[Diurnal variability of intraocular pressure]. / Variabilidad diurna de la presión intraocular.

OBJECTIVE: To assess whether there are variations in the intraocular pressure (IOP) between the morning and afternoon in healthy subjects. METHODS: This study was carried out in a Primary Care Health Center among usual patients of general practitioners. Two measurements of the intraocular pressure were assessed on the same day (between 8 and 9 a.m. and between 5 and 6 p.m.) using a Perkins applanation tonometer. The subjects (119 females and 101 males) had a mean age of 46.3 years, with ages ranging between 14 and 83 years. They were proportionally distributed among 4 age groups (14-24, 25-44, 45-64 and >65 years). RESULTS: The IOP mean values were: right eye, morning time and afternoon, 13.29 and 11.81 mm Hg, respectively (p<0.001); left eye, morning time and afternoon, 13.48 and 12.04 mm Hg (p<0.001). The IOP was significantly higher in males than in females, and showed a weak association with age. CONCLUSIONS: We found a diurnal variation of IOP of approximately 1.5 mm Hg. The time of day when the IOP is measured needs to be considered as a variable in research in ocular hypertension and glaucoma.

[Prevalence of chronic obstructive pulmonary disease and risk factors in smokers and ex-smokers]. / Prevalencia y factores de riesgo de EPOC en fumadores y ex fumadores.

OBJECTIVE: To estimate the prevalence of chronic obstructive pulmonary disease (COPD) in smokers and ex-smokers over 40 years of age and describe the associated risk factors. MATERIAL AND METHODS: A cross-sectional descriptive study at primary care level in which 444 current or ex-smokers 40 years of age or older were enrolled. Spirometry was performed with all subjects. If the ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) was less than 70%, a bronchodilator test was performed and spirometry was repeated after 2 inhalations of terbutaline (500 g/dose). If the FEV1/FVC ratio continued to be less than 70% and FEV1 less than 80% of predicted, COPD was diagnosed. Age, sex, smoking, age smoking began, index of smoking history (packs per day x year) and attempts to quit smoking were also recorded. RESULTS: The patients' mean age was 53.5 years and 65.8% were men. At the time of the study, 248 subjects (55.9%) were current smokers. The median age smoking began was 16.5 years and the median pack-years index was 26.7. At least 1 attempt to quit had been made by 72.1% of the patients. COPD was diagnosed in 70 subjects (24 with the diagnosis previously established), representing a prevalence of 16.4% (95% confidence interval, 12.9-19.9). COPD was serious in 10%. A multifactorial analysis indicated that age and smoking history in pack-years were significantly associated with COPD. CONCLUSIONS: The prevalence of COPD in our study is slightly higher than in other studies, although selection bias may have affected our results given that we were unable to contact 11.9% of the population sample. Almost two thirds of cases had not been previously diagnosed. Two major risk factors are age and cumulative tobacco consumption.