Prevalence of overweight and obesity in child population. A study of a cohort in Castile and Leon, Spain. / Prevalencia de sobrepeso y obesidad infantil. Estudio de una cohorte en Castilla y León, España.

INTRODUCTION: Several studies warn that overweight and obesity have become an epidemic with severe consequences in the population's health. The objetive of the present study is to estimate the prevalence of overweight and obesity in Castile and Leon in a sample of children at 6, 11 and 14 years of age, to describe its evolution and its association with life habits and antecedents. MATERIAL AND METHODS: Observational study, retrospective cohort, performed by the pediatricians of the Health Sentinel Network. The study is part of a joint Project with the National Research Center on Human Evolution (CENIEH) in Burgos to know the pattern of growth and development of the child population of Castile and Leon. In 2012, a health examination and a retrospective collection were carried out based on the clinical history of a simple of 326 children, from the cohort was born in 1998. RESULTS: Following the WHO references, at age 14 there was 25.3% of boys and 18.5% of girls with overweight. Obesity was estimated to affect the 8.2% and 4.8% of them respectively. At 11 years of age there was the maximum of overweight in girls and of obesity in boys. At the urban-non urban environment, quantity and quality of sleep and the parents' BMI have been some of the associated factors to weight level of the children. DISCUSSION: In Castile and Leon, as in other populations of our environment, there is a severe problema of overweight and obesity. For their control it is necesary to deepen understanding of lifestyles and antecedents related to the birth as well as to calculate the growth rate in the pediatric age.

[Prevalence of hypertension in the population of Castile-Leon (Spain)]. / Prevalencia de la hipertensión arterial en la población de Castilla y León.

OBJECTIVE: Cardiovascular disease causes one out of 3 deaths in Spain. Hypertension is involved in ischemic heart disease and in other diseases provoking high morbidity and mortality. The aim of the present study was to describe the prevalence of hypertension and other indicators of this disorder in Castile-Leon in 2004. METHODS: We performed a cross-sectional study in a random sample of 4,012 persons aged 15 years old or above, extracted through a two-stage, stratified design. Systolic and diastolic blood pressure was measured, a history was taken and clinical records were reviewed. A person was considered to be hypertensive when there was known hypertension (hyper-tension was recorded in the clinical records or the person was receiving treatment for hypertension) or when systolic blood pressure was 140 mmHg or more and diastolic blood pressure was 90 mmHg or more. RESULTS: The prevalence of hypertension in the population was 38.7% (95%CI: 36.5-40.9). The prevalence was higher in men (40.4% [95%CI: 37.4-43.4]) than in women (37.4% [95%CI: 34.7-40]). Hypertension was already known in 22.2%, representing 57.4% of all hypertensive individuals. In the remainder of the sample, 44% had prehypertension, 17.5% had stage 1 hypertension and 4% had stage II hypertension, according to the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation and Treatment of High Blood Pressure. CONCLUSIONS: The prevalence of hypertension in the population studied was consistent with that reported in other Spanish studies. A substantial proportion of hypertensive individuals were unaware of their status as such. Equally, a large proportion had prehypertension, which carries a high risk of cardiovascular disease.

[Prevalence and clinical characteristics of subclinical hypothyroidism in an opportunistic sample in the population of Castile-León (Spain)]. / Hipotiroidismo subclínico en una muestra oportunista de la población de Castilla y León.

OBJECTIVE: To describe the distribution of thyroid-stimulating hormone (TSH) values and to estimate the prevalence of subclinical hypothyroidism in the adult population of Castile and León (Spain). METHOD: An observational study was conducted in an opportunistic sample of 45 primary care centers in Castile and León. TSH was determined in people aged ≥35 years that attended a primary care physician and had a blood test for any reason. Confirmatory analysis included free thyroxine and anti-thyroid peroxidase antibody determination. RESULTS: A total of 3957 analyses were carried out, 63% in women. The mean age was 61.5 years. The median TSH value was 2.3 µIU/mL (2.5 µIU/mL in women and 2.1 µIU/mL in men), with a rising trend with age. TSH values were higher in undiagnosed or untreated subclinical hypothyroidism than in patients under treatment. The lowest levels were found in euthyroidism. The prevalence of subclinical hypothyroidism was 9.2% (95%CI: 8.3-10.2), and hypothyroidism was three times higher in women than in men (12.4% versus 3.7%). Hypothyroidism increased with age, reaching a peak of 16.9% in women aged 45 to 64 years. CONCLUSIONS: The prevalence of subclinical hypothyroidism in our sample was high and in the upper limits of values found in previous studies. Proper diagnosis and treatment are important because of the risk of progression to hypothyroidism and the association with multiple diseases and other risk factors.

Actual and preferred place of death of home-dwelling patients in four European countries: making sense of quality indicators.

BACKGROUND: Dying at home and dying at the preferred place of death are advocated to be desirable outcomes of palliative care. More insight is needed in their usefulness as quality indicators. Our objective is to describe whether "the percentage of patients dying at home" and "the percentage of patients who died in their place of preference" are feasible and informative quality indicators. METHODS AND FINDINGS: A mortality follow-back study was conducted, based on data recorded by representative GP networks regarding home-dwelling patients who died non-suddenly in Belgium (n = 1036), The Netherlands (n = 512), Italy (n = 1639) or Spain (n = 565). "The percentage of patients dying at home" ranged between 35.3% (Belgium) and 50.6% (The Netherlands) in the four countries, while "the percentage of patients dying at their preferred place of death" ranged between 67.8% (Italy) and 86.0% (Spain). Both indicators were strongly associated with palliative care provision by the GP (odds ratios of 1.55-13.23 and 2.30-6.63, respectively). The quality indicator concerning the preferred place of death offers a broader view than the indicator concerning home deaths, as it takes into account all preferences met in all locations. However, GPs did not know the preferences for place of death in 39.6% (The Netherlands) to 70.3% (Italy), whereas the actual place of death was known in almost all cases. CONCLUSION: GPs know their patients' actual place of death, making the percentage of home deaths a feasible indicator for collection by GPs. However, patients' preferred place of death was often unknown to the GP. We therefore recommend using information from relatives as long as information from GPs on the preferred place of death is lacking. Timely communication about the place where patients want to be cared for at the end of life remains a challenge for GPs.

Hipotiroidismo subclínico en una muestra oportunista de la población de Castilla y León / Prevalence and clinical characteristics of subclinical hypothyroidism in an opportunistic sample in the population of Castile-León (Spain)

Objetivo: Describir la distribución de los valores de la hormona estimulante del tiroides (TSH) y estimar la prevalencia de hipotiroidismo subclínico en la población adulta de Castilla y León. Material y método: Estudio observacional en 45 consultas de medicina de familia de Castilla y León seleccionadas de manera oportunista. Se determinó la TSH en sueros, recogidos por cualquier motivo, de personas ≥35 años de edad. Se realizó análisis de confirmación, incluyendo la tiroxina libre y los anticuerpos antitiroperoxidasa. Resultados: Se realizaron 3957 análisis. El 63,4% eran mujeres. La edad media fue de 61,5 años. La mediana de los valores de TSH fue de 2,3 ¿UI/mL (2, ¿UI/mL en mujeres y 2,1 ¿UI/mL en hombres), con tendencia ascendente con la edad. Los valores de TSH son mayores en los hipotiroidismos subclínicos desconocidos o sin tratamiento que en los tratados. Los valores más bajos se observan en los sujetos eutiroideos. La prevalencia de hipotiroidismo subclínico fue del 9,2% (intervalo de confianza del 95%: 8,3-10,2); en las mujeres fue el triple que en los hombres (12,4% frente a 3,7%) y aumenta con la edad, con un máximo del 16,9% en las mujeres de 45 a 64 años. Conclusiones: La prevalencia estimada de hipotiroidismo subclínico es alta, en los límites superiores reflejados en la literatura. La posibilidad de progresión a hipotiroidismo manifiesto, así como la asociación con diversas enfermedades y factores de riesgo, aconsejan una gestión adecuada de su diagnóstico y tratamiento (AU)

Objective: To describe the distribution of thyroid-stimulating hormone (TSH) values and to estimate the prevalence of subclinical hypothyroidism in the adult population of Castile and León (Spain). Method: An observational study was conducted in an opportunistic sample of 45 primary care centers in Castile and León. TSH was determined in people aged ≥35 years that attended a primary care physician and had a blood test for any reason. Confirmatory analysis included free thyroxine and anti-thyroid peroxidase antibody determination. Results: A total of 3957 analyses were carried out, 63% in women. The mean age was 61.5 years. The median TSH value was 2.3 ¿IU/mL (2.5 ¿IU/mL in women and 2.1 ¿IU/mL in men), with a rising trend with age. TSH values were higher in undiagnosed or untreated subclinical hypothyroidism than in patients under treatment. The lowest levels were found in euthyroidism. The prevalence of subclinical hypothyroidism was 9.2% (95%CI: 8.3-10.2), and hypothyroidism was three times higher in women than in men (12.4% versus 3.7%). Hypothyroidism increased with age, reaching a peak of 16.9% in women aged 45 to 64 years. Conclusions: The prevalence of subclinical hypothyroidism in our sample was high and in the upper limits of values found in previous studies. Proper diagnosis and treatment are important because of the risk of progression to hypothyroidism and the association with multiple diseases and other risk factors (AU)

Prevalencia de sobrepeso y obesidad infantil. Estudio de una cohorte en Castilla y León, España / Prevalence of overweight and obesity in child population. A study of a cohort in Castile and Leon, Spain

Introducción: Varios estudios advierten que el sobrepeso y la obesidad se han convertido en una epidemia con graves consecuencias sobre la salud de la población. El objetivo del presente estudio es estimar la prevalencia de sobrepeso y obesidad en Castilla y León en una muestra de niños a los 6, 11 y 14 años de edad, describir su evolución y su asociación con hábitos de vida y antecedentes. Metodología: Estudio observacional, de cohorte retrospectivo, realizado por los pediatras de la Red Centinela Sanitaria, que se enmarca en un proyecto conjunto con el Centro Nacional de Investigación sobre la Evolución Humana de Burgos para conocer el patrón de crecimiento y desarrollo de la población infantil de Castilla y León. En 2012 se realizó un examen de salud y una recogida retrospectiva a partir de la historia clínica en una muestra de 326 niños, de la cohorte de nacidos en 1998. Resultados: Según los criterios de la OMS, a los 14 años había un 25,3% de sobrepeso entre los niños y un 18,5% entre las niñas. En cuanto a la obesidad, esta afectaba al 8,2 y 4,8%, respectivamente. A los 11 años se produce un pico de sobrepeso en las niñas y de obesidad en los niños. El entorno urbano-no urbano, la calidad y duración del sueño, así como el índice de masa corporal (IMC) de los padres han sido algunos de los factores asociados con el peso de los niños. Discusión: En Castilla y León, como en otras poblaciones de nuestro entorno, existe un grave problema de sobrepeso y obesidad infantil. Para su control, es necesario profundizar sobre los estilos de vida y los antecedentes relacionados con el nacimiento, así como el cálculo de la velocidad de crecimiento en la edad pediátrica

Introduction: Several studies warn that overweight and obesity have become an epidemic with severe consequences in the population's health. The objetive of the present study is to estimate the prevalence of overweight and obesity in Castile and Leon in a sample of children at 6, 11 and 14 years of age, to describe its evolution and its association with life habits and antecedents. Material and methods: Observational study, retrospective cohort, performed by the pediatricians of the Health Sentinel Network. The study is part of a joint Project with the National Research Center on Human Evolution (CENIEH) in Burgos to know the pattern of growth and development of the child population of Castile and Leon. In 2012, a health examination and a retrospective collection were carried out based on the clinical history of a simple of 326 children, from the cohort was born in 1998. Results: Following the WHO references, at age 14 there was 25.3% of boys and 18.5% of girls with overweight. Obesity was estimated to affect the 8.2% and 4.8% of them respectively. At 11 years of age there was the maximum of overweight in girls and of obesity in boys. At the urban-non urban environment, quantity and quality of sleep and the parents' BMI have been some of the associated factors to weight level of the children. Discussion: In Castile and Leon, as in other populations of our environment, there is a severe problema of overweight and obesity. For their control it is necesary to deepen understanding of lifestyles and antecedents related to the birth as well as to calculate the growth rate in the pediatric age

Prevalencia de la hipertensión arterial en la población de Castilla y León / Prevalence of hypertension in the population of Castile-Leon [Spain]

Objetivo: Las enfermedades cardiovasculares causan unade cada 3 defunciones en España. La hipertensión arterialestá implicada en la enfermedad isquémica cardíaca y en otras afecciones de alta morbilidad y mortalidad. El objetivo de este trabajo es describir la prevalencia y otros indicadores de la presión arterial en Castilla y León en 2004.Métodos: Estudio transversal en una muestra aleatoria de4.012 personas 15 años de edad extraída de un diseño bietápico y estratificado. Se revisó la historia clínica, se realizó una anamnesis y una exploración de la presión arterial sistólica y diastólica. Se consideró a una persona como hipertensa cuando era hipertensa conocido (en su historia clínica constaba como tal o recibía tratamiento con antihipertensivos) o presentaba una cifra de presión arterial sistólica 140 mmHgo una presión arterial diastólica 90 mmHg.Resultados: La prevalencia de hipertensión arterial en la población fue de 38,7% (intervalo de confianza [IC] del 95%: 36,5-40,9). Los hombres presentaron un mayor porcentaje, 40,4% (IC del 95%: 37,4-43,4), que las mujeres, 37,4% (IC del 95%: 34,7-40). El 22,2% estaba ya diagnosticado, lo que representa el 57,4% de los hipertensos. En el resto de la muestra, el 44%estaba en un estadio prehipertensivo, el 17,5% en estadio I y el 4% en estadio II de la clasificación del séptimo informe del Joint National Committee sobre Prevención, Detección, Evaluación y Tratamiento de la Hipertensión Arterial.Conclusiones: La prevalencia de la hipertensión arterial en la población estudiada es consistente con otros estudios españoles. Una gran proporción de hipertensos no sabe que lo es, y otra gran parte se encuentra en estadios prehipertensivos, con el riesgo cardiovascular que conlleva esta situación

Objective: Cardiovascular disease causes one out of 3 deaths in Spain. Hypertension is involved in ischemic heart disease and in other diseases provoking high morbidity and mortality. The aim of the present study was to describe the prevalence of hypertension and other indicators of this disorder in Castile-Leon in 2004.Methods: We performed a cross-sectional study in a randomsample of 4,012 persons aged 15 years old or above, extracted through a two-stage, stratified design. Systolic and diastolic blood pressure was measured, a history was taken and clinical records were reviewed. A person was considered to be hypertensive when there was known hypertension (hypertension was recorded in the clinical records or the person was receiving treatment for hypertension) or when systolic blood pressure was 140 mmHg or more and diastolic blood pressure was 90 mmHg or more.Results: The prevalence of hypertension in the populationwas 38.7% (95%CI: 36.5-40.9). The prevalence was higherin men (40.4% [95%CI: 37.4-43.4]) than in women (37.4%[95%CI: 34.7-40]). Hypertension was already known in 22.2%, representing 57.4% of all hypertensive individuals. In the remainder of the sample, 44% had prehypertension, 17.5% had stage 1 hypertension and 4% had stage II hypertension, according to the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation and Treatmentof High Blood Pressure.Conclusions: The prevalence of hypertension in the population studied was consistent with that reported in other Spanish studies. A substantial proportion of hypertensive individuals were unaware of their status as such. Equally, a large proportion had prehypertension, which carries a high risk of cardiovascular disease