[Epidemiology of diabetes mellitus in the province of Leon]. / Epidemiología de la diabetes mellitus en la provincia de León.

BACKGROUND: Diabetes mellitus (DM) is a very important health problem because of its high morbidity and mortality. The aim of the present study was to investigate the prevalence of diabetes in the adult population of the León province and its possible association with the most common risk factors and markers. METHODS: A cross-sectional descriptive study was designed with a multistage stratified sampling (572 individuals). A questionnaire about several sociodemographic variables, an alimentary survey, measurements of height and weight, capillary baseline glycemia, and oral glucose tolerance test with 75 g glucose were carried out. RESULTS: The observed prevalence of diabetes mellitus was 5,6% and that of glucose intolerance 10,3%. The known/unknown DM ratio was 2,2/1. The prevalence of treated DM was 1,9%. The leading variables associated with DM were age, a positive family history of diabetes and obesity. A higher incidence of DM was found in females, in urban media, and in high social classes. BACKGROUND: Diabetes had been previously underrated in the León province. The observed prevalence values are close to those from other methodologically similar studies. In addition, an association was found between DM and some non-modifiable risk factors (age, sex or family history); by contrast, there is a very important risk factor (obesity) which may be modified by intervention.

[The diagnosis of diabetes mellitus in epidemiological studies]. / El diagnóstico de la diabetes mellitus en los estudios epidemiológicos.

The aim of the present study was to evaluate the relative usefulness of some of the diagnostic methods used to estimate the prevalence of diabetes mellitus in epidemiological studies. A cross-sectional descriptive study with multistage stratified sampling was designed. A personal interview, a capillary baseline glycemia and a OGTT were carried out. The medical records and the use of antidiabetic drugs and self-control products were also evaluated. The prevalences obtained with these methods were: Medical records = 1.31%, personal interview = 7.91%, use of drugs = 1.93%, self-control products = 1.05%, capillary baseline glycemia greater than or equal to 120 mg/dl = 4.04%, OGTT with WHO criteria = 5.62%. Using OGTT as a reference, the diagnostic test with the greatest overall value was capillary baseline glycemia equal to or higher than 120 mg/dl. We think that, as a whole, the election of one method or another will depend on both the precise aim of the study and the type of design and the cost that can be sustained.

[The usefulness of the Peak Flow Meter for assessing patients with acute respiratory disease]. / Utilidad del "Peak Flow Meter" para la valoración de enfermos respiratorios agudos.

The aim of the study was to evaluate the utility of the extrahospital use of "Peak Flow Meter" (PFM) in patients with an acute respiratory disease. 70 patients were studied. PFM, arterial gasometry, physical examination and dyspnea evaluation were performed on all of them. The PFM were posteriorly transformed into the rate related to the ideal result, following the Nunn and Gregg equation (1989). We found an association between the PFM rate and the different arterial blood gas test results, and a relation to the degree of dyspnea and the listening of sibilant rales. There was more significance with the rate of PFM than with the PFM transformed in all cases, and only association was found between arterial blood changes and PFM. We concluded that all patients with an acute respiratory disease with a rate of PFM greater than 50% should be evaluated carefully because of the probability of existing hypoxemia, and those with rate of less than 20% must be referred to hospital.

[Tuberculosis in León. An epidemiological approach]. / La tuberculosis en León. Aproximación epidemiológica.

The aim of the present study was an approach to the epidemiological status of tuberculosis in the León province. To this end, we studied the morbidity through the EDOs and we carried out two tuberculin surveys during 1988-1989 to assess RAI. The results showed infection prevalences of 1.19 and 1.09 at six years of age for the two study years, respectively, with a RAI between 0.118 and 0.079. We conclude that tuberculosis still is an important health problem. The RAI indicates that our level is that of a developed country. We also discuss the supposed increase in the frequency of tuberculosis.

[What epidemiological measures are useful in the evaluation of tuberculous disease?]. / "Qué medidas epidemiológicas son útiles en la valoración de la enfermedad tuberculosa?"

Among the epidemiological barometers useful in evaluating tuberculosis, the Annual Infection Risk is the one which has been shown to be the most useful. This rate can be calculated indirectly (by way of Tables) or directly (by testing the same group of individuals twice over a one-year period). The most ideal method for making these calculations, by consecutively having the same population of 6 year-olds at intervals over a one-year period, is presented. The results indicate a statistically significant difference (P less than 0.001) between the two methods, an indirect AIR of 0.079 to 0.118 being obtained, as related to a Case Rate of 0.44. The fact that said difference is probably due to the impact of the BCG vaccination, which leads to pressure phenomena, and finally, whilst we are not free of said vaccination, this index should be calculated indirectly, based on tuberculosis infection prevalence rates.

[Hospital emergencies in the catchment area of León. A study of the repercussions of primary care]. / Urgencias hospitalarias en el área sanitaria de León. Estudio de la repercusión de la atención primaria.

The filter role of primary health care on the attendance to hospital emergency services was evaluated in view of the saturation of the latter. It was demonstrated that those patients who had not previously attended primary care services (40.3%) had a higher rate of problems for which emergency attention was considered unjustified (51.64%), with the consequent performance deterioration. In the group of patients who were referred to the hospital by a physician, the highest rates of examination of the patient, degree of justification for care, and diagnostic agreement with our center were found among the youngest physicians. As a whole, the filter role of primary care in our area is clearly higher than that from other similar studies, although optimal levels have not yet been achieved.