[Prevalence of cancer in the Guadalajara health area]. / Prevalencia de cáncer en el área de salud de Guadalajara.

OBJECTIVE: To quantify the prevalence of cancerand its distribution in adults. DESIGN: Descriptive study of point prevalence through research into primary and secondary sources. SETTING: Primary care, Guadalajara Health Region. 133 539 people over 14 years old. PARTICIPANTS: Patients previously diagnosed with cancer, who had a health card in the health area in June 1999. MEASUREMENTS: Demographic and diagnostic details (location according to CIE-9, date and diagnostic method). DATA SOURCES: primary care clinical records, cancer morbidity records and attendance orders. Overall crude and adjusted rates, in function of sex and age group, and specific to locations, were calculated. They were compared with data from other studies and data calculated for Spain on the basis of WHO information. RESULTS: 2717 tumours (2595 patients). Mean age, 68.2 (95% CI, 67.6-68.7); diagnostic age, 62.8 (95% CI, 62.1-63.5), in both cases higher in men (P<.01). Most common tumours: prostate, bladder, colon and lung (men); breast, colon, endometrium and ovaries (women). Crude prevalence: men, 2303.8/100 000; women, 1763.8. Adjusted to world population: 1394.2 and 1227.4/100 000, respectively (prevalence ratio, 1.14; 95% CI, 1.03-1.25). Truncated rate higher in women than in men (1638/100 000 against 1308). Five-year period with highest prevalence: 75-79 years old in men (8763.5/100 000) and 80-84 in women (4558.7/100 000). CONCLUSIONS: Cancer prevalence in adults is slightly above 2%. Once adjusted for age, values are similar to other studies and as expected for our country. The most common tumours are in the digestive apparatus, breast and the genito-urinary system. The man/woman proportion is higher than that described in other studies.

[Tobacco dependence in primary care: the opinion of professionals in the Guadalajara Health Area]. / Tabaquismo en atención primaria: la opinión de los profesionales en el Area de Salud de Guadalajara.

OBJECTIVE: To find the views and approach of primary care professionals in this Health Area to questions referring to restrictions on tobacco consumption, possibilities of intervention and resources devoted to monitoring tobacco dependency. DESIGN: A crossover study using an anonymous self-administered questionnaire with closed replies. SETTING: Primary care professionals from the Guadalajara Health Area. PARTICIPANTS: Medical, nursing and other professional staff (361 people), with an 86.1% reply rate. MEASUREMENTS AND MAIN RESULTS: 90.7% thought it was a good idea that tobacco consumption was legally regulated, although only 54.3% of non-smokers and 49.7% of doctors were in favour of extending the law. 37.5% of doctors and 19.5% of nurses (at the expense above all of non-smokers) were in favour of prioritizing care for non-smokers. Over 85% considered useful or very useful the introduction of methods to combat dependency in Health Centres and among health staff. CONCLUSIONS: There is a broad consensus on restricting tobacco consumption in determined places and applying methods in primary care to facilitate giving up tobacco. A critical attitude to the state on its tobacco policy was noted.

[Characteristics of tobacco use among the primary health care personnel in Guadalajara]. / Características del tabaquismo en el personal de Atención Primaria del Area Sanitaria de Guadalajara.

BACKGROUND: Tobaccoism is one of the most important social and health problems that exists. Given the role of Health Profesionals as educators and their example within the community, this particular group of people are vital in preventing and controlling tobaccoism. The purpose of this study was to identify the number and type of smokers working as professional health personnel in the Guadalajara Primary Medical Care Services, as well as their attitudes and knowledge in relation to the problem. METHODS: A descriptive cross-sectional study was carried out by means of a survey of all Guadalajara Primary Medical Care Personnel (doctors, nurses and other professionals). Data was compiled on social and demographic factors as well as the use of tobacco and awareness, attitudes and opinions: results were then analysed according to age, sex, occupation, working environment and degree of addiction. RESULTS: The rate of response was 86.1%. 38.2% claimed to be smokers (34.9% men and 41.2% women). Single male doctors living in urban areas showed the lowest rate of tobaccism. The majority of smokers did so at work, however not in front of patients, 63.2% had tried to give up smoking. The main cause of failure was attributed to lack of willpower (45.9%). 79.7% of ex-smokers had given up the habit after diagnosis of a health problem or illness. With respect to awareness and attitude, it was the medical profession and not tobaccoism itself that provided the most effective information and created less permissiveness in relation to the habit. Over 90% are in favour of initiating anti-smoking programs in Health Departments. CONCLUSIONS: A significant number of smokers in the sector was recorded, however attitudes towards the problem were positive.

[Vaccinations in adults: the coverage of the users of a health center]. / Vacunaciones en adultos: cobertura en usuarios de un centro de salud.

OBJECTIVE: To find the cover and records of recommended adult vaccinations and to identify possible causes of deficient cover. DESIGN: A descriptive crossover study using analysis of histories and a questionnaire. SETTING: General Medical and Nursing stations at the urban Guadalajara-Sur Health Centre. PATIENTS: Those people over 15 and with a prior appointment who were treated at the stations. A random selection of 352 patients. Final size: 275 patients (78.1%). MEASUREMENTS AND MAIN RESULTS: 20.5% +/- 4.9 of the population surveyed had been correctly vaccinated against tetanus. There was better cover of males (p < 0.05) and under-45s (p < 0.001; Confidence level--95%). 41.8% +/- 13.6 of indicated patients stated that they had been vaccinated against German measles, while 79.5% +/- 7.0 had received an anti-flu vaccination in the last campaign. Between 5 and 21%, according to age groups, possessed a vaccination card, with the levels noted in the medical records oscillating between 5.7% and 38.6%, respectively, for German measles and flu vaccination. Causes cited for non-vaccination were: ignorance in the cases of anti-tetanus (87.3%) and German measles (97%), carelessness (40%) or rejection (26.7%) for the anti-flu. CONCLUSIONS: Only anti-flu vaccination reaches acceptable coverage and understanding among our Centre's adult users, lack of knowledge being the main problem cited. We consider the recording level insufficient, both in clinical notes and on the vaccination cards. An intensive information campaign by health workers is needed, along with widespread vaccination to correct these deficiencies and reach the optimum coverage.

The association of oil ingestion with toxic oil syndrome in two convents.

The authors studied the pattern of occurrence of toxic oil syndrome, a previously undescribed disease that occurred in Spain in epidemic form in 1981, in two convents in Madrid. In one convent, the disease affected 66% of 35 novices and nuns who ingested oil from a suspect source, but none of 56 laywomen who ate the same meals but used a different type of oil. In the second convent, in which nuns were also exposed but laywomen were not, 98% of 43 nuns developed toxic oil syndrome compared with none of 70 laywomen. These findings support the hypothesis that a food oil transmitted the etiologic agent of toxic oil syndrome.