Evolution of the incidence of type 1 diabetes mellitus in the Community of Madrid, 1997-2016.

INTRODUCTION: The objective of this article was to estimate the type 1 diabetes mellitus (T1DM) incidence in the child population of the Community of Madrid (CM) and its evolution between 1997 and 2016, using the medical-administrative data of the regional registry of T1DM. METHODS: T1DM cases of children under 15 years of age, reported to the regional registry or collected from secondary sources were included: Spanish Diabetics Association (1997-2013), and from 2014 on the Basic Minimum Data Set (BMDS). Annual incidence rates were estimated per 100 000 person-years. The comparison of the rates was analysed using Poisson regression models using incidence ratios (IR). RESULTS: A total of 2658 cases were identified as new diagnoses of T1DM. The mean incidence rate for 1997-2013 was 13.7 cases per 100 000 person-years. In the 2014-2016 period, 20 cases per 100 000 persons-years were registered using the BMDS. The age group with the highest incidence was 10-14 years in the two periods (16.6 vs. 25.5). In boys, the age with the highest incidence was 10-14 years in both periods (17.9 vs 30.4), and in girls, the age of 5-9 years (17.0 vs 25.1). Incidence rates decreased slightly in both genders until 2013 (from 15.0 to 11.6). In 2014-2016, the annual incidence rate varied between 18.4 and 21.1 cases (IR: 1.77). The incidence remained stable in children under 5 years old and increased from 5 to 14 years old. CONCLUSIONS: The CM is among the regions with a high incidence of T1DM. In its first phase, the regional registry underestimated the incidence of T1DM, and with the incorporation of the MBDS as a source of information, the estimates for the second period (2014-2016) are possibly closer to the actual incidence of T1DM. The data presented suggests the need to know the real evolution of the incidence of the disease by incorporating computerised health records.

[Evolution of the incidence of type 1 diabetes mellitus in the Community of Madrid, 1997-2016]. / Evolución de la incidencia de diabetes mellitus tipo 1 (0-14 años) en la Comunidad de Madrid, 1997-2016.

INTRODUCTION: The objective of this article was to estimate the type 1 diabetes mellitus (DM1) incidence in the child population of the Community of Madrid (CM) and its evolution between 1997 and 2016, using the medical-administrative data of the regional registry of DM1. METHODS: DM1 cases of children under 15 years of age, reported to the regional registry or collected from secondary sources were included: Spanish Diabetics Association (1997-2013), and from 2014 on the Basic Minimum Data Set (BMDS). Annual incidence rates were estimated per 100 000 person-years. The comparison of the rates was analysed using Poisson regression models using incidence ratios (IR). RESULTS: A total of 2658 cases were identified as new diagnoses of DM1. The mean incidence rate for 1997-2013 was 13.7 cases per 100 000 person-years. In the 2014-2016 period, 20 cases per 100 000 persons-years were registered using the BMDS. The age group with the highest incidence was 10-14 years in the 2periods (16.6 vs. 25.5). In boys, the age with the highest incidence was 10 to 14 years in both periods (17.9 vs 30.4), and in girls, the age of 5 to 9 years (17.0 vs 25.1). Incidence rates decreased slightly in both genders until 2013 (from 15.0 to 11.6). In 2014-2016, the annual incidence rate varied between 18.4 and 21.1 cases (IR: 1.77). The incidence remained stable in children under 5 years old and increased from 5 to 14 years old. CONCLUSIONS: The CM is among the regions with a high incidence of DM1. In its first phase, the regional registry underestimated the incidence of DM1, and with the incorporation of the MBDS as a source of information, the estimates for the second period (2014-2016) are possibly closer to the actual incidence of DM1. The data presented suggests the need to know the real evolution of the incidence of the disease by incorporating computerised health records.

[Incidence of type 1 diabetes mellitus in children: results from the population registry of the Madrid Region, 1997-2005]. / Incidencia de diabetes mellitus tipo 1 en niños: resultados del registro poblacional de la Comunidad de Madrid, 1997-2005.

BACKGROUND AND OBJECTIVE: Incidence of type 1 diabetes mellitus (DM) varies importantly worldwide, including European countries, and even among regions within a country. The aim of this study is to describe the incidence of type 1 DM in the Madrid Region. MATERIAL AND METHOD: We included 1130 new cases of type 1 DM in children below 15 years of age, which were notified to the diabetes registry from January, 1997 to December, 2005. Case ascertainment was evaluated through the capture-recapture method. The data was analysed using Poisson regression models. RESULTS: The incidence rate in this period was 15.9/100,000 persons-years (95% confidence interval, 15.0-16.8). Completeness of ascertainment was 82%. The incidence by age group was 12.1 (0-4 years), 18.2 (5-9 years) and 17.4 by 100,000 persons-years (10-14 years). The incidence data showed no significant changes in the studied period. We observed a seasonal variation in the incidence, with the greatest incidence in the cold months. CONCLUSIONS: The estimated incidence of type 1 DM ranks in an intermediate position with regard to that estimated more recently in other Spanish regions. During the period 1997-2005, the incidence has maintained stable in the Madrid Region.

Evolución de la incidencia de diabetes mellitus tipo 1 (0-14 años) en la Comunidad de Madrid, 1997-2016 / Evolution of the incidence of type 1 diabetes mellitus in the Community of Madrid, 1997-2016

Introducción: El objetivo fue estimar la incidencia de diabetes tipo 1 (DM1) en la población infantil de la Comunidad de Madrid (CM) y su evolución entre 1997 y 2016, a partir de los datos médicos-administrativos del registro regional de DM1. Métodos: Fueron incluidos los casos de DM1 de menores de 15 años, notificados al registro regional o captados de fuentes secundarias: Asociación Diabéticos Españoles (1997-2013) y a partir de 2014 del conjunto mínimo básico de datos (CMBD) hospitalario. Se estimaron las tasas de incidencia anual por 100.000 personas-año. La comparación de las tasas se analizó mediante modelos de regresión de Poisson a través de razones de incidencia (RI). Resultados: Un total de 2658 casos fueron identificados como nuevos diagnósticos de DM1. La tasa de incidencia media de 1997-2013 fue de 13,7 casos por 100.000 personas-año. En el periodo 2014-2016, utilizando el CMBD se registraron 20,0 casos por 100.000. El grupo de edad con mayor incidencia fue el de 10-14 años en los 2periodos (16,6 vs. 25,5). En los niños, la edad de mayor incidencia fue de 10 a 14 años en ambos periodos (17,9 vs. 30,4) y en las niñas el de 5 a 9 años (17,0 vs. 25,1). Las tasas de incidencia descendieron ligeramente en ambos sexos hasta 2013 (de 15,0 a 11,6); en 2014-2016 la tasa de incidencia anual varió entre 18,4 y 21,1 casos (RI: 1,77). La incidencia permaneció estable en menores de 5 años y aumentó de 5 a 14 años. Conclusiones: La CM se sitúa entre las regiones de alta incidencia de DM1. En su primera fase, el registro regional infraestimaba la incidencia de DM1. Con la incorporación del CMBD como fuente de información, las estimaciones del segundo periodo (2014-2016) son posiblemente más próximas a la incidencia real de DM1. Los datos que presentamos sugieren la necesidad de conocer la evolución real de la incidencia de la enfermedad incorporando los registros digitales sanitarios. (AU)

Introduction: The objective of this article was to estimate the type 1 diabetes mellitus (DM1) incidence in the child population of the Community of Madrid (CM) and its evolution between 1997 and 2016, using the medical-administrative data of the regional registry of DM1. Methods: DM1 cases of children under 15 years of age, reported to the regional registry or collected from secondary sources were included: Spanish Diabetics Association (1997-2013), and from 2014 on the Basic Minimum Data Set (BMDS). Annual incidence rates were estimated per 100 000 person-years. The comparison of the rates was analysed using Poisson regression models using incidence ratios (IR). Results: A total of 2658 cases were identified as new diagnoses of DM1. The mean incidence rate for 1997-2013 was 13.7 cases per 100 000 person-years. In the 2014-2016 period, 20 cases per 100 000 persons-years were registered using the BMDS. The age group with the highest incidence was 10-14 years in the 2periods (16.6 vs. 25.5). In boys, the age with the highest incidence was 10 to 14 years in both periods (17.9 vs 30.4), and in girls, the age of 5 to 9 years (17.0 vs 25.1). Incidence rates decreased slightly in both genders until 2013 (from 15.0 to 11.6). In 2014-2016, the annual incidence rate varied between 18.4 and 21.1 cases (IR: 1.77). The incidence remained stable in children under 5 years old and increased from 5 to 14 years old. Conclusions: The CM is among the regions with a high incidence of DM1. In its first phase, the regional registry underestimated the incidence of DM1, and with the incorporation of the MBDS as a source of information, the estimates for the second period (2014-2016) are possibly closer to the actual incidence of DM1. The data presented suggests the need to know the real evolution of the incidence of the disease by incorporating computerised health records. (AU)

[Health impact evaluation of particle air pollution in five Spanish cities. European APHEIS project]. / Evaluación en cinco ciudades españolas del impacto en salud de la contaminación atmosférica por partículas. Proyecto europeo APHEIS.

BACKGROUND: The health effects of air pollution have been analyzed in numerous studies over recent years, thus having made it possible to quantify the relationship between the two. This study is aimed at analyzing the theoretical benefits which would be achieved by meeting the air quality objectives set forth under EC Directive 1999/30/EC with regard to suspended particles. METHODS: The exposure measurement was taken for Black Smoke (Barcelona, Bilbao, Valencia) and suspended particles under 10 microm (PM10) (Bilbao, Madrid y Sevilla). The health indicators calculated were the mortality due to all causes and respiratory and cardiovascular causes, and emergency hospital admissions and mortality due to respiratory and cardiovascular causes. In the case of PM10 the impact has been calculated because its effects to short-term, within a period of up to 40 days following exposure, and to long-term. For Black Smoke the effects only has been calculated to short-term. RESULTS: The daily levels of PM10 from exceeding 50 microg/m3 in Bilbao, Madrid and Sevilla cause the earlier death of 1.4/100,000 individuals per year because its effects. The effect within a period of up to 40 days following exposure is of 2.8 deaths/100,000. The total number of deaths per year which may be later due to long-term exposure if the yearly average is lowered to 20 microg/m3 is 68/100,000. CONCLUSIONS: The health impact of the current air pollution levels is quantifiable and is not insignificant. APHEIS and the impact evaluations may be of aid in healthcare planning and environmental policies.

[The Madrid autonomous community epidemiological bulletin. A survey on its dissemination and opinion thereof on among primary care physicians for the year 2000]. / Boletín epidemiológico de la Comunidad de Madrid: encuesta sobre su difusión y percepción entre los médicos de atención primaria en el año 2000.

BACKGROUND: The Autonomous Community of Madrid Epidemiological Bulletin is the main communications link between epidemiological monitoring system and health care professionals. The purpose of this study is that of ascertaining the dissemination and opinion of this Autonomous Community of Madrid Epidemiological Bulletin among primary care physicians for the purpose of adapting this publication to its readers' interests. METHOD: A telephone survey among primary care physicians in the Autonomous Community of Madrid, asking how often they read the Bulletin, the interest and usefulness of the information included in it. The sample size was estimated at 346 physicians. A two-stage sampling process was carried out-by cluster sampling in the first stage, randomly selecting 125 health care centers and 2.7 physicians per center, 17% being primary care team coordinators. A comparison is made of the results among physicians and coordinators by means of the Chi-square and Fisher's Exact Test method, with Epi-Info v.6. RESULTS: A total of 305 surveys were conducted (245 physicians and 60 coordinators). There was an awareness of the existence of the Autonomous Community of Madrid Epidemiological Bulletin on the part of 91.5% (CI 95%: 88.1-94.8), and 27.2% (CI 95%: 21.9-32.5) were familiar with more than 50% of the last issues published. A total of 92.4% (CI 95%: 89.4-95.8) considered the Bulletin to be interesting or highly interesting, grading its usefulness an average of 3.5 on a maximum scale of 5. Of the permanent sections, the most highly-valued was Epidemic Outbreaks, those reports related to meningococcal infection, tuberculosis and HIV/AIDS being the most highly-valued. CONCLUSIONS: The Autonomous Community of Madrid Epidemiological Bulletin is a publication which, although not widely-known by the primary care physicians in the Community, is well-valued when it is read, thus being a useful feedback tool within the Epidemiological Monitoring System.

[Validity and concordance of electronic health records in primary care (AP-Madrid) for surveillance of diabetes mellitus. PREDIMERC study]. / Validez y concordancia de la historia clínica electrónica de atención primaria (AP-Madrid) en la vigilancia epidemiológica de la diabetes mellitus. Estudio PREDIMERC.

OBJECTIVE: To assess the validity and concordance of diabetes data in the electronic health records of primary care (Madrid-PC) by comparing with those from the PREDIMERC study. METHODS: The sensitivity, specificity, positive predictive value, negative predictive value and kappa index of diabetes cases recorded in the health records of Madrid-PC were calculated by using data from PREDIMERC as the gold standard. The prevalence of diabetes was also determined according to each data source. RESULTS: The sensitivity of diabetes recorded in Madrid-PC was 74%, the specificity was 98.8%, the positive predictive value was 87.9%, the negative predictive value was 97.3%, and the kappa index was 0.78. The prevalence of diabetes recorded in Madrid-PC was 6.7% versus 8.1% by PREDIMERC, where known diabetes was 6.3%. CONCLUSIONS: The electronic health records of primary care are a valid source for epidemiological surveillance of diabetes in Madrid.

[Prevalence, degree of control and treatment of hypertension in the adult population of Madrid, Spain]. / Prevalencia, grado de control y tratamiento de la hipertensión arterial en la población de 30 a 74 años de la Comunidad de Madrid: Estudio PREDIMERC.

BACKGROUND: Hypertension (HT) is a major modifiable cardiovascular risk factors. The objective of this study is to estimate the adult population of the Community of Madrid (30-74 years) prevalence of hypertension, knowledge, degree of control and drug treatment. METHODS: We studied a random sample population in 2007 among residents of Madrid Community of between 30 and 74 years, obtained by cluster sampling. An epidemiological questionnaire was applied through telephone interview. Physical examination was conducted by a team of trained nurses in the health center. To assess control of hypertension by number of active ingredients odds were calculated through logistic regression models. RESULTS: The final sample included 1,085 men and 1,183 women with a mean age of 48.3 years. The prevalence of hypertension was 29.3% (35.1% men and 23.9% in women (p<0.01). Of the 665 hypertensives identified 68.6% knew their condition (62.4 76.65% in males and females, p<0.05), of which 54% were in drug treatment (45.4% in men and 64.5% in women, p<0.05). Of the 265 treated hypertensive patients, blood pressure was controlled in 33% of males and 49% of women, p<0.05. Patients treated with two or more active improves your control (aOR: 1, 89). CONCLUSIONS: Our data on prevalence, treatment and control are at the lower-intermediate between those reported in previous studies on Spanish and European populations. However, the HA is a public health problem in the CM. Many hypertensive patients are not detected. Of those detected, only 1 in 3 of men and 1 in 2 women are well controlled.

[Prevalence of diabetes mellitus and cardiovascular risk factors in the adult population of the autonomous region of Madrid (Spain): the PREDIMERC study]. / Prevalencia de diabetes mellitus y factores de riesgo cardiovascular en la población adulta de la Comunidad de Madrid: estudio PREDIMERC.

OBJECTIVE: To describe the prevalence of diabetes and major cardiovascular risk factors in the adult population of the autonomous region of Madrid (Spain). MATERIAL AND METHOD: A population-based cross-sectional study was carried out in 2007. A random sample of the population aged 30-74 years old was selected. A fixed sample size per age stratum was assigned, weighted by the real age-specific distribution of the population of the autonomous region of Madrid. An epidemiological survey was conducted by telephone. Subsequently, physical examination was performed and a fasting blood sample was taken in the health center for glucose, cholesterol and lipid fraction determinations. RESULTS: We included 2268 people with a mean age of 48.3 years old (52% women). The response rate was 56.4%. Diabetes was found in 8.1% (95%CI: 7.0-8.9) of the adult population and impaired fasting glucose was found in 5.9% (95%CI: 4.8-6.1). The prevalence of risk factors was as follows: hypertension in 29.3% (95%CI: 27.3-31.5), hypercholesterolemia in 23.3% (95%CI: 21.8-26.1), overweight grade II in 22.8% (20.8-25.0), obesity in 21.7% (95%CI: 19.8-23.6), and central obesity in 23.9% (95%CI: 21.8-26.1). A total of 85.5% (95%CI: 83.1-87.1) were sedentary in their leisure time and 28.4% (95%CI: 26.3-30.3) were smokers. CONCLUSIONS: The prevalence of diabetes in the autonomous region of Madrid is intermediate in relation to other regions of Spain. Cardiovascular risk factors are highly prevalent, and are higher in men than in women. Overweight and obesity, affecting 4.5 out of every 10 adults, should be considered a priority for health interventions in cardiovascular disease prevention.

Validez y concordancia de la historia clínica electrónica de atención primaria (AP-Madrid) en la vigilancia epidemiológica de la diabetes mellitus. Estudio PREDIMERC / Validity and concordance of electronic health records in primary care (AP-Madrid) for surveillance of diabetes mellitus. PREDIMERC study

Objetivo. Estudiar la validez y la concordancia de los datos de diabetes en la historia clínica electrónica de atención primaria (AP-Madrid) comparándola con el estudio PREDIMERC. Métodos. En una muestra poblacional de 2268 individuos se calcularon la sensibilidad, la especificidad, el valor predictivo positivo, el valor predictivo negativo y el índice kappa de los casos de diabetes registrados en la historia clínica AP-Madrid, comparándolos con el estudio PREDIMERC (como referencia). Se estimó la prevalencia de diabetes según cada fuente de información. Resultados. La sensibilidad para la diabetes registrada en AP-Madrid fue del 74%, la especificidad del 98,8%, el valor predictivo positivo del 87,9%, el valor predictivo negativo del 97,3% y el índice kappa de 0,78. La prevalencia de diabetes registrada fue del 6,7%, frente al 8,1% de PREDIMERC, siendo la diabetes conocida del 6,3%. Conclusiones. La AP-Madrid es un sistema de información válido para realizar estudios de vigilancia epidemiológica de diabetes en la Comunidad de Madrid (AU)

Objective. To assess the validity and concordance of diabetes data in the electronic health records of primary care (Madrid-PC) by comparing with those from the PREDIMERC study. Methods. The sensitivity, specificity, positive predictive value, negative predictive value and kappa index of diabetes cases recorded in the health records of Madrid-PC were calculated by using data from PREDIMERC as the gold standard. The prevalence of diabetes was also determined according to each data source. Results. The sensitivity of diabetes recorded in Madrid-PC was 74%, the specificity was 98.8%, the positive predictive value was 87.9%, the negative predictive value was 97.3%, and the kappa index was 0.78. The prevalence of diabetes recorded in Madrid-PC was 6.7% versus 8.1% by PREDIMERC, where known diabetes was 6.3%. Conclusions. The electronic health records of primary care are a valid source for epidemiological surveillance of diabetes in Madrid (AU)

Prevalencia, grado de control y tratamiento de la hipertensión arterial en al población de 30 a 74 años de la Comunidad de Madrid. estudio Predimerc / Prevalence, degree of control and treatment of hypertension in the adult population of Madrid, Spain

Fundamentos: La hipertensión arterial (HTA) es uno de los principales factores de riesgo cardiovascular modificables. El objetivo del estudio es estimar en la población de 30 a 74 años de la Comunidad de Madrid (CM) la prevalencia de hipertensión arterial, el nivel de conocimiento y tratamiento farmacológico, y grado de control. Métodos: Estudio transversal de una muestra poblacional en 2007 entre los residentes en la Comunidad Madrid de entre 30 y 74 años, obtenida por muestreo aleatorio por conglomerados bietápico. Se aplicó un cuestionario epidemiológico por vía telefónica. En el centro de salud se realizó la exploración física por un equipo de enfermeras entrenadas. Para las variables cuantitativas se han calculado las medias e intervalos de confianza del 95% (IC del 95%) y para las cualitativas el porcentaje y el IC del 95% . Para evaluar el control de la HTA según número de principios activos se calcularon las Odds ratio mediante regresión logística. Resultados: La muestra definitiva incluyó a 1.085 hombres y 1.183 mujeres, con una edad media de 48,3 años. La prevalencia de hipertensión fue de 29,3% (IC95%:27,3-31,5) (35,1% en hombres y 23,9% en mujeres (p<0,01). De las 665 personas hipertensas detectadas el 68,6% conocía su condición (62,4% los varones y 76,65 las mujeres, p<0,05) de los cuales el 54% estaba en tratamiento farmacológico (45,4% los varones y 64,5% las mujeres, p<0,05). De las 265 personas hipertensas en tratamiento tenían controlada la tensión arterial el 33% de los varones frente al 49% de las mujeres (p<0,05). Las personas tratadas con dos o más principios activos mejoraron su control frente a las tratadas con monoterapia [ORa: 1,89; (IC95%:1,09-33,27)]. Conclusiones: Nuestras cifras de prevalencia, tratamiento y control ocupan un lugar intermedio-bajo entre las publicadas en estudios previos sobre poblaciones españolas y europeas. Sin embargo la HTA es un problema de salud pública en la CM. Un porcentaje importante de personas hipertensas no están diagnosticadas. De los hipertensos que conocen su diagnóstico y reciben tratamiento sólo 1 de cada 3 varones y una de cada 2 mujeres están bien controlados(AU)

Background: Hypertension (HT) is a major modifiable cardiovascular risk factors. The objective of this study is to estimate the adult population of the Community of Madrid (30-74 years) prevalence of hypertension, knowledge, degree of control and drug treatment. Methods: We studied a random sample population in 2007 among residents of Madrid Community of between 30 and 74 years, obtained by cluster sampling. An epidemiological questionnaire was applied through telephone interview. Physical examination was conducted by a team of trained nurses in the health center. . ; To assess control of hypertension by number of active ingredients Odds were calculated through logistic regression models. Results: The final sample included 1,085 men and 1,183 women with a mean age of 48.3 years. The prevalence of hypertension was 29.3% (35.1% men and 23.9% in women (p <0.01). Of the 665 hypertensives identified 68.6% knew their condition (62.4 76.65% in males and females, p <0.05), of which 54% were in drug treatment (45.4% in men and 64.5% in women, p <0.05). Of the 265 treated hypertensive patients, blood pressure was controlled in 33% of males and 49% of women, p <0.05. Patients treated with two or more active improves your control (aOR: 1, 89). Conclusions: Our data on prevalence, treatment and control are at the lower-intermediate between those reported in previous studies on Spanish and European populations. However, the HA is a public health problem in the CM. Many hypertensive patients are not detected. Of those detected, only 1 in3 of men and 1 in 2 women are well controlled(AU)

Smoking attributable mortality in the community of Madrid: 1992-1998.

BACKGROUND: The proportion of smokers and the number of cigarettes consumed per person-year in Madrid is above the European average. To evaluate the impact of smoking in public health smoking attributable mortality was estimated for 1998 and for changes since 1992. METHODS: The number of smoking attributable deaths and years of potential life lost attributable to cigarette smoking for 1992 and 1998 by gender and age group were estimated, based on the population attributable fraction. The relative risks of the Cancer Prevention Study II were used. To compare the two periods of study, a Poisson regression analysis adjusted by age was applied. RESULTS: In 1998, 15.9% of total mortality in the population older than 34 years was attributable to smoking. Lung cancer and chronic obstructive pulmonary disease are the main causes of death in both genders. In the period studied, 1992-1998, the adjusted rates diminished in men in both age groups, while in women they increased in the age group 35 to 64 years. The mortality from lung cancer remained stable in men, increasing in women by 12%. The years of potential life lost decreased by 14% in men and increased by 42% in women. CONCLUSIONS: One in four deaths in men and one in 36 deaths in women are attributed to cigarette smoking. The smoking attributable mortality in males has tended to stabilize, while in women premature mortality is increasing. KEY POINTS: Smoking attributable mortality was estimated for 1998 and for changes since 1992 to evaluate the impact of smoking in the population older than 34 years. MAIN RESULTS: In the period studied, 1992-1998, the adjusted mortality rates attributable to smoking diminished in men, while in women they increased in the age group 35 to 64 years. The main causes of Smoking attributable mortality are Lung cancer and chronic obstructive pulmonary disease in both genders. The mortality from lung cancer remained stable in men, increasing in women by 12%. IMPLICATIONS FOR PUBLIC HEALTH: In the Community of Madrid, health promotion programmes to reduce cigarette smoking need to be intensified, specially in women.

Prevalencia de diabetes mellitus y factores de riesgo cardiovascular en la población adulta de la Comunidad de Madrid: estudio PREDIMERC / Prevalence of diabetes mellitus and cardiovascular risk factors in the adult population of the autonomous region of Madrid (Spain): the PREDIMERC study

ObjetivoDeterminar la prevalencia de diabetes y los principales factores de riesgo cardiovascular en la población adulta de la Comunidad de Madrid.Material y métodoEstudio transversal de base poblacional en el año 2007. Se seleccionó una muestra aleatoria representativa de la población de 30–74 años, con un tamaño muestral fijo para cada estrato de edad, ponderando los resultados según la estructura por edad de la Comunidad de Madrid. Se realizó una encuesta telefónica. Posteriormente, en el centro de salud se efectuó la exploración física y la extracción de sangre en ayunas para determinar la glucemia, el colesterol y las fracciones lipídicas.ResultadosSe incluyeron 2.268 personas con una edad media de 48,3 años; el 52% eran mujeres. La tasa de respuesta fue del 56,4%. El 8,1% (intervalo de confianza del 95% [IC95%]: 7,0–8,9) de la población presenta diabetes y el 5,9% (IC95%: 4,8–6,1) una glucemia basal alterada. El 29,3% (IC95%: 27,3–31,5) tiene hipertensión arterial y el 23,3% (IC 95%: 21,4–25,2) hipercolesterolemia. El 22,8% (IC95%: 20,8–25,0) presenta sobrepeso de grado II, el 21,7% (IC95%: 19,8–23,6) obesidad y el 23,9% (IC95%: 21,8–26,1) obesidad abdominal. El 85,5% (IC95%: 83,1–87,1) eran sedentarios en tiempo libre y el 28,4% (IC95%: 26,3–30,3) fumadores.ConclusionesLa prevalencia de diabetes mellitus en la Comunidad de Madrid se sitúa en una posición intermedia con respecto a otras comunidades autónomas. Los principales factores de riesgo cardiovascular tienen una elevada prevalencia. El sobrepeso de grado II y la obesidad, que afectan a 4,5 de cada 10 adultos, representan una prioridad de intervención en la prevención de la diabetes y la enfermedad cardiovascular(AU)

ObjectiveTo describe the prevalence of diabetes and major cardiovascular risk factors in the adult population of the autonomous region of Madrid (Spain).Material and methodA population-based cross-sectional study was carried out in 2007. A random sample of the population aged 30–74 years old was selected. A fixed sample size per age stratum was assigned, weighted by the real age-specific distribution of the population of the autonomous region of Madrid. An epidemiological survey was conducted by telephone. Subsequently, physical examination was performed and a fasting blood sample was taken in the health center for glucose, cholesterol and lipid fraction determinations.ResultsWe included 2268 people with a mean age of 48.3 years old (52% women). The response rate was 56.4%. Diabetes was found in 8.1% (95%CI: 7.0–8.9) of the adult population and impaired fasting glucose was found in 5.9% (95%CI: 4.8–6.1). The prevalence of risk factors was as follows: hypertension in 29.3% (95%CI: 27.3–31.5), hypercholesterolemia in 23.3% (95%CI: 21.8–26.1), overweight grade II in 22.8% (20.8–25.0), obesity in 21.7% (95%CI: 19.8–23.6), and central obesity in 23.9% (95%CI: 21.8–26.1). A total of 85.5% (95%CI: 83.1–87.1) were sedentary in their leisure time and 28.4% (95%CI: 26.3–30.3) were smokers.ConclusionsThe prevalence of diabetes in the autonomous region of Madrid is intermediate in relation to other regions of Spain. Cardiovascular risk factors are highly prevalent, and are higher in men than in women. Overweight and obesity, affecting 4.5 out of every 10 adults, should be considered a priority for health interventions in cardiovascular disease prevention(AU)

Ingesta de alimentos, energía y nutrientes en la población de 5 a 12 años de la Comunidad de Madrid: resultados de la encuesta de nutrición infantil 2001-2002 / Food, energy and nutrient intake in children aged 5-12 in the autonomous community of Madrid, Spain: results of the 2001/2002 children’s nutrition survey

Fundamento: Para conocer la situación alimentaria y nutricionalen la población infantil, sobre la que no existía información actualizada,el Instituto de Salud Pública desarrolló la Encuesta de NutriciónInfantil de la Comunidad de Madrid 2001/2002 (ENICM). En estetrabajo se analiza la ENICM para describir y evaluar la ingesta de alimentos,energía y nutrientes en esta población.Métodos: Estudio transversal sobre una muestra representativa dela población de 5-12 años de la Comunidad de Madrid. La informaciónalimentaria se recogió en 2001 y 2002 mediante dos recuerdos de24 horas. Se ha estudiado la ingesta total diaria de alimentos, energíay nutrientes. Los análisis incluyen los 1.852 niños con informacióncompleta en los dos recuerdos (90,8% de las entrevistas realizadas).Resultados: La ingesta media total diaria de alimentos es1.460,7 gramos/persona/día. Salvo para los lácteos, huevos y aceites,la ingesta en los grupos alimentarios básicos es inadecuada, particularmentebaja en las frutas frescas, verduras y hortalizas. La ingestamedia energética y nutricional resultante es 1.905,9 kcal/persona/día;43,6% hidratos de carbono; 17,4% proteínas, 39,0% lípidos (13,3%grasas saturadas, 16,8% monoinsaturadas, 5,0% poliinsaturadas);363,8 mg de colesterol; 13,6 g de fibra e ingestas por debajo de lasrecomendadas de zinc, ácido fólico, vitaminas D y E (ambos sexos) yhierro y vitamina B6 (niñas).Conclusiones: La dieta de la población infantil de la Comunidadde Madrid presenta desequilibrios que es necesario mejorar: ingestainadecuada de alimentos básicos, exceso de proteínas, grasas saturadasy colesterol y déficit de hidratos de carbono, fibra y algunosmicronutrientes(AU)

Backgound: In order to ascertain the food intake and nutritionalsituation of the children of the Community of Madrid, on which noupdated information was available, the Institute of Public Healthconducted the 2001/2001 Children’s Nutrition Survey of theCommunity of Madrid (CNSCM). This study offers an analysis of theCNSCM that describes and evaluates the food, energy and nutrientintake of this segment of the population.Methods: Cross-sectional survey on a representative sample ofchildren aged 5-12 years from the Community of Madrid. Dietrelatedinformation was collected in 2001 and 2002 by means of two24-hour recalls. Total daily food, energy and nutrient intake werestudied. The analysis included only the 1852 children who hadcompleted both 24-h recalls (90.8% of all interviews).Results: The average daily food intake is 1460.7grams/person/day. Except for dairy products, eggs and oils, intakefrom the basic food groups is inadequate, and is particularly low forfresh fruits, green leafy vegetables and garden vegetables in general.The resulting average energy and nutrition intake is 1905.9kcal/person/day; 43.6% carbohydrates, 17.4% proteins, 39.0% fats(13.3% saturated fats, 16.8% monosaturated fats, 5.0%polyunsaturated fats); 363.8 mg cholesterol, 13.6 g of fiber and lowerthan recommended intakes of zinc, folic acid, vitamins D and E (bothsexes) and iron and vitamin B6 (girls).Conclusions: The diet of the children of the Community ofMadrid shows a number of imbalances that should be improved:inadequate intake from basic food groups; excess of proteins,saturated fats and cholesterol; and a deficit of carbohydrates, fiberand certain micronutrients(AU)

Evaluación en cinco ciudades españolas del impacto en salud de la contaminación atmosférica por partículas. Proyecto europeo APHEIS / Health impact evaluation of particle air pollution in five spanish cities. European APHEIS project

Fundamento: Los efectos de la contaminación atmosféricasobre la salud han sido objeto en los últimos años de numerosos estudiosque han permitido cuantificar la asociación entre ambas El objetivode este trabajo es llevar a cabo la Evaluación del Impacto enSalud (EIS) calculando los beneficios que se obtendrían al cumplirlos objetivos establecidos por la Directiva 1999/30/CE en relacióncon las partículas en suspensión.Métodos: Se ha valorado el impacto en salud de la contaminación atmosférica por partículas en suspensión, para lo que se han utilizadodos indicadores distintos: Humos Negros (HN) (Barcelona,Bilbao, Valencia) y partículas en suspensión menores de 10 mm(PM10) (Bilbao, Madrid y Sevilla). Los indicadores de salud fueronla mortalidad por todas las causas, por causa respiratoria y por causacardiovascular, e ingresos hospitalarios urgentes por causa respiratoriay cardiovascular. El EIS se ha realizado mediante el cálculo de lafracción atribuible a la contaminación por partículas. En el caso dePM10 se ha calculado el impacto debido a efectos de la contaminación a corto plazo, los acumulados hasta 40 días después, y a largoplazo. Para HN únicamente se han calculado efectos a corto plazo.Resultados: Los niveles diarios de PM10 por encima de 50µg/m3 en Bilbao, Madrid y Sevilla son responsables de 1,4 muertesprematuras por 100.000 habitantes y año debido a sus efectos a cortoplazo y de 2,8 muertes/100.000 en un periodo de hasta 40 días trasla exposición. A largo plazo, el número de muertes prematuras atribuiblesa la contaminación media anual de PM10 por encima de 20µg/m3 es 68/100.000.Conclusiones: El impacto en salud de los niveles actuales decontaminación atmosférica es cuantificable y no despreciable.APHEIS y las evaluaciones de impacto pueden ayudar a la planificación sanitaria y a las políticas medioambientales

Background: The health effects of air pollution have beenanalyzed in numerous studies over recent years, thus having madeit possible to quantify the relationship between the two. This studyis aimed at analyzing the theoretical benefits which would be achievedby meeting the air quality objectives set forth under EC Directive1999/30/EC with regard to suspended particles.Methods: The exposure measurement was taken for Black Smoke(Barcelona, Bilbao, Valencia) and suspended particles under 10mm (PM10) (Bilbao, Madrid y Sevilla). The health indicators calculatedwere the mortality due to all causes and respiratory and cardiovascularcauses, and emergency hospital admissions and mortalitydue to respiratory and cardiovascular causes. In the case of PM10 theimpact has been calculated because its effects to short-term, within aperiod of up to 40 days following exposure, and to long-term. ForBlack Smoke the effects only has been calculated to short-term.Results: The daily levels of PM10 from exceeding 50 µg/m3 inBilbao, Madrid and Sevilla cause the earlier death of 1.4/100,000individuals per year because its effects. The effect within a period ofup to 40 days following exposure is of 2.8 deaths/100,000. The totalnumber of deaths per year which may be later due to long-term exposureif the yearly average is lowered to 20 µg/m3 is 68/100,000.Conclusions: The health impact of the current air pollutionlevels is quantifiable and is not insignificant. APHEIS and theimpact evaluations may be of aid in healthcare planning and environmentalpolicies

Incidencia de diabetes mellitus tipo 1 en niños: resultados del registro poblacional de la Comunidad de Madrid, 1997–2005 / Incidence of type 1 diabetes mellitus in children: results from the population registry of the Madrid Region, 1997–2005

Fundamento y objetivo: La incidencia de diabetes mellitus (DM) tipo 1 presenta variaciones importantes en el ámbito mundial, tanto entre países europeos como entre regiones dentro de un mismo país. El objetivo de este estudio ha sido caracterizar los datos básicos de la incidencia y describir la epidemiología de la presentación de la DM tipo 1 en la Comunidad de Madrid. Material y método: Se incluyeron 1.130 casos nuevos de DM en menores de 14 años que fueron notificados al registro de DM desde enero de 1997 a diciembre de 2005. La exhaustividad del registro se evaluó a través del método de captura-recaptura. La comparación de incidencia entre diferentes grupos, así como la tendencia de la incidencia, se analizó mediante modelos de regresión de Poisson. Resultados: La tasa de incidencia en el período estudiado es de 15,9/100.000 personas-año (intervalo de confianza del 95%, 15,0–16,8). La exhaustividad es del 82%. La incidencia es de 12,1; 18,2, y 17,4 por 100.000 personas-año en los niños de 0–4; 5–9, y 10–14 años, respectivamente. La incidencia se ha mantenido estable en el período estudiado. El riesgo por edad presenta diferencias por sexo. Además, se observa una variación estacional, con mayor incidencia en los meses fríos. Conclusiones: La tasa de incidencia de DM tipo 1 se sitúa en un lugar intermedio respecto a las estimadas más recientemente en otras regiones españolas, y en el ámbito mundial la Comunidad de Madrid se sitúa entre los países con incidencia moderadamente alta. La incidencia en el período 1997–2005 se ha mantenido estable. En cuanto a la variación estacional, hay una mayor incidencia en los meses fríos (AU)

Background and objective: Incidence of type 1 diabetes mellitus (DM) varies importantly worldwide, including European countries, and even among regions within a country. The aim of this study is to describe the incidence of type 1 DM in the Madrid Region. Material and method: We included 1130 new cases of type 1 DM in children below 15 years of age, which were notified to the diabetes registry from January, 1997 to December, 2005. Case ascertainment was evaluated through the capture-recapture method. The data was analysed using Poisson regression models. Results: The incidence rate in this period was 15.9/100,000 persons-years (95% confidence interval, 15.0–16.8). Completeness of ascertainment was 82%. The incidence by age group was 12.1 (0–4 years), 18.2 (5–9 years) and 17.4 by 100,000 persons-years (10–14 years). The incidence data showed no significant changes in the studied period. We observed a seasonal variation in the incidence, with the greatest incidence in the cold months. Conclusions: The estimated incidence of type 1 DM ranks in an intermediate position with regard to that estimated more recently in other Spanish regions. During the period 1997-2005, the incidence has maintained stable in the Madrid Region (AU)

Boletín epidemiológico de la Comunidad de Madrid: encuesta sobre su difusión y percepción entre los médicos de atención primaria en el año 2000 / The autonomous Community of Madrid epidemiological bulletin. A survey regarding its dissemination and opinion thereof on among primary care physicians for the year 2000

Fundamento:. El objetivo es conocer la difusión y percepción del Boletín Epidemiológico de la Comunidad de Madrid (BECAM) entre los médicos de atención primaria, con el fin de adaptar la publicación al interés de sus lectores. Método: Encuesta telefónica entre los médicos de primaria de la Comunidad de Madrid, preguntando por la frecuencia de lectura, interés y utilidad de la información contenida El tamaño muestral se estimó en 346 médicos. Se realizó un muestreo bietápico por conglomerados en la primera etapa, con selección aleatoria de 125 centros de salud y 2,7 médicos por centro, siendo el 17 per cent coordinadores de equipo. Se comparan los resultados entre médicos y coordinadores mediante Chi-cuadrado y test exacto de Fisher, con Epi-Info v.6. Resultados: Se realizó un total de 305 entrevistas: 245 médicos y 60 coordinadores. Sabían de la existencia del BECAM el 91,5 per cent (IC 95 per cent: 88,1-94,8), y el 27,2 per cent (IC 95 per cent: 21,9-32,5) conocía más del 50 per cent de los números editados durante el año. El 92,4 per cent (IC 95 per cent: 89,4-95,8) lo consideraba interesante o muy interesante, puntuando con una media de 3,5 sobre 5 su utilidad. De las secciones fijas, la mejor valorada es Brotes Epidémicos, y de los informes, los relacionados con enfermedad meningocócia, tuberculosis y VIH/Sida. Conclusiones: El BECAM es una publicación que, aunque no es conocida ampliamente entre los médicos de primaria de nuestra Comunidad, cuando se lee es bien valorada; siendo así un instrumento útil de retroalimentación en la Red de Vigilancia Epidemiológico (AU)

Background: The Autonomous Community of Madrid Epidemiological Bulletin is the main communications link between epidemiological monitoring system and health care professionals. The purpose of this study is that of ascertaining the dissemination and opinion of this Autonomous Community of Madrid Epidemiological Bulletin among primary care physicians for the purpose of adapting this publication to its readers’ interests. Method: A telephone survey among primary care physicians in the Autonomous Community of Madrid, asking how often they read the Bulletin, the interest and usefulness of the information included in it. The sample size was estimated at 346 physicians. A two-stage sampling process was carried out - by cluster sampling in the first stage, randomly selecting 125 health care centers and 2.7 physicians per center, 17% being primary care team coordinators. A comparison is made of the results among physicians and coordinators by means of the Chi-square and Fisher’s Exact Test method, with Epi-Info v.6. Results: A total of 305 surveys were conducted (245 physicians and 60 coordinators). There was an awareness of the existence of the Autonomous Community of Madrid Epidemiological Bulletin on the part of 91.5% (CI 95%: 88.1-94.8), and 27.2% (CI 95%: 21.9-32.5) were familiar with more than 50% of the last issues published. A total of 92.4% (CI 95%: 89.4-95.8) considered the Bulletin to be interesting or highly interesting, grading its usefulness an average of 3.5 on a maximum scale of 5. Of the permanent sections, the most highly-valued was Epidemic Outbreaks, those reports related to meningococcal infection, tuberculosis and HIV/AIDS being the most highly-valued. Conclusions: The Autonomous Community of Madrid Epidemiological Bulletin is a publication which, although not widely-known by the primary care physicians in the Community, is well-valued when it is read, thus being a useful feedback tool within the Epidemiological Monitoring System (AU)