[Life styles associated cognitive impairment. Study from the community pharmacy]. / Estilos de vida asociados a deterioro cognitivo. Estudio preliminar desde la farmacia comunitaria.

OBJECTIVE: Frequency of cognitive impairment among people over 65 years old in community pharmacy. Study of asssociated factors, referral of cases to the specialist and inclusion in a program of health education. MATERIAL AND METHODS: Cross-sectional study of prevalence, frequency, conducted in four pharmacies (two urban and two rural pharmacies) in the Autonomous Community of Valencia. PARTICIPANTS: people over 65 years old who come to the pharmacy and who agree to participate in the study after signing an informed consent. It is used as the initial screening test, the Short Portable Mental State Questionnaire of Pfeiffer. Pfeiffer positive cases undergo a second test (Mini-Mental State Examination, NORMACODEM version). A questionnaire designed specifically for the study has been used to collect information. It includes questions to gain demographic data, questions on lifestyle and chronic diseases. We used analysis logistic regression multilevel. RESULTS: 245 patients have participated (76% of respondents). 12.65% were detected to have cognitive impairment. In the Logistic regression analysis multivariate there is a relation between cognitive impairment and some variables: age, lack of reading habit, unusual reading habit, sleeping less than 6 or more than 8 hours a day. Only 12.9% wanted to be referred for clinical evaluation and 42% were included in a cognitive training program. CONCLUSIONS: There are asssociation between lifestyle habits that are modifiable and cognitive impairment.

The G428A nonsense mutation in FUT2 provides strong but not absolute protection against symptomatic GII.4 Norovirus infection.

In November 2004, 116 individuals in an elderly nursing home in El Grao de Castellón, Spain were symptomatically infected with genogroup II.4 (GII.4) norovirus. The global attack rate was 54.2%. Genotyping of 34 symptomatic individuals regarding the FUT2 gene revealed that one patient was, surprisingly, a non-secretor, hence indicating secretor-independent infection. Lewis genotyping revealed that Lewis-positive and negative individuals were susceptible to symptomatic norovirus infection indicating that Lewis status did not predict susceptibility. Saliva based ELISA assays were used to determine binding of the outbreak virus to saliva samples. Saliva from a secretor-negative individual bound the authentic outbreak GII.4 Valencia/2004/Es virus, but did not in contrast to secretor-positive saliva bind VLP of other strains including the GII.4 Dijon strain. Amino acid comparison of antigenic A and B sites located on the external loops of the P2 domain revealed distinct differences between the Valencia/2004/Es and Dijon strains. All three aa in each antigenic site as well as 10/11 recently identified evolutionary hot spots, were unique in the Valencia/2004/Es strain compared to the Dijon strain. To the best of our knowledge, this is the first example of symptomatic GII.4 norovirus infection of a Le(a+b-) individual homozygous for the G428A nonsense mutation in FUT2. Taken together, our study provides new insights into the host genetic susceptibility to norovirus infections and evolution of the globally dominating GII.4 viruses.

[Incidence of asthma and risk factors in a cohort of schoolchildren aged from 6-7 years old to 14-15 years old in Castellón (Spain) following the International Study of Asthma and Allergies in Childhood (ISAAC)]. / Incidencia de asma y factores de riesgo en una cohorte de escolares desde los 6-7 años hasta los 14-15 años en Castellón, según el Estudio Internacional de Asma y Alergias en la Infancia (ISAAC).

BACKGROUND AND OBJECTIVE: To estimate the incidence of asthma in schoolchildren from 6-7 years old to 14-15 years old and associated risk factors. POPULATION AND METHOD: A cohort study, with the ISAAC phases I and III in 1994 and 2002, respectively, was carried out in Castellón, and the nearby towns Vila-real, Almassora, Benicàssim, El Grau de Castelló, Borriol, and L'Alcora. In 1992, 3,607 schoolchildren aged 6-7 years old took part, of whom 1,805 were again studied in 2002, at the age of 14-15. New cases of asthma were defined following the ISAAC questionnaire. Poisson regression was used in the analysis of asthma risk factors. RESULTS: Participation was 50.0%. The cumulative incidence of asthma was 6.4% during the 8 years of study, 108 new cases of 1,698 schoolchildren free of asthma at beginning. Incidence was greater in boys than girls, and in 14-year old teenagers compared to 15-year olds, although differences were not significant. Risk factors associated with the incidence of asthma were: family history of asthma, history of allergic rhinitis, history of bronchitis and upper-middle compared to lower social class. CONCLUSIONS: A low incidence of asthma was found in schoolchildren from Castellón, Spain, in comparison with other cohort studies. Estimated risk factors were generally in accordance with incidence studies.

Brote epidémico por Salmonella richmond en Castellón, España / Epidemic outbreak caused by Salmonella richmond in Castellón, España

Se efectuó un estudio de casos y controles para investigar un brote de gastroenteritis aguda declarado en un destacamento militar situado en una zona rural de Castellón, España. El objetivo del estudio fue conocer las causas del brote y adoptar medidas de control. En total se incluyó a 135 hombres de los 153 que componían dicho destacamento. Entre el 9 y el 11 de agosto de 1993 se notificaron 45 casos, cuya media de edad fue de 19,2 +- 1,5 años. La tasa de ataque fue de 33,3 por ciento. En el cuadro clínico predominaron diarreas (76 por ciento), vómitos (67 por ciento), náuseas (67 por ciento) y dolor abdominal (28 por ciento). La mediana de la duración de los síntomas fue un día y la del período de incubación, 33 horas. Solo se hospitalizó a un paciente y la evolución de todos los afectados fue buena. En cinco de 14 coprocultivos realizados se aisló Salmonella richmond (6,7:y:1,2). También se detectó una asociación entre el consumo de agua de una acequia, que discurria próxima al campamento, y la enfermedad. Mediante un modelo de regresión logística se constató que el consumo del agua de esta fuente permaneció asociado con el estado de caso después de ajustar la asociación según la edad y el consumo de distintos alimentos (razón de posibilidades + 96,5; intervalo de confianza de 95 por ciento:11,4-814,4). El riesgo de padecer la enfermedad aumentó con la cantidad de agua ingerida (prueba de tendencia X2=65,4;P<0,0001). El análisis químico y bacteriológico del agua de la acequia indicó la presencia de contaminación fecal. Esta acequia no había sido sometida a control sanitario, a pesar de que se utilizaba para riego agrícola. Se evidenció la difusión de especies de Salmonella en el medio ambiente. La educación sanitaria y los estudios microbiológicos de los cauces de agua son de gran valor para la prevención de estas epidemias

A case-control study was carried out to investigate an outbreak of acute gastroenteritis among a military detachment stationed in a rural area of Castellón, España. The purpose of the study was to determine the causes of the outbreak and develop control measures. Of the 153 men in the detachment, 135 were included in the study. Between 9 and 11 August 1993, 45 cases were reported; the patients' average age was 19.2 ± 1.5 years. The attack rate was 33.3%. The clinical picture was dominated by the following symptoms: diarrhea (76%), vomiting (67%), nausea (67%), and abdominal pain (28%). The median duration of symptoms was one day, and that of the incubation period was 33 hours. Only one patient required hospitalization and all of them recovered. Salmonella richmond (6.7: and :1.2) was isolated in 5 of the 14 stool cultures performed. An association was also discovered between the illness and consumption of water from an aqueduct that flowed near the camp. A logistic regression model showed that consumption of water from this source remained associated with cases after adjusting for age and the consumption of various foods (odds ratio = 96.5; 95% confidence interval, 11.4­814.4). The risk of suffering from the illness rose with the amount of water consumed (2 trend test = 65.4, P < 0.0001). Chemical and bacteriological analyses of the aqueduct water indicated the presence of fecal contamination. The aqueduct had not been subject to sanitary monitoring, even though the water was used to irrigate agricultural crops. The widespread presence in the environment of species of Salmonella was demonstrated. Health education and microbiological studies of water courses can be of great value in preventing such epidemics.

Brote epidémico por Salmonella richmond en Castellón, España / Epidemic outbreak caused by Salmonella richmond in Castellón, España

Se efectuó un estudio de casos y controles para investigar un brote de gastroenteritis aguda declarado en un destacamento militar situado en una zona rural de Castellón, España. El objetivo del estudio fue conocer las causas del brote y adoptar medidas de control. En total se incluyó a 135 hombres de los 153 que componían dicho destacamento. Entre el 9 y el 11 de agosto de 1993 se notificaron 45 casos, cuya media de edad fue de 19,2 +- 1,5 años. La tasa de ataque fue de 33,3 por ciento. En el cuadro clínico predominaron diarreas (76 por ciento), vómitos (67 por ciento), n—seas (67 por ciento) y dolor abdominal (28 por ciento). La mediana de la duración de los síntomas fue un día y la del período de incubación, 33 horas. Solo se hospitalizó a un paciente y la evolución de todos los afectados fue buena. En cinco de 14 coprocultivos realizados se aisló Salmonella richmond (6,7:y:1,2). También se detectó una asociación entre el consumo de agua de una acequia, que discurria próxima al campamento, y la enfermedad. Mediante un modelo de regresión logística se constató que el consumo del agua de esta fuente permaneció asociado con el estado de caso después de ajustar la asociación según la edad y el consumo de distintos alimentos (razón de posibilidades + 96,5; intervalo de confianza de 95 por ciento:11,4-814,4). El riesgo de padecer la enfermedad aumentó con la cantidad de agua ingerida (prueba de tendencia X2=65,4;P0,0001). El análisis químico y bacteriológico del agua de la acequia indicó la presencia de contaminación fecal. Esta acequia no había sido sometida a control sanitario, a pesar de que se utilizaba para riego agrícola. Se evidenció la difusión de especies de Salmonella en el medio ambiente. La educación sanitaria y los estudios microbiológicos de los cauces de agua son de gran valor para la prevención de estas epidemias