Prevalence of cognitive impairment in Spain: The Gómez de Caso study in health sentinel networks. / Prevalencia de deterioro cognitivo en España. Estudio Gómez de Caso en redes centinelas sanitarias.

INTRODUCTION: Cognitive impairment, a clinical entity causing complete or partial intellectual dysfunction, is a major public health concern that poses a challenge for health and social services. The purpose of this study is to estimate the prevalence of this disorder in people aged 65 and older visiting the primary care physician in 5 health sentinel networks. METHOD: A sample of patients visiting their primary care doctor on 4 randomly selected days completed the Mini-Cog screening test. Diagnosis of cognitive impairment was confirmed with the Mini-Mental State Examination and the Alzheimer's Questionnaire. We estimated raw and adjusted rates using demographic and social variables. RESULTS: We included 4,624 patients from 5 autonomous communities and representing a population of 1,723,216 inhabitants. The adjusted prevalence rate was 18.5% (95% CI 17.3-19.7], with differences between sentinel networks. Women showed higher adjusted rates than men: 18.5 vs. 14.3%. The highest prevalence rate was observed in people aged 85 and older (45.3%); prevalence rates vary depending on education level and marital status. CONCLUSIONS: Cognitive impairment is a frequent reason for consultations in primary care. Its prevalence is higher in women and increases exponentially with age. A number of sensitive, validated tools have been proven useful in screening for and confirming cognitive impairment. Using these tools in primary care settings enables early treatment of these patients.

[Organization of the universal vaccination program against hepatitis B in school children and coverage of the first year of vaccination. Extremadura]. / Organización del programa de vacunación universal frente a Hepatitis B en escolares y cobertura del primer año de vacunación. Extremadura.

This paper studies the proportion of the population reached by the programme of universal vaccination against Hepatitis B for children of 13 during the first year since its introduction in Extremadura (Spain). A reach of 96.04% is considered satisfactory and higher than that achieved in other pilot programmes, and even higher than that of other childhood vaccines. This is attributed to the energetic organization of the programme within those activities aimed at children of school age, to the information and participation by the various social and institutional bodies involved, to the work of the Extremaduran Health Education Board, and to the ongoing work of teams of health workers and doctors. There are no significant differences between urban and rural Health Clinics. These differences are to be found in those areas where the aforementioned teams and the traditional model have begun to operate. Given the existing health system in this country and the widespread nature of the illness, it is assumed that the most effective method of vaccination would be that aimed at the high-risk population, the children of mothers who are carriers, and universal vaccination of school-age children.

[The effect of exogenous factors on serum cholesterol concentrations and the possibilities for community intervention. Extremadura II]. / Influencia de algunos factores exógenos en las concentraciones séricas de colesterol y posibilidades de intervención comunitaria. Extremadura II.

BACKGROUND: The existence of factors susceptible to modification which have a bearing upon the seric concentrations of cholesterol and other lipids linked to the appearance of arteriosclerosis and coronary cardiopathy, make it advisable to study their impact in the Autonomous Community of Extremadura as a first step towards programming strategies for community measures. METHOD: A cross-section study was carried out on a random sampling of 1,060 people grouped by age and blood pressure, detecting the total concentration of cholesterol, HDL-C and triglycerides, on the one hand, and on the other the existing correlations of the variables; amount of alcohol and cigarettes consumed, obesity and overweight. RESULTS: The prevalence of hypercholesteremia (more than 240 mg/dl) is significantly higher in people with an index or corporal mass (ICM) greater than 25 (47% and 30%) among those with normal blood pressure. There is also a relationship between high cholesterol levels and excessive ingestion of alcohol and tobacco smoking in this group, with values of 59% in heavy drinkers and 46.7% in non-drinkers and an OR of 2. IC 95% (1.32-3.03). The relationship between the smoking habit and hypercholesteremia is also maintained among moderate smokers and those who smoke more than 20 cigarettes/day. OR = 2.83, IC 95% (1.19-6.7). An inverse relationship is detected between tobacco smoking and the level of HDL-C. CONCLUSIONS: The correlation found between the variables included in this study and hypercholesteremia, and its significance, suggests the potential benefits that the modification of these habits through community measures would have for the Community, as part of the primary assistance within a programme for prevention of cardiovascular diseases.