The prevalence of metabolic syndrome in Latin America: a systematic review.

OBJECTIVE: To assess the available data on the prevalence of metabolic syndrome (MS) in Latin-American countries. DESIGN: Systematic review. Searches were carried out in PubMed, ISIWeb, SCielo and Redalyc, using 'metabolic syndrome x' and 'prevalence' as keywords for titles and/or abstracts. Articles selected were cross-sectional studies in Latin-American countries, whose main objective was to study MS and whose study population is described below. MS must be determined using Adult Treatment Panel III criteria. Twelve studies with these criteria were selected, one of which was multi-centric. SETTING: Latin America. SUBJECTS: Apparently healthy subjects aged 18-65 years (including young adult, mature adult and elderly populations) of both genders. RESULTS: The general prevalence (weighted mean) of MS in Latin-American countries was 24·9 (range: 18·8-43·3) %. MS was slightly more frequent in women (25·3 %) than in men (23·2 %), and the age group with the highest prevalence of MS consisted of those over 50 years of age. The most frequent components of MS were low HDL cholesterol levels (62·9 %) and abdominal obesity (45·8 %). Similar outcomes were obtained from the multi-centre study on Latin-American populations analysed. CONCLUSIONS: The present review brings us closer to an understanding of the prevalence of MS in Latin-American countries. However, it is not possible to know the full scope of the problem, partly because data from some countries are not available, and because the methodological differences among the studies published up to the present limit a joint analysis of their results.

Equation to estimate body weight in elderly Mexican women using anthropometric measurements.

INTRODUCTION: Body weight is useful for many medical and nutritional procedures. When it is difficult or impossible to measure body weight in hospitalized/institutionalized elderly, it can be estimated through equations based on anthropometry generated in other countries, although their validity in other contexts has been poorly studied. OBJECTIVES: To create and validate an equation for estimating body weight for both, hospitalized and nursing home residents Mexican elderly women (institutionalized) using anthropometric measurements. METHODS: A validation study was carried out in elderly women (> or = 60 years old), admitted to the Geriatrics Service of the Hospital Civil de Guadalajara "Fray Antonio Alcalde" during February-April 19th (n = 43) and April 20th-June 2005 (n = 29), and elderly women residing in three nursing homes in the Metropolitan Area of Guadalajara evaluated during June 2003-June 2004 (n = 23). Subjects were weighed using a scale which was adapted to their clinical situation and were anthropometrically assessed. In the first sample, we generated a new equation using multiple regression analyses. Then, the equation was validated in the other two samples. We also estimated weight using Chumlea's equations: in all samples, estimated and actual weights were compared between each other through a paired t-test. A p < 0.05 was considered as significant. RESULTS: Mean ages in each sample were: 84.3 +/- 7.3, 84.4 +/- 9.1, and 84.2 +/- 8.5 years, respectively. Mean actual weights were: 48.2 +/- 13.5, 48.1 +/- 10.1, and 55.0 +/- 12.3 kg, respectively. The resulting equation was: estimated weight = (1.599* knee height) +(1.135* mid arm circumference) + (0.735*calf circumference) + (0.621* tricipital skinfold thickness)-83.123 (R2 = 0.896, p < 0.001). In hospitalized women, there were no significant differences between estimated and actual weight (sample 1:D-0.02 +/- 4.3 kg, p = 0.976; sample 2: D-0.7 +/- 4.2 kg, p = 0.352). In female nursing homes residents (institutionalized women) weight was significantly overestimated (1.9 +/- 3.2 kg p < 0.01), but the mean difference was smaller than the ones found using Chumlea's equations. CONCLUSIONS: The developed equation predicted accurately hospitalized elderly women's body weight in our context. In institutionalized elderly women, weight was significantly overestimated. It would be useful to derive equations for different settings.uals who present normal body weight.

Body fat at pubertal genital stage 2: a comparison between Spanish and Mexican boys.

BACKGROUND/OBJECTIVES: To compare body fat mass at the same stage of pubertal maturation, genital stage 2 (G2), in a Spanish and in a Mexican sample of boys. SUBJECTS/METHODS: Data from Spain (n=177) were from a previous longitudinal clinical follow-up and data from Mexico (n=91) from a cross-sectional study. Subjects were grouped according to the presence of G2 at similar ages. Spanish sample was divided into boys with G2 at age 12 (n=60), 13 (n=74) and 14 (n=43). In Mexican sample, 23 boys were at G2 at 12 years, 38 at age 13 and 30 at 14 years. Height, weight, upper arm circumference and four skinfold thicknesses were recorded. Genital development was assessed (Tanner scale). Sum of four skinfolds (SUM), body mass index (BMI), percentage of body fat (%BF) and extremity/trunk skinfold ratio (ETR=(triceps+biceps)/(subscapular+suprailiac)) was calculated. RESULTS: When comparing subjects with different ages at G2 from the same country, or with the same age at G2 from different countries, no significant differences were found in adiposity variables (%BF, SUM), nor in BMI. Nevertheless, there were differences in body fat distribution: ETR was higher in Spanish boys (P<0.001), because of their greater triceps skinfold thickness (P=0.013), and due to the greater trunk fat stores in Mexican boys (P<0.01, subscapular and suprailiac skinfolds). CONCLUSIONS: There is a subcutaneous fat mass store characteristic of G2 in boys, which is not only independent of age, but is also observable in two different populations.

Onset of puberty at eight years of age in girls determines a specific tempo of puberty but does not affect adult height.

AIMS: To analyse the effect of early puberty (onset between 7.5 and 8.5 y) on pubertal growth and adult height in girls, and the implications of this effect for the age limit for normal onset of puberty. METHODS: Longitudinal study in Reus (Spain) of 32 girls with early puberty until they reached adult height. Data from these girls were compared with longitudinal data from girls (116) from the same population with normal onset at 10 (n = 37), 11 (n = 47), 12 (n = 19) and 13 (n = 13)y. We analysed height, target height, adult height, pubertal height increase, duration of pubertal growth, age at menarche and time to menarche. RESULTS: The adult height of girls with early puberty (160.9 +/- 5.4cm) was similar to that of girls with onset at later ages (p = not significant). In these girls, puberty lasted 5.4 +/- 0.7 y and the mean growth during puberty was 31.1 +/- 3.5 cm. As the age of onset of puberty increases, the duration of puberty and mean growth during puberty progressively decreased (p < 0.001). Girls with early puberty reached menarche at a mean age of 10.9 +/- 1.0 y, 3.2 +/- 0.9 y after onset of puberty, and this time span was greater than in the other groups. CONCLUSION: Girls with onset of puberty at 8 y show all the compensatory phenomena related to height at onset, pubertal duration and height increase during puberty. These phenomena cause their adult height to be similar to that of girls who begin puberty at the age of 10 to 13 y.

Satisfacción laboral: relación con sensación de fatiga, síntomas de ansiedad y turnicidad / Work satisfaction: relation with fatigue, anxiety symptoms and shiftwork

Muchos estudios han demostrado la asociación entre el trabajo a turnos y determinados problemas relacionados con la salud. Estos problemas se deben a tres grandes grupos de causas: alteraciones en el sueño, alteraciones físicas y psíquicas y disfunciones de la vida social y doméstica. Tras analizar una muestra de trabajadores del sector de la industria química (n = 225) de los cuales 185 están sometidos a turnicidad y 40 a turno normal mediante cuestionario dirigido a valorar características del puesto de trabajo, síntomas de fatiga, ansiedad y satisfacción laboral, observamos que la turnicidad se asocia con una menor tolerancia hacia algunas características inherentes al puesto de trabajo que se traducen en una baja valoración de la satisfacción laboral (AU)

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[Usefulness of a software package to reduce medication errors in neonatal care]. / Utilidad de una aplicación informática para disminuir errores de tratamiento en neonatología.

BACKGROUND: Many treatment errors in neonatal intensive care units are caused by the need to carry out a sequence of calculations to determine the dose and dilution of the drugs used. OBJECTIVES: To help in this task, we designed a spreadsheet (Neodosis) that helps clinicians and nurses to calculate the doses and standardize the dilutions of some of the drugs most commonly used in resuscitation and neonatal intensive care units. The aim of this study was to verify the usefulness and reliability of this software package. METHODS: A randomized, cross-over, controlled trial was conducted through simulated clinical cases in which the number of errors in the prescription data and the amount of time spent in making calculations, with and without the program, were evaluated. Fifty-four tests were performed by pediatricians, third- and fourth-year pediatric residents, and nurses. RESULTS: Without computer support, all three groups made errors (residents, pediatricians and nurses in descending order). When Neodosis was used, all the medical staff made significantly fewer errors. The greatest reduction was found in errors made by pediatric residents: minor errors decreased from 16 % to 2 % and major errors from 1.6 % to zero. When using the spreadsheet, the time spent by all groups in making the calculations was reduced by between one-third and one-half. CONCLUSIONS: The tests performed with simulated clinical cases revealed that the number of errors made by the healthcare personnel who participated in this study was not inconsiderable. The use of Neodosis helped physicians and nurses to make markedly fewer errors and also saved them time.

Utilidad de una aplicación informática para disminuir errores de tratamiento en neonatología / Usefulness of a software package to reduce medication errors in neonatal care

Antecedentes: Muchos de los errores de tratamiento producidos en las unidades de cuidados intensivos neonatales (UCIN) tienen su origen en la necesidad de efectuar secuencias de cálculos para determinar dosis y diluciones de fármacos. Objetivos: Para ayudar en estas tareas se diseñó una hoja de cálculo (neodosis) que facilita los cálculos y estandariza las diluciones de algunas de las terapias más usadas en reanimación y UCIN. Para evaluar su utilidad se diseñó este trabajo. Métodos: Se efectuó un estudio controlado, cruzado y aleatorizado mediante simulaciones clínicas en las que se evaluó el número de errores y tiempo utilizado en su resolución, con y sin el programa. Fueron realizadas un total de 54 pruebas en las que intervinieron médicos (residentes de tercer y cuarto año y pediatras) y personal de enfermería. Resultados: Sin ayuda de ordenador todos los estamentos cometieron errores (en orden decreciente: residentes, pediatras y enfermería). El conjunto del estamento médico experimentó una reducción significativa de errores con la ayuda informática. El grupo de residentes fue el más beneficiado con su utilización: su porcentaje de errores "menores" pasó del 16 al 2% y el de errores "mayores" del 1,6% a 0. El tiempo empleado por todos los grupos se redujo entre un tercio y la mitad. Conclusiones: El personal asistencial probado cometió un número no insignificante de errores en pruebas de simulación sobre cálculos típicos de UCIN. Neodosis ayudó a médicos y enfermeras a reducir muy sensiblemente estos errores y a emplear menos tiempo en su resolución (AU)

[The use of "daily life activities profile" for determining incapacity]. / Utilidad del "perfil de habilidades de la vida cotidiana" para la peritación de la incapacidad.

The "Life Skill Profile" (LSP) is a test that measures psychophysical function. Fifty-five subjects arraigned in Court to have their psycho-physical ability legally assessed were included in a prospective study in which the clinical evaluation was correlated with the total LSP rating conducted by another evaluator. Age, gender, original accommodation type, diagnosis or type of evaluator were variables not significantly related to the clinical outcome. The results indicated that, using various cut-off scores, different levels of sensitivity and specificity of the LSP test are obtained which can be converted to predictive values in the legal assessment of disability. The LSP test is an efficient measure to be used in conjunction with the clinical evaluation.