Estimación de la fracción atribuible poblacional debida a la obesidad en los ingresos hospitalarios por gripe valorada según el índice de masa corporal (IMC) y el CUN-BAE / Estimation of the population attributable fraction due to obesity in hospital admissions for flu valued according to Body Mass Index (BMI) and CUN-BAE

Introducción. La pandemia de la obesidad junto con la pandemia de gripe puede dar lugar a una importante carga de enfermedad. El índice de masa corporal (IMC) no correlaciona adecuadamente con el porcentaje de grasa corporal. El CUN-BAE es un estimador de grasa corporal para caucásicos que incluye el IMC, el sexo y la edad. El objeto de este trabajo es valorar la fracción atribuible poblacional de ingreso hospitalario por gripe debido a la grasa corporal medida con el IMC y el CUN-BAE. Metodología. Estudio multicéntrico de casos y controles. Los casos fueron ingresos hospitalarios con confirmación de gripe por PCR-RT entre 2009-2011. Empleando IMC o CUN-BAE, para cada categoría de adiposidad se calculó el riesgo de hospitalización por gripe mediante regresión logística condicional, y se estimó la fracción atribuible poblacional en el total de la muestra, en no vacunados y en menores de 65 años. Resultados. Se incluyeron 472 casos hospitalizados y 493 controles. La ORa de hospitalización por gripe, en comparación con el normopeso, se incrementó con cada nivel de IMC (ORa=1,26; 2,06 y 11,64) y de CUN-BAE (ORa=2,78; 4,29; 5,43 y 15,18). La fracción atribuible poblacional de hospitalización por gripe del CUN-BAE fue 3 veces superior que la estimada con el IMC (0,72 vs. 0,27), siendo similares las diferencias encontradas en no vacunados y en menores de 65 años. Conclusión. El IMC podría estar infraestimando la carga de enfermedad atribuible a la obesidad en la hospitalización por gripe. Se debería valorar adecuadamente el impacto de la obesidad y los criterios de recomendación vacunal

Introduction. The obesity pandemic together with the influenza pandemic could lead to a significant burden of disease. The body mass index (BMI) does not discriminate obesity appropriately. The CUN-BAE has recently been used as an estimate of body fatness for Caucasians, including BMI, gender, and age. The aim of this study is to assess the population attributable fraction of hospital admissions due to influenza, due to the body fatness measured with the BMI, and the CUN-BAE. Methods. A multicentre study was conducted using matched case-controls. Cases were hospital admissions with the influenza confirmed by the RT-PCR method between 2009 and 2011. The risk of hospital admission and the population attribuible fraction were calculated using the BMI or the CUN-BAE for each adiposity category in a conditional logical regression analysis adjusted for confounding variables. The analyzes were estimated in the total sample, in unvaccinated people, and those less than 65 years-old. Results. A total of 472 hospitalised cases and 493 controls were included in the study. Compared to normal weight, the aOR of influenza hospital admissions increases with each level of BMI (aOR=1.26; 2.06 and 11.64) and CUN-BAE (aOR=2.78; 4.29; 5.43 and 15.18). The population attributable fraction of influenza admissions using CUN-BAE is 3 times higher than that estimated with BMI (0,72 vs. 0,27), with the differences found being similar the non-vaccinated and under 65 year-olds. Conclusion. The BMI could be underestimating the burden of disease attributable to obesity in individuals hospitalised with influenza. There needs to be an appropriate assessment of the impact of obesity and vaccine recommendation criteria

[Estimation of the population attributable fraction due to obesity in hospital admissions for flu valued according to Body Mass Index (BMI) and CUN-BAE]. / Estimación de la fracción atribuible poblacional debida a la obesidad en los ingresos hospitalarios por gripe valorada según el índice de masa corporal (IMC) y el CUN-BAE.

INTRODUCTION: The obesity pandemic together with the influenza pandemic could lead to a significant burden of disease. The body mass index (BMI) does not discriminate obesity appropriately. The CUN-BAE has recently been used as an estimate of body fatness for Caucasians, including BMI, gender, and age. The aim of this study is to assess the population attributable fraction of hospital admissions due to influenza, due to the body fatness measured with the BMI, and the CUN-BAE. METHODS: A multicentre study was conducted using matched case-controls. Cases were hospital admissions with the influenza confirmed by the RT-PCR method between 2009 and 2011. The risk of hospital admission and the population attribuible fraction were calculated using the BMI or the CUN-BAE for each adiposity category in a conditional logical regression analysis adjusted for confounding variables. The analyzes were estimated in the total sample, in unvaccinated people, and those less than 65 years-old. RESULTS: A total of 472 hospitalised cases and 493 controls were included in the study. Compared to normal weight, the aOR of influenza hospital admissions increases with each level of BMI (aOR=1.26; 2.06 and 11.64) and CUN-BAE (aOR=2.78; 4.29; 5.43 and 15.18). The population attributable fraction of influenza admissions using CUN-BAE is 3 times higher than that estimated with BMI (0,72 vs. 0,27), with the differences found being similar the non-vaccinated and under 65 year-olds. CONCLUSION: The BMI could be underestimating the burden of disease attributable to obesity in individuals hospitalised with influenza. There needs to be an appropriate assessment of the impact of obesity and vaccine recommendation criteria.

[Smoking in schools. A cross-sectional epidemiologic study of a population of 4,281 school children]. / Tabaquismo escolar. Estudio epidemiológico transversal en una población de 4.281 escolares.

Smokers begin to acquire their habit early. The objective of this study was therefore to determine real smoking habits among young people in Spain and create a profile of the adolescent smoker. A questionnaire was administered to a cross-section of the population. The results obtained coincide with reports by other authors in the Spanish and international literature. We found that the prevalence of smoking among young people between 9 and 19 years of age is approximately 25% and tobacco use increases with age. Young smokers participate less in sports and have a greater tendency to approve tobacco advertising. Young smokers' reasons for starting to smoke are diverse and the notion of "being grown-up" did not appear to apply to our cohort. We discuss, in the light of recent findings, the role of parents and social context in encouraging young people to smoke. The age of 14 is a key moment for taking up and establishing the habit of smoking.

[Pulmonary carcinoma associated with bullous emphysema]. / Carcinoma pulmonar asociado a enfisema bulloso.

Malignant complication of pulmonary bullous disease is rare but not negligible. Its importance lies in the young age when it appears. Eighty-nine cases in the literature, including four of our own cases, are included in this review. Etiopathogenic theories are discussed along with clinical, radiological, pathological, diagnostic, prognostic, and treatment characteristics. Smoking is a primary factor in this process, and quitting is key in terms of prevention. Surgical methods are usually necessary to perform the diagnosis, but that does not exclude the use of other techniques-particularly, fine-needle aspiration biopsy under radiological control-whose role should be validated. The prognosis is bad if there is no commitment to prevention. Even though the value of serial radiological controls is unknown, such controls may help in the early detection of neoplastic degeneration in bullous disease. The nature of the problem in handling these cases therapeutically is determined by the severity of bullous dystrophy: therefore, surgery should be considered on an individual basis.