Prevalence and caries-related risk factors in schoolchildren of 12- and 15-year-old: a cross-sectional study.

BACKGROUND: To assess the prevalence and severity of caries in 12- and 15-year-old schoolchildren, and to analyse the related risk factors. METHODS: We conducted a cross-sectional study on a random sample of 1843 schoolchildren aged 12 and 15 from Galicia (northwest of Spain). Self-administered questionnaire and dental clinical examination were performed to obtain information about oral health habits, dental caries and oral hygiene. A logistic regression model including dental-caries-related variables was generated for each age group. RESULTS: The respective findings for 12- and 15-years-old were as follows: decayed, missing, filled teeth index both for permanent and temporary dentition (DMFT/dmft) of 0.89 (95% CI, 0.87-0.91) and 1.38 (95% CI, 1.33-1.43), respectively; caries prevalence 39.6% (95% CI, 36.3-42.9) and 51.7% (95% CI, 48.0-55.4), respectively. In the 12-year-old group, individuals who occasionally, never or hardly ever brushed their teeth had higher values of caries (OR = 1.83, 95% CI 1.07-3.15, and OR = 9.14, 95% CI1.63-51.17, respectively). Also, the presence of plaque on more than 1/3 gingival was statistically associated with an increase of caries (OR = 2.03; 95% CI, 1.11-3.70), and living in a rural environment was a risk factor (OR = 1.3; 95% CI,1.02-1.80). In the 15-year-old group, higher caries risk was found when brushing was performed once a day (OR = 1.61; 95% CI,1.03-2.50), and among individuals who visited private clinics (OR = 1.77; 95% CI, 1.17-2.66), while electric toothbrush was associated with a lower caries risk (OR = 0.50; 95% CI, 0.29-0.86). CONCLUSIONS: This study revealed that risk factors of dental caries showed differences in schoolchildren of 12- and 15-year-old. Strongest evidence related to caries in 12-year-old group were found in frequency of toothbrushing and dental plaque. In 15-year old group, electric toothbrush, time since the last visit to the dentist and type of dental care (public/private) had a stronger association with dental caries. Caries prevalence and mean DMFT/dmft increased from 12- to 15-year-old, in spite of improvement in oral hygiene at the age of 15.

Social network, presence of cardiovascular events and mortality in hypertensive patients.

The aim of this study was to ascertain the relationship between social network and the appearance of mortality (cardiovascular events (CVEs)) in patients with arterial hypertension (AHT). This is a cohort study of 236 patients with a 9-year follow-up. Measurements included age, sex, blood pressure (BP), diabetes, hypercholesterolemia, marital status, social network, social support, stage of family life cycle (FLC), mortality and CVEs. Patients with a low social network registered higher global mortality (hazards ratio (HR) 2.6 (95% confidence interval (CI) 1.3; 5.5)) as did the oldest patients (HR 5.6 (1.9; 16.8)), men (HR 3.5 (95% CI 1.3; 9.3)) and subjects in the last FLC stages (HR 4.3 (95% CI 1.3;14.1)). Patients with low social support registered higher cardiovascular mortality (HR 2.6 (95% CI 1.1; 6.1)) as did the oldest patients (HR 12.4 (95% CI 2.8; 55.2)) and those with diabetes (HR 3.00 (95% CI 1.2; 7.6)). Patients with a low social network registered more CVEs (HR 2.1 (95% CI 1.1; 4.1)) than patients with an adequate network, as did the oldest patients (HR 3.1 (95% CI 1.4; 6.9)), subjects who presented with a higher grade of severity of AHT (HR 2.7 (1.3; 5.5)) and those in the last FLC stages (HR 2.5 (95% CI 1.0; 6.2)). A low social network is associated with mortality and the appearance of CVEs in patients with AHT. Low functional social support is associated with the appearance of cardiovascular mortality.

[Cultural adaptation and validation of the Medical Outcomes Study Social Support Survey questionnaire (MOS-SSS)]. / Adaptação cultural e validação da versão Portuguesa Questionário Medical Outcomes Study Social Support Survey (MOS-SSS).

The aim of this study was the assesment of psychometric properties of the Portuguese version of the instrument "Medical Outcomes Study - Social Support Survey (MOSSSS)". This questionnaire has been translated and adapted in a Portuguese sample of 101 patients with chronic illness of a rural health centre in Portugal. The average age of patients was 63.4 years, 56.4% female. 29% were illiterate and 2% had completed high school. 78% had arterial hypertension and the 56.4% had diabetes mellitus type 2. The internal consistency was evaluated using Cronbach's alpha. Exploratory and Confirmatory factor analysis were performed in order to confirm reliability and validity of the scale and its multidimensional characteristics. The 2-week test-retest reliability was estimated using weighted kappa for the ordinals variables and intraclass coefficient correlation for the quantitative variables. Cronbach's alphas for the subscales ranged from 0.873 to 0.967 at test, and 0.862 to 0.972 at retest. Exploratory factor analysis revealed the existence of four factors (emotional, tangible, positive interaction and affection support) that explain the 72.71% of the variance. Confirmatory factor analysis supported the existence of four factors that allowed the application of the scale with original items. The goodness-of-fit measures corroborate the initial structure, with chi2/ df=2.01, GFI=0.998, CFI=0.999, AGFI=0.998, TLI=0.999, NFI=0.998, SRMR=0.332, RMSEA=0.76. The 2-weeks test-retest reliability of the Portuguese MOS-SSS as measured by the intraclass correlation coefficient was ranged from 0.941 to 0.966 for the four dimensions and the overall support index. The weighted kappa was ranged from 0.67 to 0.87 for all the items. The MOS-SSS Portuguese version demonstrates good psychometric properties and seems to be useful to measure multidimensional aspects of social support in the Portuguese population.

Actitud del personal hospitalario ante la nueva ley reguladora del tabaco / No disponible

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Dose-response relationship between tobacco and lung cancer: new findings.

The purpose of this work is to model the relationship between smoking-related variables and the risk of lung cancer by using parametric and non-parametric models. A hospital-based case-control study was conducted to ascertain the influence of smoking on risk of lung cancer. We used parametric logistic regression with a series of categorized independent variables and non-parametric logistic regression models. Such models allow for variables to be treated as continuous, since they avoid arbitrariness in the selection of cut-offs and furnish information on the dose-risk relationship. The results point to the possible existence of a saturation effect for a lifetime tobacco consumption of around 25 000-30 000 packets. Duration of habit and years of abstinence show a linear relationship marked by opposite, though similar, slopes, which would seem to indicate that for every year of smoking, risk rises by an amount (8.00%, 95% confidence interval (CI) 5.94-10.06) equal to the decline in risk for every year of abstinence (6.98%, 95% CI 2.53-11.84). Lastly, a lower age of smoking initiation appears to have an influence, although non-significant, on the appearance of the disease. The risk of lung cancer due to duration of the habit would seem to be proportional to years of abstinence, and there could be a saturation effect with respect to lifetime tobacco consumption.

[Influence of social support on patients with essential hypertension]. / Influencia del apoyo social en pacientes con hipertensión arterial esencial.

OBJECTIVE: To determine whether social support affects blood pressure control in patients diagnosed with essential Hypertension. DESIGN: Observational, prospective study, with a year's follow-up. SERRING: Mariñamansa-A Cuña Health Centre, Ourense (Galicia), Spain. PARTICIPANTS: 236 patients diagnosed with essential hypertension in health centre controls. MEASUREMENTS: During the one-year follow-up the following clinical variables were measured: age, sex, blood pressure, severity of hypertension, tobacco consumption, alcohol consumption, presence of diabetes mellitus, hypercholesterolaemia, Body Mass Index and compliance with treatment. Social and family variables were: marital status, cultural level, economic and social status, type of family, stressful vital events and social support. RESULTS: Mean age was 63.51 (62.05-64.96); 66.1% were women. Predominant kind of family was nuclear (64.3%). 30.2% had low social network (0-1 social contacts). We found 22% poor functional social support. Social support remained stable throughout the study. Hypertense patients with poor social networks had, after control for possible confusing variables, their systolic pressure 9.59 mm Hg (2.6716,51) and diastolic pressure 4.29 mm Hg (0.448.15) higher than hypertense patients with broader social networks. CONCLUSION: Hypertense patients with a poor social network had higher blood pressure figures than hypertense patients with wider social networks.

[Respiratory symptoms and lung function in a geriatric population of a Galician rural community: a pilot study]. / Sintomatología respiratoria y función pulmonar en población geriátrica de una comunidad rural gallega: un estudio piloto.

INTRODUCTION: Respiratory diseases are a frequent cause of health demands and have a large impact on morbidity and mortality of the Galician population, especially among the older one. Recent work shows that the diagnosis and treatment of these diseases is not optimal. This increases the utilisation of health care resources. MATERIAL AND METHODS: We studied 28 patients of the municipality of Val del Dubra (Northwest Spain) aged between 65 and 74 years. We performed a spirometric exploration and carried out a questionnaire interview on respiratory symptoms, life style, and occupational and health-related antecedents. RESULTS: Among men, 54% of were or are smokers. None of the women ever smoked. Respiratory symptoms were more frequent among women than among men (80% versus 54%). In the spirometric study, the largest volumes and flux are observed among non-smoking males who do not report dyspnea. DISCUSSION: Respiratory symptoms are frequent in the rural population aged between 65 and 74 years. Tobacco consumption is similar to other Spanish communities, but different from that seen in other countries. Male gender, non-smoking status and absence of respiratory symptoms are associated with higher spirometric figures.

Influencia del apoyo social en pacientes con hipertensión arterial esencial / Influence of social support on patients with essential hypertension

Objetivo. Determinar si el apoyo social influye en el control de la presión arterial en pacientes diagnosticados de hipertensión arterial esencial. Diseño. Estudio observacional, prospectivo, de seguimiento a un año. Emplazamiento. Centro de saúde Mariñamansa-A Cuña. Ourense (Galicia). España. Participantes. Un total de 236 pacientes diagnosticados de hipertensión arterial esencial en control en el centro de salud. Mediciones. Durante el año de seguimiento se midieron las variables clínicas: edad, sexo, presión arterial, gravedad de la hipertensión, consumo de tabaco, consumo de alcohol, presencia de diabetes mellitus, hipercolesterolemia, índice de masa corporal y cumplimiento del tratamiento. Asimismo, se determinaron las siguientes variables sociofamiliares: estado civil, nivel cultural, nivel socioeconómico, tipo de familia, acontecimientos vitales estresantes y el apoyo social. Resultados. La edad media fue de 63,51 (rango, 62,05-64,96) años, y el 66,1 por ciento fueron mujeres. La tipología familiar predominante es la familia nuclear (64,3 por ciento).El 30,2 por ciento de los pacientes refería una baja red social (0-1 contactos sociales).Detectamos un 22 por ciento de bajo apoyo social funcional. El apoyo social se mantuvo estable a lo largo del estudio. Los hipertensos con redes sociales bajas presentan, tras controlar por las posibles variables de confusión, un incremento de la presión arterial sistólica de 9,59 mmHg (rango, 2,67-16,51) y de 4,29 mmHg (rango, 0,44-8,15) en la diastólica, respecto de los pacientes hipertensos con redes sociales más amplias. Conclusión. Los hipertensos con una baja red social presentan un incremento de las cifras de presión arterial respecto de los hipertensos con redes sociales amplias (AU)

Sintomatología respiratoria y función pulmonar en población geriátrica de una comunidad ruralgallega: un estudio piloto / Respiratory symptoms and lung function in a geriatric population of a galician rural community: a pilot study

Introducción: Las enfermedades respiratorias representan una causa frecuente de demanda sanitaria, con significativa repercusión en la morbimortalidad de la población de nuestra comunidad, en especial en la población geriátrica. Resultados de trabajos recientes muestran que el manejo diagnóstico y terapéutico de estos procesos no parece adecuado, relacionándose esto con el incremento del consumo de recursos sanitarios. Material y métodos: Se han estudiado 28 individuos del municipio de Valle del Dubra, entre 65 y 74 años. Se ha realizado una exploración espirométrica y una entrevista por cuestionario sobre síntomas respiratorios, estilo de vida, antecedentes personales sanitarios y laborales. Resultados: El 54 por ciento de los varones de esta población son o han sido fumadores, mientras nunca ha fumado ninguna de las mujeres. Los síntomas respiratorios son más frecuentes entre el sexo femenino, refiriendo algún síntoma el 80 por ciento de estas y el 54 por ciento de los varones. En la espirometría los mayores volúmenes y flujos se obtienen en el sexo masculino, entre los no fumadores y entre los que no refieren disnea. Discusión: La sintomatología respiratoria parece ser frecuente entre la población rural gallega entre 65 y 74 años. La prevalencia de tabaquismo es similar a otras comunidades de nuestro país, observándose un comportamiento distinto en poblaciones de otros países. El sexo masculino, la condición de no fumador y la ausencia de síntomas respiratorios parecen asociarse con mayores valores espirométricos (AU)

Variables familiares asociadas al incumplimiento de las citas programadas en pacientes con hipertensión arterial / Family variables linked to non-compliance with schedule appointments of patients with hypertension

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[Environmental stress and cardiovascular reactivity: the effect of stressful life events on hypertense patients]. / Estrés ambiental y reactividad cardiovascular: la influencia de los acontecimientos vitales estresantes en pacientes hipertensos.

OBJECTIVE: To assess the effect of stressful life events (SLE) on the monitoring of patients with essential hypertension. DESIGN: Observational and prospective. SETTING: Primary care. PARTICIPANTS: 236 hypertense patients selected by systematic randomised sampling. MEASUREMENTS: Age, sex, marital status, cultural level, kind of family, presence of SLE, social support, blood pressure, severity of hypertension, tobacco consumption, alcohol, presence of diabetes, hypercholesterolaemia, body mass index, compliance with hypertension treatment. RESULTS. Mean age was 63.51 (62.05; 64.96), with 66.1% being women and 33.9% men. 48.7% of the patients referred to some SLE during the follow-up. These reached a mean of 47.65 (33.16; 62.15) life change units (LCU). Patients with high-impact SLE (>150 LCU) had a significant increase of 10.91 mm Hg (0.43; 21.40) in their systolic blood pressure and of 9.48 beats per minute (3.78; 15.19) in their heart rate, after monitoring for possible factors of confusion. We observed a similar trend for diastolic pressure, but this did not reach statistical significance. CONCLUSION: The presence of SLE has a negative effect on systolic blood pressure in hypertense patients.

Estrés ambiental y reactividad cardiovascular: la influencia de los acontecimientos vitales estresantes en pacientes hipertensos / Environmental stress and cardiovascular reactivity the effect of stressful life events on hypertense patients

Objetivo. Valorar el efecto de los acontecimientos vitales estresantes (AVE) sobre el control de pacientes con hipertensión arterial esencial. Diseño. Observacional y prospectivo. Emplazamiento. Atención primaria. Participantes. Un total de 236 hipertensos seleccionados por muestreo aleatorio sistemático. Mediciones. Edad, sexo, estado civil, nivel cultural, tipo de familia, presencia de AVE, apoyo social, presión arterial, gravedad de la hipertensión, consumo de tabaco, alcohol, presencia de diabetes, hipercolesterolemia, índice de masa corporal y cumplimiento del tratamiento antihipertensivo. Resultados. La media de edad fue de 63,51 años (62,05-64,96), siendo la mayoría mujeres (66,1 por ciento). Un 48,7 por ciento de los pacientes refirieron algún AVE durante el seguimiento, y éstos alcanzaron una media de 47,65 (33,16-62,15) unidades de cambio vital (LCU). Los pacientes con AVE de alto impacto (>150 LCU) presentaron un incremento significativo de 10,91 mmHg (0,43-21,40) en la presión arterial sistólica y de 9,48 lat/min (3,78-15,19) en la frecuencia cardíaca, tras controlar por los posibles factores de confusión. Asimismo, observamos una tendencia similar respecto de la presión arterial diastólica, pero sin alcanzar significación estadística. Conclusiones. La presencia de AVE empeora el control de la presión arterial sistólica en pacientes hipertensos (AU)

[Oral health in Galician schoolchildren. 1995]. / La salud bucodental en los escolares gallegos. 1995.

BACKGROUND: To ascertain the condition of the oral hygiene of school children 6 and 12 years of age in Galicia and to assess the degree to which said condition meets the World Health Organization (WHO) oral hygiene objectives for the year 2000. METHODS: Observational cross-sectional study conducted in 1995 on a group of school children 6 and 12 years of age in Galicia selected by means of a multi-stage sampling by conglomerates, stratified by provinces and type of habitat. RESULTS: This study was conducted on 1,288 school age children, 643 in the 6-year-old group and 645 in the 12-year-old group. 46.7% of the 6 year-old children and 64.2% of the 12 year-olds were found to have cavities, which means an oc index of 1.84 and a AOC index of 1.60, respectively. CONCLUSIONS: A trend toward improvement in the oral hygiene of school-age children in Galicia has been found. The oral hygiene-related objectives recommended by the WHO for the year 2000 in the region of Europe have been accomplished, as a result of which further objectives are recommended.

[Diphtheria and poliomyelitis incidence in Europe]. / Emergencia en Europa de la difteria y la poliomelitis.

Vaccinations are considered to be one of the most protitable Public Health activities, given that almost three million deaths and four hundred thousand cases of polyomyelitis paralysis are avoided throughout the world every year. Nevertheless, in under-developed countries, especially Africa, two million children die every year from diseases that can be prevented by vaccination. This article studies the re-emergence in recent years of diphtheria in Eastern European countries (Ukrania, Russia, Belorussia, Poland, ...) and of polyomyelitis in countries with no recorded cases of the disease in many years, such as the Netherlands, Bulgaria or Transcaucasian Republics and Eastern Asian countries formerly of the Soviet Union. An anlaysis is carried out on extent and effects, the factors contributing to re-emergence and preventive measures adopted to minimise outbreaks and avoid further cases.

Smoking habits of final-year Galician medical students.

Smoking habits among final-year Galician medical students have been studied using a questionnaire complying with the recommendations of the W.H.O. and the U.I.C.C. Aspects reported include the prevalence of the smoking habit, the characteristics of smoker, drug and habit, and health problems attributed to smoking. The prevalence rate was high (61.9%); average consumption by smokers was 16 cigarettes/day; most smokers smoked cigarettes with medium-to-high nicotine and medium-to-low tar contents; and the proportion of ex-smokers was small. Smokers were found to be well aware of the dangers of smoking, and their failure to relinquish the habit is attributed to lack of social support. The role of Medical Faculties in the fight against smoking is discussed, and it is suggested that priority should be given to anti-smoking campaigns among secondary school students (14-17 year-olds) and university undergraduates, since 60% of smokers acquired the habit during the former period and 21% during the latter.