Temporary hospitals in times of the COVID pandemic. An example and a practical view.

We describe the most widely used temporary hospital in Europe during the first pandemic wave, its structure, function, and achievements. Other models of care developed during the pandemic around the world were reviewed including their capacity, total bed/ICU bed ratio and time of use. We particularly analyzed the common and differential characteristics of this type of facilities. IFEMA Exhibition Center was transformed into a temporary 1,300-bed hospital, which was in continuous operation for 42 days. A total of 3,817 people were treated, generally patients with mild to moderate COVID-19, 91% of whom had pneumonia. The average length of stay was 5 to 36 days. The most frequent comorbidities were hypertension (16.5%), diabetes mellitus (9.1%), COPD (6%), asthma (4.6%), obesity (2.9%) and dementia (1.6%). A total of 113 patients (3%) were transferred to another centers for aggravation, 19 (0.5%) were admitted to ICU and 16 patients (0.4%) died. An element of great help to reducing the overload of care in large hospitals during peaks of health emergencies could be these flexible structures capable of absorbing the excess of patients. These must be safe, breaking domestic transmission and guarantee social and emotional needs of patients. The success of these structures depends on delimitation in admission criteria taking into account the proportion of patients who may require, during admission, assistance in the critical care area.

Analysis of the implementation of a personalized care model in diabetes mellitus as an example of chronic disease with information and communication technology support.

INTRODUCTION: Diabetes mellitus affects 13.8% of the adult population in Spain, representing some 8.2% of total Spanish health spending, which may be reduced by optimizing treatment and disease monitoring. Areas covered: This perspective article aims to evaluate the possible clinical and economic outcomes of implementing a theoretical personalized care model in diabetes supported by information and communications technology in Spain vs. conventional care. Moreover, we assessed the value of emminens® eConecta, a solution designed to support the operational implementation of this model, which enables the connection and participation of patients and health professionals, facilitates patient education, decision-making, access to information, and data analysis. We carried out a review of the available evidence, consultations with experts and a clinical and cost estimation. Expert commentary: The experts consulted considered that the proposed model is consistent with Spanish strategies on chronicity, supports the management of chronicity/diabetes, and may improve the most important aspects of disease management. In the literature, this type of care models improved or provided equal disease control compared with conventional care, potentiated self-management strategies and reduced the high use of resources. Cost estimation showed a reduction of -12% in total direct costs and around -34% in the costs of outpatient visits.

Parálisis bilateral transitoria del abducens en el recién nacido. A propósito de un caso / Bilateral transient abducens palsy in the newborn. Case report and update

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[The epidemiology of tuberculosis in El Ferrol]. / Epidemiología de la tuberculosis en El Ferrol.

BACKGROUND: This study was undertaken to know the frequency of tuberculosis in El Ferrol and to contribute to the knowledge of the situation in Spain. METHODS: A retrospective study of all the cases of tuberculosis diagnosed in the Hospital A. Marcide-Novoa Santos (El Ferrol, Spain) from 1990 to 1993 was performed. RESULTS: Seven hundred twenty-four patients were diagnosed, with a mean annual prevalence of 83.3/100,000 inhabitants. Six hundred sixty-four cases (430 males [64.8%]) were evaluated. The mean age was 35.5 +/- 19 years with 58.9% under the age of 35. 98.7% of the patients lived in the health care area and 73.2% were admitted, with 13.7% having previous history of tuberculosis. Sixty-one cases (11.1%; Cl: 8.25-13.7) had HIV infection. Diagnosis was microbiological in 505 cases (76%), anatomopathological in 60 (9%) and in 99 (14.9%) diagnosis was achieved by clinical and radiological criteria. Pulmonary localization (67.2%) was the most frequent form and was predominant in males, while lymph node and osteoarticular localizations were more frequent in women. The incidence of bacilliferous patients was 30.7/100,000 inhabitants. A delay of more than one month took place in the diagnosis of 66.4% of the bacilliferous patients. CONCLUSIONS: The incidence of tuberculosis in El Ferrol is very high with an important delay in the diagnosis of bacilliferous patients. The high percentage of patients admitted to hospital carries considerable costs in the treatment of the disease.

[How many cases of tuberculosis are not reported?]. / Cuántos casos de tuberculosis no son declarados?

BACKGROUND: The aim of this study was to evaluate the degree of registry of tuberculosis and the factors associated to the same. METHODS: A retrospective study of the cases of respiratory tuberculosis diagnosed in the hospital A. Marcide-Novoa Santos (El Ferrol. La Coruña. Spain) from 1990 to 1992 was carried out. Identification was obtained from the registries of microbiology and pathology and the clinical history files. Registered cases were obtained from the nominal notifications to the Epidemiology Department of the local health service department. Sex, age, place of residence, previous history of tuberculosis, HIV, diagnostic method, localization of the tuberculosis, registration and reporting physician were evaluated for each patient. RESULTS: Three hundred ninety-three cases were identified of which 78 (19.8%) had been registered. Age and pulmonary localization were the variable influencing the degree of registration. Reporting was greater in the age group from 0 to 10 years (p < 0.05). Pulmonary tuberculosis was the most reported type although only 22.4% of the cases were declared. Bacilloscopy was positive in sputum in 190 patients and declared in 46 (24.2%). The degree of registration increased significantly over three years (p < 0.000001). Sex, previous history of tuberculosis, infection by the HIV and diagnostic method did not influence the degree of registration. CONCLUSIONS: Seventy-five percent of the cases with positive bacilloscopy in sputum were not declared. The degree of declaration has improved over time, however, remains deficient being 2.7 fold lower than the total number of cases diagnosed in 1992.