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Humanos , Feminino , Pessoa de Meia-Idade , Tromboflebite/epidemiologia , Tromboflebite/prevenção & controle , Diagnóstico Diferencial , Manejo da Dor/métodos , Dor no Peito/complicações , Dor no Peito/diagnóstico , Dor no Peito/terapia , Mamografia/métodos , Mamografia , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/tendênciasRESUMO
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Humanos , Abandono do Hábito de Fumar/métodos , Nicotina/análise , Fumar/terapia , Fatores de Risco , Segurança de EquipamentosRESUMO
Fundamento y objetivo. Estimar el grado de cumplimiento de la Ley 28/2005 en locales de restauración y hostelería de Zaragoza. Metodología. Estudio descriptivo de prevalencia, realizado durante el primer trimestre del año 2010. Muestreo aleatorio simple. Muestra: 801 locales clasificados en tres categorías: restaurantes, bares tabernas, cafeterías y comida rápida y locales de ocio. Las variables: superficie del local, local con o sin humo, separaciones de acuerdo con la ley y cartel visible. Análisis estadístico: prevalencias y sus intervalos de confianza poblacionales; para detectar diferencias entre proporciones se empleó la prueba de la X2. Resultados. En Zaragoza, se permitía fumar en el 92,63% (IC del 95%, 90,66-94,29) de los establecimientos, estaba prohibido el consumo de tabaco en un 4,24% (IC del 95%, 3-5,9), y en un 2,62% (IC del 95%, 1,67-3,91) existían zonas compartimentadas entre fumadores y no fumadores. En los locales de más de 100 m, en los bares en el 74% estaba permitido fumar. Los restaurantes representan el tipo de local en el que más se han compartimentado los espacios. No se encontró ningún local de ocio nocturno libre de humo, y sólo en un 3,4% de estos había zonas totalmente compartimentadas. Conclusiones. Tras 5 años de la ley 28/2005, no existe una protección efectiva de los fumadores pasivos que deciden acudir a estos establecimientos, ni del fumador pasivo laboral, ya que en el 92,63% de los establecimientos está permitido el consumo de tabaco (AU)
Background and objective. To estimate the level of compliance of the new smoke-free legislation in the hospitality sector in Zaragoza. Methods. We performed a descriptive prevalence study, carried out during the first trimester of 2010. Simple random sampling based on 801 premises, classified into three types: restaurants, bars including taverns, coffee shops, fast food restaurants and night clubs. Variables: area, smoking or non-smoking establishment, separation between areas following the current regulations and visible sign-posting. Statistical analysis: Prevalence and confidence intervals; ÷2 test was used to detect the differences between proportions. Results. In Zaragoza, smoking was allowed in 92.63% (95% CI, 90.66-94.29) of all establishments and was forbidden in 4.24% (95% CI, 3.00-5.9), and 2.62% (95% CI, 1.67-3.91) had separated smoking areas. In those places with an area exceeding 100 m2, 74% were allowed to smoke in bars. The restaurants had more separated areas. There are no night clubs for non-smokers and only 3.4% had separated areas. Conclusions. Four years after the introduction of the current law 28/2005, there is still no effective protection for those passive smokers who decide to visit these places, including passive-smoker employees, as 93.63% of the establishments allow smoking (AU)
Assuntos
Humanos , Masculino , Feminino , Saneamento de Hotéis , Saneamento/legislação & jurisprudência , Centros de Convivência e Lazer , Poluição por Fumaça de Tabaco/legislação & jurisprudência , Fumar/legislação & jurisprudência , 28599 , Intervalos de Confiança , Poluição por Fumaça de Tabaco/prevenção & controleRESUMO
Introducción. Evaluar la exposición al humo ambiental del tabaco (HAT) y la opinión de la población del barrio de Delicias (Zaragoza) respecto la Ley de medidas sanitarias frente al tabaquismo (2005) y su posible ampliación. Material y métodos. Estudio descriptivo transversal mediante cuestionario directo (enero a junio de 2009) a una muestra representativa de la población (186 varones y 202 mujeres). Se ha calculado la prevalencia de exposición al HAT en general y en distintos ambientes (domicilio, trabajo y tiempo libre), en días laborables y festivos. Se ha determinado la opinión de fumadores y no fumadores respecto la legislación actual frente al tabaquismo y su posible ampliación. Resultados. La prevalencia poblacional de exposición al HAT es de un 61,9% (IC al 95%: 56,9466,59%) llegando al 64% en día festivo. La prevalencia de exposición al HAT en el trabajo es 35,6%. Un 93,5% opinaba que respirar HAT es nocivo, un 91% que es peligroso para los niños, y un 97% para embarazadas. El 88,1% que causa cáncer de pulmón y un 75,5% infarto. Un 65,1% de la población se mostró totalmente de acuerdo con la prohibición de fumar en todos los lugares públicos (incluyendo bares y restaurantes). Conclusiones. Más de la mitad de la población de Delicias se encuentra expuesta al HAT. Dos de cada tres personas encuestadas se encuentran a favor de la prohibición de fumar. Un 48% acudiría más a los locales de hostelería en un escenario de prohibición total (AU)
Objective. To assess the enviromental tobacco smoke (ETS) exposure and the opinion of the Delicias neighbourhood (Zaragoza) in relation to the current legislation legislation on cigarette smoking (2005), and the probability of its widening. Material and methods. A cross-sectional descriptive study was carried out by personal survey (JanuaryJune 2009) in a representative sample of the neighbourhood (186 men and 202 women). The prevalence of the ETS exposure was calculated in general and in particular environments (place of residence and work, and leisure time), during working days and weekends. Smokers and non-smokers opinion and concerns about the current healthh legislation regarding cigarette smoke was taken into account. Results. The prevalence of ETS exposure in the general population was 61.9% (56.9466.59%, P<0.05), reaching 64% on non-working days. The prevalence of ETS exposure in working areas is 35.6%. The large majority (93.5%) considered breathing ETS harmful in general, 91% particualrly for children, and 97% for pregnant women. A total of 88.1% thought it causes lung cancer, and 75.5% coronary diseases. A majority (61.5%) of the people interviewed agreed with the prohibition of smoking in public places (including bars and restaurants). Conclusions. More than 50% of the population of Delicias is exposed to tobacco smoke. Two out of three of the people surveyed agree with the smoking ban, and 48% would attend indoor leisure places more often with a total smoking ban legislation (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Poluição por Fumaça de Tabaco/prevenção & controle , Poluição por Fumaça de Tabaco/estatística & dados numéricos , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/estatística & dados numéricos , Opinião Pública , Poluição por Fumaça de Tabaco/efeitos adversos , Poluição por Fumaça de Tabaco/ética , Poluição por Fumaça de Tabaco/legislação & jurisprudência , Atenção Primária à Saúde/normas , Atenção Primária à Saúde/tendências , Atenção Primária à Saúde , Atitude Frente a Saúde , Estudos Transversais , Inquéritos e Questionários , 28599RESUMO
El tabaquismo es un problema de salud pública de primer orden. En los últimos años, las autoridades sanitarias de muchos países occidentales, entre ellos España, están haciendo serios esfuerzos para controlar este grave problema. No obstante, se percibe que el consumo de tabaco sigue siendo muy importante, alrededor del 20% en la población escolar de 14 a 16 años son fumadores. Además, alrededor del 50% de los menores de 14 años viven en hogares donde se fuma. El consumo del tabaco durante el embarazo es una importante causa de morbimortalidad, tanto neonatal como a largo plazo. No existen estudios de suficiente calidad que evalúen la eficacia del consejo individual antitabaco en adolescentes. Los programas escolares y comunitarios tienen una eficacia reducida. Se recomienda realizar consejo antitabaco en padres y madres que asisten a la consulta de Pediatría. Es especialmente importante el consejo antitabaco en embarazadas. El consejo antitabaco en adolescentes debe ajustarse a su nivel de desarrollo y comprensión. Se debe insistir en las consecuencias a corto plazo y sobre aquellos aspectos más motivadores para los adolescentes. Se propone un folleto para administrar el consejo en adolescentes (AU)
Smoking is one of the main Public Health problems. In many western countries, Spain among them. In the last few years in particular, Health authorities are working hard in order to get this important problem under control. In spite of this, it can be seen that tobacco use is still significant, thus in secondary school children, over 20 % of adolescents aged 14-16 years are smokers. Moreover, around 50 % of children younger than 14, have domestic exposure to environmental tobacco smoke. Smoking during pregnancy causes significant morbidity and mortality, not only in neonatal age but also throughout life. There are not enough studies of sufficient quality that evaluate the effectiveness of individual advice in adolescents. School and community programs have a limited efficacy. Anti-smoking counselling to parents in a Paediatric Primary Care setting is recommended. This is of especial importance in pregnant women. We must advise adolescents to stop smoking in a way that is adapted to their development and understanding capacity. We should stress the short-term consequences and the most important motivating aspects for teenagers. A special leaflet for adolescents giving anti-smoking counselling is suggested (AU)
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Humanos , Masculino , Feminino , Criança , Adolescente , Poluição por Fumaça de Tabaco/prevenção & controle , Fumar/prevenção & controle , Tabagismo/epidemiologia , Comportamento do Adolescente , Fatores de Risco , Promoção da Saúde , Educação em Saúde , Abandono do Hábito de Fumar/estatística & dados numéricos , Exposição Materna/efeitos adversosRESUMO
El interés por los fármacos genéricos procede de lasdificultades de financiación de los sistemas sanitariosy de la necesidad de reducir la factura sanitaria sinmerma de los objetivos de salud. Su expansión y usorequiere la aceptación de la población y de los médicos,y que se despejen algunas dudas sobre su verdaderaequivalencia respecto a los fármacos originales.La identidad química cuantitativa o cualitativa de unantihipertensivo en dos formas farmacéuticas similaresno asegura la misma eficacia terapéutica de ambas.Dos formas sólo pueden considerarse equivalentescuando lo son también las características químicas,galénicas, biológicas y clínicas. La aparición de lanormativa de la especialidad farmaceútica genérica(EFG) supone que estas especialidades deben presentarestudios de bioequivalencia. Esta exigencia selimita a presentar estudios en voluntarios sanos demostrando los niveles plasmáticos. En estos parámetrosla legislación permite variaciones del ± 20%del área bajo la curva y para concentración máximay del ±30% para el tiempo en alcanzarla. La legislacióndebe ser exigente con la calidad de estos productosy regular cuidadosamente el principio de sustitución.Las compañías farmacéuticas alegan que sólo los beneficios de las especialidades no genéricasgeneran inversiones para la investigación de nuevosproductos que pueden resolver problemas de saludpendientes. Sin embargo, los EFG no han reveladofracasos terapéuticos significativos y pueden contribuira la contención del gasto farmacéutico. Sería necesarioun plan de formación orientado a desarrollarun adecuado espíritu crítico en cuestiones de eficacia,efectividad y coste-efectividad de la prescripciónde antihipertensivos
The interest about generic drugs comes from the financingdifficulties of the health care systems and theneed to reduce health care costs without decreasingthe health goals. The acceptance of the populationand the doctors is necessary in order to use them andexpand their use. It is also necessary to clear up somedoubts on the true equivalence regarding the originaldrugs. The quantitative or qualitative chemical identityof an antihypertensive drug in two similar pharmaceuticalforms does not assure their same therapeutic efficacy.Two forms can only be considered to be equivalentwhen they also have the same chemical, galenic,biological and clinical characteristics. The appearanceof the generic medicinal products (GMP) guidelinesupposes that these specialties should have bioequivalence studies. This requirement is limited to presenting studies in healthy volunteers having the same plasma levels. In these parameters, the legislations allow for variations of ± 20% area below the curve and for the maximum concentration and of ± 30% for the time to reach it. The legislation should be demanding withthe quality of these products and carefully regulate thesubstitution ingredient. The drug companies state thatonly the benefits of the non-generic medicinal productsgenerate investments for the research of new products that may solve pending health problems. However,the GMPs have not revealed significant therapeuticfailures and may contribute to the control ofdrug costs. It would be necessary to establish a trainingplan oriented at development an adequate critical spiritin questions of efficacy and cost-effectiveness of the prescribing of antihypertension drugs (AU)
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Humanos , Medicamentos Genéricos/farmacocinética , Anti-Hipertensivos/farmacocinética , Hipertensão/tratamento farmacológico , Indústria Farmacêutica/tendências , Equivalência Terapêutica , Preparações FarmacêuticasRESUMO
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Humanos , Estilo de Vida , Atividade Motora , Acidentes de Trânsito/prevenção & controle , Alcoolismo/prevenção & controle , Dieta , Fumar/prevenção & controleRESUMO
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Criança , Humanos , Poluição por Fumaça de Tabaco/efeitos adversos , Tabagismo/efeitos adversos , Morte Súbita do Lactente/etiologiaRESUMO
OBJECTIVES: Children are highly vulnerable to damage from passive smoking as they are unable to avoid environmental tobacco, if present. Some reports have suggested that domestic exposure to environmental tobacco smoke can increase respiratory diseases in children. The aim of this study was to assess whether domestic passive smoking is associated with new respiratory events. METHODS: A descriptive, retrospective study was performed of 410 children aged less than 14 years old. The variables studied were: a) smokers in the household, b) the number of cigarettes smoked per day, c) school attendance, d) the number of siblings, e) previous respiratory diseases among parents and siblings, f) maternal smoking in pregnancy, and g) the number of respiratory events recorded in the previous year. Univariate, bivariate and multivariate analyses were performed. RESULTS: A total of 50.2 % of the children cohabited with smokers at home. The mean number of upper respiratory tract events per child living in environments free of tobacco smoke was 2.53 versus 3.52 when one of the household members smoked. For respiratory disease as a whole, an inverse association with age was found [OR = 0.83; (95 % CI: 0.76-0.90)] and a direct association was found with maternal smoking [OR = 4.56 (95 % CI; 1.84-11.34)]. With upper respiratory tract disease, the OR was 1.4 if the mother smoked 11-20 cigarettes/day, and was 1.9 if the number of cigarettes was > 20. With lower respiratory diseases, the odds ratio was 3.48 (95 % CI; 2.07-6.06) if the mother smoked. CONCLUSIONS: Fifty percent of the children studied were exposed to environmental tobacco smoke in the home. Younger children were at higher risk. The major risk factor for respiratory disease was maternal smoking and the risk increased with the number of cigarettes smoked. Health education is essential to protect children from tobacco smoke exposure.
Assuntos
Poluição do Ar em Ambientes Fechados/efeitos adversos , Doenças Respiratórias/etiologia , Poluição por Fumaça de Tabaco/efeitos adversos , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Mães , Estudos RetrospectivosRESUMO
Objetivos: Los niños son muy vulnerables al tabaquismo pasivo dado que no pueden evitar la exposición al tabaco si ésta se presenta. Hay datos indicativos de que la exposición doméstica al humo de tabaco puede aumentar la patología respiratoria en la infancia. El objetivo de este estudio fue comprobar si la exposición se asociaba a la aparición de nuevos episodios respiratorios. Métodos: Se estudiaron 410 menores de 14 años. Se trata de un estudio retrospectivo descriptivo. Variables: a) fumadores entre los convivientes; b) cigarrillos/día; c) escolarización; d) hermanos; e) antecedentes patológicos respiratorios en los padres/hermanos; f) tabaquismo materno durante la gestación, y g) episodios respiratorios registrados en el ultimo año. Se hizo análisis univariante, bivariante y multivariante. Resultados: El 50,2 % de los niños conviven con fumadores en el hogar. La media de episodios de vías altas por cada niño con hogar libre de exposición al tabaco fue de 2,53 frente a 3,52 episodios que aparecieron en caso de existir fumadores en la casa. Para el conjunto de patología respiratoria se observó relación inversa con la edad: odds ratio (OR): 0,83 (intervalo de confianza del 95 % [IC 95 %]: 0,76-0,90) y directa con el hábito tabáquico de la madre: OR: 4,56 (IC 95 %: 1,84-11,34). Patología de vías altas, si la madre fuma 11-20 cigarrillos, OR: 1,4, y si fuma más de 20, OR: 1,9. Patología de vías bajas, si la madre fuma: OR: 3,48 (IC 95 %: 2,07-6,06). Conclusiones: Uno de cada 2 menores está expuesto al humo de tabaco en el hogar. Los riesgos son mayores cuando menor es la edad. El hábito tabáquico de la madre es el que más influye y se incrementa en función del número de cigarrillos. La educación sanitaria es fundamental para proteger a los niños del humo del tabaco
Objectives: Children are highly vulnerable to damage from passive smoking as they are unable to avoid environmental tobacco, if present. Some reports have suggested that domestic exposure to environmental tobacco smoke can increase respiratory diseases in children. The aim of this study was to assess whether domestic passive smoking is associated with new respiratory events. Methods: A descriptive, retrospective study was performed of 410 children aged less than 14 years old. The variables studied were: a) smokers in the household, b) the number of cigarettes smoked per day, c) school attendance, d) the number of siblings, e) previous respiratory diseases among parents and siblings, f) maternal smoking in pregnancy, and g) the number of respiratory events recorded in the previous year. Univariate, bivariate and multivariate analyses were performed. Results: A total of 50.2 % of the children cohabited with smokers at home. The mean number of upper respiratory tract events per child living in environments free of tobacco smoke was 2.53 versus 3.52 when one of the household members smoked. For respiratory disease as a whole, an inverse association with age was found [OR = 0.83; (95 % CI: 0.76-0.90)] and a direct association was found with maternal smoking [OR = 4.56 (95 % CI; 1.84-11.34)]. With upper respiratory tract disease, the OR was 1.4 if the mother smoked 11-20 cigarettes/day, and was 1.9 if the number of cigarettes was > 20. With lower respiratory diseases, the odds ratio was 3.48 (95 % CI; 2.07-6.06) if the mother smoked. Conclusions: Fifty percent of the children studied were exposed to environmental tobacco smoke in the home. Younger children were at higher risk. The major risk factor for respiratory disease was maternal smoking and the risk increased with the number of cigarettes smoked. Health education is essential to protect children from tobacco smoke exposure
Assuntos
Masculino , Feminino , Criança , Lactente , Pré-Escolar , Humanos , Doenças Respiratórias/epidemiologia , Nicotiana/efeitos adversos , Nicotiana/toxicidade , Poluição por Fumaça de Tabaco/efeitos adversos , Poluição por Fumaça de Tabaco/estatística & dados numéricos , Inquéritos Epidemiológicos , Infecções Respiratórias/diagnóstico , Monitoramento Epidemiológico , Poluição por Fumaça de Tabaco/prevenção & controle , Tabagismo/epidemiologia , Estudos Retrospectivos , Análise Multivariada , 24419RESUMO
OBJETIVO. Comparar el riesgo coronario de los individuos con hipertensión arterial (HTA) de "bata blanca" (HBB) diagnosticados mediante automedida domiciliaria de la presión arterial (AMPA), con el de los pacientes con HTA confirmada. MÉTODOS. Diseño: estudio descriptivo transversal, no aleatorizado. Emplazamiento: Atención Primaria. Centro de Salud Delicias Sur de Zaragoza. Participantes: ciento veintidós pacientes diagnosticados en la consulta mediante esfigmomanómetro de mercurio de HTA leve-moderada (fases 1 y 2 del JNC-VI) de novo y sin tratamiento farmacológico para su hipertensión. Mediciones principales: los pacientes realizaron AMPA, previo adiestramiento, protocolizada con 6 mediciones diarias durante 5 días (30 en total) recogiendo la hora, presión arterial sistólica (PAS), presión arterial diastólica (PAD) y frecuencia cardíaca en cada una de ellas. Se consideró HBB la de todo paciente con cifras de PA media en consulta >= 140/90 mmHg y domiciliarias < 135/85 mmHg. Se calcularon las medias y/o porcentajes de las siguientes variables: PAS/PAD clínicas y domiciliarias, sexo, edad, antecedentes familiares de HTA y enfermedad coronaria, tabaquismo, obesidad, hipertrofia ventricular izquierda, glucemia, colesterol total, colesterol ligado a lipoproteínas de alta densidad (HDL) y trigliceridemia, ácido úrico, microalbuminuria y cargas tensionales, calculando el riesgo coronario según criterios de Framingham y comparando HBB frente a HTA confirmada. RESULTADOS. La prevalencia de HBB fue del 29,7%. Los individuos que la padecen son de promedio 10 años más jóvenes, presentan menor PAS en la consulta, tienen menor carga de PA y menor riesgo coronario que los que tienen HTA confirmada. CONCLUSIONES. La AMPA es un elemento imprescindible para completar el diagnóstico de HTA en Atención Primaria. Dada la frecuencia de la HBB en Atención Primaria, debería incluirse al menos la AMPA para completar el estudio de la HTA en Atención Primaria debido a las repercusiones sanitarias y económicas que puede tener para el paciente y el sistema sanitario
OBJECTIVE. Compare the coronary risk of individuals with "white coat" hypertension (WCH) diagnosed by ambulatory blood pressure self-monitoring (ABPM) with that of patients with confirmed HBP. METHOD. Design: descriptive, cross-sectional, non-randomized study. Site: Primary Care. Health Care Site Delicias Sur de Zaragoza. Participants: one hundred and twenty-two patients diagnosed in consultation by mercury sphygmomanometer of mild-moderate de novo arterial hypertension (phases 1 and 2 of JNC-VI) and without drug treatment for their hypertension. Main measurements: the patients conducted ABPM after training, protocolized with 6 daily measurements for 5 days (30 in all), recording the time, SBP, DBP and heart rate in each one of them. WCH was considered to be all patients with mean BP values in consultation 140/90 mmHg and home <135/85 mmHg. Means and/or percentages of the following variables were calculated: clinical and home SBP/DBP, gender, age, family background of HBP and coronary disease, smoking, obesity, left ventricular hypertrophy, glycemia, total cholesterol, HDL and triglyceridemia, uric acid, microalbuminuria and tensional loads, calculating coronary risk according to Framingham criteria and comparing WCH versus confirmed arterial hypertension (AHT). RESULTS. Prevalence of WCH was 29.7%. Individuals who suffer it are an average of 10 years younger, have lower SPB in the consultation, have less BP load and less coronary risk than those who have confirmed AHT. CONCLUSIONS. ABPM is an essential element to complete AHT diagnosis in Primary Care. Given the frequency of WCH in Primary Care, ABPM should at least be included to complete the AHT study in Primary Care due to the health care and economic repercussions that it may have for the patient and health care system
Assuntos
Humanos , Doença das Coronárias/epidemiologia , Hipertensão/complicações , Monitorização Ambulatorial da Pressão Arterial/estatística & dados numéricos , Fatores de Risco , Epidemiologia Descritiva , Atenção Primária à Saúde/estatística & dados numéricos , Hipertensão/diagnóstico , Autoexame/estatística & dados numéricosRESUMO
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