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Cir Esp (Engl Ed) ; 100(4): 193-201, 2022 Apr.
Article in English | MEDLINE | ID: mdl-35491323


Surgical units attending sarcomas in Spain are poor studied. The aim is to know the management of this pathology to identify areas of improvement through multicenter study based on a voluntary survey. The survey was completed by 74 surgeons of different hospitals, which 32,4% is exclusively dedicated to sarcomas. Only 24.3% declared to receive specific training in sarcomas. The most frequent type of hospital was the third level (56.8%), where 38,1% of the surgeons belong to societies or working-groups in sarcoma fields vs. 9,4% in first-second levels. The number of surgeons with specific theoretical training and papers published in this field are higher in third level hospitals. 55,4% belonged to a multidisciplinary unit. A multidisciplinary team was available in 57% of third level hospital vs 28% in others. Most services in charge of this patients are characterized by deficient specialization, low workload and the absence of a multidisciplinary team.

Sarcoma , Soft Tissue Neoplasms , Hospitals , Humans , Sarcoma/epidemiology , Sarcoma/pathology , Sarcoma/therapy , Spain/epidemiology , Surveys and Questionnaires
Cardiovasc Diabetol ; 21(1): 65, 2022 May 03.
Article in English | MEDLINE | ID: mdl-35505344


BACKGROUND: We examined trends in incidence (2001-2019), clinical characteristics, and in-hospital outcomes following major and minor lower extremity amputations (LEAs) among type 1 diabetes mellitus (T1DM) patients in Spain and attempted to identify sex differences. METHODS: Retrospective cohort study using data from the Spanish National Hospital Discharge Database. We estimated the incidence of the LEA procedure stratified by type of LEA. Joinpoint regression was used to estimate incidence trends, and logistic regression was used to estimate factors associated with in-hospital mortality (IHM). RESULTS: LEA was coded in 6011 patients with T1DM (66.4% minor and 33.6% major). The incidence of minor LEA decreased by 9.55% per year from 2001 to 2009 and then increased by 1.50% per year, although not significantly, through 2019. The incidence of major LEA decreased by 13.39% per year from 2001 to 2010 and then remained stable through 2019. However, incidence increased in men (26.53% per year), although not significantly, from 2017 to 2019. The adjusted incidence of minor and major LEA was higher in men than in women (IRR 3.01 [95% CI 2.64-3.36] and IRR 1.85 [95% CI 1.31-2.38], respectively). Over the entire period, for those who underwent a minor LEA, the IHM was 1.58% (2.28% for females and 1.36% for males; p = 0.045) and for a major LEA the IHM was 8.57% (10.52% for females and 7.59% for males; p = 0.025). IHM after minor and major LEA increased with age and the presence of comorbid conditions such as peripheral arterial disease, ischemic heart disease or chronic kidney disease. Female sex was associated with a higher IHM after major LEA (OR 1.37 [95% CI 1.01-1.84]). CONCLUSIONS: Our data show a decrease in incidence rates for minor and major LEA in men and women with T1DM and a slight, albeit insignificant, increase in major LEA in men with T1DM in the last two years of the study. The incidence of minor and major LEA was higher in men than in women. Female sex is a predictor of IHM in patients with T1DM following major LEA.

Diabetes Mellitus, Type 1 , Diabetes Mellitus, Type 2 , Amputation/adverse effects , Diabetes Mellitus, Type 1/diagnosis , Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 1/surgery , Diabetes Mellitus, Type 2/epidemiology , Female , Hospital Mortality , Humans , Incidence , Lower Extremity/surgery , Male , Retrospective Studies , Sex Characteristics , Spain/epidemiology
Ann Med ; 54(1): 1255-1264, 2022 Dec.
Article in English | MEDLINE | ID: mdl-35499519


BACKGROUND: Heterogeneity in the treatment of a disease is a marker of suboptimal quality of care. The aim of this study is to evaluate the heterogeneity in the treatment used and the outcomes for Crohn's disease (CD) in Catalonia. METHODS: All patients with CD included in the Catalan Health Surveillance System (data on more than seven million individuals from 2011 to 2017) were identified. The different Catalonian health areas were grouped into 19 district groups (DG). Treatments used rates (systemic corticosteroids, non-biological and biological immunosuppressant) and outcomes rates (hospitalization and surgery) were calculated. RESULTS: The use of systemic corticosteroids presented a decreasing trend over the study period, with an average rate of use in the different territories between 11% and 17%. The use of non-biological immunosuppressant treatment has remained stable, with an average rate of use ranging from 22% to 40% per year depending on the DG. The use of biological immunosuppressant treatment increased with an average rate of use in the different territories ranging from 10 to 23%.Hospitalizations for any reason showed an increasing trend between 2011 and 2017 with an average rate of between 23% and 32% per year depending on the area. Hospitalizations for CD presented a decreasing trend, with an average rate of between 5% and 11% per year. Surgical treatment remained stable over time, rates per year were between 0.5% and 2%. CONCLUSION: A remarkable geographical heterogeneity in the use of different treatments and in outcomes of CD was observed between different geographical areas of Catalonia. KEY MESSAGEThere is a notable geographical heterogeneity in the administration of biological and immunosuppressive treatments to Crohn's disease patients in Catalonia.There is also a geographical heterogeneity in their rates of hospitalization and surgical intervention.

Crohn Disease , Adrenal Cortex Hormones/therapeutic use , Crohn Disease/drug therapy , Crohn Disease/epidemiology , Humans , Immunosuppressive Agents/therapeutic use , Spain/epidemiology , Treatment Outcome
Rev Esp Salud Publica ; 962022 May 04.
Article in Spanish | MEDLINE | ID: mdl-35506485


OBJECTIVE: The aim of this paper was to estimate the SARS-CoV-2 infection incidence regarding the occupation in Catalonia, globally and in the different waves of the pandemic. METHODS: We performed a retrospective cohort study. We included all people between 16 and 65 years old with an occupation identified from the sick leave recorded in the primary care electronic health records of the Institut Català de la Salut (ICS) (total n=2,199,745 people). The study period was from March 1st, 2020 to September 16th, 2021. RESULTS: Healthcare workers had the highest incidence, with an age and sex adjusted cumulative rate of 27.7% [95% CI: 27.3%-28.1%]: 29.4% in nursing assistants, 27.3% in medical professions and 26.3% in nursing professionals; followed by the elementary occupations group with an adjusted incidence of 16.9% [95% CI: 16.7%-17%], such as the agricultural laborers (23% [95% CI: 21%-25.1%]) and rural occupations (19.1% [95% CI: 18.3%-19.8%) -especially during the 2020 summer period-, the domestic employees (20.5% [95% CI: 18.9%-22.2%]) and cleaning professionals (17.5% [95% CI: 17.2%-17.9%]). CONCLUSIONS: Healthcare workers are the hardest hit during the pandemic. On the other hand, the less qualified professions have high incidences, highlighting the different inequities in access to telework, working conditions and other social determinants of health.

OBJETIVO: El objetivo de este estudio fue estimar la incidencia de la infección por SARS-CoV-2 según la ocupación en Cataluña, tanto de forma global como en distintos periodos de la pandemia de COVID-19. METODOS: Se realizó un estudio retrospectivo de una cohorte. Se incluyeron todas las personas entre 16 y 65 años con una ocupación identificada a partir de las bajas laborales registradas en la historia clínica informatizada de Atención Primaria del Institut Català de la Salut (ICS) (N total=2.199.745 personas). El periodo de estudio fue del 1 de marzo de 2020 al 16 de septiembre de 2021. RESULTADOS: Las ocupaciones sanitarias fueron las que más incidencia tuvieron, con una tasa acumulada ajustada por edad y sexo del 27,7% [IC 95%: 27,3%-28,1%]: un 29,4% en auxiliares de enfermería, un 27,3% en profesionales de medicina y un 26,3% en profesionales de enfermería. Éstas fueron seguidas por el grupo de ocupaciones elementales con una incidencia ajustada de un 16,9% [IC 95%: 16,7 -17%], destacando en este grupo los peones agropecuarios (23% [IC 95%: 21%-25,1%]) y agrícolas (19,1% [IC 95%: 18,3%-19,8%]) ­especialmente en el periodo del verano de 2020­, los empleados domésticos (20,5% [IC 95%: 18,9%-22,2%) y los profesionales de limpieza (17,5% [IC 95%: 17,2%-17,9%]). CONCLUSIONES: Las ocupaciones sanitarias son las más afectadas durante la pandemia. Por otro lado, las ocupaciones menos cualificadas presentan también incidencias elevadas, poniendo de manifiesto las distintas inequidades en el acceso al teletrabajo, en las condiciones laborales y en otros determinantes sociales de la salud.

COVID-19 , Adolescent , Adult , Aged , COVID-19/epidemiology , Humans , Middle Aged , Occupations , Retrospective Studies , SARS-CoV-2 , Spain/epidemiology , Young Adult
PLoS One ; 17(4): e0266658, 2022.
Article in English | MEDLINE | ID: mdl-35443000


AIMS: A Markov model was adapted to assess the real-world cost-effectiveness of rivaroxaban, dabigatran and apixaban. Each of these non-vitamin K antagonist oral anticoagulants was compared with vitamin K antagonist for stroke prevention in patients with non-valvular atrial fibrillation in Spain. METHODS: All inputs were derived from real-world studies: baseline patient characteristics, clinical event rates, as well as persistence rates for the vitamin K antagonist treatment option. A meta-analysis of real-world studies provided treatment effect and persistence data for rivaroxaban, dabigatran and apixaban, each compared with vitamin K antagonist therapy. The model considered 3-month cycles over a lifetime horizon. The model outcomes included different costs, quality-adjusted life years and life-years gained. Sensitivity analyses were performed to test the robustness of the model. RESULTS: When compared with vitamin K antagonist, rivaroxaban incurred incremental costs of €77 and resulted in incremental quality-adjusted life years of 0.08. The incremental cost per quality-adjusted life year was €952. For the same comparison, the incremental cost per quality-adjusted life year for dabigatran was €4,612. Finally, compared with vitamin K antagonist, the incremental cost per quality-adjusted life year for apixaban was €32,015. The sensitivity analyses confirmed the robustness of the base case results. The probabilities to be cost-effective versus vitamin K antagonist were 94%, 86% and 35%, respectively, for rivaroxaban, dabigatran and apixaban, considering a willingness-to-pay threshold of €22,000 per quality-adjusted life year gained, based on a cost-effectiveness study of the Spanish National Health System. CONCLUSION: These results suggest that rivaroxaban and dabigatran are cost-effective versus vitamin K antagonist for stroke prevention in non-valvular atrial fibrillation, from the Spanish National Health System perspective.

Atrial Fibrillation , Stroke , Administration, Oral , Anticoagulants , Atrial Fibrillation/complications , Atrial Fibrillation/drug therapy , Cost-Benefit Analysis , Dabigatran/therapeutic use , Humans , Pyridones , Rivaroxaban/therapeutic use , Spain/epidemiology , Stroke/drug therapy , Vitamin K
Prev Vet Med ; 202: 105637, 2022 May.
Article in English | MEDLINE | ID: mdl-35378433


Paratuberculosis is a worldwide, chronic infectious disease caused by Mycobacterium avium subsp. paratuberculosis (MAP) that mainly affects ruminant species. This disease has a significant economic impact on small ruminant production due to the costs of implementing control measures and production losses. A cross-sectional study was carried out to determine the seroprevalence, spatial distribution and risk factors associated with MAP exposure in sheep and goats in Andalusia (southern Spain). Serum samples from 4134 small ruminants (2266 sheep and 1868 goats) in 153 flocks were tested by an in-house ELISA for antibodies against MAP using paratuberculosis protoplasmic antigen 3 (PPA3) as coating antigen. Antibodies against MAP were detected in 8.1% (183/2266; 95% CI: 7.0-9.2%) of sheep and 20.0% (374/1868; 95% CI: 18.2-21.8%) of goats. The true individual seroprevalence was 8.4% (95% CI: 6.9-10.1%) in sheep and 25.2% (95% CI: 22.7-27.8%) in goats. Seropositivity was detected in 66.3% (55/83; 95% CI: 56.1-76.4%) of sheep herds and 90.0% (63/70; 95% CI: 83.0-97.0%) of goat herds. Spatial analysis identified three statistically significant clusters (p < 0.05) associated with areas with higher seroprevalence of MAP. The main risk factors potentially associated with MAP exposure were: species (goat) and absence of perimeter livestock fencing. The results of this study show that MAP is widespread in small ruminant populations in southern Spain and suggest that goats may play a more important role than sheep in the transmission and maintenance of MAP. Because of animal health concerns and the economic consequences of paratuberculosis, appropriate surveillance and control programs are required to reduce the risk of MAP infections in small ruminant flocks in this country.

Goat Diseases/epidemiology , Mycobacterium avium subsp. paratuberculosis , Paratuberculosis , Ruminants/parasitology , Sheep Diseases/epidemiology , Animals , Cross-Sectional Studies , Goat Diseases/microbiology , Goats , Paratuberculosis/microbiology , Seroepidemiologic Studies , Sheep , Sheep Diseases/microbiology , Spain/epidemiology
BMJ Open Ophthalmol ; 7(1): e000974, 2022.
Article in English | MEDLINE | ID: mdl-35415265


Objective: The aim of present study was to evaluate our clinical decision support system (CDSS) for predicting risk of diabetic retinopathy (DR). We selected randomly a real population of patients with type 2 diabetes (T2DM) who were attending our screening programme. Methods and analysis: The sample size was 602 patients with T2DM randomly selected from those who attended the DR screening programme. The algorithm developed uses nine risk factors: current age, sex, body mass index (BMI), duration and treatment of diabetes mellitus (DM), arterial hypertension, Glicated hemoglobine (HbA1c), urine-albumin ratio and glomerular filtration. Results: The mean current age of 67.03±10.91, and 272 were male (53.2%), and DM duration was 10.12±6.4 years, 222 had DR (35.8%). The CDSS was employed for 1 year. The prediction algorithm that the CDSS uses included nine risk factors: current age, sex, BMI, DM duration and treatment, arterial hypertension, HbA1c, urine-albumin ratio and glomerular filtration. The area under the curve (AUC) for predicting the presence of any DR achieved a value of 0.9884, the sensitivity of 98.21%, specificity of 99.21%, positive predictive value of 98.65%, negative predictive value of 98.95%, α error of 0.0079 and ß error of 0.0179. Conclusion: Our CDSS for predicting DR was successful when applied to a real population.

Decision Support Systems, Clinical , Diabetes Mellitus, Type 2 , Diabetic Retinopathy , Hypertension , Albumins , Diabetes Mellitus, Type 2/complications , Diabetic Retinopathy/diagnosis , Female , Glycated Hemoglobin A , Humans , Hypertension/diagnosis , Male , Risk Factors , Spain/epidemiology
Vet Microbiol ; 268: 109422, 2022 May.
Article in English | MEDLINE | ID: mdl-35421829


Coxiella burnetii is an obligate intracellular zoonotic bacterium widespread in nature that causes Q fever in animals and humans. The most common sources of human infection are domestic ruminants, but wildlife can also act as reservoir. Here, spleen samples from 652 wild ungulates and 218 wild birds collected in 2011-2019 in the Basque Country (northern Spain) were analysed by real-time PCR (IS1111 gene) and the results compared with data from a past study in 2001-2006. Among wild ungulates, C. burnetii DNA was detected in 7.0% (6/86) of roe deer (Capreolus capreolus), 1.9% (9/484) of wild boar (Sus scrofa) and 2.4% (2/82) of red deer (Cervus elaphus). The prevalence in roe deer was significantly higher compared to wild boar (p = 0.006). Among wild birds, only one white stork (Ciconia ciconia) tested positive. SNP-typing of C. burnetii-positive samples showed that wild ungulates shared SNP 2, SNP 6 and SNP 8 genotypes with domestic ruminants of the region. However, the white stork harboured a C. burnetii genotype (SNP 3) never identified in the studied area before. Comparing these results with those obtained in the same area a decade before (2001-2006), no significant differences were observed in the prevalence of C. burnetii in any of the wildlife species, indicating stability in C. burnetii prevalence. Nevertheless, continuous surveillance is needed to monitor any future changes in the reservoir role of roe deer and wild boar considering the increase in density of both species observed in Europe in the last decades.

Coxiella burnetii , Deer , Q Fever , Animals , Animals, Wild/microbiology , Birds , Coxiella burnetii/genetics , Deer/microbiology , Prevalence , Q Fever/epidemiology , Q Fever/microbiology , Q Fever/veterinary , Ruminants , Spain/epidemiology
BMJ Open ; 12(4): e056637, 2022 Apr 21.
Article in English | MEDLINE | ID: mdl-35450905


OBJECTIVES: Patients with cancer are at higher risk for severe COVID-19 infection. COVID-19 surveillance of workers in oncological centres is crucial to assess infection burden and prevent transmission. We estimate the SARS-CoV-2 seroprevalence among healthcare workers (HCWs) of a comprehensive cancer centre in Catalonia, Spain, and analyse its association with sociodemographic characteristics, exposure factors and behaviours. DESIGN: Cross-sectional study (21 May 2020-26 June 2020). SETTING: A comprehensive cancer centre (Institut Català d'Oncologia) in Catalonia, Spain. PARTICIPANTS: All HCWs (N=1969) were invited to complete an online self-administered epidemiological survey and provide a blood sample for SARS-CoV-2 antibodies detection. PRIMARY OUTCOME MEASURE: Prevalence (%) and 95% CIs of seropositivity together with adjusted prevalence ratios (aPR) and 95% CI were estimated. RESULTS: A total of 1266 HCWs filled the survey (participation rate: 64.0%) and 1238 underwent serological testing (97.8%). The median age was 43.7 years (p25-p75: 34.8-51.0 years), 76.0% were female, 52.0% were nursing or medical staff and 79.0% worked on-site during the pandemic period. SARS-CoV-2 seroprevalence was 8.9% (95% CI 7.44% to 10.63%), with no differences by age and sex. No significant differences in terms of seroprevalence were observed between onsite workers and teleworkers. Seropositivity was associated with living with a person with COVID-19 (aPR 3.86, 95% CI 2.49 to 5.98). Among on-site workers, seropositive participants were twofold more likely to be nursing or medical staff. Nursing and medical staff working in a COVID-19 area showed a higher seroprevalence than other staff (aPR 2.45, 95% CI 1.08 to 5.52). CONCLUSIONS: At the end of the first wave of the pandemic in Spain, SARS-CoV-2 seroprevalence among Institut Català d'Oncologia HCW was lower than the reported in other Spanish hospitals. The main risk factors were sharing household with infected people and contact with COVID-19 patients and colleagues. Strengthening preventive measures and health education among HCW is fundamental.

COVID-19 , Neoplasms , Adult , Antibodies, Viral , COVID-19/epidemiology , Cross-Sectional Studies , Female , Health Personnel , Humans , Male , Neoplasms/epidemiology , SARS-CoV-2 , Seroepidemiologic Studies , Spain/epidemiology
J Glob Health ; 12: 05001, 2022.
Article in English | MEDLINE | ID: mdl-35392585


Background: A previously published meta-analysis found that about one-third of the general population experienced some mental health problem during the early phase of the COVID-19 pandemic, potentially leading to a late mental health crisis. We aimed to describe the acute, short-term, and long-term effects of the COVID-19 pandemic on mental health. Methods: A one-year online survey (S) was conducted in Spain (April 2020 - March 2021). We recruited 18 180 subjects using a virtual respondent-driven snowball sampling method (S1 April 2020, n = 6108; S2 October-November 2020, n = 6418; S3 March 2021, n = 5654). Participants completed the Spanish Depression, Anxiety, and Stress Scale (DASS-21). Results: Overall, our results suggest a progressive increase in the prevalence of anxiety and stress throughout the pandemic waves and relative stability of depression. Women had a greater probability of having depression, anxiety, or stress than men in each survey (P < 0.001). The youngest group (aged 18-24) reported a higher probability (P < 0.05) of having depression, anxiety, or stress than the older groups in S1 and S2. Middle-aged people (25-59) had a greater probability of being a case in the DASS-21 scales than the oldest group (60+), except for depression in men (P = 0.179). In S3, the trend changed: the youngest group showed a decrease in depression and stress while the oldest group showed a dramatic increase (anxiety: men = 664.5%, women = 273.52%; stress: men = 786%, women = 431.37%). Conclusions: It is plausible to conclude that COVID-19 psychological fatigue exists, especially in middle-aged and older adults. Strategies to assist people who have fewer coping skills should be implemented in the near future.

COVID-19 , Mental Fatigue , Adult , Aged , COVID-19/epidemiology , COVID-19/psychology , Cross-Sectional Studies , Depression/epidemiology , Female , Humans , Male , Mental Fatigue/epidemiology , Middle Aged , Pandemics , SARS-CoV-2 , Spain/epidemiology , Surveys and Questionnaires
Rev Esp Salud Publica ; 962022 Apr 08.
Article in Spanish | MEDLINE | ID: mdl-35393980


Since the first reinfection by SARS-CoV-2 was known in August 2020, several cases have been described around the world. We present the first reinfection of an immunocompetent patient confirmed in Galicia (Spain). The clinical-epidemiological information was obtained through an interview with the patient. The microbiological diagnosis was made by PCR of the nasopharyngeal exudate samples, and a serological study was carried out. In addition, a summary of the characteristics of all reinfections identified between 04-01-2021 and 03-10-2021 is presented.

Desde que en Agosto de 2020 se conociese la primera reinfección por SARS-CoV-2, se han descrito varios casos en todo el Mundo. Presentamos el primer caso confirmado en Galicia (España) de reinfección, en una paciente inmunocompetente. La información clínico-epidemiológica se obtuvo mediante entrevista con la paciente. El diagnóstico microbiológico se realizó mediante PCR de las muestras de exudado nasofaríngeo y se realizó estudio serológico. Además, se presenta un resumen de las características de todas las reinfecciones identificadas entre el 04-01-2021 y el 03-10-2021.

COVID-19 , SARS-CoV-2 , Humans , Reinfection , Spain/epidemiology
Rev Esp Salud Publica ; 962022 Apr 04.
Article in Spanish | MEDLINE | ID: mdl-35388796


OBJECTIVE: The nursing homes represented high-risk settings for SARS-CoV-2 infection, both for residents and for the employees. The COVID-19 impact on long-term care facilities (LTCFs) is evaluated, measured through the employees sick leave (SL). The pandemic evolution in the general population aged between 16 and 65 years was analyzed together with the sick leave to assess the latter as a complementary indicator of the SARS-CoV-2 surveillance. METHODS: A descriptive study of all sick leave processes due to COVID-19 recorded between February 15th 2020 and May 1st 2021 in nursing homes was carried out. The close contact sick leave/infection sick leave ratios, the 100,000 affiliated/occupied sick leave rates were computed and compared with the COVID-19 cases cumulative incidence notified to the National Network of epidemiological Surveillance (RENAVE). RESULTS: 261.892 SL processes were recorded. The close contact sick leave/infection sick leave median ratio in nursing homes was 1.8 (Interquartile range, ICR: 1.1-3.3), with values lower than 1 at certain periods. The infection sick leaves were higher in number and ratio and prior to the cases recorded in RENAVE. The sick leave ratio ranged between 81.679/100.000 occupied in nursing homes with medical care and 4.895/100.000 in other residential facilities. CONCLUSIONS: The results confirmed the dramatic impact of COVID-19 in nursing homes and the inequalities characterizing this impact. They also confirmed the potential use of sick leave as an alternative source for epidemiological and public health surveillance, especially now, when the transition of the COVID-19 surveillance to a system not including universal individual surveillance is being discussed.

OBJETIVO: Los centros sociosanitarios representaron entornos de alto riesgo de contagio por SARS-CoV-2, tanto para los residentes como para las personas trabajadoras. Se evaluó el impacto en términos de incapacidad temporal (IT) por COVID-19 en las personas que trabajan en centros sociosanitarios y se comparó con la evolución de la pandemia en la población general de 16 a 65 años, para valorar la utilidad de la IT como indicador complementario de la epidemia por SARS-CoV-2. METODOS: Se realizó un estudio descriptivo de todos los procesos de incapacidad temporal por COVID-19 registrados entre el 15 de febrero de 2020 y el 1 de mayo de 2021 en establecimientos residenciales. Se obtuvieron las ratios de incapacidad temporal por contacto estrecho /incapacidad temporal por infección, las tasas de incapacidad temporal por 100.000 afiliados/ocupados y se compararon con la incidencia acumulada de casos COVID-19 notificados a la Red Nacional de Vigilancia Epidemiológica (RENAVE). RESULTADOS: Se registraron 261.892 procesos de incapacidad temporal. La mediana de la ratio de incapacidad temporal por contacto estrecho /incapacidad temporal por infección en residencias fue de 1,8 (Rango intercuartílico, RIC: 1,1-3,3), con valores menores a 1 en periodos. Las IT por infección fueron superiores en número, tasa y anteriores en el tiempo a los casos registrados en RENAVE. Por tipo de residencia, la tasa de incapacidad temporal osciló entre 81.679/100.000 ocupados en asistencia en establecimientos residenciales con cuidados sanitaros y 4.895/100.000 en otros establecimientos residenciales. CONCLUSIONES: Los resultados confirmaron el enorme impacto que tuvo la COVID-19 en los centros sociosanitarios y la desigualdad que ha caracterizado este impacto. Apoyan también la posible utilización de la incapacidad temporal como fuente de información alternativa para la vigilancia epidemiológica y de salud pública, lo cual resulta de especial interés en este momento en el que se está planteando una transición en la vigilancia del COVID-19 hacia un sistema que ya no incluya una vigilancia individualizada universal.

COVID-19 , Adolescent , Adult , Aged , COVID-19/epidemiology , Humans , Middle Aged , Nursing Homes , Pandemics , SARS-CoV-2 , Sick Leave , Spain/epidemiology , Young Adult
Rev Esp Salud Publica ; 962022 Apr 01.
Article in Spanish | MEDLINE | ID: mdl-35388797


OBJECTIVE: Schools can help to restore confidence in vaccines by providing reliable information to their students. To do this, teachers must be willing to convey a pro-vaccination message. In this context, know the fear and beliefs about vaccination of the teachers may be appropriate. METHODS: An online cross-sectional study was carried out, in December 2020, on active teachers from the autonomous community of Catalonia (Spain). The sample included 1507 subjects, men (23.4%) and women (76.6%), aged 21 to 66 years, from preschool (21.1%), primary (41.9%) and secondary (37%) levels. A sociodemographic questionnaire, the Vaccination Fear Scale VFS-6, and a questionnaire on vaccines and vaccination beliefs were administered. Univariate and descriptive data analysis was performed. RESULTS: In this study, only 45.3% of the teachers did not show vaccination fear; data consistent with a high proportion of teachers who did not believe they should be vaccinated (27.3%) or who hesitate about the need to do so (24.4%), regardless of the high perception of the disease severity or belonging to a risk group. With high percentages (>50%) of teachers who did not believe, or doubt, about the safety and usefulness of vaccines; and less significant but important percentages that indicated distrust in pharmaceutical companies and in the government. Being a woman, young and a preschool education teacher, followed by primary education, were risk factors for vaccination refusal. CONCLUSIONS: The study shows high rates of fear and mistrust towards vaccines in teachers.

OBJETIVO: Los centros educativos pueden ayudar a restablecer la confianza en las vacunas proporcionando información de confianza a sus alumnos. Para ello, los docentes deben estar dispuestos a transmitir un mensaje provacunación. En este contexto, se consideró adecuado conocer el miedo y las creencias sobre la vacunación de los docentes. METODOS: Se efectuó un estudio transversal en línea, en diciembre de 2020, a docentes en activo de la comunidad autónoma de Cataluña (España). La muestra incluyó 1.507 sujetos, hombres (23,4%) y mujeres (76,6%), de 21 a 66 años de edad, de educación infantil (21,1%), primaria (41,9%) y secundaria (37%). Se administró un cuestionario sociodemográfico, la Escala de Miedo a la Vacunación (VFS-6) y un cuestionario de creencias sobre las vacunas y la vacunación. Se efectuó análisis univariado y descriptivo de datos. RESULTADOS: En este estudio, solo el 45,3% de los docentes no presentó miedo a la vacunación, dato concordante con una alta proporción de docentes que no creyeron que debían vacunarse (27,3%) o que vacilaron sobre la necesidad de hacerlo (24,4%), independientemente de la alta percepción de la gravedad de la enfermedad o de pertenecer a un grupo de riesgo. Con altos porcentajes (>50%) de docentes que no creían o dudaban de la seguridad y utilidad de las vacunas; y porcentajes menos significativos pero importantes que desconfiaban de las industrias farmacéuticas y del Gobierno, siendo factores de riesgo de rechazo de la vacunación ser mujer, joven y docente de Educación Infantil, seguido de la Educación Primaria. CONCLUSIONES: El estudio muestra altos índices de miedo y desconfianza hacia las vacunas en los docentes.

COVID-19 , Adult , Aged , COVID-19/epidemiology , COVID-19/prevention & control , Child, Preschool , Cross-Sectional Studies , Fear , Female , Humans , Male , Middle Aged , Pandemics/prevention & control , Spain/epidemiology , Vaccination , Young Adult
BMC Geriatr ; 22(1): 276, 2022 Apr 04.
Article in English | MEDLINE | ID: mdl-35369862


INTRODUCTION: Social relationships (SR) are an important aspect in the healthy ageing process. The study aimed to describe SR in over-50s in Spain and analyse their association with physical/emotional, functional and cognitive/sensory health variables. METHODS: The study sample was formed by 5583 people representing the Spanish population aged 50 and over, who participated in the sixth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE). The variables were divided into socio-demographic aspects and economic, health and SR aspects represented by the number of friends, family members and satisfaction with social network and the Revised UCLA loneliness scale. The health variables were grouped using a main component analysis. Multiple linear regressions were performed between the health components with socio-demographic and SR variables. RESULTS: 67.26% of respondents said they did not feel lonely. The feeling of loneliness was the variable most closely related to the physical and emotional, functional and cognitive and sensory health components. The main SR variable associated to health components was the Revised UCLA Loneliness Scale (standardised beta, p < 0.001; p < 0.001; and p < 0.001, respectively). The number of family members in social network SR variable was also associated with the physical/emotional health (ß = 0.09, p < 0.001) and cognitive/sensory ability (ß = 0.10, p = 0.001) components. CONCLUSIONS: The main SR aspect that impacts health status was loneliness. The results of this study suggest the importance of developing public health policies oriented to promoting action on the SR characteristics that enhance older people's health.

Retirement , Social Support , Aged , Aging/psychology , Europe , Humans , Middle Aged , Spain/epidemiology
BMJ Open ; 12(4): e057866, 2022 Apr 08.
Article in English | MEDLINE | ID: mdl-35396302


OBJECTIVE: To investigate how trends in incidence of anxiety and depressive disorders have been affected by the COVID-19 pandemic. DESIGN: Population-based cohort study. SETTING: Retrospective cohort study from 2018 to 2021 using the Information System for Research in Primary Care (SIDIAP) database in Catalonia, Spain. PARTICIPANTS: 3 640 204 individuals aged 18 or older in SIDIAP on 1 March 2018 with no history of anxiety and depressive disorders. PRIMARY AND SECONDARY OUTCOMES MEASURES: The incidence of anxiety and depressive disorders during the prelockdown period (March 2018-February 2020), lockdown period (March-June 2020) and postlockdown period (July 2020-March 2021) was calculated. Forecasted rates over the COVID-19 periods were estimated using negative binomial regression models based on prelockdown data. The percentage of reduction was estimated by comparing forecasted versus observed events, overall and by sex, age and socioeconomic status. RESULTS: The incidence rates per 100 000 person-months of anxiety and depressive disorders were 151.1 (95% CI 150.3 to 152.0) and 32.3 (31.9 to 32.6), respectively, during the prelockdown period. We observed an increase of 37.1% (95% prediction interval 25.5 to 50.2) in incident anxiety diagnoses compared with the expected in March 2020, followed by a reduction of 15.8% (7.3 to 23.5) during the postlockdown period. A reduction in incident depressive disorders occurred during the lockdown and postlockdown periods (45.6% (39.2 to 51.0) and 22.0% (12.6 to 30.1), respectively). Reductions were higher among women during the lockdown period, adults aged 18-34 years and individuals living in the most deprived areas. CONCLUSIONS: The COVID-19 pandemic in Catalonia was associated with an initial increase in anxiety disorders diagnosed in primary care but a reduction in cases as the pandemic continued. Diagnoses of depressive disorders were lower than expected throughout the pandemic.

COVID-19 , Adult , Anxiety/epidemiology , COVID-19/epidemiology , Cohort Studies , Communicable Disease Control , Depression/epidemiology , Female , Humans , Mental Health , Pandemics , Retrospective Studies , SARS-CoV-2 , Spain/epidemiology
Arch Prev Riesgos Labor ; 25(2): 86-100, 2022 Apr 15.
Article in Spanish | MEDLINE | ID: mdl-35426268


AIM: To estimate the prevalence and severity of burnout syndrome among primary care team professionals and its association with work and demographic variables. METHODS: Cross-sectional, observational, descriptive, and multicenter study. The sample was made up of healthcare workers in all professional categories in central Catalonia (Barcelona). The study was conducted using the self-administered and anonymous Maslach Burnout Inventory questionnaire, adapted to the Spanish population, with three scales that assess emotional exhaustion, depersonalization, and personal accomplishment. Quantitative variables were summarized with mean and standard deviation, and qualitative variables with percentages. We used the tStudent t-test for quantitative variables, Pearson's chi-square for categorical variables with Fisher's correction and Mann-Whitney for continuous variables. Results included 95% confidence intervals and a significance level of p<0.05. RESULTS: A total of 614 professionals participated; mean age, 45.6 years, and 84.9% were women. Overall, 54.7% had no affected scales, and 30.4% had at least one affected scale; Burnout involving two or more scales was 14.3%, of which 3.7% presented severe Burnout with alteration of all three scales. High levels of emotional exhaustion and depersonalization, and low personal accomplishment were mostly found in physicians seniors and residents. CONCLUSIONS: Burnout syndrome among primary care professionals mainly affects physicians, with little association to the occupational and socio-demographic variables we  studied, and represents a psychosocial risk factor for the health of these professionals.

OBJETIVOS: Analizar la prevalencia y gravedad del síndrome de Burnout en los profesionales de los Equipos de Atención Primaria y su asociación con variables laborales y demográficas. Métodos: Estudio transversal, observacional, descriptivo y multicéntrico. La muestra la forman trabajadores de todas las categorías profesionales sanitarias de la Cataluña Central. Se realiza a través del cuestionario autoadministrado y anónimo Maslach Burnout Inventory adaptado a la población española con tres escalas que valoran cansancio emocional, despersonalización y realización personal. Las variables cuantitativas se describen con la media y desviación estándar y las cualitativas con porcentajes. Se comparan mediante la t-Student para variables cuantitativas, chi cuadrado de Pearson para las variables categóricas con la corrección de Fisher y Mann-Whitney para las variables continuas.  Resultados: Participaron 614 profesionales, edad media 45.6 años, 84.9% mujeres. El 54.7% no tiene ninguna escala afectada, un 30.94% tiene una escala afectada. El Burnout con alteración de dos o más escalas se presenta en el 14.3%, de los que un 3.74% presentan Burnout grave con alteración de las tres escalas. La dimensión de cansancio emocional y despersonalización en grado alto y baja realización personal se da mayoritariamente en médicos adjuntos y residentes. CONCLUSIONES: El síndrome de Burnout en los profesionales de Atención Primaria afecta principalmente a médicos, con ecsasa relación a variables laborales y sociodemográficas, y constituye un factor de riesgo psicosocial para la salud de estos profesionales.

Burnout, Professional , Burnout, Professional/epidemiology , Burnout, Professional/psychology , Burnout, Psychological , Cross-Sectional Studies , Female , Health Personnel/psychology , Humans , Male , Middle Aged , Prevalence , Spain/epidemiology , Surveys and Questionnaires
Nutrients ; 14(7)2022 Mar 28.
Article in English | MEDLINE | ID: mdl-35406017


Malnutrition has a multifactorial origin and can be caused by cancer. This study determined the consensus of a panel of experts on the nutritional approach for cancer patients in Spain using a multidisciplinary approach. Using the Delphi methodology, a 74-question questionnaire was prepared and sent to 46 experts. The areas of knowledge addressed were the nutritional status of the cancer patient, nutritional screening, nutritional therapy, patient referral, and multidisciplinary care. A total of 91.7% of the experts agreed with the questions posed on nutritional status, 60.0% with those on nutritional screening, 76.7% with those on nutritional therapy, and the entire panel of experts agreed with the questions posed on patient referral and multidisciplinary care. The experts agreed upon a high prevalence of malnutrition among cancer patients in Spain. Unlike medical and radiation oncologists, medical nutrition specialists believe that body composition assessment should not be carried out in all types of cancer patients during nutritional screening and that interventions can be conducted outside the oncology clinic. In general, it is recommended that nursing staff routinely perform nutritional screening before starting cancer treatment. It is necessary to develop a multidisciplinary action protocol that includes nutritional and/or sarcopenia screening.

Malnutrition , Neoplasms , Consensus , Humans , Malnutrition/diagnosis , Malnutrition/epidemiology , Malnutrition/etiology , Neoplasms/complications , Neoplasms/therapy , Nutrition Assessment , Nutritional Status , Spain/epidemiology
Med Oral Patol Oral Cir Bucal ; 27(3): e223-e229, 2022 May 01.
Article in English | MEDLINE | ID: mdl-35368010


BACKGROUND: The coronavirus pandemic has impacted health systems worldwide, with Spain being one of the most affected countries. However, little is known about the extent to which the effects of staying home, social distancing, and quarantine measures have influenced the epidemiology of patients with maxillofacial trauma. The aim of this study was to analyze the impact of the coronavirus pandemic on the incidence, demographic patterns, and characteristics of maxillofacial fractures in the largest hospital in southern Spain. MATERIAL AND METHODS: Data from patients who underwent surgery for maxillofacial fractures during the first year of the pandemic between 16 March 2020 and 14 March 2021 (pandemic group) were retrospectively compared with a control group during the equivalent period of the previous year (pre-pandemic group). The incidence was compared by weeks and by lockdown periods of the population. Demographic information, aetioloy, fracture characteristics, treatment performed, and days of preoperative stay were evaluated. Descriptive and bivariate statistics were calculated (p<0.05). RESULTS: During the first year of the pandemic, there was a 35.2% reduction in maxillofacial fractures (n=59) compared to the pre-pandemic year (n=91, p=0.040). A significant drop was detected during the total home lockdown period of the population (p=0.028). In the pandemic group, there was a reduction in fractures due to interpersonal aggressions, an increase in panfacial fractures, a significant increase in other non-facial injuries associated with polytrauma (p=0.037), a higher number of open reduction procedures with internal fixation, and a significantly longer mean preoperative stay (p=0.016). CONCLUSIONS: The first pandemic year was associated with a decline in the frequency of maxillofacial trauma and a change in the pattern and characteristics of fractures. Inter-annual epidemiological knowledge of maxillofacial fractures may be useful for more efficient planning of resource allocation and surgical practice strategy during future coronavirus outbreaks and population lockdowns.

Coronavirus , Fractures, Bone , Maxillofacial Injuries , Fractures, Bone/epidemiology , Humans , Maxillofacial Injuries/epidemiology , Maxillofacial Injuries/etiology , Maxillofacial Injuries/surgery , Pandemics , Retrospective Studies , Spain/epidemiology