[Epidemiological surveillance of syphilis in the city of Valencia. Impact and evolution of the period 2003-2014]. / Vigilancia epidemiológica de la sífilis en la ciudad de Valencia. Impacto y evolución del período 2003-2014.

UNLABELLED: In Spain syphilis shows an increasing trend from last decade and multiple papers reported an increasing of exposed population. Our aim was to describe the evolution of the incident of the syphilis in the geographical frame of the city of Valencia, to identify the characteristics and practices of risk of the affected ones. A classic design of vigilance of public health was applied, longitudinal retrospective study. Geographical area: the city of Valencia. PERIOD: January 2003-December 2014. VARIABLES: age and sex, national origin, dates of access to the sanitary system, date of diagnosis, clinical forms of presentation, conducts of risk, and practices of risk. The annual impact of the disease evolved from 2.4 × 10(5) in 2004 up to 14.5 × 10(5) in 2014. Males (82.96%) masculinity rate: 4.8. Major specific incidence took places on age-groups 35-39 years with 16.49 × 10(5) and 40-44 years with 16.98 × 10(5). The difference between women stands out according to origin: middle ages in autochthonous (39.72 years) opposite to foreigners (32.91 years); P = .004. The primary forms were 5 times more probable in males. The major factor of risk was to have multiple couples (54.89%), man-to-man homo or bisexuals reaches 90.0% of it. The HIV (human immunodeficiency virus) infection was 29.07% in males and 4.35% in women. Precedent of multiple couple relations would not be a minor of 42 times more likely among the homosexual population with syphilis. Major determinant of risk were the relations with multiple pairs and the prevention will have to be focused to the group of men who practice sex with men.

A "Before and After" in the Use of Emergency Services in Spain? The Impact of the Economic Crisis.

The objective of this study was to analyse whether variables associated with emergency services (ES) use in Spain have changed in the period 2006-2011 using a comparative analysis of the 2006 and 2011 Spanish National Health Surveys. The measure of association was the prevalence ratio with its 95% confidence interval, obtained by Poisson regression with robust variance. We studied interactions between the explanatory variables for ES use and year and subsequently performed a stratified analysis by year. ES use declined by 2.1% in 2011. Most emergency care (approximately 60% in both surveys) was provided in public hospitals. Between 2006 and 2011, ES use increased by 9% in women (p for interaction = 0.008) [ref. men], 3% in persons with poor mental health (p for interaction = 0.072) [ref. good mental health], and 8% in individuals with limitations on activities of daily living (p for interaction = 0.006) [ref. no limitations]. The change in the effect of the variables sex, mental health, and limitations on activities of daily living on use of ES (2006 and 2011) is not explained by either demographic characteristics or individual socioeconomic indicators. These results could be associated with macroeconomic and structural changes occurring during the period 2006-2011.