A study of leishmanin skin test reactors was carried out in 1997 and 1998 in an endemic region in southeast Spain, to estimate the magnitude of and the factors related to subclinical Leishmania infantum infection. In the main focus of leishmaniasis in the region, 11.5% of the children and 52.8% of the adults reacted to the skin test. Among the adults, the response was significantly greater for males and for those who had resided in the area for > or = 15 years. In the whole region, 3.7% 14-year-old students reacted to the skin test, with no gender differences. The main factors related to a positive skin test result were having a parent or sibling recovered from leishmaniasis (relative risk = 14) and living in the rural periphery of the region as opposed to the metropolitan area (relative risk = 4). These results indicate a high frequency of subclinical leishmaniasis in the region. We postulate that the decline in childhood visceral leishmaniasis in southern Europe in the second half of the 20th century is related to social changes, which gave rise to a less frequent exposure at a young age as well as a lowered susceptibility to disease through nutritional and immune improvements.

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International organizations have raised awareness of the increasing prevalence of overweight and obesity worldwide and the impact on morbidity, mortality, quality of life, and cost of healthcare. The development and implementation of obesity prevention strategies requires the identification and understanding of determinant factors that can be influenced by effective large-scale action plans over time. Strategies aimed at the primary prevention of obesity in a population should be multifaceted and designed to actively involve stakeholders and other major parties concerned; in addition, multiple settings for implementation should be considered. In this paper, an overview is presented of the strategies currently in place for obesity prevention, particularly in Spain.

Background=objective: Long chain polyunsaturated fatty acids have beneficial effects in preterm neurophysiological development and are semi-essential. Their levels and variation in plasma and red cells in term and preterms are better known than their intestinal absorption. In this paper the absorption of supplemented arachidonic acid (AA) and docosahexaenoic acid (DHA) is evaluated in a preterm group. Design: Four newborn randomized groups were studied. Group T comprised 11 terms on regular formula. Preterms: group P (n ¼ 9) was on a classic preterm formula. Intervention: groups PA (n ¼ 9) and PB (n ¼ 13) were on the same formula but PB contained AA and DHA in similar proportion to breast milk. At 20 days a 3 day metabolic balance was taken for Ca, P i , Mg, total fat and individual fatty acids (C8 -C24, saturated unsaturated). Results: Calcium absorption was (mean AE s.d.) 51 AE 13% in terms. In preterms it was respectively 45 AE 18, 38 AE 11 and 37 AE 21%. Total fat absorption was 92.0AE 8.0% in terms, and from 95.0 AE 2.0 to 91.0 AE 8.0% in preterms. Absorption of 8:0, 10:0 and 12:0 showed a very high and constant rate despite significant intake differences (715 -33 mg=kg=day). Linoleic acid and a-linolenic acid were absorbed in the three groups at around 94% regardless of a greater LA intake in group P. Details of absorption (mg=kg=day) were: for AA, intake 17 AE 7, fecal excretion 5 AE 4, net retention 12 AE 5 (75.0 AE 18%); for DHA, intake 10 AE 3, fecal excretion 3 AE 2, net retention 6 AE 4 (62.3AE 30%). Conclusion: Intestinal absorption of fatty acids is high and is comparable in terms and preterms as regards the studied acids. Longer acids were less well absorbed. The supplemented amounts of AA and DHA were less well absorbed and probably not impairing calcium absorption. Sponsorship: University of Alicante, University of Miguel Hernández.

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