Obesidad infantil en España: hasta qué punto es un problemade salud pública o sobre la fiabilidad de las encuestas / Childhood obesity in Spain: to what extent is a public health problem or about the reliability of the polls

Los datos estadísticos revelan en los últimos años un deterioro paulatino de la calidad de la dieta ingerida en toda Europa así cómo una insuficiente práctica de la actividad física. De este modo, en las tres últimas décadas se ha producido un fuerte aumento del sobrepeso y la obesidad en el conjunto de la población de la Unión Europea. La obesidad y el sobrepeso presentes durante la infancia y la adolescencia pueden ser causa de hipertensión y complicaciones vasculares en etapas vitales posteriores. Ciertamente, en las investigaciones de carácter epidemiológico es habitual utilizar cuestionarios que recogen la talla y el peso. Sin embargo, la inexactitud de los datos auto-referidos puede sesgar el resultado de la evaluación nutricional. En España son pocos los estudios que hayan realizado una medición física del peso y la estatura para estimar la magnitud del problema. Los estudios relativos a la estimación del sobrepeso y la obesidad infantil y juvenil en España son relativamente recientes y no muy grandes en número. Para revisar los datos que ofrecen, hemos recopilado los resultados de cinco estudios destacados. Llama la tención la enorme diferencia entre los datos ofrecidos por unos estudios y otros, tanto en cifras totales como refiriéndose exclusivamente a obesidad o a sobrepeso. Así, en lo que se refiere a la suma de obesidad y sobrepeso (que denominamos exceso de peso) las mayores cifras se obtienen en el estudio Aladino (45.2% de la población muestreada) frente al 26.3% (cifra más reducida) ofrecido por el estudio Enkid de 2005. Cuando comparamos los resultados obtenidos en estudios coetáneos hallamos también diferencias bastante importantes: un 38.28% de diferencia entre los del estudio Aladino (45.2%) y los de la Encuesta nacional de salud de 2012 (27.9%). De acuerdo a los datos presentados en esta revisión, reiteramos la importancia de establecer un acuerdo para efectuar estudios rigurosos, con una metodología claramente establecida y que pueda ser replicada. Siendo la prevención de la obesidad un aspecto fundamental de la promoción de la salud, es imprescindible dedicar los recursos necesarios a efectuar estudios que, en primer lugar, estén basados en mediciones antropométricas directas realizadas por personal debidamente entrenado y capacitado para ello. Asimismo, es necesario que se apliquen criterios diagnósticos consensuados que de una vez por todas faciliten el contraste regional, internacional y secular de las cifras de sobrecarga ponderal en la infancia (AU)

The statistical data show, in recent years, a gradual deterioration of the quality of the diet consumed in all Europe as well as a insufficient practice of physical activity. In this way, in the past three decades, there has been a strong increase of overweight and obesity in the entire population of the European Union. Obesity and overweight present during childhood and adolescence can be a cause of hypertension and vascular complications in later life stages. Certainly, in the researches of epidemiological nature it is customary to use polls that reflected the height and weight. However, the inaccuracy of the self-reported data may skew the result of nutritional assessment. In Spain there are few studies that have made a physical measurement of the height and weight to estimate the magnitude of the problem. Studies relating to the estimate of overweight and obesity in children and young people in Spain are relatively recent and not very large in number. To review the information provided, we have compiled the results of five studies. We found a big difference between the data offered between different studies. Thus, with regard to the amount of obesity and overweight (that we call excess weight) the largest numbers are derived from the Aladino study (45.2% of the sampled population) compared to 26.3% (lowest figure) offered by the ENKID study of 2005. When we compared the results obtained in contemporary studies, are also fairly important differences: a 38.28% difference between the Aladino study (45.2%) and those of the national health survey of 2012 (27.9%). According to the data presented in this review, we reiterate the importance of establishing an agreement to carry out rigorous studies, with a clearly and well established methodology that can be replicated. Being the prevention of obesity a key aspect of the promotion of health, it is imperative award the necessary resources to carry out studies that are based on direct anthropometric measurements carried out by properly trained people (AU)

Epidemiología del síndrome de burnout / Burnout syndrome epidemiology

El síndrome de burnout constituye un proceso de alta prevalencia e importantes consecuencias entre los profesionales sanitarios y especialmente en enfermería. Por ello nos hemos propuesto estudiar las tres dimensiones del síndrome (cansancio emocional, despersonalización y falta de realización) y la función que ciertos factores personales, laborales e institucionales tienen en el desarrollo del proceso. Se realizó un estudio transversal tras un muestreo aleatorio entre todo el personal adscrito al área de enfermería de un hospital de Madrid. Se aplicaron dos tipos de instrumentos de recogida de información: un cuestionario que recopilaba variables sociodemográficas, laborales e institucionales y el Maslach Burnout Inventory (MBI) en su versión validada en español, que estudiaba las tres dimensiones del síndrome de burnout. Se realizó un análisis de regresión logística múltiple, tomando como variables dependientes las tres escalas del síndrome y ajustando por todas las demás variables. Se mostraron como factores de riesgo claro las opiniones desfavorables de los profesionales de las variables institucionales, siendo especialmente importantes para la escala de cansancio emocional(AU)

The burnout syndrome constitutes a process which bears high prevalence and important consequences among sanitary professionals, particularly among nurses. Therefore, the authors have proposed to study the three dimensions of this syndrome, namely emotional tiredness, depersonalization and lack of a sense of achievement plus the function certain personal, labor, and institutional factors have in development of this process. The authors carried out a transversal study based on a random sample from among all the nursing staff at a Madrid hospital. Two methods to gather information were employed: one questionnaire gathered socio-demographic data, labor and institutional variables while the Maslach Burnout Inventory (MBI), in its verified Spanish version, studied the three burnout syndrome dimensions. The authors made a multiple logistical regression analysis, using as dependent variables the three syndrome scales and adjusting parameters for all the other variables. Clear risk factors were shown; these included unfavorable opinions professionals hold regarding institutional variables; the scale for emotional tiredness warrants special note(AU)

Prevalence and risk factors of lens opacities in the elderly in Cuenca, Spain.

PURPOSE: To estimate the prevalence of lens opacities in a group of elderly people and evaluate their relation with diverse risk factors. METHODS: Cross-sectional observational study of the cohort of all persons over the age of 64 years from an urban area and a rural nucleus of the province of Cuenca, Spain. Information on sociodemographic parameters and smoking was compiled using a structured questionnaire. A physical examination was made in which weight, height, and waist circumference were measured, and an ophthalmologic examination was made of visual acuity and lens opacities. Cataracts were classified using the method of the WHO cataract group. RESULTS: The study included 1155 subjects out of 1435 elderly persons who were invited to participate (response rate 80.5%). The prevalence of cataract in men was 69.2% and in women, 65.5% (p>0.05). The percentage of persons with aphakia/pseudophakia was 17.8% in men and 17.5% in women (p>0.05). In a logistic regression model, age, obesity of more than 35 kg/m2, and low educational level were associated with the presence of cataract or aphakia/pseudophakia. CONCLUSIONS: The prevalence of cataract in people over 64 years is similar to that of other countries, but the prevalence of subjects with previous surgery for cataracts is the highest reported in the literature. Age, body mass index of more than 35 kg/m2, and low educational level were associated with the probability of having cataracts or undergoing surgery for cataracts.

[Influence of the diet on the development of colorectal cancer in a population of Madrid]. / Influencia de la dieta en la aparición del cáncer colorrectal en una población de Madrid.

OBJECTIVE: Although the genetic component in colorectal carcinoma (CRC) is well established, some environmental factors, mainly dietary, can favor its development. The objective of this study is to evaluate the relationship between daily consumption of specific food groups and development of CRC. METHODS: We carried out a case-control study in an area of Madrid; 196 patients with diagnosis of CRC with confirmed histology and registered to May 1998 in the Community of Madrid tumor register were included, and they were compared with 196 controls matched by age, sex, and geographical area. All of them filled out a questionnaire with information on diet, substance abuse, physical activity, drugs, and family history of CRC. RESULTS: The logistic regression analysis showed a weakly positive association with meat (OR: 1.02; CI: 1.01-1.04), viscera (OR: 1.12; CI: 1.02-1.23), and sausage (OR: 1.07; CI: 1.03-1.1) consumption, and a modest inverse association with consumption of yogurt (OR: 0.97; CI: 0.95-0.98), tomato (OR: 0.99; CI: 0.98-0.99), strawberries and cherries (OR: 0.97; CI: 0.95-0.99), oranges, grapefruits, and natural fruit juices (OR: 0.99; CI: 0.98-1). CONCLUSIONS: These results are an additional empirical evidence that must be confirmed through prospective studies.

Physical exercise, use of Plantago ovata and aspirin, and reduced risk of colon cancer.

To evaluate certain risk and protective factors for colon cancer in our population, we conducted a paired case-control study where cases were all people diagnosed with colon cancer who were registered at the Cancer Data Exchange Systems of the Community of Madrid between January 1995 and December 1996, and controls were randomly taken from electoral lists. The study population consisted of 424 persons. Using SPSS for Windows, variables were adjusted by multiple logistic regression. The results indicate that lack of physical exercise is associated with an increased risk of colon cancer, with an odds ratio (OR) of 2.8 (95% confidence interval (CI) 1.28-6.21) as compared with moderate activity 1-2 days a week. The risk decreases linearly with increasing physical exercise, and this association remains after stratifying the analysis for the existence of constipation. The consumption of is associated with a reduced risk of colon cancer in constipated patients, with an OR of 0.094 (0.014-0.639), as is aspirin use, with an OR of 0.980 (0.898-0.999). These results were obtained after adjusting all the ORs for diet, smoking, alcohol consumption, family history and socio-demographic factors such as marital status and educational level.

[Epidemiological characteristics of breast cancer development in pre and postmenopausal women]. / Características epidemiológicas relacionadas con el cáncer de mama en mujeres pre y posmenopáusicas.

BACKGROUND: To study the relation between breast cancer and different risk factors, personal, familial and demographic factors. An statistic and epidemiologic study was also carried on a whole population of women and then classified on pre and postmenopausal women. PATIENTS AND METHODS: A matched case-control study was performed based on age, urban area and hormonal activity. Total population was composed by 274 cases and same number of controls. Studied variables were obtained by a questionnaire asking for study level, reproductive and personal history, familial considerations and lifestyles. A multiples logistic regression model was made. RESULTS: Over total population, late menarcheal age, late first pregnancy, and familial history of breast cancer were shown as independent risk factors, but a low study level, and oral contraception were shown as protective factors. This risk model was confirmed on postmenopausal women but no over premenopausal women, so in this group, main risk factors were familial breast cancer history and a medical history of benign breast disease. Moreover, the low study level was also a protective factor. CONCLUSIONS: Familial history of breast cancer in mothers or sisters was the main risk factor for breast cancer, mainly in premenopausal women, and low study level showed as protective factor.

[The evaluation of the mutagenic activity of public drinking water by the Ames test]. / Evaluación de la actividad mutagénica de aguas de consumo público por medio del test de Ames.

BACKGROUND: The sources of potential mutagens in our environment are many, but the most important of these is water for public consumption. This is a result of the chlorinating process which is the main reason for the appearance of these mutagens. With this in mind, the aim of our study was to check a possible mutagenic activity, using the Ames test, in organic concentrates taken from water for public consumption in Madrid. METHODS: Several bacterial strains were used, namely Salmonella histidine dependent TA1535, TA1538, TA98 and TA100, taken originally from Salmonella typhimurium LT2. Each test was performed twice, with or without the introduction of the mammalian-microsome activation (S9 mix), as per the indications in Ames. The plate incorporation assay was used to test the mutagenicity. All samples of the water in question were processed and treated so as to create concentrates of organic chlorinated compounds. RESULTS: The highest levels of mutagenicity appeared in the TA1535 strain and in the tests where the microsome fraction was not used (IM = 1.94). CONCLUSIONS: With regard to mutagenic evaluation in organic concentrates taken from water for public consumption, no positive activity was found in any of the tester strains.

Predictive equation for acquisition of hepatitis B in hospital workers in a general hospital.

A cross-sectional study was performed to obtain risk factors for hepatitis B disease, HBsAg carriers and immunised personnel, among 2470 workers in a general hospital in Madrid, Spain. The data obtained were analyzed with multiple logistic regression to obtain beta coefficients for variables. The results of the analysis show that being a nurse or being regularly exposed to blood are the most important risk factors for hepatitis B acquisition. The length of time working at the same job activity was also a risk factor. The resulting beta coefficients allow the construction for a hepatitis non-immunised, HBsAg carrier and immunised HBV status, which can select subjects for a hepatitis B vaccination program.

[The seroepidemiology of the varicella-zoster virus in children and adolescents]. / Seroepidemiología del virus de la varicela zoster en niños y adolescentes.

OBJECTIVE: To know the sero-protection level existing of varicella-zoster virus in a population of children and adolescents from Madrid. METHODS: To carry out this work we have had a total 560 serum from children and adolescents between 1 and 15 years old. Later to detect the title of antibodies against the varicella zoster virus (IgG VZV), we used enzymo immuno-analysis (PLATEST). RESULTS: The 96.5% of them were positive. Distributing this percentage in a similar way for every age, we get 100% at 8, 9, 10, 11 and 15 years old; 97.5% at 5, 6, 7, 12 and 13 years; 95% at 14 years old; 92.5% at 4 years old and 85% at 1 years old and 84% at 2 years old. CONCLUSIONS: The prevalence gradually increases with the age, from 20% at 1 year old to 100% at 15, finding the smallest prevalence in 84% to reach rapidly 100%.

[An epidemiological study of the body mass index in a school-aged population of Madrid]. / Estudio epidemiológico del índice de masa corporal en una población escolar de Madrid.

FOUNDATION: A descriptive study has been carried out, to perform body mass index, between 2606 schoolchildren at Madrid, during 1986 to 1990. METHODS: Observational and transversal study. RESULTS: The data obtained were compared by age and sex for each year, and we calculated the body mass index percentiles for each group in the study. Mean body mass index rises with age and also 90 and 95 percentiles. CONCLUSION: The 1.5% and 0.8% of children at 6 years had BMI more than 26, for male and female respectively. At age 10, this percentages were 9.5% and 11.6% for male and female, and the results for age 13 were 16.1% and 17.8% respectively.

[Epidemiological study and development of dental caries in Madrid students]. / Estudio epidemiológico y evolución de la caries dental en colegios de Madrid.

It has been done an epidemiologic study about dental caries prevalence in a school population in Madrid. We have studied 3,608 schoolchildren. Total caries prevalence was 53.4%, according other authors. Caries is more frequent between ten years children. We also observed low prevalence in the third year of the study.

[Dental care for 6 to 15-year old children]. / Atención odontológica en niños de 6 a 15 años.

It has been realized a descriptive study about odontological assistance in 883 schoolchildren, they are from Madrid, attending age, sex and social status. Equally we analyze the variable dental caries in relationship with social class and odontological assistance.

[Family background. Parity. Breast feeding and cancer of the breast]. / Antecedentes familiares. Paridad. Lactancia y cáncer de mama.

A study has been carried out of case-controls in a population of 482 women aged between 40 and 98. Of these, 194 had been diagnosed with breast cancer by means of a biopsy and the remaining 288 were controls whose lack of tumoral processes had been ensured by the usual diagnostic means. In the population under study we have found that the maternal family background in the first degree was a risk factor for breast cancer, while giving birth and breast-feeding, both one's own and one's children, acted as protective factor.

[Caries prevalence of a school population]. / Prevalencia de caries en una población escolar.

We have made a cross-sectional study about dental caries in 883 children between 6 and 15 years old, belonging to 3 public schools representing the municipal district of Tetuan (Madrid). The studied variables, that were related with presence/absence of caries were: age, sex, school, social class, number of meals per day, tooth brushing and use of fluor. We have also established the indexes DMFT, dmft, DMFM, together with the affection percentage of each tooth and its graphic representation.

[Prevalence of tooth discoloration from tetracycline in a school population]. / Prevalencia de tinciones dentales por tetraciclinas en una población escolar.

We have made a transversal study in a population of 910 scholars from Madrid with the purpose of knowing the prevalence to tetracycline-stained, and we have found a 3.11% of children affected. We have referred study by age, sex, socioeconomic level and dental caries.