[Families of the economic crisis in paediatric Primary Care clinics: descriptive observational study]. / Las familias de la crisis en las consultas pediátricas de Atención Primaria: estudio descriptivo observacional.

OBJECTIVE: To study the impact of the economic crisis on the families of the children who attend Primary Health Care and its relationship with their socioeconomic status. PATIENTS AND METHODS: Observational descriptive study was conducted by analysing the results of 453 questionnaires, given to the parents of children between 1 and 7 years old who attended 4 paediatric clinics in Madrid. The raw data was analysed, and comparisons between groups and multivariate analysis were performed. RESULTS: In the multivariate analysis, the variables related to the non-acquisition of prescribed medication are: lower income level OR=0.118, p<.0001 and lower educational level OR=0.464, p<.001; the variables related to the reduction of food expenditure are: lower income level OR=0.100, p<.0001 and a higher number of family members OR=1.308, p=.045; the variables related to anti-pneumococcal vaccination without public funding are: higher income level OR=2.170, p=.0001, higher educational level OR=1.835, p=.013, and not being an immigrant OR=0.532, p=.037. The presence of health problems from the beginning of the economic crisis is related to unemployment OR=4.079, p=.032, lower educational level R=0.678, p=.042, and income level OR=0.342, p<.0001. In all cases, the models achieved a statistical significance of p<.0001. CONCLUSIONS: The economic crisis has greater impact on the group with the lowest income level in all analysed variables. The lower educational level and higher number of family members has an impact on the reduction in food expenditure. The fact of being an immigrant has an impact on not receiving the anti-pneumococcal and rotavirus vaccination. Unemployment leads to an increase in health problems in the family. To sum up, the economic crisis has increased inequalities according to socioeconomic status.

[Determination of growth hormone: comparison between a physiologic stimulus (exercise) and pharmacologic stimuli (clonidine/guanfacine)]. / Valoración de hormona de crecimiento: comparación entre un estímulo fisiológico (ejercicio) y estímulos farmacológicos (clonidina/guanfacina).

We have compared the release of growth hormone (GH) after exercise (10 minutes pedaling on a fixed bicycle with ergometer), and two pharmacological alpha-adrenergic stimuli: clonidine (CL) or guanfacine (GU); in 36 prepuberal children whose height was below the third percentile. The tests were carried out in basal conditions, randomized and with a minimum interval of seven days between them. Blood GH was determined from cannulated antecubital veins. The results show a positive response (GH greater than 7 ng/ml) in 65.7% of cases after exercise, in 74.2% after CL and 71% after GU. The significant secondary effects observed after CL administration were sleepiness and decrease of arterial pressure. It is concluded that exercise is a useful test for assessing a possible deficiency of GH, and lacks significant side effects and that the diagnostic value of GU is similar to that of CL.