Scabies in Spain: Trends in Public Interest and Ectoparasiticide Use. / Escabiosis en España: tendencias del interés público y consumo de ectoparasiticidas.

Scabies is an ectoparasitic dermatosis caused by the Sarcoptes scabiei var. hominis mite, which lives and reproduces in humans. Its incidence in Spain has increased in recent years. The aim of this study was to complement existing evidence on the increasing number of scabies cases in our country by analyzing changes in ectoparasiticide prescriptions and Internet searches for scabies infestations measured by Google Trends. We also examined correlations between these two variables. Our results show that public interest in scabies has increased in recent years and is positively and significantly correlated with an increasing use of ectoparasiticides. We believe that Google Trends should be considered as a complementary tool for monitoring real-time trends in scabies infestations in Spain.

[Translated article] Scabies in Spain: Trends in Public Interest and Ectoparasiticide Use.

Scabies is an ectoparasitic dermatosis caused by the Sarcoptes scabiei var. hominis mite, which lives and reproduces in humans. Its incidence in Spain has increased in recent years. The aim of this study was to complement existing evidence on the increasing number of scabies cases in our country by analyzing changes in ectoparasiticide prescriptions and Internet searches for scabies infestations measured by Google Trends. We also examined correlations between these two variables. Our results show that public interest in scabies has increased in recent years and is positively and significantly correlated with an increasing use of ectoparasiticides. We believe that Google Trends should be considered as a complementary tool for monitoring real-time trends in scabies infestations in Spain.

Hospital surge capacity preparedness in disasters and emergencies: a systematic review.

BACKGROUND: Adequate and effective emergency preparedness for hospital surge capacity is a prerequisite to ensuring standard healthcare services for disaster victims. This study aimed to identify, review, and synthesize the preparedness activities for and the barriers to hospital surge capacity in disasters and emergencies. METHODS: We systematically searched seven databases (PubMed, MEDLINE, CINAHL, Scopus, Embase, Ovid, and PsycINFO). We included all English peer-reviewed studies published in January 2016 and July 2022 on surge capacity preparedness in hospital settings. Two independent researchers screened titles and abstracts, reviewed the full texts, and conducted data extractions using CADIMA software. We assessed the rigor of the included studies using the NIH quality assessment tools for quantitative studies, the Noyes et al. guidelines for qualitative studies, and the MMAT tool for mixed methods studies and summarized findings using the narrative synthesis method. We also used PRISMA reporting guidelines. RESULTS: From the 2560 studies identified, we finally include 13 peer-reviewed studies: 10 quantitative, one qualitative, and two mixed methods. Five studies were done in the USA, three in Iran (n = 3), and the remaining in Australia, Pakistan, Sweden, Taiwan, and Tanzania. The study identified various ways to increase hospital surge capacity preparedness in all four domains (staff, stuff, space, and system); among them, the use of the Hospital Medical Surge Preparedness Index and the Surge Simulation Tool for surge planning was noteworthy. Moreover, nine studies (69%) recognized several barriers to hospital surge capacity preparedness. CONCLUSION: The review provides synthesized evidence of contemporary literature on strategies for and barriers to hospital surge capacity preparedness. Despite the risk of selection bias due to the omission of gray literature, the study findings could help hospital authorities, public health workers, and policymakers to develop effective plans and programs for improving hospital surge capacity preparedness with actions, such as enhancing coordination, new or adapted flows of patients, disaster planning implementation, or the development of specific tools for surge capacity. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022360332.

Prevalence and severity of periodontal disease among Spanish military personnel.

INTRODUCTION: Periodontal disease ranges from simple gums inflammation to major damage to the periodontal tissues, even losing teeth. Severe periodontitis has a world overall prevalence of 11.2%. These are evaluated with periodontal probes and oral epidemiological indices. Our aim is to estimate the prevalence and severity of periodontal disease of a Spanish military population according to the 2013 WHO criteria. METHODS: Observational study of prevalence carried out in a representative random sample of 221 military staff from the Spanish Army base 'Conde de Gazola'. Prevalence was estimated by calculating the Community Periodontal Index modified, loss of attachment, Plaque Index and Gingival Bleeding Index measured with a third-generation electronic 'Pa-on' periodontal probe. RESULTS: Averages of probing depth, recession and clinical attachment level were 2.17, 0.19 and 2.36 mm. Plaque and gingival bleeding indices were 71% and 40.3%. All subjects bled in some tooth after probing. 3.6% of subjects had no periodontal pockets, 58.8% mild periodontal pockets and 37.1% severe periodontal pockets. All had some loss of attachment, 52% mild loss of attachment and 47.5% severe loss of attachment. Teeth present with and without bleeding were 24.4 (86.5%) and 3.6 (13.1%). 28% of teeth had periodontal pockets and 40.4% loss of attachment. Sextant averages with periodontal pockets and loss of attachment were 2.79 and 3.56. CONCLUSIONS: Our plaque and gingival bleeding indices were high and we found a higher prevalence and severity of periodontal disease than other Spanish and foreign military populations. This could be related to differences in context, life habits and insufficient dental hygiene.

Epidemiological methods used in the periodontal health research in military personnel: a systematic review.

INTRODUCTION: Periodontal disease is a prevalent pathology in military personnel worldwide. The objective is to analyse the methodological features of periodontal health research performed in military personnel in their home countries. METHODS: A PRISMA systematic review of literature was carried out in PubMed, EMBASE and Web of Science databases on military periodontal health studies. Study design type, language, publication date, year, country, size and sample selection, age, sex, military, diagnostic procedure, examiners, periodontal, gingival and oral hygiene index were extracted. RESULTS: Eighty-eight out of 5355 studies found were selected, published between 1921 and 2020, with samples ranging from 52 to 16 869 individuals, generally not randomised, and consisting mainly of men with a mean age of 25 years. Predominant studies were cross-sectional descriptive studies, carried out in the Army, on American military personnel, and in the English language. Most of the studies used the WHO periodontal probe handled by two or more examiners. The Löe and Silness gingival index and the Silness and Löe plaque index were the most used indexes to assess gingival condition and oral hygiene, respectively. Community Periodontal Index of Treatment Needs was the most widely used periodontal index. CONCLUSIONS: Research on periodontal health carried out in military populations from the 1920s to the present has been performed from an almost exclusively descriptive approach. Issues such as the characteristics and representativeness of the samples, the epidemiological design and the different gingival-periodontal indexes used may limit the comparability of the study results.

[A system, developed by prescribing doctors, of indicators of the quality of pharmaceutical prescription in primary care]. / Un sistema de indicadores de calidad de prescripción farmacéutica en atención primaria desarrollado por médicos prescriptores.

OBJECTIVE: To work out a system of indicators and standards, designed by means of a consensus group of general practitioners, that enables evaluation of the quality of Primary Care prescription to be improved. Design. Informal consensus method. SETTING: A PC area in Asturias with 156 614 inhabitants and 9 health centres.Participants. Nine PC doctors accepted voluntarily to take part in the project. METHOD: A consensus group of nine PC doctors was formed. At a first meeting they worked out some potential indicators of quality of prescription. After applying these indicators to the prescription data, a second meeting was held, at which the results of applying the indicators along with criteria of excellence were used to establish the definitive indicators and their numerical values of optimum compliance. RESULTS: It was possible to agree by consensus 11 indicators of quality of prescription and their values of optimum compliance. Eight of the indicators referred to choice of a medicine within a pharmaco-therapeutic group; and three, to groups in which the volume of prescription may suggest improper usage. CONCLUSIONS: It is feasible for PC doctors to reach a consensus on a group of criteria that is perceived as valid for measuring quality of prescription and which includes certain impalpable values for determining quality.

[Pharmaceutical care in people who have had acute coronary episodes (TOMCOR study)]. / Atención farmacéutica en personas que han sufrido episodios coronarios agudos (Estudio TOMCOR).

BACKGROUND: This study evaluates the effects on coronary patients of a new practice in community pharmacies called Pharmaceutical Care (PhC) as compared to the traditional pattern of pharmacy practice. It attempts to ascertain whether pharmaceutical care is feasible in addition to ascertaining differences in effectiveness for coronary patients' pharmacotherapeutic health outcomes, potentially attributable to PhC. METHODS: A randomized prospective controlled-intervention study was conducted in 83 community pharmacies in the provinces of Asturias, Barcelona, Madrid and Biscay in a one-year monitoring of the drug-use of 735 patients at the start of the study (330 intervention patients and 405 control) and 600 at the end. RESULTS: Differences were fund in favor of the intervention group in: a) the use of health care services as a morbidity indicator such as frequency of hospital emergency room visits 1.27 I (CI95%; 1.10-1.44) and 1.63 C (CI95%; 1.36-1.90) or average length-of-stay in Intensive Care Units 2.46 I (CI95%; 1.56-3.36) and 5.87 C (CI95%; 3.57-8.17), both due to coronary causes; b) health-related quality of life score (physical functioning dimension difference of 4.7 (p < 0.05); c) average patient knowledge of coronary heart disease risk factors having improved by 10% (p < 0002-0.007 depending on dimension); d) patient knowledge of the name and identification of their drugs having improved by 10% (p < 0.001) along with their subjective perception of the antiagregans drugs relative importance having improved by 12% (p < 0.009) and effects of beta-blockers having improved by 25% (p < 0.02); e) average satisfaction with pharmaceutical care service and perception of pharmacist's professional competence having improved by 2% (p < 0.000 to 0.05 depending on dimension). CONCLUSIONS: A decrease in emergency health care demand due to coronary causes, a fewer number of patient hospitalizations and a shorter length-of-stay in Coronary Intensive Care Units due to hospitalization regarding coronary patients on pharmaceutical care would suggest that patients who suffered an acute coronary heart episode made a better use of drugs and would tend to be less ill. Furthermore, coronary patients who received pharmaceutical care services showed a better knowledge of the reasons for their pharmacotherapy and therefore took better advantage of health care resources and improved their health condition.

[Risk of chemical disaster as a public health problem]. / El riesgo de desastre químico como cuestión de salud pública.

This revision is aimed at providing health care personnel, particularly those who may be involved in planning and/or responding to a chemical accident, with an overview of the subject of major industrial accidents. In the introduction, a brief presentation is made of some data concerning the main industrial disasters which have occurred in the past in addition to some accidents which have occurred in our area that could have evolved into a major accident. A review is also provided of Spanish and European laws currently in effect regarding this matter, in addition to summarizing the main consequences which may result from explosions, phenomena of a thermal type and the leakage of hazardous substances, particularly stressing the third of these three cases. A brief summary is also given of the main steps to be taken for a correct risk analysis in a given geographical area. Lastly, the overall organization of the Chemical Industry Emergency Plans and the functions of the different groups taking part therein, including the main functions of the medical team, is provided. Planning and responding to an industrial disaster is markedly multi-disciplinary endeavor, and this document is aimed at providing health care professionals with an overview of the main aspects involved in order to thus contribute to a more in-depth knowledge of a subject which we consider to be of importance for health care personnel and a better-integrated response, given that were an industrial disaster to occur, we would have to deal with a serious public health care problem on the spot.

[The evaluation of hospital management of sanitary waste in the principality of Asturias]. / Evaluación de la gestión hospitalaria de residuos sanitarios en el Principado de Asturias.

BACKGROUND: With the object of evaluating the management of sanitary waste of 12 publicly funded Asturian hospitals, a visit was paid to the hospital services, particularly significant as regards the generation of waste (a total of 91 services). The evaluated hospitals represent 75.10% of the total hospital beds in the Principality. METHODS: Interviews with personnel from 91 different services were undertaken, always by the same interviewer, and according to the rules of the Joint Commission of Health Care Organizations. The information obtained was afterwards verified by the interviewer by means of direct observation. RESULTS: Amongst the most relevant results, the absence of adequate containers for "clinical" waste in 28.5% of the services visited, stands out. Into the bargain, 82.4% of the services classify this type of waste incorrectly. The percentage of incorrect classification is 1.1% for "special" waste. In large hospitals (with over 300 beds), 60% of the services have information on the handling of waste, but only 40% of these hospitals have adequate supervision over the management of waste by the Service of Preventive Medicine or another equivalent service. CONCLUSIONS: The level of incorrect classification of sanitary waste which has been discovered suggests that, in order to improve the intra-hospital management of waste, it is necessary to increase the amount of information, modify certain attitudes of the hospital staff and reinforce the level of supervision executed by the Services of Preventive Medicine.

[The new pharmacy practice: can pharmaceutical intervention improve therapeutical efficiency]. / La nueva atención farmacéutica: puede la intervención farmacéutica mejorar la eficiencia terapéutica?

BACKGROUND: The pharmaceutical activity has experienced over the last 50 years an important evolution in terms of concepts and contents affecting not only pharmacists but the whole health professionals. The subject of this study were the characteristics and implications of that change. METHODS: We review the main conditions leading to this change and characteristics of the new pharmaceutical activity focused mainly on the filtrate and alert about drug related problems and the professional intervention facing a proper resolution. RESULTS AND CONCLUSIONS: Some preliminary results from an investigation about the mentioned conditions are presented supporting the idea that this new proposed pharmaceutical intervention model can actually improve benefits on therapeutical effectiveness and save resources.

[The concept of disaster and its application in Asturias]. / El concepto de desastre y su aplicación en Asturias.

FUNDAMENTALS: Disaster can be defined as an unusual event for which the impact exceeds the affected community ability to meet the effects using own resources. The aim of the study is review the recent disaster profile of Asturias and assess the applicability of current disaster definitions in our context. METHODS: We considered as disaster each event producing casualties and requiring intervention of the civil protection services during the period 1982-1993, excluding minor transit accidents with no participation of the civil protection services. Date, place, characteristics, mortality and morbidity impact were studied for each event and then analyzed. We studied also current availability health resources in case of disaster. RESULTS: 14 events were recorded yielding to 88 deceased and 3 injured people (6.28 deaths by event). Aviation accidents were the most frequent event (35.7%) followed by railway, mining, shipwrecks and floods. Shipwrecks had higher mortality impact (36.3% of the total deceased people). Only minor technological disasters has happened in Asturias. This prevalence pattern differs from the spanish one characterized by a double face (natural and technological disasters). CONCLUSIONS: Traditional concept of major disaster cannot be applied to the Asturias context as the exam of our recent epidemiological prevalence pattern shows. Only mayor transit accidents (aviation, railway and shipwrecks) occur and its impact can be easily managed by the current relief community resources. However, an important potential risk of technological disasters exists and it requires have ready sectorial prevention plans.

[The triage in disaster medicine: analysis of a practical exercise]. / El triaje en medicina de catástrofes: análisis de un ejercicio práctico.

BACKGROUND: The triage is a procedure for casualties classification using some criteria (severity, survival, therapeutical delay, etc.) which is basic for the preparedness of health personnel in event of disaster. Even being a basic procedure, its teaching and training is not enough extended among health personnel. The goal of this study was assess the efficacy of teaching triage procedures in terms of its capability to carry out the examination and classification of massive casualties under different conditions of environmental difficulties. METHODS: 25 couples of health professionals (doctor and nurse) were trained during 90 minutes on triage procedures and them aleatory located at 3 groups with 12 simulated casualties at each group corresponding to 3 different levels of environmental difficulties. They were asked to perform the triage and complete the information contained at the triage card. This information was analyzed in order to see and compare the results of each group. RESULTS: All the health professionals showed high correlations between observed and expected responses for the evacuation priority variable. However, only the group of less environmental difficulty showed a significative statistical correlation (p = 0.03). No significative statistical differences were found on the diagnostic classification but the adjust level was poor for the high environmental difficulties group. CONCLUSIONS: Acceptable levels of efficacy on triage procedures can be obtained using a single teaching session of theoretical contents plus a practical exercise, specially for the casualties prioritization. On the other hand, environmental conditions looks as a variable influencing the efficacy of other acceptable results expected on this kind of technic perhaps requiring further training.

[An analysis of the potential years of life lost to cancer in Asturias and Spain]. / Análisis de los años potenciales de vida perdidos por cáncer en Asturias y España.

BACKGROUND: Potential years of life lost (PYLL) constitute a health indicator, used to study premature mortality. If applied, it produces an order in causes of death, which can be very different from that one, obtained with mortality rates. METHODS: Mortality, due to different pathologies, was analyzed with this indicator and, particularly, mortality due to cancer in Asturias and Spain. The estimation of (PYLL) was made using fixed age limits: the first anniversary, as the lowest limit, and 65 years, as the highest limit. RESULTS: Cancer happened to be the first cause of (PYLL) in both populations (286,473 PYLL in Spain; out of them 9,985 belonging to Asturias); road accidents were the second cause (139,673 and 4,755 respectively) and acute myocardium infarcts were the third cause (70,106 PYLL and 2,897 PYLL). Lung tumours, leukaemias and breast cancer in women are the malignant tumours which produce the highest number of PYLL. CONCLUSIONS: Malignant tumours, road accidents and ischaemic heart disease are the three major causes responsible for the PYLL production in Spain and Asturias. These three pathologies are associated to well known risk factors, whose disappearance would considerably reduce early mortality. Likewise, an excess of premature mortality is observed in Asturias compared with Spain, and in men compared with women.

[Hospital utilization in health areas of the principality of Asturias]. / Estudio de utilización de hospitales en areas de salud del principado de Asturias.

In order to examine the characteristics of the use of the hospitals in the Principality of Asturias by the population in several different health areas in which the Autonomous Community is divided, a study of admittances and discharges has been carried out on a sample of 2,321 files out of a total number of files of 14,973. The purpose was to find out the frequency of visits, the attractiveness and the geographical accessibility of the hospitals, as well as some of the factors which modify the flow of patients and which cause disequilibrium between the various areas. We have found important differences in the use of hospitals relating to age, sex, distance from the facility, and the characteristics of the area, which reflect serious intra-regional disequilibrium; there is a tendency towards the most frequent use of facilities among those situated in the central part of the Principality, in a range varying from 1.85 to 3.20 admittances/day by 10E-4. This data can be useful at the present time as there is currently under way a regional health plan for the distribution of hospital resources.