[Management from Primary Care of monkeypox infection (MPOX) in humans]. / Manejo desde atención primaria de la infección por la viruela del mono (MPOX) en humanos.

Monkeypox (MPOX) is a viral zoonosis endemic in West or Central African countries that is sporadically exported to another area. In May 2022, a global outbreak of MPOX smallpox began to occur in several countries in Europe and North America. Most of the reported cases are identified at the outpatient level and mainly affect men who have sex with men (MSM). Transmission is by close contact with lesions, body fluids, respiratory secretions or contaminated material from an infected person or animal. The clinical picture is similar to human smallpox, with less severity. Mild, self-limiting skin involvement predominates after 2-4 weeks. In MSM, atypical skin lesions appear due to the mode of infection. Severe forms or complications may appear in certain risk groups. The case fatality rate is 3%-6% depending on the clade responsible. The diagnosis of suspicion is confirmed by detection of the virus from exudates of lesions or scabs, with nucleic acid amplification techniques by conventional or real-time PCR. Clinical management in most cases is performed in primary care (PC), by monitoring the main symptoms. Between 5-10% require hospital management and there are some specific antiviral treatment options. Human smallpox vaccines protect against MPOX and are used as pre- and post-exposure prophylaxis for persons at risk. Measures to reduce exposure to the virus are the main MPOX prevention strategy. In addition, the role of the family physician is key to controlling the spread of MPOX through active surveillance and early diagnosis of the disease.

[Consensus document for the management of schistosomiasis in Primary Care]. / Documento de consenso para el manejo de la esquistosomiasis en atención primaria.

Human schistosomiasis is the parasitic disease with the highest morbidity and mortality worldwide after malaria. It is endemic in more than 78 tropical and subtropical countries, especially in sub-Saharan Africa, and it is estimated that 236 million people are infected. It can cause serious health complications at the genitourinary and hepatosplenic level, leading to the death of 300,000 people each year. The number of imported cases in Western countries has increased in recent years due to the arrival of a significant number of migrants from endemic regions and a growing number of travelers who have visited them. On the other hand, outbreaks of autochthonous transmission have recently been reported in Corsica (France) and Almería (Spain). For all these reasons, the European health authorities have recommended serological screening for the disease in all migrants from endemic areas who have been living in Europe for less than 5 years. Since Primary Care is usually the first point of contact for these people with the Health System, doctors must know the main aspects of the disease, and be provided with the necessary means for its diagnosis and treatment. This document has been prepared by professionals belonging to five scientific societies of Primary Care (SEMFyC, SEMG, SEMERGEN), Pediatrics (SEIP) and Tropical Medicine and International Health (SEMTSI), in order to establish clear recommendations for the diagnosis and management of schistosomiasis in Primary Care.

[Basic aspects of COVID-19 for management from primary care]. / Aspectos básicos de la COVID-19 para el manejo desde atención primaria.

SARS-CoV-2 is transmitted from person to person by inhalation or contact with respiratory droplets and aerosols. The median incubation period is 5.1 days. Fever, dry cough, dyspnea and fatigue are the most common symptoms. Almost half of the cases are asymptomatic. The spectrum of disease varies from mild (81%) to critical (5%). Older age, male gender and comorbidities negatively impact on the severity and mortality of COVID-19. The diagnosis of acute COVID-19 is made with RT-PCR or antigenic detection tests. In hospital patients, remdesivir reduces recovery time. Oral steroids are recommended for severe or critical cases requiring oxygen therapy or mechanical ventilation. Thromboprophylaxis is recommended in all severe and non-severe cases with high thrombotic risk. Antibiotherapy is limited to cases of high suspicion of bacterial superinfection. Mild-moderate and severe cases after discharge from hospital should be clinically monitored for a minimum period of two weeks.

[Evolution of the outpatient antibiotic prescription between 2012 and 2018. Characteristics of the ABPresclín platform created for the analysis of antibiotic prescription in the health service of the Balearic Islands.] / Evolución de la prescripción antibiótica ambulatoria entre 2012 y 2018. Características de la plataforma ABPresclín creada para el análisis de prescripción antibiótica en el Servicio de Salud de las Islas Baleares.

OBJECTIVE: One of the fist lines of action of the National Plan against Antibiotic Resistance (PRAN) is to monitor the use of antibiotics as a fundamental basis for the fight against resistance. In order to know the antibiotic prescription habits, we pretended to describe the outpatient prescription of systemic antibiotics in the Balearic Islands through exploitation of ABPresclín database. METHODS: It was an ecological descriptive study of the electronic outpatient prescriptions of systemic antibiotics of the Health Service of the Balearic Islands from 2012 to 2018. Combining the prescription with population information data by year and geographical area, prescription rates were obtained per 1,000 person, distributed by professional, health centres, geographical areas: distribution per patient characteristics, type of antibiotics and associated diagnoses. RESULTS: 3,517,101 prescriptions are analyzed with an average prescription period (TPp) per 1,000 person-years of 472.1. A quarter of the population received at least one prescription of antibiotics. TPp was higher in over 80 years (899.0) and in women (553.4). 68.9% of the prescription was made in primary care (AP) and 17.9% in out-of-hours settings. TPp in AP was 333.1, varying from 192.3 to 527.0, according to basic health areas. The TPp of the most commonly used antibiotics was: amoxicillin/clavulanic (143), amoxicillin (95.9), azithromycin (54.5), fosfomycin (41.5) and ciprofloxacin (29.7). The main associated diagnoses were: lower respiratory infections (16.5%), urinary infections (15%), non-infectious (15%), tonsillitis (14.3%) and upper respiratory infections (13%). CONCLUSIONS: Balearic Islands have a relatively low antibiotic prescription rate with a marked variability between prescribers. Amoxicillin/clavulanic was the most prescribed antibiotic, with an increase in azithromycin. Respiratory infections were the main reason for prescription. ABPresclín is useful to promote better use of antibiotics.

OBJETIVO: Una de las líneas de actuación del Plan Nacional frente a la Resistencia a los Antibióticos (PRAN) es la vigilancia del uso de los antibióticos como pilar fundamental en la lucha frente a la resistencia. Con la finalidad de conocer los hábitos de prescripción de antibióticos, este trabajo pretendió describir la prescripción ambulatoria de antibióticos sistémicos en Baleares mediante la explotación de la base de datos ABPresclín. METODOS: Se elaboró un diseño descriptivo ecológico de la prescripción ambulatoria de antibióticos sistémicos en el Servicio de Salud de las Islas Baleares, entre 2012 y 2018. Se realizó un análisis descriptivo de la prescripción antibiótica que, si se refería a un denominador poblacional por año o periodo, permitía obtener tasas de prescripciones por cada 1.000 personas, distribuidas por profesional, por cupo o por áreas geográficas (zonas básicas de salud y áreas), o bien según las características del paciente, el tipo de antibióticos y los diagnósticos asociados. RESULTADOS: Se analizaron 3.517.101 prescripciones, con una tasa de prescripción del período (TPp) por cada 1.000 personas-año de 472,1. Una cuarta parte de la población recibió al menos una prescripción de antibióticos. La TPp fue mayor en >80 años (899) y en mujeres (553,4). El 68,9% de la prescripción se realizó en consulta de atención primaria (AP) y el 17,9% en urgencias extrahospitalarias. La TPp en AP fue de 333,1, variando entre 192,3 y 527, según las zonas básicas de salud. La TPp de los antibióticos más utilizados fue: amoxicilina/clavulánico, 143; amoxicilina, 95,9; azitromicina, 54,5; fosfomicina, 41,5; y ciprofloxacino, 29,7. Se asociaron principalmente los diagnósticos de infecciones respiratorias de vías bajas (16,5%), infecciones urinarias (15%), no infecciosos (15%), amigdalitis (14,3%) e infecciones respiratorias de vías altas (13%). CONCLUSIONES: Baleares presenta una tasa de prescripción de antibióticos relativamente baja, con una marcada variabilidad. Amoxicilina/clavulánico es el antibiótico más prescrito, con incremento de la azitromicina. Las infecciones respiratorias son el principal motivo de prescripción. ABPresclín resulta útil para promover un mejor uso de antibióticos.

Documento de consenso para el manejo de la esquistosomiasis en atención primaria / Consensus document for the management of schistosomiasis in Primary Care

La esquistosomiasis humana es la enfermedad parasitaria con mayor morbimortalidad a nivel mundial después de la malaria. Es endémica en más de 78 países tropicales y subtropicales, sobre todo de África Subsahariana, estimándose que 236 millones de personas están infectadas. Puede causar graves complicaciones de salud a nivel genitourinario y hepatoesplénico, llegando a ocasionar la muerte de 300.000 personas cada año. El número de casos importados en los países occidentales se ha ido incrementado en los últimos años debido a la llegada de un importante número de migrantes procedentes de regiones endémicas y de un creciente número de viajeros que han visitado las mismas. Por otro lado, recientemente se han comunicado brotes de transmisión autóctona en Córcega (Francia) y Almería (España). Por todos estos aspectos, las autoridades sanitarias europeas han recomendado el cribado serológico de la enfermedad en todas las personas migrantes procedentes de zonas endémicas y que lleven menos de 5 años en Europa. Dado que atención primaria es habitualmente el primer punto de contacto de estas personas con el sistema sanitario, los médicos deben conocer los principales aspectos de la enfermedad, y ser dotados de los medios necesarios para su diagnóstico y tratamiento. Este documento ha sido elaborado por profesionales pertenecientes a 5 sociedades científicas de atención primaria (SEMFyC, SEMG, SEMERGEN), Pediatría (SEIP) y Medicina Tropical y Salud Internacional (SEMTSI), con objeto de establecer unas recomendaciones claras para el diagnóstico y el manejo de la esquistosomiasis en atención primaria.(AU)

Human schistosomiasis is the parasitic disease with the highest morbidity and mortality worldwide after malaria. It is endemic in more than 78 tropical and subtropical countries, especially in sub-Saharan Africa, and it is estimated that 236 million people are infected. It can cause serious health complications at the genitourinary and hepatosplenic level, leading to the death of 300,000 people each year. The number of imported cases in Western countries has increased in recent years due to the arrival of a significant number of migrants from endemic regions and a growing number of travelers who have visited them. On the other hand, outbreaks of autochthonous transmission have recently been reported in Corsica (France) and Almería (Spain). For all these reasons, the European health authorities have recommended serological screening for the disease in all migrants from endemic areas who have been living in Europe for less than 5 years. Since Primary Care is usually the first point of contact for these people with the Health System, doctors must know the main aspects of the disease, and be provided with the necessary means for its diagnosis and treatment. This document has been prepared by professionals belonging to five scientific societies of Primary Care (SEMFyC, SEMG, SEMERGEN), Pediatrics (SEIP) and Tropical Medicine and International Health (SEMTSI), in order to establish clear recommendations for the diagnosis and management of schistosomiasis in Primary Care.(AU)

Infección por SARS-CoV2: dudas razonables y certezas en el manejo clínico por el médico de familia / SARS-CoV-2 infection: reasonable doubts and certainties in the clinical management by the family physician

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COVID-19 en España, ¿cómo hemos llegado hasta aquí? / COVID-19 in Spain, how did we get here?

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La infección por el virus Ébola. Podemos hacerlo mejor / Ebola virus infection. We can do better

No disponible

Evolución de la prescripción antibiótica ambulatoria entre 2012 y 2018. características de la plataforma abpresclín creada para el análisis de prescripción antibiótica en el servicio de salud de las Islas Baleares / Evolution of the outpatient antibiotic prescription between 2012 and 2018. Characteristics of the ABPresclín platform created for the analysis of antibiotic prescription in the health service of the Balearic Islands

OBJETIVO: Una de las líneas de actuación del Plan Nacional frente a la Resistencia a los Antibióticos (PRAN) es la vigilancia del uso de los antibióticos como pilar fundamental en la lucha frente a la resistencia. Con la finalidad de conocer los hábitos de prescripción de antibióticos, este trabajo pretendió describir la prescripción ambulatoria de antibióticos sistémicos en Baleares mediante la explotación de la base de datos ABPresclín. MÉTODOS: Se elaboró un diseño descriptivo ecológico de la prescripción ambulatoria de antibióticos sistémicos en el Servicio de Salud de las Islas Baleares, entre 2012 y 2018. Se realizó un análisis descriptivo de la prescripción antibiótica que, si se refería a un denominador poblacional por año o periodo, permitía obtener tasas de prescripciones por cada 1.000 personas, distribuidas por profesional, por cupo o por áreas geográficas (zonas básicas de salud y áreas), o bien según las características del paciente, el tipo de antibióticos y los diagnósticos asociados. RESULTADOS: Se analizaron 3.517.101 prescripciones, con una tasa de prescripción del período (TPp) por cada 1.000 personas-año de 472,1. Una cuarta parte de la población recibió al menos una prescripción de antibióticos. La TPp fue mayor en >80 años (899) y en mujeres (553,4). El 68,9% de la prescripción se realizó en consulta de atención primaria (AP) y el 17,9% en urgencias extrahospitalarias. La TPp en AP fue de 333,1, variando entre 192,3 y 527, según las zonas básicas de salud. La TPp de los antibióticos más utilizados fue: amoxicilina/clavulánico, 143; amoxicilina, 95,9; azitromicina, 54,5; fosfomicina, 41,5; y ciprofloxacino, 29,7. Se asociaron principalmente los diagnósticos de infecciones respiratorias de vías bajas (16,5%), infecciones urinarias (15%), no infecciosos (15%), amigdalitis (14,3%) e infecciones respiratorias de vías altas (13%). CONCLUSIONES: Baleares presenta una tasa de prescripción de antibióticos relativamente baja, con una marcada variabilidad. Amoxicilina/clavulánico es el antibiótico más prescrito, con incremento de la azitromicina. Las infecciones respiratorias son el principal motivo de prescripción. ABPresclín resulta útil para promover un mejor uso de antibióticos

OBJECTIVE: One of the fist lines of action of the National Plan against Antibiotic Resistance (PRAN) is to monitor the use of antibiotics as a fundamental basis for the fight against resistance. In order to know the antibiotic prescription habits, we pretended to describe the outpatient prescription of systemic antibiotics in the Balearic Islands through exploitation of ABPresclín database. METHODS: It was an ecological descriptive study of the electronic outpatient prescriptions of systemic antibiotics of the Health Service of the Balearic Islands from 2012 to 2018. Combining the prescription with population information data by year and geographical area, prescription rates were obtained per 1,000 person, distributed by professional, health centres, geographical areas: distribution per patient characteristics, type of antibiotics and associated diagnoses. RESULTS: 3,517,101 prescriptions are analyzed with an average prescription period (TPp) per 1,000 person-years of 472.1. A quarter of the population received at least one prescription of antibiotics. TPp was higher in over 80 years (899.0) and in women (553.4). 68.9% of the prescription was made in primary care (AP) and 17.9% in out-of-hours settings. TPp in AP was 333.1, varying from 192.3 to 527.0, according to basic health areas. The TPp of the most commonly used antibiotics was: amoxicillin/clavulanic (143), amoxicillin (95.9), azithromycin (54.5), fosfomycin (41.5) and ciprofloxacin (29.7). The main associated diagnoses were: lower respiratory infections (16.5%), urinary infections (15%), non-infectious (15%), tonsillitis (14.3%) and upper respiratory infections (13%). CONCLUSIONS: Balearic Islands have a relatively low antibiotic prescription rate with a marked variability between prescribers. Amoxicillin/clavulanic was the most prescribed antibiotic, with an increase in azithromycin. Respiratory infections were the main reason for prescription. ABPresclín is useful to promote better use of antibiotics