[Translated article] Treatment of supracondylar femoral fractures by minimally invasive techniques vs. exposure of the fracture site: A retrospective cohort study.

INTRODUCTION: Fractures of the distal femoral third are an important cause of morbidity and mortality, and their treatment is currently controversial. OBJECTIVES: To compare the results between minimally invasive techniques versus exposure of the fracture site. Secondly, to evaluate the relationship between demographic factors, mechanism of injury and surgical delay with patient prognosis. METHOD: Retrospective cohort study carried out between 2015 and 2021 in a tertiary hospital. Data collection was performed by reviewing medical histories, measuring demographic and hospital parameters and definitive treatment strategy. One year of follow-up was completed in all patients, assessing the occurrence of surgical complications and mortality. A stratified analysis of the variables of interest was performed among patients over 65 years of age. RESULTS: 128 fractures were recorded, with definitive osteosynthesis being performed in 117. Patients who underwent minimally invasive techniques required a shorter hospital stay (9 [7-12] vs. 12 [8.75-16] days) (p=0.007), with no differences in mortality or complications during follow-up. In those over 65 years of age, opening the fracture site was associated with an increased risk of infection compared to minimally invasive techniques (33.3% vs. 2%) (p=0.507). All the deceased were patients over 65 years of age (33.7% at one year). Surgical delay longer than 48h increased mortality by 10% among those older than 65 years (p=0.3). High-energy trauma had a higher proportion of pseudarthrosis (27.6% vs. 6.1%) (p=0.011). CONCLUSIONS: Minimally invasive techniques decreased hospital stay but not complications or long-term mortality. LEVEL OF EVIDENCE: IIb.

Quantification of Major Inorganic Contaminants in a Mediterranean Coastal Lagoon with a Large Dystrophic Crisis.

In August 2021, the Mar Menor, a saltwater lagoon located in the Region of Murcia (Spain), suffered a tragic environmental episode of dystrophic crisis and anoxia. The appearance of numerous dead fish in different areas of the lagoon over the course of days put all the authorities and the population of the area on alert. This paper shows a case study of what happened in the lagoon in terms of the presence of the most common inorganic pollutants. Measurements of the concentration of nitrogen species, phosphates and main heavy metals were carried out at different sampling sites in the Mar Menor from May 2021 to November 2022. Chemical analyses were carried out for each of the species under study. These analyses provide valuable information about the dystrophic crisis caused by a classic eutrophication process that began with the excessive nutrient input into the Mar Menor. Ion chromatography and Inductively Coupled Plasma Mass Spectrometry (ICP-MS) were used as instrumentation for the quantification of these samples. The species whose values were greatly increased after the tragic episode described above were nitrates. The concentration varied significantly at the different sampling sites throughout the study. On the last sampling date, decreased concentrations of all the species were measured at each of the sampling sites, coinciding with the apparent good state of the lagoon.

Treatment of supracondylar femoral fractures by minimally invasive techniques vs. exposure of the fracture site: A retrospective cohort study. / Tratamiento de fracturas supracondíleas de fémur mediante técnicas mínimamente invasivas vs. exposición del foco de fractura: un estudio de cohortes retrospectivas.

INTRODUCTION: Fractures of the distal femoral third are an important cause of morbidity and mortality, and their treatment is currently controversial. OBJECTIVES: To compare the results between minimally invasive techniques versus exposure of the fracture site. Secondly, to evaluate the relationship between demographic factors, mechanism of injury and surgical delay with patient prognosis. METHOD: Retrospective cohort study carried out between 2015 and 2021 in a tertiary hospital. Data collection was performed by reviewing medical histories, measuring demographic and hospital parameters and definitive treatment strategy. One year of follow-up was completed in all patients, assessing the occurrence of surgical complications and mortality. A stratified analysis of the variables of interest was performed among patients over 65 years of age. RESULTS: 128 fractures were recorded, with definitive osteosynthesis being performed in 117. Patients who underwent minimally invasive techniques required a shorter hospital stay (9 [7-12] vs. 12 [8.75-16] days) (p=0.007), with no differences in mortality or complications during follow-up. In those over 65 years of age, opening the fracture site was associated with an increased risk of infection compared to minimally invasive techniques (33.3% vs. 2%) (p=0.507). All the deceased were patients over 65 years of age (33.7% at one year). Surgical delay longer than 48hours increased mortality by 10% among those older than 65 years (p=0.3). High-energy trauma had a higher proportion of pseudarthrosis (27.6% vs. 6.1%) (p=0.011). CONCLUSIONS: Minimally invasive techniques decreased hospital stay but not complications or long-term mortality. LEVEL OF EVIDENCE: IIb.

Epidemiology of bacterial co-infections and risk factors in COVID-19-hospitalized patients in Spain: a nationwide study.

BACKGROUND: We performed a nationwide population-based retrospective study to describe the epidemiology of bacterial co-infections in coronavirus disease 2019 (COVID-19)-hospitalized patients in Spain in 2020. We also analyzed the risk factors for co-infection, the etiology and the impact in the outcome. METHODS: Data were obtained from records in the Minimum Basic Data Set (MBDS) of the National Surveillance System for Hospital Data in Spain, provided by the Ministry of Health and annually published with 2 years lag. COVID-19 circulated in two waves in 2020: from its introduction to 31st June and from 1st July to 31st December. The risk of developing a healthcare-associated bacterial co-infection and the risk for in-hospital and intensive care unit (ICU) mortality in co-infected patients was assessed using an adjusted logistic regression model. RESULTS: The incidence of bacterial co-infection in COVID-19 hospitalized patients was 2.3%. The main risk factors associated with bacterial co-infection were organ failure, obesity and male sex. Co-infection was associated with worse outcomes including higher in-hospital, in-ICU mortality and higher length of stay. Gram-negative bacteria caused most infections. Causative agents were similar between waves, although higher co-infections with Pseudomonas spp. were detected in the first wave and with Haemophilus influenzae and Streptococcus pneumoniae in the second. CONCLUSIONS: Co-infections are not as common as those found in other viral respiratory infections; therefore, antibiotics should be used carefully. Screening for actual co-infection to prescribe antibiotic therapy when required should be performed.

Consenso multidisciplinar español sobre las características de los pacientes con asma grave en tratamiento con biológicos susceptibles de pasar a tratamiento domiciliario / Spanish multidisciplinary consensus on the characteristics of severe asthma patients on biologic treatment who are candidates for at-home administration

Antecedentes y objetivo Es bien sabido que las terapias biológicas reducen las exacerbaciones y mejoran el tratamiento del asma grave no controlada. La administración domiciliaria de biológicos ha aumentado durante la pandemia de COVID-19, pero aún no se han identificado las características de los pacientes con asma grave no controlada que pueden beneficiarse de la administración domiciliaria de terapia biológica. Materiales y métodos Este proyecto se basa en la metodología Delphi, diseñada para alcanzar un consenso entre expertos a través de un comité científico multidisciplinar que aborda las siguientes cuestiones: características clínicas, adherencia al tratamiento, capacidad de administración del paciente o cuidador, autocuidado del paciente, relación con el profesional sanitario, preferencias del paciente y acceso al hospital. Resultados Ciento treinta y un profesionales sanitarios (neumólogos, alergólogos, enfermeros y farmacéuticos hospitalarios) cumplimentaron las dos rondas de consenso del cuestionario Delphi. Se identificaron 14 ítems como características prioritarias, siendo los cinco primeros: 1. El paciente sigue las indicaciones/recomendaciones del equipo sanitario para controlar su enfermedad. 2. El paciente es capaz de detectar cualquier deterioro de su enfermedad y de identificar los factores desencadenantes de las exacerbaciones. 3. El paciente recibe tratamiento biológico y tiene una enfermedad estable sin riesgo vital. 4. El paciente se responsabiliza de su autocuidado y 5. el paciente tiene obligaciones laborales/educativas que le impiden acudir al hospital con regularidad (AU)

Background and objective Biologic therapies are known to reduce exacerbations and improve severe uncontrolled asthma management. The at-home administration of biologics has increased during the COVID-19 pandemic, but the characteristics of severe uncontrolled asthma patients who may benefit from at-home administration of biologic therapy have yet to be identified. Materials and methods This project is based on the Delphi method, designed to reach an expert consensus through a multidisciplinary scientific committee addressing the following questions: clinical characteristics, treatment adherence, patient or caregiver administration ability, patient self-care, relationship with the healthcare professional, patient preference, and access to the hospital. Results One hundred and thirty-one healthcare professionals (pulmonologists, allergists, nurses, and hospital pharmacists) completed two Delphi consensus questionnaires. Fourteen items were identified as priority characteristics, the first five being: 1. The patient follows the healthcare team's indications/recommendations to control their disease, 2. The patient is capable of detecting any deterioration in their disease and of identifying exacerbation triggers, 3. The patient receives biologic therapy and has stable disease with no vital risk, 4. The patient takes responsibility for their self-care, 5. The patient has occupational/educational obligations that prevent them from going to the hospital regularly. Conclusions Disease stability and control plus the ability to identify exacerbation triggers are the most important characteristics when opting for at-home administration for a patient with severe uncontrolled asthma on biologic therapy. These recommendations could be applicable in clinical practice (AU)

Spanish multidisciplinary consensus on the characteristics of severe asthma patients on biologic treatment who are candidates for at-home administration.

BACKGROUND AND OBJECTIVE: Biologic therapies are known to reduce exacerbations and improve severe uncontrolled asthma management. The at-home administration of biologics has increased during the COVID-19 pandemic, but the characteristics of severe uncontrolled asthma patients who may benefit from at-home administration of biologic therapy have yet to be identified. MATERIALS AND METHODS: This project is based on the Delphi method, designed to reach an expert consensus through a multidisciplinary scientific committee addressing the following questions: clinical characteristics, treatment adherence, patient or caregiver administration ability, patient self-care, relationship with the healthcare professional, patient preference, and access to the hospital. RESULTS: One hundred and thirty-one healthcare professionals (pulmonologists, allergists, nurses, and hospital pharmacists) completed two Delphi consensus questionnaires. Fourteen items were identified as priority characteristics, the first five being: 1. The patient follows the healthcare team's indications/recommendations to control their disease, 2. The patient is capable of detecting any deterioration in their disease and of identifying exacerbation triggers, 3. The patient receives biologic therapy and has stable disease with no vital risk, 4. The patient takes responsibility for their self-care, 5. The patient has occupational/educational obligations that prevent them from going to the hospital regularly. CONCLUSION: Disease stability and control plus the ability to identify exacerbation triggers are the most important characteristics when opting for at-home administration for a patient with severe uncontrolled asthma on biologic therapy. These recommendations could be applicable in clinical practice.

Total removal of amoxicillin from water using magnetic core nanoparticles functionalized with silver.

Framed in the problem of emerging pollutants, in this work we introduce a novel procedure for the total removal of amoxicillin from water samples using magnetic nanoparticles functionalized with nanometric silver (Fe3O4@AgNPs). Experimental conditions such as pH, contact time, temperature, as well as adsorbate and adsorbent doses have been studied to achieve the total adsorption for different concentrations of amoxicillin in water. Particularly, for concentrations 10 and 100 mg L-1, a maximum removal efficiency of 100% was reached at room temperature and pH = 7 after 15 min of contact time between adsorbent and water samples under gentle shaking. The doses of adsorbent employed to remove 10 and 100 mg L-1 of amoxicillin were 100 and 500 µL, respectively. Characterization of the adsorbent surfaces was performed by Scanning and Transmission Electron Microscopy, Energy Dispersive X-ray Spectroscopy, BET analysis and Fourier-transform infrared spectroscopy. Recycling studies were carried out employing 500 µL of NaOH solution 1 M during 15 min in order to explore desorption and reuse of the adsorbent, showing that Fe3O4@AgNPs remains unaltered and can be used for two more additionally adsorption cycles, exhibiting 93% adsorption efficiency after the third regeneration. The characterization of equilibrium isotherms and thermodynamics reveal a Langmuir-type endothermic chemisorption.

Simultaneous adsorption of mercury species from aquatic environments using magnetic nanoparticles coated with nanomeric silver functionalized with l-Cysteine.

We introduce a novel, efficient and fast method for the total and simultaneous removal of monomethylmercury, dimethylmercury, ethylmercury and Hg (II) from aquatic environments using magnetic core nanoparticles, coated with metallic nanomeric silver and functionalized with l-Cysteine. As far as the authors know, simultaneous removal has not been achieved previously. The experimental design was based on exploring a wide range of experimental conditions, including pH of the medium (2-12), contact time (up to 20 min), adsorbent dose (50-800 µL) and temperature (293-323 K), in order to achieve the highest adsorption efficiency. The results show that, for a pH equal to 6.2 at room temperature, 400 µL of nanoparticles is sufficient to achieve 100% adsorption efficiency for all the studied Hg species after a contact time of 30 s. The adsorbent was characterized by means of Scanning Electron Microscopy, Energy Dispersive X-ray Analysis, Fourier-Transform Infrared Spectroscopy and a BET test. Moreover, the procedure allows the total recovery and recycling of the nanoparticles using 50 µL of 0.01 M KI. As regards reuse, the adsorbent exhibits no loss of adsorption capacity during the first three adsorption cycles. Thermodynamics reveals that adsorption is of a physicochemical nature, the equilibrium isotherms being described by a Langmuir model for all the Hg species. The ability of the method to simultaneously adsorb all species of mercury present in water, achieving full adsorption in just a few seconds, along with the simple experimental conditions and its cost-effectiveness, strongly support the approach as an alternative to current procedures.

Graphene oxide and graphene oxide functionalized with silver nanoparticles as adsorbents of phosphates in waters. A comparative study.

Phosphate removal is an important factor that must be taken into account in eutrophized waters. For this reason, many studies on different ways of removing phosphates from water have been published nowadays. In this work, a comparative study between the use of graphene oxide (GO) and graphene oxide functionalized with silver nanoparticles (GO@AgNPs) as adsorbents to remove phosphates from water samples has been carried out. Experimental conditions, including the pH, adsorbent dose, contact time and temperature, have been analyzed to achieve the highest adsorption efficiency. Although both adsorbents can be considered suitable for removing phosphates from aqueous solutions, GO@AgNPs provided a maximum removal efficiency of 100%, reaching the equilibrium conditions instantaneously under straightforward experimental conditions. Moreover, a much lower adsorbent dose was necessary than with graphene oxide. When GO was used, the maximum removal efficiency was 75%, 9 min were necessary to reach the equilibrium conditions and 20 mg of adsorbent were needed. Both adsorbents can be regenerated in an acid medium, giving recovery percentages of 98% and 80% for GO and GO@AgNPs respectively, which allows them to be recycled and used again.

Adverse drug reactions to anticoagulants in Spain: analysis of the Spanish National Hospital Discharge Data (2010-2013).

OBJECTIVE: To describe and analyse hospitalisations for adverse drug reactions (ADRs) involving anticoagulants. We also analysed the progress of the reactions over time, the factors related with ADRs. DESIGN: A retrospective, descriptive, epidemiological study. SETTING: This study used the Spanish National Hospital Discharge Database (Conjunto Mínimo Básico de Datos, CMBD), over a 4-year period. PARTICIPANTS: We selected CMBD data corresponding to hospital discharges with a diagnosis of ADRs to anticoagulants (International Classification of Diseases-Ninth Revision, Clinical Modification (ICD-9-CM) code E934.2) in any diagnostic field during the study period. MAIN OUTCOME MEASURES: We calculated the annual incidence of ADRs to anticoagulants according to sex and age groups. The median lengths of hospital stay and in-hospital mortality (IHM) were also estimated for each year studied. Bivariate analyses of the changes in variables according to year were based on Poisson regression. IHM was analysed using logistic regression models. The estimates were expressed as ORs and their 95% CI. RESULTS: During the study period, 50 042 patients were hospitalised because of ADRs to anticoagulants (6.38% of all ADR-related admissions). The number of cases increased from 10 415 in 2010 to 13 891 in 2013. Cumulative incidence of ADRs to anticoagulants was significantly higher for men than women and in all age groups. An adjusted multivariate analysis revealed that IHM did not change significantly over time. We observed a statistically significant association between IHM and age, with the highest risk for the ≥85 age group (OR 2.67; 95% CI 2.44 to 2.93). CONCLUSIONS: The incidence of ADRs to anticoagulants in Spain increased from 2010 to 2013, and was significantly higher for men than women and in all age groups. Older patients were particularly susceptible to being hospitalised with an adverse reaction to an anticoagulant.

RELIGIOUS EXCLUSIVITY AND PSYCHOSOCIAL FUNCTIONING.

In the present study we sought to clarify links between religious exclusivity, as form of intergroup favoritism, and indices of psychosocial functioning. The study of in group favoritism has generally been invoked within Social Identity Theory and related perspectives. However, there is a lack of literature regarding religious exclusivity from the standpoint of social identity. In particular, the ways in which religious exclusivity is linked with other dimensions of religious belief and practice, and with psychosocial functioning, among individuals from different religious backgrounds are not well understood. A sample of 8545 emerging-adult students from 30 U.S. universities completed special measures. Measure of religious exclusivity was developed and validated for this group. The results suggest that exclusivity appears as predictor for impaired psychosocial functioning, low self-esteem and low psychosocial well-being for individuals from organized faiths, as well as for those identifying as agnostic, atheist, or spiritual/nonreligious. These findings are discussed in terms of Social Identity Theory and Terror Management Theory (TMT).

Trends in nontuberculous mycobacterial disease in hospitalized subjects in Spain (1997-2010) according to HIV infection.

OBJECTIVES: The aim of the study was to estimate the incidence of nontuberculous mycobacterial (NTM) disease and the rate of NTM disease-related mortality and to analyse trends in these variables according to HIV infection. METHODS: We performed a retrospective study for the period 1997-2010 using data from the Minimum Basic Data Set (MBDS) provided by the Spanish Ministry of Health. The exposure variables were: (i) HIV infection (HIV positive versus HIV negative); (ii) calendar period in relation to widespread use of combination antiretroviral therapy (cART) [1997-1999 (early cART period), 2000-2003 (middle cART period) and 2004-2010 (late cART period)]. The outcome variables were (i) new NTM disease diagnosis and (ii) mortality. RESULTS: A total of 3729 cases of incident NTM disease were collected in MBDS, 1795 in the HIV-negative group and 1934 in the HIV-positive group, among whom 602 deaths occurred, 223 in the HIV-negative group and 379 in the HIV-positive group. The incidence of NTM disease and the rate of NTM disease-related mortality were 1000-fold higher in the HIV-positive group than in the HIV-negative group. Regarding the incidence of NTM disease, in the HIV-negative group the incidence increased from 2.91 to 3.97 events per 1,000,000 patient-years from 1997-1999 to 2004-2010 (P < 0.001), while in the HIV-positive group the incidence decreased from 2.29 to 0.71 events per 1000 patient-years from 1997-1999 to 2004-2010 (P < 0.001). Regarding mortality, in the HIV-negative group mortality increased from 2.63 to 4.26 events per 10,000,000 patient-years from 1997-1999 to 2000-2003 (P = 0.059), and then the rate stabilized at around 3.87 events per 10,000,000 patient-years in 2004-2010 (P = 0.128), while in the HIV-positive group mortality decreased from 4.28 to 1.39 events per 10,000 patient-years from 1997-1999 to 2004-2010 (P < 0.001). CONCLUSIONS: HIV infection was associated with a higher NTM disease incidence and higher NTM disease-related mortality than in the general population, but these rates decreased in the HIV-positive group from 1997-1999 to 2004-2010, whereas the NTM disease incidence increased in the HIV-negative group.

Attempted and completed suicide: not what we expected?

BACKGROUND: Suicide attempters and suicide completers are two overlapping but distinct suicide populations. This study aims to present a more accurate characterization by comparing populations of suicide attempters and completers from the same geographical area. METHODS: Samples and procedure: All cases of attempted suicide treated at the emergency room of the Corporacio Sanitària i Universitària Tauli Parc de Sabadell in 2008 (n=312) were compared with all completed suicides recorded in the same geographical area from 2008 to 2011 (n=86). Hospital and primary care records were reviewed for sociodemographic and clinical variables. STATISTICAL ANALYSIS: Chi-square, ANOVA, and Mann-Whitney U tests were used to identify characteristics related to suicide completion. RESULTS: Compared to suicide attempters, suicide completers were more likely to be male (73.3% vs. 37.8%; p<0.001), pensioners (73.7% vs. 23.4%; p<0.001), and people living alone (31.8% vs. 11.4%; p=0.006). Suicide completers more frequently presented somatic problems (71.7 vs. 15.7; p<0.001), Major Depressive Disorder (54.7% vs. 27.9%; p<0.001), and made use of more lethal methods (74.1 vs. 1.9; p<0.001). Suicide completers were more likely to have been followed by a primary care provider (50.0% vs. 16.0%; p<0.001). 92.3% of the suicides committed were completed during the first or second attempt. LIMITATIONS: Suicide completers were not evaluated using the psychological autopsy method. CONCLUSIONS: Despite presenting a profile of greater social and clinical severity, suicide completers are less likely to be followed by Mental Health Services than suicide attempters. Current prevention programs should be tailored to the specific profile of suicide completers.

Epidemiology of suicide in Spain, 1981-2008: a spatiotemporal analysis.

OBJECTIVE: To analyse the epidemiology of suicide, and compare its occurrence between the sexes and in various regions in Spain. METHOD: Age-specific analysis and spatiotemporal analysis to analyse death by suicide between 1981 and 2008 in Spain. STUDY DESIGN: Ecological study. RESULTS: Death by suicide has decreased since the 1990s in Spain, although peaks in suicides correspond with times of economic crisis. Death by suicide was more common among men than among women, although the suicide mortality rate increased over the study period among women aged 35-49 years. Geographical analysis showed that rural populations and areas with historically higher levels of unemployment have higher suicide rates. In contrast, less-populated regions have lower suicide rates. CONCLUSION: Suicides in Spain exhibit a clear geographic pattern and occur at different rates between the genders. The results suggest an increasing number of suicides among women aged 35-49 years over the study period.

Factors involved in health-related transitions after curative resection for pancreatic cancer. 10-years experience: a multi state model.

BACKGROUND: Pancreatic cancer is one of the least common tumours, nevertheless it is one of the most lethal. This lethality is mainly due to the fact that the vast majority of patients are diagnosed in an advanced stage. The purpose of this study was to investigate how different covariates affect the transition to death or discharge with and without complications after pancreatic resection. METHODS: We analyse the impact of different factors on transitions after pancreatic resection based on a multi state model. RESULTS: Transitions of interest include the transition to death/discharge with/without complications after pancreatic resection. We consider presence of comorbidities, higher age (>60), gender-male, lower hospital volume (<10 cases per year), type of surgery, localization of tumour and transfusion received as covariates with a potentially negative effect on the transition intensities to death with or without complications. CONCLUSIONS: The multi-state model allows for a very detailed analysis of the impact of covariates on each transition, since effects of covariates may change depending on the current state of the patient, thus helping surgeons and patients throughout the surgical process and counselling patients if needed.

Breast cancer mortality in Spain: has it really declined for all age groups?

OBJECTIVES: In recent years, the incidence of breast cancer has increased in Spain but mortality has decreased, particularly since 1992. Despite the general decrease in mortality, the intensity of this disease differs between age groups. The main objective of this study was to examine mortality due to breast cancer for different age groups in Spain from 1981 to 2007, and to forecast the mortality rate in 2023. STUDY DESIGN: Ecological study. METHODS: Trends in mortality due to breast cancer were analysed using the Lee-Carter model, which is the typical analysis for mortality in the general population but is rarely used to analyse specific causes of death. RESULTS: This study found a decreasing trend in mortality due to breast cancer from 1993 to 2007, and it is predicted that this trend will continue. However, mortality rates varied between age groups: a decreasing trend was seen in younger and middle-aged women, whereas mortality rates remained stable in older women. CONCLUSIONS: Preventive breast cancer practices should differ by patient age.

In-hospital death caused by pancreatic cancer in Spain: application with a bayesian network.

Pancreatic cancer is one of the least common tumors (2.1%), but it remains one of the most lethal. This lethality is primarily due to late stage diagnosis in the vast majority of patients. Here we demonstrate, using a Bayesian network, that we can determine a posteriori, with a high probability of success, the probability of in-hospital death of pancreatic cancer in hospitals across Spain with information related to the type of admission, the type of procedure, the primary diagnosis or the Charlson co-morbidity index. The advantages of using a Bayesian network are that it allows us to examine multiple hypotheses and to measure the effect of the introduction of variables on our hypotheses. Being able to determine deceases in the probability of survival based on hospital admission data, such as the diagnosis resulting in the present admission or the presence of co-morbidities, could facilitate the detection of deficiencies in the patient treatment and improve hospital management. Moreover, the control of related co-morbidities may have an impact on the in-hospital deaths of these patients.

[Epidemiology of hospitalizations caused by rubella in the general population in Spain (1997-2006)]. / Epidemiología de las hospitalizaciones causadas por rubéola en la población general en España (1997-2006).

BACKGROUND: Rubella is benign in children, but in pregnant women it can produce Congenital Rubella Syndrome (CRS) with severe consequences for the foetus. In spite of vaccination coverage in Spain being above 95%, isolated cases and outbreaks continue to occur. The aim of this study is to estimate the incidence of hospitalisations due to rubella in Spain (1997-2006). METHODS: Utilising the basic minimum dataset (National System of Epidemiological Surveillance) we calculated: rate of hospitalisation, average stay and cost. RESULTS: There were 267 hospitalisations, amongst them 144 due to rubella during pregnancy, 1 due to CRS and 8 due to encephalomyelitis. The overall rate of hospitalisation was 0.065 per 105 inhabitants (IC95%=0.0649-0.0654). The average stay was 3 days. The average cost of a hospitalisation was 2,082 euros, and if complicated by encephalomyelitis it rose to 8.191 euros. CONCLUSION: There continue to be hospitalisations due to rubella, basically due to problems in gestation and to complications in the existing susceptible population group.

Epidemiología de las hospitalizaciones causadas por rubéola en la población general en España (1997-2006) / Epidemiology of hospitalisations caused by rubella in the general population in Spain (1997-2006)

Fundamento. La rubéola es benigna en niños, pero enembarazadas puede producir el síndrome de rubéolacongénita (SRC) con graves consecuencias para el feto.A pesar de que en España la cobertura vacunal actuales mayor del 95%, siguen produciéndose casos aisladosy brotes. El objetivo de este estudio es estimar la incidenciade hospitalizaciones por rubéola en España,(1997-2006).Material y método. Utilizando el conjunto mínimo básicode datos (Sistema Nacional de Vigilancia Epidemiológica)se ha calculado: tasa de hospitalización, estanciamedia y coste.Resultados. Hubo 267 hospitalizaciones, entre ellas 144por rubéola en el embarazo, 1 por SRC y 8 casos porencefalomielitis. La tasa de hospitalización global fuede 0,065 por 105 habitantes (IC95%=0,0649-0,0654). Lamediana del tiempo de hospitalización fue de 3 días. Elcoste medio de una hospitalización fue de 2.082 € y si secomplica con encefalomielitis asciende a 8.191 €.Conclusión. En España, sigue habiendo hospitalizacionespor rubéola, debidas fundamentalmente a problemasen la gestación y a complicaciones en el grupo depoblación susceptible existente(AU)

Background. Rubella is benign in children, but in pregnantwomen it can produce Congenital Rubella Syndrome(CRS) with severe consequences for the foetus. Inspite of vaccination coverage in Spain being above 95%,isolated cases and outbreaks continue to occur. Theaim of this study is to estimate the incidence of hospitalisationsdue to rubella in Spain (1997-2006).Methods. Utilising the basic minimum dataset (NationalSystem of Epidemiological Surveillance) we calculated:rate of hospitalisation, average stay and cost.Results. There were 267 hospitalisations, amongst them144 due to rubella during pregnancy, 1 due to CRS and8 due to encephalomyelitis. The overall rate of hospitalisationwas 0.065 per 105 inhabitants (IC95%=0.0649-0.0654). The average stay was 3 days. The average costof a hospitalisation was 2,082 €, and if complicated byencephalomyelitis it rose to 8.191 €.Conclusion. There continue to be hospitalisations dueto rubella, basically due to problems in gestation andto complications in the existing susceptible populationgroup(AU)

Valoración del estado nutricional en pacientes ingresados en el servicio de neumología / Evaluation of the nutritional condition in patients hospitalized in the Pneumology Department

Introducción. La desnutrición hospitalaria se ha estimado entre un 25-50% y se ha relacionado con la mortalidad, aumento de días de estancia y reingresos hospitalarios. Objetivo. Valorar la desnutrición en pacientes ingresados en el servicio de neumología mediante herramientas sencillas y fácilmente aplicables. Pacientes y métodos. A los pacientes que ingresaron en el servicio de neumología desde 1 de septiembre del 2008 hasta el 15 de enero del 2009 se les valoró el estado nutricional mediante 2 parámetros bioquímicos, el índice de masa corporal (IMC) y el cuestionario de SNAQ (Short Nutritional Assessment Questionnaire). Las puntuaciones totales y la clasificación nutricional obtenida se compararon con el número de exacerbaciones e ingresos. Resultados. Se han valorado 141 enfermos con una edad media 66,07 (rango, 18-93 años), 78 hombres y 63 mujeres. Los principales diagnósticos fueron EPOC en un 28,6%, neumonía en un 25%, asma en un 10% e infección respiratoria en un 7,9%. El número de agudizaciones en el año previo fue de 1,55 (rango: 0-10) y de ingresos de 1,01 (rango 0-8). Según el IMC, el 11% presentó desnutrición leve, 2,2% moderada y 0,7% grave. El 49,3% de los pacientes mostraron un IMC > 25 kg/m2. Teniendo en cuenta la albúmina, el 24,1% desnutrición leve, 6,4% moderada y 5% grave y, según los linfocitos, el 22, 23,4 y 22%, leve, moderada y grave, respectivamente. Según el cuestionario SNAQ, el 23,3% mostraba desnutrición. La puntuación total de SNAQ se relacionó con el número de exacerbaciones e ingresos previos y sólo el IMC con las agudizaciones. Conclusiones. Un elevado porcentaje de pacientes presentan desnutrición y ello puede ser causa o consecuencia de los ingresos hospitalarios. Mediante métodos sencillos, aplicables en la práctica clínica habitual, podemos valorar el estado nutricional de nuestros enfermos y actuar precozmente (AU)

Abstract. Hospital malnutrition is estimated between 25-50% and it has been associated with mortality, increased days of hospitalization and readmissions. Objective. To assess malnutrition in patients admitted to the Pneumology Department using simple tools and easy to apply. Patients and methods. Patients admitted in the Pneumology Department from the 1st September 2008 until 15 January 2009 were assessed using 2 nutritional biochemical parameters, body mass index (BMI) and the questionnaire SNAQ (Short Nutritional Assessment Questionnaire). The total scores and nutritional classification were compared with the number of exacerbations and income. Results. We evaluated 141 patients with a mean age 66.07 (range 18 - 93 years), 78 men and 63 women. The main diagnoses were COPD in 28.6%, pneumonia 25%, 10% asthma and respiratory infection 7.9%. The number of exacerbations in the previous year was 1.55 (range: 0-10) and revenue of 1.01 (range 0-8). According to BMI, 11% had mild, moderate 2.2% and 0.7% severe. 49.3% of patients showed a BMI > 25 kg/m2.Considering albumin, 24.1% mild, 6.4% and 5% moderate and severe malnutrition according lymphocytes: 22%, 23.4% and 22% respectively mild, moderate and severe according to the questionnaire the SNAQ 23.3% showed malnutrition. SNAQ total score was related to the number of exacerbations, and previous hospitalization and BMI with the exacerbation. Conclusions. A high percentage of patients develop malnutrition and this could be one cause or consequence of hospital admissions. Using simple methods, applicable in routine clinical practice, we can assess the nutritional status of our patients and act earlier (AU)