1
|
Domínguez Aurrecoechea B, Fernández Francés M, Ordóñez Alonso MÁ, López Vilar P, Pérez Candás JI, Merino Ramos L, Aladro Antuña A, Fernández López FJ, Pérez López AM. [Infectious diseases and use of health care resources in children less than 2 years-old who attend kindergarten]. An Pediatr (Barc) 2015; 83:149-59. [PMID: 25455913 DOI: 10.1016/j.anpedi.2014.10.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 09/24/2014] [Accepted: 10/07/2014] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Parents often ask paediatricians for advice about the best way to care for their children. There are discrepancies in the literature on this subject. The objective of this study is to evaluate the influence of attending kindergartens on the risk of acute infections and the use of health care resources in children less than 24 months. POPULATION AND METHODS A prospective longitudinal study was conducted on two cohorts of children 0-24 months (born between 1 January and 30 September 2010), who were grouped according to whether they attended kindergarten or not, and were usually seen in 33 pediatric clinics of the Principality of Asturias Public Health Service. RESULTS AND CONCLUSIONS A total of 975 children were studied, of whom 43.7% attended a kindergarten at 24 months. Attending kindergarten increases the risk of pneumonia by 131%, recurrent wheezing by 69%, bronchitis by 57%, and otitis media by 64%. Early exposure to kindergarten increases the risk of pneumonia from 2.31 to 2.81, and the mean emergency room visits from 1 to 2.3. The mean antibiotic cycle is 1.7 in children who do not go to kindergarten, 3.4 if started within the first 6 months, and 2 if they start at 18 months. Day-care attendance is a risk factor of infectious diseases that increases if attending kindergartens from an early age.
Collapse
|
2
|
Rojo-Martínez G, Valdés S, Colomo N, Lucena MI, Gaztambide S, Gomis R, Casamitjana R, Carmena R, Catalá M, Martínez-Larrad MT, Serrano-Ríos M, Castaño L, Vendrell J, Girbés J, Franch J, Vázquez JA, Mora-Peces I, Urrutia I, Pascual-Manich G, Ortega E, Menéndez E, Delgado E, Bordiú E, Castell C, López-Alba A, Goday A, Calle A, Bosch-Comas A, Soriguer F. Use of drugs related to the treatment of diabetes mellitus and other cardiovascular risk factors in the Spanish population. The Di@bet.es study. ACTA ACUST UNITED AC 2014; 66:854-63. [PMID: 24773992 DOI: 10.1016/j.rec.2013.05.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 05/31/2013] [Indexed: 01/10/2023]
Abstract
INTRODUCTION AND OBJECTIVES To assess the patterns of use of 8 therapeutic drug groups for the treatment of diabetes mellitus and other cardiovascular risk factors, and to identify sociodemographic and health determinants of their use in the overall Spanish population. METHODS A representative sample of the Spanish population within the Di@bet.es study, a cross-sectional population-based survey, was included. STUDY VARIABLES sociodemographic, clinical, and lifestyle data; physical examination, and an oral glucose tolerance test in patients without known diabetes mellitus. Furthermore, patients were systematically queried about current medication use, and 8 pharmacotherapeutic groups were evaluated: lipid-lowering therapy, antihypertensives, oral hypoglycemic agents, insulin, thyroid hormone, uricosurics, psychoactive drugs, and nonsteroidal anti-inflammatory drugs. RESULTS Sixty-six percent of the Spanish population was taking at least one medication. Therapeutic drug use was associated with age, independently of the higher prevalence of diabetes mellitus, hypertension, or hyperlipidemia in older patients. Sex disparities were found in the use of lipid-lowering agents, allopurinol, levothyroxine, nonsteroidal anti-inflammatory drugs, and psychoactive drugs. Use of psychoactive drugs was related to education level, work status, physical activity, smoking, and alcohol consumption. Almost 30% of patients with diabetes mellitus were taking 6 or more medications daily. Diabetes mellitus was associated with greater use of antihypertensives, lipid-lowering agents, and nonsteroidal anti-inflammatory drugs. CONCLUSIONS Age and sex are the most important factors determining therapeutic drug use. Lifestyle patterns and sociocultural factors have an impact only on psychoactive drug use. Diabetes mellitus is associated with greater use of antihypertensives, lipid-lowering agents, and nonsteroidal anti-inflammatory drugs.
Collapse
Affiliation(s)
- Gemma Rojo-Martínez
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | - Sergio Valdés
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | - Natalia Colomo
- Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | - M Isabel Lucena
- Departamento de Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Facultad de Medicina, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | - Sonia Gaztambide
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Grupo de Investigación de Diabetes, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Vizcaya, Spain
| | - Ramón Gomis
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Unidad de Endocrinología y Diabetes, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Roser Casamitjana
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Centro de Diagnóstico Biomédico, Hospital Clínic, Barcelona, Spain
| | - Rafael Carmena
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Departamento de Medicina y Endocrinología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Miguel Catalá
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Departamento de Medicina y Endocrinología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - María T Martínez-Larrad
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Manuel Serrano-Ríos
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Luis Castaño
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Grupo de Investigación de Diabetes, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Vizcaya, Spain
| | - Joan Vendrell
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Universitario Joan XXIII, Institut d'Investigacions Sanitàries Pere Virgili, Tarragona, Spain
| | - Juan Girbés
- Unidad de Diabetes, Hospital Arnau de Vilanova, Valencia, Spain
| | - Josep Franch
- EAP Raval Sud, Institut Català de la Salut, Red GEDAPS, Atención Primaria, Unitat de Suport a la Recerca (IDIAP-Fundació Jordi Gol), Barcelona, Spain
| | - José A Vázquez
- Plan Nacional de Diabetes, Ministerio de Sanidad, Madrid, Spain
| | | | - Inés Urrutia
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Grupo de Investigación de Diabetes, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Vizcaya, Spain
| | - Gemma Pascual-Manich
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
| | - Emilio Ortega
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Unidad de Endocrinología y Diabetes, Hospital Clínic, Barcelona, Spain
| | - Edelmiro Menéndez
- Departamento de Medicina-Endocrinología y Nutrición, Hospital Universitario Central de Asturias (HUCA), Universidad de Oviedo, Oviedo, Asturias, Spain
| | - Elias Delgado
- Departamento de Medicina-Endocrinología y Nutrición, Hospital Universitario Central de Asturias (HUCA), Universidad de Oviedo, Oviedo, Asturias, Spain
| | - Elena Bordiú
- Laboratorio de Endocrinología, Hospital Universitario San Carlos, Madrid, Spain
| | - Conxa Castell
- Departament de Salut Pública, Conselleria de Sanitat, Generalitat de Catalunya, Barcelona, Spain
| | | | - Alberto Goday
- Servicio de Endocrinología y Nutrición, Hospital del Mar, Barcelona, Spain
| | - Alfonso Calle
- Servicio de Endocrinología y Nutrición, Hospital Universitario San Carlos, Madrid, Spain
| | - Anna Bosch-Comas
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Federico Soriguer
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain.
| |
Collapse
|
3
|
Aguilar-Palacio I, Carrera-Lasfuentes P, Poblador-Plou B, Prados-Torres A, Rabanaque-Hernández MJ. [Morbidity and drug consumption. Comparison of results between the National Health Survey and electronic medical records]. Gac Sanit 2013; 28:41-7. [PMID: 23680136 DOI: 10.1016/j.gaceta.2013.04.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 03/19/2013] [Accepted: 04/03/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To compare the prevalence of disease and drug consumption obtained by using the National Health Survey (NHS) with the information provided by the electronic medical records (EMR) in primary health care and the Pharmaceutical Consumption Registry in Aragon (Farmasalud) in the adult population in the province of Zaragoza. METHODS A cross-sectional study was performed to compare the prevalence of diseases in the NHS-2006 and in the EMR. The prevalence of drug consumption was obtained from the NHS-2006 and Farmasalud. Estimations using each database were compared with their 95% confidence intervals (95% CI) and the results were stratified by gender and age groups. The comparability of the databases was tested. RESULTS According to the NHS, a total of 81.8% of the adults in the province of Zaragoza visited a physician in 2006. According to the EMR, 61.4% of adults visited a primary care physician. The most prevalent disease in both databases was hypertension (NHS: 21.5%, 95% CI: 19.4-23.9; EMR: 21.6%, 95% CI: 21.3-21.8). The greatest differences between the NHS and EMR was observed in the prevalence of depression, anxiety, and other mental illnesses (NHS: 10.9%; EMR: 26.6%). The most widely consumed drugs were analgesics The prevalence of drug consumption differed in the two databases, with the greatest differences being found in pain medication (NHS: 23.3%; Farmasalud: 63.8%) and antibiotics (NHS: 3.4%; Farmasalud: 41.7%). These differences persisted after we stratified by gender and were especially important in the group aged more than 75 years. CONCLUSIONS The prevalence of morbidity and drug consumption differed depending on the database employed. The use of different databases is recommended to estimate real prevalences.
Collapse
Affiliation(s)
- Isabel Aguilar-Palacio
- Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, España.
| | | | - Beatriz Poblador-Plou
- Grupo de Investigación en Enfermedades Crónicas (EpiChron), Instituto de Investigación Sanitaria de Aragón (IIS), Hospital Universitario Miguel Servet, Zaragoza, España
| | - Alexandra Prados-Torres
- Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, España; Grupo de Investigación en Enfermedades Crónicas (EpiChron), Instituto de Investigación Sanitaria de Aragón (IIS), Hospital Universitario Miguel Servet, Zaragoza, España
| | - M José Rabanaque-Hernández
- Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, España
| | | |
Collapse
|