Trends in hip fracture rates in spain from 2001 to 2018.

The present study includes the longest period of analysis with the highest number of hip fracture episodes (756,308) described in the literature for Spain. We found that the age-adjusted rates progressively decreased from 2005 to 2018. We believe that this is significant because it may mean that measures such as prevention and treatment of osteoporosis, or programs promoting healthy lifestyles, have had a positive impact on hip fracture rates. PURPOSE: To describe the evolution of cases and rates of hip fracture (HF) in patients 65 years or older in Spain from 2001 to 2018 and examine trends in adjusted rates. METHODS: Retrospective, observational study including patients ≥65 years with acute HF. Data from 2001 to 2018 were obtained from the Spanish National Record of the Minimum Basic Data Set of the Ministry of Health. We analysed cases of HF, crude incidence and age-adjusted rates by sex, length of hospital stay (LOS) and in-hospital mortality, and used joinpoint regression analysis to explore temporal trends. RESULTS: We identified 756,308 HF cases. Mean age increased 2.5 years, LOS decreased 4.5 days and in-hospital mortality was 5.5-6.5%. Cases of HF increased by 49%. Crude rate per 100,000 was 533.3 (95% confidence interval [CI], 532.1-534.5), increasing 14.0% (95%CI, 13.7-14.2). Age-adjusted HF incidence rate increased by 6.9% from 2001 (535.7; 95%CI, 529.9-541.5) to 2005 (572.4; 95%CI, 566.7-578.2), then decreased by 13.3% until 2017 (496.1, 95%CI, 491.7-500.6). Joinpoint regression analysis indicated a progressive increase in age-adjusted incidence rates of 1.9% per year from 2001 to 2005 and a progressive decrease of -1.1% per year from 2005 to 2018. A similar pattern was identified in both sexes. CONCLUSIONS: Crude incidence rates of HF in Spain in persons ≥65 years from 2001 to 2018 have gradually increased. Age-adjusted rates show a significant increase from 2001 to 2005 and a progressive decrease from 2005 to 2018.

Location also matters: The oxidative response of the intertidal purple mussel Perumytilus purpuratus during tidal cycle.

For sessile intertidal organisms, periods of low tide impose both cellular and physiological challenges that can determine bathymetric distribution. To understand how intertidal location influences the cellular response of the bivalve Perumytilus purpuratus during the tidal cycle (immersion-emersion-immersion), specimens from the upper intertidal (UI) and lower intertidal (LI) of bathymetric distribution were sampled every 2 h over a 10-h period during a summer tidal cycle. Parallelly, organisms from the UI and LI were reciprocally transplanted and sampled throughout the same tidal cycle. Levels of oxidative damage (lipid peroxidation and protein carbonyls) as well as total antioxidant capacity and total carotenoids were evaluated as cellular responses to variations in environmental conditions throughout the tidal cycle. The results indicate that both the location in the intertidal zone (UI/LI), the level of aerial exposure, and the interaction of both factors are determinants of oxidative levels and total antioxidant capacity of P. purpuratus. Although oxidative damage levels are triggered during the low tide period (aerial exposure), it is the UI specimens that induce higher levels of lipid peroxidation compared to those from the LI, which is consistent with the elevated levels of total antioxidant capacity. On the other hand, organisms from the LI transplanted to the UI increase the levels of lipid peroxidation but not the levels of protein carbonyls, a situation that is also reflected in higher levels of antioxidant response and total carotenoids than those from the UI transplanted to the LI. The bathymetric distribution of P. purpuratus in the intertidal zone implies differentiated responses between organisms of the lower and upper limits, influenced by their life history. A high phenotypic plasticity allows this mussel to adjust its metabolism to respond to abrupt changes in the surrounding environmental conditions.

Colorectal cancer risk after removal of polyps in fecal immunochemical test based screening.

Background: Colonoscopy surveillance intervals are based on the predicted risk of metachronous colorectal cancer (CRC) after polyp removal. However, risk estimation per polyp subtype is difficult due to the fact that many patients have multiple polyps. To enable risk estimation per polyp subtypes we examined the metachronous CRC risk of subgroups based on presence or absence of co-occurring findings. Methods: Using high-quality screening colonoscopies performed after a positive fecal immunochemical test between 2014 and 2020 within the Dutch CRC screening program, we applied Cox regression analysis to evaluate the association between findings at baseline colonoscopy and metachronous CRCs. For our primary outcome, we appointed each patient to unique subgroups based on removed polyp subtypes that were present or absent at baseline colonoscopy and used the groups without polyps as reference. High-risk subgroups were individuals with high-risk serrated polyps, defined as serrated polyp ≥10 mm, sessile serrated lesions with dysplasia, or traditional serrated adenomas, as well as high-risk adenomas, defined as adenoma ≥10 mm or containing high-grade dysplasia. Findings: In total 253,833 colonoscopies were included. Over a median follow-up of 36 months (IQR, 21-57), we identified 504 metachronous CRCs. Hazard ratios for metachronous CRC was 1.70 (95% CI, 1.07-2.69) for individuals with high-risk serrated polyps without high-risk adenomas, 1.22 (0.96-1.55) for individuals with high-risk adenomas without high-risk serrated polyps, and 2.00 (1.19-3.39) for individuals with high-risk serrated polyps and high-risk adenomas, compared to patients without polyps. Interpretation: Accounting for co-occurring findings, we observed an increased metachronous CRC risk for individuals that had high-risk serrated polyps with the presence of high-risk adenomas, or individuals with high-risk serrated polyps without high-risk adenomas. These findings could provide more evidence to support post-polypectomy surveillance guidelines. Funding: None.

Mars 2020 Perseverance Rover Studies of the Martian Atmosphere Over Jezero From Pressure Measurements.

The pressure sensors on Mars rover Perseverance measure the pressure field in the Jezero crater on regular hourly basis starting in sol 15 after landing. The present study extends up to sol 460 encompassing the range of solar longitudes from L s  âˆ¼ 13°-241° (Martian Year (MY) 36). The data show the changing daily pressure cycle, the sol-to-sol seasonal evolution of the mean pressure field driven by the CO2 sublimation and deposition cycle at the poles, the characterization of up to six components of the atmospheric tides and their relationship to dust content in the atmosphere. They also show the presence of wave disturbances with periods 2-5 sols, exploring their baroclinic nature, short period oscillations (mainly at night-time) in the range 8-24 min that we interpret as internal gravity waves, transient pressure drops with duration ∼1-150 s produced by vortices, and rapid turbulent fluctuations. We also analyze the effects on pressure measurements produced by a regional dust storm over Jezero at L s  âˆ¼ 155°.

The sound of a Martian dust devil.

Dust devils (convective vortices loaded with dust) are common at the surface of Mars, particularly at Jezero crater, the landing site of the Perseverance rover. They are indicators of atmospheric turbulence and are an important lifting mechanism for the Martian dust cycle. Improving our understanding of dust lifting and atmospheric transport is key for accurate simulation of the dust cycle and for the prediction of dust storms, in addition to being important for future space exploration as grain impacts are implicated in the degradation of hardware on the surface of Mars. Here we describe the sound of a Martian dust devil as recorded by the SuperCam instrument on the Perseverance rover. The dust devil encounter was also simultaneously imaged by the Perseverance rover's Navigation Camera and observed by several sensors in the Mars Environmental Dynamics Analyzer instrument. Combining these unique multi-sensorial data with modelling, we show that the dust devil was around 25 m large, at least 118 m tall, and passed directly over the rover travelling at approximately 5 m s-1. Acoustic signals of grain impacts recorded during the vortex encounter provide quantitative information about the number density of particles in the vortex. The sound of a Martian dust devil was inaccessible until SuperCam microphone recordings. This chance dust devil encounter demonstrates the potential of acoustic data for resolving the rapid wind structure of the Martian atmosphere and for directly quantifying wind-blown grain fluxes on Mars.

Dust, Sand, and Winds Within an Active Martian Storm in Jezero Crater.

Rovers and landers on Mars have experienced local, regional, and planetary-scale dust storms. However, in situ documentation of active lifting within storms has remained elusive. Over 5-11 January 2022 (LS 153°-156°), a dust storm passed over the Perseverance rover site. Peak visible optical depth was ∼2, and visibility across the crater was briefly reduced. Pressure amplitudes and temperatures responded to the storm. Winds up to 20 m s-1 rotated around the site before the wind sensor was damaged. The rover imaged 21 dust-lifting events-gusts and dust devils-in one 25-min period, and at least three events mobilized sediment near the rover. Rover tracks and drill cuttings were extensively modified, and debris was moved onto the rover deck. Migration of small ripples was seen, but there was no large-scale change in undisturbed areas. This work presents an overview of observations and initial results from the study of the storm.

Hexagonal Prisms Form in Water-Ice Clouds on Mars, Producing Halo Displays Seen by Perseverance Rover.

Observations by several cameras on the Perseverance rover showed a 22° scattering halo around the Sun over several hours during northern midsummer (solar longitude 142°). Such a halo has not previously been seen beyond Earth. The halo occurred during the aphelion cloud belt season and the cloudiest time yet observed from the Perseverance site. The halo required crystalline water-ice cloud particles in the form of hexagonal columns large enough for refraction to be significant, at least 11 µm in diameter and length. From a possible 40-50 km altitude, and over the 3.3 hr duration of the halo, particles could have fallen 3-12 km, causing downward transport of water and dust. Halo-forming clouds are likely rare due to the high supersaturation of water that is required but may be more common in northern subtropical regions during northern midsummer.

Hazy Blue Worlds: A Holistic Aerosol Model for Uranus and Neptune, Including Dark Spots.

We present a reanalysis (using the Minnaert limb-darkening approximation) of visible/near-infrared (0.3-2.5 µm) observations of Uranus and Neptune made by several instruments. We find a common model of the vertical aerosol distribution i.e., consistent with the observed reflectivity spectra of both planets, consisting of: (a) a deep aerosol layer with a base pressure >5-7 bar, assumed to be composed of a mixture of H2S ice and photochemical haze; (b) a layer of photochemical haze/ice, coincident with a layer of high static stability at the methane condensation level at 1-2 bar; and (c) an extended layer of photochemical haze, likely mostly of the same composition as the 1-2-bar layer, extending from this level up through to the stratosphere, where the photochemical haze particles are thought to be produced. For Neptune, we find that we also need to add a thin layer of micron-sized methane ice particles at ∼0.2 bar to explain the enhanced reflection at longer methane-absorbing wavelengths. We suggest that methane condensing onto the haze particles at the base of the 1-2-bar aerosol layer forms ice/haze particles that grow very quickly to large size and immediately "snow out" (as predicted by Carlson et al. (1988), https://doi.org/10.1175/1520-0469(1988)045<2066:CMOTGP>2.0.CO;2), re-evaporating at deeper levels to release their core haze particles to act as condensation nuclei for H2S ice formation. In addition, we find that the spectral characteristics of "dark spots", such as the Voyager-2/ISS Great Dark Spot and the HST/WFC3 NDS-2018, are well modelled by a darkening or possibly clearing of the deep aerosol layer only.

Winds at the Mars 2020 Landing Site. 2. Wind Variability and Turbulence.

Wind speeds measured by the Mars 2020 Perseverance rover in Jezero crater were fitted as a Weibull distribution. InSight wind data acquired in Elysium Planitia were also used to contextualize observations. Jezero winds were found to be much calmer on average than in previous landing sites, despite the intense aeolian activity observed. However, a great influence of turbulence and wave activity was observed in the wind speed variations, thus driving the probability of reaching the highest wind speeds at Jezero, instead of sustained winds driven by local, regional, or large-scale circulation. The power spectral density of wind speed fluctuations follows a power-law, whose slope deviates depending on the time of day from that predicted considering homogeneous and isotropic turbulence. Daytime wave activity is related to convection cells and smaller eddies in the boundary layer, advected over the crater. The signature of convection cells was also found during dust storm conditions, when prevailing winds were consistent with a tidal drive. Nighttime fluctuations were also intense, suggesting strong mechanical turbulence. Convective vortices were usually involved in rapid wind fluctuations and extreme winds, with variations peaking at 9.2 times the background winds. Transient high wind events by vortex-passages, turbulence, and wave activity could be driving aeolian activity at Jezero. We report the detection of a strong dust cloud of 0.75-1.5 km in length passing over the rover. The observed aeolian activity had major implications for instrumentation, with the wind sensor suffering damage throughout the mission, probably due to flying debris advected by winds.

Evaluación psicológica y cognitiva de autismo en un paciente con síndrome de MOMO: reporte de caso y revisión de la literatura / Psychological and cognitive evaluation of autism in a patient with MOMO syndrome: a case report and literature review

MOMO es un acrónimo para los términos macrosomía, obesidad, macrocefalia y anomalías oculares. El síndrome fue descrito por primera vez en 1993, con un total de nueve pacientes publicados a la fecha. Todos los casos reportaron discapacidad intelectual y en un caso se describió a un paciente con autismo. Presentamos un nuevo caso de paciente con síndrome de MOMO que consultó por fenómenos alucinatorios. Se completó una evaluación neuropsicológica, clínica y cognitiva, en donde se demostró un cociente intelectual limítrofe y se corroboraron los criterios para trastorno del espectro autista. Ésta es la primera evaluación neurocognitiva de un paciente con MOMO, la que apoya el uso de escalas estandarizadas a fin de evaluar el autismo y otras comorbilidades psiquiátricas en pacientes con síndromes genéticos.

MOMO is an acronym for macrosomia, obesity, macrocephaly and ocular abnormalities. The syndrome was first described in 1993, with a total of nine patients published thus far. All the cases presented intellectual disability and in one case autism was described. We present a new case of a patient with MOMO syndrome, who consulted for hallucinatory phenomena. He completed a neuropsychological, clinical and cognitive evaluation, showing a borderline intelligence quotient and fulfilled the criteria for autism spectrum disorder. This is the first neurocognitive evaluation of a patient with MOMO, supporting the use of standardized scales in order to assess the autism and other psychiatric comorbidities in patients with genetics syndromes.

Adaptation of antibiotic treatment to clinical practice guidelines in patients aged ⩾65 years hospitalised due to community-acquired pneumonia.

Early, conforming antibiotic treatment in elderly patients hospitalised for community-acquired pneumonia (CAP) is a key factor in the prognosis and mortality. The objective was to examine whether empirical antibiotic treatment was conforming according to the Spanish Society of Pulmonology and Thoracic Surgery guidelines in these patients. Multicentre study in patients aged ⩾65 years hospitalised due to CAP in the 2013-14 and 2014-15 influenza seasons. We collected socio-demographic information, comorbidities, influenza/pneumococcal vaccination history and antibiotics administered using a questionnaire and medical records. Bivariate analyses and multilevel logistic regression were made. In total, 1857 hospitalised patients were included, 82 of whom required intensive care unit (ICU) admission. Treatment was conforming in 51.4% (95% confidence interval (CI) 49.1-53.8%) of patients without ICU admission and was associated with absence of renal failure without haemodialysis (odds ratio (OR) 1.49, 95% CI 1.15-1.95) and no cognitive dysfunction (OR 1.71, 95% CI 1.25-2.35), when the effect of the autonomous community was controlled for. In patients with ICU admission, treatment was conforming in 45.1% (95% CI 34.1-56.1%) of patients and was associated with the hospital visits in the last year (<3 vs. ⩾3, OR 2.70, 95% CI 1.03-7.12) and there was some evidence that this was associated with season. Although the reference guidelines are national, wide variability between autonomous communities was found. In patients hospitalised due to CAP, health services should guarantee the administration of antibiotics in a consensual manner that is conforming according to clinical practice guidelines.

Possible Mechanisms of Hatching from Egg Capsules in the Gastropods Crepipatella dilatata and Crepipatella peruviana, Species with Different Modes of Early Development.

Many invertebrates enclose their embryos within egg capsules, from which the offspring hatch. In marine gastropods that brood their egg capsules, hatching could involve radular activity by the mother or by unhatched stages, increased osmotic concentration of the intracapsular fluid, or production of hatching enzymes. The present research sought to determine whether mechanical action by the brooding female or by the encapsulated embryos was involved in the hatching for two sympatric and closely related species of calyptraeid: Crepipatella dilatata, which exhibits direct development without free-living larvae, and Crepipatella peruviana, which releases free-living veliger larvae. We also considered the role that enzymatic action or osmotic changes in the intracapsular fluid might play in hatching. Using scanning electron micrograph analyses, we found no evidence that the well-developed, pre-hatching juvenile radula of C. dilatata played any role in the hatching process and that the radula of C. peruviana did not even develop until long after hatching; so there was no evidence of radular activity involved in the hatching of either species. For C. peruviana, the intracapsular fluid osmolality was always higher than that of the surrounding seawater, suggesting that there is a strong natural water inflow during development. Moreover, when egg capsules of C. peruviana were exposed to lower ambient salinities, the substantial entry of water correlated well with high percentages of hatching, particularly for egg capsules containing advanced veligers, suggesting that an osmotic mechanism may be involved in the hatching process of this species. In contrast, hatching in C. dilatata appeared to be enzymatically mediated.

Terminal 13p deletion in squirrel monkey (Saimiri sciureus) with differentiated phenotype.

BACKGROUND: The taxonomic classification of squirrel monkeys is often controversial issue offering many different information. The classification of captive animals is difficult due to the phenotypic similarities between the presented species, which is observed mainly in coat coloration. METHODS: The objective of this study was to analyze the chromosome pattern of one squirrel monkey with off standard physical characteristics, which is kept in the Laboratory Animals Breeding Center in Rio de Janeiro State, Brazil, and try to establish some correlations. Chromosomes were obtained using lymphocyte culture technique. RESULTS AND CONCLUSIONS: Evaluation of G bands showed a terminal deletion in one chromosome of pair 13. The association of the results found with the different phenotypic characteristics led us to classify it as a Saimiri sciureus specimen with a structural chromosomal change, possibly allowing the expression of hemizygous alleles.

Manejo de la pancreatitis aguda grave en niños. Serie de 3 casos / Management of severe acute pancreatitis in children. A series of 3 cases

La pancreatitis aguda es una entidad poco frecuente en la población pediátrica, cuya incidencia ha aumentado en las últimas dos décadas. Sin embargo, existen pocos estudios sobre esta afección, por lo que su manejo terapéutico resulta muy variable, especialmente en los casos graves. En este trabajo describimos nuestra experiencia sobre el manejo en una unidad de cuidados intensivos pediátrica de 3 casos clínicos con esta afección en los últimos meses. En ellos se aplicaron las directrices extraídas de las guías clínicas sobre el manejo de la pancreatitis aguda en pacientes adultos basadas en la optimización de la analgesia, la administración de fluidoterapia i.v. agresiva y el reposo pancreático inicial con reintroducción precoz de la nutrición enteral, con lo que mostraron una buena evolución clínica posterior. Nuestro objetivo principal, dado el aumento en la incidencia de esta entidad, es destacar la importancia de un alto nivel de sospecha clínica ante un cuadro de dolor abdominal que permita un diagnóstico precoz y la rápida instauración de un tratamiento adecuado en estos casos, así como incidir en los puntos más importantes de su manejo

Acute pancreatitis is a rare entity among pediatric population, whose incidence has increased in the last two decades. However, there are few studies on this condition, so its therapeutic management is unsteady, especially in severe cases. In this article, we describe our experience in a pediatric intensive care unit in the management of 3 clinical cases with pancreatitis occured in the last months. We applied the guidelines extracted from the clinical guides about management of acute pancreatitis in adult patients, based on improving analgesia, administration of intensive fluid therapy and initial pancreatic rest with early reintroduction of enteral nutrition, which showed a good subsequent clinical evolution. Our main purpose, given the increase in the incidence of this entity, is to emphasize the importance of a high level of clinical suspicion when facing a case of abdominal pain that may allow an early diagnosis and a quick establishment of a proper treatment in these cases, as well as to highlight the most important facts of its management

Suitability of multiple Mediterranean oak species as a food resource for Reticulitermes grassei Clément (Isoptera: Rhinotermitidae).

The subterranean termite Reticulitermes grassei Clément causes lesions in the trunk of Quercus suber L. by constructing feeding galleries, but no information is available regarding other Quercus species from the Mediterranean region. This work aimed to study the suitability of the other main oak species of Mediterranean forests as a food resource for R. grassei. Two experiments, choice and non-choice feeding, were conducted lasting for 15, 30, and 45 days each. In the non-choice experiment, termites were offered one of the following food types: Quercus suber, Quercus ilex L., Quercus faginea Lam, cork or Pinus pinea L., which was considered the control. The choice feeding experiment used all the same food types listed above, supplied simultaneously in the same container. Food selection was examined by analysing the relationships over time between surviving termites and food consumption. The results indicated that R. grassei could be considered a generalist species, as it consumed the cork and wood of all oak species, as well as displaying a clear preference for soft wood (pine). Correlation analysis indicated that consumption was not dependent on wood density. Survival of R. grassei was influenced by the time of exposure to different oak species, but a high survival rate was maintained over time in the pine treatment (upper 70% in the three experiments). Given these results, it can be concluded that all the oak species are a suitable food source for R. grassei.

Effectiveness of acellular pertussis vaccination during childhood (<7 years of age) for preventing pertussis in household contacts 1-9 years old in Catalonia and Navarra (Spain).

Pertussis vaccination with 4-5 doses of acellular vaccines is recommended in Spain to all children at 2 months to 6 years of age. The effectiveness of the acellular pertussis vaccination was assessed in this study by comparing the incidence of secondary pertussis in vaccinated (4-5 doses) and unvaccinated or partially vaccinated (0-3 doses) household contacts 1-9 years old of confirmed cases of pertussis in Spain in 2012-13. Eighty-five percent of contacts had been vaccinated with 4-5 doses of acellular pertussis vaccines. During the 2-year study period, 64 cases of secondary pertussis were detected among 405 household contacts 1-9 years old: 47 among vaccinated and 17 among unvaccinated or partially vaccinated contacts. The effectiveness for preventing secondary pertussis, calculated as 1 minus the relative risk (RR) of secondary pertussis in vaccinated vs. unvaccinated/partially vaccinated contacts, was 50 % [95 % confidence interval (CI): 19-69 %, p < 0.01] when household contacts were vaccinated using DTaP, Tdap, hexavalent or heptavalent vaccines, and it was 51.3 % (95 % CI: 21-70 %, p < 0.01) when they were vaccinated using DTaP or TdaP vaccines. The effectiveness adjusted for age, sex, pertussis chemotherapy and type of household contact was 58.6 % (95 % CI: 17-79 %, p < 0.05) when contacts were vaccinated using available acellular vaccines, and it was 59.6 % (95 % CI: 18-80 %, p < 0.01) when they were vaccinated using DTaP vaccines. Acellular pertussis vaccination during childhood was effective for preventing secondary pertussis in household contacts 1-9 years old of pertussis cases in Catalonia and Navarra, Spain.

La Unidad de Cuidados Intensivos Pediátricos en el Hospital Universitario Ramón y Cajal en el año 2015 / The Pediatric Intensive Care unit in the Hospital Ramón y Cajal in the year 2015

Este documento esquematiza la organización y principales características de la Unidad de Cuidados Intensivos Pediátricos del Hospital Universitario Ramón y Cajal de Madrid, catalogada del máximo nivel asistencial (nivel III) en el último informe técnico de la SECIP. Tras una breve reseña histórica, se señalan sus principales valores describiéndose, a continuación, sus características físicas (su reciente reubicación ha permitido un moderno diseño arquitectónico, con boxes individualizados donde el acompañamiento de los enfermitos por sus padres goza de un importante grado de confortabilidad). También se presentan los principales recursos humanos y materiales con los que ha sido dotada, situados al frente de la mayor vanguardia asistencial y tecnológica. A continuación mostramos su cartera de servicios, una sucinta memoria asistencial, y los objetivos de gestión (basados en una cultura de excelencia, calidad y seguridad del paciente). Finalmente, integrada en un hospital docente de la mayor complejidad asistencial, se resalta la actividad formadora e investigadora de la misma (AU)

This paper summarizes the organization and the main charateristics of the Unidad de Cuidados Intensivos Pediátricos del Hospital Universitario Ramón y Cajal de Madrid, scored as level III (the major level) by the SECÏIP. After a brief historic background, their values as organization are presented. Secondly, we describe their modern archithetonic design which allows an individualized care in medical boxes as a comfortable presence of parents with their children. Human and material resources, having the best technologies currently available, are also shared. Following, portfolio services with a brief attending report, and the managing objectives (based on strategies concerned about the highest quality) are also shown. Finally, due to the PICU is integrated in an University Hospital, where highly complex patients are treated, it must be emphasized the wide PICU teaching and researching activities (AU)

[Attitudes, perceptions and factors associated with influenza vaccination among primary healthcare professionals in Navarre, 2011-2012]. / Actitudes, percepciones y factores asociados a la vacunación antigripal en los profesionales de atención primaria de Navarra, 2011-2012.

BACKGROUND: The influenza vaccine is recommended for all healthcare workers to protect their own health and their patients. We aimed to describe the influenza vaccine coverage in primary healthcare professionals in the 2011-12 season in Navarre and to study the factors associated with this coverage. METHODS: An anonymous web-based survey was sent to primary healthcare professionals in 2012. The survey collected information on the influenza vaccination status for the four previous seasons, the attitudes towards and knowledge of the vaccine, and socio-demographic and professional data. RESULTS: Of 1,083 professionals, 381 (35%) completed the survey: 54.3% nurses, 35.7% general practitioners and 10% paediatricians. In the 2011-12 season, 56.2% had received the influenza vaccine, without significant changes compared to previous seasons. The vaccination in any previous season was the main predictive factor for current vaccination (odds ratio (OR): 20.87; confidence interval (CI) 95%: 8.98-48.48). The vaccine coverage was higher among those living with persons with risk factors for influenza (OR: 1.72; CI 95%: 1.05-2.84), those worried about becoming ill (OR: 4.59; CI 95%: 2.30-9.15), or infecting their patients (OR: 6.29; IC 95%: 3.02-13.13). Participation in training activities on influenza or vaccines was not significantly associated with influenza vaccination. CONCLUSIONS: Influenza vaccination coverage in primary healthcare professionals in Navarre is below desirable levels. A greater involvement of healthcare professionals is necessary in the influenza prevention strategy.

Actitudes, percepciones y factores asociados a la vacunación antigripal en los profesionales de atención primaria de Navarra, 2011-2012 / Attitudes, perceptions and factors associated with influenza vaccination among primary healthcare professionals in Navarre, 2011-2012

Fundamento. La vacuna de la gripe está indicada en los profesionales sanitarios para proteger su salud y la de sus pacientes. El objetivo fue describir la cobertura de vacunación antigripal en los profesionales de atención primaria durante la temporada 2011-12 en Navarra y estudiar los factores asociados a la vacunación. Material y métodos. Se envió una encuesta anónima vía web a los profesionales de atención primaria en 2012. La encuesta recogió información sobre el estado de vacunación antigripal de las últimas temporadas, sobre las actitudes y conocimientos de la vacuna y datos sociodemográficos y profesionales. Resultados. De 1.083 profesionales, 381 (35%) completaron la encuesta: 54,3% profesionales de enfermería, 35,7% médicos de familia y 10% pediatras. En la temporada 2011-12 se habían vacunado el 56,2%, sin cambios significativos con respecto a temporadas previas. El principal predictor de la vacunación fue el haberse vacunado en alguna temporada previa (odds ratio (OR): 20,87; intervalo de confianza (IC) 95%: 8,98-48,48).Se vacunaron más los que tenían personas con factores de riesgo en la familia (OR: 1,72; IC 95%: 1,05-2,84), los que estaban preocupados por enfermar (OR: 4,59; IC 95%: 2,30-9,15) y por contagiar a sus pacientes (OR: 6,29; IC 95%: 3,02-13,13).El haber participado en actividades formativas sobre gripe y vacunas no influyó en la decisión de vacunarse. Conclusiones. La cobertura de vacunación entre los profesionales sanitarios de atención primaria de Navarra está por debajo de los niveles deseables. Se debe mejorar la implicación de los profesionales en la estrategia de prevención de la gripe (AU)

Background. The influenza vaccine is recommended for all healthcare workers to protect their own health and their patients. We aimed to describe the influenza vaccine coverage in primary healthcare professionals in the 2011-12 season in Navarre and to study the factors associated with this coverage. Methods. An anonymous web-based survey was sent to primary healthcare professionals in 2012. The survey collected information on the influenza vaccination status for the four previous seasons, the attitudes towards and knowledge of the vaccine, and socio-demographic and professional data. Results. Of 1,083 professionals, 381 (35%) completed the survey: 54.3% nurses, 35.7% general practitioners and 10%paediatricians. In the 2011-12 season, 56.2% had received the influenza vaccine, without significant changes compared to previous seasons. The vaccination in any previous season was the main predictive factor for current vaccination (odds ratio (OR): 20.87; confidence interval (CI) 95%:8.98-48.48). The vaccine coverage was higher among those living with persons with risk factors for influenza (OR: 1.72; CI 95%: 1.05-2.84), those worried about becoming ill (OR: 4.59; CI 95%: 2.30-9.15), or infecting their patients (OR: 6.29; IC 95%: 3.02-13.13). Participation in training activities on influenza or vaccines was not significantly associated with influenza vaccination. Conclusions. Influenza vaccination coverage in primary healthcare professionals in Navarre is below desirable levels. A greater involvement of healthcare professionals is necessary in the influenza prevention strategy (AU)

Autismo infantil comportamiento en la provincia de Sancti Spíritus

Dentro de los trastornos generalizados del desarrollo encontramos el Autismo Infantil descrito por Leo Kanner en 1943, caracterizado por un comportamiento anormal que afecta la comunicación, socialización e integración, con actividades repetitivas y restrictivas. En nuestra provincia se le ha dado prioridad al programa de atención al niño autista, por lo que decidimos hacer un estudio descriptivo retrospectivo de los 6 casos de autismo infantil diagnosticados que residen en nuestra provincia. Predominan los varones con edades entre 5 y 7 años, se realizó el diagnóstico en un 50 por ciento a los 3 años de edad. En la mayoría el síntoma que motivo la consulta fue el trastorno del lenguaje seguido de inquietud y dificultades en la comunicación afectiva. Un 33 por ciento tienen la epilepsia como patología asociada y antecedentes familiares de patologías psiquiátricas.[AU]