[Prevalence of hypertension and diabetes in residents from Lima and Callao, Peru]. / Prevalencia de hipertensión arterial y diabetes en habitantes de Lima y Callao, Perú

OBJECTIVES: To determine the prevalence of hypertension and diabetes in residents of districts in metropolitan Lima and Callao, Peru. MATERIALS AND METHODS: This was a cross-sectional study conducted during September 2006 in people aged 15 years and older, residing in metropolitan Lima and Callao. Participants were selected using a sample of “conglomerados” (neighborhoods) in three stages. Standardized procedures were used to measure weight, height, waist circumference, blood pressure and blood glucose levels. Univariate, bivariate and logistic regression analysis were performed to estimate odds ratios (OR) and their respective confidence intervals at 95%. RESULTS: We enrolled 1,771 subjects; the mean age was 39.5 ± 16.5 years. 62% were women. 19.5% (95% CI 17.6-21.4) were obese, 15.8% (95% CI 14.1-17.6) had hypertension and 3.9% (95% CI: 3.0-4.8) had diabetes. Obesity was associated with a greater likelihood of having hypertension (OR 2.15, 95% CI 1.57-2.94) and diabetes (OR 1.97, 95% CI 1.02-3.80). CONCLUSIONS: . The results of this study in a representative sample of residents in Lima and Callao showed high prevalences of hypertension and obesity and a moderate prevalence of diabetes. These results can be used as a reference for public health interventions and to monitor their impact.

Prevalencia de hipertensión arterial y diabetes en habitantes de Lima y Callao, Perú / Prevalence of hypertension and diabetes in residents from Lima and Callao, Peru

Objetivos. Determinar la prevalencia de hipertensión y diabetes en habitantes de los distritos de Lima metropolitana y El Callao en Perú. Materiales y métodos. Estudio transversal analítico, realizado durante el mes de septiembre del 2006 en habitantes de 15 años de edad a más, residentes en Lima metropolitana y El Callao. Los participantes fueron seleccionados mediante un muestreo por conglomerados en tres etapas. Se utilizaron procedimientos estandarizados para medir peso, talla, perímetro de cintura, presión arterial y niveles de glucosa en sangre. Se realizó análisis univariados, bivariados y procedimientos de regresión logística para estimar los odds ratio (OR) y sus respectivos intervalos de confianza al 95%. Resultados. Enrolamos 1 771 sujetos el promedio de edad fue de 39,5 ± 16,5 años. El 62% fueron mujeres. El 19,5% (IC 95%: 17,6-21,4) tuvo obesidad, el 15,8% (IC 95%: 14,1-17,6) hipertensión arterial y el 3,9% (IC 95%: 3,0-4,8) tuvo diabetes. La obesidad estuvo asociada con un mayor probabilidad de tener hipertensión arterial (OR 2,15; IC 95%: 1,57-2,94) y diabetes (OR 1,97; IC 95%: 1,02-3,80). Conclusiones. Los resultados de este estudio en una muestra representativa de residentes en Lima y Callao mostraron altas prevalencias de hipertensión arterial y obesidad así como una moderada prevalencia para diabetes. Estos resultados pueden utilizarse como referencia para intervenciones de salud pública y monitorear su impacto...

Objectives. To determine the prevalence of hypertension and diabetes in residents of districts in metropolitan Lima and Callao, Peru. Materials and methods. This was a cross-sectional study conducted during September 2006 in people aged 15 years and older, residing in metropolitan Lima and Callao. Participants were selected using a sample of ôconglomeradosõ (neighborhoods) in three stages. Standardized procedures were used to measure weight, height, waist circumference, blood pressure and blood glucose levels. Univariate, bivariate and logistic regression analysis were performed to estimate odds ratios (OR) and their respective confidence intervals at 95%. Results. We enrolled 1,771 subjects; the mean age was 39.5 ± 16.5 years. 62% were women. 19.5% (95% CI 17.6-21.4) were obese, 15.8% (95% CI 14.1-17.6) had hypertension and 3.9% (95% CI: 3.0-4.8) had diabetes. Obesity was associated with a greater likelihood of having hypertension (OR 2.15, 95% CI 1.57-2.94) and diabetes (OR 1.97, 95% CI 1.02-3.80). Conclusions. The results of this study in a representative sample of residents in Lima and Callao showed high prevalences of hypertension and obesity and a moderate prevalence of diabetes. These results can be used as a reference for public health interventions and to monitor their impact...

[Results of the epidemiological surveillance of diabetes mellitus in hospitals in Peru, 2012]. / Resultados de la vigilancia epidemiológica de diabetes mellitus en hospitales notificantes del Perú, 2012.

OBJECTIVES: To describe the findings of a year of epidemiological surveillance in pilot hospitals in Peru belonging to the diabetes surveillance (DS) system. MATERIALS AND METHODS: Cross-sectional study involving diabetic patients in the DS system from 18 hospitals during 2012. The DS database was assessed and epidemiological and laboratory variables were obtained including age, sex, type of diabetes, complications, comorbidity, microalbuminuria, fasting blood glucose and glycosylated hemoglobin (HbA1c) at two time points - at the time of enrollment and the last followup. RESULTS: 2,959 cases were found. At the time of enrollment into the DS system, 91.2% had a fasting blood glucose test of which 65.4% had a level 130 mg/dL. 8.9% had a microalbuminuria test of which 20.5% had microalbuminuria and 6.5% proteinuria. In total, 1025 patients had a follow-up visit; 93.1% had a fasting blood glucose test and 22.3% had HbA1c test. 63.5% had a fasting glycemia level 130 mg/dL and 73.4% HbA1c level 7.0%. The most common complication was neuropathy (21.4 %) and the most frequent comorbidity was high blood pressure (10.5%). Tuberculosis and cancer cases were observed; the most frequent cancer was breast cancer, particularly in postmenopausal women. CONCLUSIONS: The DS shows that among diabetics of the pilot hospitals, which have laboratory results, there is a high frequency of inadequate glycemic control and poor adherence to treatment. The high frequency of complications found highlights the need to strengthen early diagnosis.

Resultados de la vigilancia epidemiológica de diabetes mellitus en hospitales notificantes del Perú, 2012 / Results of the epidemiological surveillance of diabetes mellitus in hospitals in Peru, 2012

Objetivos: Describir los hallazgos de un año de la vigilancia epidemiológica de diabetes mellitus en hospitales piloto pertenecientes al sistema de vigilancia de diabetes (VD). Materiales y métodos. Estudio transversal que incluyó a los pacientes diabéticos notificados durante el 2012 en 18 hospitales piloto del Perú. Se revisó la base de datos de la VD, obteniéndose variables epidemiológicas y de laboratorio como edad, sexo, tipo de diabetes, complicaciones, comorbilidad, microalbuminuria, glucosa en ayunas y hemoglobina glucosilada (HbA1c) al momento de captación por la VD y en el último control. Resultados. Se encontraron 2959 casos. Al momento de captación por la VD, 91,2% contaba con glicemia en ayunas de los cuales, 65,4% presentaba valor ≥ 130 mg/dL. El 8,9% contaba con estudio de microalbuminuria, el 20,5% de ellos presentaba microalbuminuria y el 6,5% proteinuria. En total, 1025 pacientes tuvieron consulta de control; 93,1% contaba con glicemia en ayunas y 22,3% con HbA1c. El 63,5% tenía glicemia en ayunas ≥ 130 mg/dL y 73,4% HbA1c ≥ 7,0%. La complicación más frecuente fue la neuropatía (21,4%) y la comorbilidad más frecuente la hipertensión arterial (10,5%). Se observó casos de tuberculosis y cáncer, de los cánceres, el más frecuente fue el de mama, principalmente en mujeres posmenopáusicas. Conclusiones. La VD muestra que en los diabéticos de los hospitales piloto en los que se cuenta con resultados de laboratorio existe una alta frecuencia control glicémico inadecuado y pobre adherencia al tratamiento. La alta frecuencia de complicaciones encontrada evidencia la necesidad de fortalecer el diagnóstico temprano.

Objectives: To describe the findings of a year of epidemiological surveillance in pilot hospitals in Peru belonging to the diabetes surveillance (DS) system. Materials and methods. Cross-sectional study involving diabetic patients in the DS system from 18 hospitals during 2012. The DS database was assessed and epidemiological and laboratory variables were obtained including age, sex, type of diabetes, complications, comorbidity, microalbuminuria, fasting blood glucose and glycosylated hemoglobin (HbA1c) at two time points - at the time of enrollment and the last followup. Results. 2,959 cases were found. At the time of enrollment into the DS system, 91.2% had a fasting blood glucose test of which 65.4% had a level ≥130 mg/dL. 8.9% had a microalbuminuria test of which 20.5% had microalbuminuria and 6.5% proteinuria. In total, 1025 patients had a follow-up visit; 93.1% had a fasting blood glucose test and 22.3% had HbA1c test. 63.5% had a fasting glycemia level ≥ 130 mg/dL and 73.4% HbA1c level ≥ 7.0%. The most common complication was neuropathy (21.4 %) and the most frequent comorbidity was high blood pressure (10.5%). Tuberculosis and cancer cases were observed; the most frequent cancer was breast cancer, particularly in postmenopausal women. Conclusions. The DS shows that among diabetics of the pilot hospitals, which have laboratory results, there is a high frequency of inadequate glycemic control and poor adherence to treatment. The high frequency of complications found highlights the need to strengthen early diagnosis.

Estudio del duelo migratorio en pacientes inmigrantes que acuden a las consultas de atención primaria. Presentación de un cuestionario de valoración del duelo migratorio / Study of migratory grief in immigrant patients seen in Primary Care clinics. Presentation of a migratory grief evaluation questionnaire

ObjetivosValidar un cuestionario que permita conocer la existencia de duelo migratorio (DM) y sus dimensiones en la población inmigrante, y estudiar la relación del mismo con determinadas variables sociodemográficas (VSD).DiseñoEstudio descriptivo, transversal, multicéntrico.EmplazamientoConsultas de atención primaria (AP).Pacientes290 pacientes inmigrantes (PI) de AP, excluyendo los < 18 años. Se produjeron 12 negativas por falta de tiempo, falta de entendimiento y ausencia de traductor.Mediciones principalesSe usa el cuestionario sobre DM con 17 preguntas, realizándose su análisis factorial, con extracción final de 4 factores que explican el 52,1% de la varianza global. Se recogen VSD: género, edad, estado civil, nacionalidad, red social, tiempo en España, situación legal y laboral y dificultades de comunicación. Se realiza análisis multivariante de las variables construidas con las VSD.ResultadosSe han encontrado 4 factores (miedo, nostalgia, preocupación y pérdida de identidad [PdI]) comprobándose que ninguna comunalidad era < 0,30 considerándose que los 4 factores representan el conjunto de variables del cuestionario del DM. Analizando las correlaciones entre factores se apreció que la preocupación se relaciona con el miedo y la nostalgia, siendo ésta independiente del miedo. La PdI tiene una correlación baja con los otros factores. El alfa de Cronbach muestra una consistencia buena en los factores 1, 2 y 3. Algunas VSD se relacionan con la presencia de cada factor.ConclusionesSe presenta un instrumento validado para estudiar y caracterizar el DM, adecuado para estudiar las distintas dimensiones del duelo en la población inmigrante(AU)

ObjectivesTo validate a questionnaire designed to show the existence of migratory grief (MG) and its dimensions in the immigrant population, and to study its relationship with certain sociodemographic variables.DesignA descriptive, cross-sectional, multicentre study.EmplacementConsultations in Primary Health Care.PatientsThe study included 290 Primary Health Care immigrant patients over 18-years old. There were 12 rejections due to, lack of time, absence of a translator, and lack of understanding.Principal measurementsAn MG questionnaire with 17 questions was employed, carrying out a factor analysis with final extraction of 4 factors explaining 52.1% of overall variance. Sociodemographic variables were collected: gender, age, marital status, nationality, social network, time in Spain, legal and work situation and communication difficulties. Multivariate analysis was performed using the sociodemographic variables.ResultsFour factors were found (fear, homesickness, concern and loss of identity), showing that non-communality was < 0.30 and considering that the 4 factors represent the group of variables from the questionnaire. After analysing the correlations between the different factors, it was observed that concern is related to fear and homesickness, this latter being independent from fear. The loss of identity had a low correlation with other factors. Cronbach's alpha showed good consistency in factors 1, 2 and 3. Some sociodemographic variables are associated with the presence of each factor.ConclusionsWe present a validated instrument to study and characterise MG, adapted to study the different dimensions of the grief in immigrant population(AU)

[Study of migratory grief in immigrant patients seen in primary care clinics. Presentation of a migratory grief evaluation questionnaire]. / Estudio del duelo migratorio en pacientes inmigrantes que acuden a las consultas de atención primaria. Presentación de un cuestionario de valoración del duelo migratorio.

OBJECTIVES: To validate a questionnaire designed to show the existence of migratory grief (MG) and its dimensions in the immigrant population, and to study its relationship with certain sociodemographic variables. DESIGN: A descriptive, cross-sectional, multicentre study. EMPLACEMENT: Consultations in Primary Health Care. PATIENTS: The study included 290 Primary Health Care immigrant patients over 18-years old. There were 12 rejections due to, lack of time, absence of a translator, and lack of understanding. PRINCIPAL MEASUREMENTS: An MG questionnaire with 17 questions was employed, carrying out a factor analysis with final extraction of 4 factors explaining 52.1% of overall variance. Sociodemographic variables were collected: gender, age, marital status, nationality, social network, time in Spain, legal and work situation and communication difficulties. Multivariate analysis was performed using the sociodemographic variables. RESULTS: Four factors were found (fear, homesickness, concern and loss of identity), showing that non-communality was < 0.30 and considering that the 4 factors represent the group of variables from the questionnaire. After analysing the correlations between the different factors, it was observed that concern is related to fear and homesickness, this latter being independent from fear. The loss of identity had a low correlation with other factors. Cronbach's alpha showed good consistency in factors 1, 2 and 3. Some sociodemographic variables are associated with the presence of each factor. CONCLUSIONS: We present a validated instrument to study and characterise MG, adapted to study the different dimensions of the grief in immigrant population.

Association between insulin resistance and c-reactive protein among Peruvian adults.

OBJECTIVE: Insulin resistance (IR), a reduced physiological response of peripheral tissues to the action of insulin, is one of the major causes of type 2 diabetes. We sought to evaluate the relationship between serum C-reactive protein (CRP), a marker of systemic inflammation, and prevalence of IR among Peruvian adults. METHODS: This population based study of 1,525 individuals (569 men and 956 women; mean age 39 years old) was conducted among residents in Lima and Callao, Peru. Fasting plasma glucose, insulin, and CRP concentrations were measured using standard approaches. Insulin resistance was assessed using the homeostasis model (HOMA-IR). Categories of CRP were defined by the following tertiles: <0.81 mg/l, 0.81-2.53 mg/l, and >2.53 mg/l. Logistic regression procedures were employed to estimate odds ratios (OR) and 95% confidence intervals (CI). RESULTS: Elevated CRP were significantly associated with increased mean fasting insulin and mean HOMA-IR concentrations (p < 0.001). Women with CRP concentration >2.53 mg/l (upper tertile) had a 2.18-fold increased risk of IR (OR = 2.18 95% CI 1.51-3.16) as compared with those in the lowest tertile (<0.81 mg/l). Among men, those in the upper tertile had a 2.54-fold increased risk of IR (OR = 2.54 95% CI 1.54-4.20) as compared with those in the lowest tertile. CONCLUSION: Our observations among Peruvians suggest that chronic systemic inflammation, as evidenced by elevated CRP, may be of etiologic importance in insulin resistance and diabetes.

Disfunción familiar o crisis de desarrollo en la adolescencia / Family dysfunction or crisis in adolescent development

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[Psychosocial nature of chronic illnesses in the dependent elderly]. / Tipología psicosocial de las enfermedades crónicas en los mayores dependientes.

OBJECTIVE: To find the psychosocial nature of chronic diseases in elderly dependent persons. DESIGN: Transversal, observational study. SETTING: Two urban health districts in Granada and Jaén, Spain. PARTICIPANTS: One hundred five patients included in the Family and Home Care programme for elderly dependent persons. MAIN MEASUREMENTS: The type of chronic illness was analysed through the modified Rolland classification. Types of incapacity, demographic variables and the presence of multi-pathologies were recorded. RESULTS: 47.6% of the 105 participants were between 70 and 79 years old. On their psychosocial nature, 94.2% had some kind of disability, 78% had a gradual start, 61% had a progressive course of disease, and 63.8% had a possibly fatal prognosis. Psychosocial type B -- incapacitating, gradual start, progressive and possibly fatal -- was the most common (44.7%). CONCLUSION: The study of psychosocial type in elderly dependent persons is an important instrument for the analysis of families with chronic illnesses within them. Questions relating to its progressive course and the fatal prognosis may have a more determining prognostic weight.

Tipología psicosocial de las enfermedades crónicas en los mayores dependientes / Psychosocial nature of chronic illnesses in the dependent elderly

Objetivo. Conocer la tipología psicosocial de las enfermedades crónicas en las personas mayores dependientes. Diseño. Estudio observacional, transversal. Emplazamiento. Dos zonas básicas de salud urbanas en Granada y Jaén. Participantes. Participaron 105 pacientes incluidos en el Programa de Atención Domiciliaria y Atención Familiar en Personas Mayores Dependientes. Mediciones principales. Se analiza la tipología de la enfermedad crónica según la clasificación de Rolland modificada. Se registran los tipos de incapacidad, las variables demográficas y la presencia de varias enfermedades. Resultados. De los 105 participantes, el 47,6% tiene entre 70 y 79 años. En cuanto a los rasgos de la tipología psicosocial, el 94,2% tiene algún tipo de incapacidad, el 78% tiene un inicio gradual, el curso es progresivo en el 61% y el 63,8% tiene un pronóstico posiblemente fatal. La tipología psicosocial B ­incapacitante, inicio gradual, progresiva y posiblemente fatales la más frecuente (44,7%). Conclusión. El estudio de la tipología psicosocial en personas mayores dependientes es un instrumento importante para el análisis de las familias con enfermedades crónicas en su seno. Los aspectos relativos al curso progresivo y al pronóstico fatal pueden proporcionar un factor pronóstico más determinante

Objective. To find the psychosocial nature of chronic diseases in elderly dependent persons. Design. Transversal, observational study. Setting. Two urban health districts in Granada and Jaén, Spain. Participants. One hundred five patients included in the Family and Home Care programme for elderly dependent persons. Main measurements. The type of chronic illness was analysed through the modified Rolland classification. Types of incapacity, demographic variables and the presence of multi-pathologies were recorded. Results. 47.6% of the 105 participants were between 70 and 79 years old. On their psychosocial nature, 94.2% had some kind of disability, 78% had a gradual start, 61% had a progressive course of disease, and 63.8% had a possibly fatal prognosis. Psychosocial type B--incapacitating, gradual start, progressive and possibly fatal--was the most common (44.7%). Conclusion. The study of psychosocial type in elderly dependent persons is an important instrument for the analysis of families with chronic illnesses within them. Questions relating to its progressive course and the fatal prognosis may have a more determining prognostic weight

[Factors underlying psycho-social problems]. / Factores que intervienen en la producción de los problemas psicosociales.

OBJECTIVE: To investigate personal and family variables involved in the appearance of psychosocial problems (PSP) and the role of stressful life events (SLE) and Social Network and Support in its genesis; and to construct a profile of a PSP patient. DESIGN: Transversal, descriptive study. SETTING: Almanjayar Health Centre, Granada, Spain. PARTICIPANTS: Three hundred fourteen patients over 18 selected by systematic sampling in on-demand consultation. MAIN MEASUREMENTS: Every patient had an interview, filling in the GHQ-28 (with scores>or=8 considered indicative of PSP), the family Apgar test (Family Function study), the Holmes-Rahe Social Readjustment Scale (SLE in the last year), the DUKE-UNC questionnaire (Social Support), and Social Network (number of people). The Structure and Stage of the Family Life Cycle, social-economic and cultural level, work and income were also determined. A descriptive analysis of each variable and its association with the GHQ-28 through the chi2 test were also conducted. To find what categories were associated independently with high scores on the GHQ, a multivariate analysis was carried out. RESULTS: Categories of age (between 30 and 59 years old), gender (being a woman) and social-economic level (unskilled workers) entail greatest risk of PSP. Similarly, single-parent families, perception of family dysfunction, high levels of stress (OR=3.02; 95% CI, 1.76-5.18), and low social support affect PSP. CONCLUSIONS: The profile of a PSP patient in our setting is of a middle-aged woman forming part of a single-parent and/or dysfunctional family, who has suffered major SLEs and has insufficient social support.

Factores que intervienen en la producción de los problemas psicosociales / Factors underlying psycho-social problems

Objetivo. Investigar variables personales y familiares que intervienen en la aparición de problemas psicosociales (PPS). Conocer el papel de los acontecimientos vitales estresantes (AVE) y la red y apoyo social en su génesis, y construir un perfil del paciente con PPS. Diseño. Estudio transversal, descriptivo. Emplazamiento. Centro de Salud de Almanjayar, Granada. Participantes. Muestreo sistemático de 314 pacientes mayores de 18 años. Mediciones principales. Cada paciente cumplimentó el GHQ-28 (las puntuaciones ≥ 8 se consideraron indicativas de PPS), el test Apgar familiar, la Escala de Reajuste Social de Holmes y Rahe, el cuestionario Duke-UNC, Red Social y se determinaron la estructura y la etapa del ciclo vital familiar, el nivel socioeconómico y cultural, la actividad y los ingresos. Para determinar qué categorías se asociaban de manera independiente con las puntuaciones altas de GHQ se hizo un análisis multivariable. Resultados. Tener una edad entre los 30 y los 59 años, ser mujer, y ser trabajador no cualificado conlleva mayor riesgo de PPS. En el mismo sentido actúan la estructura familiar monoparental, la percepción de disfunción familiar, los altos grados de estrés (odds ratio [OR] = 3,02; intervalo de confianza [IC] del 95%, 1,76-5,18) y el bajo apoyo social. Conclusiones. El perfil de paciente con PPS en nuestro medio sería el de una mujer de mediana edad que forma parte de una familia monoparental y/o disfuncional, que ha presentado importantes AVE y que no tiene suficiente apoyo social

Objective. To investigate personal and family variables involved in the appearance of psychosocial problems (PSP) and the role of stressful life events (SLE) and Social Network and Support in its genesis; and to construct a profile of a PSP patient. Design. Transversal, descriptive study. Setting. Almanjayar Health Centre, Granada, Spain. Participants. Three hundred fourteen patients over 18 selected by systematic sampling in on-demand consultation. Main measurements. Every patient had an interview, filling in the GHQ-28 (with scores ≥8 considered indicative of PSP), the family Apgar test (Family Function study), the Holmes-Rahe Social Readjustment Scale (SLE in the last year), the DUKE-UNC questionnaire (Social Support), and Social Network (number of people). The Structure and Stage of the Family Life Cycle, social-economic and cultural level, work and income were also determined. A descriptive analysis of each variable and its association with the GHQ-28 through the χ2 test were also conducted. To find what categories were associated independently with high scores on the GHQ, a multivariate analysis was carried out. Results. Categories of age (between 30 and 59 years old), gender (being a woman) and social-economic level (unskilled workers) entail greatest risk of PSP. Similarly, single-parent families, perception of family dysfunction, high levels of stress (OR=3.02; 95% CI, 1.76-5.18), and low social support affect PSP. Conclusions. The profile of a PSP patient in our setting is of a middle-aged woman forming part of a single-parent and/or dysfunctional family, who has suffered major SLEs and has insufficient social support

El Torno de Pedal / The foot pedal dental engine

El Torno de Pedal ha sido y en muchos lugares del mundo continúa siendo una herramienta básica para el desarrollo de la odontología. Se describen desde un punto de vista mecánico los elementos que generalmente constituyen un Torno de Pedal. Finalmente se describe su funcionamiento (AU)

The foot pedal dental engine was –and still is in a lot of places around the wold– a basic tool for the development of dentistry. The parts that generally make up a foot pedal dental engina are described from a mechanical point of view, as well as its performance (AU)

Ciudadanía, derechos y legislación, presupuestos de la participación juvenil / Citizenship, rights and legislation, budgets of the juvenile participation

El capitulo hace promover la participación de los jóvenes en jóvenes con el presupuesto de que ellos quieren participar,podria acerarse entonces, a impulsar su intervención en las areas productivas,en espacios en los medios de comunicacion,escuchar su opinion,al menos representa,en los colegios y en las universidades,sus puntos de vista respecto de las alternativas sobre recreacion,familia,cultura,economia o servicio militar.