[Driving and health: the difficult balance between fitness assesment, risk prevention and quality of life. A compromise for driver medical assessment centers.] / Conducción de vehículos y estado de salud: el dificil equilibrio entre valoración de aptitudes, prevención del riesgo y calidad de vida. Un compromiso para los centros de reconocimiento de conductores.

Injuries associated with road crashes are one of the main causes of morbidity and mortality in our country. The causes are varied and involve the person driving, the vehicle and other external factors such as public roads and legislation. However most important injuries can be prevented. A useful tool for this purpose is the Psychological Medical Examination Protocol for Drivers' Health Assessment Centers, which has been updated by a working group coordinated by the General Directorate of Traffic and the General Directorate of Public Health with the participation of experts from the Spanish Society of Traffic Medicine and the collaboration of institutions related to road risk assessment. The new version of the protocol highlights both the assessment of road risk associated with health conditions, and as a novelty, the importance of road safety professional's advice to inform and train citizens on how to prevent risks based on their health situation or health condition. It highlights the need for the Drivers' Health Assessment Centers intervention to focus on prevention, being necessary to accompany psychophysical assessment with road safety advice that allows the driver to be aware of the road safety benefits of the prescribed measures. The objective of this article was to make known not only the psychological medical examination protocol, but also the approach that is given to the preventive intervention of road accidents from the health field.

Las lesiones asociadas a siniestros viales son una de las principales causas de morbimortalidad en nuestro país. Las causas son variadas e implican a la persona que conduce, al vehículo y a otros factores externos como las vías públicas y la legislación. Pero lo fundamental es que se pueden prevenir. Una herramienta de utilidad para ello es el Protocolo de exploración médico psicológica para centros de reconocimiento de conductores, el cual ha sido actualizado por un grupo de trabajo coordinado por la Dirección General de Tráfico y la Dirección General de Salud Pública, con la participación de personas expertas de la Sociedad Española de Medicina del Tráfico y la colaboración de instituciones relacionadas con la evaluación del riesgo vial. En él se destaca no solo la valoración del riesgo vial asociado a las condiciones de salud sino también, y como novedad, la importancia del consejo sanitario para informar y formar a la ciudadanía sobre cómo prevenir riesgos en función de su situación o condición de salud. Destaca la necesidad de que la intervención de los centros de reconocimiento de conductores se dirija hacia la prevención, siendo necesario acompañar la valoración psicofísica de un consejo sanitario vial que permita concienciar a la persona conductora acerca del beneficio para la salud vial de las medidas prescritas. El objetivo de este trabajo fue dar a conocer no solo el protocolo de exploración médico psicológica, sino el enfoque que se le da a la intervención preventiva de la siniestralidad vial desde el ámbito sanitario.

Conducción de vehículos y estado de salud: el dificil equilibrio entre valoración de aptitudes, prevención del riesgo y calidad de vida. Un compromiso para los centros de reconocimiento de conductores / Driving and health: the difficult balance between fitness assesment, risk prevention and quality of life. A compromise for driver medical assessment centers

Las lesiones asociadas a siniestros viales son una de las principales causas de morbimortalidad en nuestro país. Las causas sonvariadas e implican a la persona que conduce, al vehículo y a otros factores externos como las vías públicas y la legislación.Pero lo fundamental es que se pueden prevenir. Una herramienta de utilidad para ello es elProtocolo de exploración médico psicoló-gica para centros de reconocimiento de conductores, el cual ha sido actualizado por un grupo de trabajo coordinado por la DirecciónGeneral de Tráfico y la Dirección General de Salud Pública, con la participación de personas expertas de la Sociedad Española de Medi-cina del Tráfico y la colaboración de instituciones relacionadas con la evaluación del riesgo vial. En él se destaca no solo la valoracióndel riesgo vial asociado a las condiciones de salud sino también, y como novedad, la importancia del consejo sanitario para informary formar a la ciudadanía sobre cómo prevenir riesgos en función de su situación o condición de salud.Destaca la necesidad de que la intervención de los centros de reconocimiento de conductores se dirija hacia la prevención, siendonecesario acompañar la valoración psicofísica de un consejo sanitario vial que permita concienciar a la persona conductora acercadel beneficio para la salud vial de las medidas prescritas. El objetivo de este trabajo fue dar a conocer no solo el protocolo de explo-ración médico psicológica, sino el enfoque que se le da a la intervención preventiva de la siniestralidad vial desde el ámbito sanitario.(AU)

Injuries associated with road crashes are one of the main causes of morbidity and mortality in our country. The causes are varied andinvolve the person driving, the vehicle and other external factors such as public roads and legislation.However most important injuries can be prevented. A useful tool for this purpose is thePsychological Medical Examination Protocolfor Drivers’ Health Assessment Centers, which has been updated by a working group coordinated by the General Directorate of Trafficand the General Directorate of Public Health with the participation of experts from the Spanish Society of Traffic Medicine and thecollaboration of institutions related to road risk assessment. The new version of the protocol highlights both the assessment ofroad risk associated with health conditions, and as a novelty, the importance of road safety professional’s advice to inform and traincitizens on how to prevent risks based on their health situation or health condition.It highlights the need for the Drivers’ Health Assessment Centers intervention to focus on prevention, being necessary to accompanypsychophysical assessment with road safety advice that allows the driver to be aware of the road safety benefits of the prescribedmeasures. The objective of this article was to make known not only the psychological medical examination protocol, but also theapproach that is given to the preventive intervention of road accidents from the health field.(AU)

Documento internacional de consenso sobre apnea obstructiva del sueño / International Consensus Document on Obstructive Sleep Apnea

El objetivo principal de este documento internacional de consenso sobre apnea obstructiva del sueño es proporcionar unas directrices que permitan a los profesionales sanitarios tomar las mejores decisiones en la asistencia de los pacientes adultos con esta enfermedad según un resumen crítico de la literatura más actualizada. El grupo de trabajo de expertos se ha constituido principalmente por 17 sociedades científicas y 56 especialistas con amplia representación geográfica (con la participación de 4 sociedades internacionales), además de un metodólogo experto y un documentalista del Centro Cochrane Iberoamericano. El documento consta de un manuscrito principal, con las novedades más relevantes, y una serie de manuscritos online que recogen las búsquedas bibliográficas sistemáticas de cada uno de los apartados del documento internacional de consenso. Este documento no cubre la edad pediátrica ni el manejo del paciente en ventilación mecánica crónica no invasiva (que se publicarán en sendos documentos de consenso aparte). Palabras clave: Apnea obstructiva del sueño Diagnóstico Tratamiento

The main aim of this international consensus document on obstructive sleep apnea is to provide guidelines based on a critical analysis of the latest literature to help health professionals make the best decisions in the care of adult patients with this disease. The expert working group was formed primarily of 17 scientific societies and 56 specialists from a wide geographical area (including the participation of 4 international societies), an expert in methodology, and a documentalist from the Iberoamerican Cochrane Center. The document consists of a main section containing the most significant innovations and a series of online manuscripts that report the systematic literature searches performed for each section of the international consensus document. This document does not discuss pediatric patients or the management of patients receiving chronic non-invasive mechanical ventilation (these topics will be addressed in separate consensus documents). Keywords: Obstructive sleep apnea Diagnosis Treatment

International Consensus Document on Obstructive Sleep Apnea. / Documento internacional de consenso sobre apnea obstructiva del sueño.

The main aim of this international consensus document on obstructive sleep apnea is to provide guidelines based on a critical analysis of the latest literature to help health professionals make the best decisions in the care of adult patients with this disease. The expert working group was formed primarily of 17 scientific societies and 56 specialists from a wide geographical area (including the participation of 4 international societies), an expert in methodology, and a documentalist from the Iberoamerican Cochrane Center. The document consists of a main section containing the most significant innovations and a series of online manuscripts that report the systematic literature searches performed for each section of the international consensus document. This document does not discuss pediatric patients or the management of patients receiving chronic non-invasive mechanical ventilation (these topics will be addressed in separate consensus documents).

[Spanish medical and psycho-technical model within the context of the second directive (91/439/EEC). Results when conducted on a specific group of drivers (45-70 age range)]. / El modelo español de reconocimiento médico y psicotécnico en el contexto de la 2a Directiva (91/439/CEE). Resultados al ser aplicado sobre un grupo específico de conductores (45 a 70 años).

BACKGROUND: Directive 91/439/EEC marked the start of what the European Economic Community driver's license is going to be like at some time in the future. However, differences currently exist with regard to the driver license eligibility requirements and renewal periods. This study provides the results of the physical and psychotechnical exam conducted on 606 drivers of the following characteristics: both males and females, aged between 45-70, revising the group 1 (B) license, and with a renewal period of less than 5 years. METHODS: Five years later some of these qualified drivers were examined again in order to check changes with regard to previous exam results. Results show that 86.47% were qualified the same; 12.21% were qualified with some restriction and 1.65% was unqualified. RESULTS: By age groups, it was found that the older the applicants, the lower the percentage of those qualified and the higher the percentage of those qualified with some restriction (in the 45-49 age range, 93.19% are qualified, while the percentage qualified in the 65-69 age group is 67.35%). Within five years time, 11.13% of the qualified drivers had made some change in their status (9.98% qualified with some restriction, 1.15% unqualified), significant differences also having been found by age groups (in the 45-49 age group, 6.8% had change in status compared to 18.1% in the 65-69 age group). CONCLUSIONS: Therefore, differences can be said to exist between the different ages and the qualifications obtained to keep a driver's license, and a significant percentage of qualified drivers undergo some change in their eligibility within a minimum five-year period.

El modelo español de reconocimiento médico y psicotécnico en el contexto de la 2ª directiva (91/439/cee). Resultados al ser aplicado sobre un grupo específico de conductores (45 a 70 años) / The Spanish Medical and Psychotecnical Exam Model within the Context of Second Directive (91/439/EEC). Results when Conducted on a Specific Group of Drivers (45-70 Age Range)

Fundamento: Con la Directiva 91/439/CEE se inició lo que en un futuro será el permiso de conducir comunitario. Ahora bien, en el momento actual existen diferencias en cuanto a las condiciones de aptitud y a los periodos de prórroga del mismo. El presente estudio ofrece los resultados del reconocimiento médico y psicotécnico realizado a 606 conductores. Métodos: 606 conductores que reunían las siguientes características: edad entre 45 y 70 años, revisan el permiso del grupo 1 (B); hombres y mujeres; y finalmente, el periodo de prorroga es < 5 años. Posteriormente, se hace un seguimiento de los que, siendo aptos, regresan al centro y de esta manera podemos comprobar si existen modificaciones en cuanto al resultado del reconocimiento. Resultados: El 86,47 por ciento fueron aptos, un 12,21 por ciento aptos con restricción y un 1,65 por ciento no aptos. Por grupos de edad se apreció que a medida que avanza la edad disminuye el porcentaje de aptos y aumenta el de aptos con restricción (de 45-49 años hay un 93,19 por ciento de aptos, mientras que en el grupo de 65-69 se sitúa en un 67,35 por ciento). A los 5 años, un 11,13 por ciento de los conductores aptos habían modificado su condición (9,98 por ciento aptos con restricción; 1,15 por ciento no aptos), apreciándose que por grupos de edad también existen diferencias significativas (en el grupo de 45-49 años modifican su condición un 6,8 por ciento, mientras que en el de 65-69 lo hace un 18,1 por ciento). Conclusiones: De esta manera, podemos decir que existen diferencias entre las distintas edades y las condiciones de aptitud para la conducción, y también que un porcentaje significativo de conductores aptos modifica su condición de aptitud transcurridos al menos 5 años (AU)

Background: Directive 91/439/EEC marked the start of what the European Economic Community driver's license is going to be like at some time in the future. However, differences currently exist with regard to the driver license eligibility requirements and renewal periods. This study provides the results of the physical and psychotechnical exam conducted on 606 drivers of the following characteristics: both males and females, aged between 45-70, revising the group 1 (B) license, and with a renewal period of less than 5 years. Methods: Five years later some of these qualified drivers were examined again in order to check changes with regard to previous exam results. Results show that 86.47% were qualified the same; 12.21% were qualified with some restriction and 1.65% was unqualified. Results: By age groups, it was found that the older the applicants, the lower the percentage of those qualified and the higher the percentage of those qualified with some restriction (in the 45-49 age range, 93.19% are qualified, while the percentage qualified in the 65-69 age group is 67.35%). Within five years time, 11.13% of the qualified drivers had made some change in their status (9.98% qualified with some restriction, 1.15% unqualified), significant differences also having been found by age groups (in the 45-49 age group, 6.8% had change in status compared to 18.1% in the 65-69 age group). Conclusions: Therefore, differences can be said to exist between the different ages and the qualifications obtained to keep a driver´s license, and a significant percentage of qualified drivers undergo some change in their eligibility within a minimum five-year period (AU)