Association between red meat consumption and metabolic syndrome in a Mediterranean population at high cardiovascular risk: cross-sectional and 1-year follow-up assessment.

BACKGROUND AND AIMS: Little is known about the role that red meat and processed red meat (RM) consumption plays in the development of the metabolic syndrome (MetS). The aim was to assess the relationship between RM consumption and the prevalence or incidence of the MetS and its components in a Mediterranean population at high risk of cardiovascular disease. METHODS AND RESULTS: Cross-sectional analyses were carried out at baseline and at 1-year follow-up and longitudinal analysis were conducted in a cohort of individuals at high risk of cardiovascular disease from the PREDIMED study. A 137-item validated semi-quantitative food frequency questionnaire, anthropometric measurements, blood pressure, fasting plasma glucose and lipid profile were evaluated both at baseline and after 1-year follow-up. The MetS was defined in accordance with the updated ATP III criteria. Subjects in the upper quartile of RM consumption were more likely to meet the criteria for the MetS at baseline (OR, 2.3; 95% CI, 1.4-3.9; P-trend = 0.001) and after 1-year follow-up (OR, 2.2; 95% CI, 1.3-3.7; P-trend = 0.034) compared with those in the quartile of reference, even after adjusting for potential confounders. The longitudinal analyses showed that individuals in the fourth quartile of RM consumption had an increased risk of MetS (OR, 2.7; 95% CI, 1.1-6.8; P-trend = 0.009) or central obesity incidence (OR, 8.1; 95% CI, 1.4-46.0; P-trend = 0.077) at the end of the follow-up compared to the lowest quartile. CONCLUSIONS: Higher RM consumption is associated with a significantly higher prevalence and incidence of MetS and central obesity in individuals at high risk of cardiovascular disease.

The prevalence of metabolic syndrome in Latin America: a systematic review.

OBJECTIVE: To assess the available data on the prevalence of metabolic syndrome (MS) in Latin-American countries. DESIGN: Systematic review. Searches were carried out in PubMed, ISIWeb, SCielo and Redalyc, using 'metabolic syndrome x' and 'prevalence' as keywords for titles and/or abstracts. Articles selected were cross-sectional studies in Latin-American countries, whose main objective was to study MS and whose study population is described below. MS must be determined using Adult Treatment Panel III criteria. Twelve studies with these criteria were selected, one of which was multi-centric. SETTING: Latin America. SUBJECTS: Apparently healthy subjects aged 18-65 years (including young adult, mature adult and elderly populations) of both genders. RESULTS: The general prevalence (weighted mean) of MS in Latin-American countries was 24·9 (range: 18·8-43·3) %. MS was slightly more frequent in women (25·3 %) than in men (23·2 %), and the age group with the highest prevalence of MS consisted of those over 50 years of age. The most frequent components of MS were low HDL cholesterol levels (62·9 %) and abdominal obesity (45·8 %). Similar outcomes were obtained from the multi-centre study on Latin-American populations analysed. CONCLUSIONS: The present review brings us closer to an understanding of the prevalence of MS in Latin-American countries. However, it is not possible to know the full scope of the problem, partly because data from some countries are not available, and because the methodological differences among the studies published up to the present limit a joint analysis of their results.

Parents' perceptions of their neonates and their relation to infant development.

BACKGROUND: Father and mother neonatal perceptions can alter the parents' behaviour towards their child and influence their relationship and, consequently, his/her development. The aim of this study was to examine how mother-father perceptions of their neonates evolve during the first month of life, and whether these perceptions, and the psychological and social characteristics of the mothers are good predictors of infant development. METHODS: Seventy-two mother-father-child triads participated. Maternal personality, including neuroticism, and maternal depression and anxiety symptoms were assessed. Parents' neonatal perceptions and neonatal behaviour were assessed at 3 days and at 1 month post partum and infant development at 4 and 12 months post partum. RESULTS: Parents' initial perceptions were positive, decreased in both parents during the first month and evolved differently according to the child's gender. High maternal neuroticism was related to worse neonatal perceptions, and high father perception was related to better infant development at 12 months. CONCLUSIONS: These results support the contribution of parents' neonatal perception on infant development and may have social implications regarding the role of fathers in the parenting of their children.

Ankle taping can improve proprioception in healthy volunteers.

BACKGROUND: Taping is a common technique to treat inversion ankle sprains, but the effects of tape on proprioception are still not clear. The purpose of this study was to establish whether proprioception would be modified by the use of ankle tape. To do so we studied joint position sense (JPS) in healthy volunteers using three-dimensional (3D) movement analysis systems. MATERIAL AND METHODS: Forty healthy volunteers (mean age and SD = 23.2 ± 4.2) were asked to actively reproduce four different ankle positions: 10 degrees of dorsiflexion, neutral, 10 degrees and 20 degrees of plantarflexion. The absolute difference between the estimated angle and the target angle was used to assess JPS. This difference was named Error. Subjects were randomly assigned to the control (n = 21) or the intervention (n = 19) groups. Members of the intervention group received ankle tape for a lateral ligament sprain in the non-dominant leg. A t-test was used to evaluate the results. RESULTS: Tape significantly improved JPS for the dorsiflexion position (p = 0.038). Neutral was the most accurately reproduced position, and the remaining positions were overestimated for both groups. CONCLUSION: Taping improved proprioception in healthy volunteers, and 3D movement analysis was a useful method to accurately quantify joint position sense. CLINICAL RELEVANCE: Because ankle proprioception is critical to the functional success of surgical and rehabilitation treatments, these results regarding proprioception are of particular importance because ankle taping is often used in preventing ankle sprains and it is a common treatment after ankle injuries.

Equation to estimate body weight in elderly Mexican women using anthropometric measurements.

INTRODUCTION: Body weight is useful for many medical and nutritional procedures. When it is difficult or impossible to measure body weight in hospitalized/institutionalized elderly, it can be estimated through equations based on anthropometry generated in other countries, although their validity in other contexts has been poorly studied. OBJECTIVES: To create and validate an equation for estimating body weight for both, hospitalized and nursing home residents Mexican elderly women (institutionalized) using anthropometric measurements. METHODS: A validation study was carried out in elderly women (> or = 60 years old), admitted to the Geriatrics Service of the Hospital Civil de Guadalajara "Fray Antonio Alcalde" during February-April 19th (n = 43) and April 20th-June 2005 (n = 29), and elderly women residing in three nursing homes in the Metropolitan Area of Guadalajara evaluated during June 2003-June 2004 (n = 23). Subjects were weighed using a scale which was adapted to their clinical situation and were anthropometrically assessed. In the first sample, we generated a new equation using multiple regression analyses. Then, the equation was validated in the other two samples. We also estimated weight using Chumlea's equations: in all samples, estimated and actual weights were compared between each other through a paired t-test. A p < 0.05 was considered as significant. RESULTS: Mean ages in each sample were: 84.3 +/- 7.3, 84.4 +/- 9.1, and 84.2 +/- 8.5 years, respectively. Mean actual weights were: 48.2 +/- 13.5, 48.1 +/- 10.1, and 55.0 +/- 12.3 kg, respectively. The resulting equation was: estimated weight = (1.599* knee height) +(1.135* mid arm circumference) + (0.735*calf circumference) + (0.621* tricipital skinfold thickness)-83.123 (R2 = 0.896, p < 0.001). In hospitalized women, there were no significant differences between estimated and actual weight (sample 1:D-0.02 +/- 4.3 kg, p = 0.976; sample 2: D-0.7 +/- 4.2 kg, p = 0.352). In female nursing homes residents (institutionalized women) weight was significantly overestimated (1.9 +/- 3.2 kg p < 0.01), but the mean difference was smaller than the ones found using Chumlea's equations. CONCLUSIONS: The developed equation predicted accurately hospitalized elderly women's body weight in our context. In institutionalized elderly women, weight was significantly overestimated. It would be useful to derive equations for different settings.uals who present normal body weight.

Adherence to the Mediterranean diet and risk of metabolic syndrome and its components.

BACKGROUND AND AIMS: The role of diet in the aetiology of metabolic syndrome (MetS) is not well understood. The aim of the present study was to evaluate the relationship between adherence to the Mediterranean diet (MedDiet) and MetS. METHODS AND RESULTS: A cross-sectional study was conducted with 808 high cardiovascular risk participants of the Reus PREDIMED Centre. MetS was defined by the updated National Cholesterol and Education Program Adult Treatment Panel III criteria. An inverse association between quartiles of adherence to the MedDiet (14-point score) and the prevalence of MetS (P for trend<0.001) was observed. After adjusting for age, sex, total energy intake, smoking status and physical activity, participants with the highest score of adherence to the MedDiet (>/=9 points) had the lowest odds ratio of having MetS (OR [95% CI] of 0.44 [0.27-0.70]) compared to those in the lowest quartile. Participants with the highest MedDiet adherence had 47 and 54% lower odds of having low HDL-c and hypertriglyceridemia MetS criteria, respectively, than those in the lowest quartile. Some components of the MedDiet, such as olive oil, legumes and red wine were associated with lower prevalence of MetS. CONCLUSION: Higher adherence to a Mediterranean diet is associated with a significantly lower odds ratio of having MetS in a population with a high risk of cardiovascular disease.

Body fat at pubertal genital stage 2: a comparison between Spanish and Mexican boys.

BACKGROUND/OBJECTIVES: To compare body fat mass at the same stage of pubertal maturation, genital stage 2 (G2), in a Spanish and in a Mexican sample of boys. SUBJECTS/METHODS: Data from Spain (n=177) were from a previous longitudinal clinical follow-up and data from Mexico (n=91) from a cross-sectional study. Subjects were grouped according to the presence of G2 at similar ages. Spanish sample was divided into boys with G2 at age 12 (n=60), 13 (n=74) and 14 (n=43). In Mexican sample, 23 boys were at G2 at 12 years, 38 at age 13 and 30 at 14 years. Height, weight, upper arm circumference and four skinfold thicknesses were recorded. Genital development was assessed (Tanner scale). Sum of four skinfolds (SUM), body mass index (BMI), percentage of body fat (%BF) and extremity/trunk skinfold ratio (ETR=(triceps+biceps)/(subscapular+suprailiac)) was calculated. RESULTS: When comparing subjects with different ages at G2 from the same country, or with the same age at G2 from different countries, no significant differences were found in adiposity variables (%BF, SUM), nor in BMI. Nevertheless, there were differences in body fat distribution: ETR was higher in Spanish boys (P<0.001), because of their greater triceps skinfold thickness (P=0.013), and due to the greater trunk fat stores in Mexican boys (P<0.01, subscapular and suprailiac skinfolds). CONCLUSIONS: There is a subcutaneous fat mass store characteristic of G2 in boys, which is not only independent of age, but is also observable in two different populations.

Validación de un cuestionario de frecuencia de consumo alimentario corto: reproducibilidad y validez / Validation of a short questionnaire on frequency of dietary intake: Reproducibility and validity

Antecedentes: El conocimiento de la ingesta dietética de los individuos es una herramienta fundamental para conocer patrones alimentarios y explorar su asociación con el riesgo de enfermedad. Actualmente, uno de los métodos más utilizados son los cuestionarios de consumo alimentario. El principal inconveniente de su uso es la necesidad de ser validado previamente. Nuestro objetivo es validar un cuestionario de frecuencia de consumo alimentario corto. Ámbito: Reus (Cataluña), España. Sujetos: 71 adolescentes y adultos de ambos sexos, con niveles socioculturales y categorías profesionales diferentes. Intervenciones: El cuestionario fue administrado 2 veces en un periodo aproximado de un año para valorar la reproducibilidad. A lo largo de este mismo periodo se administraron 9 recordatorios de 24 horas (método de referencia) para determinar su validez. Resultados: Los coeficientes de correlación de Spearman para el estudio de reproducibilidad oscilaban entre 0,49 y 0,75 para los alimentos y entre 0,44 y 0,78 para la energía y los nutrientes. La mayoría de coeficientes de correlación intraclase oscilaron entre 0,53 y 0,96 para los alimentos y entre 0,49 y 0,78 para la energía y los nutrientes. En el estudio de validez las correlaciones oscilaron entre 0,27 y 0,59 para los alimentos y entre 0,30 y 0,49 para la energía y los nutrientes. Los coeficientes de correlación intraclase en el estudio de validez oscilaron entre 0,41 y 0,67 para los alimentos y entre 0,29 y 0,47 para la energía y nutrientes. Conclusión: El cuestionario permite valorar en general el consumo de grupos de alimentos, energía y macronutrientes con adecuada reproducibilidad y validez (AU)

Background: Knowledge on dietary intake in individuals is an essential tool to know the dietary patterns and explore their association with the disease risk. One of the current methods most currently used are dietary intake questionnaires. The main drawback of their use is the need for previous validation. Our objective was to validate a short questionnaire on the frequency of dietary intake. Setting: Reus (Catalonia), Spain. Subjects: 71 adolescents and adults from both genders, with different socio-cultural levels and professional categories. Interventions: The questionnaire was administered two times within an approximated period of one year to assess the reproducibility. Through this time, 9 24-hour recalls (gold standard method) were administered to determine the validity. Results: Spearman's correlation coefficients for the reproducibility analysis varied 0.49-0.75 for foods and 0.44-0.78 for energy and nutrients. Most of intra-class correlation coefficients varied 0.53-0.96 for foods and 0.49-0.78 for energy and nutrients. In the validity analysis, the correlations varied 0.27-0.59 for foods, and 0.30-0.49 for energy and nutrients. The correlation coefficients in the validity study varied 0.41-0.67 for foods, and 0.29-0.47 for energy and nutrients. Conclusion: The questionnaire allows assessing the consumption of groups of foods, energy and macronutrients with adequate reproducibility and validity (AU)

Non-clinical adolescent girls at risk of eating disorder: under-reporters or restrained eaters?

BACKGROUND: To evaluate the plausibility of self-reported energy intake, Goldberg et al proposed a technique to identify the miss-reporters. SUBJECTS: After screening 2,967 adolescents by EAT-40 test, 132 at risk of ED and 151 as a control group were studied. AIM: To determine whether subjects at risk of eating disorders that are identified as under reporters can be considered as UR or in turn as restrained eaters. METHODS: We determined dietary energy intake, body mass index, body satisfaction, physical activity, psychopathology, dietary restraint factor, weight loss and diagnoses of eating disorders. We applied Goldberg's equations to identify under reporters. RESULTS: 40.9% of girls at risk of eating disorders were identified as under reporters and only 7.3% were in the control group. A total of 64.4% of the Eating Disorders Not Otherwise Specified were under reporters. The body mass index of under reporters was significantly higher than in the other of subjects regardless of whether they were at risk of eating disorders. Girls at risk of eating disorders and under reporter had significantly lower body satisfaction than other groups. Multiple logistic regressions in all subjects showed that the risk of being UR was associated with an increase in the body mass index, increase in dietary restraint scores and weight loss; whereas, that only the body mass index was associated with the control group. CONCLUSION: The prevalence of under reporter increases with the severity of the eating disorders several adolescent girls at risk of eating disorder and identified by Goldberg cut-off technique as under reporter may to be restricting their intake and therefore they would not be under reporter.

Non-clinical adolescent girls at risk of eating disorder: under-reporters or restrained eaters? / Mujeres adolescentes en riesgo de trastorno de la conducta alimentaria, no clínicas: ¿infra-declaran o restringen el consumo?

Background: To evaluate the plausibility of self-reported energy intake, Goldberg et al proposed a technique to identify the miss-reporters. Subjects: After screening 2,967 adolescents by EAT-40 test, 132 at risk of ED and 151 as a control group were studied. Aim: To determine whether subjects at risk of eating disorders that are identified as under reporters can be considered as UR or in turn as restrained eaters. Methods: We determined dietary energy intake, body mass index, body satisfaction, physical activity, psychopathology, dietary restraint factor, weight loss and diagnoses of eating disorders. We applied Goldberg's equations to identify under reporters. Results: 40.9% of girls at risk of eating disorders were identified as under reporters and only 7.3% were in the control group. A total of 64.4% of the Eating Disorders Not Otherwise Specified were under reporters. The body mass index of under reporters was significantly higher than in the other of subjects regardless of whether they were at risk of eating disorders. Girls at risk of eating disorders and under reporter had significantly lower body satisfaction than other groups. Multiple logistic regressions in all subjects showed that the risk of being UR was associated with an increase in the body mass index, increase in dietary restraint scores and weight loss; whereas, that only the body mass index was associated with the control group. Conclusion: The prevalence of under reporter increases with the severity of the eating disorders several adolescent girls at risk of eating disorder and identified by Goldberg cut-off technique as under reporter may to be restricting their intake and therefore they would not be under reporter (AU)

Antecedentes: Para validar la ingesta valorada a través de encuestas alimentarias, Goldberg y cols., propusieron ecuaciones para detectar a sujetos que informan mal de su consumo alimentario. Sujetos: Después de realizar un cribado entre 2.967 escolares adolescentes mediante el cuestionario EAT-40, se estudiaron 132 mujeres en riesgo de Trastorno del Comportamiento Alimentario (TCA) y 151 como grupo control. Objetivo: Determinar si las adolescentes en riesgo de TCA que son identificadas como infra-declarantes de su consumo alimentario (IDCA) pueden considerarse como casos IDCA o por el contrario restringen la ingesta. Métodos: Se determinó la ingesta energética, el índice de masa corporal (IMC), la satisfacción corporal, la actividad física, la psicopatología, el factor de restricción dietética, la pérdida de peso y los diagnósticos de TCA. Se aplicaron las ecuaciones de Goldberg para identificar los sujetos IDCA. Resultados: El 40,9% de las adolescentes en riesgo de TCA fueron identificadas como IDCA y solamente el 7,3% del grupo control. Un total de 64,4% de los TCA no especificados fueron IDCA. El IMC de las IDCA fue significativamente más alto que en los otros grupos, tanto si estaban o no en riesgo de TCA. Las adolescentes en riesgo de TCA e IDCA presentaron significativamente menor satisfacción corporal que ningún otro grupo. Mediante análisis de regresión logística múltiple en el conjunto de los sujetos se observó que ser IDCA estaba asociado con un aumento del IMC, un aumento de las puntuaciones de restricción dietética y con pérdida de peso; sin embargo, en el grupo control, solamente se asociaba con el IMC. Conclusiones: La prevalencia de IDCA aumenta con la severidad de los TCA en las mujeres adolescentes en riesgo de TCA y su identificación como IDCA mediante la técnica de Goldberg podrían ser debidas a la restricción de su ingesta y por tanto no ser IDCA (AU)

Dietary calcium and body mass index in a Mediterranean population.

This cross-sectional study evaluated the association between daily calcium intake and body mass index (BMI) in 647 subjects from Reus, Spain. 261 men and 313 women, aged 18 to 70 years, were randomly selected from the population census. Food intake was quantified by the 24-hour recall method, for three non-consecutive days including one holiday. Weight and height were measured. The study sample was divided into quartiles of calcium intake adjusted for age, energy, and total fat and fiber intake in both men and women. Average calcium intake was low (557.6 +/- 234.0 mg/day). Calcium intake was significantly (p < 0.0001) and positively associated with energy intake (r = 0.50 for men; r = 0.49 for women; p < 0.0001) and dietary fiber consumption (r = 0.27 for men; r = 0.25 for women; p < 0.0001). After adjusting for age, energy intake, fat intake, and dietary fiber, the odds ratio of being in the highest quartile of BMI was significantly reduced in the highest quartile of calcium intake [men: 0.63 (0.30-1.29); women: 0.36 (0.17-0.79)] compared to the lowest quartile in both sexes. We conclude that our study showed a negative relationship between calcium intake and BMI in a Mediterranean community.

Association of maternal protein intake before conception and throughout pregnancy with birth weight.

BACKGROUND: The aim of this study is to analyze how the maternal intake of macronutrients before conception and in the 6th, 10th, 26th, and 38th weeks of pregnancy affects birth weight. METHODS: A longitudinal study of food consumption to assess the nutritional status of 77 healthy female volunteers (age range: 24-36) who were planning immediate pregnancy was performed in Reus between 1992 and 1996. A seven-consecutive-day dietary record was used in order to evaluate the dietary intake. We fitted multiple linear regression models of macronutrients on birth weight adjusted for energy intake, maternal age, pre-conceptional body mass index, sex of the newborn, length of pregnancy, parity, physical activity in leisure time, and smoking. RESULTS: In the 6th, 10th, and 26th weeks of pregnancy, 7.2-12.7% of the variability of the birth weight can be explained by the intake of macronutrients. In the protein and fat model, a 1 g increase in maternal protein intake during preconception and in the 10th, 26th, and 38th weeks of pregnancy leads to a significant increase of 7.8-11.4 g in birth weight. CONCLUSIONS: The diet of well-nourished women in the preconception period and throughout most of pregnancy has a significant effect on birth weight, and proteins are the macronutrient that has the greatest influence.

Dietary patterns and associated lifestyles in preconception, pregnancy and postpartum.

OBJECTIVE: To identify dietary patterns in women who are planning immediate pregnancy in preconception, weeks 6, 10, 26 and 38 of pregnancy, and 6 months postpartum, and to describe how particular lifestyles, the body mass index (BMI) and sociodemographic factors are associated to these patterns. DESIGN: Longitudinal study throughout the reproductive cycle of food consumption carried out in a Spanish Mediterranean city. SETTING: Faculty of Medicine and Health Sciences, Rovira i Virgili University. SUBJECTS: In total, 80 healthy female volunteers who were planning immediate pregnancy. INTERVENTIONS: A seven-consecutive-day dietary record was used to evaluate the dietary intake. Exploratory factor analysis was used to identify the main dietary patterns in each of the periods. Fitted multiple linear regression models were used to study the associations between the lifestyle and sociodemographic variables, and each dietary pattern. RESULTS: The 'sweetened beverages and sugars' pattern was identified from preconception to 6 months postpartum and the 'vegetables and meat' pattern to the end of pregnancy. The 'sweetened beverages and sugars' pattern is positively associated with smoking and negatively associated with physical activity before conception and in the first trimester of pregnancy. The 'vegetables and meat' pattern is negatively associated with the BMI during the preconception period and positively associated with age in weeks 10 and 38 of pregnancy. It is shown that the patterns do not change significantly throughout the period studied. CONCLUSIONS: We have identified two stable dietary patterns from preconception to postpartum. The 'sweetened beverages and sugars' pattern is associated with habits of risk for the health of the pregnant woman and her offspring. SPONSORSHIP: 'Comisión Interministerial de Ciencia y Tecnología' (CICYT: ALI89-0388) and 'Instituto de Salud Carlos III', RCMN (C03/08), Madrid, Spain'.

Validación de la versión española del Fibromyalgia Impact Questionnaire / Validation of the Spanish version of the Fibromyalgia Impact Questionnaire

Objetivo: Traducir, validar y adaptar el Fibromyalgia Impact Questionnaire (FIQ) al castellano para poder utilizarlo en España. Material y métodos: La traducción del FIQ original a la lengua castellana fue realizada por un traductor oficial (nativo español). El documento resultante fue de nuevo traducido al inglés por otro traductor independiente (nativo inglés). Se compararon los 2 documentos y se elaboró un documento en castellano consensuado por el grupo de investigadores y los traductores, así se obtuvo el Spanish FIQ (S-FIQ). Participaron 41 mujeres afectadas del síndrome de fibromialgia (SFM). Se explora la validez del S-FIQ. Para comparar el S-FIQ con otro test ya validado en español se administra el S-FIQ y el Cuestionario de Salud SF-36. Para analizar la reproducibilidad, se pidió a los pacientes que cumplimentaran el S-FIQ 7 días más tarde. Resultados: Se realizaron algunas adaptaciones culturales para obtener el S-FIQ final. El valor del coeficiente de correlación intraclase del S-FIQ total fue de 0,81. Las puntuaciones S-FIQ se correlacionaban con las del SF-36. Conclusión: El S-FIQ mantuvo las propiedades metodológicas de la versión original y se puede usar como herramienta de medida en pacientes españoles con SFM (AU)

Onset of puberty at eight years of age in girls determines a specific tempo of puberty but does not affect adult height.

AIMS: To analyse the effect of early puberty (onset between 7.5 and 8.5 y) on pubertal growth and adult height in girls, and the implications of this effect for the age limit for normal onset of puberty. METHODS: Longitudinal study in Reus (Spain) of 32 girls with early puberty until they reached adult height. Data from these girls were compared with longitudinal data from girls (116) from the same population with normal onset at 10 (n = 37), 11 (n = 47), 12 (n = 19) and 13 (n = 13)y. We analysed height, target height, adult height, pubertal height increase, duration of pubertal growth, age at menarche and time to menarche. RESULTS: The adult height of girls with early puberty (160.9 +/- 5.4cm) was similar to that of girls with onset at later ages (p = not significant). In these girls, puberty lasted 5.4 +/- 0.7 y and the mean growth during puberty was 31.1 +/- 3.5 cm. As the age of onset of puberty increases, the duration of puberty and mean growth during puberty progressively decreased (p < 0.001). Girls with early puberty reached menarche at a mean age of 10.9 +/- 1.0 y, 3.2 +/- 0.9 y after onset of puberty, and this time span was greater than in the other groups. CONCLUSION: Girls with onset of puberty at 8 y show all the compensatory phenomena related to height at onset, pubertal duration and height increase during puberty. These phenomena cause their adult height to be similar to that of girls who begin puberty at the age of 10 to 13 y.

Estudio de relación entre microangiopatía retinianay renal en pacientes diabéticos tipo 1 / Study of the relationship between retinal and renal microangiopathy in patients with diabetes mellitus type 1

Las similitudes en la vascularización de la retina y el riñón hacen que las complicaciones de la diabetes mellitus en los pequeños vasos (microangiopatía) aparezcan en ambos órganos. El presente estudio ofrece los resultados obtenidos de forma prospectiva a lo largo de 10 años en 104 pacientes diabéticos tipo 1, con las características de no presentar microalbuminuria ni retinopatía diabética al inicio del mismo; los resultados tienen por objetivo la relación entre la presencia de retinopatía diabética proliferativa y microalbuminuria, teniendo en cuenta diferentes factores de riesgo epidemiológico: sexo, duración de la diabetes, presencia de hipertensión arterial diastólica, niveles de HbA1c y lípidos sanguíneos. Los resultados obtenidos indican una incidencia de retinopatía diabética a los 10 años de seguimiento de 37,50 por ciento (siendo la forma proliferativa 13,46 por ciento) y la incidencia de microalbuminuria es de un 20,19 por ciento. La aparición de retinopatía diabética proliferativa se asocia a la presencia de hipertensión arterial diastólica, mientras que la aparición de microalbuminuria a los niveles elevados de HbA1c. Los resultados obtenidos de incidencia de retinopatía diabética proliferativa y microalbuminuria son similares a los de otros autores. Al final del estudio se configuran 4 grupos de pacientes según presenten retinopatía diabética proliferativa y/o microalbuminuria. De los resultados obtenidos en el presente estudio se desprende la posible existencia de dos poblaciones de pacientes diabéticos, una que desarrollaría retinopatía diabética proliferativa y lesión renal y una segunda en la que solamente aparecería retinopatía diabética proliferativa (AU)

[Study of the relationship between retinal and renal microangiopathy in patients with diabetes mellitus type 1]. / Estudio de relación entre microangiopatía retiniana y renal en pacientes diabéticos tipo 1.

The similarities in the vascularization of the retina and the kidney give rise to the complications of diabetes mellitus in the small vessels (microangiopathy) that appear in both organs. The present study presents the prospectively obtained results along 10 years in 104 diabetic type 1 patients, with the characteristics not to present microalbuminuria nor diabetic retinopathy at the beginning of the study; the results bear as objective the establishment of the relation between the presence of proliferative diabetic retinopathy and microalbuminuria, taking into account different factors of epidemiological risk: gender, duration of diabetes, presence of diastolic hypertension, levels of HbAlc, and blood lipids. The results obtained indicate a 10 years of follow-up incidence of diabetic retinopathy of 37.50% (being the proliferative form 13.46%) and the incidence of microalbuminuria is of 20.19%. The appearance of proliferative diabetic retinopathy is associated to the presence of diastolic hypertension, while the appearance of microalbuminuria is related to the elevation of levels of HbAlc. The results obtained in the proliferative diabetic retinopathy and microalbuminuria incidence are similar to those of other authors. At the end of the study four groups of patients are configured depending on whether they present proliferative diabetic retinopathy and/or microalbuminuria. The results obtained in the present study suggest the possible existence of two populations of diabetic patients, one that would develop proliferative diabetic retinopathy and renal injury, and a second population in which only would appear proliferative diabetic retinopathy.

Satisfacción laboral: relación con sensación de fatiga, síntomas de ansiedad y turnicidad / Work satisfaction: relation with fatigue, anxiety symptoms and shiftwork

Muchos estudios han demostrado la asociación entre el trabajo a turnos y determinados problemas relacionados con la salud. Estos problemas se deben a tres grandes grupos de causas: alteraciones en el sueño, alteraciones físicas y psíquicas y disfunciones de la vida social y doméstica. Tras analizar una muestra de trabajadores del sector de la industria química (n = 225) de los cuales 185 están sometidos a turnicidad y 40 a turno normal mediante cuestionario dirigido a valorar características del puesto de trabajo, síntomas de fatiga, ansiedad y satisfacción laboral, observamos que la turnicidad se asocia con una menor tolerancia hacia algunas características inherentes al puesto de trabajo que se traducen en una baja valoración de la satisfacción laboral (AU)

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[Usefulness of a software package to reduce medication errors in neonatal care]. / Utilidad de una aplicación informática para disminuir errores de tratamiento en neonatología.

BACKGROUND: Many treatment errors in neonatal intensive care units are caused by the need to carry out a sequence of calculations to determine the dose and dilution of the drugs used. OBJECTIVES: To help in this task, we designed a spreadsheet (Neodosis) that helps clinicians and nurses to calculate the doses and standardize the dilutions of some of the drugs most commonly used in resuscitation and neonatal intensive care units. The aim of this study was to verify the usefulness and reliability of this software package. METHODS: A randomized, cross-over, controlled trial was conducted through simulated clinical cases in which the number of errors in the prescription data and the amount of time spent in making calculations, with and without the program, were evaluated. Fifty-four tests were performed by pediatricians, third- and fourth-year pediatric residents, and nurses. RESULTS: Without computer support, all three groups made errors (residents, pediatricians and nurses in descending order). When Neodosis was used, all the medical staff made significantly fewer errors. The greatest reduction was found in errors made by pediatric residents: minor errors decreased from 16 % to 2 % and major errors from 1.6 % to zero. When using the spreadsheet, the time spent by all groups in making the calculations was reduced by between one-third and one-half. CONCLUSIONS: The tests performed with simulated clinical cases revealed that the number of errors made by the healthcare personnel who participated in this study was not inconsiderable. The use of Neodosis helped physicians and nurses to make markedly fewer errors and also saved them time.

Utilidad de una aplicación informática para disminuir errores de tratamiento en neonatología / Usefulness of a software package to reduce medication errors in neonatal care

Antecedentes: Muchos de los errores de tratamiento producidos en las unidades de cuidados intensivos neonatales (UCIN) tienen su origen en la necesidad de efectuar secuencias de cálculos para determinar dosis y diluciones de fármacos. Objetivos: Para ayudar en estas tareas se diseñó una hoja de cálculo (neodosis) que facilita los cálculos y estandariza las diluciones de algunas de las terapias más usadas en reanimación y UCIN. Para evaluar su utilidad se diseñó este trabajo. Métodos: Se efectuó un estudio controlado, cruzado y aleatorizado mediante simulaciones clínicas en las que se evaluó el número de errores y tiempo utilizado en su resolución, con y sin el programa. Fueron realizadas un total de 54 pruebas en las que intervinieron médicos (residentes de tercer y cuarto año y pediatras) y personal de enfermería. Resultados: Sin ayuda de ordenador todos los estamentos cometieron errores (en orden decreciente: residentes, pediatras y enfermería). El conjunto del estamento médico experimentó una reducción significativa de errores con la ayuda informática. El grupo de residentes fue el más beneficiado con su utilización: su porcentaje de errores "menores" pasó del 16 al 2% y el de errores "mayores" del 1,6% a 0. El tiempo empleado por todos los grupos se redujo entre un tercio y la mitad. Conclusiones: El personal asistencial probado cometió un número no insignificante de errores en pruebas de simulación sobre cálculos típicos de UCIN. Neodosis ayudó a médicos y enfermeras a reducir muy sensiblemente estos errores y a emplear menos tiempo en su resolución (AU)