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1.
Rev Neurol ; 76(11): 343-350, 2023 06 01.
Artigo em Espanhol | MEDLINE | ID: mdl-37231547

RESUMO

INTRODUCTION: Huntington disease (HD) is a rare neurodegenerative disorder of the central nervous system characterized by unwanted choreatic movements, behavioral and psychiatric disturbances and dementia. OBJECTIVE: Describe the geographical, age and sex distribution of HD in the Valencia Region (VR) and determine its prevalence and mortality. MATERIALS AND METHODS: Cross-sectional study for the period 2010-2018. Confirmed cases of HD were identified through the Rare Disease Information System of the VR. Sociodemographic characteristics were described, and the prevalence and mortality rate were obtained. RESULTS: 225 cases were identified, 50.2% women. 52.0% lived in the province of Alicante. 68.9% were verified by their clinical diagnosis. The median age at diagnosis was 54.1 years, 54.7 years in men and 53.0 years in women. The prevalence in 2018 was 1.97/100,000 inhabitants (95%; CI: 0.39-2.37), showing a no significant increasing trend, overall and by sex. 49.8% died, 51.8% men. The median age at death was 62.7 years, being lower in men than in women. The mortality rate in 2018 was 0.32/100,000 inhabitants (95%; CI: 0.32-2.28), with no statistically significant differences. CONCLUSIONS: The prevalence obtained was within the range estimated by Orphanet (1-9/100,000). A difference between sexes was observed in the diagnosis age. Men are the group with the highest mortality and the earliest age of death. It is a disease with high mortality with an average of 6.5 years between diagnosis and death.


TITLE: La enfermedad de Huntington en la Comunitat Valenciana.Introducción. La enfermedad de Huntington (EH) es un trastorno raro neurodegenerativo caracterizado por movimientos coreicos involuntarios, trastornos conductuales y psiquiátricos, y demencia. Objetivo. Describir la distribución geográfica, etaria y por sexo de la EH en la Comunitat Valenciana (CV), y determinar su prevalencia y mortalidad. Materiales y métodos. Estudio transversal en el período 2010-2018. Se identificaron, a través del Sistema de Información de Enfermedades Raras de la CV, los casos confirmados de EH. Se describieron las características sociodemográficas, y se obtuvieron la prevalencia y la tasa de mortalidad. Resultados. Se identificaron 225 casos, un 50,2% mujeres. El 52% residía en la provincia de Alicante. Un 68,9% se verificó por su diagnóstico clínico. La mediana de edad en el momento del diagnóstico fue 54,1 años, 54,7 en los hombres y 53 en las mujeres. La prevalencia en 2018 fue de 1,97/100.000 habitantes ­intervalo de confianza al 95% (IC 95%): 0,39-2,37­. El 49,8% falleció, un 51,8% hombres. La mediana de edad en el momento del fallecimiento fue de 62,7 años, y fue inferior en los hombres que en las mujeres. La tasa de mortalidad en 2018 fue de 0,32/100.000 habitantes (IC 95%: 0,32-2,28) y no se observaron diferencias estadísticamente significativas, ni en conjunto ni por sexos, durante el período de estudio. Conclusiones. La prevalencia obtenida estaba dentro del rango estimado por Orphanet (1-9/100.000). Se observó una diferencia por sexos en la edad de diagnóstico. Los hombres son el grupo de mayor mortalidad y de edad de fallecimiento más temprana. Es una enfermedad con alta mortalidad, con una media de 6,5 años entre el diagnóstico y el fallecimiento.


Assuntos
Doença de Huntington , Masculino , Humanos , Feminino , Pessoa de Meia-Idade , Doença de Huntington/epidemiologia , Estudos Transversais , Prevalência , Distribuição por Sexo
2.
PLoS One ; 16(8): e0256535, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34449798

RESUMO

EUROCAT is a European network of population-based congenital anomaly (CA) registries. Twenty-one registries agreed to participate in the EUROlinkCAT study to determine if reliable information on the survival of children born with a major CA between 1995 and 2014 can be obtained through linkage to national vital statistics or mortality records. Live birth children with a CA could be linked using personal identifiers to either their national vital statistics (including birth records, death records, hospital records) or to mortality records only, depending on the data available within each region. In total, 18 of 21 registries with data on 192,862 children born with congenital anomalies participated in the study. One registry was unable to get ethical approval to participate and linkage was not possible for two registries due to local reasons. Eleven registries linked to vital statistics and seven registries linked to mortality records only; one of the latter only had identification numbers for 78% of cases, hence it was excluded from further analysis. For registries linking to vital statistics: six linked over 95% of their cases for all years and five were unable to link at least 85% of all live born CA children in the earlier years of the study. No estimate of linkage success could be calculated for registries linking to mortality records. Irrespective of linkage method, deaths that occurred during the first week of life were over three times less likely to be linked compared to deaths occurring after the first week of life. Linkage to vital statistics can provide accurate estimates of survival of children with CAs in some European countries. Bias arises when linkage is not successful, as early neonatal deaths were less likely to be linked. Linkage to mortality records only cannot be recommended, as linkage quality, and hence bias, cannot be assessed.


Assuntos
Declaração de Nascimento , Anormalidades Congênitas/epidemiologia , Estatísticas Vitais , Anormalidades Congênitas/patologia , Europa (Continente)/epidemiologia , Feminino , Humanos , Recém-Nascido , Masculino , Gravidez , Sistema de Registros
3.
Eur J Nutr ; 58(6): 2439-2448, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30066178

RESUMO

PURPOSE: The effect of coffee consumption on mortality has been scarcely investigated in the elderly. We assessed the association between coffee consumption and mortality from all-cause, cardiovascular disease (CVD) and cancer, in an elderly population of Spain. METHODS: We studied 903 individuals (511 women) aged 65 years and older from two population-based studies, the EUREYE-Spain study and the Valencia Nutritional Survey. Coffee consumption and diet were assessed using a validated food frequency questionnaire. Information on education, anthropometry, sleeping time, smoking, alcohol intake, physical activity and pre-existing disease was collected at baseline. Deaths were ascertained during a 12-year follow-up period, and Cox proportional hazards regression models were used to estimate adjusted hazard ratios (HR). RESULTS: There were 403 deaths during the 12-year period (40% from CVD), 174 of which occurred during the first 6 years. We observed evidence of a lower CVD mortality among coffee drinkers in the first 6 years of follow-up. Drinkers of ≤1 cup of coffee/day and > 1 cup/day showed lower CVD mortality than non-drinkers of coffee, HR 0.82 (95% CI 0.46-1.44) and HR 0.38 (0.15-0.96), respectively (p trend = 0.04). This association of coffee with CVD mortality attenuated after 12 years of follow-up. No significant association was observed with all-cause or cancer mortality, neither for caffeinated and decaffeinated coffee. CONCLUSIONS: In this study, coffee consumption was associated with lower CVD mortality in elderly. Although this association should be further investigated, coffee consumption appears to be safe for the elderly since no increased mortality was observed in coffee drinkers.


Assuntos
Doenças Cardiovasculares/mortalidade , Café , Morte , Avaliação Geriátrica/métodos , Neoplasias/mortalidade , Idoso , Dieta , Feminino , Avaliação Geriátrica/estatística & dados numéricos , Humanos , Masculino , Modelos de Riscos Proporcionais , Fatores de Risco , Espanha/epidemiologia , Inquéritos e Questionários
4.
An Pediatr (Barc) ; 84(4): 203-10, 2016 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-26526828

RESUMO

OBJECTIVE: To describe the temporal trend and distribution of chromosomal congenital abnormalities (CA) in the Valencia Region, in less than one year olds, during the period 2007-2011. METHODOLOGY: Live births, still births and termination of pregnancy due to foetal anomaly between 2007 and 2011 with chromosomal CA (Q90-Q99.9 codes of the 10th International Classification of Diseases -British Paediatric Association) were selected from the CA population-based Registry of Valencia Region The prevalence per 10,000 births for the chromosomal CA and for the different types of chromosomal syndromes with 95% confidence intervals was calculated. The analysis was performed by calculating prevalences and data were compared using Pearson Chi-squared test. RESULTS: A total of 895 cases were found, representing a prevalence of 33.5 per 10,000 births (95% CI: 31.0-35.9), highlighting five syndromes: Down's, Edward's, Patau, Turner and Klinefelter. The prevalence of chromosomal CA and Down's syndrome were stable over the period, except in 2010. Down's was the most frequent chromosomal CA (67% of the cases), and the most frequent termination of pregnancy type was for foetal anomaly (69%). Cardiac heart defects represented 70.3% of the associated congenital anomalies. Mothers of children with chromosomal CA were mainly Spanish (73.3%). The age group of mothers over 39 years had a higher prevalence (133.0 per 10,000 births). The province of Castellón had the highest prevalence, 39.1 per 10,000 births. CONCLUSIONS: The prevalence has remained stable over the five years, excluding the significant decline in 2010, for chromosomal CA detected and two of the major syndromes. The chromosomal CA are an important public health problem as they represent 15% of all CA identified in the Valencia Region, and agrees with the European data.


Assuntos
Transtornos Cromossômicos/epidemiologia , Anormalidades Congênitas/epidemiologia , Síndrome de Down/epidemiologia , Feminino , Cardiopatias Congênitas/epidemiologia , Humanos , Idade Materna , Gravidez , Prevalência , Sistema de Registros , Espanha/epidemiologia
5.
Epidemiol Infect ; 142(12): 2629-41, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24476599

RESUMO

The aim of this study was to monitor the spatio-temporal spread of influenza incidence in Spain during the 2009 pandemic and the following two influenza seasons 2010-2011 and 2011-2012 using a Bayesian Poisson mixed regression model; and implement this model of geographical analysis in the Spanish Influenza Surveillance System to obtain maps of influenza incidence for every week. In the pandemic wave the maps showed influenza activity spreading from west to east. The 2010-2011 influenza epidemic wave plotted a north-west/south-east pattern of spread. During the 2011-2012 season the spread of influenza was geographically heterogeneous. The most important source of variability in the model is the temporal term. The model of spatio-temporal spread of influenza incidence is a supplementary tool of influenza surveillance in Spain.


Assuntos
Surtos de Doenças , Vírus da Influenza A Subtipo H1N1 , Influenza Humana/epidemiologia , Teorema de Bayes , Humanos , Incidência , Influenza Humana/transmissão , Influenza Humana/virologia , Vigilância da População , Conglomerados Espaço-Temporais , Espanha/epidemiologia
6.
An Pediatr (Barc) ; 79(3): 149-56, 2013 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-23481464

RESUMO

OBJECTIVES: The objective of this study is to estimate the prevalence of congenital heart defects (CHD) in the Comunitat Valenciana (CV) in children less than one year old and identify whether there are temporal and geographic variations within this prevalence. METHODS: The minimum basic data set from hospital discharge reports was used to select patients, who were born between 1999-2008, were less than one year old, and who lived in the CV with at least one hospital admission in which the primary diagnosis and/or any of the events were coded as CHD (codes 745-747 of the International Classification of Diseases 9th Revision Clinical Modification). The first hospital discharge report with CHD was selected, using the health card number to detect duplication. The prevalence and 95% confidence intervals were calculated, and the prevalence ratio (PR) and smoothed PR was obtained for each municipality to identify geographic patterns. RESULTS: In the period 1999-2008 there were 6.377 patients younger than one year with some CHD, representing the 43.2% of cases of congenital anomalies. The prevalence was 134.3 per 10.000 live births (95% CI: 131.1-137.6). There was a significant increase in the prevalence, from 115.8 in the 1999-2003 period to 149.5 in the 2004-2008 period. A higher risk was identified in the north of the CV, and in some municipalities of the province of Alicante, in the south. CONCLUSIONS: The observed increase in CHD agrees with the findings in other countries and it can be explained, at least in part, by improved diagnostic techniques. The geographic pattern identified requires a more detailed analysis that could explain the geographic variations found.


Assuntos
Cardiopatias Congênitas/epidemiologia , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Prevalência , Espanha/epidemiologia , Fatores de Tempo
7.
Nefrologia ; 28(2): 151-8, 2008.
Artigo em Espanhol | MEDLINE | ID: mdl-18454704

RESUMO

In 2005, renal replace treatment (dialysis and transplant) was necessary for about 40,000 people, without being known the number accurate and either their basic characteristics, such as: time in treatment, modality or treatment changes. The presented data cover the 76% of the Spanish population and are the result of the cooperation among technicians of registries, nephrologists and transplant coordinations. 4,125 people started RRT in 2005, the total estimated acceptance rate for renal replacement therapy in adults in Spain was 126 pmp and regarding other European countries it locates us in an intermediate area. The incidence rate seems to keep stable in the last years although there were some differences among communities (from 104 pmp in Castile and Leon to 186 pmp in Canary Islands). Diabetes Mellitus is the most diagnosed cause of renal failure in 2005, more than 20% of patients, followed by vascular diseases. The estimated prevalence of renal replacement therapy in Spain at the end of 2005 was 903 pmp, with important variations among communities (from 806 pmp in Cantabria to 1056 pmp in Valencia Region). The 47% of prevalent RRT patients had a functioning transplant. Mortality on haemodialysis and peritoneal dialysis was 13.7% and 10.8% respectively. Mortality on transplant was 1.3%, one of the lowest values registered so far. Mortality on renal replacement therapy was around 5% among patients from 45 to 64 years, 11% between 65 and 74 years and 19% among the patients older than 75 years.


Assuntos
Transplante de Rim/estatística & dados numéricos , Diálise Renal/estatística & dados numéricos , Adolescente , Adulto , Idoso , Humanos , Transplante de Rim/mortalidade , Pessoa de Meia-Idade , Diálise Renal/mortalidade , Espanha
9.
Stat Med ; 25(2): 345-58, 2006 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-16220471

RESUMO

In this paper we analyse the renal transplant waiting list of the País Valencià in Spain, using Queueing theory. The customers of this queue are patients with end-stage renal failure waiting for a kidney transplant. We set up a simplified model to represent the flow of the customers through the system, and perform Bayesian inference to estimate parameters in the model. Finally, we consider several scenarios by tuning the estimations achieved and computationally simulate the behaviour of the queue under each one. The results indicate that the system could reach equilibrium at some point in the future and the model forecasts a slow decrease in the size of the waiting list in the short and middle term.


Assuntos
Teorema de Bayes , Transplante de Rim , Teoria de Sistemas , Listas de Espera , Humanos , Espanha
12.
13.
Gac Sanit ; 16(5): 445-9, 2002.
Artigo em Espanhol | MEDLINE | ID: mdl-12372192

RESUMO

Point pattern analysis pattern comprises a series of techniques that enables the distribution of a series of events occurring in the vicinity of a particular region of a map to be studied. In epidemiology, this problem arises when a potential source of environmental contamination, possibly leading to cases of a specific disease, is investigated.The present study provides a brief description of point pattern analysis. The approach is illustrated through determination of the environmental source and study of the areas of greatest risk of incidence of an outbreak of legionella pneumonia that occurred between the middle of September and beginning of October in the city of Alcoi in Alicante (Spain).Point pattern analysis was able to confirm the environmental source of the outbreak and identify the areas of the city at greatest risk. This provided the justification for an exhaustive inspection of the installations generating aerosols after which, to date, the epidemics ceased.


Assuntos
Microbiologia Ambiental , Humanos , Estatística como Assunto
14.
Gac Sanit ; 16(4): 324-33, 2002.
Artigo em Espanhol | MEDLINE | ID: mdl-12106552

RESUMO

OBJECTIVES: To evaluate geostatistical description of influenza data from the Valencian Sentinel Network (VSN) in Spain using the kringing method and to assess the possibility of incorporating this method into routine surveillance. METHODS: We use influenza surveillance data on three influenza seasons (1997-1998, 1998-1999 and 1999-2000) from the VSN to construct a geocodified data matrix of the incidence of this disease. The geographic distribution was studied using the kringing method, which enables estimation of the incidence in a few strategically distributed points. Influenza isoincidence maps for each week were plotted. Cross validation was used to evaluate the method. RESULTS: In most of the weeks, the values of reduced standard deviation and reduced mean were close to the optimal values (0 and 1, respectively). Out of range reduced standard deviation values were found in 12 of 20 weeks in the last season only. The estimation of rates in all three seasons showed coherence in spatial distribution and temporal evolution. CONCLUSIONS: In most situations the results were acceptable. The method does not require extra computer resources or an excessive amount of time and requires only annual adaptation. Because it is easy to use, the technique is appropriate for routine use but the accuracy of estimations could be improved by increasing the complexity of the model.


Assuntos
Sistemas de Informação Geográfica , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Vigilância de Evento Sentinela , Humanos , Espanha
15.
Nefrologia ; 22(3): 253-61, 2002.
Artigo em Espanhol | MEDLINE | ID: mdl-12123125

RESUMO

To choose the best possible dialysis technique for those patients with end-stage renal disease continues to be a matter of debate. Even after putting aside the evident influence that economic and geographic factors as well as the health politics may have in the selection of the technique, different studies comparing survival between hemodialysis (HD) and peritoneal dialysis (PD) have shown contradictory results which could be explained by the differing methodological and statistical methods used together with the different influence assigned to the comorbidity found when starting the treatment, a situation that has increased the confusion about this topic. Based on this we performed a retrospective analysis with a follow-up time of seven years including all those patients who started dialytic treatment in our area, with a final number of 3.106 hemodialysis patients and 542 peritoneal dialysis patients. Those patients who were transferred to another treatment technique during the time of the study were excluded. Age higher than 70 years, cardiovascular disease, liver disease, diabetes mellitus and the presence of dyslipidemia were included as comorbidity factors. Peritoneal dialysis patients were younger than those treated by hemodialysis (54.53 vs 60.1 years), but suffered from higher cardiovascular comorbidity and were more often diabetic. The global survival was the same in both groups up to 32 months of treatment. Although no differences were found when comparing those patients without comorbidity factors, those with comorbidity had better survival on hemodialysis. Age higher than 70 years was the only comorbidity factor with statistically significant difference for a better survival in hemodialysis.


Assuntos
Falência Renal Crônica/mortalidade , Diálise Peritoneal , Diálise Renal , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Falência Renal Crônica/complicações , Falência Renal Crônica/terapia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taxa de Sobrevida
18.
Gac Sanit ; 4(16): 24-8, 1990.
Artigo em Espanhol | MEDLINE | ID: mdl-2262283

RESUMO

We present a pilot experience about the introduction of a information system designed for the knowledge of infant morbidity (4-15 years) in a 13 school week period in a representative sample of 60 schools of the Valencian Community. We studied school absences that lasted three days or longer. Reports of teachers and parents were the source of information (100% response rate). Medical certification was also requested to the pediatricians and general practitioners of the area of the schools (12.74% response rate). To test the validity of this information system, absences caused by hepatitis were compared with the registry of Notifiable Diseases System (NDS) for the same period. We recorded 3,968 absences, with a cumulative incidence of 100.68 per 1,000 (C.I., alpha = .05, +/- 4.97) for females, and 119.4 (C.I., alpha = .05, +/- 18.36) for males. These differences were statistically significant. There was a concordance of 80.25% of the hepatitis cases between the registry of absenteeism and that of the NDS (chi 2 goodness of fit test = 3.16, p = .754). Although absences shorter than 3 days were not taken into account, the information system provided relevant and valid estimates of morbidity. Moreover, collaboration of teachers was considered very positive, which led us to use this health information system in five health areas of the Valencian Community.


Assuntos
Absenteísmo , Sistemas de Informação , Morbidade , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Projetos Piloto , Espanha/epidemiologia
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