Sourdough bread enriched with exopolysaccharides and gazpacho by-products modulates in vitro the microbiota dysbiosis.

Sourdough bread enriched with soluble fiber (by in-situ exopolysaccharides production) and insoluble fiber (by gazpacho by-products addition) showed prebiotic effects an in vitro dynamic colonic fermentation performance with obese volunteer's microbiota. Bifidobacterium population was maintained whereas Lactobacillus increased throughout the colonic sections. Conversely, Enterobacteriaceae and Clostridium groups clearly decreased. Specific bacteria associated with beneficial effects increased in the ascending colon (Lactobacillus fermentum, Lactobacillus paracasei, Bifidobacterium longum and Bifidobacterium adolescentis) whereas Eubacterium eligens, Alistipes senegalensis, Prevotella copri and Eubacterium desmolans increased in the transversal and descending colon. Additionally, Blautia faecis and Ruminococcus albus increased in the transversal colon, and Bifidobacterium longum, Roseburia faecis and Victivallis vadensis in the descending colon. Bifidobacterium and Lactobacillus fermented the in-situ exopolysaccharides and released pectins from gazpacho by-products, as well as cellulosic degraded bacteria. This increased the short and medium chain fatty acids. Acetic acid, as well as butyric acid, increased throughout the colonic tract, which showed greater increases only in the transversal and descending colonic segments. Conversely, propionic acid was slightly affected by the colonic fermentation. These results show that sourdough bread is a useful food matrix for the enrichment of vegetable by-products (or other fibers) in order to formulate products with microbiota modulatory capacities.

Fiber from elicited butternut pumpkin (Cucurbita moschata D. cv. Ariel) modulates the human intestinal microbiota dysbiosis.

Elicited pumpkin was evaluated as a potential daily consumption product able to modulate the gut microbiota. An in vitro dynamic colonic fermentation performance with microbiota from obese volunteers was used. Prebiotic effects were observed after the pumpkin treatment. Bifidobacterium abundance was maintained during the treatment period whereas Lactobacillus increased in the transversal and descending colon. Conversely, Enterobacteriaceae and Clostridium groups were more stable, although scarce decreasing trends were observed for same species. Increments of Lactobacillus acidophilus and Limosilactobacillus fermentum (old Lactobacillus fermentum) were observed in the whole colonic tract after the treatment period. However, modulatory effects were mainly observed in the transversal and descending colon. Diverse bacteria species were increased, such as Akkermansia muciniphila, Bacteroides dorei, Cloacibacillus porcorum, Clostridium lactatifermentans, Ruminococcus albus, Ruminococcus lactaris, Coprococcus catus, Alistipes shahii or Bacteroides vulgatus. The prebiotic effect of the elicited pumpkin was provided by the fiber of the pumpkin, suggesting a release of pectin molecules in the transversal and distal colonic tract through low cellulosic fiber degradation, explaining the increases in the total propionic and butyric acid in these colonic sections. Also, a possible modulatory role of carotenoids from the sample was suggested since carotenes were found in the descending colon. Hence, the results of this research highlighted pumpkin as a natural product able to modulate the microbiota towards a healthier profile.

Effects of Glucosinolate-Enriched Red Radish (Raphanus sativus) on In Vitro Models of Intestinal Microbiota and Metabolic Syndrome-Related Functionalities.

The gut microbiota profile is determined by diet composition, and therefore this interaction is crucial for promoting specific bacterial growth and enhancing the health status. Red radish (Raphanus sativusL.) contains several secondary plant metabolites that can exert a protective effect on human health. Recent studies have shown that radish leaves have a higher content of major nutrients, minerals, and fiber than roots, and they have garnered attention as a healthy food or supplement. Therefore, the consumption of the whole plant should be considered, as its nutritional value may be of greater interest. The aim of this work is to evaluate the effects of glucosinolate (GSL)-enriched radish with elicitors on the intestinal microbiota and metabolic syndrome-related functionalities by using an in vitro dynamic gastrointestinal system and several cellular models developed to study the GSL impact on different health indicators such as blood pressure, cholesterol metabolism, insulin resistance, adipogenesis, and reactive oxygen species (ROS). The treatment with red radish had an influence on short-chain fatty acids (SCFA) production, especially on acetic and propionic acid and many butyrate-producing bacteria, suggesting that consumption of the entire red radish plant (leaves and roots) could modify the human gut microbiota profile toward a healthier one. The evaluation of the metabolic syndrome-related functionalities showed a significant decrease in the gene expression of endothelin, interleukin IL-6, and cholesterol transporter-associated biomarkers (ABCA1 and ABCG5), suggesting an improvement of three risk factors associated with metabolic syndrome. The results support the idea that the use of elicitors on red radish crops and its further consumption (the entire plant) may contribute to improving the general health status and gut microbiota profile.

Familial Mediterranean Fever in Spain: Time Trend and Spatial Distribution of the Hospitalizations.

Familial Mediterranean Fever (FMF) is a rare, hereditary, auto-inflammatory disease. The aims of this study were to explore the time trend and geographical distribution of hospitalizations in Spain from 2008 to 2015. We identified hospitalizations of FMF from the Spanish Minimum Basic Data Set at hospital discharge, using ICD-9-CM code 277.31. Age-specific and age-adjusted hospitalization rates were calculated. The time trend and the average percentage change were analyzed using Joinpoint regression. Standardized morbidity ratios were calculated and mapped by province. A total of 960 FMF-related hospitalizations (52% men) were identified across the period 2008-2015, with an increase in hospitalizations of 4.9% per year being detected (p < 0.05). The risk of hospitalization was higher than expected for the national total (SMR > 1) in 13 provinces (5 in the Mediterranean area), and lower (SMR < 1) in 14 provinces (3 in the Mediterranean area). There was an increase in hospitalizations of patients with FMF in Spain throughout the study period, with a risk of hospitalization that was higher, though not exclusively so, in provinces along the Mediterranean coast. These findings contribute to the visibility of FMF and provide useful information for health planning. Further research should take into account new population-based information, in order to continue monitoring this disease.

A population-based study of mortality due to muscular dystrophies across a 36-year period in Spain.

Muscular dystrophies (MD) are a group of rare hereditary degenerative diseases. Our aim was to analyze the mortality pattern in Spain from 1981 to 2016 to assess the temporal trend and discern possible geographic differences using population-based data. Annual deaths related to MD were obtained from the National Statistics Institute with codes 359.1 of the ICD-9 (1981-1998) and G71.0 of the ICD-10 (1999-2016). Age-adjusted mortality rates were calculated and changes in mortality trends were identified. The standardized mortality ratios (SMR) and their respective 95% confidence intervals were calculated by district for 1999-2016. Smoothed SMRs and posterior probability were also assessed and then mapped to look for patterns or geographic distribution. All rates were expressed per 1,000,000 inhabitants. A total of 2,512 deaths (73.8% men) were identified. The age-adjusted mortality rates varied from 0.63 (95% CI 0.40-0.95) in 1981 to 1.51 (95% CI 1.17-1.93) in 2016. MD mortality showed a significant increase of 8.81% per year (95% CI 5.0-12.7) from 1981 to 1990, remaining stable afterwards. Areas with risk of death higher than expected for Spain as a whole were identified, not showing a specific regional pattern. In conclusion, the rising trend in MD mortality might be attributable to advanced improvements in diagnostic techniques leading to a rise in prevalence. Further research on the districts with the highest mortality would be necessary.

An In Vitro Protocol to Study the Modulatory Effects of a Food or Biocompound on Human Gut Microbiome and Metabolome.

The gut microbiota plays a key role in gastrointestinal immune and metabolic functions and is influenced by dietary composition. An in vitro protocol simulating the physiological conditions of the digestive system helps to study the effects of foods/biocompounds on gut microbiome and metabolome. The Dynamic-Colonic Gastrointestinal Digester consists of five interconnected compartments, double jacket vessels that simulate the physiological conditions of the stomach, the small intestine and the three colonic sections, which are the ascending colon, transverse colon and descending colon. Human faeces are required to reproduce the conditions and culture medium of the human colon, allowing the growth of the intestinal microbiota. After a stabilization period of 12 days, a food/biocompound can be introduced to study its modulatory effects during the next 14 days (treatment period). At the end of the stabilization and treatment period, samples taken from the colon compartments are analysed. The 16S rRNA gene analysis reveals the microbiota composition. The untargeted metabolomics analysis gives more than 10,000 features (metabolites/compounds). The present protocol allows in vitro testing of the modulatory effects of foods or biocompounds on gut microbiota composition and metabolic activity.

Mortality Due to Cystic Fibrosis over a 36-Year Period in Spain: Time Trends and Geographic Variations.

The aim of this study is to analyze population-based mortality attributed to cystic fibrosis (CF) over 36 years in Spain. CF deaths were obtained from the National Statistics Institute, using codes 277.0 from the International Classification of Diseases (ICD) ninth revision (ICD9-CM) and E84 from the tenth revision (ICD10) to determine the underlying cause of death. We calculated age-specific and age-adjusted mortality rates, and time trends were assessed using joinpoint regression. The geographic analysis by district was performed by standardized mortality ratios (SMRs) and smoothed-SMRs. A total of 1002 deaths due to CF were identified (50.5% women). Age-adjusted mortality rates fell by -0.95% per year between 1981 and 2016. The average age of death from CF increased due to the annual fall in the mortality of under-25s (-3.77% males, -2.37% females) and an increase in over-75s (3.49%). We identified districts with higher than expected death risks in the south (Andalusia), the Mediterranean coast (Murcia, Valencia, Catalonia), the West (Extremadura), and the Canary Islands. In conclusion, in this study we monitored the population-based mortality attributed to CF over a long period and found geographic differences in the risk of dying from this disease. These findings complement the information provided in other studies and registries and will be useful for health planning.

Integrated Evaluation of the Potential Health Benefits of Einkorn-Based Breads.

Nowadays the high nutritional value of whole grains is recognized, and there is an increasing interest in the ancient varieties for producing wholegrain food products with enhanced nutritional characteristics. Among ancient crops, einkorn could represent a valid alternative. In this work, einkorn flours were analyzed for their content in carotenoids and in free and bound phenolic acids, and compared to wheat flours. The most promising flours were used to produce conventional and sourdough fermented breads. Breads were in vitro digested, and characterized before and after digestion. The four breads having the best characteristics were selected, and the product of their digestion was used to evaluate their anti-inflammatory effect using Caco-2 cells. Our results confirm the higher carotenoid levels in einkorn than in modern wheats, and the effectiveness of sourdough fermentation in maintaining these levels, despite the longer exposure to atmospheric oxygen. Moreover, in cultured cells einkorn bread evidenced an anti-inflammatory effect, although masked by the effect of digestive fluid. This study represents the first integrated evaluation of the potential health benefit of einkorn-based bakery products compared to wheat-based ones, and contributes to our knowledge of ancient grains.

Alimentación en población infantil inmigrante recién llegada / Infant feeding in recent immigrant population

Introducción. El exceso o defecto de nutrientes se ha relacionado con problemas de salud. El objetivo de este estudio es conocer los hábitos alimentarios de los inmigrantes a su llegada y su relación con variables sociodemográficas y patologías asociadas. Material y métodos. Estudio descriptivo observacional transversal. Población: niños inmigrantes con edad entre 6 meses y 15 años. Variables: edad, sexo y país de procedencia. En los menores de 24 meses introducción de los alimentos según la OMS y la ESPGHAN. En toda la población: raciones de cereales/farináceos, frutas, verduras, lácteos, proteínas, legumbres, aceites/grasas, bollería, dulces y golosinas, bebidas refrescantes, aperitivos salados, frutos secos, cacao, té y café. Presencia o no de: talla baja, obesidad y caries. Resultados. En los menores de 24 meses de edad se encontraron porcentajes elevados de introducción incorrecta de ciertos alimentos (36,7% leche de vaca). En la población estudiada se observan raciones insuficientes de alimentos (28,4% en verduras), excesos (47,2% en embutidos) y dieta incorrecta en el 32,6%. Se encontró significación estadística entre procedencia y déficit de alimentos (lácteos el 39,10% de los indopakistaníes) o excesos (embutidos en el 71,8% de los de Caribe). En la valoración de la dieta: correcta en el 57,1% de los magrebíes o incorrecta del 48,1% de los indopakistaníes y 43,1% en los de Europa del Este. Conclusiones. Se han de tener en cuenta las prácticas alimentarias inadecuadas encontradas y la asociación a ciertas procedencias por al riesgo que pueden suponer para la salud infantil y adulta. Su abordaje requiere recursos para acciones preventivas y educativas específicas (AU)

Introduction. The excess or deficiency of nutrients have related health problems. The aim of this study is to describe the eating habits of immigrants on their arrival and their relationship with socio-demographic variables and pathologies associated. Methods. A descriptive, observational transversal study. Population: immigrants between 6 months and 15 years. Variables: age, sex and country of origin. Children under 24 months food supply introduction according to WHO and ESPGHAN. In the entire population: cereal/farinaceous rations, fruits, vegetables, milk, protein, legumes, oils and fats, pastry, sweets and candy, soft drinks, salty snacks, nuts, cocoa, tea and coffee. Presence or not: low share, obesity and caries. Results. In children under 24 months were found significant percentages in incorrect introduction of certain foods (36.7% milk cow). In the studied population: inadequate basic foodstuffs (28.4% in vegetables), not needed developed food excesses (47.2% in sausages) and incorrect diet in 32.6%. Found statistical significance between origin and deficit of foods (milk 39.1% of Indo-Pakistanis) or excess (sausages 71.8% of the Caribbean). In the dietary's assessment: correct 57.1% of Maghrebi or incorrect 48.1% of Pakistani Indus and 43.1% in the Eastern Europe. Conclusions. Inadequate habits of nutrition and their association to certain regions must be taken into account because of the risk on childhood and adult health. Resources to specific preventive and educational actions are needed (AU)

[Infant feeding in recent immigrant population]. / Alimentación en población infantil inmigrante recién llegada.

INTRODUCTION: The excess or deficiency of nutrients have related health problems. The aim of this study is to describe the eating habits of immigrants on their arrival and their relationship with socio-demographic variables and pathologies associated. METHODS: A descriptive, observational transversal study. POPULATION: immigrants between 6 months and 15 years. VARIABLES: age, sex and country of origin. Children under 24 months food supply introduction according to WHO and ESPGHAN. In the entire population: cereal/farinaceous rations, fruits, vegetables, milk, protein, legumes, oils and fats, pastry, sweets and candy, soft drinks, salty snacks, nuts, cocoa, tea and coffee. Presence or not: low share, obesity and caries. RESULTS: In children under 24 months were found significant percentages in incorrect introduction of certain foods (36.7% milk cow). In the studied population: inadequate basic foodstuffs (28.4% in vegetables), not needed developed food excesses (47.2% in sausages) and incorrect diet in 32.6%. Found statistical significance between origin and deficit of foods (milk 39.1% of Indo-Pakistanis) or excess (sausages 71.8% of the Caribbean). In the dietary's assessment: correct 57.1% of Maghrebi or incorrect 48.1% of Pakistani Indus and 43.1% in the Eastern Europe. CONCLUSIONS: Inadequate habits of nutrition and their association to certain regions must be taken into account because of the risk on childhood and adult health. Resources to specific preventive and educational actions are needed.

Indicación de la determinación de los anticuerpos para los virus de la hepatitis C y de la hepatitis A en los protocolos de atención a los niños inmigrantes / Indication of determination of antibodies against hepatitis C and A viruses in the protocol for the care of young immigrants

ObjetivoValorar la determinación sistemática de los anticuerpos para el virus de la hepatitis C (Ac. VHC) y para el virus de la hepatitis A (Ac. VHA) dentro de los protocolo de atención a niños inmigrantes (PANI).MétodosEstudio descriptivo, transversal y multicéntrico. Se determinaron los Ac. VHC y Ac.VHA, en niños de 6 meses a 15 años procedentes de países de baja renta que habían inmigrado hacía menos de 12 meses. Se registró la edad, el sexo y el país de origen. Se ha comparado el coste de la vacunación (con vacuna HA y vacuna HA-HB, precio de sanidad pública y precio de venta al público) a todos los niños inmigrantes sin cribado, con el coste de la vacunación sólo a los no inmunes.ResultadosSe determinaron los Ac. VHC a 1055 niños/as, un caso resultó positivo: 0,09% (IC95%: 0–0,53%). Se determinaron los Ac. VHA a 992 niños/as, y fueron positivos el 38% (IC 95%: 35,0–41,1); en los de América Central y del Sur (n=352) el 34,9%; del Magreb (n=246) el 44,7%; de Indo-Pakistán (n=162) el 58,6%. Según el país de procedencia, la edad y el precio de la vacuna utilizada, es eficiente la determinación de los Ac. VHA previamente a la vacunación para el VHA.ConclusionesLa baja prevalencia de Ac. VHC en población infantil inmigrada no justifica su determinación sistemática. Valorar la determinación de los Ac. VHA en cada niño inmigrante en particular puede aumentar la eficiencia de los PANI (AU)

ObjectivesTo evaluate systematic determination of antibodies against hepatitis C virus (HCV) and hepatitis A virus (HAV) within the protocols for the care of young immigrants (PCYI).MethodsWe performed a descriptive, cross-sectional, multicenter study. Antibodies against HCV and HAV were determined in children aged from 6 months to 15 years from low-income countries who had immigrated to Spain less than 12 months previously. Age, sex and country of origin were registered. The cost of vaccinating all immigrant children (with the HA vaccine and HA-HB vaccine, public health price and retail price) without screening was compared with that of vaccinating non-immune children only.ResultsHCV antibodies were determined in 1055 children and only one was positive [0.09% (95% CI: 0–0.53%)]. HAV antibodies were determined in 992 children and, overall, 38% were positive (95% CI: 35.0–41.1). Distribution by country of origin was as follows: Central and South America (n=352) 34.9%, Maghreb (n=246) 44.7%, and India, Pakistan and Bangladesh (n=162) 58.6%. According to the children's age, country of origin, and the price of the vaccine used, HAV antibody determination in young immigrants before HAV vaccination is efficient.ConclusionsBecause of the low prevalence of HCV antibodies in the pediatric immigrant population, systematic determination is not warranted. Evaluating HAV antibodies in each immigrant child could increase the efficiency of PCYI (AU)

[Indication of determination of antibodies against hepatitis C and A viruses in the protocol for the care of young immigrants]. / Indicación de la determinación de los anticuerpos para los virus de la hepatitis C y de la hepatitis A en los protocolos de atención a los niños inmigrantes.

OBJECTIVES: To evaluate systematic determination of antibodies against hepatitis C virus (HCV) and hepatitis A virus (HAV) within the protocols for the care of young immigrants (PCYI). METHODS: We performed a descriptive, cross-sectional, multicenter study. Antibodies against HCV and HAV were determined in children aged from 6 months to 15 years from low-income countries who had immigrated to Spain less than 12 months previously. Age, sex and country of origin were registered. The cost of vaccinating all immigrant children (with the HA vaccine and HA-HB vaccine, public health price and retail price) without screening was compared with that of vaccinating non-immune children only. RESULTS: HCV antibodies were determined in 1055 children and only one was positive [0.09% (95% CI: 0-0.53%)]. HAV antibodies were determined in 992 children and, overall, 38% were positive (95% CI: 35.0-41.1). Distribution by country of origin was as follows: Central and South America (n=352) 34.9%, Maghreb (n=246) 44.7%, and India, Pakistan and Bangladesh (n=162) 58.6%. According to the children's age, country of origin, and the price of the vaccine used, HAV antibody determination in young immigrants before HAV vaccination is efficient. CONCLUSIONS: Because of the low prevalence of HCV antibodies in the pediatric immigrant population, systematic determination is not warranted. Evaluating HAV antibodies in each immigrant child could increase the efficiency of PCYI.

Cobertura vacunal en la infancia en familias inmigrantes / Childhood vaccine cover in immigrant families

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¿Cual es el "Draf factor" del concept 2 que mejor simula el remo en trainera? / Setting the concept 2 "Draf factor" for the simulation of fixed-thwart boat rowing?

Antecedentes: El remo ergómetro CONCEPT 2 (C2) es uno de los más utilizados en todo el mundo, tanto en la valoración funcional de los remeros, como en sus entrenamientos fuera del agua. Este ergómetro controla la resistencia del ventilador mediante una ventanilla que regula la entrada de aire al mismo. El fabricante denomina a esta resistencia drag factor (DF), y recomienda utilizar DF entre 115 y 140, debido a que son los que mejor simulan las sensaciones delos remeros de banco móvil en el agua. A pesar de que elC2 es también el remo ergómetro más utilizado en el remo de banco fijo (trainera), se desconoce cuál es el DF que mejor simula las condiciones de esta modalidad. Objetivo: Determinar cuál era el DF del C2 más adecuado al remo en la trainera. Diseño: Estudio transversal comparativo. Sujetos: 19 Remeros varones, edad de 26 ± 5 años, y un umbral anaeróbico (4 mmol/l) (W4) de 231 ± 26 W. Medidas: Se midió la frecuencia cardiaca (FC) en trainera y en el C2 con tres DF diferentes (140, 150 y 160). Se tomaron 34 muestras para cada DF. Para asegurar la similitud entre la remada del ergómetro y la de la trainera también se controló la cadencia de palada (R) y el tiempo de la fase de pasada (TP).Análisis: Método de Bland-Altman para comprobar la concordancia de la FC entre el C2 y la trainera para los diferentes DF. Resultados: La mejor concordancia se encontró para un DF de 160. Las diferencias de las FC de la trainera y el C2mostraron una dispersión importante, y unas diferencias significativas, de 7, 4 y 5 lat/min, para los DF de 140, 150 y160 respectivamente. Conclusiones: De los tres DF del C2 utilizados en este estudio (140, 150 y 160), el que mejor concordancia demostró con el remo de la trainera de banco fijo fue el de160. Sin embargo, se produjo un error sistemático en la medida de la FC entre ambas condiciones para todos los DF testados (AU)

Background: The CONCEPT 2 rowing ergometer (C2)is a world wide used device, both for rowers performance assessment and for indoor training. In order to regulate the resistance of the flywheel the C2 has a damper to control the air that can pass across the fan. This resistance is called drag factor (DF) and the manufacturer recommend to use the machine in the 115-140 range, because at this level the perception is closest to that of a racing boat. Although theC2 is also the most commonly used ergometer in fixed thwart rowing (trainer a), it is unknown which is the DF that better simulate the conditions of this rowing modality. Objective: To assess the most appropriate DF of the C2 to reflect fixed-thwart trainer a rowing. Design: Cross-sectional comparative study. Subjects: 19 Well trained male rowers, age 25 ± 5 year, anaerobic threshold (4 mmol/l) (W4) 231 ± 26 W. Measurements: The heart rate (FC) in trainer a and in C2was measured using three different DF (140, 150 and 160),34 samples at each DF were taken. To assure that the C2and the trainer a rowing was similar, the stroke rate (R) and the drive phase duration (TP) were controlled. Analysis: The Bland-Altman`s method was used to test the agreement of the FC between the C2 and the trainer a at the three different DF. Results: The best agreement was found at 160 DF of theC2. The differences between the FC of the trainer a and the C2 showed a great data dispersion in all the DF. The FC demonstrated a significant difference of 7, 4 and 5 lat/min, for the 140, 150 and 160 DF, respectively. Conclusions: Among the three DF of the C2 studied in this investigation (140, 150 and 160) the one that best reflect the trainer a rowing is 160. Although, a systematic error were found in the measurement of the FC at all of the three tested DF (AU)

Valoración del estado vacunal de la población pediátrica inmigrante a su llegada a una área básica de salud de Barcelona y a los 12 meses / Evaluation of vaccination status of immigrant children on their first visit to a primary health area of Barcelona and 12 months later

Objetivos. Evaluar el estado de las vacunaciones de los inmigrantes recién llegados en la primera visita y a los 12 meses. Método. Estudio transversal con 2 cortes, retrospectivo y descriptivo. Mediante muestreo aleatorio simple se seleccionaron 180 historias clínicas, de un total de 338, de la población pediátrica inmigrante. Se estudiaron las siguientes variables: fecha de nacimiento, sexo, país de procedencia y fecha de primera visita, tipo y dosis de vacunas administradas. Para evaluar el estado vacunal se utilizó: Expanded Program on Immunization (EPI) OMS 1974 y protocolo de atención al niño inmigrante (PAI). Resultados. A la llegada resultó correctamente vacunado, según EPI, el 61,2% (intervalo de confianza [IC] del 95%, 51,2-71,1). Resultaron bien vacunados, según PAI a la llegada: triple vírica el 7,8% (IC del 95%, 3,9-11,7); tétanos, difteria el 45,0% (IC del 95%, 37,7-52,3); Pertusis el 45,0% (IC del 95%, 37,7-52,3); poliomielitis el 51,1% (IC del 95%, 43,8-58,4); Haemophilus el 3,9% (IC del 95%, 1,1-6,7); meningitis C el 1,7% (IC del 95%, 0,6-4,8); hepatitis A y B el 0,6% (IC del 95%, 0,1-3,1). A los 12 meses: triple vírica el 92,8% (IC del 95%, 88,7-96,8); tétanos, difteria y poliomielitis el 95,6% (IC del 95%, 92,2-98,8); Pertusis el 61,7% (IC del 95%, 54,6-68,8); Haemophilus el 21,1% (IC del 95%, 15,1-27,1); meningitis C el 95% (IC del 95%, 91,5-98,4), y hepatitis A y B el 61,7% (IC del 95%, 54,6-68,8). Conclusiones. Hay un alto porcentaje de niños que no cumplen el EPI 1974 originario. Según PAI a la llegada las coberturas eran muy bajas. A los 12 meses de la primera visita, las dosis registradas evidencian estados óptimos, excepto en el caso de las hepatitis A y B en el que es necesario su mejora

Objectives. To evaluate vaccination status in recently arrived immigrant children in the first medical visit and 12 months later. Method. We performed a cross-sectional study with two cross-sections: retrospective and descriptive. Of a total of 338 clinical histories among the immigrant population, simple random sampling was used to select 180 clinical histories. The following variables were studied: date of birth, gender, country of origin, date of the first medical visit, and type and dose of the vaccines administered. To evaluate vaccination status, the Expanded Program on Immunization (EPI) of the World Health Organization (WHO), 1974, and the protocol for the care of the immigrant child (PCIC) were used. Results. According to the EPI, 61.2% (95% CI: 51.2-71.1) of the immigrant children were correctly immunized on arrival. According to the PCIC, correct vaccination on arrival in Spain was as follows: measles-mumps-rubella (MMR): 7.8% (95% CI: 3.9-11.7); tetanus, diphtheria: 45.0% (95% CI: 37.7-52.3); pertussis: 45.0% (95% CI: 37.7-52.3); polio: 51.1% (95% CI: 43.8-58.4); Haemophilus: 3.9% (95% CI; 1.1-6.7); meningitis C: 1.7% (95% CI: 0.6-4.8), hepatitis A and B: 0.6% (95% CI: 0.1-3.1). Correct vaccination at 12 months was as follows: MMR: 92.8% (95% CI: 88.7-96.8); tetanus, diphtheria and polio: 95.6% (95% CI: 92.2-98.8); pertussis: 61.7% (95% CI: 54.6-68.8); Haemophilus: 21.1% (95% CI: 15.2-27.1); meningitis C: 95% (95% CI: 91.5-98.4); and hepatitis A and B 61.7% (95% CI: 54.6-68.8). Conclusions. A high percentage of the children had not received one or more of the vaccines included in the WHO's 1974 EPI. According to the PCIC, vaccination coverage on arrival was very low. Twelve months after the first medical visit, the doses registered were optimal, except in the case of hepatitis A and B. Vaccination against hepatitis A and B should be increased

Valoración de la carga asistencial del personal de enfermería en función de los nuevos usuarios de los servicios de pediatría / Evaluation of nursing workload generated by the immigrant pediatric population in primary care

Objetivo. Determinar las cargas asistenciales para el personal de enfermería generadas por la inmigración infantil y el seguimiento del Protocolo de Atención al Inmigrante (PAI) en la edad pediátrica, en relación con la atención a los niños autóctonos. Método. Niños de 6 meses a 15 años de edad llegados de países de baja renta, así como los nacidos en España que permanecieron más de 2 años en el país de sus padres y que fueron visitados entre el 31 de mayo de 2001 al 31 de mayo de 2002; se seleccionaron 74 de un total de 136. El número de niños autóctonos del mismo sexo y edad que los recién llegados fue de 74. Se utilizó una técnica de muestreo aleatorio. Resultados. El número de visitas en el grupo de inmigrantes fue de 454, con una mediana de 6 (mínimo, 2; máximo, 15). Destacan las 292 visitas relacionadas con la aplicación del PAI, 129 en los niños autóctonos, con una mediana de 2 (mínimo, 0; máximo, 8). Las actividades realizadas con los niños inmigrantes relacionadas con el PAI fueron 614, con una mediana de 8 (mínimo, 2; máximo, 19). En los autóctonos el número de actividades fue de 101, con una mediana de 1 (mínimo, 0; máximo, 6). Se llevaron a cabo 115 captaciones en los niños inmigrantes, con una mediana de 1, y 23 en los autóctonos (mediana, 0). Conclusiones. Hay una gran diferencia en el número de visitas y actividades entre los niños inmigrantes y los autóctonos. Las visitas y las actividades derivadas de la aplicación del PAI, que ha de realizarse sólo en inmigrantes, aumenta la carga asistencial global. Esta diferencia en las cargas asistenciales es el trabajo necesario para igualar ambos grupos en el nivel de salud. También hay mucha diferencia en el número de captaciones y el de actividades de recaptación entre niños inmigrantes y autóctonos

Objective. To determine the nursing workload generated by childhood immigration and by the Immigrant Healthcare Protocol (IHP) in pediatric patients in comparison with that generated by the autochthonous pediatric population. Method. Children aged between 6 months and 15 years from low-income countries as well as children born in Spain and resident in their parents' country of origin for more than 2 years who were attended between 31 May 2001 and 31 May 2002 were included. Of 136 children, 74 were selected. Autochthonous children of the same age and sex as immigrant children (n = 74) were also included. A randomized sampling technique was used. Results. There were 454 consultations in the immigrant group with a median of 6 visits (minimum, 2; maximum, 15). Noteworthy was the number of consultations exclusively related to the application of the IHP (292). There were 129 consultations in the autochthonous group with a median of 2 (minimum, 0; maximum, 8). There were 614 IHP-related activities in immigrant children with a median of 8 (minimum, 2; maximum, 19) while in autochthonous children there were 101 activities with a median of 1 (minimum, 0; maximum, 6). There were 115 missed appointments in immigrants (median, 1) and 23 in autochthonous children (median, 0). Conclusions. There was a marked difference between immigrant and autochthonous children in the number of consultations and activities. IHP-related consultations and activities, performed only in immigrant children, increased the overall workload. This difference is required to reduce inequalities in health between the two groups. A marked difference was also found in the number of missed appointments and in the number of activities related to rescheduling missed appointments between immigrant and autochthonous children