Immunogenicity and safety of AS03-adjuvanted H1N1 pandemic vaccines in children and adolescents.

Vaccines with acceptable efficacy profile against the H1N1 A/California/7/2009 virus are needed for use in children. The two studies presented here evaluated the immunogenicity and the reactogenicity/safety of A/H1N1/2009 vaccines containing either 3.75 µg haemagglutinin antigen (HA) and AS03(A)-adjuvant (3.75 µg HA/AS03(A) study) (N=210 [53, 57 and 100 in the 3-5, 6-9 and 10-17 years age strata, respectively]) or 1.9 µg HA and AS03(B)-adjuvant (1.9 µg HA/AS03(B) study) (N=244 [61, 65 and 118 in the 3-5, 6-9 and 10-17 years age strata, respectively]), given as two-dose series. Although the haemagglutination inhibition antibody titres were higher in the 3.75 µg HA/AS03(A) study, both vaccine dosages were highly immunogenic and exceeded regulatory acceptance criteria after the first and the second doses. Seroprotection rates reached 100% and seroconversion rates ranged from 98.2% to 99.1% after each dose of both vaccine dosages. Geometric mean titres increased from 456.5 to 1538.5 and from 297.9 to 1106.7 between the first and the second doses in the 3.75 µg HA/AS03(A) study and the 1.9 µg HA/AS03(B) study, respectively. Despite an observed slight increase of the reactogenicity following the second dose in the 3.75 µg HA/AS03(A) study, the vaccines safety profiles were considered clinically acceptable. In conclusion, both dosages of the AS03-adjuvanted A/H1N1/2009 pandemic influenza vaccines were highly immunogenic and well-tolerated in children and adolescents.

Gestación en paciente con leucemia linfoide crónica B / No disponible

La coincidencia de embarazo junto con neoplasiamaligna de células linfoides es muy infrecuente, y todavía más encontrar una leucemia linfoide crónica Ben adulta joven embarazada. El control de estas pacientes debe ser muy cuidadoso por parte del obstetra y el hematólogo, informando con claridad y con un completo soporte bibliográfico basado en la evidencia científica acerca del conocimiento actual del tema, e intentando responder a todas las dudas que nos planteen. Se presenta el caso de una gestante de 31 años de edad que es diagnosticada de leucemia linfoide crónica B tras el primer control hematológico de rutina (AU)

The concurrence of pregnancy with malignant lymphoid neoplasia is highly infrequent, and a finding of B-cell chronic lymphoid leukemia in a young pregnant adult is exceptional. Careful management of these patients by the obstetrician and hematologist is required, with clear communication and complete literature support on the current knowledge of the topic, aiming to answer all the doubts posed. We present the case of a 31-year-old pregnant woman who was diagnosed with B-cell chronic lymphoid lymphoma in the first routine hematological visit (AU)

Magnetic properties of ZnO nanoparticles.

We experimentally show that it is possible to induce room-temperature ferromagnetic-like behavior in ZnO nanoparticles without doping with magnetic impurities but simply inducing an alteration of their electronic configuration. Capping ZnO nanoparticles ( approximately 10 nm size) with different organic molecules produces an alteration of their electronic configuration that depends on the particular molecule, as evidenced by photoluminescence and X-ray absorption spectroscopies and altering their magnetic properties that varies from diamagnetic to ferromagnetic-like behavior.

Microstructure and macroscopic properties of bioactive CaO-SiO2-PDMS hybrids.

CaO-SiO2-PDMS (polydimethylsiloxane) hybrid materials were synthesized as crack-free monoliths presenting in vitro bioactivity, i.e. able to be coated with a calcium phosphate-rich layer after having been soaked in simulated body fluid (SBF). A wide physical-chemical characterization of these materials was carried out to relate their microscopic structure and macroscopic properties. The effect of PDMS and the amounts of water used for the tetraethoxysilane (TEOS) hydrolysis on the mechanical properties of hybrid materials was investigated by three-point bending tests. For a given amount of water, as PDMS content in hybrids increased, the elastic modulus decreased. Furthermore, keeping the PDMS content constant, when the amount of H2O decreased, the elastic modulus increased. Regarding in vitro bioactivity and mechanical properties, the hybrid material obtained with molar ratios H2O/TEOS = 2 and TEOS/PDMS = 3.5 proved to be the best candidate for either soft tissue substitution or metallic implant coating since the hybrid material would promote bond to bone formation, simultaneously dampening the mechanical charges.

Budesonide/formoterol maintenance and reliever therapy: an effective asthma treatment option?

This 12-month dose-titration study assessed the effectiveness of budesonide/formoterol for maintenance plus relief with a control group using salmeterol/fluticasone for maintenance plus salbutamol for relief. Adolescents and adults (n = 2,143; mean forced expiratory volume in one second (FEV1) 73% predicted; mean inhaled corticosteroid (ICS) 884 microg.day(-1)) were randomised to budesonide/formoterol 160/4.5 microg two inhalations b.i.d. plus additional inhalations as needed, or salmeterol/fluticasone 50/250 microg b.i.d. plus salbutamol as needed. Treatment was prescribed open label; after 4 weeks, physicians could titrate maintenance doses in accordance with normal clinical practice. Maintenance plus as-needed budesonide/formoterol prolonged the time to first severe exacerbation versus salmeterol/fluticasone (25% risk reduction). The total number of severe exacerbations was significantly reduced in the budesonide/formoterol group (255 versus 329). Both regimens provided sustained improvements in symptoms, as-needed use, quality of life and FEV1, with differences in favour of the budesonide/formoterol group for as-needed use (0.58 versus 0.93 inhalations.day(-1)) and FEV1 (post-beta2-agonist values). Mean ICS dose during treatment was similar in both groups (653 microg budesonide.day(-1) (maintenance plus as-needed) versus 583 microg fluticasone.day(-1)). The simplified strategy using budesonide/formoterol for maintenance and reliever therapy is feasible, safe and at least as effective as salmeterol/fluticasone plus salbutamol.

[Antimicrobial susceptibility of Escherichia coli isolated from bacteriurias in Bierzo health area during 2003]. / Sensibilidad microbiana de Escherichia coli en bacteriurias en el área sanitaria del Bierzo en el año 2003.

OBJECTIVE: Sensitivity to antibiotics of Escherichia coli isolated from intrahospital and extrahospital bacteriurias is analyzed. MATERIAL AND METHODS: Sensitivity to nineteen antibiotics used in the clinical practice was determined in strains of Escherichia coli isolated from intrahospital and extrahospital bacteriurias. RESULTS: The prevalence of in-vitro susceptibilities to antibiotics were (hospital, state health service clinic, health center-primary-care): imipenem (100%-100%-100%; p=NS), amikacin (100%-100%-99.7%; p=NS), fosfomicyn (98.6%-98.4%-99.6%; p=NS), cefepime (96%-96.9%-98.3%; p=NS), piperacillin-tazobactam (96%-95.3%-96.6%; p=NS), aztreonam (93.5%-94.7%-97.7%; p<0.001), ceftazidime (93.5%-94.3%-97.8%; p<0.001), cefotaxime (93.1%-95%-97.7%; p<0.001), cefixime (92.7%-94.6%-96.7%; p<0.05), nitrofurantoin (92%-94.7%-94.7%; p=NS), cefuroxime (88.4%-93.1%-95%; p<0.001), amoxicillin-clavulanic (87.7%-88.7%-93.8%; p<0.001), tobramicyn (87%-93.7%-93.8%; p<0.001), gentamcin (85.9%-92.8%-93%; p<0.001), cefazolin (84.4%-88.7%-91.6%; p<0.01), ciprofloxacin (63.8%-71.4%-78.4%; p<0.001), norfloxacin (63%-70.8%-78.2%; p<0.001), cotrimoxazole (65.2%-68.6%-74.9%; p<0.01) and ampicillin (35.5%-42.5%-47.8%; p<0.01). (*NS= No significant differences). CONCLUSIONS: The knowledge of the sensitivity of uropathogens to antimicrobians can allow us to initiate empirical therapy of urinary tract infections.

Sensibilidad microbiana de escherichia coli en bacteriurias en el área sanitaria del Bierzo en el año 2003 / Antimicrobial susceptibility of escherichia coli isolated from bacteriurias in Bierzo Health Area during 2003

OBJETIVO: Evaluar la sensibilidad a varios antibióticos en cepas de Escherichia coli aisladas en muestras de orina de pacientes hospitalarios y extrahospitalarios. MATERIAL Y MÉTODOS: Se analizaron los urocultivos positivos para Escherichia coli obtenidos de muestras de pacientes hospitalizados y atendidos en consultas externas hospitalarias y atención primaria. Se determinó la sensibilidad de este germen a diecinueve antibióticos de uso hospitalario y/o extrahospitalario. RESULTADOS: Según el origen hospitalario, consultas externas hospitalarias y atención primaria, respectivamente, la sensibilidad in vitro ha sido la siguiente: imipenem (100%, 100% y 100%; p=NS), amikacina (100%, 100% y 99,7%; p=NS), fosfomicina (98,6%, 98,4% y 99,6%; p=NS), cefepima (96%, 96,9% y 98,3%; p=NS), piperacilina-tazobactam (96%, 95,3% y 96,6%; p=NS), aztreonam (93,5%, 94,7% y 97,7%; p<0,001), ceftazidima (93,5%, 94,3% y 97,8%; p<0,001), cefotaxima (93,1%, 95% y 97,7%; p<0,001), cefixima (92,7%, 94,6% y 96,7%; p<0,05), nitrofurantoína (92%, 94,7% y 94,7%; p=NS), cefuroxima (88,4%, 93,1% y 95%; p<0,001), amoxicilina-clavulánico (87,7%, 88,7% y 93,8%; p<0,001), tobramicina (87%, 93,7% y 93,8%; p<0,001), gentamicina (85,9%, 92,8% y 93%; p<0,001), cefazolina (84,4%, 88,7% y 91,6%; p<0,01), ciprofloxacino (63,8%, 71,4%, 78,4%; p<0,001), norfloxacino (63%, 70,8 y 78,2%; p<0,001), cotrimoxazol (65,2%, 68,6% y 74,9%; p<0,01) y ampicilina (35,5%, 42,5% y 47,8%; p<0,01). (NS= No significativo). CONCLUSIONES: El tratamiento de las infecciones del tracto urinario frecuentemente se inicia de forma empírica. Por este motivo resulta esencial conocer los patrones de sensibilidad de las bacterias potencialmente causantes del cuadro

OBJECTIVE: Sensitivity to antibiotics of Escherichia coli isolated from intrahospital and extrahospital bacteriurias is analized. MATERIAL AND METHODS: Sensitivity to nineteen antibiotics used in the clinical practise was determined in strains of Escherichia coli isolated from intrahospital and extrahospital bacteriurias. RESULTS: The prevalence of in-vitro susceptibilities to antibiotics were (hospital, state health service clinic, health center-primary-care): imipenem (100%-100%-100%; p=NS), amikacin (100%-100%-99.7%; p=NS), fosfomicyn (98.6%- 98.4%-99.6%; p=NS), cefepime (96%-96.9%-98.3%; p=NS), piperacillin-tazobactam (96%-95.3%-96.6%; p=NS), aztreonam (93.5%-94.7%-97.7%; p<0.001), ceftazidime (93.5%-94.3%-97.8%; p<0.001), cefotaxime (93.1%-95%-97.7%; p<0.001), cefixime (92.7%-94.6%-96.7%; p<0.05), nitrofurantoin (92%-94.7%-94.7%; p=NS), cefuroxime (88.4%-93.1%- 95%; p<0.001), amoxicillin-clavulanic (87.7%-88.7%-93.8%; p<0.001), tobramicyn (87%-93.7%-93.8%; p<0.001), gentamcin (85.9%-92.8%-93%; p<0.001), cefazolin (84.4%-88.7%-91.6%; p<0.01), ciprofloxacin (63.8%-71.4%-78.4%; p<0.001), norfloxacin (63%-70.8%-78.2%; p<0.001), cotrimoxazole (65.2%-68.6%-74.9%; p<0.01) and ampicillin (35.5%-42.5%-47.8%; p<0.01). (*NS= No significant differences). CONCLUSIONS: The knowledge of the sensitivity of uropathogens to antimicrobians can allow us to initiate empirical therapy of urinary tract infections

[Extracorporeal shock wave lithotripsy of urolithiasis in patients with urinary diversion]. / Litotricia extracorpórea en litiasis en pacientes con derivación urinaria.

We evaluate the efficacy of ESWL in the management of calculi in patients with urinary diversion. We treated 5 patients who suffered from urinary lithiasis after urinary diversion post cistectomy. We managed the patients with extracorporeal shock wave lithotripsy in monotherapy with a Siemens Lithostar Modularis device. Mean stone size (long axis) was 1.95 cm (range 1 to 3.5 cm). The mean shockwave number per session was 2.6 per patient. Stone free result was 100%. We conclude that ESWL technique can provide acceptable results in patients with urinary diversion and can be used as first choice treatment in these type of patients due to its minimal morbidity and excellent results, equivalent to those achieved in patients without urinary diversion.

Litotricia extracorpórea en litiasis en pacientes con derivación urinaria / Extracorporeal shock wave lithotripsy of urolithiasis in patients with urinary diversion

Exponemos nuestra experiencia en el tratamiento de litiasis en pacientes con derivación urinaria. Hemos tratado 5 pacientes con litiasis en el tracto urinario superior tras cistectomía y derivación urinaria. El tratamiento se ha hecho con monoterapia por ondas de choque con el litotritor Lithostar Modularis de Siemens. El tamaño medio de las litiasis fue de 1,95 cm (rango 1 a 3,5 cm). El número medio de sesiones ha sido 2,6, con 3961 ondas de choque de media por sesión. Hemos conseguido un 100% de pacientes libres de litiasis, indicando que la litotricia extracorpórea tiene unos buenos resultados en el tratamiento de las litiasis en pacientes con derivación urinaria, siendo el tratamiento de elección en estos pacientes, con muy baja morbilidad y alta eficacia, comparable a los pacientes sin derivación urinaria (AU)

We evaluate the efficacy of ESWL in the management of calculi in patients with urinary diversion. We treated 5 patients who suffered from urinary lithiasis after urinary diversion post cistectomy. We managed the patients with extracorporeal shock wave lithotripsy in monotherapy with a Siemens Lithostar Modularis device. Mean stone size (long axis) was 1.95 cm (range 1 to 3.5 cm). The mean shockwave number per session was 2.6 per patient. Stone free result was 100%. We conclude that ESWL technique can provide acceptable results in patients with urinary diversion and can be used as first choice treatment in these type of patients due to its minimal morbidity and excellent results, equivalent to those achieved in patients without urinary diversion (AU)

Sensibilidad microbiana de Escherichia coli en infecciones urinarias extrahospitalarias / Antimicrobial susceptibility of Escherichia coli associated with community-acquired urinary tract infections

OBJETIVO: El tratamiento empírico de las infecciones urinarias extrahospitalarias debe tener en cuenta la sensibilidad de las bacterias potencialmente causantes de las mismas. Además, la comparación con años anteriores permite observar la evolución de la sensibilidad microbiana. Analizamos estos aspectos con respecto a Escherichia coli en nuestro medio. MATERIAL Y MÉTODOS: Se analizaron los urocultivos positivos para Escherichia coli obtenidos de muestras enviadas desde atención primaria en El Bierzo (León) durante los años 2002 y 1998, en número de 895 y 595, respectivamente. Se determinó la sensibilidad de este germen a nueve antibióticos de uso frecuente. Se analizó mediante chi cuadrado la existencia de diferencias estadísticamente significativas de sensibilidad en los años estudiados. RESULTADOS: El 63,4 por ciento de todos los urocultivos positivos de atención primaria en 2002 y el 50,8 por ciento en 1998 resultaron positivos para Escherichia coli. La sensibilidad in vitro en 2002 y 1998, respectivamente, ha sido la siguiente: fosfomicina (99,2 por ciento-99,3 por ciento; p=NS*), cefixima (98,3 por ciento-92,9 por ciento; p<0,001), cefuroxima (96,5 por ciento-94,1 por ciento; p<0,05), nitrofurantoína (94,5 por ciento-86,9 por ciento; p<0,001), amoxicilina-clavulánico (93,1 por ciento-90,1 por ciento; p<0,05), ciprofloxacino (77,1 por ciento-81,6 por ciento; p<0,05), norfloxacino (75,8 por ciento-80,3 por ciento; p<0,05), cotrimoxazol (71,5 por ciento-73,4 por ciento; p=NS*) y ampicilina (44 por ciento-41,4 por ciento; p=NS*). (*NS= No significativo). CONCLUSIONES: El conocimiento de los patrones de sensibilidad de los gérmenes más frecuentemente aislados en muestras de orina en cada zona permite aplicar el tratamiento empírico más adecuado en caso de infección (AU)

Efectos-vecindario sobre la salud reproductiva de la mujer chilena / Neighborhood effects influencing reproductive health of Chilean women

BACKGROUND: Fecundity rates have decreased considerably in Latin America, due to a higher contraceptive use and better family planning programs. AIM: To determine whether neighborhood level socioeconomic variables have an independent effect on reported modern contraceptive use, over and above the effect of individual level measures of socioeconomic status and reproductive health behavior. SUBJECTS AND METHODS: Multilevel logistic models determined the effects of individual and neighborhood dimensions (socioeconomic status, urbanization, quality of public health facilities) on contraceptive use among 509 women aged 15 to 49 years living in 85 neighborhoods within the Region of Bio Bio, Chile. RESULTS: After adjustment for women's individual socioeconomic characteristics and other risk factors, less favorable neighborhood socioeconomic characteristics were significantly associated with lower rates of modern contraceptive use. CONCLUSIONS: Changes in the quality of facilities for family planning at the neighborhood level may enhance modern contraceptive use.

[Microbial sensitivity of Escherichia coli in community-acquired urinary tract infections]. / Sensibilidad microbiana de Escherichia coli en infecciones urinarias extrahospitalarias.

OBJECTIVE: For effective empiric therapy of urinary tract infections in the extra-hospital setting the susceptibility pattern of uropathogens should be considered. Moreover, the evolution in sensitivity can be observed when comparing with susceptibility patterns in the previous years. This paper presents an analysis of our experience with Escherichia coli. MATERIAL AND METHODS: During 2002 and 1998, 895 and 595 strains of Escherichia coli respectively, isolated from extrahospitalary bacteriurias were collected in ten health centers in Bierzo (León, Spain). Sensitivity to nine most commonly antibiotics used in the clinical practise was determined. The existence of significant differences of susceptibility among years (2002-1998) was analyzed by the chi square test. RESULTS: Escherichia coli accounted for 63.4% of all isolates in 2002 and 50.8% in 1998. The prevalence of in-vitro susceptibilities to antibiotics were (2002-1998): fosfomycin (99.2%-99.3%; p = NS*), cefixime (98.3%-92.9%; p < 0.001), cefuroxime (96.5%-94.1%; p < 0.05), nitrofurantoin (94.5%-86.9%; p < 0.001), amoxycillin-clavulanic acid (93.1%-90.1%; p < 0.05), ciprofloxacin (77.1%-81.6%; p < 0.05), norfloxacin (75.8%-80.3%; p < 0.05), cotrimoxazole (71.5%-73.4%; p = NS*) and ampicillin (44%-41.4%; p = NS*). (*NS = No significant differences). CONCLUSION: The knowledge of the sensitivity of uropathogens to antimicrobians in a specific medium can allow us to use antibiotics rationally and initiate empirical therapy.

[Utility of prostate-specific antigen in pleural fluid for the diagnosis of metastatic effusion secondary to prostate cancer]. / Utilidad del antígeno prostático específico en líquido pleural para el diagnóstico del derrame metastático por cáncer de próstata.

Pulmonary or pleural involvement from prostate cancer is an uncommon clinical finding. We report on a patient with prostate cancer and a diagnosis of malignant pleural effusion made by determination of pleural fluid prostate specific antigen.

[Ectopic prostatic tissue in the bladder]. / Tejido prostático ectópico en vejiga urinaria.

We report the case of a 58-year-old man with ectopic prostatic tissue at the bladder trigone. The diagnosis was by chance during study and treatment of benign prostatic hyperplasia. The appearance was pseudocystic. It occupied completely the bladder trigone. On histology, the lesion was formed by prostatic type-glands, which were positive for the presence of prostatic specific antigen by using inmunoperoxidase technique. It was partially covered by normal urothelium. Ten months later, no trace of recurrence has been evidenced.

Tejido prostático ectópico en vejiga urinaria / Ectopic prostatic tissue in urinary bladder

Se presenta un caso de tejido prostático ectópico localizado en trígono vesical, en un paciente de 58 años. El hallazgo fue casual durante el estudio y tratamiento de un paciente con hipertrofia benigna de próstata. Se manifestó como lesiones seudoquísticas que ocupaban la totalidad del trígono vesical. El tejido de recubrimiento, obtenido por resección transuretral, estaba formado por focos de revestimiento urotelial y glándulas de aspecto prostático que presentaron positividad en el estudio inmunohistoquímico frente a PSA. No existe evidencia de recurrencia a los diez meses del diagnóstico (AU)

No disponible

The content of glycogen phosphorylase and glycogen in preparations of sarcoplasmic reticulum-glycogenolytic complex is enhanced in diabetic rat skeletal muscle.

AIMS/HYPOTHESIS: We have examined the effect of diabetes and pharmacological insulin treatment on the content of glycogen phosphorylase and glycogen associated with the sarcoplasmic reticulum-glycogenolytic complex from rat skeletal muscle. METHODS: Diabetes was induced in rats by streptozotocin injection. Enzymatic activities were measured using spectrophotometric methods. Glycogen phosphorylase was determined measuring the pyridoxal-5' -phosphate content and using polyacrylamide gel electrophoresis. Glycogen content was measured by enzymatic and the phenol sulfuric methods. RESULTS: The content of glycogen phosphorylase associated with the sarcoplasmic reticulum glycogenolytic complex gradually arises after diabetes induction. The content of glycogen phosphorylase was restored to a control value by pharmacological insulin treatment. In addition, the content of glycogen in preparations of sarcoplasmic reticulum-glycogenolytic complex of diabetic animals was also increased, whereas the content of glycogen in total muscle of diabetic rats was similar to that of the control rats. The absolute and relative amount of glycogen associated with sarcoplasmic reticulum seemed to increase in diabetic animals. These effects on the compartmentalisation of glycogen were suppressed by insulin treatment. Additionally, the rate of conversion of glycogen phosphorylase b to a, an index of the phosphorylase kinase activity, was 50 % lower in diabetic rats, increasing the dephosphorylated form of glycogen phosphorylase and, as a consequence, its association with sarcoplasmic reticulum membranes. CONCLUSION/INTERPRETATION: These results suggest that under diabetic conditions, both glycogen phosphorylase and a small percentage of muscle glycogen are relocalized in the sarcoplasmic reticulum-glycogenolytic complex.

[Urologic disease emergency. Clinico-epidemiologic analysis at a district hospital]. / Patología urológica urgente. Análisis clínico-epidemiológico en un hospital comarcal.

OBJECTIVE: To present the results of a one-year retrospective study that analyzed the clinical and epidemiological aspects of urological emergencies, which is not a negligible percentage of all hospital emergencies. METHODS: Data on all the urological emergencies of the emergency department of our hospital were collected during a one-year period by filling out a form that included sex, age, whether referred or not, disease, etc. RESULTS: There were 1504 urological emergencies; the urologist was required in 458 of these cases (30.45%). There were more men (837) than women (667). Patient ages ranged from 1-101 years (mean 53 years); a higher incidence was found for those aged 65 years. By age groups, there were more patients aged 61-80 years (575 patients). Most of the patients came to the hospital on their own initiative (1114) and 390 had been referred by their primary care physician. Renal colic (670 cases) was the most common diagnosis in both males and females, followed by cystitis, which was prevalent in the females (67.35%). Other conditions seen were urinary retention, hematuria, etc. CONCLUSIONS: There was a higher prevalence of males that consulted for urological conditions at the emergency department and there was a higher incidence in patients in the 6th and 7th decades of life, which is similar to the findings reported in other studies. Renal colic was the main reason for consultation for both genders and for all age groups, except those younger than 20 who presented more scrotal and penile involvement. Infective conditions involving the lower urinary tract (cystitis) and pyelonephritis were prevalent in the females. The large number of patients that were discharged from the emergency department and who consulted on their own initiative shows their confidence in the emergency services and that they could have been attended to at other health centers and did not have to come and unnecessarily strain the hospital emergency services.

[Prevalence and risk factors for erectile dysfunction in the Region of Bierzo]. / Prevalencia y factores de riesgo de disfunción eréctil en la Comarca del Bierzo.

OBJECTIVE: To analyze the prevalence and risk factors for erectile dysfunction in Bierzo (León, Spain). METHODS: A study was conducted based on a self-administered survey in males aged 19 to 90 years that consulted at the urology and family medicine services of 10 health centers in Bierzo (León, Spain). To determine the existence or absence of erectile dysfunction, the male sexual health questionnaire (SHIM) was included, and those with a score of 21 or less were considered to have some degree of erectile dysfunction. Distribution of the questionnaire began in September 1999 and ended in May 2000. Submission of the questionnaires concluded on May 31, 2000. Of 935 questionnaire that were received, 830 were valid. RESULTS: The overall prevalence of erectile dysfunction in this study was 63.9%, which increased with age and was markedly higher after age 50 years (38.6% for age 41-50 years and 72.6% for age 51-60 years). The age-adjusted analysis showed the risk factors for erectile dysfunction were depression and arterial hypertension on treatment with drugs. Diabetes mellitus on treatment with oral glucose lowering agents or insulin, heart disease and hypercholesterolemia were also associated with the more severe forms. CONCLUSIONS: The prevalence of erectile dysfunction in patients consulting at the primary care and general urological services in Bierzo (León, Spain) was outstandingly high. The present study showed erectile dysfunction to be an age-dependent disease that caused concern in slightly more than half of the patients with this condition. Apart from age, depression and vascular disease were found to be risk factors.