Las voluntades vitales anticipadas en Andalucía, 2004-2014 / Advanced care directives in Andalusia, 2004-2014

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[Place of death in Andalusia: influence of age, gender and cause of death]. / El lugar de la muerte en Andalucía: influencia de la edad, sexo y causa de defunción.

AIM: To know the place of death and its relationship to age, gender and causes of death. MATERIAL AND METHODS: A cross-sectional analysis of national population data using 31,463 deaths derived from Official Statistics on Mortality in Andalusia for the year 2009 was carried out. The variables studied were place of death (hospital, home or care home), age, gender and cause of mortality. Odds ratio adjusted by gender, age and cause of mortality using a multinomial logistic regression model. Place of death was chosen as dependent variable and age, gender and cause of death as independent ones. RESULTS: The place of death was hospital (61%), home (31%) and care home (8%). The higher the age, the higher the percentage of deaths at home and especially in care homes. Deaths in care homes are related to age (OR: 1,054; 95%CI: 1,049-1,059) and central nervous system (OR: 2,221; 95%CI: 1,826-2,071) and endocrine diseases (OR: 1,391; 95%CI: 1,141-1,697). There is a lower likelihood of dying at home due to digestive diseases (OR: 0,272; 95%CI: 0.23-0.32), genitourinary diseases (OR: 0.54; 95%CI: 0.44-0.65) and respiratory diseases (OR: 0.73; 95%CI: 0.64-0.82). CONCLUSIONS: Most Andalusians die in the hospital and increasing age has been found to be associated with higher probability of dying at home or in care homes. There are differences between death causes regarding place of death.

El lugar de la muerte en Andalucía: influencia de la edad, sexo y causa de defunción / Place of death in Andalusia: influence of age, gender and cause of death

Objetivo. Conocer el lugar de la muerte y su relación con la edad, sexo y causas de defunción. Material y método. Estudio transversal de base poblacional a partir de 31.463 defunciones procedentes de las estadísticas oficiales de mortalidad de Andalucía en el año 2009. Las variables estudiadas han sido: lugar donde ocurrió la muerte (hospital, domicilio o residencia socio-sanitaria), edad, sexo y causa de mortalidad. Se han calculado las odds ratio ajustadas por edad, sexo y causa de defunción mediante un modelo de regresión logística multinomial. Como variable dependiente se ha usado el lugar de fallecimiento y como independiente la edad, sexo y causa. Resultados. El lugar de fallecimiento fue: hospital (61%), domicilio (31%) y residencia socio-sanitaria (8%). A mayor edad aumenta el porcentaje de fallecidos en el domicilio y especialmente en las residencias respecto al hospital. Resultados. Las muertes en residencia se asocian con la edad (OR: 1,054; intervalo de confianza [IC] del 95%, 1,049-1,059) y las enfermedades del sistema nervioso central (OR: 2,221; IC del 95%, 1,826-2,701) y endocrinas (OR: 1,391; IC del 95%, 1,141-1,697). Resultados. Hay una menor probabilidad de morir en domicilio por las enfermedades digestivas (OR: 0,272; IC del 95%, 0,23-0,32), genitourinarias(OR: 0,54; IC del 95%, 0,44-0,65) y respiratorias (OR: 0,73; IC del 95%, 0,64-0,82). Conclusiones. La mayoría de los andaluces mueren en el hospital y a medida que aumenta la edad se incrementa la posibilidad de morir fuera del mismo. Hay diferencias significativas en la causa de defunción según el lugar de fallecimiento(AU)

Aim. To know the place of death and its relationship to age, gender and causes of death. Material and methods. A cross-sectional analysis of national population data using 31,463 deaths derived from Official Statistics on Mortality in Andalusia for the year 2009 was carried out. The variables studied were place of death (hospital, home or care home), age, gender and cause of mortality. Odds ratio adjusted by gender, age and cause of mortality using a multinomial logistic regression model. Place of death was chosen as dependent variable and age, gender and cause of death as independent ones. Results. The place of death was hospital (61%), home (31%) and care home (8%). The higher the age, the higher the percentage of deaths at home and especially in care homes. Results. Deaths in care homes are related to age (OR: 1,054; 95%CI: 1,049-1,059) and central nervous system (OR: 2,221; 95%CI: 1,826-2,071) and endocrine diseases (OR: 1,391; 95%CI: 1,141-1,697). Results. There is a lower likelihood of dying at home due to digestive diseases (OR: 0,272; 95%CI: 0.23-0.32), genitourinary diseases (OR: 0.54; 95%CI: 0.44-0.65) and respiratory diseases (OR: 0.73; 95%CI: 0.64-0.82). Conclusions. Most Andalusians die in the hospital and increasing age has been found to be associated with higher probability of dying at home or in care homes. There are differences between death causes regarding place of death(AU)

Una búsqueda bibliográfica fallida; ¿qué faltó por buscar? El caso del test de Lattinen / A failed bibliographical search. What was lacking? The case of the Lattinen test

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Brucellosis outbreak due to unpasteurized raw goat cheese in Andalucia (Spain), January - March 2002.

Eleven brucellosis cases were identified in three municipalities of Cordoba (Andalucia, Spain). A case-control study was conducted, selecting three cases per control. Persons having eaten unpasteurized raw goat cheese produced in a farmhouse located in the epidemic territory, were at higher risk for presenting brucellosis (OR=21.6, IC95%=1.6-639.8). Brucella melitensis serovar 3 was identified in clinical specimens and in goat tissue and milk samples from the herd's farmhouse. Preventive measures were implemented and the outbreak was stopped after the withdrawal of all suspicious cheeses from the market, additional sanitation of the farmhouse and health promotion activities.

[Levels of bactericidal antibodies against meningococcus C after vaccination in 2- to 6-year-old children in Andalusia]. / Niveles de anticuerpos bactericidas frente a meningococo C tras la vacunación de niños de 2 a 6 años de edad en Andalucía.

BACKGROUND: In 1997, 18.5% of the cases of Meningococcal Disease caused b serogroup C in Andalusia were children between 2 and 4 years of age; ages where the initial immune response and the duration of the capsular A + C meningococcal polysaccharide vaccine is less than in older age groups. Research was designed in order to measure the immune response produced by this vaccine in children from 2 to 6 years of age and to compare it with the natural immunity present in unvaccinated children. METHODS: I. Dual monitoring study: a) groups of children vaccinated previously and control groups, b) groups of children who were going to be vaccinated, for pre and post-vaccination (1, 6 and 12 months) analysis and a control group. II. The bactericidal activity was measured according to the standardised protocol of the CDC with regard to the strain of N. meningitidis C-11. The sera with bactericidal activity (TAB) > 1:8 were considered to be protective. RESULTS: 1 and 2 months following vaccination, the proportion of TAB > 1:8 was significantly higher than that of the control group (65.6% and 73% in comparison to 2.2% and 12%). In the pre-vaccine and post-vaccine (after 6, 7, 12 and 13 months) verification, no significant difference between vaccinated individuals and controls was observed. CONCLUSIONS: The differences between vaccinated and unvaccinated individuals 1 and 2 months following vaccination indicate seroconversion in the vaccinated individuals. For the age group of between 2 to 6 years of age, the bactericidal activity acquired decline quickly, as, after 6 months, differences between this group and the control group are no longer observed.

[The utilization of parenteral nutrition at Hospital de Jerez (Cádiz): a description and comparison with other hospital centers]. / Utilización de la nutrición parenteral en el Hospital de Jerez (Cádiz): descripción y comparación con otros centros hospitalarios.

This retrospective study aims to analyze, and compare with other Spanish hospitals, the use of parenteral nutrition, its characteristics and complications, in a general hospital with 610 beds, during 1992. To conduct this study, we have used clinical histories and follow up sheets made up by the Department of Pharmacy for each patient, as well as the results of the sample processing in the microbiology laboratory. Between 1992 and 1993 we have seen an increase in the use of parenteral nutrition, with the number of bags increasing from 2134 to 2575. The departments which have used parenteral nutrition most, were Surgery (57.3%), and ICU (24.8%), with the mean duration being 10.4 days 8SD = +/- 9.3 days). The most frequently used access route in the hospital was the drum, but there are significant differences between the departments. Gastroenterological pathology was, with 71.4% the most frequent indication for its use, and within this, the neoplasias stand out with 26.3% of the total of parenteral nutrition. The complications which affected most patients are: increases of the liver enzymes, hypokalemias, hyponatremias, and hyperglycemias.