ABSTRACT
In October 2010, one case of autochthonous malaria due to Plasmodium vivax was diagnosed in Spain. The case occurred in Aragon, north-eastern Spain, where the vector Anopheles atroparvus is present. Although the source of infection could not be identified, this event highlights that sporadic autochthonous transmission of vector-borne diseases in continental Europe is possible and calls for enhanced surveillance and vector control measures.
Subject(s)
Malaria, Vivax/diagnosis , Plasmodium vivax/isolation & purification , Adult , Antimalarials/therapeutic use , Chloroquine/therapeutic use , Endemic Diseases , Humans , Malaria, Vivax/drug therapy , Malaria, Vivax/epidemiology , Microscopy , Polymerase Chain Reaction , Primaquine/therapeutic use , Spain/epidemiology , Treatment OutcomeABSTRACT
We describe the clinical and epidemiological characteristics of patients hospitalised with confirmed 2009 pandemic influenza A(H1N1) in Spain from April to December 2009 and the risk factors associated with a worse outcome (admission to an intensive care unit or death) in adults. Case-based epidemiological information was collected as part of the national strategy for the surveillance of severe cases. Of 3,025 patients, 852 were admitted to an intensive care unit and overall, 200 died. The median patient age was 38 years (range: 094). A total of 662 (26%) patients had no underlying risk conditions. Antiviral therapy was initiated within 48 hours after symptom onset in only 35.2% (n=711); the median length of time before treatment was four days. In a multivariate analysis, the start of antiviral therapy more than 48 hours after symptom onset (odds ratio (OR) 2.39; 95% confidence interval (CI): 1.79 to 3.2), morbid obesity (OR: 2.01; 95% CI 1.38 to 2.94), cardiovascular disease (OR: 1.79; 95% CI: 1.2 to 2.67) and chronic obstructive pulmonary disease (OR: 1.51; 95% CI: 1.03 to 2.2) were significantly associated with a worse outcome in adults.
Subject(s)
Hospitalization , Influenza A Virus, H1N1 Subtype , Influenza, Human/epidemiology , Pandemics , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant , Influenza, Human/diagnosis , Influenza, Human/therapy , Male , Middle Aged , Risk Factors , Severity of Illness Index , Spain/epidemiology , Time Factors , Young AdultABSTRACT
OBJECTIVES: To analyse the statistical and characteristics of the attendance to the elderly patient at the Emergency Department of a General Hospital. METHODS: Retrospective study of patients > or = 65 years assisted at the Emergency Department of the Hospital Clínico San Carlos (Madrid), during 1998, taking into consideration different parameters as age, sex, time of year, referred pathology and final destination; results were compared with data relating to the population under 65. RESULTS: Over 28.4% of the 129,586 subjects that attended the Emergency Department were elderly people. Those ones aged between 65-74 years demanded assistance more frequently, being women's requests higher, particularly among the eldest patients. Assistance requests were higher in winter time, being the most common reason for consultation medical and surgical general troubles (76.4%), followed by trauma emergencies (12.35%). Hospital admission's percentage of elderly people was three times higher than the non-elderly ones, needing more admissions men than women (29 vs 22.7%). CONCLUSIONS: The high statistical of urgent attendance to the elderly patient compared with younger people as well as the higher number of admissions due to this assistance, seem to make necessary the implantation of Geriatric Evaluation Units at the hospital's Emergency Departments.
Subject(s)
Emergency Treatment/statistics & numerical data , Geriatrics , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
Objetivos: Analizar la frecuencia y peculiaridades de la asistencia al sujeto anciano en el Servicio de Urgencias de un hospital general.Métodos: Realización de un estudio retrospectivo de los pacientes de 65 años asistidos en el Servicio de Urgencias del Hospital Clínico San Carlos (Madrid), durante el año 1998, con la consideración paralela de diferentes parámetros, tales como edad, sexo, época del año, patología presentada y destino final; comparando los resultados hallados con datos referentes a la población de menos de 65 años.Resultados: De 129.585 sujetos que acudieron al Servicio de Urgencias, un 28,4 por ciento eran ancianos. Dentro de la población perteneciente a este área sanitaria, precisaron asistencia urgente un 34 por ciento de ancianos, frente a un 22,3 por ciento en la población de menor edad. Demandaron asistencia de forma más frecuente aquellos con edades comprendidas entre 65-74 años, siendo superior la presencia de mujeres, en especial conforme la edad era más avanzada. Los requerimientos asistenciales fueron más elevados en la estación invernal, predominando en cuanto a motivo de consulta los problemas médico-quirúrgicos generales (76,4 por ciento), seguidos por las urgencias traumatológicas (12,35 por ciento). El porcentaje de ingresos hospitalarios en sujetos ancianos en relación con la población no anciana fue tres veces superior, precisando mayor número de ingresos los hombres que las mujeres (29,1 vs 22,7 por ciento).Conclusiones: La elevada frecuencia de asistencia urgente al paciente anciano, en comparación con sujetos más jóvenes, así como el mayor número de ingresos derivado de tal asistencia, parecen hacer necesaria la consideración del funcionamiento de Unidades de Valoración Geriátrica en los Servicios de Urgencias hospitalarios. (AU)
