[Ponderal evolution in the Girona population, 1989-1999]. / Evolución ponderal en la población de Girona, 1989-1999.

BACKGROUND AND OBJECTIVE: Despite the number of plans leading to lose weight among individuals in the developed countries, the prevalence of obesity has increased since 1980. The knowledge of ponderal evolution in a given population is very important because the adverse effects of obesity vary greatly among individuals and populations. The objective of the present paper was to determine the modifications in the different degrees of body adiposity in a population in Catalunya. PATIENTS AND METHODS: A measurement was made of weight and height of 24554 users aged over 14 years (10595 males and 13959 females) attended at four basic health areas (BHA): Girona 1, Girona 4, Salt and Camprodon, and a Primary Health Center (PHC) in the Girona province, for a five-year period, 1995-1999. The prevalence of the different degrees of obesity was compared with that obtained in a previous study with 6373 individuals during the 1986-1989 period (4,579 males and 1794 females). RESULTS: The prevalence of women with overweight (defined as a body mass index [BMI] > 25 kg/m2) increased from 7.3% (1986-1989, study 0) to 17.6% (1995-1999, study 1) for women aged 15 to 24 years ( p < 0.001), from 17.9 % to 28.1% for women aged 25 to 34 years (p < 0.001), and from 37.5% to 44.7 % for women aged 35 to 44 years (p < 0.001). In the latter age group, the proportion of women with obesity (BMI > 30 kg/m2) increased from 6.9% to 12.9%. Similar trends were observed among men, and the change in the 35-44 year age group (from 10.5 % of obese men to 16% [p < 0.001]), and 55 to 65 years (from 16.6% of obese men to 22.7% [p < 0.001] was particularly significant. And lastly, it is also noteworthy the proportion of individuals with low weight (BMI < 18.5 kg/m2) which increased from 7.3% to 11.6% for women aged 15 to 24 years, and from 0.3% to 2.2% for women aged 35 to 44 years. This trend was also observed for men aged 15 to 24 years (11% to 17.2%). CONCLUSIONS: The relative increase in the prevalence of overweight and obesity runs in parallel to that found in other surrounding countries. Also, it is worth mentioning that among women aged 15 to 24 years the increase in the prevalence of low weight and obesity is almost identical, which invalidates the mean and median values as a means to assess the ponderal evolution in this population. The current compartmentalization between the extreme BMIs, particularly among the youngest portion of population should be addressed from a multidisciplinary perspective.

Evolución ponderal en la población de Girona, 1989-1999 / Ponderal evolution in the Girona population, 1989-1999

Introducción y objetivo. A pesar de los numerosos planes encaminados a perder peso en los países desarrollados, la prevalencia de obesidad se ha incrementado desde 1980. El conocimiento de la evolución ponderal de una población dada es muy importante porque los efectos adversos de la obesidad son muy variables entre individuos y entre poblaciones. El objetivo de este estudio fue determinar las modificaciones de los diferentes grados de adiposidad corporal en población catalana. Pacientes y métodos. Se midió el peso y la talla a 24.554 usuarios mayores de 14 años (10.595 hombres y 13.959 mujeres) atendidos en cuatro áreas básicas de salud (ABS): Girona 1, Girona 4, Salt y Camprodon y un Centro de Atención Primaria (CAP) de la provincia de Girona, durante un período de 5 años, 1995-1999. La prevalencia de los diferentes grados de obesidad se comparó con la obtenida en un estudio previo sobre 6.373 sujetos durante el período 1986-1989 (4.579 hombres y 1.794 mujeres).Resultados. La prevalencia de las mujeres que presentaban sobrepeso (definido como un índice de masa corporal [IMC] > 25 kg/m2) creció de un 7,3 por ciento (1986-1989, estudio 0) a un 17,6 por ciento (1995-1999, estudio 1) entre las mujeres de 15 a 24 años ( p 30 kg/m2) pasó del 6,9 por ciento al 12,9 por ciento. En los hombres se observaron tendencias similares, siendo especialmente significativo el cambio en la década de 35 a 44 años (de un 10,5 por ciento de hombres obesos a un 16 por ciento [p < 0,001]) y de 55 a 65 años (de un 16,6 por ciento de hombres obesos a un 22,7 por ciento [p < 0,001]). Por último, también es de destacar el cambio en la proporción de sujetos con bajo peso (IMC < 18,5 kg/m2), que creció de un 7,3 por ciento a un 11,6 por ciento en las mujeres de 15 a 24 años y de un 0,3 por ciento a un 2,2 por ciento en las mujeres de 35 a 44 años. Esta tendencia también se observó entre los hombres de 15 a 24 años (11 por ciento a 17,2 por ciento). Conclusiones. El crecimiento relativo de la prevalencia de sobrepeso y de obesidad es paralela a la de otros países de nuestro entorno. Además es de destacar que en el caso de las mujeres de 15 a 24 años el aumento de la prevelancia de bajo peso y de obesidad es casi idéntico, lo que invalida a la media y mediana de IMC como medio de valorar la evolución ponderal en esta población. Es necesario abordar desde una perspectiva multidisciplinaria la tendencia a la compartimentalización actual entre los IMC extremos, especialmente en el segmento más joven de la población (AU)

[Analysis of the mortality in a Catalonian rural population in the last third of the 19th. Century: Canet d'Adri, 1872-1900]. / Análisis de la mortalidad en una población rural catalana en el último tercio del siglo XIX: Canet d'Adri, 1872-1900.

BACKGROUND: We carried out a descriptive analysis of the mortality in a Catalonian rural town (Canet d'Adri, 12 km from Girona) for the period 1872-1900. The knowledge of the main mortality causes, especially those non-transmissible, could be very illustrative. The objective was to show the distribution of the mortality by age and cause, and to compare mortality due to infections with mortality consequence of the rest of the causes. METHOD: Three aspects were analysed: the distribution of the deaths by age and sex; the temporal and seasonal evolution; and the distribution by cause-specific. RESULTS: 49.3% of the deaths corresponded to women and 50.7% to men. Younger than one-year old were the most important group, 35.6% of the total mortality, followed by older than 65, 23.7%. Respiratory diseases were responsible for 33.4% of deaths; infectious diseases 31.1%, circulatory diseases 13.4% and digestive diseases 2.6%. Amongst younger than 45 year old the main cause of mortality was infectious diseases, above all in women. Respiratory diseases were the main cause of mortality in women older than 45 and in men older than 65 year old. Deaths because circulatory diseases were a very important cause amongst men older than 65. CONCLUSIONS: Besides of the importance of the infectious diseases as the main cause of death, it is surprising the importance of circulatory diseases (the third cause of mortality).

Prevalencia de la obesidad en la población atendida en asistencia primaria de Girona, 1995-1999 / Prevalence of obesity in the population of Girona, Spain, 1995-1999

Objetivos: Estimar y comparar la prevalencia de la obesidad y el sobrepeso en la población de Girona, entre 1995 y 1999, estratificando geográficamente por sexo y edad. Métodos: Medidas directas de talla y peso correspondientes a 24.554 usuarios mayores de 14 años (10.595 varones y 13.959 mujeres) atendidos en cuatro áreas básicas de salud (ABS): Girona 1, Girona 4, Salt y Camprodon, así como en un centro de atención primaria (CAP) de la provincia de Girona. Se calculó el índice de masa corporal (IMC) como el cociente entre el peso y la talla al cuadrado. La obesidad se define como los grados II y III del índice de Garrow (IMC 30 kg/m2) y el sobrepeso como el grado I (25 kg/m2 IMC < 30 kg/m2). Al no utilizarse una muestra aleatoria de sujetos, el cálculo de prevalencias y de sus errores estándar se corrigió mediante el uso de ponderaciones adecuadas. La comparación de las prevalencias entre dos ABS distintas para cada sexo se realizó utilizando un contraste paramétrico de diferencia de proporciones La comparación entre las prevalencias de un determinado grado del índice de Garrow, controlando por sexo y edad, se llevó a cabo utilizando una regresión logística j árquica. Resultados: La prevalencia de la obesidad se estimó en 15,6 por ciento entre los varones de 20 a 74 años (desde el 14,0 por ciento en Girona 1 hasta el 22,4 por ciento en Camprodon) y en un 17,5 por ciento entre las mujeres (un 15,6 por ciento en Girona 1 y un 22,7 por ciento en Camprodon), un 16,7 por ciento de promedio ponderado. La prevalencia del sobrepeso se sitúa en el 44 por ciento en varones y en un 33 por ciento en mujeres, un 37,8 por ciento de promedio ponderado. Existe una gradación en las prevalencias de la obesidad, con diferencias estadísticamente significativas: Girona 1, Salt, Girona 4, Camprodon y Sils (AU)

[Comparative double-blind study of the analgesic activity of fosfosal (UR-1521) in patients with musculoskeletal and articular pain (author's transl)]. / Estudio doble ciego, comparativo con placebo, de la actividad analgésica del fosfosal (UR-1521) en pacientes con dolor musculoesquelético y articular.

Fosfosal or 2-phosphonoxybenzoic acid is a new analgesic drug, whose analgesic activity and side effects have been determined in a double blind clinical study in comparison with placebo. The study has been done with 60 outpatients, of both sexes, which suffered musculoskeletal and arthritic pains. Patients were treated with fosfosal or placebo for eight days. The daily dose of fosfosal was 1 gram three times a day, once every 6-8 hours. The results obtained show that fosfosal has a clear analgesic activity, statistically significant versus placebo in all the parameters that were measured: pain severity, activity impairment and insomnia. The overall evaluation of the group of patients treated with fosfosal showed a marked improvement with a difference statistically significant with respect to the control group treated with placebo (p less than 0.001). The distribution of results in the fosfosal treated group was as follows: poor, 1; regular, 8; good, 10 and excellent, 6. The distribution in the placebo group was as follows: poor, 15; regular, 3; good, 2 and excellent, 0. The marked analgesic activity, the absence of side effects and the excellent gastric tolerance suggest that fosfosal is a promising new analgesic drug useful for the treatment of painful syndromes of several etiologies.

[Uremic pericarditis. Preliminary evaluation of treatment with indomethacin (author's transl)]. / Pericarditis urémica. Valoración inicial del tratamiento con indometacina.

Numerous therapeutic schemes have been proposed for pericarditis, whether or not accompanied by pericardial effusion in patients with terminal chronic renal insufficiency of subjects on periodic hemodialysis. All of the authors agree that dialysis must be initiated, or at least must not be interrupted once it is begun. There is some disagreement over the system that should be used (peritoneal dialysis or hemodialysis). Anti-inflammatory drugs have been used in association, since the condition is an inflammatory disease. Five episodes of pericarditis with daily hemodialysis and local heparine were treated, plus five other cases with the addition of 3 mg indomethacin/kg/day for 8 days. No secondary effects of indomethacin were reported. A definite reduction in the duration of pain, fever, pericardial rub, and increase in the size of the cardiac shadow was seen in the episodes treated with the association of indomethacin. This furthermore involved the number of days the patient was subjected to hemodialysis. Partial pericardiectomy was practiced on two patients not treated with indomethacin. The later course of the patients treated with indomethacin was more favorable since pericardial effusion did not lead to significant hemodynamic symptoms. There were no recurrences or other complications.