Sedentarismo en el embarazo: efectos sobre la madre y el recién nacido / Sedentary lifestyle in pregnancy: Effects on the mother and the newborn

Objetivo Identificar el estado de sedentarismo durante el embarazo y los factores asociados a este comportamiento, los posibles factores, su situación de salud y del recién nacido. Material y métodos Este estudio observacional transversal de 2 fases se desarrolló en el Hospital Universitario y Politécnico de La Fe, y participaron 228 mujeres embarazadas. Las características sociodemográficas maternas se obtuvieron mediante cuestionario estructurado e información de salud de la historia clínica electrónica, así como los resultados perinatales del recién nacido. Para evaluar el sedentarismo se valoró el ejercicio en el tiempo libre y el ejercicio en horario laboral, categorizándolos en función de la intensidad (sedentarismo, actividad leve, actividad moderada e intenso). Resultados En total, la prevalencia de sedentarismo fue del 31,14%. El perfil de este grupo tiene menor nivel educativo y desempleo (p<0,05), presentando una mayor prevalencia de problemas durante el parto, que requirió cesárea, así como problemas posparto en el recién nacido (p<0,05). Conclusiones La inactividad física es altamente prevalente entre las mujeres embarazadas. Debido a los beneficios (o no daños) atribuidos al ejercicio durante el embarazo. Se deben realizar mayores esfuerzos para superar las barreras para promover actividades entre las mujeres embarazadas que son más jóvenes, menos educadas y desempleadas, y aquellas con varios hijos y menores ingresos tienen menos probabilidades de participar en una cantidad adecuada de actividad física, conscientes de la importancia de hacerlo, resolviendo dudas y disipando temores que puedan surgir por una mala comprensión del mecanismo de su beneficio (AU)

Objective Identify the state of sedentary lifestyle during pregnancy and the factors associated with this behavior, the possible factors of your health situation and that of the newborn. Material and methods This two-phase, cross-sectional observational study was developed at the La Fe University and Polytechnic Hospital and 228 pregnant women participated. Maternal sociodemographic characteristics were obtained using structured questionnaire and health information from the electronic medical records, as well as perinatal results of the newborn. To assess sedentary lifestyle, exercise in free time and exercise during working hours were assessed, categorizing them based on intensity (sedentary lifestyle, light activity, moderate and intense activity). Results In total, the prevalence of physical inactivity was 31.14%. The profile of this group has a lower level of education and unemployment (P<.05), presenting a higher prevalence of problems during childbirth, which required a caesarean section, as well as problems after birth in the newborn (P<.05). Conclusions Physical inactivity is highly prevalent among pregnant women. Due to the benefits (or non-harm) attributed to exercise during pregnancy. Further efforts should be taken to overcome the barriers to promote activities among pregnant women who are younger, less well educated, and unemployed and those with multiple children and a lower income are less likely to engage in an adequate amount of physical activity, aware of the importance of doing it, resolving doubts and allaying fears that may arise from a poor understanding of the mechanism of its benefit (AU)

Fish intake in pregnant women and its impact on maternal-fetal health status / Ingesta de pescado en mujeres embarazadas y su impacto en el estado de salud materno-fetal

Objective The objective was to evaluate the consumption of fish in pregnant women and its association with maternal and infant outcomes. Material and methods In this observational study carried out at the La Fe University and Polytechnic Hospital in Valencia, 300 pregnant women participated. The participants were divided into 2 groups according to their fish consumption during pregnancy for comparison. The χ2 test or ANOVA test were applied for comparisons for qualitative and quantitative variables respectively. Results It was observed that 49% of women consumed adequate amounts of fish during pregnancy (2 or 3 weekly servings). Significant differences were observed for iron supplementation (higher in women with inadequate fish consumption), threatened pregnancy loss (higher in women with inadequate fish consumption), infant size (better in women with adequate fish consumption), and arterial O2 pressure (better in women with adequate fish consumption). In regard to the other components of the dietary pattern, no differences were observed but the adequacy of intake for grains and white meat was very poor (less than 5.0%). Conclusions Half of the women met the recommendations for fish intake during pregnancy and presented an overall healthier eating pattern but without statistical significance (AU)

Objetivo Evaluar el consumo de pescado en mujeres embarazadas y su asociación con la salud materno-infantil. Material y métodos En este estudio observacional llevado a cabo en el Hospital Universitario y Politécnico La Fe de Valencia participaron 300 mujeres embarazadas. Las participantes se dividieron en dos grupos según su consumo de pescado durante el embarazo para comparar. Para las comparaciones de variables cualitativas y cuantitativas se aplicaron la prueba de χ2 o la ANOVA, respectivamente. Resultados Se observó que el 49% de las mujeres consumieron cantidades adecuadas de pescado durante el embarazo (2 o 3 raciones semanales). Se observaron diferencias significativas para la suplementación con hierro (mayor en mujeres con consumo inadecuado de pescado), amenaza de pérdida del embarazo (mayor en mujeres con consumo inadecuado de pescado), tamaño del bebé (mejor en mujeres con consumo adecuado de pescado) y presión arterial de O2 (mejor en mujeres con consumo adecuado de pescado). En cuanto a los demás componentes del patrón dietético, no se observaron diferencias, pero la adecuación del consumo de cereales y de carnes blancas fue muy pobre (menos del 5,0%). Conclusiones La mitad de las mujeres cumplían con las recomendaciones de consumo de pescado durante el embarazo y presentaban un patrón alimentario globalmente más saludable, pero sin significación estadística (AU)

Fish intake in pregnant women and its impact on maternal-fetal health status.

OBJECTIVE: The objective was to evaluate the consumption of fish in pregnant women and its association with maternal and infant outcomes. MATERIAL AND METHODS: In this observational study carried out at the La Fe University and Polytechnic Hospital in Valencia, 300 pregnant women participated. The participants were divided into 2 groups according to their fish consumption during pregnancy for comparison. The χ2 test or ANOVA test were applied for comparisons for qualitative and quantitative variables respectively. RESULTS: It was observed that 49% of women consumed adequate amounts of fish during pregnancy (2 or 3 weekly servings). Significant differences were observed for iron supplementation (higher in women with inadequate fish consumption), threatened pregnancy loss (higher in women with inadequate fish consumption), infant size (better in women with adequate fish consumption), and arterial O2 pressure (better in women with adequate fish consumption). In regard to the other components of the dietary pattern, no differences were observed but the adequacy of intake for grains and white meat was very poor (less than 5.0%). CONCLUSIONS: Half of the women met the recommendations for fish intake during pregnancy and presented an overall healthier eating pattern but without statistical significance.

[Sedentary lifestyle in pregnancy: Effects on the mother and the newborn]. / Sedentarismo en el embarazo: efectos sobre la madre y el recién nacido.

OBJECTIVE: Identify the state of sedentary lifestyle during pregnancy and the factors associated with this behavior, the possible factors of your health situation and that of the newborn. MATERIAL AND METHODS: This two-phase, cross-sectional observational study was developed at the La Fe University and Polytechnic Hospital and 228 pregnant women participated. Maternal sociodemographic characteristics were obtained using structured questionnaire and health information from the electronic medical records, as well as perinatal results of the newborn. To assess sedentary lifestyle, exercise in free time and exercise during working hours were assessed, categorizing them based on intensity (sedentary lifestyle, light activity, moderate and intense activity). RESULTS: In total, the prevalence of physical inactivity was 31.14%. The profile of this group has a lower level of education and unemployment (P<.05), presenting a higher prevalence of problems during childbirth, which required a caesarean section, as well as problems after birth in the newborn (P<.05). CONCLUSIONS: Physical inactivity is highly prevalent among pregnant women. Due to the benefits (or non-harm) attributed to exercise during pregnancy. Further efforts should be taken to overcome the barriers to promote activities among pregnant women who are younger, less well educated, and unemployed and those with multiple children and a lower income are less likely to engage in an adequate amount of physical activity, aware of the importance of doing it, resolving doubts and allaying fears that may arise from a poor understanding of the mechanism of its benefit.

Evaluating hazardous waste generation in for-profit outpatient haemodialysis centres.

BACKGROUND: "Green" haemodialysis management to reduce the environmental impact of haemodialysis is growing. OBJECTIVES: Dealing with hazardous waste production could heighten healthcare professionals' awareness of this problem, and improve their healthcare involvement in environmental sustainability and environmental-friendliness. DESIGN AND MEASUREMENTS: A list of for-profit outpatient haemodialysis centres in the Valencian Community (E Spain) was compiled. Data on their hazardous waste production from 2008 to 2012 through the annual waste reports issued by official organisations competent in environmental issues were collected. RESULTS: There are 22 for-profit dialysis centres, that managed the treatment for 69.1% of all dialysis patients in the region. Data were collected from 16 centres that collectively offer 350 dialysis places (33.8% of all the places in this region). Mean annual hazardous waste production per dialysis session increased by 14% during the study period: 0.640 kg per session in 2008 vs. 0.740 kg in 2012. DISCUSSION AND CONCLUSIONS: As hazardous waste production is high, we must examine the reasons why it is growing. Information about haemodialysis waste production and management is scarce and difficult to access. Having an evaluation of its production would motivate further research, especially as end-stage kidney disease is increasing, and whose main long-term treatment, haemodialysis, produces hazardous waste and employs substantial natural resources. Minimising its environmental impact is not mission impossible.

Occupational exposure to pesticides and bile tract carcinoma in men: results from a European multicenter case-control study.

OBJECTIVES: To estimate the associations between occupational exposure to pesticides and extrahepatic biliary tract carcinoma in men, a population-based case-control study was carried out. METHODS: Cases (n = 104), aged 35-70, diagnosed in 1995-1997, were sampled by active reporting systems from hospitals. Controls (n = 1,401) were a random sample of the general male population. Information on occupation and confounding factors was obtained by questionnaires. Exposures were quantified with respect to time, application methods, and use of personal protective equipment. Intensity was evaluated by using a published algorithm which weighted the exposure assigned according to the use of personal protective equipment and mode of application. Logistic regression analyses were conducted adjusted for gallstones, age, and country. RESULTS: Being ever exposed to pesticides resulted in an odds ratio (OR) of 1.0 [95%-confidence interval (CI) 0.6-1.6]. A modestly elevated risk was found for backpack mounted sprayers OR = 1.4 [95% CI 0.7-2.6] and vine farmers OR = 2.5 [95% CI 0.9-7.2]. Using time periods and exposure frequency as intensity measure, no elevated risks were found. The only exception was year of maximum exposure which yielded an OR of 1.6 [95% CI 0.7-3.5]. However, no clear trend was observed in this analysis. CONCLUSIONS: This study does not rule out that pesticide exposure represents an occupational risk factor for extrahepatic biliary tract carcinoma, but no indication of a strong association was observed. Some modes of exposure were weakly, albeit not significantly associated with carcinoma risk. The observed estimates of effects may be influenced by a lack of precise exposure assessment. Different chemical compositions of pesticides were utilized during a long time span of pesticide exposure, and it should be considered that the exposure is assessed with substantial uncertainty that could non-differential and bias results toward the null.

Diet and prevalence of atopic eczema in 6 to 7-year-old schoolchildren in Spain: ISAAC phase III.

BACKGROUND: The prevalence of atopic dermatitis (AD), a chronic skin disease, has increased substantially in recent decades, and different factors have been implicated in its etiology. Although dietary habits are being investigated, few conclusive findings have been reported. Nevertheless, increased consumption of polyunsaturated fatty acids (PUFA) and a diet poor in antioxidants have been related to AD. OBJECTIVES: The objectives of this study were to investigate the association between AD, the intake of different foods, and the effect of a Mediterranean diet among Spanish schoolchildren aged 6 to 7. METHODS: We performed a cross-sectional study with 20 106 schoolchildren aged 6-7 years from 10 different areas of Spain. The participation rate was 76.50%. The prevalence of AD was assessed using the International Study of Asthma and Allergies in Childhood questionnaire and the criteria of the Spanish Academy of Dermatology. To calculate the Mediterranean diet score, we classified food into 2 groups: Mediterranean food, including fruit, seafood, vegetables, pulses, cereals, pasta, rice, and potatoes; and non-Mediterranean food, including meat, milk, and fast food. RESULTS: Milk was negatively associated with AD. Butter and nuts also were negatively associated, although statistical significance was only reached when these foods were consumed 3 or more times a week. CONCLUSIONS: We found no association between the Mediterranean diet score and AD and a positive association between AD and obesity.

Parents’ smoking habit and prevalence of atopic eczema in 6-7 and 13-14 year-old schoolchildren in Spain. ISAAC Phase III

Background and aims: Atopic eczema (AE) is the most frequent inflammatory skin disease in childhood in the western world. Several studies have reported a significant increase of prevalence in recent decades and the environmental factors implicatedin its a etiology, including environmental tobacco smoke.This study aims to investigate the possible association of AE prevalence in Spanish school children aged 6-7 and 13-14 years in relation to their parents’smoking habits. Methods: We conducted a cross-sectional population-based study with 6-7 year-old (n = 27805) and 13-14 year-old (n = 31235) school children from10 Spanish centres. AE prevalence was assessed using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, and the Spanish Academy of Dermatology criteria, used in Spain to diagnose AE. Results: An association was found in school children aged 6-7 (adjusted for gender, presence of asthma, presence of rhinitis, siblings and mother’s level of education) between AE being clinically diagnosed with the mother’s smoking habit (RPRa 1.40,1.10-1.78) and there being more than 2 smokers at home (RPRa 1.34, 1.01-1.78). Regarding the presence of itchy rash, an association was observed with fathers who smoke (RPRa 1.40, 1.13-1.72). Among the 13-14 year-olds, no association was observed in relation to either clinically diagnosed AE or the appearance of itchy rash with parents’ smoking habit. Conclusions: Our results indicate the risk for children of being exposed to environmental tobacco smoke in terms of AE, especially when they are younger

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Parents' smoking habit and prevalence of atopic eczema in 6-7 and 13-14 year-old schoolchildren in Spain. ISAAC phase III.

BACKGROUND AND AIMS: Atopic eczema (AE) is the most frequent inflammatory skin disease in childhood in the western world. Several studies have reported a significant increase of prevalence in recent decades and the environmental factors implicated in its aetiology, including environmental tobacco smoke. This study aims to investigate the possible association of AE prevalence in Spanish schoolchildren aged 6-7 and 13-14 years in relation to their parents' smoking habits. METHODS: We conducted a cross-sectional population-based study with 6-7 year-old (n = 27805) and 13-14 year-old (n = 31235) schoolchildren from 10 Spanish centres. AE prevalence was assessed using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, and the Spanish Academy of Dermatology criteria, used in Spain to diagnose AE. RESULTS: An association was found in school-children aged 6-7 (adjusted for gender, presence of asthma, presence of rhinitis, siblings and mother's level of education) between AE being clinically diagnosed with the mother's smoking habit (RPRa 1.40, 1.10-1.78) and there being more than 2 smokers at home (RPRa 1.34, 1.01-1.78). Regarding the presence of itchy rash, an association was observed with fathers who smoke (RPRa 1.40, 1.13-1.72). Among the 13-14 year-olds, no association was observed in relation to either clinically diagnosed AE or the appearance of itchy rash with parents' smoking habit. CONCLUSIONS: Our results indicate the risk for children of being exposed to environmental tobacco smoke in terms of AE, especially when they are younger.

[Study of the obsesity and overweight as a risk factor for asthma and severity of the asthma in children of Valencia (Spain)]. / Estudio de la obesidad y del sobrepeso como factores de riesgo de la prevalencia y severidad del asma en niños de Valencia.

BACKGROUND: Obesity and overweight have been described as factors associated with asthma. Our aim was to evaluate the role obesity plays on asthma in children. SCOPE AND SUBJECTs: A study carried out on children and teenagers between 8 and 15 years of age, chosen for a cluster-type random sampling from children who studied in 80 schools, which represents 30% of the schools in the city of Valencia. MATERIAL AND METHODS: The analysed data was organized into two groups, obese (from the Body Mass Index (Kg/m2)), showing children with a percentile over 85% of the measuring reference for the Spanish population) and non obese, when they did not fulfil this condition. The prevalence of the different parameters studied was calculated by an Interval of Confidence of 95%. The risk was calculated (Relative Risk) from those symptoms compatible with asthma among obese children compared to non obese children. RESULTS: No significant relative risk (RR) was seen for obesity with regards to asthma in those percentiles of obesity over 85. Otherwise, an increase in the relative risk (RR) regarding the severity of asthma was seen in relation to obesity, mainly in the 85th percentile (RR = 1.51 of suffering between 4-12 wheezing attacks and RR = 1.86 of suffering more than 12 attacks in obese children as opposed to non obese children). CONCLUSIONS: In this study, we did not identify a higher risk of asthma among obese children than among non obese children, although we did find there was a higher risk of severity of asthmatic symptoms. As far as the severity of the asthma is concerned, we saw a higher risk of wheezing and whistling attacks among obese children with the 85th and the 95th percentiles according to the Body Mass Index.

Estudio de la obesidad y del sobrepeso como factores de riesgo de la prevalencia y severidad del asma en niños de Valencia / Study of the obsesity and overweight as a risk factor for asthma and severity of the asthma in children of Valencia (Spain)

Antecedentes: La obesidad y el sobrepeso se han descrito como factores de riesgo asociados a la prevalencia y severidad del asma en niños y adolescentes. El objetivo del estudio ha sido el valorar el papel de la obesidad en el asma infantil. Ámbito de estudio y sujetos: Estudio realizado en niños y adolescentes entre 8 y 15 años, elegidos por un muestreo aleatorio tipo cluster entre los niños que estudiaban en 80 colegios, el cual representa el 30% de los colegios de la ciudad de Valencia. Material y métodos: El análisis de los datos se organizó en dos grupos, obesos (aquellos niños en un percentil superior al 85 del Índice de Masa Corporal (kg/m2), tomando como referencia la población española) y no obesos, cuando no cumplían esta condición. Se calcularon la prevalencia de los diferentes parámetros con un intervalo de confianza al 95%, y el riesgo relativo (RR) de los síntomas compatibles con asma entre niños obesos comparándolos con los no obesos. Resultados: No se obtuvo un riesgo relativo significativo para la obesidad con respecto al asma en aquellos niños por encima del percentil 85. Por otra parte, un incremento en el riesgo en relación con la severidad del asma se observó con la obesidad, principalmente en el percentil 85 (RR = 1,51 de sufrir entre 4-12 ataques de pitos y RR = 1,86 de sufrir más de 12 ataques en niños obesos frente a los no obesos). Conclusiones: En este estudio, no identificamos un riesgo más alto de asma entre niños obesos frente a los no obesos, aunque encontramos que hubiera un riesgo más alto de severidad de síntomas asmáticos. En relación con la severidad del asma, observamos un riesgo más alto de ataques de pitos y sibilancias entre los niños obesos en los percentiles 85 y 95 del Indice de Masa Corporal (AU)

Background: Obesity and overweight have been described as factors associated with asthma. Our aim was to evaluate the role obesity plays on asthma in children. Scope and subjects: A study carried out on children and teenagers between 8 and 15 years of age, chosen for a cluster-type random sampling from children who studied in 80 schools, which represents 30% of the schools in the city of Valencia. Material and Methods: The analysed data was organized into two groups, obese (from the Body Mass Index (Kg/m2)), showing children with a percentile over 85% of the measuring reference for the Spanish population) and non obese, when they did not fulfil this condition. The prevalence of the different parameters studied was calculated by an Interval of Confidence of 95%. The risk was calculated (Relative Risk) from those symptoms compatible with asthma among obese children compared to non obese children. Results: No significant relative risk (RR) was seen for obesity with regards to asthma in those percentiles of obesity over 85. Otherwise, an increase in the relative risk (RR) regarding the severity of asthma was seen in relation to obesity, mainly in the 85th percentile (RR = 1.51 of suffering between 4-12 wheezing attacks and RR = 1.86 of suffering more than 12 attacks in obese children as opposed to non obese children).  Conclusions: In this study, we did not identify a higher risk of asthma among obese children than among non obese children, although we did find there was a higher risk of severity of asthmatic symptoms. As far as the severity of the asthma is concerned, we saw a higher risk of wheezing and whistling attacks among obese children with the 85th and the 95th percentiles according to the Body Mass Index (AU)

Conocimientos sobre el asma infantil entre el profesorado escolar / Knowledge about asthma in children between school teachers

Antecedentes y objetivo: El asma continúa siendo la causa más común de enfermedad crónica entre los escolares, y es una de las principales causas de absentismo. Estudios sobre la salud escolar mostraron la relevancia de los profesores desde el punto de vista sanitario. Estudiar los conocimientos sobre el asma y enfermedades alérgicas del profesorado de los centros escolares para conocer las posibles orientaciones en la atención al niño asmático. Material y métodos: Estudio realizado en centros escolares de educación primaria y secundaria de Valencia. Se trata de un estudio descriptivo, entre 772 profesores que cumplimentaron un cuestionario sobre experiencia personal, conocimientos generales e información sobre el asma y la alergia. Resultados: El 92,2% de los profesores identificaba el ahogo como un síntoma del asma, el 71,9% y el 66,0% relacionan los sibilancias espontáneas y las sibilancias al realizar el ejercicio físico, respectivamente. El 88,5% manifestó que no había recibido suficiente información sobre el asma y el 92,1% sobre la alergia. Conclusiones: Se necesitaría una mayor información en los centros escolares de las pautas a seguir en caso de que haya niños asmáticos para su mejor atención así como para identificar a aquellos niños con esta enfermedad

Antecedents and objectives: Asthma is the most common cause of chronic disease in childhood, and one the most causes of scholar absenteeism. Studies showed the importance of the role that teachers play in children´s health. This work is performed to study the knowledge about asthma and allergy between school teachers, to know possible ways in the asthmatic child care. Material and Methods: Study about the knowledge of asthma and allergy in childhood. It was carried out in school canters of compulsory education in Valencia (Spain). The descriptive study was made among 772 teachers, who filled a questionnaire about personal experience, general knowledge and information about asthma, allergy and atopic dermatitis in childhood. Results: The 92.2% of the teachers identified the breathlessness as an asthma symptom, 71,9% and 66.0% knew whistles and whistle during physical exercise, respectively. The 88.5% answered they had not received enough information about asthma and 92.1% about allergy. Conclusions: In the case of asthmatic children in school centers, more information about the guidelines to follow will be necessary to improve their care, as well as to identify these children with asthma symptoms

Estudio de la presencia de animales domésticos: gatos y perros, y su papel en el asma, la rinitis alérgica y la dermatitis atópica en niños / Study of the presence of domestic animals: cats and dogs and their role in asthma allergic rhinitis and atopic dermatitis in children

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Socioeconomic factors and cervical cancer mortality in Spain during the period 1989-1997.

METHODS: A study was made of cervical cancer (CC) mortality trends in Spain during the period 1989-1997 at National, Autonomous Community and Provincial levels, in relation to different socioeconomic factors. Data were obtained from the Spanish National Institute of Statistics (Instituto Nacional de Estadística, INE). The crude mortality rates were age-adjusted using the indirect method and Gross Domestic Product (GDP) as socioeconomic status (SES) indicator. RESULTS: National CC age-adjusted mortality rates have increasing slightly, varying from 3.09 deaths/100000 women in 1989 to 3.42 in 1996. The highest age-adjusted mortality rates corresponded to Seville, Palencia and Orense, with 4.13, 4.06 and 3.98 cases/100000 women, respectively. The lowest mortality rates were found in Las Palmas, Cantabria and Alicante with 2.63, 2.77 and 2.80 deaths/100000 women, respectively. A relative risk (RR) of 1.14 (95%CI: 0.98-1.32) ( P=0.048) was observed between the provinces with the lowest SES and highest mortality rate, and those with the highest SES and lowest mortality rate. CONCLUSION: The results of our study show a slight increasing trend in CC mortality rates in Spain during the period 1989-1997, and suggest that the variations among provinces and Autonomous Communities could be due to CC risk factors (SES related to human papillomavirus, parity, diet, etc.) and differences in early diagnosis.

La mortalidad por cáncer de mama entre provincias en relación con factores socioeconómicos, tasa de natalidad y edad del primer embarazo a término (1989-97) / Breast cancer mortality between Spanish provinces and its relation with socioeconomic factors, birthrate and age of the first at term pregnancy

- Propósito: En este estudio tratamos de conocer el papel del nivel socioeconómico (NSE), en la evolución de la mortalidad por cáncer de mama (CM) en España y por provincias durante el período 1989-97, teniendo en cuenta la tasa de natalidad y la edad del primer embarazo a término.- Material y métodos: La información de la mortalidad por CM a nivel nacional y por provincias se obtuvo del INE. Defunciones según la causa de muerte (IX Revisión de la Clasificación Internacional de Enfermedades). La información sobre el NSE, la tasa de natalidad y la edad a la maternidad se obtuvieron del INE. Contabilidad regional de España e INE. Indicadores demográficos básicos para el período 1989-97. Calculándose el coeficiente de correlación de Pearson y realizándose un análisis multivariante.- Resultados: Se observaron las tasas de mortalidad por CM más elevadas en las provincias de NSE más elevado, Barcelona, Gerona, Valencia, Alicante y Murcia, aunque no se obtuvo significación estadísticamente significativa. Los coeficientes de correlación de Pearson entre las tasas de mortalidad por CM, con la tasa de natalidad y la edad del primer embarazo a término fueron (-0.421) y 0.240, obteniéndose significación estadística (p<0.05). En el análisis multivariante de regresión lineal se obtuvo una asociación estadísticamente significativa entre el descenso de la tasa de natalidad y el aumento de la mortalidad por CM.- Conclusiones: Nuestros resultados muestran cómo la baja tasa de natalidad, edad tardía de la mujer en el primer embarazo a término y alto NSE, se presentan con una mayor mortalidad por cáncer de mama (AU)

Evolución de la mortalidad y morbilidad del cáncer de mama por provincias y comunidades autónomas en el período 1989-97 / Evolution of mortality and morbidity due to breast cancer according to provinces and autonomous communities in spain 1989-97

El objetivo de este estudio fue analizar la evolución de la mortalidad y morbilidad por cáncer de mama (CM) por provincias y Comunidades Autónomas para el período 1989-1997.Los datos se obtuvieron del Instituto Nacional de Estadística. Las tasas brutas de mortalidad y morbilidad se ajustaron por el método directo e indirecto. Se obtuvieron el coeficiente de correlación de Pearson y las razones de mortalidad y morbilidad. La tasa de mortalidad estandarizada más elevada por provincias se observó en Huesca y Lérida con 37,60 y 37,11 casos/100.000 mujeres, respectivamente. La tasa más baja se encontró en Navarra y Jaén con 14,11 y 18,21 casos/100.000 mujeres, respectivamente. Por Comunidades Autónomas, las tasas de mortalidad más elevadas correspondieron a Aragón, Baleares y Cataluña con 34,31, 32,90 y 32,31 casos/100.000 mujeres. Se observa un aumento de las tasas de mortalidad y morbilidad por CM tanto por provincias como por comunidades autónomas en el período 1989-1997, principalmente en áreas de nivel socioeconómico más elevado (AU)

[Spontaneous pneumothorax and atmospheric pressure]. / Neumotórax espontáneo y presión atmosférica.

In order to assess factors associated with spontaneous pneumothorax (SP), mainly climatic changes, a prospective study was undertaken of 62 SP episodes among patients admitted to our hospital during a two-year period, from January 1994 to January 1996. Atmospheric pressure (AP) changes were analyzed, with daily recording of the number of unusual changes in AP (increases above 95th percentile and decreases below 5th percentile) and how many of these changes were followed by some episode of spontaneous pneumothorax during the following five days. To measure the degree of this association between the emergence of pneumothorax and exposure to unusual changes I AP, the relative risk (RR) was calculated. A total of 77 unusual AP changes were observed, 17 of which concurred with the emergence of 8 episodes of SP during the following five days, with a RR of 2.7 (1.6-4.4). Although the etiology of SP is unknown and probably of multifactorial origin, these data suggest that unusual changes in AP may play a relevant role in triggering this condition.

Neumotórax espontáneo y presión atmosférica / Spontaneous pneumothorax and atmospheric pressure

Con el fin de valorar los factores asociados al neumotórax espontáneo (NE), fundamentalmente climáticos, se realizó un estudio prospectivo de 62 episodios de NE ingresados en nuestro hospital durante un período de 2 años, desde enero de 1994 a enero de 1996. Para ello se analizaron las variaciones de la presión atmosférica (PA), determinándose diariamente el número de cambios no usuales de la PA (aumentos por encima del percentil 95 y caídas por debajo del percentil 5) y cuántos de estos cambios fueron seguidos de algún episodio de neumotórax en los 5 días siguientes. Para medir la fuerza de asociación entre la aparición del neumotórax y la exposición a cambios no usuales de la PA se calculó el riesgo relativo (RR). Se observaron 77 cambios no usuales de PA y 17 de ellos coincidieron con la aparición de 8 episodios de NE en los 5 días siguientes, obteniéndose un RR de 2,7 (1,6-4,4). Estos datos sugieren que aunque la etiología del NE es desconocida y, probablemente multifactorial, los cambios no usuales de la PA pueden desempeñar un papel importante en el desencadenamiento del mismo (AU)