Prevalence of osteoporotic fracture risk factors and antiosteoporotic treatments in the Valencia region, Spain. The baseline characteristics of the ESOSVAL cohort.

UNLABELLED: This study provides information on the prevalence of the most important risk factors for osteoporosis and osteoporotic fracture in a large sample of women and men from the Valencia region and also provides the FRAX 10-year major and hip fracture risks for this population, as well as data about the use of diagnostic tests and antiosteoporotic treatments. INTRODUCTION: The purpose of this study was to describe demographic characteristics, osteoporosis risk factors, the 10-year risk of osteoporotic fracture, and the use of densitometry and antiosteoporotic treatments in the Valencia region, Spain. METHODS: A cross-sectional study using the ESOSVAL cohort baseline data was conducted. We analyze the data from 5,310 women and 5,725 men aged 50 and over who attended to 272 collaborating primary care centers in 2009-2010. We collected the demographic, anthropometric, clinical, and pharmacy data from the electronic medical record. RESULTS: The mean age of participants was 64.3 years old for women and 65.6 years old for men. The most frequent fracture risk factors were sedentary life (22.2 %) and previous fracture (15.8 %) in women and low calcium intake (21.4 %) and current smoker (20.9 %) in men. According to FRAX(®), the 10-year risk of presenting a major fracture was 5.5 % for the women and 2.8 % for the men. The 10-year risk for hip fracture was 1.9 and 1.1 % for the women and the men, respectively; 23.8 % of the women and 5.2 % of the men had a densitometry test, 27.7 % of the women and 3.5 % of the men were taking calcium and/or vitamin D supplements, and 28.2 % of the women (22.0 % in the 50-64 age group) and 2.3 % of the men were taking antiosteoporotic drugs. CONCLUSIONS: The prevalence of certain fracture risk factors not included in the FRAX tool (sedentary life, falls, low calcium intake) is high. In young women, their low risks estimated by FRAX contrast with the high figures for densitometry testing and treatment.

First Report of Alternaria petroselini Causing Leaf Blight of Fennel in Spain.

Fennel (Foeniculum vulgare Mill.) is an aromatic herb widely cultivated in Mediterranean areas for culinary and medicinal uses. In 2010, symptoms consisting of leaf blight and necrosis were observed in commercial organic fennel production areas in Valencia Province in east-central Spain. Disease incidence in affected fields was approximately 20%. Symptomatic leaves from four fields were surface disinfected with 0.5% NaOCl for 2 min, and small fragments from necrotic lesions were then plated on potato dextrose agar (PDA) amended with 0.5 g of streptomycin sulfate/liter. After 7 days at 25°C, isolates of the genus Alternaria were consistently isolated. Single conidium cultures were grown on PDA and V8 agar for morphological examination. On both agar media, colonies were dark olive brown without production of pigments. On V8 agar, conidia were solitary, darkly pigmented, and predominantly ovoid-subsphaeroid. Mature conidia were 25 to 59 × 12 to 23 µm with up to six to seven transepta and one to three longisepta. The 5.8S, ITS2, and 28S ribosomal RNA (rRNA) regions were amplified with the primers ITS3 and ITS4 (3) from DNA extracted from the isolate IVIA-A029, and sequenced (GenBank Accession No. JQ240204). The sequence had 100% identity (total score 399, 97% coverage) with that of Alternaria petroselini (Neergard) Simmons strain EGS 09-159 (GenBank Accession No. AF229454.1) (1). Pathogenicity tests were conducted on four 3-month-old fennel plants (cv. Giotto) by spraying a conidial suspension of the fungus (10 ml/plant, 103 conidia/ml of water). Four control plants were sprayed with sterile, distilled water. Plants were covered with plastic bags and incubated in a growth chamber for 72 h at 25°C. Leaf necrosis was visible on inoculated plants after 4 days, but symptoms were not observed on control plants. The fungus was reisolated from leaf lesions on inoculated plants, but not from leaves of control plants, confirming Koch's postulates. On the basis of the morphological (2), molecular, and pathogenicity data, the disease was identified as Alternaria leaf blight of fennel caused by A. petroselini. To our knowledge, this is the first report of A. petroselini in Spain. References: (1) B. M. Pryor and R. L. Gilbertson. Mycol. Res. 104:1312, 2000. (2) E. G. Simmons. Alternaria: An Identification Manual. CBS Fungal Biodiversity Centre, Utrecht, The Netherlands, 2007. (3) T. J. White et al. Pages 315 in: PCR Protocols: A Guide to Methods and Applications. Academic Press, San Diego, CA, 1990.

El concepto de primípara añosa / The concept of the older primipara

Nuestro objetivo es demostrar que el concepto de "primípara añosa" no se corresponde en la obstetricia actual con su significado real y debe ser sustituido por otro concepto estadístico independiente de la modificación de la edad del parto de la mujer. En un estudio retrospectivo entre 1980 y 1999 observamos un aumento continuo de hasta el 7 per cent de las "primíparas añosas" en el último año. La población discriminada está más relacionada con la media aritmética + 2 DE que con el percentil 90. Se analiza el empleo de 3 DE, en vez de 2 DE. Por tanto, proponemos cambiar el concepto de "primípara añosa" utilizando los valores obtenidos con la media aritmética + 2 DE de la edad de la mujer en el parto (AU)

Edad y paridad de la mujer en el momento del parto / a woman age and parity at the time of delivery

Se estudian 152.470 partos con feto único habidos en la maternidad La Fe entre el 1 de enero de 1980 y el 31 de diciembre de 1999. Al clasificarlos según la paridad de la mujer, se observó que 77.877 (51,1 por ciento) eran nulíparas y 74.593 (48,8 por ciento) multíparas. Se comparan los partos habidos en este centro entre las fechas indicadas, observando una disminución progresiva que alcanza significación entre los valores extremos. Esta disminución no se produce de forma uniforme, sino con un aumento relativo de las nulíparas en detrimento de las multíparas, siendo en la actualidad de 51,1 y 48,8 por ciento, respectivamente, frente al 46,6 y 56,4 por ciento, que eran los valores al inicio del estudio. Las multíparas se clasifican con arreglo a la paridad observando un aumento de las primíparas y una disminución del resto con el paso del tiempo. Se observa una disminución del número de partos por mujer, que ha pasado de 2,0 a 1,5, existiendo entre ambos valores diferencias estadísticamente significativas. Al clasificar las nulíparas según la edad en el momento del parto se observó en la actualidad una tendencia a mayores edades, sin que alcanzara significación estadística; esto mismo ocurría al considerar a todas las mujeres, por lo que recurrimos a hacerlo por paridades. Podemos afirmar que en nuestro medio, la edad de la mujer en el momento del parto ha aumentado con el tiempo, de forma que las nulíparas y las primíparas muestran valores que alcanzan significación estadística respecto a lo que ocurría al principio del estudio, no alcanzándose en las secundíparas, tercíparas y cuartíparas (AU)

Nuevo aparato para el estudio del equilibrio ácido-base / New equipment for measuring acid base balance

La vigilancia fetal intraparto se basa en la monitorización de la frecuencia cardíaca fetal, monitorización de la saturación de oxígeno fetal mediante pulsioximetría y en el estudio del equilibrio ácido-base de sangre fetal. En el presente estudio, proponemos un nuevo sistema analizador clínico portátil del equilibrio ácidobase. Para ello estudiamos 65 muestras de sangre fetal en diferentes momentos del parto y en sangre de cordón umbilical y comparamos los resultados de dicho sistema con los de los aparatos anteriormente utilizados en nuestro centro, observando que éstos son prácticamente intercambiables para los parámetros pH, pO2 y pCO2, con coeficientes de determinación (r2) excelentes, sin encontrarse diferencias estadísticamente significativas. Concluimos que las ventajas que presenta el nuevo aparato son: menor coste económico, mayor comodidad y disponibilidad, seguridad para el personal sanitario al manipular sangre contaminada y menor cantidad de muestra necesaria para el análisis (AU)