Prevalencia de esteatosis hepática no alcohólica en una ciudad española: estudio poblacional / Prevalence of nonalcoholic fatty liver disease in a Spanish town: A population-based study

Objetivo La esteatosis hepática no alcohólica (EHNA) es la causa más importante de esteatosis hepática e hipertransaminasemia en los países occidentales. El objetivo consistía en determinar la prevalencia de EHNA entre 261025 personas del área de salud pública de Valladolid Este en España. Métodos Se seleccionó al azar a 1800 participantes a partir de una base de datos de tarjetas del sistema sanitario público, que fueron representativos de la mayor parte de la población. En todos los pacientes se realizó una historia clínica, medición de parámetros antropométricos, ecografía abdominal y análisis de sangre para descartar hepatopatía. También se calculó la puntuación FLI en todos los casos. Resultados Cuatrocientos cuarenta y ocho participantes aceptaron participar en el estudio. La prevalencia de EHNA en nuestro estudio fue del 22,3% (18,5-26,2%). La prevalencia fue máxima entre los 50 y los 70 años, y se incrementó con la edad (p <0,006). No hubo diferencias significativas en cuanto al sexo (p=0,338). La mediana del índice de masa corporal fue de 27,2 y la EHNA se relacionó con el peso (p <0,001) y el perímetro abdominal (p <0,001). El análisis de regresión logística reveló que una γ-GT inferior a 26 UI/ml, un índice de masa corporal superior a 31 y una puntuación HOMA-IR superior a 2,54 fueron factores predictivos independientes de EHNA en la muestra. El diagnóstico de EHNA se correspondió con una puntuación FLI elevada en el 88% de los casos. Conclusiones De acuerdo con otros estudios epidemiológicos, la prevalencia de EHNA es muy alta. Un estudio completo con consulta clínica, estudios de imagen y análisis de sangre en todos los pacientes permite determinar la prevalencia de EHNA en la población (AU)

Objective Nonalcoholic fatty liver disease (NAFLD) is western countries’ most important cause of hepatic steatosis and hypertransaminasemia. The objective was to evaluate the prevalence of NAFLD among 261,025 people in the East Valladolid public healthcare area in Spain. Methods We randomly selected 1800 participants from a public healthcare system card database, representing most of the population. We performed a medical record, measurement of anthropometric parameters, abdominal ultrasound, and blood tests to rule out hepatic disease in all patients. We calculated the FLI score in all patients. Results Four hundred and forty-eight participants agreed to participate in the study. The prevalence of nonalcoholic fatty liver disease in our study was 22.3% [18.5–26.2%]. Prevalence was highest between 50 and 70 years, increasing with age (p < 0.006). There were no significant differences in sex (p = 0.338). The median body mass index was 27.2, and NAFLD was related to the weight (p < 0.001) and abdominal perimeter (p < 0.001). Logistic regression analysis showed GGT lower than 26UI/ml, body mass index higher than 31, and HOMA IR greater than 2.54 as independent factors to predict NAFLD in the sample. NAFLD diagnosis matched with an elevated FLI score in 88% of cases. Conclusion According to other epidemiological studies, NAFLD's prevalence is very high. A complete study with a clinical consultation, image studies, and blood tests in all patients allows us to assess the prevalence of NAFLD in the population (AU)

Prevalence of nonalcoholic fatty liver disease in a Spanish town: a population-based study.

OBJECTIVE: Nonalcoholic fatty liver disease (NAFLD) is western countries' most important cause of hepatic steatosis and hypertransaminasemia. The objective was to evaluate the prevalence of NAFLD among 261,025 people in the East Valladolid public healthcare area in Spain. METHODS: We randomly selected 1800 participants from a public healthcare system card database, representing most of the population. We performed a medical record, measurement of anthropometric parameters, abdominal ultrasound, and blood tests to rule out hepatic disease in all patients. We calculated the FLI score in all patients. RESULTS: 448 participants agreed to participate in the study. The prevalence of nonalcoholic fatty liver disease in our study was 22.3% [18.5%-26.2%]. Prevalence was highest between 50 and 70 years, increasing with age (p < 0.006). There were no significant differences in sex (p = 0.338). The median Body mass index was 27.2, and NAFLD was related to the weight (p < 0,001) and abdominal perimeter (p < 0.001). Logistic regression analysis showed GGT lower than 26 UI/ml, body mass index higher than 31, and HOMA IR greater than 2.54 as independent factors to predict NAFLD in the sample. NAFLD diagnosis matched with an elevated FLI score in 88% of cases. CONCLUSION: According to other epidemiological studies, NAFLD's prevalence is very high. A complete study with a clinical consultation, image studies, and blood tests in all patients allows us to assess the prevalence of NAFLD in the population.

Influence of epidemiological and clinical factors in the reactogenicity to Comirnaty® vaccine in health care workers of a Spanish university teaching hospital (COVIVAC study).

OBJECTIVE: Comirnaty® is an mRNA vaccine against COVID-19 which has been administered to millions of people since the end of 2020. Our aim was to study epidemiological and clinical factors influencing reactogenicity and functional limitation after the first two doses of the vaccine in health care workers (HCWs). METHODS: Prospective post-authorization cohort study to monitor safety and effectiveness of the vaccine. RESULTS: Local side effects were mild and presented both with first and second dose of Comirnaty. Systemic side effects were more frequent after 2nd dose. Nevertheless, previous SARS-CoV-2 infection was associated with systemic effects after the first dose of the vaccine (OR ranging from 2 to 6). No severe adverse effects were reported. According to multivariate analysis, the degree of self-reported functional limitation after the first dose increased with age, female sex, previous COVID-19 contact, previous SARS-CoV-2 infection, and Charlson Comorbidity Index (CCI). After the second dose, the degree of functional limitation observed was lower in those with previous SARS-CoV-2 infection, and it was positively associated to the degree of functional limitation after the first dose. CONCLUSIONS: Systemic adverse effects were more frequent after the second dose of Comirnaty. Previous SARS-CoV-2 infection was associated with systemic effects after the first dose. Age, female sex, previous COVID-19, previous isolation due to COVID-19 contact, and CCI showed to be independent predictors of the degree of functional limitation after the 1st dose of Comirnaty®. After the 2nd dose, the degree of functional limitation was lower in those who previously had SARS-CoV-2 infection.

[Choice of influenza vaccine in people over 65 years old. Analysis of reports from international vaccination advisory committees]. / Elección de vacuna antigripal en personas mayores de 65 años. Análisis de informes de comités asesores de vacunación internacionales.

OBJECTIVE: Annual recommendations on influenza vaccine use in different countries are developed by influenza-specific working groups within their Immunization Advisory Committees. Adults aged 65 years and over are included in the groups for which vaccination against influenza is particularly recommended due to the morbidity associated. A variety of influenza vaccines are available, some of which boosted immunity, are licensed for use only in this specific age group, where the immune response to traditional influenza vaccines may be suboptimal. We analyze the main annual recommendations on the use of the influenza vaccine issued by advisory committees on immunization for the population over 65 years of age. METHODS: The latest influenza vaccination guidelines have been selected and the recommendations for people over 65 years of age published by the main vaccination advisory committees have been reviewed. RESULTS: The UK Advisory Committee (JCVI) recommends the use of Quadruvalent Inactivated Influenza Vaccine with Adjuvant (aQIV) or High Dose Quadrivalent Inactivated Influenza Vaccine (QIV-HD). The US committee (ACIP) does not express a preference for any type of vaccine. The Australian committee (ATAGI) preferably recommends adjuvanted influenza vaccine. The advisory committees of Canada and Germany (NACI, STIKO) and the European Center for Disease Control (Ecdc) recommend using any of the age-appropriate flu vaccines available, although they bet on the The UK Advisory Committee (JCVI) recommends the use of Quadruvalent Inactivated Influenza Vaccine with Adjuvant (aQIV) or High Dose Quadrivalent Inactivated Influenza Vaccine (QIV-HD). The US committee (ACIP) does not express a preference for any type of vaccine. The Australian committee (ATAGI) preferably recommends adjuvanted influenza vaccine. The advisory committees of Canada and Germany (NACI, STIKO) and the European Center for Disease Control (Ecdc) recommend using any of the age-appropriate flu vaccines available, although they bet on the use of inactivated quadrivalent flu vaccine high dose at the individual level for those over 65 years.use of inactivated quadrivalent flu vaccine high dose at the individual level for those over 65 years. CONCLUSIONS: It is necessary further studies and improvement in their quality that analyze the different vaccines available and their comparability, although the use of reinforced immunity vaccines is generally recommended in the population over 65 years of age.

Resurgir del sarampión: una llamada a la prevención / The resurgence of measles: a call to prevention

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Vacunación antigripal y protección del paciente crítico: responsabilidad de los profesionales sanitarios / Influenza vaccination and critical patient protection: responsibility of healthcare workers

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Epidemiología de la hospitalización por neumonía / The epidemiology of hospital admissions due to pneumonia

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Impacto de la carga de hospitalización por neumonía / Impact of the burden of hospitalisation for pneumonia

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[Economic and Health impact of influenza vaccination with adjuvant MF59 in population over 64 years in Spain]. / Impacto económico y sanitario de la utilización de vacuna antigripal adyuvada con MF59 en población mayor de 65 años en España.

OBJECTIVE: Influenza is an important health problem due to the mortality it can cause directly or indirectly as well as the complications and the economic and social costs it produces. Influenza epidemics are being addressed through vaccination campaigns aimed at preventing cases and complications, and the vaccine is officially recommended, as in the case of Spain, for certain risk groups, such as older people, chronic diseases and institutionalized population. The adjuvanted influenza vaccine with MF59, indicated for population over 65 years, has been shown to be more immunogenic than conventional influenza vaccines. The objective of this study is to assess the impact on the national and regional budget of the seasonal vaccination campaigns carried out in Spain using the MF59 adjuvanted vaccine compared to a conventional vaccine in a population older than 65 years. METHODS: We analyzed the budgetary impact of the use of the MF59-adjuvanted vaccine in the national territory and by Autonomous Communities through a modeling of two alternatives, conventional vaccination versus adjuvant vaccination with MF59 in a population older than 65 years. The cases of avoided influenza, avoided complications and avoided costs, as well as the economic impact of the vaccination program have been calculated. RESULTS: With the available information, the budgetary impact of using the influenza vaccine with MF59 in all the over 65 years, amounts to 6,967,288.10 €, avoiding for the national set a cost of 89.5 million Euros, which represents a potential savings of 82 million Euros and a cost-benefit ratio of 12.83. CONCLUSIONS: The use of the influenza vaccine with the MF59 adjuvant to all those over 65 years would mean an increase in the efficiency of the vaccination programs currently proposed in all the Autonomous Communities and in the Spanish state.

The rapid test in Spanish pharmacies: a novel programme to reach heterosexual men?

OBJECTIVES: Spain has been a pioneer in the implementation of rapid HIV testing programmes in pharmacies to increase access to testing. However, no formal evaluation of the effectiveness of these programmes has been carried out to date. Our aim was to evaluate the ability of a novel in-pharmacy rapid HIV testing programme to promote diagnosis and reach vulnerable populations. METHODS: Between 2011 and 2012, 2168 people underwent testing in 16 urban pharmacies in 10 cities of a Spanish region with a low prevalence of HIV infection. The main outcomes of the programme were compared with those of the regional surveillance system for new HIV diagnoses (RHSS-CyL). RESULTS: Overall, 52.8% of those tested were heterosexual men, 15.8% were men who have sex with men (MSM) and 25.3% were women. Nine per cent were immigrants and 41.9% were < 30 years old. In total, 59.5% of the heterosexual men, 44.6% of the MSM and 65.3% of the women were previously untested. There were 23 positive results, representing 6% of all new regional diagnoses in 2011. The global prevalence was 1.1% (95% confidence interval 0.6-1.5%) and the prevalence in MSM was 3.8%. Of the reactive results, 60.9% were in MSM, 34.8% in heterosexual men and only 4.3% in women, vs. 35.4%, 37.5% and 15.0%, respectively, reported by the RHSS-CyL. The mean age of those testing positive was 32.7 years vs. 38.7 years in the RHSS-CyL. Fifty per cent of MSM and 75% of heterosexual men testing positive were previously untested. CONCLUSIONS: In Spain, this is the first programme not targeted at the most at-risk populations, and has been shown to be effective in reaching and diagnosing heterosexual men, who are the group most affected by delayed diagnoses. Heterosexual men accounted for over half of those tested and a third of those diagnosed, and most of them were previously untested. Young and previously untested MSM also greatly benefitted from the programme.