Dislipidemias y riesgo cardiovascular en la población adulta de Castilla y León / Dyslipidemia and cardiovascular risk in the adult population of Castile-Leon (Spain)

ObjetivoLa hipercolesterolemia es uno de los factores de riesgo cardiovascular más sensible a las medidas de prevención y control. Este estudio pretende conocer las características clínicas y epidemiológicas de las personas dislipidémicas en Castilla y León.MétodosSe realizó un muestreo bietápico-estratificado y se obtuvieron datos de 4.013 personas, representativas de la población de 15 o más años de edad en Castilla y León. Se recogieron las variables relacionadas con la enfermedad cardiovascular de la historia clínica, la anamnesis y la exploración. Se determinaron el colesterol total y las distintas fracciones lipídicas (c-HDL, c-LDL y triglicéridos).ResultadosEl colesterol total, el c-HDL, el c-LDL y los triglicéridos aumentan con la edad, y todos excepto el primero presentan diferencias según el sexo. El c-LDL y los triglicéridos están más elevados en los hombres que en las mujeres hasta los 60 años de edad, pero luego el patrón se invierte, mientras que el c-HDL siempre es más alto en las mujeres. El 14,6% de la población tiene un colesterol total ≥250mg/dl y un 56,3% lo tiene ≥200mg/dl. Sólo el 49,6% de las personas con ≥250mg/dl tenían antecedentes en su historia clínica, y únicamente un 15,2% recibían tratamiento. El colesterol total ajustado por la edad se correlacionaba positivamente con todos los demás factores de riesgo cardiovascular. Además, más del 70% de la población presenta al menos un factor de riesgo cardiovascular.ConclusionesDestacan los altos valores de colesterol total y c-LDL, así como los bajos de c-HDL en los hombres, y el infradiagnóstico en las historias clínicas. La asociación de hipercolesterolemia con otros factores de riesgo cardiovascular es similar a la observada en otros estudios (AU)

bjectiveHypercholesterolemia is one of the cardiovascular risk factors more sensitive to preventive and control interventions. This study aims to determine the epidemiological pattern of dyslipidemic people in Castilla y Leon.MethodsA representative stratified two-stage sample of the population resident in Castilla y León (Spain) was obtained. A total of 4,013 people age 15 years and older were interviewed. Cardiovascular disease related variables were gathered from clinical records and medical examination. Total cholesterol, HDL-c, LDL-c, and triglycerides were measured.ResultsTotal cholesterol, HDL-c, LDL-c and triglycerides increase with age and, all but total cholesterol present gender differences. LDL-c and triglycerides are higher in men than in women under the age of 60, and lower from that age on, while HDL-c is always higher in women. Total cholesterol was ≥250mg/dl in 14.6% of the sample and ≥200mg/dl in the 56.3%. Only 49.6% of people with total cholesterol ≥250mg/dl had been diagnosed and only 15.2% were under treatment. Age-adjusted total cholesterol was positively correlated with all cardiovascular risk factors. Furthermore, over 70% of the population presented, at least, one cardiovascular risk factor.ConclusionsThe results above shows high levels of total cholesterol and LDL-c, low levels of HDL-c in males and the under diagnosis in clinical records. The association between hypercholesterolemia and other cardiovascular risk factors is similar to previous studies (AU)

[Dyslipidemia and cardiovascular risk in the adult population of Castile-Leon (Spain)]. / Dislipidemias y riesgo cardiovascular en la población adulta de Castilla y León.

OBJECTIVE: Hypercholesterolemia is one of the cardiovascular risk factors more sensitive to preventive and control interventions. This study aims to determine the epidemiological pattern of dyslipidemic people in Castilla y Leon. METHODS: A representative stratified two-stage sample of the population resident in Castilla y León (Spain) was obtained. A total of 4,013 people age 15 years and older were interviewed. Cardiovascular disease related variables were gathered from clinical records and medical examination. Total cholesterol, HDL-c, LDL-c, and triglycerides were measured. RESULTS: Total cholesterol, HDL-c, LDL-c and triglycerides increase with age and, all but total cholesterol present gender differences. LDL-c and triglycerides are higher in men than in women under the age of 60, and lower from that age on, while HDL-c is always higher in women. Total cholesterol was ≥250mg/dl in 14.6% of the sample and ≥200mg/dl in the 56.3%. Only 49.6% of people with total cholesterol ≥250mg/dl had been diagnosed and only 15.2% were under treatment. Age-adjusted total cholesterol was positively correlated with all cardiovascular risk factors. Furthermore, over 70% of the population presented, at least, one cardiovascular risk factor. CONCLUSIONS: The results above shows high levels of total cholesterol and LDL-c, low levels of HDL-c in males and the under diagnosis in clinical records. The association between hypercholesterolemia and other cardiovascular risk factors is similar to previous studies.

Guía de principios y métodos de las redes centinelas sanitarias en España / Guide to the principles and methods of health sentinel networks in Spain

Las redes centinelas sanitarias son cada vez más utilizadas en el estudio de problemas relacionados con la salud. Este documento tiene como objetivo la presentación de una guía metodológica para la instauración y desarrollo de redes centinelas sanitarias, que ha sido elaborada por gestores de las redes centinelas autonómicas a partir de los resultados obtenidos de un estudio Delphi. Los principales apartados recogidos en la guía son: definición de una red centinela sanitaria; descripción de la red –objetivos y composición–; modo de selección de los centinelas participantes; descripción de los procesos de salud adecuados para su estudio mediante esta metodología –incidencia, definición de casos, criterios de inclusión y exclusión–; descripción de la población diana; establecimiento de indicadores de calidad; periodicidad de la recogida de datos; diffusion de la información –periodicidad y métodos–, e incorporación de los participantes en los órganos de decisión a través de comisiones multidisciplinarias. La guía tiene como fin contribuir al desarrollo de redes con una metodología común en las diferentes comunidades autónomas. Asimismo, se considera de gran utilidad contar con un modelo para la implantación de nuevas redes en nuestro país. Por último, se concluye que es importante dar a conocer el concepto de red centinela sanitaria, difundir la información que generan y potenciar su uso desde la Administración (AU)

Health sentinel networks are being increasingly used in the study of health-related problems. The present article aims to provide a methodological guide – designed by regional sentinel network managers and based on the results of a Delphi study – that can be used to set up and develop a health sentinel network. The main topics in the guide are the following: definition of a health sentinel network; network description: aims and structure; methods for the selection of sentinel participants; description of health processes suitable for study through this methodology: incidence, case definition, exclusion and inclusion criteria; description of the target population: the denominator for incidence rates estimates; quality indicators; periodicity of data collection; dissemination of the information: periodicity and methods, and incorporation of the participants in the decision- making process through multidisciplinary commissions. This guide aims to contribute to the development of sentinel networks in the autonomous communities by providing a common methodology, which could be highly useful when introducing new networks in Spain. Finally, we conclude that it is important to raise awareness of the concept of health sentinel networks, disseminate the information generated, and promote its use by public health administration (AU)

Redes centinela sanitarias en España. Consenso para una guía de principios y métodos / Health sentinel networks in Spain. Consensus for a guide of principles and methods

Las redes centinela sanitarias han estado activas en nuestro país desde la década de los años ochenta, con variados objetivos, metodología y diferente grado de desarrollo en las comunidades autónomas donde se han implantado. La necesidad de normalizar el funcionamiento y de armonizar los indicadores ha propiciado un proyecto de investigación de redes centinela sanitarias españolas, uno de cuyos objetivos es establecer una guía de principios y métodos de trabajo. Se ha procedido a realizar un estudio con el método Delphi, en el que un panel de 23 expertos ha consensuado, en 3 fases consecutivas, la definición de red centinela, los objetivos, los principios que deben regirlas y otros aspectos relacionados con la organización y funcionamiento. En conjunto se plantearon 41 cuestiones sobre la base de un primer borrador, las cuales necesitaban un 80% de consenso en una primera fase y un 70% en la segunda. Todos los expertos participaron en la primera fase, 22 en la segunda y 20 en la tercera. Se alcanzó un consenso en 36 cuestiones en la primera fase y en 4 de las 5 restantes en la segunda. En la tercera fase se dio forma definitiva al documento de la guía. El método de consenso Delphi ha resultado extremadamente útil en la resolución de discrepancias y divergencias, obteniéndose una guía válida para redes centinela. Los expertos ajenos a los sistemas centinela del panel seleccionado aportaron una visión más extensa sobre los objetivos y la aplicabilidad de las redes centinela sanitarias en España

Since the eighties, health sentinel networks have been active in our country, but with a variety of objectives, methods and different development levels in the autonomous communities. The necessity of standardising the management and harmonising the indicators has concluded in a research project on the Spanish health sentinel networks, one of whose objectives is to establish a guide for work principles and methods. A panel of 23 experts has made a study using the Delphi method to agree, in three consecutive phases, a definition of sentinel network, the objectives and the management principles and other aspects related to the organisation and functioning. Altogether, 41 questions were gathered from a previous draft which needed 80% of consensus in the first phase and 70% in the second. All the experts participated in the first phase, 22 in the second and 20 in the third. A consensus was achieved on 36 questions in the first phase and in 4 of the remaining ones in the second. In the third phase the shape of the guide document was given. The Delphi consensus method has been extremely useful in the resolution of discrepancies and divergences. The experts who were selected outside of the sentinel networks contributed with a wider vision on the objectives and applicability of the health sentinel networks in Spain

[Guide to the principles and methods of health sentinel networks in Spain]. / Guía de principios y métodos de las redes centinelas sanitarias en España.

Health sentinel networks are being increasingly used in the study of health-related problems. The present article aims to provide a methodological guide - designed by regional sentinel network managers and based on the results of a Delphi study - that can be used to set up and develop a health sentinel network. The main topics in the guide are the following: definition of a health sentinel network; network description: aims and structure; methods for the selection of sentinel participants; description of health processes suitable for study through this methodology: incidence, case definition, exclusion and inclusion criteria; description of the target population: the denominator for incidence rates estimates; quality indicators; periodicity of data collection; dissemination of the information: periodicity and methods, and incorporation of the participants in the decision-making process through multidisciplinary commissions. This guide aims to contribute to the development of sentinel networks in the autonomous communities by providing a common methodology, which could be highly useful when introducing new networks in Spain. Finally, we conclude that it is important to raise awareness of the concept of health sentinel networks, disseminate the information generated, and promote its use by public health administration.

[Health sentinel networks in Spain. Consensus for a guide of principles and methods]. / Redes centinela sanitarias en España. Consenso para una guía de principios y métodos.

Since the eighties, health sentinel networks have been active in our country, but with a variety of objectives, methods and different development levels in the autonomous communities. The necessity of standardising the management and harmonising the indicators has concluded in a research project on the Spanish health sentinel networks, one of whose objectives is to establish a guide for work principles and methods. A panel of 23 experts has made a study using the Delphi method to agree, in three consecutive phases, a definition of sentinel network, the objectives and the management principles and other aspects related to the organisation and functioning. Altogether, 41 questions were gathered from a previous draft which needed 80% of consensus in the first phase and 70% in the second. All the experts participated in the first phase, 22 in the second and 20 in the third. A consensus was achieved on 36 questions in the first phase and in 4 of the remaining ones in the second. In the third phase the shape of the guide document was given. The Delphi consensus method has been extremely useful in the resolution of discrepancies and divergences. The experts who were selected outside of the sentinel networks contributed with a wider vision on the objectives and applicability of the health sentinel networks in Spain.

Eating disorders. Prevalence and risk profile among secondary school students.

BACKGROUND: Eating disorders (EDs) are an important public health problem in developed countries. Despite the amount of epidemiological studies and causal theories, there is a great disparity of estimates and many questions remain still unclear. The aim of this study was to estimate the prevalence of the population at risk of developing EDs and describe the risk profiles among adolescents and young people. METHODS: A transversal design using a two-stage cluster sample of secondary education students aged between 12 and 18 years was used. The survey consisted of a socio-demographic questionnaire along with the Eating Attitudes Test (EAT)-40 index and was carried out between May and June 1999. RESULTS: Results showed that 7.8% of the secondary school population had a high risk of developing eating disorders (EAT-40 higher than 30). Females presented a higher percentage [12.3%; 95% confidence limits (CL) 10.4-14.3%] than males (3.2%; 95% CL 2.1-4.2%) at the highest risk levels. A decreasing risk gradient was observed with age. CONCLUSIONS: The estimates show an important difference between the risk in females and in males and suggests that the risk is incremented above all in the last few years of infancy and the first years of adolescence, when these boys and girls are more vulnerable to socio-cultural influences and do not yet have defined image and "behaviour models".