Abstract Objective: The aims of this study were to examine the incidence and in-hospital outcomes of surgical aortic valve replacement (SAVR) and to identify factors associated with in-hospital mortality (IHM) among patients according to the type of implanted valve used in SAVR. Methods: We performed a retrospective study using the Spanish National Hospital Discharge Database, 2001-2015. We included patients who had SAVR listed as a procedure in their discharge report. Results: We identified 86,578 patients who underwent SAVR (52.78% mechanical and 47.22% bioprosthetic). Incidence of SAVR coding increased significantly from 11.95 cases per 100,000 inhabitants in 2001 to 17.92 in 2015 (P<0.001). Age and comorbidities increased over time (P<0.001). There was a significant increase in the frequency of concomitant coronary artery bypass grafting (CABG) and in the use of pacemaker implantation. The use of mechanical SAVR decreased and the use of bioprosthetic valves increased over time. IHM decreased over time (from 8.13% in 2001-05 to 5.39% in 2011-15). Patients who underwent mechanical SAVR had higher IHM than those who underwent bioprosthetic SAVR (7.44% vs. 6%; P<0.05). Higher IHM rates were associated with advanced age, female sex, comorbidities, concomitant CABG, and the use of mechanical SAVR (OR 1.67; 95% CI 1.57-1.77). Conclusion: The number of SAVRs performed in Spain has increased since 2001. The use of mechanical SAVR has decreased and the use of bioprosthetic valves has increased over time. IHM has decreased over time for both types of valves and despite a concomitant increase in age and comorbidities of patients during the same period.

Abstract Objective To examine relevant differences in the prevalence of overweight and obesity in children aged 2-15 years according to different sets of criteria (Orbegozo Foundation, International Obesity Task Force and World Health Organization), and how their use affects the trends in obesity recorded for both sexes between 1995 and 2011 in Spain. Method Cross-sectional study, a population between 2 and 15 years. Three diagnosis criteria of overweight and obesity were be used. Results The boys according to the three criteria, showed higher values of overweight and obesity compared to the girls. The lowest levels of overweight and obesity were observed using the Orbegozo tables. Discussion The prevalence of overweight and obesity varies significantly according to the criteria used to define overweight and obesity. The percentiles of the Foundation Orbegozo gave the lowest estimates and the standards of growth of the World Health Organization were higher.

Resumen Objetivo Evaluar si existen diferencias relevantes entre los valores de prevalencia de sobrepeso y obesidad infantil en función de los tipos de criterios utilizados (Fundación Orbegozo, International Obesity Task Force, Organización Mundial de la Salud), y el modo en que su uso afecta a las tendencias sobre obesidad registradas para ambos sexos en España entre 2005 y 2011. Método Estudio transversal, en una población de entre 2 y 15 años de edad. Se usaron tres criterios diagnósticos de sobrepeso y obesidad. Resultados Los niños, según los tres criterios utilizados, presentaron valores superiores de sobrepeso y obesidad en comparación con las niñas. Las cifras más bajas de sobrepeso y obesidad se observaron al emplear las tablas de Orbegozo. Discusión Las prevalencias de sobrepeso y obesidad varían de manera significativa según los criterios utilizados para definir sobrepeso y obesidad. Los percentiles de la Fundación Orbegozo proporcionan las estimaciones más bajas, y los estándares de crecimiento de la Organización Mundial de la Salud las más altas.

Abstract Objective To examine relevant differences in the prevalence of overweight and obesity in children aged 2-15 years according to different sets of criteria (Orbegozo Foundation, International Obesity Task Force and World Health Organization), and how their use affects the trends in obesity recorded for both sexes between 1995 and 2011 in Spain. Method Cross-sectional study, a population between 2 and 15 years. Three diagnosis criteria of overweight and obesity were be used. Results The boys according to the three criteria, showed higher values of overweight and obesity compared to the girls. The lowest levels of overweight and obesity were observed using the Orbegozo tables. Discussion The prevalence of overweight and obesity varies significantly according to the criteria used to define overweight and obesity. The percentiles of the Foundation Orbegozo gave the lowest estimates and the standards of growth of the World Health Organization were higher.

Resumen Objetivo Evaluar si existen diferencias relevantes entre los valores de prevalencia de sobrepeso y obesidad infantil en función de los tipos de criterios utilizados (Fundación Orbegozo, International Obesity Task Force, Organización Mundial de la Salud), y el modo en que su uso afecta a las tendencias sobre obesidad registradas para ambos sexos en España entre 2005 y 2011. Método Estudio transversal, en una población de entre 2 y 15 años de edad. Se usaron tres criterios diagnósticos de sobrepeso y obesidad. Resultados Los niños, según los tres criterios utilizados, presentaron valores superiores de sobrepeso y obesidad en comparación con las niñas. Las cifras más bajas de sobrepeso y obesidad se observaron al emplear las tablas de Orbegozo. Discusión Las prevalencias de sobrepeso y obesidad varían de manera significativa según los criterios utilizados para definir sobrepeso y obesidad. Los percentiles de la Fundación Orbegozo proporcionan las estimaciones más bajas, y los estándares de crecimiento de la Organización Mundial de la Salud las más altas.

Abstract Introduction: Childhood obesity is a recognized public health problem. The present work reports the changing prevalence of childhood overweight/obesity in Spanish boys and girls over the period 1993-2011, and examines the risk factors apparent in 2011. Methods: Children with a body mass index (BMI) of ≥ 25 were deemed overweight, and those with a BMI of ≥ 30 were deemed obese. Overweight and obesity was consistently more common among boys than among girls. Results: The prevalence of overweight and obesity in Spain increased over the study period. Conclusions: According to the 2011 data, children who undertook no physical activity, or whose parents/guardians had a low level of education, showed the highest prevalence of obesity.

Resumen Introducción: la obesidad infantil es un problema de salud pública a nivel mundial. El objetivo de este trabajo es describir la evolución de la prevalencia de sobrepeso/obesidad infantil en niños y niñas durante el periodo 1993-2011 y analizar cuáles son los factores de riesgo asociados, utilizando la Encuesta Nacional de Salud (ENS) de 2011. Métodos: los niños con índice de masa corporal (IMC) ≥ 25 se consideraron con sobrepeso y aquellos con IMC ≥ 30, como obesos. Se hizo uso de la ENS desde 1993 a 2011. Resultados: la prevalencia de sobrepeso y obesidad en España aumentó durante el periodo de estudio. La prevalencia de sobrepeso y obesidad fue más elevada en niños que en niñas. Conclusiones: según los datos de 2011, los niños que no realizaban ningún tipo de actividad física o cuyos padres tenían un nivel de educación bajo mostraron la mayor prevalencia de obesidad.

We aimed to compare incidence and outcomes for endoscopic biliary sphincterotomies in people with or without type 2 diabetes mellitus (T2DM) in Spain (2003-2013). We collected all cases of endoscopic biliary sphincterotomies using national hospital discharge data and evaluated annual incidence rates stratified by T2DM status. We analyzed trends over time for in-hospital mortality (IHM) as the primary outcome and a composite of IHM or procedure-related complications (key secondary outcome). In multivariate analyses, we tested T2DM as an independent factor of IHM and IHM or complications. We identified 126,885 endoscopic biliary sphincterotomies (23,002 [18.1%] in T2DM people). Crude incidence rates of endoscopic biliary sphincterotomies were > 3-fold higher in people with vs without T2DM (85.5/10(5) vs 26.9/10(5) population, respectively). Annual incidence rates of endoscopic biliary sphincterotomies showed 11-year relative increments of 77.5% (from 60.0 to 106.5/105) in T2DM, and 53.7% (from 21.6 to 33.2/105) in non-T2DM people (p < 0.001). We found no significant changes in mortality trends over time for the populations with or without T2DM (p = 0.15 and p = 0.21, respectively). Rates of procedural pancreatitis decreased in people without T2DM (p < 0.001). In the multivariate analysis, older age, higher comorbidity and endoscopic biliary sphincterotomy during urgent admission were associated with a higher IHM. T2DM was associated with a lower IHM after an endoscopic biliary sphincterotomy (OR = 0.82 [0.74-0.92]). Time trend multivariate analyses 2003-2013 showed significant reductions in IHM over time only in people with T2DM (OR = 0.97 [0.94-1.00]). Further studies are needed to confirm a lower IHM for endoscopic biliary sphincterotomies in people with T2DM.

Objective: Evaluate the effectiveness of systematic diabetes education in children diagnosed with Diabetes Mellitus type 1 (DM1), in Fuenlabrada University Hospital (Madrid). Methods: A comparative study of two sample groups of children aged 0 to 14 diagnosed with DM1, before and after having been inducted into the diabetes education program. 34 children, admitted with a DM1 diagnosis, both with and without ketoacidosis, and assigned to Fuenlabrada University Hospital were studied. To evaluate the effectiveness of the program, bivariable analysis was undertaken with the objective of finding relationships between systematic diabetes education and the variables. Those variables were; admission days, frequency of visits to the emergency ward due to complications, and permissions to go home and HbA1c at 3 to 6 months after discharge from the hospital. Results: The admission days was reduced 3 days (p< 0.001), the complications within the 6 month after discharge decreased 41,2% and the permissions to go home increased 23,6% (p=0.001). Conclusions: The results of the study suggest the effectiveness of systematic diabetes education.

Objetivo principal: Evaluar la efectividad de la educación diabetológica sistematizada en niños que debutan con DM1 en el Hospital Universitario de Fuenlabrada (HUF), Madrid. Metodología: Estudio comparativo entre dos muestras de niños de 0 a 14 años que debutaron con DM1 antes y después de haberse instaurado un programa de educación diabetológica Se estudió a 34 niños adscritos al HUF que ingresaron por debut de DM1. Para evaluar la efectividad del programa se realizaron análisis bivariados con el fin de encontrar relaciones entre la educación diabetológica sistematizada y las variables: días de ingreso, frecuentación a urgencias por complicaciones, permisos domiciliarios y HbA1c a los 3 y 6 meses del alta. Resultados principales: Los días de ingreso se redujeron 3 días (p<0.001), disminuyeron un 41.2% las complicaciones dentro de los 6 meses posteriores al alta (p=0.019) y los permisos domiciliarios aumentaron un 23,6% (p=0.001). Conclusión principal: Los resultados sugieren la efectividad de la educación diabetológica sistematizada en niños que debutan con DM1.