Hepatitis A virus genotype distribution during a decade of universal vaccination of preadolescents.

A universal vaccination program among preadolescents was implemented in Catalonia, Spain, during the period of 1999-2013 and its effectiveness has been clearly demonstrated by an overall significant attack rate reduction. However, reductions were not constant over time, and increases were again observed in 2002-2009 due to the occurrence of huge outbreaks. In the following years, in the absence of large outbreaks, the attack rate decreased again to very low levels. However, an increase of symptomatic cases in the <5 age group has recently been observed. This is an unexpected observation since children younger than 6 are mostly asymptomatic. Such a long vaccination campaign offers the opportunity to analyze not only the effectiveness of vaccination, but also the influence of the circulating genotypes on the incidence of hepatitis A among the different age groups. This study has revealed the emergence of genotype IC during a foodborne outbreak, the short-lived circulation of vaccine-escape variants isolated during an outbreak among the men-having-sex-with-men group, and the association of genotype IIIA with the increase of symptomatic cases among the very young. From a public health perspective, two conclusions may be drawn: vaccination is better at an early age, and the vaccination schedule must be complete and include all recommended vaccine doses.

[Incidence of whooping cough in the city of Barcelona between 1999 and 2011]. / Evolución de la incidencia de tos ferina en la ciudad de Barcelona entre 1999 y 2011.

INTRODUCTION: The aim of the study was to describe the long-term incidence of whooping cough in a large city. METHODS: Descriptive study of the cases reported in the notifiable disease registry between 1999 and 2011 in Barcelona. RESULTS: An increase in incidence was observed, especially in children and in the year 2011. Children younger than one year still were most affected, with a specific rate of 426.87/100,000 in 2011. CONCLUSION: A new approach in adolescent and adult vaccination is needed to provide more protection to younger children, as well as research to assess a possible shift in the bacteria itself.

[Estimation of environmental tobacco smoke exposure: review of questionnaires used in Spain]. / Estimación de la exposición al humo ambiental de tabaco: revisión de cuestionarios utilizados en España.

INTRODUCTION: In the last few years, health surveys and epidemiological studies on smoking have introduced questions on environmental tobacco smoke (ETS) exposure. However, a standardized questionnaire is lacking. METHODS: Between January and May 2008, we reviewed surveys containing items on ETS exposure carried out in Spain by public administrations, scientific societies and research institutes. The wording of the questions was reviewed and classified according to the study type, target population, geographical setting and place of exposure. RESULTS: We identified 27 surveys that included questions on passive smoking. Most were health surveys (81.5%) and were aimed at the general population (70.4%). The most frequent geographical setting consisted of autonomous regions (48.1%) and the most common place of exposure was the home (88.9%) DISCUSSION: The results show wide variability in the questions used. Questionnaire items on ETS exposure should be homogenized to allow comparison of the results of surveys.

Ambient air pollution and risk of congenital anomalies: a systematic review and meta-analysis.

OBJECTIVE: We systematically reviewed epidemiologic studies on ambient air pollution and congenital anomalies and conducted meta-analyses for a number of air pollutant-anomaly combinations. DATA SOURCES AND EXTRACTION: From bibliographic searches we extracted 10 original epidemiologic studies that examined the association between congenital anomaly risk and concentrations of air pollutants. Meta-analyses were conducted if at least four studies published risk estimates for the same pollutant and anomaly group. Summary risk estimates were calculated for a) risk at high versus low exposure level in each study and b) risk per unit increase in continuous pollutant concentration. DATA SYNTHESIS: Each individual study reported statistically significantly increased risks for some combinations of air pollutants and congenital anomalies, among many combinations tested. In meta-analyses, nitrogen dioxide (NO2) and sulfur dioxide (SO2) exposures were related to increases in risk of coarctation of the aorta [odds ratio (OR) per 10 ppb NO2 = 1.17; 95% confidence interval (CI), 1.00-1.36; OR per 1 ppb SO2 = 1.07; 95% CI, 1.01-1.13] and tetralogy of Fallot (OR per 10 ppb NO2 = 1.20; 95% CI, 1.02-1.42; OR per 1 ppb SO2 = 1.03; 95% CI, 1.01-1.05), and PM10 (particulate matter ≤ 10 µm) exposure was related to an increased risk of atrial septal defects (OR per 10 µg/m³ = 1.14; 95% CI, 1.01-1.28). Meta-analyses found no statistically significant increase in risk of other cardiac anomalies and oral clefts. CONCLUSIONS: We found some evidence for an effect of ambient air pollutants on congenital cardiac anomaly risk. Improvements in the areas of exposure assessment, outcome harmonization, assessment of other congenital anomalies, and mechanistic knowledge are needed to advance this field.

Confiabilidad del cuestionario Brief COPE inventory en versión en español para evaluar estrategias de afrontamiento en pacientes con cáncer de seno / Confiabilidade do questionário Brief COPE inventory em versão em espanhol para avaliar estratégias de afrontamento em pacientes com câncer de mama / Reliability of the questionnaire brief COPE inventory in Spanish version for Assessing Coping strategies in patients with breast cancer, Bogotá, Colombia, 2009

Introducción: El cáncer de seno no sólo se caracteriza por sus elevadas cifras estadísticas, sino por las cargas emocionales que conlleva y que desempeñan un papel importante en la enfermedad, pues estas se equilibran a través del proceso de afrontamiento mediante dos estrategias: una activa (relacionada con enfrentar la enfermedad de manera directa) y una pasiva (que trata de evitar y negar el conflicto que vive la mujer). Objetivo: Establecer la confiabilidad del cuestionario Brief COPE Inventory (BCI) en versión en español para evaluar estrategias de afrontamiento en mujeres con cáncer de seno. Metodología: Estudio psicométrico con 140 aplicaciones del cuestionario a pacientes en una unidad oncológica de Bogotá. Para el análisis se utilizó el programa estadístico SPSS 16.0, que determinó la confiabilidad a través del modelo alfa de Cronbach. Resultados: El estudio determinó para el BCI un alfa de Cronbach total de 0,698. Para la dimensión afrontamientoactivo, el valor del alfa fue de 0,663, y para la dimensión afrontamiento pasivo, de 0,523. El cuestionario quedó conformado por 28 ítems que evalúan dos dimensiones:afrontamiento activo y afrontamiento pasivo, cada una con siete estrategias. Conclusión: El BCI en versión en español aplicado a mujeres con cáncer de seno no sufrió cambios significativos en su constructo teórico, lo que muestra que puede utilizarse en esta población, así como en las que ya fue validado; sin embargo, se recomienda continuar con el análisis psicométrico, aplicándolo a población colombiana para evaluar estrategias de afrontamiento con el fin de obtener indicadores de validez externa...

Introduction: Breast cancer is not only characterized by their high statistical figures but also by emotional burdens that play an important role in the disease which are balanced through the process of coping, which is carried out using various strategies, with two forms: An active form (associated with the disease face a direct), and a passive form (seeks to avoid conflict and deny the patient lives). Objective: To establish the reliability of the questionnaire Brief COPE Inventory (BCI) in Spanish to assess coping strategies in women with breast cancer. Methodology: A psychometric questionnaire applications with 140 patients in an oncology unit in Bogota was used to analyze the statistical program SPSS 16.0, determining the reliability by Cronbach’s alpha model. Results: Showed the BCI in a Spanish Cronbach alpha of 0.698. For the active coping dimension value was 0.663, and for passive coping dimension 0.523. The questionnaire was composed of 28 items that assess two dimensions: coping and stand, each with seven coping strategies. Conclusion: The BCI in Spanish applied to women with breast cancer did not suffer significant changes in his theoretical construct, which shows that can be used in this population as well as the already approved and recommended to continue with the analysis applied to psychometric Colombian population to assess coping strategies in order to obtain indicators of external validity...

Introdução: O câncer de mama não só está caracterizado por seu alto número de casos, senão também pela carga emocional, que desempenha um papel importante na doença, aspecto que é equilibrado através do processo de afrontamento realizado por os doentes, mediante duas estratégias que incluem: uma forma ativa (relacionada com o afrontamento da doença) e uma forma passiva (que tenta evitar e negar o conflito). Objetivo: Determinar a confiabilidade do questionário Brief COPE Inventory (BCI) em versão ao espanhol para avaliar as estratégias de afrontamento em mulheres com câncer de mama. Metodologia: Foi feito um estudo psicometrico com 140 aplicações do questionário em doentes de uma unidade de cuidado de oncologia de Bogotá. Para o analise dos dados foi utilizado o programa estatístico SPSS 16.0, e se estabeleceu a confiabilidade com o modelo de alfa de Cronbach. Resultados: O estudo encontrou para o BCI um alfa de Cronbach global de 0,698. A dimensão de afrontamento ativo teve um valor de alfa de 0,663, e para a dimensão de afrontamento passivo, de 0,523. O questionário finalmente esta composto por 28 itens que avaliam duas dimensões: ativa e passiva, cada uma com sete estratégias de afrontamento. Conclusão: A versão em espanhol do BCI aplicado a mulheres com câncer da mama não sofreu alterações significativas na sua construção teórica, o que mostra que pode ser usado nesta população e naqueles onde foi validado o questionário, mas recomenda-se a continuar o análise psicométrica, aplicando-o à população colombiana com características similares para determinar os indicadores de validade externa...