Trayectorias diagnósticas de los trastornos mentales en 10 años de seguimiento de una cohorte de niños y adolescentes / Diagnostic trajectories of mental disorders in a 10-year follow-up cohort of children and adolescents

Los trastornos psiquiátricos en la infancia y adolescencia pueden persistir, cambiar, remitir o aumentar en la edad adulta. Este estudio explora la estabilidad y las trayectorias diagnósticas de 311 niños y adolescentes entre 3 y 17 años hasta la edad adulta. Se encuentra que la estabilidad diagnóstica varía en función de la enfermedad. Los cambios de diagnóstico son más frecuentes en el trastorno de conducta y los trastornos afectivos, mientras que la mayor estabilidad diagnóstica se da en las dificultades del aprendizaje, trastorno de déficit de atención con hiperactividad y trastornos del espectro autista. La remisión completa es más frecuente en los trastornos de ansiedad. Los diagnósticos psiquiátricos tienen implicaciones sociales, emocionales y prácticas. Es necesario adaptar los recursos de salud mental a las necesidades de cada grupo de edad. (AU)

Psychiatric disorders in childhood and adolescence may persist, change, remit or increase in adulthood. This study explores the diagnostic stability and trajectories of 311 children and adolescents aged 3-17 years into adulthood. Diagnostic stability is found to vary according to pathology. Diagnostic changes are more frequent in conduct disorder and affective disorders, while the highest diagnostic stability was found in learning difficulties, attention deficit learning disabilities, attention deficit hyperactivity disorder and autism spectrum disorders. Complete remission is more frequent in anxiety disorders. Psychiatric diagnoses have social, emotional and practical implications. Mental health resources need to be adapted to the needs of each age group. (AU)

Papel de la temperatura aparente y de los contaminantes atmosféricos en los ingresos por infarto agudo de miocardio en el norte de España / Role of apparent temperature and air pollutants in hospital admissions for acute myocardial infarction in the North of Spain

Introducción y objetivos: El papel del entorno en la salud cardiovascular ha ganado protagonismo en el contexto del cambio global. Este trabajo persigue analizar la relación de la temperatura aparente (TA) y los contaminantes atmosféricos con los ingresos por infarto agudo de miocardio (IAM) y realizar un análisis temporal de la enfermedad y la mortalidad asociada. Métodos: Se desarrolló un estudio de serie temporal de los ingresos por IAM en Cantabria entre 2001 y 2015. La asociación entre las variables ambientales (entre ellas, se estimó un índice biometeorológico, la TA) y los ingresos por IAM se analizó mediante una regresión de cuasi-Poisson, y se creó un modelo no lineal de retardo distribuido dentro de un modelo generalizado aditivo, con el fin de atender el efecto retardado y la presencia de relaciones no lineales de las variables ambientales. Resultados: La tasa de incidencia y la mortalidad por IAM siguieron una tendencia descendente durante el periodo de estudio (CC=-0,714; p=0,0002). Los ingresos por IAM tenían un patrón anual con máximos en invierno (p=0,005); había diferencias intrasemanales, y los mínimos se registraron durante el fin de semana (p=0,000005). Se encontró una asociación inversa entre la TA y el número de ingresos por IAM y una relación directa y estadísticamente significativa con las concentraciones de partículas de diámetro<10 μm en la atmósfera. Conclusiones: Hay una tendencia descendente en los IAM en el periodo 2007-2015. La mortalidad asociada con los ingresos por este diagnóstico se ha reducido. La TA y las partículas de diámetro <10 μm en la atmósfera son factores predictores de esta enfermedad

Introduction and objectives: The role of the environment on cardiovascular health is becoming more prominent in the context of global change. The aim of this study was to analyze the relationship between apparent temperature (AT) and air pollutants and acute myocardial infarction (AMI) and to study the temporal pattern of this disease and its associated mortality. Methods: We performed a time-series study of admissions for AMI in Cantabria between 2001 and 2015. The association between environmental variables (including a biometeorological index, AT) and AMI was analyzed using a quasi-Poisson regression model. To assess potential delayed and non-linear effects of these variables on AMI, a lag non-linear model was fitted in a generalized additive model. Results: The incidence rate and the mortality followed a downward trend during the study period (CC=-0.714; P=.0002). An annual pattern was found in hospital admissions (P=.005), with the highest values being registered in winter; a weekly trend was also identified, reaching a minimum during the weekends (P=.000005). There was an inverse association between AT and the number of hospital admissions due to AMI and a direct association with particulate matter with a diameter smaller than 10 μm. Conclusions: Hospital admissions for AMI followed a downward trend between 2007 and 2015. Mortality associated with admissions due to this diagnosis has decreased. Predictive factors for this disease were AT and particulate matter with a diameter smaller than 10 μm

Role of Apparent Temperature and Air Pollutants in Hospital Admissions for Acute Myocardial Infarction in the North of Spain.

INTRODUCTION AND OBJECTIVES: The role of the environment on cardiovascular health is becoming more prominent in the context of global change. The aim of this study was to analyze the relationship between apparent temperature (AT) and air pollutants and acute myocardial infarction (AMI) and to study the temporal pattern of this disease and its associated mortality. METHODS: We performed a time-series study of admissions for AMI in Cantabria between 2001 and 2015. The association between environmental variables (including a biometeorological index, AT) and AMI was analyzed using a quasi-Poisson regression model. To assess potential delayed and non-linear effects of these variables on AMI, a lag non-linear model was fitted in a generalized additive model. RESULTS: The incidence rate and the mortality followed a downward trend during the study period (CC=-0.714; P=.0002). An annual pattern was found in hospital admissions (P=.005), with the highest values being registered in winter; a weekly trend was also identified, reaching a minimum during the weekends (P=.000005). There was an inverse association between AT and the number of hospital admissions due to AMI and a direct association with particulate matter with a diameter smaller than 10 µm. CONCLUSIONS: Hospital admissions for AMI followed a downward trend between 2007 and 2015. Mortality associated with admissions due to this diagnosis has decreased. Predictive factors for this disease were AT and particulate matter with a diameter smaller than 10 µm.