Prevalencia del síndrome de burnout en médicos y enfermeros de un hospital militar / Prevalence of the burnout syndrome in doctors and infirmary personnel of a military hospital

Introducción. El burnout es un síndrome de cansancio emocional, despersonalización y falta de realización personal que puede ocurrir entre individuos que trabajan con personas. Es más frecuente en profesiones de ayuda, como sanitarios y educadores que prestan servicios al público. Los factores laborales que pueden producir burnout en médicos y enfermeros son la sobrecarga laboral, el trato con pacientes y familiares, y la falta de motivación laboral y de apoyo social. En personal sanitario militar se describe también la asistencia a misiones internacionales como un factor de riesgo para la aparición de este síndrome. El objetivo principal de este estudio es conocer la prevalencia de las tres dimensiones del síndrome de burnout en médicos y enfermeros militares destinados en el Hospital Central de la Defensa «Gómez Ulla». Personas y Métodos. Se ha diseñado un estudio transversal, y se ha realizado sobre la totalidad de los médicos y enfermeros militares destinados en el hospital «Gómez Ulla» de Madrid. Se han recogido los datos mediante dos cuestionarios autoadministrados: la versión en castellano del Maslach Burnout Inventory (MBI), y un cuestionario de variables sociodemográficas y laborales. Se ha realizado un estudio descriptivo, bivariante y multivariante, de las tres dimensiones del síndrome. Resultados. La tasa de respuesta es del 70,24%. El 81,8% son hombres, y la edad media es de 45,84 años (DS 7,87). La mayoría son médicos (91,2%), y algo más de la mitad (54,3%) tiene entre 15-30 años de antigüedad en la profesión. El 94,7% realiza atención especializada, y el 42,7% atiende menos de 10 enfermos al día. El 59,9% ejerce también su profesión fuera de la Sanidad Militar y el 45% ha realizado alguna misión internacional a lo largo de su carrera profesional. Los valores medios de las tres dimensiones del burnout son: 24,42 (DS 13,66) para cansancio emocional, 8,08 (DS 6,51) para despersonalización y 12,54 (DS 8,63) para falta de realización personal. El 42,4% de los médicos y enfermeros militares analizados tienen niveles altos de cansancio emocional, y el 35,9% niveles altos de despersonalización y falta de realización personal (AU)

Introduction. The burnout is a syndrome of emotional tiredness, personality damage and lack of own fulfilment, that may occur between individuals working with people. It is more frequent in helping professionals, like health workers and educators serving to general public. The labour aspects that may produce burnout in doctors and infirmary personnel are the overloaded labour, dealing with patients and families, and the lack of morale and social support. Within the military health workers, the attendance to international missions, as another risk factor for this syndrome appearance, is described too. The main objective for this study is to detect the prevalence of the three dimensions at the burnout syndrome in doctors and infirmaries in the Hospital Central de la Defensa «Gómez Ulla». Staff and Methods. A transversal study was designed, and it was done over the total number of doctors and infirmary personnel posted at hospital «Gómez Ulla», fromMadrid. Data were collected by two questionnaires self-filled: the castilian version of the Maslach Burnout Inventory (MBI) test, and a questionnaire of social-demographic and job variables. A descriptive study was done, bivariant and multivariant, of the syndrome’s three dimensions. Results. The response rate was of 70.24%. 81.8% were men, with a medium age of 45.84 years (SD 7.87). Mainly were doctors (91.2%), and more than a half (54.3%) had a professional career between 15 and 30 years. 94.7% is working in specialized health assistance, and 42.7% assist less than 10 patients daily. 59.9% have professional works out of the Military Health Service too, and 45% have done some international mission along their professional careers. Medium values of the three burnout dimensions are: 24.42 (SD 13.66) for emotional tiredness, 8.08% (SD 6.51) for personality damage and 12.54 (SD 8.63) for lack of own fulfilment. 42.4% of the doctors and military infirmary personnel analysed had high levels of emotional tiredness, and 35.9% high levels of personality damage and lack of own fulfilment (AU)

Epidemiología del síndrome de burnout / Burnout syndrome epidemiology

El síndrome de burnout constituye un proceso de alta prevalencia e importantes consecuencias entre los profesionales sanitarios y especialmente en enfermería. Por ello nos hemos propuesto estudiar las tres dimensiones del síndrome (cansancio emocional, despersonalización y falta de realización) y la función que ciertos factores personales, laborales e institucionales tienen en el desarrollo del proceso. Se realizó un estudio transversal tras un muestreo aleatorio entre todo el personal adscrito al área de enfermería de un hospital de Madrid. Se aplicaron dos tipos de instrumentos de recogida de información: un cuestionario que recopilaba variables sociodemográficas, laborales e institucionales y el Maslach Burnout Inventory (MBI) en su versión validada en español, que estudiaba las tres dimensiones del síndrome de burnout. Se realizó un análisis de regresión logística múltiple, tomando como variables dependientes las tres escalas del síndrome y ajustando por todas las demás variables. Se mostraron como factores de riesgo claro las opiniones desfavorables de los profesionales de las variables institucionales, siendo especialmente importantes para la escala de cansancio emocional(AU)

The burnout syndrome constitutes a process which bears high prevalence and important consequences among sanitary professionals, particularly among nurses. Therefore, the authors have proposed to study the three dimensions of this syndrome, namely emotional tiredness, depersonalization and lack of a sense of achievement plus the function certain personal, labor, and institutional factors have in development of this process. The authors carried out a transversal study based on a random sample from among all the nursing staff at a Madrid hospital. Two methods to gather information were employed: one questionnaire gathered socio-demographic data, labor and institutional variables while the Maslach Burnout Inventory (MBI), in its verified Spanish version, studied the three burnout syndrome dimensions. The authors made a multiple logistical regression analysis, using as dependent variables the three syndrome scales and adjusting parameters for all the other variables. Clear risk factors were shown; these included unfavorable opinions professionals hold regarding institutional variables; the scale for emotional tiredness warrants special note(AU)

¿Una intervención educativa en niños de doce años de Madrid modifica sus conocimientos y hábitos de higiene buco-dental? / An educative intervention in children of twelve years of Madrid could modify its knowledge and habits bucodental hygiene?

Una adecuada educación en higiene buco-dental en niños es deseable para que éstos adquieran desde la infancia unos hábitos saludables que prevengan posibles enfermedades odontológicas en el futuro. En este estudio nos hemos propuesto valorar la eficacia de un programa de intervención en escolares que les proporcione unos conocimientos básicos sobre este aspecto sanitario. Para ello hemos impartido a sesenta niños y niñas de sexto de primaria (de doce años) del colegio Berriz Veracruz una charla educativa, distribuyéndoles dos encuestas, una antes y otra cuatro semanas después del programa educativo, y hemos estudiado los conocimientos y hábitos que sobre salud e higiene buco-dental presentaron antes de la intervención, así como las modificaciones que sufrieron tras la misma. Observamos cambios significativos tanto en la frecuencia como en la técnica de cepillado, en la actitud a tomar ante el sangrado de encías y en el abandono de hábitos nocivos. Por todo ello concluimos que los programas educativos sobre higiene y salud buco-dental son eficaces para modificar positivamente las conductas de niños de esta edad, subrayando el interés que tiene la implantación de los mismos en el ámbito escolar (AU)

The proper education on dental hygiene is desirable for children, so that they acquire from an early age good habits that prevent possible future diseases. Our study focuses on the results of an educational program for school age children that provide basic knowledge about dental hygiene. To do this, we have given an educational workshop to a group of sixth graders from The School Berriz Veracruz. We conducted a survey before and after the survey to monitor the children's dental hygiene habits before and after the workshop. That way we could determine the changes in attitudes upon attending an information workshop on dental hygiene. We noticed significant changes both in the frequency and technique of mouth washing. We also observed changes in attitude toward gums bleeding and abandonment of poor hygiene habits. Thus, we conclude that educational workshops about dental hygiene provide positive results in children's habits. We must highlight the importance of implementing such workshops among school-age children (AU)

[Influence of the diet on the development of colorectal cancer in a population of Madrid]. / Influencia de la dieta en la aparición del cáncer colorrectal en una población de Madrid.

OBJECTIVE: Although the genetic component in colorectal carcinoma (CRC) is well established, some environmental factors, mainly dietary, can favor its development. The objective of this study is to evaluate the relationship between daily consumption of specific food groups and development of CRC. METHODS: We carried out a case-control study in an area of Madrid; 196 patients with diagnosis of CRC with confirmed histology and registered to May 1998 in the Community of Madrid tumor register were included, and they were compared with 196 controls matched by age, sex, and geographical area. All of them filled out a questionnaire with information on diet, substance abuse, physical activity, drugs, and family history of CRC. RESULTS: The logistic regression analysis showed a weakly positive association with meat (OR: 1.02; CI: 1.01-1.04), viscera (OR: 1.12; CI: 1.02-1.23), and sausage (OR: 1.07; CI: 1.03-1.1) consumption, and a modest inverse association with consumption of yogurt (OR: 0.97; CI: 0.95-0.98), tomato (OR: 0.99; CI: 0.98-0.99), strawberries and cherries (OR: 0.97; CI: 0.95-0.99), oranges, grapefruits, and natural fruit juices (OR: 0.99; CI: 0.98-1). CONCLUSIONS: These results are an additional empirical evidence that must be confirmed through prospective studies.

Influencia de la dieta en la aparición del cáncer colorrectal en una población de Madrid / Influence of the diet on the development of colorectal cancer in a population of Madrid

Objetivo. Aunque el componente genético en el carcinoma colorrectal (CCR) está bien establecido, algunos factores ambientales, principalmente dietéticos, pueden favorecer su aparición. El objetivo de este estudio es evaluar la relación entre el consumo diario de grupos específicos de alimentos y la presencia de CCR. Métodos. Realizamos en un área de Madrid un estudio de casos controles, incluyendo 196 diagnósticos de CCR, con histología confirmada y registrados en el registro de tumores de la Comunidad de Madrid a fecha de mayo de 1998, que se compararon con 196 controles pareados por edad, sexo y ámbito geográfico. Todos respondieron a un cuestionario que incluía información sobre dieta, hábitos tóxicos, actividad física, fármacos e historia familiar de CCR. Resultados. El análisis de regresión logística mostró una asociación débilmente positiva para el consumo de carne (odds ratio [OR]: 1,02; intervalo de confianza [IC]: 1,01-1,04); vísceras (OR: 1,12; IC: 1,02-1,23), y embutidos (OR: 1,07; IC: 1,03-1,1), y una modesta asociación inversa para el consumo de yogur (OR: 0,97; IC: 0,95-0,98); tomate (OR: 0,99; IC: 0,98-0,99); fresas, cerezas (OR: 0,97; IC: 0,95-0,99); naranjas, pomelos y zumos naturales de fruta (OR: 0,99; IC: 0,98-1). Conclusiones. Estos resultados intentan sumar evidencias empíricas que habría que confirmar con estudios prospectivos (AU)

Mutagenicidad en aguas de consumo mediante el test de reversión trp- en Escherichia coli / Mutagenicity in drinking water

Una de las principales fuentes de mutágenos ambientales se deriva de la cloración de las aguas de consumo público, ya que es bien conocido que el cloro reacciona con precursores del agua produciendo un grupo de compuestos que incluyen posibles carcinógenos humanos. Con el objeto de evaluar la actividad mutagénica de derivados orgánicos procedentes del agua de consumo de Madrid, nos planteamos utilizar el test de mutación reversa con Escherichia coli. Material y métodos: Se emplearon las cepas de Escherichia coli triptófano dependientes, WP2, WP2 uvrA – y WP2 uvrA – pKM 101. Cada experiencia se realizó con y sin activación metabólica (mezcla S9) y utilizando el método de incorporación en placa. Las muestras de agua fueron procesadas con el fin de concentrar los compuestos orgánicos clorados. Resultados y conclusiones: No hemos encontrado actividad mutagénica positiva con ninguna de las cepas de ensayo. Los mayores índices de mutación se obtuvieron con la cepa WP2 uvrA – pKM 101 y en las experiencias sin fracción microsomal (índice de mutación de 1,84) (AU)

Chlorinated drinking water is one of the primary sources of enviromental mutagens. Chlorine reacts with specific water precursors, creating a group of compounds with suspected human carcinogens. This study was conducted to investigate possible mutagenic activity in organic chlorinated compounds in the drinking water in Madrid using the Escherichia coli everse mutation assay. Materials and methods: Escherichia coli triptophan-dependent strains WP2, WP2 uvrA – and WP2 uvrA – pKM 101 were used in this study. Each test was performed with and without metabolic activation (S9 mix), using the plate incorporation method. The water samples were processed in order to concentrate the organic chlorinated compounds. Results and conclusions: No positive activity was found in any of the strains tested. The highest levels of mutagenicity appeared in the WP2 uvrA – pKM 101 strain and in the test where the microsome fraction was not used (index of mutation, 1.84) (AU)

Risk factors in miscarriage: a review.

Miscarriage is one of the most frequent problems in human pregnancy. The most widely accepted definition is that proposed by the World Health Organization (WHO) in 1977. The incidence among clinical pregnancies is about 12-15% but including early pregnancy losses it is 17-22%. The only two etiologic factors recognized by all authors are uterine malformations and parental balanced chromosomal rearrangements. There have been many other suggested risk factors. In this revision we discuss these.

Cinco años de evolución del consumo extrahospitalario de betalactámicos en España (1993-1997) / Five-year analysis of extrahospital consumption of betalactams in Spain (1993-1997)

Se ha realizado un estudio cualitativo y cuantitativo del consumo extrahospitalario de penicilinas de amplio espectro y de cefalosporinas en España entre 1993 y 1997. Las penicilinas representan el grupo de mayor consumo, seguidas de los macrólidos y las cefalosporinas. Las unidades y valores (ptas.) de penicilinas y cefalosporinas durante estos cinco años presentan oscilaciones; sin embargo, el análisis del consumo mensual para ambos grupos mantiene una tendencia estable, con picos en los meses de invierno y mínimos en los de verano. Tanto las penicilinas (54,38 por ciento) como las cefalosporinas (27,71 por ciento) han sido prescritas fundamentalmente para infecciones respiratorias de vías altas. Los hombres han recibido más penicilinas y cefalosporinas que las mujeres (51,02 por ciento y 55,09 por ciento, respectivamente). Los niños menores de 11 años representan el grupo de mayor consumo para ambas familias de antibióticos, mientras que las personas entre 55 y 64 años representan el grupo de menor consumo (AU)

[Incidence of dental caries in a child population from Mostoles: evaluation of a preventive program after 2 years]. / Incidencia de caries en una población infantil de Móstoles: evaluación de un programa preventivo transcurridos 2 años.

OBJECTIVE: To know the efficacy and effectivity od dental health program after 2 years. DESIGN: The study of prospective cohorts not aleatorized. POPULATION AND METHODS: The exposed cohort is composed of 583 school children, 296 girls and 287 boys, the non-exposed cohort is composed of 261 school children, 132 girls and 129 boys. We carried out and odontological exploration following the criteria of the WHO the preventive measures we carried out are health education, weekly mouthrinse of NaFl at 0.2%, occlusive sealant in the first permanent molar and external application fluorine gel. We measured and compared the different indexes of tooth decay and sociodemographic variables between both cohorts, the statistic meaning has been determined through the U est of Mann Whitney. RESULTS: We have found statistically significant differences between both cohorts in the indexes of decay in the exposed cohorts. The indexes of decay in the exposed cohort being DMFT: 0.31; DMFM (first permanent molar): 0.31; DMFS: 0.4. And in the non-exposed cohort DMFT: 0.81; DMFM: 0.81; DMFS; 1.09. Existing an epidemiological association between the preventive program and the prevention of dental decay with a relative risk of 0.24 (95% CI, 0.17-0.33) and the prevention fraction of 76.3% (95% CI, 67-83). CONCLUSIONS: The preventive program after two years elapsed is effective and has a clear protector effect.

Incidencia de caries en una población infantil de móstoles: evaluación de un programa preventivo transcurridos 2 años / Incidence of caries in a child population in mostoles: evaluation of a preventive programme after two years

Objetivo. Conocer la eficacia y efectividad de un programa de salud bucodental transcurridos 2 años. Diseño. Estudio de cohortes prospectivas no aleatorizado. Población y métodos. La cohorte expuesta consta de 583 escolares, 296 niñas y 287 niños; la cohorte no expuesta consta de 261 escolares, 132 niñas y 129 niños. Realizamos una exploración odontológica siguiendo los criterios de la OMS. Las medidas preventivas que llevamos a cabo son educación sanitaria, colutorio semanal de FlNa al 0,2 por ciento, selladores oclusales en el primer molar permanente y flúor tópico gel. Hemos medido y comparado diferentes índices de caries y variables sociodemográficas entre ambas cohortes; la significación estadística se ha determinado mediante el test de la 'U' de Mann Whitney. Resultados. Hemos encontrado diferencias estadísticamente significativas entre ambas cohortes, siendo los índices de caries en la cohorte expuesta: CAOD, 0,31; CAOM, 0,31, y CAOS, 0,4, y en la cohorte no expuesta: CAOD, 0,81; CAOM, 0,81, y CAOS: 1,09. Habiendo una asociación epidemiológica entre el programa preventivo y la prevención de caries dental con un riesgo relativo de 0,24 (IC del 95 por ciento, 0,17-0,33) y la fracción prevenible del 76,3 por ciento (IC del 95 por ciento, 67-83). Conclusiones. El programa preventivo transcurridos 2 años es eficaz y tiene un claro efecto protector (AU)

Prevalencia de caries en una población infantil de Móstoles / Prevalence of decay in children population of Móstoles (Spain)

Objetivo: Conocer la prevalencia de caries de los escolares de Móstoles y diseñar el plan de actuación para la implantación de un programa preventivo de salud bucodental. Diseño: Estudio epidemiológico observacional de tipo transversal. Población y métodos: El grupo general consta de 953 escolares, que dividimos en dos grupos expuesto/no expuesto al programa de salud Bucodental. El grupo expuesto consta de 655 escolares pertenecientes a 10 colegios de Móstoles y ubicados en la zona de influencia del Centro de Salud. El grupo no expuesto consta de 298 escolares pertenecientes a 5 colegios de Móstoles fuera de la zona de influencia del Centro de Salud. Revisamos a los escolares siguiendo los criterios de la O.M.S. Hemos medido y comparado los diferentes índices y variables (sexo, clase social, mordida cruzada, maloclusión, frecuencia de cepillado, selladores) entre ambos grupos, la significación estadística se ha determinado mediante el test de la "U" de Mann Whitney. Resultados: La prevalencia total de caries en el grupo general fue del 56,2 por ciento, en el grupo expuesto del 58 por ciento y en el grupo no expuesto del 52,3 ° por ciento. Se obtuvo los siguientes índices de caries en dentición permanente en el grupo expuesto: CAOD (0,13); CAOM (0,13) y CAOS (0,13) y en el grupo no expuesto: CAOD (0,12); CAOM (0,12) y CAOS (0,14). No se encontraron diferencias estadísticamente significativas al comparar los respectivos índices. Conclusiones: Más de un 50 por ciento de los escolares de ambos grupos tiene caries en su dentición temporal, lo que nos aparta de los objetivos de la O.M.S. para el año 2.000. Los índices de caries en dentición permanente son prácticamente igual a 0 siendo un buen momento para iniciar el programa para la dentición. La frecuencia de cepillado es escasa, más de un 70 por ciento de los niños no se cepilla los dientes diariamente (AU)

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Risk of oral cancer associated with tobacco smoking, alcohol consumption and oral hygiene: a case-control study in Madrid, Spain.

Oral cancer is a disease whose principal etiological factors are tobacco and alcohol consumption, which if controlled could help avoid many tumors. However, consumption has continued to grow for years. We have studied the risk of the principal factors established in the development of oral cancer and the influence of the oral hygiene level on the appearance of these tumors. Seventy-five cases of oral cancer and 150 controls from the Madrid community were interviewed on tobacco and alcohol consumption habits and their oral hygiene level. The Odds Ratio (OR) for consumption of 6-20 cigarettes/day is 3.1 and 7.96 for more than 20 cigarettes/day. When more than 50 g of alcohol/day is consumed the risk results in an OR of 5.3. Daily brushing is a protective factor (OR, 0.41). In conclusion, the most important risk factor for developing oral cancer is tobacco consumption followed by alcohol consumption.

[Five-year analysis of extrahospital consumption of betalactams in Spain]. / Cinco años de evolución del consumo extrahospitalario de betalactámicos en España (1993-1997).

We carried out a qualitative and quantitative study to determine extrahospital consumption of both broad-spectrum penicillins and cephalosporins in Spain in the period 1993-1997. Penicillins were the most consumed group, followed by macrolides and cephalosporins. Units and value (ptas.) of penicillins and cephalosporins during these five years show interannual variations. Nevertheless, monthly analysis of consumption for both groups showed a stable tendency, with peaks in winter months and drops in the summer. Both penicillins (54.38%) and cephalosporins (27.71%) were prescribed mainly for upper respiratory tract infections. Men received more penicillins and cephalosporins than women (51.02% and 55.09%). Children under 11 years were the main group for consumption of both types of antibiotic, while patients aged 55-64 years were the group with the least consumption.

[Functional deterioration secondary to hospitalization for an acute disease in the elderly. An analysis of its incidence and the associated risk factors]. / Deterioro funcional secundario a la hospitalización por enfermedad aguda en el anciano. Análisis de la incidencia y los factores de riesgo asociados.

OBJECTIVE: To determine the incidence of functional impairment at hospital admission and after hospital discharge, and to identify those factors that could be predictors of such impairment in a cohort of elderly people with high level of independence in the basic activities of daily living (BADL). DESIGN: Epidemiologic, longitudinal and prospective study. SETTING: Acute unit in a geriatric department. SUBJECTS: The follow-up population was made up by 150 subjects older than 65 years, admitted on account of acute medical conditions from December, 15th, 1995, to December, 15th, 1996, who were independent for walking and independent or with slight dependence for BADL. STUDY PARAMETERS: All patients were evaluated at 48 hours after admission and one month after discharge by means of a protocol including sociodemographic, clinical, attending, functional and mental parameters. RESULTS: The incidence of functional impairment at hospital admission was 70.66%; such impairment persisted one month after discharge in 29.3% of subjects. The most involved activities related to motility. In the analysis of crude data, the following parameters showed association with functional impairment risk one month after discharge: female sex (OR: 2.5), sensorial organ pathology (OR: 2.6), hospital stay longer than 15 days (OR: 7.2), and Lawton Index score (3.8 +/- 2.6 in impaired patients vs. 4.9 +/- 2 in non-impaired patients; p < 0.01). Barthel Index score at admission lower than 60 (OR: 9.5), Cognitive Miniexam score lower than 28 (OR: 4.1), Informant Test score higher than 84 (OR: 2.5) and Geriatric Depression Scale score 9 (OR: 3.1). In the logistic regression model, the following parameters remained as predictors of impairment: sex (OR: 3.3), days of hospital stay (OR: 2.3) and Barthel Index score at admission (OR: 6.1) and Cognitive Miniexam score (OR: 2.7). CONCLUSIONS: For our population, sex, hospital stay days, functional impairment in Barthel Index at admission and Cognitive Miniexam score parameters seem to behave as independent variables that can predict functional impairment risk for BADL one month after discharge. These parameters could be useful to select groups of elderly people with impairment risk, who could benefit from specialized interventions leading to prevent/decrease functional impairment secondary to acute disease and hospitalization.

[Seroprevalence of antibodies against measles, rubella, mumps and varicella among school children in Madrid]. / Seroprevalencia de anticuerpos frente a sarampión, rubéola, parotiditis y varicela en escolares madrileños.

OBJECTIVE: The aim of this study was to assess the seroprevalence of antibodies against MMR and varicella in a population of children between 6 and 7 years of age vaccinated against measles, mumps and rubella at 15 months of age. PATIENTS AND METHODS: This cross-sectional study was carried out in a group of healthy children (6-7 years of age) of the Autonomous Community of Madrid, Spain. Vaccination against MMR at 15 months of age was documented for all children included in the study. Blood samples were drawn from all participants and sera were stored at -20C until they were tested at the end of the study. Measles, mumps, rubella and varicella antibody levels were measured by means of the enzyme linked immunosorbent assay (ELISA) method (IgG Genzyme Virotech GmbH). Positive values were defined as optical density values of > or = 0.20 for measles, > or = 0.30 for mumps, > or = 0.40 for rubella and > or = 0.36 for varicella. Prevalence (and the corresponding 95% confidence limits) assessed by the presence of anti-measles, anti-mumps, anti-rubella and anti-VZV antibodies on the study population were calculated. The Chi-squared test was used to evaluate differences in prevalence between sexes. The Chi-squared test was used to evaluate differences in prevalence between the sexes. RESULTS: A total of 174 children were recruited between October and November 1997. The mean age (SD) and male/female ratio were 6.4 (0.5) years and 0.8 (45.6%/54.5%), respectively. Prevalence of antibodies against measles, rubella, mumps and varicella were 92% (88-96%), 95% (92-98%), 81% (76-86%) and 85% (90-90%), respectively. There were no significant differences between the sexes in relationship to the prevalence of measles, mumps, rubella or varicella antibodies. CONCLUSIONS: Approximately 20% of these 6 to 7 year old children vaccinated at 15 months of age were unprotected against the mumps. Eight percent and 5% were sero-negative for measles and rubella, respectively. Administration of the second dose of MMR vaccine at 4 to 6 years of age instead of at 11 years would contribute to avoid the accumulation of non-immune children. Eighty-five percent of the study population was sero-positive for VZV. These data suggest that, in Spain, VZV infections commonly affect children younger than 5 years of age.

Familial aggregation of cardiovascular disease risk factors: the Cuenca Study.

OBJECTIVE: The familial aggregation of lipid levels, blood pressure, and body mass index (BMI) was studied in schoolchildren in Cuenca, Spain. METHODS: A cross-sectional observation study was made of 307 schoolchildren of both sexes, age range 9-12 years, from three schools in Cuenca, Spain, and of 346 parents. Social and demographic variables, weight, height, body mass index, systolic blood pressure, diastolic blood pressure, and fasting plasma concentrations of total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides were evaluated. RESULTS: The Spearman coefficients of correlation for total cholesterol, LDL-cholesterol, and BMI for parents and daughters were 0.34-0.42 (P < 0.01). These coefficients of correlation for parents and sons were lower (P > 0.05). The coefficient of correlation for blood pressure in parents and sons was low (P < 0.05). None of the variables showed any coefficient of correlation between spouses. The sexual differences in the correlations between the levels of the different variables were confirmed by multiple regression analysis. Total cholesterol and LDL-cholesterol levels and BMI accounted for larger percentages of variability in these parameters in daughters than in sons. The paternofilial aggregation of HDL-cholesterol and triglyceride levels was weak. The only variable that accounted for a significant variability in blood pressure (systolic and diastolic) was weight in children of both sexes. CONCLUSIONS: The familial aggregation of lipid levels and body mass index showed sex differences. The paternofilial aggregation of blood pressure was weak. There was no relation between spouses.

[Familial aggregation of arterial pressure figures and weight indices: study in Cuenca]. / Agregación familiar de cifras de presión arterial e índices ponderales: estudio de Cuenca.

BACKGROUND: The aim of this study was to assess the familial aggregation of blood pressure and body mass index levels in schoolchildren of Cuenca city, Spain. SUBJECTS AND METHODS: A cross sectional study was made including 307 both sexes schoolchildren 9-12 years old recruited in three schools of Cuenca city, and 346 of their parents. There were determined sociodemographics variables, weight, height, body mass index, SBP, DBP and fasting plasma total cholesterol, cLDL, cHDL and triglyceride concentrations. RESULTS: Parents-children correlation coefficients in blood pressure levels ranged between -0.1 and 0.2. Parents-daughters correlations were stronger than parents-sons in ponderal indexes. The relationship of ponderal indexes and blood pressure between spouses was weak, with correlation coefficients between 0.08 y 0.1. By stepwise multiple regression analysis it was found that the only variable that explained a significant percentage of blood pressure variability (both systolic and diastolic) was the weight of the schoolchildren in both sexes. Parents body mass index explained more than 32% of body mass index daughter's variability. In sons any variable explained a significant percentage of variability. CONCLUSIONS: The parents-children aggregation of blood pressure is weak. Parents-children aggregation of ponderal indexes is stronger, though there are considerable sex-differences. Spouses relationship, though positive, is weak in all variables.

Adherence of mouse peritoneal macrophages following exposure to lead.

Lead is a toxin widely used in industry. Recently, medical investigation into lead exposure has turned to testing organ systems, such as the immune system, that historically were not associated with lead poisoning. We evaluated the effects of doses of 13, 130 or 1,300 ppm of lead on the adherence of mouse peritoneal cells, and particularly on macrophages. Cellular adherence was measured according to the De la Fuente technique. Adherence of macrophages showed significant changes in the 1,300 ppm group, revealing a reduction to 55% of the control group. The macrophage adherence index showed 91% sensitivity and 96% specificity. These results indicate a considerable reduction in the adherence of peritoneal macrophages following exposure to certain levels of lead.