Incidencia de diabetes tipo 2 y factores asociados en la población adulta de la Comunidad de Madrid. Cohorte PREDIMERC / Incidence of type 2 diabetes and associated factors in the adult population of the Community of Madrid. PREDIMERC cohort

Objetivos. Estimar la incidencia y los factores de riesgo de diabetes tipo2 en la población adulta de Madrid (España) y comparar los modelos predictivos de diabetes tipo2 basados en los criterios de prediabetes de la American Diabetes Association (ADA) y la Organización Mundial de la Salud (OMS). Material y métodos. Estudio prospectivo de una cohorte poblacional formada por 2048 individuos de entre 30 y 74años sin diabetes. Al inicio del estudio se realizó una encuesta epidemiológica y se midió la glucemia basal, la HbA1c, el índice de masa corporal y el perímetro de la cintura. Se realizó un seguimiento de 6,4años. Los casos nuevos de diabetes tipo2 se identificaron a través de la historia clínica electrónica de atención primaria. Resultados. La incidencia de diabetes tipo2 fue 3,5 casos/1.000 personas-año. En el análisis multivariante las variables que se asociaron con la aparición de diabetes tipo2 fueron la edad, los antecedentes familiares de diabetes, la glucemia basal (100-125mg/dl), la HbA1c (5,7-6,4%) y el perímetro de la cintura (≥94cm en hombres y ≥80cm en mujeres). De estas, las más significativamente asociadas fueron la glucemia basal y la HbA1c. Los criterios de la ADA y la OMS para definir prediabetes tuvieron la misma capacidad predictiva. Conclusión. La incidencia de diabetes tipo2 estimada en Madrid fue inferior a la encontrada en otros estudios poblacionales, siendo el estado glucometabólico el principal factor asociado a la progresión a diabetes tipo2. No se han detectado diferencias entre la prediabetes definida por la ADA y la OMS para predecir la aparición de la enfermedad (AU)

Objectives. Determine the incidence and risk factors of type2 diabetes in the adult population of Madrid (Spain) and compare the predictive models of type2 diabetes based on the prediabetes criteria of the American Diabetes Association (ADA) and the World Health Organisation (WHO). Material and methods. A prospective study was conducted on a population cohort composed of 2048 individuals between 30 and 74years of age with no diabetes. At the start of the study, an epidemiological survey was performed, and baseline glycaemia, HbA1c, body mass index and waist circumference were measured. A follow-up of 6.4years was conducted. New cases of type2 diabetes were identified using the electronic primary care medical history. Results. The incidence of type2 diabetes was 3.5 cases/1000 person-years. In the multivariate analysis, the variables that were associated with the onset of type2 diabetes were age, family history of diabetes, baseline glycaemia (100-125mg/dL), HbA1c (5.7-6.4%) and waist circumference (≥94cm for men and ≥80cm for women). Of these, the most significantly associated variables were baseline glycaemia and HbA1c. The ADA and WHO criteria for defining prediabetes had the same predictive capacity. Conclusion. The incidence of type2 diabetes measured in Madrid was lower than that found in other population studies, with the glucometabolic state the main factor associated with progression to type2 diabetes. There were no differences between the prediabetes defined by the ADA and the WHO for predicting the onset of the disease (AU)

Incidence of type 2 diabetes and associated factors in the adult population of the Community of Madrid. PREDIMERC cohort.

OBJECTIVES: Determine the incidence and risk factors of type2 diabetes in the adult population of Madrid (Spain) and compare the predictive models of type2 diabetes based on the prediabetes criteria of the American Diabetes Association (ADA) and the World Health Organisation (WHO). MATERIAL AND METHODS: A prospective study was conducted on a population cohort composed of 2048 individuals between 30 and 74years of age with no diabetes. At the start of the study, an epidemiological survey was performed, and baseline glycaemia, HbA1c, body mass index and waist circumference were measured. A follow-up of 6.4years was conducted. New cases of type2 diabetes were identified using the electronic primary care medical history. RESULTS: The incidence of type2 diabetes was 3.5 cases/1000 person-years. In the multivariate analysis, the variables that were associated with the onset of type2 diabetes were age, family history of diabetes, baseline glycaemia (100-125mg/dL), HbA1c (5.7-6.4%) and waist circumference (≥94cm for men and ≥80cm for women). Of these, the most significantly associated variables were baseline glycaemia and HbA1c. The ADA and WHO criteria for defining prediabetes had the same predictive capacity. CONCLUSION: The incidence of type2 diabetes measured in Madrid was lower than that found in other population studies, with the glucometabolic state the main factor associated with progression to type2 diabetes. There were no differences between the prediabetes defined by the ADA and the WHO for predicting the onset of the disease.

Análisis de las patologías con mayor prevalencia en las Unidades Móviles de Rehabilitación y Fisioterapia de la provincia de Almería / Analysis of the most prevalent disorders in home-rehabilitation and physiotherapy units in the province of Almería (Spain)

Objetivos Describir las patologías de mayor prevalencia en 1753 pacientes derivados a las Unidades Móviles de Rehabilitación y Fisioterapia. Método Estudio descriptivo transversal. Las variables analizadas fueron la edad, el sexo, el diagnóstico principal, la capacidad funcional (Índice de Barthel), los objetivos fisioterapéuticos, las técnicas de tratamiento y el número de sesiones realizadas. Resultados Los diagnósticos principales fueron secuelas por inmovilización (29%), fracturas de cadera (16,5%), accidente vascular cerebral (13,7%), prótesis de rodilla (11,9%) y cadera (4,7%), enfermedad pulmonar obstructiva crónica (2,6%) y enfermedad de Alzheimer (2,4%). Los Índices de Barthel iniciales más bajos se obtuvieron en Alzheimer, accidente vascular cerebral y secuelas por inmovilización; el más alto se obtuvo en los pacientes intervenidos de prótesis de rodilla. El proceso que necesitó mayor número de sesiones para su recuperación fue el accidente vascular cerebral. Conclusiones Se confirman ganancias positivas entre el Índice de Barthel inicial y el final tras el tratamiento rehabilitador para cada proceso descrito, con una mayor independencia funcional del paciente (AU)

Objectives To describe the most prevalent disorders in 1753 patients referred to home rehabilitation and home physiotherapy units. Method We carried out a cross-sectional descriptive study. The variables analyzed were age, gender, main diagnosis, functional capacity (Barthel Index), physiotherapeutic objectives, the treatment applied and the number of sessions. Results The main diagnoses were immobilization effects (29%), hip fracture (16.5%), stroke (13.7%), knee replacement (11.9%), hip replacement (4.7%), chronic obstructive pulmonary disease (2.6%), and Alzheimer's disease (2.4%). The lowest Barthel Index was obtained in Alzheimer's disease, stroke and immobilization effects and the highest in patients with knee replacement. The process requiring the highest number of sessions for complete recovery was stroke. Conclusions Significant improvements were confirmed in pre- and post- Barthel Index scores for each of the above-mentioned diagnoses, demonstrating greater functional independence among patients (AU)

[Analysis of the most prevalent disorders in home-rehabilitation and physiotherapy units in the province of Almería (Spain)]. / Análisis de las patologías con mayor prevalencia en las Unidades Móviles de Rehabilitación y Fisioterapia de la provincia de Almería.

OBJECTIVES: To describe the most prevalent disorders in 1753 patients referred to home rehabilitation and home physiotherapy units. METHOD: We carried out a cross-sectional descriptive study. The variables analyzed were age, gender, main diagnosis, functional capacity (Barthel Index), physiotherapeutic objectives, the treatment applied and the number of sessions. RESULTS: The main diagnoses were immobilization effects (29%), hip fracture (16.5%), stroke (13.7%), knee replacement (11.9%), hip replacement (4.7%), chronic obstructive pulmonary disease (2.6%), and Alzheimer's disease (2.4%). The lowest Barthel Index was obtained in Alzheimer's disease, stroke and immobilization effects and the highest in patients with knee replacement. The process requiring the highest number of sessions for complete recovery was stroke. CONCLUSIONS: Significant improvements were confirmed in pre- and post- Barthel Index scores for each of the above-mentioned diagnoses, demonstrating greater functional independence among patients.

Percepción social de la sordera en el entorno escolar: proceso de elaboración de un cuestionario de evaluación / Social perception of deafness in the educational environment: designing an evaluation questionnaire

Se analizan los resultados de un estudio piloto para un modelo de cuestionario sobre la percepción de la sordera en el entorno educativo de primaria y secundaria. La primera parte del estudio presenta la justificación de una evaluación de la integración de alumnos y alumnas con deficiencia auditiva en la escuela ordinaria, así como la utilidad del uso de cuestionarios para dicha evaluación. La segunda parte describe el proceso de elaboración de los ítems que cubren aspectos como la calidad de la comunicación, la percepción social de la sordera desde el punto de vista de los oyentes, la autoestima de los alumnos sordos y el grado de integración social que pueden alcanzar. La tercera parte analiza los resultados del cuestionario aplicado a una muestra experimental. A partir de estos resultados, se propone una nueva versión del cuestionario de cara a poder utilizarlo en investigaciones posteriores, con la posibilidad de relacionar los datos con variables independientes (modalidades de integración escolar, modalidad comunicativa principal, características sociales de la población, etc.) y mejorar así las tomas de decisión en programas de integración (AU)

This article analyzes the results of a pilot study of the application of a proposed questionnaire on social perception of deafness in the primary and secondary education setting. The first part of the article discusses the rationale for evaluating the integration of deaf girls and boys in mainstream schools and the suitability of the questionnaire for this purpose. The second part describes the process of drafting the items covering aspects such as the quality of communication, social perceptions of deafness from the point of view of the hearing person, deaf students' self-esteem and the degree of social integration they can attain. The third part analyzes the results obtained when the questionnaire was first applied to an experimental sample. Based on these results, we propose a new version of the questionnaire to be used in subsequent studies, with the possibility of relating data to independent variables (social integration and principle communication modalities, social characteristics of the population, etc.) in order to improve decision making in mainstream school programs (AU)

[Arsenic levels in drinking water supplies from underground sources in the community of Madrid]. / Nivel de arsénico en abastecimientos de agua de consumo de origen subterráneo en la comunidad de Madrid.

BACKGROUND: In 1998, arsenic concentrations of more than 50 micrograms/l were detected in some drinking water supplies from underground sources in the Autonomous Community of Madrid, which is the maximum permissible concentration for drinking water in Spain. These two facts have meant the getting under way of a specific plan for monitoring arsenic in the drinking water in the Autonomous Community of Madrid. METHODS: The results of the first two sampling processes conducted in the arsenic level monitoring plan set out are presented. In the initial phase, water samples from 353 water supplies comprised within the census of the Public Health Administration of the Autonomous Community of Madrid were analyzed. A water supply risk classification was made based on these initial results. In a second phase, six months later, the analyses were repeated on those 35 water supplies which were considered to possibly pose a risk to public health. RESULTS: Seventy-four percent (74%) of the water supplies studied in the initial phase were revealed to have an arsenic concentration of less than 10 micrograms/l, 22.6% containing levels of 10 micrograms/l-50 micrograms/l, and 3.7% over 50 micrograms/l. Most of the water supplies showing arsenic levels of more than 10 micrograms/l are located in the same geographical area. In the second sampling process (six months later), the 35 water supplies classified as posing a risk were included. Twenty-six (26) of these supplies were revealed to have the same arsenic level ((10-50 micrograms/l), and nine changed category, six of which had less than 10 micrograms/l and three more than 50 micrograms/l. CONCLUSIONS: In the Autonomous Community of Madrid, less than 2% of the population drinks water coming from supplies which are from underground sources. The regular water quality monitoring conducted by the Public Health Administration has led to detecting the presence of more than 50 micrograms/l of arsenic in sixteen drinking water supplies from underground sources, which is the maximum permissible level under the laws currently in force in Spain. Measures have been taken to prevent water from being used from these water supplies. Around 20% of the water supplies studies must take measures in the near future to lower the arsenic concentration to below 10 micrograms/l when the water directive which is currently in the process of being written into Spanish law enters into effect.

[Study of non-insulin-dependent diabetes mellitus in primary care in the community of Madrid using the network of sentinel physicians]. / Estudio de la diabetes mellitus no insulinodependiente en atención primaria el la Comunidad de Madrid a través de la red de médicos centinelas. Red de Médicos Centinelas de la Comunidad de Madrid.

OBJECTIVES: To describe the frequency, clinical features and therapeutic management of diagnosed diabetics not dependent on insulin, who were controlled in Primary Care in the Community of Madrid. DESIGN: The study was performed through a network of sentinel doctors, which covered about 2% of Madrid's total population. The sentinel doctors had to notify on each known diabetic patient once (new cases), on their first consultation during the study period. SETTING: Community of Madrid. Information on 1,449 diabetic patients not dependent on insulin and diagnosed in Primary Care was obtained. Their personal and clinical data and prior history of chronic complications were gathered. RESULTS: Average number of notified diabetics was 28.4 per doctor (18.7 per 1,000 registered patients > 14 years old). About 4.1 new cases (1.46 per 1,000) were diagnosed each year. CONCLUSIONS: Diabetic patients not dependent on insulin represent an enormous burden on Primary Health Care in the Community of Madrid.

Sinonasal cancer and wood dust exposure: results from a case-control study.

A case-control study of occupational risk factors for sinonasal cancer was conducted in France in 1986-1988. The study included 207 histologically confirmed cases and 409 controls. Among the male cases were 59 men with squamous cell carcinoma and 82 with adenocarcinoma. The risk of sinonasal cancer in relation to wood dust exposure was studied in these two groups. The analysis was based on a case-by-case assessment of exposure by an industrial hygienist. Hardwood and softwood were distinguished. An approximate twofold increase in risk for squamous cell carcinomas was observed for cases whose first exposure to either hardwood or softwood occurred before 1945; however, the two types of exposure were highly correlated. An exposure to wood dust--from either hardwood alone or hardwood and other kinds of wood--was found for all but two of the 82 male cases with adenocarcinoma. The effects of different elements of exposure to hardwood (duration, level, period) were studied in detail with a logistic model. Two components of exposure--duration and average level--contributed independently to the overall very elevated risk. Additional exposure to wood other than hardwood did not increase the risk.