Consuelo Prado Martínez

Utilidad del boletín estadístico de defunción para la identificación de muertes extrahospitalarias en un registro poblacional de infartos agudos de miocardio

Introduccion y objetivos Se estudio la utilidad del boletin estadistico de defuncion (BED) para la identificacion de muertes extrahospitalarias por isquemia coronaria aguda y la estrategia en la seleccion de causas de defuncion aparecidas en el BED mas eficiente para dicha identificacion. Metodos Se seleccionaron aquellos BED correspondientes a defunciones extrahospitalarias que incluyesen alguna causa de muerte indicativa de que esta pudo ser debida a isquemia cardiaca. Para estudiar la utilidad del BED se calculo la sensibilidad y el valor predictivo de la isquemia cardiaca. Para determinar la estrategia mas eficiente en la seleccion de causas de muerte se compararon 2 estrategias: la primera, utilizando la causa basica de defuncion, y la segunda, teniendo en cuenta todos los procesos patologicos mencionados en el BED. Resultados De los 395 BED seleccionados, 161 fueron clasificados como infartos agudos de miocardio. En aquellos BED en los que figuraba la isquemia cardiaca como causa basica de muerte se obtuvo una sensibilidad de 82,6% (IC del 95%: 75,9-88,1) y un valor predictivo de 72,7% (IC del 95%: 65,6-79). La estrategia en la seleccion de BED mas eficiente fue la de investigar aquellos en los que aparecia mencionada la isquemia cardiaca y los BED cuya causa basica de muerte fue: diabetes mellitus, hipertension arterial esencial, enfermedad cardiaca hipertensiva, disritmia cardiaca o insuficiencia cardiaca. Conclusiones La informacion que aportan los BED para las muertes extrahospitalarias por isquemia coronaria resulta fiable. Se propone una estrategia sensible y eficiente en la seleccion de BED para la deteccion de casos.

Association Between Adiposity and Blood Pressure Levels Between the Ages of 6 and 16 Years. Analysis in a Student Population From Madrid, Spain

INTRODUCTION AND OBJECTIVES The increase in the incidence of hypertension in children can be attributed to the rising prevalence of obesity. The objective is to analyze the impact of overweight and the degree or distribution of adiposity on blood pressure levels in a population of Spanish schoolchildren. METHODS A cross-sectional study was carried out in 1511 schoolchildren between 6 years and 16 years of age. We measured weight, height, waist circumference, subcutaneous skinfolds, and blood pressure. Nutritional categories were established on the basis of body mass index, waist-to-height ratio, and percent body fat. According to the National High Blood Pressure Education Program Working Group, subjects whose blood pressure was above the 90th percentile of the standard normal distribution were considered to have high blood pressure. RESULTS In all, 3.17% of the boys and 3.05% of the girls had high blood pressure. According to odds ratio analysis, the risk of high blood pressure increased in individuals with a body mass index indicative of obesity (7.87-fold in boys, 12.32-fold in girls), with a percent body fat>97th percentile (6.98-fold in boys, 18.51-fold in girls), or with a waist-to-height ratio ≥0.5 (10.56-fold in boys, 7.82-fold in girls). CONCLUSIONS Overweight and obesity increase the risk of high blood pressure in children between 6 years and 16 years of age, although the risk level varies depending on the amount and distribution of adipose tissue. Anthropometric indicators of relative adiposity and fat distribution are especially useful in the identification of children and adolescents with high blood pressure.

Socio-economic Factors Associated with the Reproductive Behaviour in Rural Population of the Granada Province, Spain

Abstract This study was aimed towards the characterization of the reproductive behaviour of women, living in mid-size populations of the rural context of the Granada province (Andalusia, Spain). The analysis focused on the role of the women’s socio-economic status as a modulator of these patterns, as well as their variation according to the age of the woman. A total of 214 residents of Guadix and Motril, within 20 to 82 years of age, were interviewed, getting information regarding several reproductive variables (age at first marriage and first birth, number of pregnancies and children, among others) along with socio-economic related ones (level of education and economic activity). Results showed that, apart from the youngest ones, within the range of age comprised in the study, the reproductive behaviour of these women has not varied noticeably. Besides, compared to available data for the rest of the territory, it could be classified as traditional. For the other aspects included in the research, the level of education, unlike in other populations, happens to have no effect, while economic activity has greater weight as a conduct modifier. Because of this all, it can be inferred that, at least for their reproductive patterns, the women of these two populations maintain deeply-rooted customs.

ASSESSMENT OF SOMATIC MATURATION OF VENEZUELAN ADOLESCENTS.

INTRODUCTION beginning of adolescence comprises important physical modifications, which affects growth and changes in body composition, therefore it is important to consider maturation assessment. OBJECTIVE to develop a non-invasive method to assess maturity status in Venezuelan adolescents from peak height velocity (PHV) by means of anthropometric variables in a cross-sectional sample. METHODS data comprised 681 Venezuelan adolescents 9 up to 18 years of age. Mirwald equation was applied to derived PHV. Regression analysis was used in order to build a model for Venezuelan sample as well as, ROC curves to assess sensitivity and specificity of anthropometric variables. RESULTS the predictive equations for both sexes, exhibited a high determination coefficient (< 0.99) and a minimal estimation error (0.06). Mean decimal age at categories of PHV obtained by both equations: criterion and model, were very similar (13.27 vs. 13.39) for boys, and (11.62 vs. 11.77) for girls. Bland-Altman plot showed a tight concordance between the two equations and all anthropometric indices, exhibited high area under the curve > 0.75, specially sitting height. DISCUSSION AND CONCLUSION in Venezuela, there is little work based on longitudinal studies of the maturation status. Giving the difficult faced in the longitudinal studies recent works have been used cross-sectional methodology in the assessment of the somatic maturation, both in non athletic and athletic populations. This study provides predicting equations for the assessment of the somatic maturation adjusted to Venezuelan population developed from Mirwald equation, which may be used to aid in evaluation of nutritional and general health, as well as, a reduction of risks associated with miss-classification for chronological age.