[Influence of birth weight on the lipid profile and blood pressure in Madrid adolescents]. / Influencia del peso de recién nacido en el perfil lipídico y la presión arterial en adolescentes de Madrid.

OBJECTIVE: The aim of this study is to assess the relationship between birth weight and the lipid profile and blood pressure in adolescents. PATIENTS AND METHODS: Cross sectional study. We studied seven hundred and forty adolescents aged 18 who attended four different schools located in Madrid. Birth weight (BW) data were obtained from delivery records. All subjects underwent a physical examination, including measurement of blood pressure. Plasma lipids were determined using standardised methods after ten hour fasting. RESULTS: Total cholesterol and cholesterol-LDL in males and females with BW < 3.000 grams were statistically greater than those from subjects with BW > 3,800 grams. Male adolescents also showed a difference in the apolipoprotein B (ApoB) levels. We only found a statistically significant difference in the diastolic blood pressure of male adolescents belonging to the extreme birth weight quintiles. CONCLUSIONS: We found an inverse relationship between birth weight and total cholesterol and cholesterol LDL levels in males and females. This association was also noted in Apo B concentrations in male adolescents. The only influence birth weight had on blood pressure was on the diastolic blood pressure of males.

Influencia del peso de recién nacido en el perfil lipídico y la presión arterial en adolescentes de Madrid / Influence of birth weight on the lipid profile and blood pressure in Madrid adolescents

Objetivo: Estudiar la relación entre el peso de recién nacido (PRN) y el perfil lipídico y la presión arterial en adolescentes de 18 años. Pacientes y métodos: Se trata de un estudio descriptivo transversal. Se estudiaron 740 adolescentes de 18 años de edad, pertenecientes a cuatro centros educativos situados en el Área II de Atención Primaria de Salud de Madrid. El peso de recién nacido se obtuvo de los informes del nacimiento. A todos los participantes se les practicó una exploración física que incluía toma de la presión arterial y una extracción analítica para determinar el perfil lipídico, según métodos estandarizados. Resultados: Las concentraciones de colesterol total (CT) y de colesterol de las lipoproteínas de baja densidad (c-LDL) de los niños y niñas de PRN inferior a 3.000 g fueron estadísticamente superiores a las de los pacientes con PRN de más de 3.800 g. En los varones hubo, asimismo, diferencia en las concentraciones de la apolipoproteína B (apo-B). Con respecto a la presión arterial, sólo encontramos una diferencia estadísticamente significativa en los valores de presión arterial diastólica (PAD) de los varones con PRN de quintiles extremos. Conclusiones: Existe una relación inversa entre el PRN y el colesterol total y el c-LDL en niños y niñas. Dicha relación se aprecia también en las cifras de apo-B en los varones. Sólo encontramos influencia del PRN en la PAD de los varones (AU)

Objective: The aim of this study is to assess the relationship between birth weight and the lipid profile and blood pressure in adolescents. Patients and methods: Cross sectional study. We studied seven hundred and forty adolescents aged 18 who attended four different schools located in Madrid. Birth weight (BW) data were obtained from delivery records. All subjects underwent a physical examination, including measurement of blood pressure. Plasma lipids were determined using standardised methods after ten hour fasting. Results: Total cholesterol and cholesterol-LDL in males and females with BW < 3.000 grams were statistically greater than those from subjects with BW > 3,800 grams. Male adolescents also showed a difference in the apolipoprotein B (ApoB) levels. We only found a statistically significant difference in the diastolic blood pressure of male adolescents belonging to the extreme birth weight quintiles. Conclusions: We found an inverse relationship between birth weight and total cholesterol and cholesterol LDL levels in males and females. This association was also noted in Apo B concentrations in male adolescents. The only influence birth weight had on blood pressure was on the diastolic blood pressure of males (AU)

Diferencias evolutivas en las actitudes respecto al tabaquismo en médicas y enfermeras de la Comunidad de Madrid según el nivel asistencial / Evolutive differences in attitudes regarding smoking in physicians and nurses of the Madrid Community according to care level

Objetivos: Conocer la prevalencia actual de tabaquismo entre lasmédicas y enfermeras de la Comunidad de Madrid y la evolución de susactitudes hacia este hábito desde 1998.Métodos: Estudio descriptivo transversal. Se analizan los resultadosde dos encuestas realizadas en 1998 y 2003 a profesionales sanitarias(médicas y enfermeras) de la Comunidad de Madrid, seleccionadasmediante muestreo polietápico por conglomerados.Resultados: El número de cuestionarios evaluados fue de 1.235(391 de Atención Primaria y 844 de Atención Especializada) en 1998y de 1.000 (392 de AP y 608 de AE) en 2003. En general, no se ha demostradouna mejora relevante en las actitudes con respecto al tabaquismoentre las profesionales de salud, debido fundamentalmente a que,aunque ha habido avances significativos en Atención Especializada,en Atención Primaria la situación se puede considerar estacionaria. Elporcentaje total de fumadoras ha pasado del 50,35% al 37,5% en AtenciónEspecializada y del 42,19% al 38,01% en Atención Primaria.Conclusiones: Ha habido una ligera mejoría en la sensibilizaciónantitabaco de las profesionales sanitarias de Atención Especializada, noasí en las de Atención Primaria.Es necesario continuar aplicando programas de prevención y deshabituaciónsobre estos colectivos

Objectives: Know the present prevalence of smoking among physiciansand nurses of the Madrid Community and evolution of their attitudestowards this habit since 1998.Methods: Descriptive, cross-sectional study. The results of two surveysconducted in 1998 and 2003 to health care professionals (physiciansand nurses) of the Madrid Community, chosen by multi-stage samplingby clusters, are analyzed.Results: A total of 1,235 (391 from Primary Health Care and 844from Specialized Care) questionnaires were evaluated in 1998 and 1,000(392 from PHC and 608 from SC) in 2003. In general, no improvementregarding attitudes related to smoking among health care professionalshas been demonstrated, basically due to the fact that the situation can beconsidered stationary in Primary Health Care, even though there havebeen significant advances in Specialized Care. The total percentage ofsmokers has gone from 50.35% to 37.5% in Specialized Care and from42.19% to 38.01% in Primary Health Care.Conclusions: There has been a mild improvement in antitobaccosensitization of the health care professionals of Specialized Care but notin Primary Health Care. Prevention and dehabituation programs mustcontinued to be applied in these groups

[Socioeconomic status and resource consumption in primary care]. / Nivel socioeconómico y consumo de recursos sanitarios en atención primaria.

OBJECTIVE: To determine the influence of socioeconomic status on healthcare demand and resource consumption in our population. PATIENTS AND METHODS: We performed a cross sectional, retrospective study of socioeconomic status and healthcare and pharmaceutical consumption in randomly selected patients from five primary care pediatric clinics in Madrid. The chi-square test was used to compare percentages. For the remaining analyses, nonparametric tests were used after confirming that the data followed non-normal distribution. RESULTS: We compared 684 questionnaires. Patients in the most disadvantaged socioeconomic levels consumed a greater number of drugs than those in more privileged levels (mean 0.79 vs. 0.47, p = 0.04). The mean pharmacological expenditure was also higher in the lowest socioeconomic levels than in the highest levels (5.28 Euros vs. 2.21 Euros, respectively; p = 0.001). No significant differences were found among socioeconomic levels in the number of consultations or diagnostic tests requested. The number of consultations was higher in younger patients (p < 0.001) or in those with chronic diseases (p = 0.001). Drug consumption was increased in the most disadvantaged levels (p = 0.002) and in patients with chronic diseases (p < 0.001). Lastly, pharmacological expenditure expressed in Euros was also higher in the lowest socioeconomic levels (p = 0.001) and in patients with chronic diseases (p < 0.001) but was lower if one of the parents was a foreigner (p = 0.031). CONCLUSIONS: We found a relationship between socioeconomic level and drug consumption and its attributable cost. These data should be confirmed by broader studies.

Nivel socioeconómico y consumo de recursos sanitarios en atención primaria / Socioeconomic status and resource consumption in primary care

Objetivo: Conocer la influencia del nivel socioeconómico en la demanda y consumo de recursos sanitarios de nuestra población. Pacientes y métodos: Estudio retrospectivo transversal, mediante cuestionario estructurado, del nivel socioeconómico y el consumo de recursos sanitarios y farmacéuticos en pacientes seleccionados aleatoriamente en cinco consultas de pediatría de atención primaria de Madrid. Se utilizó la prueba de la chi cuadrado (X2) para la comparación de porcentajes. Para el resto de los análisis se emplearon pruebas no paramétricas tras comprobarse la distribución anormal de los datos. Resultados: Se analizaron 684 cuestionarios. Los pacientes pertenecientes a los niveles socioeconómicos más desfavorecidos consumieron mayor número de fármacos que los de los niveles privilegiados (media, 0,79 frente a 0,47; p=0,04) y el gasto farmacéutico atribuido también fue mayor: en el nivel socioeconómico bajo el gasto medio fue de 5,28 y en el superior de 2,21 € (p=0,001). No hubo diferencias significativas entre los niveles socioeconómicos en lo que respecta al número de consultas o pruebas diagnósticas solicitadas. El número de consultas fue mayor en los pacientes de menor edad (p < 0,001) o en los que padecían alguna enfermedad crónica (p=0,001). El número de fármacos consumido se incrementó en los niveles más desfavorecidos (p=0,002) y en los pacientes con enfermedades crónicas (p < 0,001). Por último, el gasto farmacéutico expresado en euros también fue superior en los niveles socioeconómicos bajos (p=0,001) y en los pacientes con enfermedad crónica (p < 0,001), pero fue inferior si alguno de los progenitores era extranjero (p=0,031). Conclusiones: En nuestro estudio se ha encontrado una relación entre el nivel socioeconómico y el consumo de fármacos y su coste atribuido. Son necesarios estudios más amplios para confirmar estos datos (AU)

[The prevalence of anemia in the children and adolescents of Madrid]. / Prevalencia de anemia en niños y adolescentes de Madrid.

Iron deficiency and iron deficiency anemia are very important disorders in childhood because, during this stage of life, the confluence of different factors can lead to iron deficiency. During childhood, there are rapid growth periods in which the need for iron increases and these needs are not always compensated for by a sufficient iron intake. We have studied a sample of 2,224 schoolchildren, both males and females, between the ages of 2 and 18 years, from five different schools in the Community of Madrid. The prevalence of anemia was studied by determining the hemoglobin, MCV and MCHC, whereas iron deficiency was assessed by measurement of serum iron. In our study population, the prevalence of iron deficiency was 4.94% and the rate of iron deficiency anemia was 0.94%. This disorder is predominant in 13 to 15 year olds (3.7% of the males and 3.53% of the females showed hemoglobin values below the reference range). In addition 6.73% of this group were iron deficient. The MCV was decreased in 2.69% of the subjects, after the exclusion of six children with thalassemia trait.

[The effect of the socioeconomic level on the lipid pattern in children and adolescents]. / Influencia del nivel socioeconómico en el patrón lipídico de niños y adolescentes.

BACKGROUND: The aim of this study was to evaluate the association between socioeconomic status and the presence of cardiovascular risk factors in children from Madrid. METHODS: We studied 2224 boys and girls, ages 2-18 years, attending five different school centers. They were divided into three socioeconomic groups: low class, middle-low class and middle high class, in regard to their parent's occupation and educational attainment. The evaluation included a blood analysis of serum triglycerides (TG), total cholesterol (CT), low density lipoprotein cholesterol (LDL), high density lipoprotein cholesterol (HDL), apolipoprotein A1 (ApoA), apolipoprotein B100 (Apo B), and the Apo A/Apo B and LDL/HDL ratios. RESULTS: There was a positive correlation between socioeconomic status and total cholesterol, Apo A, Apo B and Apo A/Apo B, whereas socioeconomic status and triglycerides were inversely related. The LDL/HDL ratio varied according to age. CONCLUSIONS: Unlike some previously published studies, we found that children belonging to high socioeconomic status have a more atherogenic lipid profile than those of middle low or low socioeconomic levels.

[Lipid profiles of children and adolescents in Madrid]. / Patrón lipídico de niños y adolescentes de Madrid.

We have studied 2,224 children and adolescents of both sexes, ranging between 2 and 18 years of age, at five schools in the city of Madrid. We determined the lipid profile: total cholesterol (T-C), cholesterol bound to high density lipoproteins (HDL-C), cholesterol bound to low density lipoproteins (LDL-C), cholesterol bound to very low density lipoproteins (VLDL-C), triglycerides (TG), apolipoprotein AI and apolipoprotein B100 (Apo A1 and Apo B100, respectively). In relationship to age and sex, in males, as age increases, there is an elevation in LDL-C and TG and a diminution in T-C, HDL-C, Apo AI and Apo B100. There are no changes in VLDL-C. In females, there is a diminution in LDL-C, TG, Apo-B100 and an increase in HDL-C, Apo AI and T-C, with the increase in T-C being found only in those older than 15 years.