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Background: The role of adiponectin (ADIPOQ) polymorphisms in weight loss and serum lipid changes following different dietary interventions remain unclear. The Mediterranean dietary pattern has been associated with improved cardiovascular risk factors in different studies. Objective: Our aim was to analyze the effects of a hypocaloric diet with a Mediterranean dietary pattern on the metabolic response and adiposity parameters, taking into account the 712 G/A rs3774261 polymorphisms in ADIPOQ. Design: A population of 135 obese patients was enrolled. Anthropometric and serum parameters (lipid profile, insulin, homeostasis model assessment for insulin resistance [HOMA-IR], glucose, C-reactive protein [CRP], adiponectin, resistin, and leptin levels) were measured before and after the dietary intervention (12 weeks). All of the patients were genotyped for the rs3774261 polymorphism. Results: The genotype distribution of this population was 36 patients with AA (26.7%), 68 patients with AG (50.4%), and 31 patients with GG (22.9%). After the dietary intervention and in both genotypes, BMI, weight, fat mass, systolic blood pressure, waist circumference, glucose, insulin, HOMA-IR, and leptin levels all decreased. After the dietary intervention with secondary weight loss and in non-G-allele carriers (AA vs. AG+GG), total cholesterol (Δ = –15.7 ± 3.9 vs. –4.9 ± 2.9 mg/dL; p = 0.02), LDL cholesterol (Δ = –15.3 ± 3.8 vs. –1.7 ± 1.9 mg/dL; p = 0.01), triglyceride levels (Δ = –23.4 ± 5.6 vs. 2.3 ± 2.3 mg/dL; p = 0.01), and CRP (Δ = –1.1 ± 0.1 vs. –0.4 ± 0.2 mg/dL; p = 0.01) decreased. Adiponectin levels (Δ = 7.2 ± 2.1 vs. –0.4 ± 0.3 ng/dL; p = 0.02) increased. Notably, G-allele carriers did not show this improvement. Conclusion: Non-G-allele carriers of the ADIPOQ variant (rs3774261) showed significant improvement in serum levels of adiponectin, lipid profiles, and CRP in response to a hypocaloric diet with a Mediterranean dietary pattern.

Background: The role of ADIPOQ gene on serum lipid and adiponectin levels after a dietary intervention remained unclear. Some polymorphisms have been described in this gene that they could interact with metabolic changes after diet intervention. Objective: Our aim was to analyze the effects of a high fat hypocaloric diet with a Mediterranean dietary pattern on metabolic response and adiponectin levels taking to account of rs3774261 of ADIPOQ. Design: A population of 284 obese patients was enrolled. Anthropometric parameter and serum parameters (lipid profile, insulin, homeostasis model assessment (HOMA-IR), glucose, C reactive protein, adiponectin, resistin and leptin levels) were measured, at basal time and after high fat hypocaloric diet (12 weeks). All patients were genotyped in the rs3774261. Results: The genotype distribution was; 78 patients (27.5%) AA, 144 patients AG (50.7%) and 62 patients GG (21.8%). After a significant weight loss secondary to diet intervention (AA vs. AG vs. GG); total cholesterol (delta:-15.1 ± 2.9 mg/dl vs. -7.2 ± 2.1 mg/dl vs. -5.0 ± 1.9 mg/dl; p=0.03), LDL cholesterol (delta:-14.1 ± 2.9 mg/dl vs. -6.4 ± 1.8 mg/dl vs. -3.2 ± 2.0 mg/dl; p=0.01), triglyceride levels (delta:-26.0 ± 4.6 mg/dl vs 6.4 ± 3.3 mg/dl vs. -5.7 ± 2.9 mg/dl; p=0.01), C reactive protein (CRP) (delta:-2.4 ± 0.1 mg/dl vs -1.3 ± 0.2 mg/dl vs. -0.7 ± 0.1 mg/dl; p=0.01) and serum adiponectin levels (delta: 17.6 ± 3.9 ng/dl vs. 1.9 ± 3.3 ng/dl vs. 2.1 ± 1.3 ng/dl; p=0.02) improved only in AA group. Conclusion: Subjects with AA genotype of ADIPOQ variant (rs3774261) showed a significant increase in serum levels of adiponectin and decrease on lipid profile and C-reactive protein (CRP) after weight loss with a hypocaloric high fat Mediterranean diet.

Increasing bacterial resistance is strictly correlated to the increasing use of antibiotics, currently constituting a public health problem. The aim of this study was to describe the consumption of antibiotics in Asturias, an autonomous community in northwestern Spain, and compare the results obtained with data from elsewhere in Spain and other European countries. A descriptive study was carried out on the use of antibacterial drugs for systemic use, ATC code J01 in Asturias in 2011-2015. Data were obtained from the prescription-billing information system charged to the Health Service of Asturias. The consumption data are expressed in daily doses per 1,000 inhabitants and day (DHD), and number of packages per thousand inhabitants per day. The average weighted consumption of antibiotics for systemic use in the Asturian community was 26.23 daily doses per 1000 inhabitants per day (DHD) in 2015. This figure was higher than that of the EU/EEA population, which was 22.4 DHD, and that of the whole of Spain at 22.2 DHD. There is a wide variability in consumption among the different areas of the Asturian region. This variability is common to the rest of the country and Europe. It can be explained by the influence of the data used in the indicators and by the variability in medical practice. Priority should be given to homologating consumer-monitoring information systems and implementing national strategies aimed at providing more information to medical practitioners, encouraging the appropriate use of antibiotics so as to reduce variability, consumption and resistance.

Producción Científica, Rotavirus vaccines (RV) have decreased the infant morbidity and mortality in countries that included RV in their national schedule. Rotavirus vaccination is recommended by the Spanish Society of Pediatrics; however, Spain, as most countries in Europe, has authorized commercialization but not included RV in its national vaccination program. We assessed the impact of RV on the rotavirus hospitalization rate through an interrupted time series analysis. There was a 46.8% (95% CI: 29.3–60.2) decrease on the rotavirus hospitalizations rate in the study region after RV commercialization in 2006. Currently there is limited evidence about the impact of RV in Europe, especially among countries not offering systematic vaccination in their national schedule. Documentation of RV coverage, effectiveness and impact is urgently needed in these countries.

Producción Científica, Hemos leído con interés la publicación de Troncoso et al1, en el que se expone la importancia de las prácticas en la calidad de la enseñanza en el pregrado de Medicina y al hilo de sus reflexiones quisiéramos establecer una breve aportación. Percibimos que la “empatía” hacia el paciente parece menos relevante en los planes docentes y ello es concordante con la escasa importancia que se le ha concedido como área de competencia. En este sentido queremos señalar que el reducido impacto de la misma en el nivel docente puede comprobarse reseñando que en el prestigioso examen del Médico Interno Residente (MIR), durante los últimos 36 años, las cuestiones relativas a este ámbito de conocimiento se han situado entre las menos frecuentes.

Role of GLP-1 variants on basal GLP-1 levels, body weight and cardiovascular risk factors remains unclear in patients with diabetes mellitus type 2.Our aim was to analyze the effects of rs6923761 GLP-1 receptor polymorphism on body weight, cardiovascular risk factors, basal GLP-1 levels and serum adipokine levels in naïve patients with diabetes mellitus type 2.A sample of 104 naïve patients with diabetes mellitus type 2 was enrolled in a prospective way. Basal fasting glucose, c-reactive protein (CRP), insulin, insulin resistance (HOMA), total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides concentration, basal GLP-1, HbA1c and adipokines (leptin, adiponectin, resistin) levels were determined. Weights, body mass index, waist circumference, fat mass by bioimpedance and blood pressure measures were measured.Forty-nine patients (47.1%) had the genotype GG and 55 (52.9%) diabetic subjects had the next genotypes; GA (44 patients, 42.3%) or AA (11 study subjects, 10.6%) (second group). In A allele carriers, basal GLP-1 levels were higher than non-carriers (2.9 ± 2.1 ng/ml; p0.05). No differences were detected between both genotype groups.Our cross-sectional study revealed an association between the rs6923761 GLP-1 receptor polymorphism (A allele carriers) and basal GLP-1 levels in naïve patients with diabetes mellitus type 2.

Background: The role of glucagon-like peptide 1 (GLP-1) variants in metabolic syndrome (MS) and its components remains unclear in obese subjects. Objective: The aim of our study was to evaluate the relationship of rs6923761 with MS and its components in obese subjects. Design: A population of 1,122 obese subjects was analyzed in a cross-sectional survey. To estimate the prevalence of MS, we considered the definitions of the Adult Treatment Panel III. Results: Five hundred and forty-eight patients (48.8%) had the GG genotype (wild-type group), whereas 487 patients (43.4%) had the GA genotype and 87 patients (7.8%) the AA genotype. The mean age was 48.9 ± 12.8 years. The prevalence of MS was 47.4% (532 patients), and 52.6% of patients had no MS (n = 590). The odds ratio of MS for the wild-type versus the mutant genotype was 1.02, with a 95% confidence interval of 0.88-1.12. Body mass index, weight, fat mass, waist circumference, and waist to hip ratio were lower in the mutant than in the wild-type group in patients with and without MS. Conclusion: The GLP-1 receptor variant rs6923761 was found to be associated with decreased weight and anthropometric parameters in A allele carriers with and without MS. MS or its components were not associated with this polymorphism in obese adults.

Background and aim: The C385A polymorphism of FAAH gene (rs324420C>A) has been associated with obesity. We investigate the role of this polymorphism on cardiovascular risk factors and weight loss secondary to a high protein/ low carbohydrate vs. a standard hypocaloric diets (1000 kcal/day) during 9 months. Methods: A sample of 284 subjects with obesity (body mass index (BMI) >30) was enrolled. These subjects were randomly allocated to one of two diets for a period of nine months Diet S (standard protein hypocaloric diet) vs. Diet HP (high protein-low carbohydrate hypocaloric diet). Results: After both diets and in both genotype groups (CC vs. CA+AA), body mass index (BMI), weight, fat mass, waist circumference and systolic blood pressure decreased. With the diet type HP and in non A carriers, glucose (-5.3 ± 1.2 mg/dl vs. -1.8 ± 2.1 mg/dl; p

To cite this article: Matias V, San Feliciano L, Fernandez JE, Lapena S, Garrido E, Ardura J, Soga MJ, Aragon MP, Remesal A, Benito F, Andres J, Centeno F, Marugan V, Bachiller R, Bermejo-Martin JF. Host and environmental factors influencing respiratory secretion of pro-wheezing biomarkers in preterm children. Pediatric Allergy Immunology 2012: 23: 441–447. Abstract Cytokines are actively secreted by the respiratory mucosa of preterm children and participate in the pathogenesis of wheezing. This study aimed to identify the factors that could potentially influence respiratory secretion of cytokines in these children. A nasopharyngeal aspirate (NPA) was collected from 77 preterm children 1 yr after birth. NPAs from 14 healthy, 1-yr-old term children were collected in parallel. 27 cytokines were measured in the NPAs using a multiplex assay. Multivariate stepwise regression analysis with Bonferroni correction evidenced that the variable [daycare attendance] was associated with higher levels of [monocyte chemoattractant protein-1 (MCP-1), IL-6, vascular endothelial growth factor (VEGF), IL-1β, IL-10, tumor necrosis factor (TNF)-α]; [male sex] with higher levels of (MCP-1, VEGF, and IL-1β); [smokers at home] was associated with higher levels of MCP-1 (p

Rotavirus is one of the most common causes of gastroenteritis worldwide. With the commercialisation of effective rotavirus vaccines in Europe in sight, it is necessary to provide studies which evaluate the disease burden. The aim of this study is two-fold, on one hand, to determine the burden of the rotavirus disease in Spanish children under the age of five, and on the other, to estimate the economic cost of these hospitalizations. The study was undertaken during a 5 year period (2000-2004). The rotavirus hospitalization rate was determined using the Minimum Basic Data Set of the national hospital discharge register. The observed data were compared with those expected by applying a model developed by the Centers for Disease Control and Prevention (CDC) adapted for European Countries. The financial expense of these hospitalizations was estimated. Of all admissions coded as gastroenteritis, 31.6% were due to rotavirus. The hospitalization rate by rotavirus was 480 cases per 100,000 children under five. These data are within the confidence range proposed by the adapted CDC model. The financial expense due to hospitalizations reaches 123,262 euros yearly in a Spanish University Hospital. In conclusion, rotavirus contributes significantly to the hospitalization of acute gastroenteritis. The rate of hospitalization by rotavirus is higher compared to other studies carried out in Spain. In view of future commercialisation of rotavirus vaccines, more in-depth analysis considering direct and indirect costs are necessary.

breast milk, besides being a source of feeding for children, it can be a vehicle for transmission of some infectious diseases.to revise the main viral agents which can be acquired for children through breast milk and its possible clinical implication.literature search was made in different databases and books.date on the human immunodeficiency virus type 1 and 2, human T-lymphotropic virus, cytomegalovirus, hepatitis A, B and C virus, herpes simplex virus types 1 and 2, varicella zoster virus and other viruses are exposed in detail.the human immunodeficiency virus type 1 and 2, human T-lymphotropic virus and cytomegalovirus in preterm newborns or low birth weight are the most frequent viruses that cause infection or illness in children as a result of its transmission through breast milk. For other viruses, such as varicella zoster, hepatitis A or hepatitis B, the immunoprophylaxis of the newborn, through the administration of immunoglobulin and vaccine, protect children against their transmission.Introducción: la leche materna, además de ser una fuente de alimentación para los niños, puede ser un vehículo de transmisión de diversas enfermedades infecciosas. Objetivo: revisar los agentes virales que pueden ser adquiridos por el niño a través de la leche materna y su posible implicación clínica.se han hecho búsquedas bibliográficas en diferentes bases de datos y libros. Resultados: se exponen datos relativos al virus de la inmunodeficiencia humana tipo 1 y tipo 2, virus linfotrópico humano de células T, citomegalovirus, virus de la hepatitis A, B y C, virus del herpes simple tipos 1 Y 2, virus de la varicela zóster y otros. Conclusiones: el virus de la inmunodeficiencia humana, HTLV-1 y citomegalovirus en recién nacidos pretérmino o de bajo peso son los virus que más frecuentemente causan infección o enfermedad en el niño como consecuencia de su transmisión a través de la leche materna. Para otros virus, como el de la varicela-zóster, la hepatitis A o la hepatitis B, la inmunoprofilaxis del recién nacido, mediante la administración de inmunoglobulina y la vacuna correspondiente, protegen al lactante del riesgo de transmisión.

Recent dietary trials and observational studies have focused on the effects of diet on health outcomes such as improvement in levels of surrogate biomarkers. The aim of our study was to examine the changes in weight, adipocytokines levels and insulin resistance after a high-protein/low carbohydrate hypocaloric diet vs. a standard hypocaloric diet during an intervention of 9 months.331 obese subjects were randomly allocated to one of two diets for a period of 9 months. Diet HP (n=168) (high-protein hypocaloric diet) consisted in a diet of 1050 cal/day, 33% of carbohydrates, 33% of fats and 34% of proteins. Diet S (n=163) (standard protein hypocaloric diet) consisted in a diet of 1093 cal/day, 53% carbohydrates, 27%fats, and 20% proteins.With the diets HP and S, BMI, weight, fat mass, waist circumference, waist-to-hip ratio, systolic blood pressure, total cholesterol, LDL-cholesterol, insulin and HOMA decreased. The decrease at 9 months of (BMI: -2.6±1.3kg/m(2) vs. -2.1±1.2kg/m(2):p0.05), weight (-8.4±4.2kg vs. -5.0±4.1kg: p0.05), fat mass (-5.1±4.1kg vs. -3.4±4.2kg: p0.05), systolic blood pressure (-5.1±7.1mmHg vs. -3.1±2.1mmHg: p0.05), (insulin levels -4.0±4.8 UI/L vs. -2.2±2.4 UI/L; p0.05) and HOMA (-0.8±1.0 units vs. -0.3±1.0 units; p0.05) was higher in diet HP than Diet S. With both diets, leptin levels decreased.A high-protein/low carbohydrate hypocaloric diet shows a higher weight loss, insulin and HOMA-R decreased after 9 months than a standard hypocaloric diet. The improvement in adipokine levels was similar with both diets.

Leclercia adecarboxylata is being increasingly diagnosed as a causative agent of infection due to the availability of rapid molecular diagnostic techniques Few cases of bacteraemia in subjects with underlying medical conditions have been reported. We report a case of L. adecarboxylata bacteraemia in an immunocompromised patient with metabolic syndrome.

Studies of the GLP-1 receptor have been directed at identifying polymorphisms in the GLP-1 receptor gene that may be a contributing factor in the pathogenesis of diabetes mellitus and cardiovascular risk factors. Nevertheless, the role of GLP-1 variants on body weight, cardiovascular risk factors and adipokines remains unclear in obese patients.Our aim was to analyze the effects of rs6923761 GLP-1 receptor polymorphism on body weight, cardiovascular risk factors and serum adipokine levels in morbid obese patients.A sample of 175 morbid obese patients was enrolled in a prospective way. Basal fasting glucose, c-reactive protein (CRP), insulin, insulin resistance (HOMA), total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides concentration and adipokines were measured. Weights, body mass index, waist circumference, fat mass by bioimpedance and blood pressure measures were measured.87 patients (49,7%) had genotype GG and 88 (50,3%) had; GA (71 patients, 40,6%) or AA (17 patients, 9,7%) (second group). In the group with GG genotype, levels of glucose (4,4 ± 2,3 mg/dl, p0,05), tryglicerides (6,8 ± 4,3 mg/dl , p0,05), insulin (4,5 ± 2,3 UI/l , p0,05) and HOMA (1,5 ± 0,9 units, p0,05) were higher than mutant group. No differences were detected in other parameters.Data from our study revealed an association with metabolic parameters and rs6923761. Levels of triglycerides, insulin and HOMA were higher in subjects with A alelle than non A allele subjects.Antecedentes: Los estudios de receptor de GLP-1 se han dirigido a la identificación de polimorfismos en el gen receptor de GLP- 1 que pueden ser un factor que contribuye en la patogénesis de la diabetes mellitus y factores de riesgo cardiovascular. Sin embargo, el papel de las variantes del receptor de GLP-1 variantes en el peso corporal, factores de riesgo cardiovasculares y adipocitoquinas sigue estando poco estudiado en pacientes con obesidad morbida. Objetivo: Nuestro objetivo fue analizar los efectos del polimorfismo del receptor de GLP-1 rs6923761 sobre el peso corporal, factores de riesgo cardiovascular y los niveles de adipocitoquinas séricas en pacientes con obesidad mórbida. Diseño: Se estudió una muestra de 175 obesos mórbidos. La glucosa en ayunas, proteína C reactiva (PCR), insulina, resistencia a la insulina ( HOMA), colesterol total, LDL- colesterol, HDL- colesterol, triglicéridos y la concentración de adipoquinas se midieron. También se determinaron el peso, índice de masa corporal, circunferencia de la cintura, masa grasa a través de bioimpedancia y la presión arterial. Resultados: Un total de 87 obesos (49,7%) tenían el genotipo GG y 88 (50,3%) de los sujetos del estudio tenían los siguientes genotipos; GA (71 obesos, el 40,6%) o AA (17 sujetos del estudio, el 9,7%) ( segundo grupo) . En el grupo con genotipo GG, los niveles de glucosa (4,4 ± 2,3 mg/dl, p0,05), triglicéridos (6,8 ± 4,3 mg/dl , p0,05), insulina (4,5 ± 2,3 UI/l , p0,05) y HOMA (1,5 ± 0,9 unidades, p0,05 ) fueron mayores que en el grupo mutante. No se detectaron diferencias en el resto de parámetros analizados Conclusión: Existe una asociación entre los parámetros metabólicos y el alelo mutante (A) del polimorfismo rs6923761 del receptor de GLP- 1 en pacientes con obesidad mórbida. Los niveles de triglicéridos, insulina y resistencia a la insulina son más elevados en los sujetos portadores del alelo A.

The role of GLP-1 R variants on body weight response after dietary intervention is unclear. Our aim was to evaluate the effect of this polymorphism on cardiovascular risk factors, adipokine levels and weight loss secondary to a high monounsaturated fat vs. a high polyunsaturated fat hypocaloric diets in obese subjects. 391 obese subjects were randomly allocated to one of these two diets for a period of 3 months; diet M (high monounsaturated fat hypocaloric diet) and diet P (high polyunsaturated (PUFAs) fat hypocaloric diet). Two hundred and twelve patients (54.2 %) had the genotype GG (wild group) and 179 (45.8 %) patients had the next genotypes; GA (146 patients, 37.3 %) or AA (33 patients, 8.7 %) (Mutant group). With both diets and in wild-type and mutant-type groups, BMI, weight, fat mass, waist circumference and systolic blood pressure decreased. Anthropometric parameters were higher in non-A-allele carriers than A-allele carriers. With both diets and in both genotypes, leptin, insulin levels and HOMA decreased. With the diet P and in wild genotype, total cholesterol and LDL-cholesterol levels decreased, too. Our data showed a lack of association of rs6923761 GLP-1 R polymorphism with weight loss after a high monounsaturated fat and a high polyunsaturated fat hypocaloric diets. Better anthropometric parameters in obese subjects with the mutant allele (A) of rs6923761 GLP-1 R polymorphism were observed. Insulin levels and HOMA decreased in non-A carriers.

Fundamento: El Campylobacter es uno de los principales patógenos entéricos, sin embargo algunos aspectos de su epidemiología no se conocen con precisión. El objetivo de este trabajo es analizar en la provincia de Valladolid la tendencia y variación estacional de las gastroenteritis que provoca. Métodos: Se realizó un análisis de series temporales mediante un modelo aditivo a partir de las declaraciones realizadas al Sistema de Información Microbiológico por los dos principales hospitales de la provincia de Valladolid. Se consideró como caso a los pacientes que presentaron un coprocultivo con un aislamiento de Campylobacter spp. en el período 2000-2004. Se determinaron la tendencia, los coeficientes estacionales de la serie de casos, las tasas de incidencia en función de la edad, el sexo y el año de declaración y las razones de tasas. Resultados: Se observó una tendencia descendente en la declaración de casos durante el periodo de estudio y se detectó un coeficiente estacional significativo en la cuatrisemana seis (c=12,854, p=0,023). La tasa de incidencia fue mayor en los menores de cinco años y en los hombres, ascendiendo a 1841,9 casos (IC 95: 1797,2-1889,6) y 99,7 casos (IC 95% 96,9-102,4) por 100.000 habitantes-año respectivamente. Conclusiones: La infección por Campylobacter tiene lugar en mayor medida en la época del final de la primavera, afectando principalmente a los niños. Es necesario profundizar en el conocimiento de la epidemiología de este microorganismo a nivel local con un abordaje multidisciplinar que considere tanto aspectos microbiológicos como epidemiológicos. Background: Campylobacter is one of the main enteric pathogens, nevertheless many aspects of its epidemiology still are not well known. This study aims to analyze the trend and seasonal pattern in Valladolid. Methods: A time series analysis was developed using an additive model. The information sources were the reports to the Microbiological Information System from the main hospitals in Valladolid. Patients who showed a positive coproculture to Campylobacter spp. in the period 2000-2004 were considered cases. Trend, seasonal coefficients, incidence rates by age, sex and year of notification and incidence rate ratios were calculated. Results: A decreasing trend in reported cases was observed. A significant seasonal coefficient was obtained in the 6th four-week period (c=12,854, p=0,023). The incidence rate was higher among those under five years of age and among males, rising up to 1841.9 cases (95% CI: 1797.2-1889.6) and 99.7 cases (95% CI: 96.9-102.4) per 100,000 inhabitants-year respectively. Conclusions: Campylobacter infections occurs to a greater extent in late springtime, affecting mainly children. It is necessary to delve deeper into the knowledge of the epidemiology of this microorganism at the local level with a multidisciplinary approach, taking both microbiological and epidemiological aspects into account.

The high level of consumption of systemic antibiotics in our country prompted a study of factors affecting the geographical variations in this consumption. Several parameters explain the uneven distribution of consumption: (a) the epidemiology of the infections, (b) population-dependent factors and (c) factors dependent on the prescribing doctor. The aim of this study was to study population-dependent parameters (type of population and age). A retrospective longitudinal study was made from antibiotic consumption data provided by International Marketing Services (IMS) between 1 January 1996 and 31 December 2000. The consumption indicator used was the number of defined daily doses per 1000 inhabitants per day (DID). Global consumption in regions under study varied by 5.7 DID: Medina del Campo (25.9 DID), Valladolid city (23.4 DID), Laguna de Duero (22.6 DID), Northern Region (22.4 DID), Southern Region (21.4 DID) and lastly Central Region (20.2 DID). The specific consumption per area showed a greater consumption of amoxicillin in the three urban areas, amoxicillin-clavulanic acid and the main macrolides in Medina del Campo, quinolones antibiotics in the Northern Region and tetracyclines and sulphonamides in Valladolid City. Significant area-dependent global consumption differences were observed with the most marked in urban areas. The differences were more marked when studying the geographical distribution of consumption of the commonly used antibiotics.

The importance acquired by the strategy of anticipating rubella revacunation needs no emphasis1. Recommendations by experts committees and actualization of the prevailing childhood immunization schedules are unanimous when it comes to including the above-mentioned strategy2. In this context, seroepidemiologic survey studies allow the assesment of humoral immunologic response against viral structural antigens3,4 despite the assumed potential bias attached to their design. Being aware of the importance of describing rubella seropositivity real status in our setting we decided to document such situation in children under theoretically proper immunization schedules. The present contribution relies on data from a cross-sectional study carried out between 1999 and 2000 in children from the autonomous region of Spain, Castilla y Leon, (the largest region in the European Economic Community). The chosen framework was restricted to serum samples received in a Microbiology Laboratory of a University Hospital with the request of analyzing infectious markers other than rubella antibodies. According to demographic features a double stratification was made and we evaluated 323 children whose age was between 1 and 5 years and 1166 from 6 to 14 years of age. All samples were alicuoted and frozen (-20oC) until the moment of processing. Antibodies to proteic antigens of rubella viral envelope were determined by means of an indirect enzymeimmunoassay (EIA) (Bio-Whittaker, USA). Results were validated according to manufacturer's instructions and samples that showed a neat absorbance greater the cut-off value plus 15% were considered positive. Our findings reveal that 309 of the investigated samples belonging to children from 1 to 5 years of age (95.7%) had antibodies to rubella virus (95% CI, 93.2% to 98.2%), being the rest of them seronegative at the moment of our study. In the age group ranging from 6 to 14 years the prevalence of antibodies was 90.5% (1055/1166) (95% CI, 88.6% to 92.5%) which resulted lower to that found in the previous group and the difference was statistically significant (p=0.003). This fact reflects a decrease of 5.2% in the seropositivity percentage of the second age group. An additional finding was that when we investigated the 6 to 14 years old group in terms of gender differences, girls (568) reached significantly higher percentages of seroprotection than boys (521) did (94.4 vs 87.1%, p=0.000). Conscious of the caution required in this kind of studies and assuming the internal validity for the evaluated population, our results point out to a age dependent loss of seroprotection. Among the potential causes that maintain this fact we may denote on the one hand the differences in vaccine coverage reached by both groups of children, just as Davidkina et al.5 have recently reported, and on the other hand limitations inherent in the vaccination itself6,7. Moreover, it is of course true that in our country, as well as in all developed countries, systematic vaccination of girls before puberty yields high efficiency, in order to prevent consequences derived from a potential primary infection during pregnancy8,9, all the same it is also certain that we still attend to the presence of small proportions of unprotected persons. The efficiency of new strategies of anticipating combined vaccines needs to be evaluated, and seroepidemiological studies seem to be a good tool for such

The activity of PSPF was studied in 38 normal newborns. The production of 6-keto-PGF1 (PGI2 stable metabolite) after stimulation with cord blood plasma, 0.72 +/- 0.50 pmol/10(5) cells, was lesser than after stimulation with plasma from 2-3 years old children, 3.00 +/- 0.89 pmol/10(5) cells (p less than 0.01), or from adults, 7.74 +/- 5.00 pmol/10(5) cells (p less than 0.001). No differences were shown during neonatal period. The presence of a circulating inhibitor factor in newborns was dismissed by mixed cultures. The behaviour of neonatal plasma after consecutive stimulations with AA was similar to adult plasma response. We proved that newborns show a deficient capacity to stimulate PGI2, which is not due to circulating inhibitor factor, and we think that this deficiency is due to a weaker action of stimuli, rather than to an immaturity.