A systematic review of the concept of self-regulation in infants between 0 and 36 months in Latin America.

This paper aims to identify how cognitive and emotional self-regulation (SR) processes in infants from 0 to 36 months are defined within the Latin American academic context. A systematic review based on the PRISMA methodology was implemented to review the conceptual and operational definition of SR, the type of study, the country of origin of the authors, and the reference to the adequacy of the research to the specific cultural context of Latin America. Twenty-two papers that met the selection criteria were selected. The study identified four types of conceptual definitions for SR, each associated with different constructs or sets of constructs: executive functions, temperament, the integration of executive functions and temperament, and physiological homeostasis. These definitions were based on mainstream approaches to SR rather than being specific to the Latin American region. The study also found compatibility between the sample and some observed trends. On one hand, there was an underrepresentation of the Latin American population in high-impact publications on the subject. However, from 2010 to the present, there is evidence of growth in publications on SR in the analyzed sample. On the other hand, the sample also indicates a disparate representation of the countries of Latin America and the Caribbean in existing publications. Finally, concerning the adaptation to the cultural context of the research, a small number of studies addressed this variable in a specific and significant way. However, even in these cases, the approach is based on models and hypotheses that are limited to understanding the Latin American region's cultural, socioeconomic, and demographic diversity.

Progresión temporal de la distribución de los serotipos de Streptococcus pneumoniae productores de enfermedad neumocócica invasiva en Galicia (España) y su relación con la resistencia a antibióticos (periodo 2011-2021) / Temporal progression of the distribution of Streptococcus pneumoniae serotypes causing invasive pneumococcal disease in Galicia (Spain) and its relationship with resistance to antibiotics (period 2011-2021)

Introducción: Streptococcus pneumoniae causa enfermedades graves en la población susceptible. La vacuna neumocócica conjugada (PCV) 13-valente (PCV13) se incluyó en el calendario infantil en 2011. Este estudio analiza la evolución de los serotipos de neumococo y de sus resistencias tras la PCV13. Métodos: Se incluyeron los neumococos serotipados en Galicia en 2011-2021. Se estudió la sensibilidad antibiótica siguiendo criterios EUCAST. Se analizaron los datos en 3 subperíodos: inicial (2011-2013), medio (2014-2017) y final (2018-2021). Se calcularon las prevalencias de los serotipos y el porcentaje de resistencia a los antibióticos más representativos. Resultados: Se incluyeron 2.869 aislados. Inicialmente el 42,7% presentaba tipos capsulares incluidos en la PCV13, frente al 15,4% al final. Los incluidos en la PCV20 y no en la PCV13 y PCV15 fueron el 12,5% inicialmente y el 41,3% al final. El 26,4% de los serotipos a lo largo del estudio no estaban incluidos en ninguna vacuna. La prevalencia del serotipo 8 se multiplicó casi por 8 y la del 12F se triplicó. El serotipo 19A fue el más resistente inicialmente. La resistencia de los serotipos 11A y 15A aumentó a lo largo del estudio. Conclusiones: La introducción de la PCV13 en la población infantil determinó un cambio en los serotipos de neumococo hacia los incluidos en la PCV20 y los no incluidos en ninguna vacuna. El serotipo 19A inicialmente fue el más resistente, y el 15A, no incluido en ninguna vacuna, merece un especial seguimiento. El serotipo 8, que fue el que más se incrementó, no mostró resistencia destacable.(AU)

Introduction: Streptococcus pneumoniae causes serious diseases in the susceptible population. The 13-valent pneumococci conjugate vaccine (PCV13) was included in the children's calendar in 2011. The objective of the study was to analyze the evolution of pneumococcal serotypes and their resistance after PCV13. Methods: This study included the pneumococci serotyped in Galicia in 2011-2021. Antibiotic susceptibility was analyzed following EUCAST criteria. The data was analyzed in 3 sub-periods: initial (2011-2013), middle (2014-2017) and final (2018-2021). The prevalence of serotypes and their percentage of resistance to the most representative antibiotics were calculated. Results: A total of 2.869 isolates were included. Initially, 42.7% isolates presented capsular types included in PCV13, compared to 15.4% at the end. Those included in PCV20 and not in PCV13 and PCV15 were 12.5% at baseline and 41.3% at the end; 26.4% of the isolates throughout the study had serotypes not included in any vaccine. The prevalence of serotype 8 multiplied almost by 8 and that of 12F tripled. The 19A serotype was initially the most resistant, while the resistance of serotypes 11A and 15A increased throughout the study. Conclusions: The introduction of PCV13 in the pediatric population determined a change in pneumococcal serotypes towards those included in PCV20 and those not included in any vaccine. Serotype 19A was initially the most resistant and the 15A, not included in any vaccine, deserves special follow-up. Serotype 8, which increased the most, did not show remarkable resistance.(AU)

Temporal progression of the distribution of Streptococcus pneumoniae serotypes causing invasive pneumococcal disease in Galicia (Spain) and its relationship with resistance to antibiotics (period 2011-2021).

INTRODUCTION: Streptococcus pneumoniae causes serious diseases in the susceptible population. The 13-valent pneumococci conjugate vaccine (PCV13) was included in the children's calendar in 2011. The objective of the study was to analyze the evolution of pneumococcal serotypes and their resistance after PCV13. METHODS: This study included the pneumococci serotyped in Galicia in 2011-2021. Antibiotic susceptibility was analyzed following EUCAST criteria. The data was analyzed in 3 sub-periods: initial (2011-2013), middle (2014-2017) and final (2018-2021). The prevalence of serotypes and their percentage of resistance to the most representative antibiotics were calculated. RESULTS: A total of 2.869 isolates were included. Initially, 42.7% isolates presented capsular types included in PCV13, compared to 15.4% at the end. Those included in PCV20 and not in PCV13 and PCV15 were 12.5% at baseline and 41.3% at the end; 26.4% of the isolates throughout the study had serotypes not included in any vaccine. The prevalence of serotype 8 multiplied almost by 8 and that of 12F tripled. The 19A serotype was initially the most resistant, while the resistance of serotypes 11A and 15A increased throughout the study. CONCLUSIONS: The introduction of PCV13 in the pediatric population determined a change in pneumococcal serotypes towards those included in PCV20 and those not included in any vaccine. Serotype 19A was initially the most resistant and the 15A, not included in any vaccine, deserves special follow-up. Serotype 8, which increased the most, did not show remarkable resistance.

Lifting COVID-19 mitigation measures in Spain (May-June 2020).

Introduction: The state of alarm was declared in Spain due to the COVID-19 epidemic on March 14, 2020, and established population confinement measures. The objective is to describe the process of lifting these mitigation measures. Methods: The Plan for the Transition to a New Normality, approved on April 28, contained four sequential phases with progressive increase in socio-economic activities and population mobility. In parallel, a new strategy for early diagnosis, surveillance and control was implemented. A bilateral decision mechanism was established between the Spanish Government and the autonomous communities (AC), guided by a set of qualitative and quantitative indicators capturing the epidemiological situation and core capacities. The territorial units were established ad-hoc and could be from Basic Health Zones to entire AC. Results: The process run from May 4 to June 21, 2020. AC implemented plans for reinforcement of core capacities. Incidence decreased from a median (50% of territories) of 7.4 per 100,000 in 7 days at the beginning to 2.5 at the end. Median PCR testing increased from 53% to 89% of suspected cases and PCR total capacity from 4.5 to 9.8 per 1000 inhabitants weekly; positivity rate decreased from 3.5% to 1.8%. Median proportion of cases with traced contacts increased from 82% to 100%. Conclusion: Systematic data collection, analysis, and interterritorial dialogue allowed adequate process control. The epidemiological situation improved but, mostly, the process entailed a great reinforcement of core response capacities nation-wide, under common criteria. Maintaining and further reinforcing capacities remained crucial for responding to future waves.

Introducción: El 14 de marzo de 2020 España declaró el estado de alarma por la pandemia por COVID-19 incluyendo medidas de confinamiento. El objetivo es describir el proceso de desescalada de estas medidas. Métodos: Un plan de transición hacia una nueva normalidad, del 28 de abril, incluía 4 fases secuenciales incrementando progresivamente las actividades socioeconómicas y la movilidad. Concomitantemente, se implementó una nueva estrategia de diagnóstico precoz, vigilancia y control. Se estableció un mecanismo de decisión bilateral entre Gobierno central y comunidades autónomas (CCAA), guiado por un panel de indicadores cualitativos y cuantitativos de la situación epidemiológica y las capacidades básicas. Las unidades territoriales evaluadas comprendían desde zonas básicas de salud hasta CCAA. Resultados: El proceso se extendió del 4 de mayo al 21 de junio y se asoció a planes de refuerzo de las capacidades en las CCAA. La incidencia disminuyó de una mediana inicial de 7,4 por 100.000 en 7 días a 2,5 al final del proceso. La mediana de pruebas PCR aumentó del 53% al 89% de los casos sospechosos, y la capacidad total de 4,5 a 9,8 pruebas semanales por 1.000 habitantes; la positividad disminuyó del 3,5% al 1,8%. La mediana de casos con contactos trazados aumentó del 82% al 100%. Conclusión: La recogida y análisis sistemático de información y el diálogo interterritorial logaron un adecuado control del proceso. La situación epidemiológica mejoró, pero sobre todo, se aumentaron las capacidades, en todo el país y con criterios comunes, cuyo mantenimiento y refuerzo fue clave en olas sucesivas.

Lifting COVID-19 mitigation measures in Spain (May-June 2020).

INTRODUCTION: The state of alarm was declared in Spain due to the COVID-19 epidemic on March 14, 2020, and established population confinement measures. The objective is to describe the process of lifting these mitigation measures. METHODS: The Plan for the Transition to a New Normality, approved on April 28, contained four sequential phases with progressive increase in socio-economic activities and population mobility. In parallel, a new strategy for early diagnosis, surveillance and control was implemented. A bilateral decision mechanism was established between the Spanish Government and the autonomous communities (AC), guided by a set of qualitative and quantitative indicators capturing the epidemiological situation and core capacities. The territorial units were established ad-hoc and could be from Basic Health Zones to entire AC. RESULTS: The process run from May 4 to June 21, 2020. AC implemented plans for reinforcement of core capacities. Incidence decreased from a median (50% of territories) of 7.4 per 100,000 in 7 days at the beginning to 2.5 at the end. Median PCR testing increased from 53% to 89% of suspected cases and PCR total capacity from 4.5 to 9.8 per 1000 inhabitants weekly; positivity rate decreased from 3.5% to 1.8%. Median proportion of cases with traced contacts increased from 82% to 100%. CONCLUSION: Systematic data collection, analysis, and interterritorial dialogue allowed adequate process control. The epidemiological situation improved but, mostly, the process entailed a great reinforcement of core response capacities nation-wide, under common criteria. Maintaining and further reinforcing capacities remained crucial for responding to future waves.

[Description of the first case of SARS-CoV-2 reinfection in Galicia (Spain).] / Descripción del primer caso de reinfección por SARS-CoV-2 en Galicia (España).

Since the first reinfection by SARS-CoV-2 was known in August 2020, several cases have been described around the world. We present the first reinfection of an immunocompetent patient confirmed in Galicia (Spain). The clinical-epidemiological information was obtained through an interview with the patient. The microbiological diagnosis was made by PCR of the nasopharyngeal exudate samples, and a serological study was carried out. In addition, a summary of the characteristics of all reinfections identified between 04-01-2021 and 03-10-2021 is presented.

Desde que en Agosto de 2020 se conociese la primera reinfección por SARS-CoV-2, se han descrito varios casos en todo el Mundo. Presentamos el primer caso confirmado en Galicia (España) de reinfección, en una paciente inmunocompetente. La información clínico-epidemiológica se obtuvo mediante entrevista con la paciente. El diagnóstico microbiológico se realizó mediante PCR de las muestras de exudado nasofaríngeo y se realizó estudio serológico. Además, se presenta un resumen de las características de todas las reinfecciones identificadas entre el 04-01-2021 y el 03-10-2021.

Learning-by-Teaching Approach Improves Dengue Knowledge in Children and Parents.

There is narrow evidence on which strategies are most effective for disseminating information on dengue prevention. This is particularly relevant because social habits have a great prevention capacity for dengue. We investigated how effective are children as health educators, and how much they learn as they teach. We recruited 142 children and 97 parents in Argentina's tropical area for two cluster randomized parallel trials. In Study 1, we compared the dynamics of dengue knowledge of 10-year-old children who-after receiving a dengue talk-1) listened to an unrelated topic; 2) read a booklet with information about dengue, 3) taught their parents about dengue, or 4) taught their parents about dengue, using the booklet. In Study 2, we assessed whether the parents' dengue knowledge changed after interacting with their children, in comparison with parents learning about dengue from an expert or about an unrelated topic. Children that taught their parents what they learned, using a booklet, showed 2.53 more correct responses (95% CI [0.20, 4.85]; P = 0.027) than children who listened to an unrelated topic. This style of teaching also serves to effectively propagate knowledge: parents learned from their children the same as from an expert; and significantly more than parents who learned about an unrelated topic. Parents learned from their children even if they were taught with booklets (1.49, 95% CI [0.01, 2.96]; P = 0.048) or without (1.94, 95% CI [0.44, 3.44]; P = 0.006). Specifically, after being taught by their children, parents showed on average 1.49 (if they were taught with a booklet) and 1.94 (without booklet) more correct responses than parents that learned about an unrelated topic. The simple action of prompting children to teach consolidated their own knowledge and broadcasted it effectively to their parents. This strategy is a potential low to no-cost method for sharing information about dengue prevention.

Lifting COVID-19 mitigation measures in Spain (May-June 2020).

INTRODUCTION: The state of alarm was declared in Spain due to the COVID-19 epidemic on March 14, 2020, and established population confinement measures. The objective is to describe the process of lifting these mitigation measures. METHODS: The Plan for the Transition to a New Normality, approved on April 28, contained four sequential phases with progressive increase in socio-economic activities and population mobility. In parallel, a new strategy for early diagnosis, surveillance and control was implemented. A bilateral decision mechanism was established between the Spanish Government and the autonomous communities (AC), guided by a set of qualitative and quantitative indicators capturing the epidemiological situation and core capacities. The territorial units were established ad-hoc and could be from Basic Health Zones to entire AC. RESULTS: The process run from May 4 to June 21, 2020. AC implemented plans for reinforcement of core capacities. Incidence decreased from a median (50% of territories) of 7.4 per 100,000 in 7 days at the beginning to 2.5 at the end. Median PCR testing increased from 53% to 89% of suspected cases and PCR total capacity from 4.5 to 9.8 per 1000 inhabitants weekly; positivity rate decreased from 3.5% to 1.8%. Median proportion of cases with traced contacts increased from 82% to 100%. CONCLUSION: Systematic data collection, analysis, and interterritorial dialogue allowed adequate process control. The epidemiological situation improved but, mostly, the process entailed a great reinforcement of core response capacities nation-wide, under common criteria. Maintaining and further reinforcing capacities remained crucial for responding to future waves.

Characterization and Analysis of the Carbonation Process of a Lime Mortar Obtained from Phosphogypsum Waste.

This work addresses the reuse of waste products as a raw material for lime putties, which are one of the components of mortar. 1:3 Lime/sand mortars very similar to conventional construction mortars were prepared using a lime putty obtained from the treatment of phosphogypsum with sodium hydroxide. The physical, rheological and mechanical properties of this phosphogypsum-derived mortar have been studied, as well as the mineralogical composition, microstructure by scanning electron microscope (SEM) and curing process by monitoring carbonation and ultrasonic propagation velocity. Considering the negative influence of sulphates on the hardened material, the behaviour of the material after sulphates precipitation by adding barium sulphate was additionally tested. Carbonation progressed from the outside to the inside of the specimen through the porous system by Liesegang rings patterns for mortars with soluble sulphates, while the carbonation with precipitated sulphates was controlled by diffusion-precipitation. Overall, the negative influence of low-sulphate contents on the mechanical properties of mortars was verified. It must be highlighted the importance of their precipitation to obtain adequate performance.

Bioinstructive Layer-by-Layer-Coated Customizable 3D Printed Perfusable Microchannels Embedded in Photocrosslinkable Hydrogels for Vascular Tissue Engineering.

The development of complex and large 3D vascularized tissue constructs remains the major goal of tissue engineering and regenerative medicine (TERM). To date, several strategies have been proposed to build functional and perfusable vascular networks in 3D tissue-engineered constructs to ensure the long-term cell survival and the functionality of the assembled tissues after implantation. However, none of them have been entirely successful in attaining a fully functional vascular network. Herein, we report an alternative approach to bioengineer 3D vascularized constructs by embedding bioinstructive 3D multilayered microchannels, developed by combining 3D printing with the layer-by-layer (LbL) assembly technology, in photopolymerizable hydrogels. Alginate (ALG) was chosen as the ink to produce customizable 3D sacrificial microstructures owing to its biocompatibility and structural similarity to the extracellular matrices of native tissues. ALG structures were further LbL coated with bioinstructive chitosan and arginine-glycine-aspartic acid-coupled ALG multilayers, embedded in shear-thinning photocrosslinkable xanthan gum hydrogels and exposed to a calcium-chelating solution to form perfusable multilayered microchannels, mimicking the biological barriers, such as the basement membrane, in which the endothelial cells were seeded, denoting an enhanced cell adhesion. The 3D constructs hold great promise for engineering a wide array of large-scale 3D vascularized tissue constructs for modular TERM strategies.

Corrigendum: Risks for Child Cognitive Development in Rural Contexts.

[This corrects the article DOI: 10.3389/fpsyg.2018.02735.].

¿Necesidad de cambio en la definición de caso del sarampión? / Is it necessary to change the measles case definition?

No disponible

Utilidad de la vigilancia microbiológica del virus respiratorio sincitial en Galicia (España): 2008-2017 / Usefulness of the microbiological surveillance of respiratory syncytial virus in Galicia (Spain): 2008-2017

OBJETIVO: Describir si la información microbiológica del virus respiratorio sincitial (VRS) facilitada semanalmente por cuatro hospitales captura adecuadamente la estacionalidad del VRS en toda la comunidad. MÉTODO: Estudio descriptivo retrospectivo. Se compararon las detecciones de VRS en muestras respiratorias de pacientes (ingresados y no), de todos los grupos de edad, de los cuatro hospitales que forman parte del sistema de vigilancia microbiológica (SVM), con datos del Conjunto Mínimo Básico de Datos de hospitalización por bronquiolitis causada por VRS u otro microorganismo infeccioso, en pacientes menores de 5 años ingresados en cualquier hospital público de Galicia (temporadas 2008/2009 a 2016/2017). Se consideró como periodo de onda epidémica cuando la positividad de detecciones de VRS en el total de muestras respiratorias del SVM superó el 10%. Se calculó la sensibilidad del SVM como el porcentaje de ingresos ocurridos en la onda epidémica. RESULTADOS: La sensibilidad del SVM fue del 92% (86-96%) para los ingresos por bronquiolitis por VRS en cada temporada y del 79% (75-84%) para los ingresos por bronquiolitis totales. CONCLUSIONES: El SVM del VRS, basado en información de solo cuatro hospitales, mostró muy buena sensibilidad para predecir el inicio y el final de la onda anual de VRS en toda la comunidad autónoma. Estos resultados respaldan la utilización de esta información para alertar a todo el sistema sanitario del inicio de la onda

OBJECTIVE: To describe whether the microbiological information of the respiratory syncytial virus (RSV), provided by four hospitals on a weekly basis, adequately captures the seasonality of the RSV in the entire community. METHOD: Retrospective descriptive study. We compared the detection of RSV in respiratory samples of patients (hospitalized and not) from all age groups, from the 4 hospitals that are part of the microbiological surveillance system (MSS), with data from the Minimum Basic Data Set of hospitalization for bronchiolitis by RSV or another infectious organism, in patients under 5 years of age, admitted to any public hospital in Galicia (seasons 2008/2009 to 2016/2017). An epidemic wave period was considered when the positivity of RSV detections in the total respiratory samples of the SVM exceeded 10%. The sensitivity of the MSS was calculated as a percentage of admissions occurring in the epidemic wave. RESULTS: MSS sensitivity was 92% (86%-96%) for RSV bronchiolitis admissions in each season and 79% (75%-84%) for total bronchiolitis admissions. CONCLUSIONS: The RSV microbiological surveillance system, based on data from only 4 hospitals, showed very good sensitivity to predict the start and end of the annual RSV wave throughout the Galician region. These results support the use of this information to alert the entire health system of the onset of the wave

Comportamiento clínico epidemiológico de gestantes adolescentes con hipertensión arterial / Clinical epidemiological behavior of adolescent pregnant women with arterial hypertension

RESUMEN Fundamento: los trastornos hipertensivos son considerados como la principal causa de morbimortalidad materna y fetal a nivel mundial y en Ecuador. Objetivo: describir el comportamiento clínico epidemiológico de los trastornos hipertensivos de la gestación en adolescentes. Métodos: se realizó un estudio descriptivo que incluyó las 59 de gestantes adolescentes que presentaron preeclampsia o eclampsias atendidas en el contexto de la investigación durante el periodo comprendido entre mayo y diciembre de 2017. Se aplicó un cuestionario de investigación para obtener la información relacionada con las variables de investigación definidas. Resultados: promedio de edad de 16,32 años, predominio de gestantes con color de la piel no blanco y nulíparas. Elevado número de comorbilidades asociadas con predominio del sobrepeso e hipertensión arterial; predominio de pacientes que no habían recibido tratamiento preventivo con calcio y aspirina. La cefalea y el edema en miembros inferiores fueron las complicaciones maternas más frecuentes. El sufrimiento fetal, el crecimiento intrauterino retardado y la prematuridad fueron las complicaciones fetales con mayor frecuencia de presentación. Conclusiones: el patrón clínico y epidemiológico de las adolescentes con preeclampsia y eclampsia coincide con lo reportado en la literatura universal. Se evidencian falencias en el programa de control de riesgo preconcepcional y en la calidad del seguimiento de las gestantes que motiva un aumento de la incidencia de eclampsia y preeclampsia.

ABSTRACT Background: hypertensive disorders are considered as the main cause of maternal and fetal morbidity and mortality worldwide and in Ecuador. Objective: to describe the epidemiological clinical behavior of hypertensive disorders of pregnancy in adolescents. Methods: a descriptive study was carried out which included the 59 of pregnant teenagers who presented preeclampsia and/or eclampsia attended in the context of the research during the period from May to December 2017. A research questionnaire was applied to obtain information related to the variables of defined research. Results: average age of 16.32 years, predominance of pregnant women with non-white skin color and nulliparous. High number of comorbidities associated with a predominance of overweight and arterial hypertension; predominance of patients who had not received preventive treatment with calcium and aspirin. Headache and edema in the lower limbs were the most frequent maternal complications. Fetal distress, delayed intrauterine growth and prematurity were the fetal complications with the highest frequency of presentation. Conclusions: the clinical and epidemiological pattern of adolescents with preeclampsia and eclampsia coincides with that reported in the universal literature. Failures are evident in the preconception risk control program and in the quality of the follow-up of pregnant women that motivates an increase in the incidence of eclampsia and preeclampsia.

De la vigilancia a la acción: modificando conductas terapéuticas en la infección gonocócica / From surveillance to action: Modifying therapeutic behaviours in gonococcal infections

OBJETIVOS: Evaluar la mejora en la prescripción del tratamiento ante una sospecha de infección gonocócica tras desarrollarse una intervención sanitaria específica; además, conocer la fracción de casos diagnosticados por cultivo y las resistencias antimicrobianas de las cepas de Neisseria gonorrhoeae que circulan en nuestra comunidad. Emplazamiento: Galicia, España. DISEÑO: Estudio antes-después de la adherencia al tratamiento recomendado para la infección gonocócica (ceftriaxona más azitromicina), tras una intervención de Salud Pública. PARTICIPANTES: Todos los médicos de atención primaria que identifican y tratan un caso de infección gonocócica. PERIODO DE ESTUDIO: Preintervención (2012-13) y postintervención (2014-17). INTERVENCIONES: Se facilitó el acceso en atención primaria al tratamiento recomendado (ceftriaxona y azitromicina) y se difundió toda la información a los médicos de atención primaria y microbiólogos a través de la publicación Venres Epidemiolóxico. Mediciones principales: Las variables a estudio fueron: año, tratamiento prescrito, realización de cultivo, sensibilidad a antibióticos. Se calcularon los porcentajes para cada una de ellas. RESULTADOS: El tratamiento recomendado se empleó en un 3% en 2012-2013, aumentando, después de las intervenciones, a un 58% de media. La frecuencia de cultivo se mantuvo relativamente constante después de las intervenciones. La sensibilidad a otros antibióticos mejoró al disminuir su uso. CONCLUSIONES: Las intervenciones realizadas supusieron una mejora en la adherencia al tratamiento recomendado para la infección gonocócica en Galicia

OBJECTIVES: To evaluate improvements in the prescriptions for gonococcal infection after developing a specific public health intervention. Furthermore, to ascertain the proportion of cases diagnosed by culture and current antimicrobial resistance. LOCATION: Galicia, Spain. DESIGN: Before-after study of adherence to the recommended treatment for gonococcal infection (ceftriaxone + azithromycin) after a Public Health intervention. PARTICIPANTS: All Primary Care physicians who had identified and treated a case of gonococcal infection. Study period: Preintervention (2012-13) and postintervention (2014-17). INTERVENTIONS: Access to the recommended treatment (ceftriaxone and azithromycin) was provided in Primary Care and all the information was disseminated to Primary Care physicians and microbiologists through the publication Venres Epidemiolóxico. MAIN MEASUREMENTS: The study variables were year, prescribed treatment, performing of culture, antibiotic susceptibility testing. The percentages for each of them were calculated. RESULTS: The recommended treatment was used in 3% in 2012-2013, and after the interventions it increased to a mean of 58%. The frequency of culture remained relatively constant after the interventions. Sensitivity to other antibiotics improved as their use decreased. CONCLUSIONS: The interventions carried out implied an improvement in the adherence to the recommended treatment for gonococcal infection in Galicia

[Hepatitis A outbreak in Galicia during 2016-2018]. / Brote de hepatitis A en Galicia durante 2016-2018.

OBJECTIVE: In Galicia, the incidence (I) of hepatitis A (HA) is low and the susceptibility is 51% in adults (18-64 years). Between 2016 and 2018 the cases increased, mainly in men. We intend to describe the cases of HA in Galicia during this outbreak period (PB), compare them with the pre-outbreak period (PPB), and the interventions performed. METHODS: Descriptive study of the cases of HA declared between 2016-18 (PB), compared to those from the previous period (2010-2015, PPB). Cases recorded in the mandatory notification system (general practice, hospitalization and microbiology) from 2010 to 2018 were included. For the pre-outbreak period 2010-2015 (PPB) it was calculated the average of cases/four-week period to compare observed/expected cases; the incidence (I) [cases/100,000 inhabitants (c/105h)] by sex and age was compared with the PPB through the Relative Risk (RR). It were sent messages with recommendations through men who have sex with men (MSM) reference websites. RESULTS: The outbreak lasted 80 weeks (september of 2016 to march of 2018). The incidence was 3 cases/105h in men and 0.5 cases/105h in women. Compared to the PPB, the RR-PB in men was 4.8 (95%CI=4-7) and 20.4 (95%CI=5-87) in 40-44 years. 42% of men declared to have relationships with other men (57% in 20-30 years). At the end of 2016, a message with recommendations (specially vaccination) was sent via Wapo (promoted to MSM through one of its reference websites), where 331 entries were registered. CONCLUSIONS: HA's incidence, in Galicia, increased in 2016-2018 by an outbreak in MSM. We found an increased susceptibility among young people which makes necessary to insist on the vaccination of groups at risk.

OBJETIVO: En Galicia, la incidencia (I) de hepatitis A (HA) es baja y la susceptibilidad es del 51% en adultos (18-64 años). Entre 2016 y 2018 se incrementaron los casos, fundamentalmente en hombres. El objetivo de este estudio fue describir los casos de HA en Galicia en este periodo de brote (PB), compararlos con el periodo pre-brote (PPB), y describir las intervenciones realizadas. METODOS: Se realizó un estudio descriptivo de los casos de HA declarados entre 2016-2018 (PB), comparados con los del periodo previo (2010-2015, PPB). Se incluyeron los casos del Sistema de Notificación Obligatoria (por atención primaria, hospitalaria y microbiología) de 2010 a 2018. Se calculó el canal epidémico para el PPB, como media de casos/cuatrisemana para comparar casos observados/esperados. La incidencia (I) [casos por cada 100.000 habitantes (c/105h)] por sexo y edad se comparó con el PPB mediante el Riesgo Relativo (RR). Se enviaron mensajes con recomendaciones específicas a través de webs de referencia para hombres que tenían sexo con hombres (HSH). RESULTADOS: El brote duró 20 cuatrisemanas (septiembre de 2016 a marzo de 2018). La incidencia fue de 3 casos por cada 100.000 habitantes en hombres y 0,5 casos por cada 100.000 habitantes en mujeres. Frente al PPB, el RR-PB en hombres fue 4,8 (IC95%=4-7) y 20,4 (IC95%=5-87) entre 40 y 44 años. El 42% de los hombres respondieron tener relaciones con otros hombres (el 57% entre 20 y 30 años). A finales de 2016 se envió a través de Wapo (una de las webs de referencia de HSH) un mensaje con recomendaciones (fundamentalmente sobre vacunación), registrándose 331 entradas. CONCLUSIONES: La incidencia de HA aumenta en Galicia en el período 2016-2018 por un brote en HSH. La susceptibilidad se incrementa entre jóvenes, lo que hace necesario insistir en la vacunación de los grupos de riesgo.

[Usefulness of the microbiological surveillance of respiratory syncytial virus in Galicia (Spain): 2008-2017]. / Utilidad de la vigilancia microbiológica del virus respiratorio sincitial en Galicia (España): 2008-2017.

OBJECTIVE: To describe whether the microbiological information of the respiratory syncytial virus (RSV), provided by four hospitals on a weekly basis, adequately captures the seasonality of the RSV in the entire community. METHOD: Retrospective descriptive study. We compared the detection of RSV in respiratory samples of patients (hospitalized and not) from all age groups, from the 4 hospitals that are part of the microbiological surveillance system (MSS), with data from the Minimum Basic Data Set of hospitalization for bronchiolitis by RSV or another infectious organism, in patients under 5 years of age, admitted to any public hospital in Galicia (seasons 2008/2009 to 2016/2017). An epidemic wave period was considered when the positivity of RSV detections in the total respiratory samples of the SVM exceeded 10%. The sensitivity of the MSS was calculated as a percentage of admissions occurring in the epidemic wave. RESULTS: MSS sensitivity was 92% (86%-96%) for RSV bronchiolitis admissions in each season and 79% (75%-84%) for total bronchiolitis admissions. CONCLUSIONS: The RSV microbiological surveillance system, based on data from only 4 hospitals, showed very good sensitivity to predict the start and end of the annual RSV wave throughout the Galician region. These results support the use of this information to alert the entire health system of the onset of the wave.

[From surveillance to action: Modifying therapeutic behaviours in gonococcal infections]. / De la vigilancia a la acción: modificando conductas terapéuticas en la infección gonocócica.

OBJECTIVES: To evaluate improvements in the prescriptions for gonococcal infection after developing a specific public health intervention. Furthermore, to ascertain the proportion of cases diagnosed by culture and current antimicrobial resistance. LOCATION: Galicia, Spain. DESIGN: Before-after study of adherence to the recommended treatment for gonococcal infection (ceftriaxone + azithromycin) after a Public Health intervention. PARTICIPANTS: All Primary Care physicians who had identified and treated a case of gonococcal infection. STUDY PERIOD: Preintervention (2012-13) and postintervention (2014-17). INTERVENTIONS: Access to the recommended treatment (ceftriaxone and azithromycin) was provided in Primary Care and all the information was disseminated to Primary Care physicians and microbiologists through the publication Venres Epidemiolóxico. MAIN MEASUREMENTS: The study variables were year, prescribed treatment, performing of culture, antibiotic susceptibility testing. The percentages for each of them were calculated. RESULTS: The recommended treatment was used in 3% in 2012-2013, and after the interventions it increased to a mean of 58%. The frequency of culture remained relatively constant after the interventions. Sensitivity to other antibiotics improved as their use decreased. CONCLUSIONS: The interventions carried out implied an improvement in the adherence to the recommended treatment for gonococcal infection in Galicia.