Community-wide measles outbreak in the Region of Madrid, Spain, 10 years after the implementation of the Elimination Plan, 2011-2012.

We describe a community-wide outbreak of measles due to a D4 genotype virus that took place in the Region of Madrid, Spain, between February 2011 and August 2012, along with the control measures adopted. The following variables were collected: date of birth, sex, symptoms, complications, hospital admission, laboratory test results, link with another cases, home address, places of work or study, travel during the incubation period, ethnic group, and Mumps-Measles-Rubella (MMR) vaccination status. Incidences were calculated by 100,000 inhabitants. A total of 789 cases were identified. Of all cases, 36.0% belonged to Roma community, among which 68.7% were 16 months to 19 y old. Non-Roma cases were predominantly patients from 6 to 15 months (28.1%) and 20 to 39 y (52.3%). Most cases were unvaccinated. We found out that 3.0% of cases were healthcare workers. The first vaccination dose was brought forward to 12 months, active recruitment of unvaccinated children from 12 months to 4 y of age was performed and the vaccination of healthcare workers and of members of the Roma community was reinforced. High vaccination coverage must be reached with 2 doses of MMR vaccine, aimed at specific groups, such as young adults, Roma population and healthcare workers.

Incidencia de diabetes tipo 2 y factores asociados en la población adulta de la Comunidad de Madrid. Cohorte PREDIMERC / Incidence of type 2 diabetes and associated factors in the adult population of the Community of Madrid. PREDIMERC cohort

Objetivos. Estimar la incidencia y los factores de riesgo de diabetes tipo2 en la población adulta de Madrid (España) y comparar los modelos predictivos de diabetes tipo2 basados en los criterios de prediabetes de la American Diabetes Association (ADA) y la Organización Mundial de la Salud (OMS). Material y métodos. Estudio prospectivo de una cohorte poblacional formada por 2048 individuos de entre 30 y 74años sin diabetes. Al inicio del estudio se realizó una encuesta epidemiológica y se midió la glucemia basal, la HbA1c, el índice de masa corporal y el perímetro de la cintura. Se realizó un seguimiento de 6,4años. Los casos nuevos de diabetes tipo2 se identificaron a través de la historia clínica electrónica de atención primaria. Resultados. La incidencia de diabetes tipo2 fue 3,5 casos/1.000 personas-año. En el análisis multivariante las variables que se asociaron con la aparición de diabetes tipo2 fueron la edad, los antecedentes familiares de diabetes, la glucemia basal (100-125mg/dl), la HbA1c (5,7-6,4%) y el perímetro de la cintura (≥94cm en hombres y ≥80cm en mujeres). De estas, las más significativamente asociadas fueron la glucemia basal y la HbA1c. Los criterios de la ADA y la OMS para definir prediabetes tuvieron la misma capacidad predictiva. Conclusión. La incidencia de diabetes tipo2 estimada en Madrid fue inferior a la encontrada en otros estudios poblacionales, siendo el estado glucometabólico el principal factor asociado a la progresión a diabetes tipo2. No se han detectado diferencias entre la prediabetes definida por la ADA y la OMS para predecir la aparición de la enfermedad (AU)

Objectives. Determine the incidence and risk factors of type2 diabetes in the adult population of Madrid (Spain) and compare the predictive models of type2 diabetes based on the prediabetes criteria of the American Diabetes Association (ADA) and the World Health Organisation (WHO). Material and methods. A prospective study was conducted on a population cohort composed of 2048 individuals between 30 and 74years of age with no diabetes. At the start of the study, an epidemiological survey was performed, and baseline glycaemia, HbA1c, body mass index and waist circumference were measured. A follow-up of 6.4years was conducted. New cases of type2 diabetes were identified using the electronic primary care medical history. Results. The incidence of type2 diabetes was 3.5 cases/1000 person-years. In the multivariate analysis, the variables that were associated with the onset of type2 diabetes were age, family history of diabetes, baseline glycaemia (100-125mg/dL), HbA1c (5.7-6.4%) and waist circumference (≥94cm for men and ≥80cm for women). Of these, the most significantly associated variables were baseline glycaemia and HbA1c. The ADA and WHO criteria for defining prediabetes had the same predictive capacity. Conclusion. The incidence of type2 diabetes measured in Madrid was lower than that found in other population studies, with the glucometabolic state the main factor associated with progression to type2 diabetes. There were no differences between the prediabetes defined by the ADA and the WHO for predicting the onset of the disease (AU)

Incidence of type 2 diabetes and associated factors in the adult population of the Community of Madrid. PREDIMERC cohort.

OBJECTIVES: Determine the incidence and risk factors of type2 diabetes in the adult population of Madrid (Spain) and compare the predictive models of type2 diabetes based on the prediabetes criteria of the American Diabetes Association (ADA) and the World Health Organisation (WHO). MATERIAL AND METHODS: A prospective study was conducted on a population cohort composed of 2048 individuals between 30 and 74years of age with no diabetes. At the start of the study, an epidemiological survey was performed, and baseline glycaemia, HbA1c, body mass index and waist circumference were measured. A follow-up of 6.4years was conducted. New cases of type2 diabetes were identified using the electronic primary care medical history. RESULTS: The incidence of type2 diabetes was 3.5 cases/1000 person-years. In the multivariate analysis, the variables that were associated with the onset of type2 diabetes were age, family history of diabetes, baseline glycaemia (100-125mg/dL), HbA1c (5.7-6.4%) and waist circumference (≥94cm for men and ≥80cm for women). Of these, the most significantly associated variables were baseline glycaemia and HbA1c. The ADA and WHO criteria for defining prediabetes had the same predictive capacity. CONCLUSION: The incidence of type2 diabetes measured in Madrid was lower than that found in other population studies, with the glucometabolic state the main factor associated with progression to type2 diabetes. There were no differences between the prediabetes defined by the ADA and the WHO for predicting the onset of the disease.

Formación médica continuada en un hospital de referencia. ¿Quo vadis? / Continuing medical education in a reference hospital. Quo vadis?

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[Accidents with biological material in health care workers in 2 primary health care areas (1990-1999)]. / Accidentes con material biológico en trabajadores sanitarios de 2 áreas de atención primaria (1990-1999).

OBJECTIVE: To find out the exposures with biological material in health care workers in primary health care, registered in the biological accidents database from Preventive Medicine Service in Miguel Servet Universitary Hospital of Zaragoza. DESIGN: Descriptive study of a retrospective cohort. SITE: Primary health care, Areas II and V of Zaragoza.Participants. Workers in this areas, distributed by: physician, nursing staff, auxiliary, orderly, housekeeping staff, others. MEASUREMENTS AND MAIN RESULTS: Data of: workers, accident, serologic source, worker protection and vaccinal status of hepatitis B. The incidence of accidents was 26 (period 1997-1999). Most proportion of accidents were declared by nursing (78%). The highest occupational incidence was in auxiliary (63 ). In 90,1% of the cases, the accident was needlestick injury. The source was known in 67,7% of cases. The accidents occurred in hands in 96,8% of cases, and only one third of workers carried gloves. CONCLUSIONS: Results obtained are similar with previous studies about this event. We must insist on the need to declare these accidents, providing more information and accessibility for the declaration to worker. Moreover, we must insist on the correct application in the health care field of the standard precautions, because almost 50% of accidents are evitable, and to increase hepatitis B vaccination covertures.

Accidentes con material biológico en trabajadores sanitarios de 2 áreas de atención primaria (1990-1999) / Accidents with biological material in health care workers in two primary health care areas (1990-1999)

Objetivo. Conocer el perfil de las exposiciones con material biológico en trabajadores sanitarios de atención primaria a través del registro de accidentes biológicos del Servicio de Medicina Preventiva del Hospital Universitario Miguel Servet de Zaragoza entre 1990 y 1999.Diseño. Estudio descriptivo de una cohorte retrospectiva. Emplazamiento. Atención primaria, Áreas II y V de Zaragoza. Participantes. Trabajadores de estas áreas, distribuidos en: médicos, enfermería, auxiliar de clínica, celador, personal de limpieza y otros. Mediciones y resultados principales. Datos sobre: trabajador, accidente, serología de la fuente si ésta era conocida, protección del trabajador y sobre el estado vacunal frente a hepatitis B. La incidencia acumulada global de accidentes fue del 26,9 (período 1997-1999). La mayor proporción de accidentes declarados tuvo lugar en enfermería (78 por ciento). La categoría profesional con mayor incidencia de accidentes fue auxiliar de clínica (63 ). En un 90,1 por ciento de los casos el accidente fue un pinchazo. La fuente era conocida en el 67,7 por ciento de los casos. Los accidentes se produjeron en las manos en un 96,8 por ciento de declaraciones y sólo un tercio de los trabajadores portaba guantes. Conclusiones. Los resultados obtenidos coinciden con estudios previos que estudian el mismo fenómeno. Debemos incidir en la necesidad de declarar estos accidentes, facilitando mayor información y accesibilidad para la declaración al trabajador. Además deberíamos insistir en la correcta aplicación en el medio sanitario de las precauciones estándar, ya que casi un 50 por ciento de los accidentes son evitables. Un objetivo fundamental debe ser aumentar la cobertura de vacunación frente a la hepatitis B (AU)