgesics (38.7%) and heart drugs (24.8%). Drugs were used to a greater extent among the oldest age group (p < 0.0001), those having the lowest educational level (p < 0.001), those with impaired eyesight and hearing (p < 0001), those having the lowest social status (p < 001), more contacts with the health care services (p < 0001), worse self-assessed health condition (p < 0001), a greater number of chronic diseases (p < 0.0001) and depressive disorders (p = 0.004). The linear regression analysis revealed a positive relationship between the number of medications taken and the number of chronic diseases (r = 0.518; p < 0.0001). Females report worse health conditions (p < 0.05). The variables analyzed with regard to polypharmacy by means of logistic regression are age (over age 75; OR = 1.1478), three or more chronic diseases (OR = 1.83) and poor self-assessed health condition (OR = 1.22). CONCLUSIONS: Physical checkups on the elderly must include a review of the medications being taken, especially among those over age 75 who have a worse self-assessed health condition and a larger number of chronic diseases.