Prevalencia de la osteoporosis determinada por ultrasonografía de calcáneo en una población laboral / Prevalence of osteoporosis as assessed by "os calcaneus" ultrasonography among a working population

La osteoporosis es una de las enfermedades que han aumentado su prevalencia en los últimos años debido al aumento de la esperanza de vida. Su prevención se puede realizar desde la edad media de la vida realizando un diagnóstico precoz y modificando estilos de vida. Objetivo: Conocer la prevalencia de la osteoporosis entre los trabajadores de una empresa de administración local. Metodología: Estudio transversal descriptivo de prevalencia de enfermedad. En una empresa de 1.500 trabajadores se realizó, de forma voluntaria, una densitometría ósea ultrasónica. Se analizaron las siguientes variables: edad, sexo, peso, talla, IMC, BUA (broadband ultrasound attenuation), porcentaje en comparación con la población normal, Z-score, T-score. Los cálculos estadísticos se analizaron con el programa Statgraphics Plus. Resultados: La prevalencia de la osteoporosis fue del 21,83%, con un claro predominio en el sexo masculino (42,5%) y con un 17,46% en mujeres. Conclusiones: Alta prevalencia de la osteoporosis entre la población masculina estudiada (AU)

Background: Osteoporosis ranks among the diseases having increased their prevalence over the last years because of the increase in life expectancy. Prevention can be achieved as from the middle ages of life through early diagnosis and lifestyle modifications. Objective: To assess the prevalence of osteoporosis among workers of a local management enterprise. Methods: Cross-sectional, descriptive, disease-prevalence study. Within a company encompassing 1,500 workers, volunteer ultrasound bone densitometry assessments were performed. The following variables were analyzed: age, gender, weight, height, BMI, BUA (broad-band ultrasound attenuation), proportion (%) to the normal population, Z-score and T-score. The Statgraphics Plus software was used for the statistical calculations.Results: The overall prevalence of osteoporosis was 21.83%, with a clear predominance of the male gender (42.5% vs. 17.46% in females). Conclusions: There was a high prevalence of osteoporosis among the males in the studied population (AU)

Las enfermedades neoplásicas como causa de incapacidad permanente / No disponible

El cáncer es la primera causa de mortalidad en hombres y la segunda en mujeres, tras las enfermedades cardiovasculares. Desde el punto de vista económico, los costes atribuibles a las enfermedades neoplásicas son principalmente indirectos (pérdida de productividad asociada a la mortalidad o a la incapacidad permanente). Analizando las incapacidades permanentes producidas en la Diputación Provincial de Cádiz en el período 1990-2005, que fueron un total de 208, se concluye, por orden de frecuencia, que las enfermedades neoplásicas se sitúan en tercer lugar (17,87%), precedidas de las enfermedades osteomusculares (24,15%) y de las enfermedades cardiovasculares (23,67%). En cuanto a la pérdida de años de vida laboral, las enfermedades neoplásicas ocupan el segundo lugar con 11,24 años, detrás de las enfermedades psiquiátricas con 14,18 años. Por sexos las causas de incapacidad permanente se distribuyeron por el siguiente orden decreciente. En mujeres: enfermedades osteomusculares (39,08%), enfermedades neoplásicas (19,54%) y enfermedades cardiovasculares (16,09%). En hombres: enfermedades cardiovasculares (28,93%), enfermedades neoplásicas (16,53%) y enfermedades osteomusculares (13,22%)

The cancer is the first cause of mortality in men and second in women, after the cardiovascular diseases. From the economic point of view, the costs attributable to the cancer diseases are mainly indirect (loss of productivity associated to mortality or the permanent incapacity). Analysing the produced permanent incapacities in the Provincial Delegation of Cadiz in period 1990-2005, that were a total of 208, one concludes, by frequency order, which the cancer diseases are located thirdly (17.87%), preceded of the diseases osteomusculares (24.15%) and of the cardiovascular diseases (23.67%). As far as the loss of years and labour life, the cancer diseases occupy the second place with 11.24 years, behind the psychiatric diseases with 14.18 years. By sexes the causes of permanent incapacity were distributed by the following decreasing order. In women: diseases osteomusculares (39.08%), cancer diseases (19.54%) and cardiovascular diseases (16.09%). In men: cardiovascular diseases (28.93%), cancer diseases (16.53%) and diseases osteomusculares (13.22%)

Detección precoz del cáncer de próstata. ¿Beneficios de su inclusión en el protocolo de vigilancia de la salud? / Precocious detection of the prostate cancer. Benefits of its inclusion in the protocol of monitoring of the health?

Aunque el cáncer de próstata afecta fundamentalmente a hombres de edad avanzada, alrededor del 25% se diagnostican antes de los 65 años. La técnica de cribado que se ha demostrado de mayor utilidad es la determinación del Antígeno Prostático Específico (PSA). Su relación con el PSA libre discrimina la patología benigna de las de origen tumoral. Objetivo: Conocer la prevalencia de patología prostática entre los de trabajadores de la Diputación Provincial de Cádiz. Material y método: Como parte del protocolo de vigilancia de la salud realizado por el Servicio de Prevención y Salud Laboral se incluye la realización de Ecografía Abdominal/ Prostática y la determinación de PSA en varones mayores de 50 años. Participaron en el estudio un total de 229 trabajadores a los que también se les realizó una encuesta autoadministrada sobre «patología urológica». Tipo de estudio: Descriptivo-observacional. Resultados: Media de edad: 61,07 años (DS 5,95). Los valores del PSA fueron inferiores a 4ng/ml en el 92,14%, en el 5,71% presentaron valores entre 4-10 ng/ml, y el 2,14% presentó valores superiores a 10 ng/ml. De los 152 trabajadores que se realizaron ecografía abdominal, en 21 casos (13,82%) se detectó la presencia de un nódulo prostático

Although the prostate cancer fundamentally affects to age men older, around 25% are diagnosed before the 65 years. The sifting technique that has been demonstrated of greater utility is the determination of Prostate Specific Antigen (PSA). Its relation with the PSA frees discriminates the benign pathology of those of tumour like origin. Objective: To know the prevalence prostate pathology between those of workers of the Provincial Delegation of Cadiz. Measurement: As it leaves from the protocol of monitoring of the health made by the Service of Prevention and Labour Health include the accomplishment of Ultrasound Abdominal/Prostates and the determination of PSA in greater men of 50 years. A total of 229 workers participated in the study to whom also a survey on «urology pathology» was made to them. Desingn: Descriptive observacional study. Results: Age Average: 61.07 years (DS 5.95) the values of the PSA were inferior to 4ng/ml in 92.14%, in 5.71% they presented/displayed values between 4-10 ng/ml, and 2.14% presented/displayed 10 values superior to ng/ml. Of the 152 workers who were made abdominal ultrasound, in 21 cases (13,82%) the presence of a prostate nodule was detected

Diagnóstico del síndrome metabólico a través de la vigilancia de la salud / Diagnosis of metabolic sindrome in health work

Introducción: El síndrome metabólico (SM) se caracteriza por la intolerancia a la glucosa, dislipemia, obesidad e hipertensión arterial. Su importancia radica en que las personas que lo padecen tienen un mayor riesgo de eventos coronarios a 10 años vista. En determinadas poblaciones presenta una alta prevalencia, que lega hasta casi el 20%. Objetivos: Conocer la prevalencia del SM entre los trabajadores de una empresa de Administración Local. Metodología: Con una población de 1500 trabajadores, se analizaron los resultados de 276 reconocimientos realizados en el segundo semestre de 2002 (139 mujeres y 137 hombres). Se estudiaron las siguientes variables: glucemia, triglicéridos, colesterol HDL, peso, talla, índice de masa corporal (IMC), tensión arterial sistólica (TAS) y tensión arterial diastólica (TAD). Se utilizó el algoritmo propuesto por el Grupo Latino Americano de la Oficina Internacional de Información de Lípidos (ILIB-LA). Los cálculos estadísticos se realizaron con el programa Stagraphics Plus. Resultados: La prevalencia del SM fue del 10,14%, existiendo un claro predominio en el sexo masculino, 16,87% en hombres y 3,59% en mujeres. La media de glucemia fue de 86,05 mg/dl (DS 17,03), los triglicéridos 109,24 mg/dl (DS 83,67), el colesterol HDL 56,70 mg/dl (DS 15,33), el IMC 26,38 Kg/m2, TAS 120,50 mm Hg y la TAD 79,09 mm Hg. Existía una correlación estadísticamente significativa entre los niveles de glucemia y el colesterol, y entre los niveles de triglicéridos y el colesterol HDL. Conclusiones: Alta prevalencia del SM entre la población masculina estudiad (AU)

Introduction: The metabolic syndrome (SM) characterizes for the intolerance to the glucose, dislipemia, obesity and arterial hypertension. His importance takes root in that the persons who endure it have a major risk of coronary events to 10 years dress. In certain populations he(she) presents a discharge prevalencia, that bequeaths up to almost 20%. Objetive: To know the prevalencia of the SM among the workers of a company of Local Administration. Methodology: With a population of 1500 workers, there were analysed the results of 276 recognitions realized in the second semester of 2002 (139 women and 137 men). The following variables were studied: glucose, triglycerides, cholesterol HDL, weight, height, index of corporal mass (IMC), arterial tension systolic (TAS) and arterial tension diastolic (TAD). There was in use the algorithm proposed by the Latin American Group of the International Office of Lipidos's Information (ILIB - LA). The statistical calculations fulfilled with the program Stagraphics Plus. Results: The prevalencia of the SM was 10,14%, existing a clear predominance in the male, 16,87% in men and 3,59% in women. The averageof glucose was of 86,05 mg/dl (DS 17,03), the triglycerides 109,24 mg/dl (DS 83,67), the cholesterol HDL 56,70 mg/dl (DS 15,33), the IMC 26,38 Kg/m2, TAS 120,50 mm Hg and TAD 79,09 mm Hg. A statistically significant correlation existed among the levels of glucose and the cholesterol, and among the levels of triglycerides and the cholesterol HDL. Conclusions: Discharge prevalencia of the SM among the masculinepopulation (AU)

Linfomas no Hodgkin y actividad laboral / Non-Hodgkin's lymphomata and occupational activity

La incidencia y la mortalidad de los linfomas no Hodgkin (LNH) han aumentado en algunos países del mundo, sobre todo en los más desarrollados. Este aumento puede deberse a la mejora en los medios diagnósticos disponibles y al aumento de los trastornos inmunosupresores (VIH, quimioterapia inmunosupresora, etc.). No obstante, parte de ese aumento puede deberse a hábitos dietéticos, y a exposiciones ambientales, algunas de ellas en el medio laboral. Se realiza una revisión bibliográfica de la relación entre la mortalidad por LNH y la exposición en el medio laboral. Trabajos en centrales eléctricas, granjas, industrias metalúrgicas, industrias petroquímicas y ebanisterías pueden estar relacionadas. Exposiciones a óxido de etileno, funguicidas, herbicidas, fertilizantes, pesticidas, disolventes orgánicos y radiaciones ionizantes parecen aumentar el riesgo (AU)

No disponible

Coupling of 5-fluoro 2'-deoxyuridine to lactosaminated poly-l-lysine: an approach to a regional, non-invasive chemotherapy of liver micrometastases.

Nucleoside analogs conjugated with galactosyl-terminating peptides selectively enter liver cells and after intracellular release from the carrier partly exit into bloodstream, resulting in higher concentrations in liver blood than in systemic circulation. The aim of the present experiments was to ascertain whether, in mice injected with non-toxic doses of a 5-fluoro 2'-deoxyuridine (FUdR) conjugate with lactosaminated poly-L-lysine (L-poly(LYS)), the drug was released by hepatic cells in high enough amounts to be pharmacologically active on neoplastic cells infiltrating the liver. We observed that L-poly(LYS)-FUdR inhibited the growth of hepatic metastases induced by intrasplenic administration of murine colon carcinoma C-26 cells. L-poly(LYS)-FUdR was not toxic for C-26 cells in vitro, was selectively taken up by mouse liver, and was stable in mouse blood, indicating that the effect on the metastases was due to FUdR (and/or its active metabolites) released in liver blood after the conjugate was taken up by the hepatic cells. These results suggest that L-poly(LYS)-FUdR might be useful in adjuvant chemotherapy of tumors giving liver metastases. The drug released from hepatic cells into liver blood following conjugate administration via the peripheral venous route might accomplish a locoregional, non-invasive treatment of micrometastases nourished by liver sinusoids.

Evolución de la mortalidad por cáncer de pulmón en la provincia de Cádiz (1975-1995) / Evolution of lung cancer mortality in the province of Cadiz

Propósito: Conocer la evolución de la mortalidad por cáncer de pulmón en la provincia de Cádiz durante el periodo comprendido entre los años 1975 y 1995.Materia y métodos: Se recogieron los datos de los Boletines Estadísticos que acompañan a los Certificados de Defunción con el diagnóstico de "cáncer de pulmón" (CIE 8ª y CIE 9ª) de los 44 municipios que componen la provincia de Cádiz durante los años 1975 a 1995. Se utilizaron indicadores estadísticos sencillos: tasa específica de mortalidad, tasa truncada (> 50 años) y tasa de masculinidad. El ajuste de tasas se realizó por el método directo y la población de referencia fue la europea. Resultado: Se produjeron 6.947 casos de fallecimiento por cáncer de pulmón (19,32 por ciento de todas las muertes por neoplasias), correspondiendo el 92,10 por ciento a hombres. Destaca la clara tendencia al alza de las tasas específicas. El porcentaje de incremento en varones fue del 110,51 por ciento y en mujeres del 74,88 por ciento. Conclusiones: El exceso de mortalidad por cáncer de pulmón en la provincia de Cádiz se ha intentado explicar por diversas causas (industrias contaminantes, consumo de tabaco, desigualdades sociales, etc.), no obstante son necesarios estudios epidemiológicos que justifiquen estos resultados (AU)

Enhanced liver blood concentrations of adenine arabinoside accomplished by lactosaminated poly-L-lysine coupling: implications for regional chemotherapy of hepatic micrometastases.

Conjugates of antiviral and antiblastic nucleoside analogs (NAs) with galactosyl-terminating peptides selectively enter hepatocytes after binding of the carrier galactose residues to the asialoglycoprotein receptor. Since NAs, when set free from the carrier within hepatocytes, partly exit from these cells into the bloodstream, we considered the possibility that administration of galactosyl-terminating conjugates of NAs could result in plasma concentrations of these drugs that would be higher in liver sinusoids than in capillaries of other organs. In the present study we demonstrated the validity of this hypothesis. We injected rats with a conjugate of adenine arabinoside (ara-A) with lactosaminated poly-L-lysine and found that the plasma concentrations of ara-A were >2-fold higher in blood of liver than in systemic circulation. Liver blood was collected from the inferior vena cava after closing below and above the outflows of the hepatic veins. The present result suggests that conjugation with galactosyl-terminating peptides might be a way to selectively increase the concentrations of NAs not only in hepatocytes, which have the asialoglycoprotein receptor, but also in cells infiltrating the liver, such as neoplastic cells of micrometastases nourished by hepatic sinusoids.

Testosterone hydroxylase as multibiomarker of effect in evaluating vinclozolin cocarcinogenesis.

In this work the modulation of the regio- and stereo-selective hydroxylation of testosterone by vinclozolin was studied in evaluating cocarcinogenic properties. Changes of cytochrome P450-(CYP)-catalysed drug metabolism was investigated in liver, kidney and lung microsomes of Swiss Albino CD1 mice of both sexes after single (625 or 1250 mg kg-1 b.w.) or repeated (daily 750 mg kg-1 b.w. for 3 days) i.p. administrations. Treatment of mice with a single dose of vinclozolin caused in a dose-dependent fashion from 2 1 to 14 1-fold increase in the 7-, 6- and 2-hydroxylations of testosterone in liver. Lower increase in extrahepatic tissues ranging from 2 3 to 8 1-fold for testosterone 6-, 16 -, 2- and 2- hydroxylase activity in the kidney or from 2 2 to 5 1-fold for 6-, 16 -, 16 - and 2- hydroxylase activity in the lung were observed. Repeated treatment with this fungicide did not substantially modify the extent and pattern of induction, the liver being the only tissue responsive (up to 7 6-fold increase, 7-hydroxylation) in both male and female. In the kidney (7-, 6-, 16 -, 2-, 7-hydroxylations) and lung (6-, 7-, 6-, 16 -, 16 - and 2- hydroxylations), a typical sex-dependent induction (up to 9 0-fold, 16 -hydroxylation in the lung, female) was achieved. In general, however, vinclozolin has a complex pattern of induction and suppression of CYP-dependent enzymes, as exemplified from the reduced expression of some hydroxylations depending upon dose, sex and organ considered. For example, after a single administration, 16 -hydroxylation was suppressed in liver (up to 78% loss in male, higher dose), whereas 16 -hydroxylation was reduced in kidney up to 50% in both sexes (at the higher dose). Glutathione S-transferase activity, measured as index of post-oxidative reactions, was markedly increased by vinclozolin in the liver (up to 5 2-fold, female) and kidney (up to 3 9-fold, female) but not in the lung. Because both phase I and phase II reactions were enhanced by vinclozolin treatment in liver and kidney, the ratio between activation/detoxification mechanisms was slightly affected. Conversely, this ratio was shifted toward activating mechanisms in the lung, sustaining, in part, the expression of certain type of tumours tissue-dependent. Taken together, these findings seem to indicate the cotoxic, cocarcinogenic and promoting potential of this fungicide.

Selective neuronal targeting in prion disease.

The pattern of scrapie prion protein (PrP(Sc)) accumulation in the brain is different for each prion strain. We tested whether the PrP(Sc) deposition pattern is influenced by the Asn-linked oligosaccharides of PrP(C) in transgenic mice. Deletion of the first oligosaccharide altered PrP(C) trafficking and prevented infection with two prion strains. Deletion of the second did not alter PrP(C) trafficking, permitted infection with one prion strain, and had a profound effect on the PrP(Sc) deposition pattern. Our data raise the possibility that glycosylation can modify the conformation of PrP(C). Glycosylation could affect the affinity of PrP(C) for a particular conformer of PrP(Sc), thereby determining the rate of nascent PrP(Sc) formation and the specific patterns of PrP(Sc) deposition.

Aberrant induction of neuropeptide Y mRNA in hippocampal CA3 pyramidal neurones in scrapie-infected mice.

The neurochemical alterations preceding neurological dysfunction and neuronal death in prion diseases are not well characterized. Here we examined, using in situ hybridization histochemistry, the expression of neuropeptide Y (NPY), an inducible and abundant neuropeptide in mammalian brain with known neuroregulatory functions, and glial fibrillary acidic protein (GFAP), a marker for astroglial activation, in the hippocampus at different time points following intracerebral prion inoculation in male CD-1 mice. Between 110 and 140 days postinoculation NPY mRNA expression was specifically up-regulated in CA3 pyramidal neurones, whereas expression of NPY in hilar neurones remained unaltered. Up-regulation of GFAP mRNA was observed in the CA1 stratum radiatum at 60 days, and spread throughout the hippocampus, cortex and thalamus between 110 and 140 days, suggesting early accumulation of scrapie prion protein in these regions. The clinical symptoms were first manifested 120 days postinoculation. Aberrant induction of NPY mRNA in the hippocampal CA3 pyramidal neurones preceded the onset of neurological symptoms, and may be involved in the regulation of glutamate release at the Schaffer collateral-CA1 synapses in scrapie-infected mice.

Scrapie in mice deficient in apolipoprotein E or glial fibrillary acidic protein.

In the prion diseases, extensive reactive gliosis is often found to be out of proportion to the degree of apparent neuronal damage. To evaluate the role of astrocytic gliosis in experimental scrapie of the mouse, we inoculated mice deficient in apolipoprotein E (apoE) or the glial fibrillary acidic protein (GFAP) with mouse prions. The expression of both apoE and GFAP in astrocytes increases as part of the reactive gliosis that accompanies scrapie. Null mice deficient in either apoE or GFAP inoculated with prions exhibited incubation times indistinguishable from untargeted control mice. The level of PrPSc and its regional deposition in the brains of ill mice deficient in either protein were also similar to control mice. Our findings demonstrate that neither apoE nor GFAP participates in the pathogenesis of the disease or in the production of PrPSc.

[Delay in the diagnosis of malignant tumors (breast, larynx, bladder)]. / Retraso en el diagnóstico de tumores malignos (mama, laringe y vejiga).

Cancer is the second leading cause of mortality in developed countries. Irrespective of its malignant degree, certain histological types and locations, there is a number of authors who hold the view that a delay in diagnosis can be one of the factors leading to a fatal outcome of the disease. In this study an assessment was made of diagnostic delay in three locations (breast, bladder, and larynx) in which the disease usually begins with evident alarm symptoms. The natural history of disease, from the first symptom to hospital admission and clinical diagnosis, was reconstructed by means of a questionnaire administered to patients from May, first, 1989, to April, 30th, 1990. It is concluded that patient's responsibility is great for the diagnostic delay of breast malignant tumors, whereas such a responsibility can be attributed to the Health Maintenance System for the other two types of cancer, bladder and larynx.

[Cancer mortality in women from Cadiz. 1975-1983]. / Mortalidad por cáncer en la mujer gaditana. 1975-1983.

Both in Spain and in the rest of industrialized countries, cancer is the second caused mortality in accordance with its incidence. Respect to the different Autonomous Communities, Andalucia is that where men are at most unfavorable situation, and women are within the most unfavored. Out of all the Provinces which constituted this Community, mainly Cadiz attracted attention by its systematically and constantly growing rates of that tumors present in the most common localizations. The aim of the present work is to study, by means of death certificate dates, the mortality rate of women from Cadiz between 1975-1983. Mortality rate was 104.08 decease per 100,000 inhabitants. The cut off rate of female population older than 40 years was 287.77. The temporal trend of women cancer in our ambient was studied comparing the mortality rates with the incidence rates from some Spanish Populational-Based Cancer Registers (Granada, Murcia, Tarragona and Navarra). We conclude that in Cadiz Province there is a higher number of women decreased by cancer, mainly by liver cancers.

[Prevalence of hepatitis B markers in the personnel of psychiatric hospitals]. / Prevalencia de marcadores de la hepatitis B entre el personal laboral de un hospital psiquiátrico.

The current rules and regulations in Spain state that those working in closed institutions, helping mentally disturbed patients, are considered personnel at risk for acquiring hepatitis B virus infection, without drawing distintions between professions and fields of work. The immunological state against HBV has been studied in a representative population group of workers of the Cadiz Provincial Psychiatric Hospital (82.90%). Our results show that the percentage of chronic carriers (3.15%) and those with other positive biological markers (30.07%) is greater than that found in the General hospitals of our country. Thus, the inclusion of this population group in preventive programs as well as vaccination programs against hepatitis B virus infection is totally justified.