Progresión temporal de la distribución de los serotipos de Streptococcus pneumoniae productores de enfermedad neumocócica invasiva en Galicia (España) y su relación con la resistencia a antibióticos (periodo 2011-2021) / Temporal progression of the distribution of Streptococcus pneumoniae serotypes causing invasive pneumococcal disease in Galicia (Spain) and its relationship with resistance to antibiotics (period 2011-2021)

Introducción: Streptococcus pneumoniae causa enfermedades graves en la población susceptible. La vacuna neumocócica conjugada (PCV) 13-valente (PCV13) se incluyó en el calendario infantil en 2011. Este estudio analiza la evolución de los serotipos de neumococo y de sus resistencias tras la PCV13. Métodos: Se incluyeron los neumococos serotipados en Galicia en 2011-2021. Se estudió la sensibilidad antibiótica siguiendo criterios EUCAST. Se analizaron los datos en 3 subperíodos: inicial (2011-2013), medio (2014-2017) y final (2018-2021). Se calcularon las prevalencias de los serotipos y el porcentaje de resistencia a los antibióticos más representativos. Resultados: Se incluyeron 2.869 aislados. Inicialmente el 42,7% presentaba tipos capsulares incluidos en la PCV13, frente al 15,4% al final. Los incluidos en la PCV20 y no en la PCV13 y PCV15 fueron el 12,5% inicialmente y el 41,3% al final. El 26,4% de los serotipos a lo largo del estudio no estaban incluidos en ninguna vacuna. La prevalencia del serotipo 8 se multiplicó casi por 8 y la del 12F se triplicó. El serotipo 19A fue el más resistente inicialmente. La resistencia de los serotipos 11A y 15A aumentó a lo largo del estudio. Conclusiones: La introducción de la PCV13 en la población infantil determinó un cambio en los serotipos de neumococo hacia los incluidos en la PCV20 y los no incluidos en ninguna vacuna. El serotipo 19A inicialmente fue el más resistente, y el 15A, no incluido en ninguna vacuna, merece un especial seguimiento. El serotipo 8, que fue el que más se incrementó, no mostró resistencia destacable.(AU)

Introduction: Streptococcus pneumoniae causes serious diseases in the susceptible population. The 13-valent pneumococci conjugate vaccine (PCV13) was included in the children's calendar in 2011. The objective of the study was to analyze the evolution of pneumococcal serotypes and their resistance after PCV13. Methods: This study included the pneumococci serotyped in Galicia in 2011-2021. Antibiotic susceptibility was analyzed following EUCAST criteria. The data was analyzed in 3 sub-periods: initial (2011-2013), middle (2014-2017) and final (2018-2021). The prevalence of serotypes and their percentage of resistance to the most representative antibiotics were calculated. Results: A total of 2.869 isolates were included. Initially, 42.7% isolates presented capsular types included in PCV13, compared to 15.4% at the end. Those included in PCV20 and not in PCV13 and PCV15 were 12.5% at baseline and 41.3% at the end; 26.4% of the isolates throughout the study had serotypes not included in any vaccine. The prevalence of serotype 8 multiplied almost by 8 and that of 12F tripled. The 19A serotype was initially the most resistant, while the resistance of serotypes 11A and 15A increased throughout the study. Conclusions: The introduction of PCV13 in the pediatric population determined a change in pneumococcal serotypes towards those included in PCV20 and those not included in any vaccine. Serotype 19A was initially the most resistant and the 15A, not included in any vaccine, deserves special follow-up. Serotype 8, which increased the most, did not show remarkable resistance.(AU)

Consumo de alcohol y caracterización de los bebedores problemáticos en Galicia / Alcohol consumption and characterization of hazardous drinkers in Galicia

Conocer en detalle la epidemiología del consumo de alcohol a nivel poblacional es indispensable para diseñar programas de Salud Pública eficaces. Los objetivos de este estudio fueron estimar la prevalencia del consumo de alcohol diario, ocasional, esporádico, intensivo y problemático entre los gallegos de 16 y más años y caracterizar a los bebedores problemáticos teniendo en cuenta la perspectiva de género. Se realizó un estudio transversal en 2017 entre la población mayor de 15 años residente en Galicia en el marco del Sistema de Información sobre Conductas de Riesgo (SICRI). En 2017, se entrevistaron 7.841 adultos seleccionados mediante muestreo aleatorio estratificado. Se incluyeron preguntas relacionadas con el consumo de alcohol en el último mes y se estimó la prevalencia de consumo problemático empleando el test AUDIT. Para caracterizar a los bebedores problemáticos se ajustó un modelo de regresión logística multivariante. El 18,8% de la población gallega consumía alcohol a diario y el 3,4% tenían un consumo problemático. Las prevalencias de consumo de alcohol diario, ocasional, esporádico, intensivo o problemático fueron más altas entre los hombres y variaron por edad. La prevalencia de consumo diario-ocasional y esporádico fue más alta a edades medias (45-64 años), y el intensivo y problemático entre los 16 y 24 años. Las características asociadas a un consumo problemático de alcohol varían por sexo, identificándose características comunes como la edad o ser fumador de tabaco o cannabis, y diferenciales como el nivel de estudios. Las tipologías de consumo cambian en función de la edad y del sexo. Los sistemas de vigilancia deberían monitorizar de forma periódica el consumo de alcohol para adaptar las medidas de prevención a cambios en la tipología de consumo. (AU)

Detailed knowledge of the epidemiology of alcohol consumption at the population level is essential to the design of effective public health programs. The objectives of this study were to estimate the prevalence of daily, sporadic, occasional, binge and hazardous alcohol consumption among the Galician population aged 16 years and over, and to characterize hazardous drinkers, taking into account the gender perspective. A cross-sectional study was conducted in 2017 among people aged over 15 years residing in Galicia in the framework of the Risk Behavior Information System (SICRI). In 2017, 7,841 adults were interviewed by stratified random sampling. Questions related to alcohol consumption in the last month were included and the prevalence of hazardous consumption was estimated using the AUDIT test. A multivariate logistic regression model was fitted to characterize hazardous drinkers. A total of 18.8% of the Galician population consumed alcohol daily and 3.4% had hazardous consumption. The prevalence of daily, occasional, sporadic, binge and hazardous drinking was higher among men and varied by age. The prevalence of daily-occasional and sporadic drinking was highest at middle age (45-64 years), and binge and hazardous drinking among those aged 16 to 24 years. The characteristics associated with hazardous drinking varied by gender, and are identified by common characteristics to both genders such as age or being a tobacco or cannabis smoker, and differential characteristics such as educational level. Typologies of consumption changed according to age and gender. Surveillance systems should regularly monitor alcohol consumption in order to adapt prevention measures to changes in drinking patterns. (AU)

Temporal progression of the distribution of Streptococcus pneumoniae serotypes causing invasive pneumococcal disease in Galicia (Spain) and its relationship with resistance to antibiotics (period 2011-2021).

INTRODUCTION: Streptococcus pneumoniae causes serious diseases in the susceptible population. The 13-valent pneumococci conjugate vaccine (PCV13) was included in the children's calendar in 2011. The objective of the study was to analyze the evolution of pneumococcal serotypes and their resistance after PCV13. METHODS: This study included the pneumococci serotyped in Galicia in 2011-2021. Antibiotic susceptibility was analyzed following EUCAST criteria. The data was analyzed in 3 sub-periods: initial (2011-2013), middle (2014-2017) and final (2018-2021). The prevalence of serotypes and their percentage of resistance to the most representative antibiotics were calculated. RESULTS: A total of 2.869 isolates were included. Initially, 42.7% isolates presented capsular types included in PCV13, compared to 15.4% at the end. Those included in PCV20 and not in PCV13 and PCV15 were 12.5% at baseline and 41.3% at the end; 26.4% of the isolates throughout the study had serotypes not included in any vaccine. The prevalence of serotype 8 multiplied almost by 8 and that of 12F tripled. The 19A serotype was initially the most resistant, while the resistance of serotypes 11A and 15A increased throughout the study. CONCLUSIONS: The introduction of PCV13 in the pediatric population determined a change in pneumococcal serotypes towards those included in PCV20 and those not included in any vaccine. Serotype 19A was initially the most resistant and the 15A, not included in any vaccine, deserves special follow-up. Serotype 8, which increased the most, did not show remarkable resistance.

Cannabis use in adult population in Galicia: Prevalence and associated characteristics. / Consumo de cannabis en población adulta en Galicia: Prevalencias y características asociadas.

Cannabis is the most widely consumed illegal drug in Spain, with consumption concentrated mainly in adolescence and early adulthood. The objectives were to estimate the prevalence of cannabis use, cannabis use disorder (CUD) and dependent use in the Galician population aged 16 years and over, and to characterize cannabis users and cannabis dependent users. Data are from two cross-sectional studies from the Risk Behavior Information System conducted in 2017 (n = 7,841) and 2018 (n = 7,853). The Cannabis Abuse Screening Test (CAST) was used to identify users with CUD and/or dependent use. Prevalences were estimated and regression models were fitted to identify variables associated with cannabis use and dependent use. In 2017-2018, 2.7% (95% CI: 2.5-3.0) of the Galician population aged 16 years and over consumed cannabis at the time of the survey, with this prevalence being 9% in the 16-24 years age group. Prevalence decreased with age and was higher in males in all age groups. The prevalence of CUD in users was 69.5% (95% CI 61.1-78.1) and of dependent use it was 49.2% (95% CI 46.6-53.9). Tobacco use was the major determinant of being a cannabis user [OR = 19.8 (95% CI 13.8-28.4)] and daily cannabis use of being a dependent user [OR = 5.5 (95% CI 3.2-9.5)]. Cannabis use among the Galician population is high, especially among young people aged 16-24 years, who show the highest probability of dependent use. Prevention measures should be aimed especially at the younger population aged 16 years to curb its use and the development of consequences such as CUD and dependent use.

El cannabis es la droga ilegal más consumida en España con un consumo que se concentra principalmente en la adolescencia y primeros años de la edad adulta. Los objetivos de este estudio fueron estimar la prevalencia de consumo de cannabis, de trastorno por consumo de cannabis (CUD) y de consumo dependiente (CD) en la población gallega ≥16 años y caracterizar a los consumidores y a los consumidores dependientes. Los datos proceden de dos estudios transversales del Sistema de Información sobre Conductas de Riesgo realizados en 2017 (n = 7.841) y 2018 (n = 7.853). Se utilizó el test de adicción al cannabis (CAST) para identificar a los consumidores con CUD y/o CD. Se estimaron prevalencias y se ajustaron modelos de regresión para identificar variables asociadas al consumo y CD de cannabis.  El 2,7% (IC 95%: 2,5-3,0) de la población gallega ≥16 años consumía cannabis en el momento de la encuesta (2017-2018), siendo esta prevalencia del 9% en el grupo de 16-24 años. La prevalencia disminuye con la edad y es superior en hombres en todos los grupos etarios. La prevalencia de CUD en los consumidores fue del 69,5% (IC 95% 61,1-78,1) y de CD del 49,2% (IC 95% 44,6 -53,9). Consumir tabaco es el mayor determinante para ser consumidor de cannabis [OR = 19,8 (IC 95% 13,8-28,4)] y consumir diariamente cannabis para ser consumidor dependiente [OR = 5,5 (IC 95% 3,2-9,5)]. El consumo de cannabis entre la población gallega es bajo, aunque entre los jóvenes de 16-24 años, que son los que muestran más probabilidad de CD, la prevalencia es elevada. Las medidas de prevención deben dirigirse especialmente a la población más joven de 16 años para frenar su consumo y el desarrollo de consecuencias como el CUD y el CD.

Effectiveness of a Meningococcal Group B Vaccine (4CMenB) in Children.

BACKGROUND: In September 2015, the four-component, protein-based meningococcal serogroup B vaccine (4CMenB; Bexsero) became available for private purchase in Spain. METHODS: We conducted a nationwide matched case-control study to assess the effectiveness of 4CMenB in preventing invasive meningococcal disease in children. The study included all laboratory-confirmed cases of invasive meningococcal disease in children younger than 60 months of age between October 5, 2015, and October 6, 2019, in Spain. Each case patient was matched with four controls according to date of birth and province. 4CMenB vaccination status of the case patients and controls was compared with the use of multivariate conditional logistic regression. RESULTS: We compared 306 case patients (243 [79.4%] with serogroup B disease) with 1224 controls. A total of 35 case patients (11.4%) and 298 controls (24.3%) had received at least one dose of 4CMenB. The effectiveness of complete vaccination with 4CMenB (defined as receipt of at least 2 doses, administered in accordance with the manufacturer's recommendations) was 76% (95% confidence interval [CI], 57 to 87) against invasive meningococcal disease caused by any serogroup, and partial vaccination was 54% (95% CI, 18 to 74) effective. Complete vaccination resulted in an effectiveness of 71% (95% CI, 45 to 85) against meningococcal serogroup B disease. Vaccine effectiveness with at least one dose of 4CMenB was 64% (95% CI, 41 to 78) against serogroup B disease and 82% (95% CI, 21 to 96) against non-serogroup B disease. With the use of the genetic Meningococcal Antigen Typing System, serogroup B strains that were expected to be covered by 4CMenB were detected in 44 case patients, none of whom had been vaccinated. CONCLUSIONS: Complete vaccination with 4CMenB was found to be effective in preventing invasive disease by serogroup B and non-serogroup B meningococci in children younger than 5 years of age.

Caracterización del juego de azar en Galicia: Un problema de Salud Pública / Gambling characteristics in Galicia: A Public Health problem

Debido a la expansión de los juegos de azar, los trastornos asociados al juego se convierten en un gran problema social con una alta relevancia para la Salud Pública, afectando tanto a adultos como a adolescentes. Los principales objetivos de este estudio fueron conocer la prevalencia de gallegos que gastaron dinero en juegos de azar en el último año y de jugadores con un trastorno de juego o de riesgo. Los datos se obtuvieron del estudio transversal realizado en 2017 por el Sistema de Información sobre Conductas de Riesgo (SICRI). El SICRI se basa en la realización anual de encuestas telefónicas a la población gallega residente que tiene al menos 16 años de edad con la muestra equidistribuida en 12 meses. Un total de 7.841 participantes fueron seleccionados mediante un muestreo aleatorio estratificado. Con el objetivo de estimar la prevalencia de trastorno de juego o de riesgo se utilizó el cuestionario South Oaks Gambling Screen (SOGS) de Lesieur y Blume. Se estimó la prevalencia de juego y jugadores con un trastorno de juego o juego de riesgo y se ajustaron modelos de regresión para identificar las variables asociadas al trastorno de juego o juego de riesgo. De la población gallega de 16 años en adelante, el 58,1% (IC 95%: 57,0-59,2) gastó dinero en juegos de azar en los 12 meses previos a la realización del estudio, siendo la prevalencia de jugadores más alta en los hombres (64,6% vs. 52,2%) en todos los grupos de edad. La prevalencia de trastorno de juego o juego de riesgo en la población es del 1,6% (IC 95%: 1,3-1,9), siendo más alta entre los hombres y en los jugadores más jóvenes. Las prevalencias obtenidas señalan al juego como un importante problema de Salud Pública, siendo los varones jóvenes los que tienen un mayor riesgo de desarrollar un problema asociado al juego. (AU)

Due to the increase in gambling, gambling disorders have become a major social problem of importance for public health, affecting both adults and adolescents. The main objectives of this study were to assess the prevalence of the Galician population who spent money on gambling in the last year and the prevalence of people with, or at risk of, gambling disorder. Data was obtained from a cross-sectional survey carried out in 2017 by the Galician Information System on Risk Behaviors (SICRI). The SICRI conducts annual telephone surveys of Galician residents who were at least 16 years of age, with the sample equidistributed over a 12-month period. A total of 7,841 participants were selected using stratified random sampling. In order to estimate the prevalence of gambling disorder or at-risk gambling, The South Oaks Gambling Screen (SOGS) questionnaire by Lesieur and Blume was applied. The prevalence of gambling and having or being at risk of gambling disorder was estimated and regression models were adjusted to identify variables associated with gambling disorder or being at risk. Of the Galician population aged 16 years and older, 58.1% (95% CI: 57.0-59.2) spent money on gambling in the 12 months previous to this study, with the highest prevalence of gambling found in men (64.6% vs. 52.2%) in all age groups. The prevalence of gambling disorder or at-risk gambling at the population level is 1.6% (95% CI 1.3-1.9), and is higher among men and younger gamblers. The prevalence obtained signals to gambling as a major public health concern, with young males being at greater risk of developing a gambling problem. (AU)

Uso y abuso de Internet en la población adulta de Galicia: Prevalencia y características asociadas / Internet use and abuse in the adult population of Galicia: Prevalence and associated characteristics

El uso de Internet se ha extendido rápidamente por todo el mundo convirtiéndose en una parte indispensable de la vida cotidiana. A pesar de sus ventajas, el uso disfuncional o el abuso de Internet puede conducir a problemas de adicción. Los principales objetivos de este estudio fueron evaluar la prevalencia de uso de Internet, de uso problemático de Internet (UPI) o de riesgo de UPI en la población general gallega en 2017. El Sistema de Información sobre Conductas de Riesgo de Galicia (SICRI) se basa en la realización de encuestas transversales con periodicidad cuasianual entre la población de 16 años y más residente en Galicia, España. En 2017, se incluyeron a 7.841 participantes mediante un muestreo aleatorio estratificado. Los usuarios de Internet se clasificaron en tres categorías: uso normal, inadaptado/en riesgo de UPI y UPI, en función de su puntuación en el cuestionario de experiencias relacionadas con Internet. El 74,8%, 95% IC [73,8-75,8], de la población gallega de 16-74 años utilizó Internet en el último mes, siendo esta prevalencia superior al 95% en la población menor de 45 años. La mayoría de los usuarios utilizan aplicaciones de chat y redes sociales. La prevalencia de UPI o riesgo de UPI en la población de 16 a 74 años fue del 1,0% 95% IC [0,8-1,3], alcanzando el 5,2% 95% IC [4,2-6,2] en la población de 16 a 24 años. La prevalencia de uso de Internet en Galicia es ligeramente inferior a las obtenidas en España y Europa. Además, el UPI es un problema emergente en la población, siendo la población más joven la más afectada. (AU)

Internet use has rapidly spread around the world becoming an indispensable part of daily life. Despite its advantages, the dysfunctional use or abuse of the Internet can lead to addiction problems. The main objectives established in this study were to assess the prevalence of Internet use in the general Galician population and the prevalence of problematic internet use (PIU) and at-risk of PIU in 2017. The Surveillance Information System on Risk Behavior is based on annual cross-sectional surveys among the population aged at least 16 years residing in Galicia, Spain. A total of 7,841 participants were recruited in 2017 using a stratified random sampling. Internet users were classified into three categories: normal use, maladaptive/at-risk of PIU and PIU, based on their score in the Internet-related experiences questionnaire. A total of 74.8%, 95% CI [73.8-75.8], of the Galician population aged 16 to 74 used the Internet in the month before the survey was performed, exceeding 95% in the population aged below 45 years. Most users use chat applications and social networks. The prevalence of PIU or at-risk of PIU in the population aged 16 to 74 was 1.0% [0.8-1.3], reaching 5.2% [4.2-6.2] in the population aged between 16 and 24. The prevalence of Internet use in Galicia is slightly lower than those obtained in Spain and Europe. Moreover, PIU is an emerging problem in the population with the youngest population being the most affected. (AU)

Alcohol consumption and characterization of hazardous drinkers in Galicia. / Consumo de alcohol y caracterización de los bebedores problemáticos en Galicia.

Detailed knowledge of the epidemiology of alcohol consumption at the population level is essential to the design of effective public health programs. The objectives of this study were to estimate the prevalence of daily, sporadic, occasional, binge and hazardous alcohol consumption among the Galician population aged 16 years and over, and to characterize hazardous drinkers, taking into account the gender perspective. A cross-sectional study was conducted in 2017 among people aged over 15 years residing in Galicia in the framework of the Risk Behavior Information System (SICRI). In 2017, 7,841 adults were interviewed by stratified random sampling. Questions related to alcohol consumption in the last month were included and the prevalence of hazardous consumption was estimated using the AUDIT test. A multivariate logistic regression model was fitted to characterize hazardous drinkers. A total of 18.8% of the Galician population consumed alcohol daily and 3.4% had hazardous consumption. The prevalence of daily, occasional, sporadic, binge and hazardous drinking was higher among men and varied by age. The prevalence of daily-occasional and sporadic drinking was highest at middle age (45-64 years) and binge and hazardous drinking among those aged 16 to 24 years. The characteristics associated with hazardous drinking varied by gender, and are identified by common characteristics to both genders such as age or being a tobacco or cannabis smoker, and differential characteristics such as educational level. Typologies of consumption changed according to age and gender. Surveillance systems should regularly monitor alcohol consumption in order to adapt prevention measures to changes in drinking patterns.

Conocer en detalle la epidemiología del consumo de alcohol a nivel poblacional es indispensable para diseñar programas de Salud Pública eficaces. Los objetivos de este estudio fueron estimar la prevalencia del consumo de alcohol diario, ocasional, esporádico, intensivo y problemático entre los gallegos de 16 y más años y caracterizar a los bebedores problemáticos teniendo en cuenta la perspectiva de género. Se realizó un estudio transversal en 2017 entre la población mayor de 15 años residente en Galicia en el marco del Sistema de Información sobre Conductas de Riesgo (SICRI). En 2017, se entrevistaron 7.841 adultos seleccionados mediante muestreo aleatorio estratificado. Se incluyeron preguntas relacionadas con el consumo de alcohol en el último mes y se estimó la prevalencia de consumo problemático empleando el test AUDIT. Para caracterizar a los bebedores problemáticos se ajustó un modelo de regresión logística multivariante. El 18,8% de la población gallega consumía alcohol a diario y el 3,4% tenían un consumo problemático. Las prevalencias de consumo de alcohol diario, ocasional, esporádico, intensivo o problemático fueron más altas entre los hombres y variaron por edad. La prevalencia de consumo diario-ocasional y esporádico fue más alta a edades medias (45-64 años), y el intensivo y problemático entre los 16 y 24 años. Las características asociadas a un consumo problemático de alcohol varían por sexo, identificándose características comunes como la edad o ser fumador de tabaco o cannabis, y diferenciales como el nivel de estudios. Las tipologías de consumo cambian en función de la edad y del sexo. Los sistemas de vigilancia deberían monitorizar de forma periódica el consumo de alcohol para adaptar las medidas de prevención a cambios en la tipología de consumo.

Gambling characteristics in Galicia: a Public Health problem. / Caracterización del juego de azar en Galicia: un problema de Salud Pública.

Due to the increase in gambling, gambling disorders have become a major social problem of importance for public health, affecting both adults and adolescents. The main objectives of this study were to assess the prevalence of the Galician population who spent money on gambling in the last year and the prevalence of people with, or at risk of, gambling disorder. Data was obtained from a cross-sectional survey carried out in 2017 by the Galician Information System on Risk Behaviors (SICRI). The SICRI conducts annual telephone surveys of Galician residents who were at least 16 years of age, with the sample equidistributed over a 12-month period.  A total of 7,841 participants were selected using stratified random sampling. In order to estimate the prevalence of gambling disorder or at-risk gambling, The South Oaks Gambling Screen (SOGS) questionnaire by Lesieur and Blume was applied. The prevalence of gambling and having or being at risk of gambling disorder was estimated and regression models were adjusted to identify variables associated with gambling disorder or being at risk. Of the Galician population aged 16 years and older, 58.1% (95% CI: 57.0-59.2) spent money on gambling in the 12 months previous to this study, with the highest prevalence of gambling found in men (64.6% vs. 52.2%) in all age groups. The prevalence of gambling disorder or at-risk gambling at the population level is 1.6% (95% CI 1.3-1.9), and is higher among men and younger gamblers. The prevalence obtained signals to gambling as a major public health concern, with young males being at greater risk of developing a gambling problem.

Debido a la expansión de los juegos de azar, los trastornos asociados al juego se convierten en un gran problema social con una alta relevancia para la Salud Pública, afectando tanto a adultos como a adolescentes. Los principales objetivos de este estudio fueron conocer la prevalencia de gallegos que gastaron dinero en juegos de azar en el último año y de jugadores con un trastorno de juego o de riesgo. Los datos se obtuvieron del estudio transversal realizado en 2017 por el Sistema de Información sobre Conductas de Riesgo (SICRI). El SICRI se basa en la realización anual de encuestas telefónicas a la población gallega residente que tiene al menos 16 años de edad con la muestra equidistribuida en 12 meses. Un total de 7.841 participantes fueron seleccionados mediante un muestreo aleatorio estratificado. Con el objetivo de estimar la prevalencia de trastorno de juego o de riesgo se utilizó el cuestionario South Oaks Gambling Screen (SOGS) de Lesieur y Blume. Se estimó la prevalencia de juego y jugadores con un trastorno de juego o juego de riesgo y se ajustaron modelos de regresión para identificar las variables asociadas al trastorno de juego o juego de riesgo. De la población gallega de 16 años en adelante, el 58,1% (IC 95%: 57,0-59,2) gastó dinero en juegos de azar en los 12 meses previos a la realización del estudio, siendo la prevalencia de jugadores más alta en los hombres (64,6% vs. 52,2%) en todos los grupos de edad. La prevalencia de trastorno de juego o juego de riesgo en la población es del 1,6% (IC 95%: 1,3-1,9), siendo más alta entre los hombres y en los jugadores más jóvenes. Las prevalencias obtenidas señalan al juego como un importante problema de Salud Pública, siendo los varones jóvenes los que tienen un mayor riesgo de desarrollar un problema asociado al juego.

Estudio de sensibilidad de Escherichia coli productores de infecciones del tracto urinario comunitarias en Galicia. Período: 2016-2017 / Antimicrobial susceptibility of Escherichia coli producers of community urinary tract infections in Galicia (Spain). Period: 2016-2017

OBJETIVO: Escherichia coli (E. coli) es el responsable de la mayoría de las infecciones del tracto urinario comunitarias. El objetivo del estudio es conocer el espectro de sensibilidad de E. coli en infecciones del tracto urinario para recomendar el tratamiento antibiótico empírico adecuado. DISEÑO: Estudio transversal, multicéntrico, retrospectivo. EMPLAZAMIENTO: Ocho hospitales públicos gallegos, prácticamente toda la población de Galicia (España). PARTICIPANTES: Cuarenta y tres mil ciento treinta y siete pacientes ambulatorios con infección del tracto urinario por E. coli aislados en orina en 2016/2017. MEDICIONES PRINCIPALES: Variables analizadas: demográficas, concentración mínima inhibitoria e interpretación de la sensibilidad según criterios de CLSI y mecanismos de resistencia. Los antibióticos estudiados fueron: ampicilina, amoxicilina-ácido clavulánico, ciprofloxacino, cefotaxima, cefepime, gentamicina, nitrofurantoína, fosfomicina, cotrimoxazol, imipenem y ertapenem. La identificación y sensibilidad se hicieron principalmente por sistemas automatizados. RESULTADOS: Los porcentajes de no sensibilidad de los aislamientos de E. coli fueron: ampicilina 49,2%, amoxicilina-ácido clavulánico 17,8%, cefotaxima 6,7%, cefepime 5,7%, ertapenem 0,04%, imipenem 0,05%, gentamicina 9,1%, ciprofloxacino 26,2%, fosfomicina 3,3%, nitrofurantoína 2,4% y cotrimoxazol 23,9%. Las no sensibilidades fueron superiores en hombres y a medida que aumenta la edad. El 6% fueron productores de betalactamasas de espectro extendido. CONCLUSIONES: El tratamiento empírico en Galicia para cistitis no complicadas producidas por E. coli en mujeres continúa siendo nitrofurantoína y fosfomicina. En hombres menores de 15 años se indica fosfomicina y en hombres mayores de 15 años el tratamiento en nuestro medio debe incluir la realización de cultivo y administrar una cefalosporina de 3.a generación oral empíricamente. No se recomienda cotrimoxazol ni ciprofloxacino como tratamiento empírico por sus altos porcentajes de resistencia

OBJECTIVE: Escherichia coli (E. coli) is responsible for the majority of community urinary tract infections. The objective of the study is to know the sensitivity spectrum of E. coli in urinary tract infections to be able to recommend the appropriate empirical antibiotic treatment. DESIGN: Cross-sectional, multicentric, retrospective study. LOCATION: Galician 8 public hospitals, practically the entire population of Galicia (Spain). PARTICIPANTS: 43,137 outpatients with urinary tract infection due to E. coli isolated in urine in 2016/2017. MAIN MEASUREMENTS: Analyzed variables: demographic, minimum inhibitory concentration and interpretation of sensitivity according to CLSI criteria and resistance mechanisms. The antibiotics studied were: ampicillin, amoxicillin-clavulanic acid, ciprofloxacin, cefotaxime, cefepime, gentamicin, nitrofurantoin, fosfomycin, cotrimoxazole, imipenem and ertapenem. The identification and sensitivity were made mainly by automated methods. RESULTS: The percentages of non-sensitivity of E. coli isolates were: ampicillin 49.2%, amoxicillin-clavulanic acid 17.8%, cefotaxime 6.7%, cefepime 5.7%, ertapenem 0.04%, imipenem 0.05%, gentamicin 9,1%, ciprofloxacin 26.2%, fosfomycin 3.3%, nitrofurantoin 2.4% and cotrimoxazole 23.9%. The non-sensitivities were higher in men and as age increases. Six percent of E. coli were producers of extended-spectrum beta-lactamases. CONCLUSIONS: The empirical treatment in Galicia for uncomplicated cystitis produced by E. coli in women continues to be nitrofurantoin and fosfomycin. In men under 15 years of age, fosfomycin is indicated and in men older than 15 years, treatment in our environment should include culture and administer a 3rd generation oral cephalosporin empirically. Cotrimoxazole and ciprofloxacin are not recommended as empirical treatment because of their high resistance rates

Baby-led weaning: prevalence and associated factors in Spain.

The main goals of this study are to estimate the percentage of mothers who declared feeding their children with baby-led weaning (BLW) and to characterize them. A cross-sectional survey was carried out in 2016 targeting women who had given birth in 2016 (sample size 6777) in Galicia (Spain). The questionnaire included questions regarding the mother's characteristics and behaviors, attitudes, and practices related to BLW. Prevalence of exclusive and non-exclusive BLW was estimated. Different maternal characteristics were evaluated for their possible association with BLW using a logistic regression model. The percentages and ORs were presented with a 95% confidence interval. The study included 6355 women, of which 38.6% (37.4-39.9) had heard of BLW and the overall prevalence of BLW was estimated at 14.0% (13.1-14.9). Prevalence of exclusive BLW was estimated at 2.1% (2.4-3.3). No differences were observed when age was taken into consideration. Children fed with BLW were more likely among mothers who continue with exclusive breastfeeding (OR, 4.1 (95% CI, 3.3-5.0)); live in an urban setting (OR, 1.6 (1.2-2.2)); or have a higher level of education (OR, 1.3 (1.1-1.5)).Conclusion: Full adherence to BLW seems low among mothers who claimed to have fed their children following this method.What is Known:• Baby-led weaning (BLW) has been present in our society for almost two decades, but it remains unclear how many mothers choose BLW for their children.What is New:• BLW is not a common choice for weaning in Spain, and more than half of the mothers had not heard about it.• Full adherence to BLW seems low among mothers who claimed to have fed their children following this method.

[Antimicrobial susceptibility of Escherichia coli producers of community urinary tract infections in Galicia (Spain). Period: 2016-2017]. / Estudio de sensibilidad de Escherichia coli productores de infecciones del tracto urinario comunitarias en Galicia. Período: 2016-2017.

OBJECTIVE: Escherichia coli (E. coli) is responsible for the majority of community urinary tract infections. The objective of the study is to know the sensitivity spectrum of E. coli in urinary tract infections to be able to recommend the appropriate empirical antibiotic treatment. DESIGN: Cross-sectional, multicentric, retrospective study. LOCATION: Galician 8 public hospitals, practically the entire population of Galicia (Spain). PARTICIPANTS: 43,137 outpatients with urinary tract infection due to E. coli isolated in urine in 2016/2017. MAIN MEASUREMENTS: Analyzed variables: demographic, minimum inhibitory concentration and interpretation of sensitivity according to CLSI criteria and resistance mechanisms. The antibiotics studied were: ampicillin, amoxicillin-clavulanic acid, ciprofloxacin, cefotaxime, cefepime, gentamicin, nitrofurantoin, fosfomycin, cotrimoxazole, imipenem and ertapenem. The identification and sensitivity were made mainly by automated methods. RESULTS: The percentages of non-sensitivity of E. coli isolates were: ampicillin 49.2%, amoxicillin-clavulanic acid 17.8%, cefotaxime 6.7%, cefepime 5.7%, ertapenem 0.04%, imipenem 0.05%, gentamicin 9,1%, ciprofloxacin 26.2%, fosfomycin 3.3%, nitrofurantoin 2.4% and cotrimoxazole 23.9%. The non-sensitivities were higher in men and as age increases. Six percent of E. coli were producers of extended-spectrum beta-lactamases. CONCLUSIONS: The empirical treatment in Galicia for uncomplicated cystitis produced by E. coli in women continues to be nitrofurantoin and fosfomycin. In men under 15 years of age, fosfomycin is indicated and in men older than 15 years, treatment in our environment should include culture and administer a 3rd generation oral cephalosporin empirically. Cotrimoxazole and ciprofloxacin are not recommended as empirical treatment because of their high resistance rates.

Prevalence and associated risk factors of urinary incontinence and dyspareunia during pregnancy and after delivery.

OBJECTIVE: The objective of this study is to estimate the prevalence of dyspareunia and stress urinary incontinence (SUI) during pregnancy and after delivery, in addition to evaluating possible associated risk factors. STUDY DESIGN: A cross-sectional study was conducted in 2016 with the target population being women who had given birth within the previous 12 months (n = 6436) in Galicia (Spain). Information was collected regarding the mother's status 6 months before pregnancy, during pregnancy, at the time of delivery, and at the time of the survey. The prevalence of SUI and dyspareunia were estimated and regression models were performed to identify variables associated with both pathologies. RESULTS: The prevalence of SUI and dyspareunia after delivery were 20.4 % (CI95 %: 19.2-22.0) and 23.4 % (22.3-24.8), respectively. The presence of dyspareunia during pregnancy (adjusted prevalence ratio PR 2.1), breastfeeding (PR 1.2), and having a history of episiotomy (PR 1.3) were all variables associated with the presence of dyspareunia after delivery. SUI after delivery was related to the mother's history of SUI before pregnancy (PR 2.4) and during pregnancy (PR 2.0), as well as having undergone vaginal delivery (PR 2.0). CONCLUSION: Knowing which factors are associated with the manifestation of SUI and dyspareunia in women after delivery is useful for identifying susceptible or "at risk" patients. These variables should be included in the clinical history of every pregnant woman.

Prevalencia de malnutrición en escolares españoles / Prevalence of malnutrition in Spanish schoolchildren

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Exceso ponderal y obesidad abdominal en niños y adolescentes gallegos / Excess weight and abdominal obesity in Galician children and adolescents

INTRODUCCIÓN Y OBJETIVOS: El exceso de peso, fundamentalmente la obesidad, en edad pediátrica aumenta el riesgo de morbimortalidad en la edad adulta. El objetivo de este trabajo es estimar la prevalencia, global y en función de la edad y del sexo, de bajo peso, normopeso, exceso ponderal y de obesidad abdominal en los escolares gallegos de 6 a 15 años en el curso escolar 2013-2014. MATERIAL Y MÉTODOS: Los datos proceden de un estudio transversal realizado en una muestra representativa por sexo y edad de escolares gallegos de 6 a 15 años. A partir de mediciones realizadas en los centros escolares se estimaron las prevalencias de bajo peso, normopeso, sobrepeso y obesidad, aplicando los puntos de corte propuestos por Cole, y la prevalencia de obesidad abdominal a partir de los puntos de corte de Taylor. RESULTADOS: Se pesaron y midieron 7.438 escolares en los 137 centros educativos participantes. La prevalencia de sobrepeso fue de 24,9% y la de obesidad, de 8,2%. El 25,8% presentaban obesidad abdominal. El 4% de los escolares con normopeso tenían obesidad abdominal. CONCLUSIONES: Estos datos ponen de manifiesto que se deben promover medidas de prevención primaria a edades tempranas encaminadas a disminuir la prevalencia de este factor de riesgo y a evitar complicaciones futuras. La prevalencia de exceso de peso, si no se tiene en cuenta la obesidad abdominal, se estaría infraestimando

INTRODUCTION AND OBJECTIVES: The excess of weight, mainly obesity, during childhood and adolescence increases morbimortality risk in adulthood. The aim of this article is to estimate both the overall prevalence, as well as according to age and gender, of underweight, overweight, obesity and abdominal obesity among schoolchildren aged between 6-15-years-old in the school year 2013-2014. MATERIAL AND METHODS: Data were taken from a cross-sectional community-based study carried out on a representative sample, by gender and age, of the Galician population aged between 6 and 15 years-old. The prevalence of underweight, overweight, and obese children (Cole's cut-off criteria) and abdominal obesity (Taylor's cut-off criteria) were estimated after performing objective measurements of height, weight and waist circumference at school. RESULTS: A total of 7,438 students were weighed and measured in 137 schools. The prevalence of overweight and obese individuals was 24.9% and 8.2%, respectively. The prevalence of abdominal obesity was 25.8%, with 4% of children with normal weight having abdominal obesity. CONCLUSIONS: These data highlight the need to promote primary prevention measures at early ages in order to decrease the occurrence of the premature onset of disease in the future. The prevalence of excess weight is underestimated if abdominal obesity is not taken into consideration

Evaluación, corrección e impacto de la no respuesta en estudios de obesidad infantil / Evaluation, correction and impact of non-response in studies of childhood obesity

Objetivo: Evaluar y corregir, usando escalas de siluetas corporales, el impacto de la no respuesta en las prevalencias de bajo peso, sobrepeso y obesidad en niños/as de 6-15 años de edad. Método: Estudio transversal realizado en 2013 con 8145 escolares gallegos/as de 6-15 años. Quienes aceptaron participar fueron pesados/as y medidos/as, y a partir del índice de masa corporal se estimaron las prevalencias de bajo peso, sobrepeso y obesidad. Los/las profesores/as valoraron a todo el alumnado mediante escalas de siluetas corporales, y las valoraciones se usaron para estimar las prevalencias corregidas por la no respuesta. Aplicando el teorema de Bayes se estimaron las tasas de participación en función del estado ponderal. Resultados: La tasa de participación fue del 92,3% para los/las de 6-11 años y del 90% para los/las de 12-15 años. En ambos grupos, las prevalencias de bajo peso y sobrepeso fueron similares entre participantes y no participantes, pero la obesidad fue mayor entre los no participantes, sobre todo a los 12-15 años (6,3% vs. 12,2%; p<0,05). Las prevalencias no variaron al ser corregidas con las valoraciones. La tasa de participación de los/las escolares obesos/as fue inferior a la global (82% vs. 90% a los 12-15 años; p <0,05). Conclusiones: Se confirma la presencia de sesgo de participación, mayor a los 12-15 años, aunque su impacto en las prevalencias fue despreciable debido a la alta tasa de participación. En los estudios de obesidad con medidas objetivas es fundamental cuantificar la no respuesta, así como valorar el impacto que tiene y corregirlo

Objective: To evaluate and correct the impact of non-response in the prevalence of underweight, overweight and obesity in children aged 6 to 15 years old using silhouette scales. Method: Cross-sectional study carried out in 2013 among 8,145 Galician schoolchildren aged 6-15 years old. The students who agreed to participate were weighed and measured and, based on body mass index, the prevalence of underweight, overweight and obesity was estimated. Teachers rated all students using silhouette scales. The valuations were used to estimate the prevalence corrected by non-response. Using the Bayes theorem, participation rates were estimated according to weight status. Results: The participation rate was 92.3% in the 6 -to 11-year-old group, and 90% in the 12- to 15-year old age group. In both groups, the prevalence of underweight and overweight were similar between participants and non-participants. However, obesity was higher among non-participants, especially at 12 to 15 years of age (6.3% vs. 12.2% ; p < 0.05). The prevalence did not change when corrected by the teacher's valuation. The participation rate of obese students was lower than the overall rate (82% vs. 90% at 12 to 15 years old; p < 0.05). Conclusions: The presence of participation bias, which was greater at 12-15 years old, was confirmed. However, the impact of the bias on prevalence was negligible due to the high participation rate. In obesity studies with objective measures, it is essential to quantify non-participation, as well as to assess its impact and correct it

Prevalencia de malnutrición en escolares españoles / Prevalence of malnutrition in Spanish schoolchildren

INTRODUCCIÓN Y OBJETIVOS: Bajo el término malnutrición se agrupa la malnutrición por exceso, por defecto y por retraso en el crecimiento. Su prevalencia, a nivel poblacional, se puede estimar mediante variables antropométricas. El objetivo de este trabajo es estimar la prevalencia de malnutrición en los escolares gallegos de 6 a 15 años en el curso escolar 2013-2014. MÉTODOS: Estudio transversal sobre una muestra representativa por sexo y edad de la población gallega de 6 a 15 años. Se estimó la prevalencia de obesidad, bajo peso y baja estatura en función del sexo y la edad utilizando los criterios de referencia propuestos por la Organización Mundial de la Salud. RESULTADOS: Se pesaron y midieron 7.438 escolares. En global, el 16,4% de los escolares presentaban malnutrición. La prevalencia de obesidad fue del 14,8%, la de bajo peso, del 0,7%, y la de baja estatura para la edad, del 1%. La obesidad fue más prevalente entre los niños; respecto al bajo peso o baja estatura cuando aparecieron diferencias, las prevalencias fueron más altas entre las niñas. CONCLUSIONES: En Galicia, 16 de cada 100 escolares de 6 a 15 años presentaban malnutrición, siendo la malnutrición por exceso u obesidad la manifestación más frecuente. La prevalencia de bajo peso y baja estatura no superaron el 1%. Estos datos ponen de manifiesto que se deben promover medidas de prevención primaria a edades tempranas encaminadas a disminuir la malnutrición, especialmente por exceso o adiposidad

INTRODUCTION AND OBJETIVES: The term malnutrition includes malnutrition due to excess or obesity, underweight as well as stunted growth. Its prevalence in a population can be estimated using anthropometric variables. The aim of this study is to estimate the prevalence of malnutrition in Galician schoolchildren aged 6 to 15 years in the school year 2013-2014. METHODS: A cross-sectional study was conducted on a representative sample by gender and age of the Galician population of 6 to 15 years old. The prevalence of obesity, underweight, and short stature was estimated by age and gender using the reference standards proposed by the World Health Organisation. RESULTS: Of the total of 7,438 schoolchildren weighed and measured, 16.4% had malnutrition. The prevalence of obesity was 14.8%, underweight was 0.7%, and short stature for age was estimated at 1%. Obesity was more prevalent among boys. As regards underweight and short stature, when there were differences, prevalence was higher among girls. CONCLUSIONS: In Galicia, 16 out of every 100 schoolchildren aged 6 to 15 years had malnutrition, with that due to excess or obesity being the most frequent. Prevalence of underweight and short stature did not exceed 1%. This data shows that primary prevention measures should be promoted at an early age to reduce malnutrition due to excess or adiposity, in particular

[Excess weight and abdominal obesity in Galician children and adolescents]. / Exceso ponderal y obesidad abdominal en niños y adolescentes gallegos.

INTRODUCTION AND OBJECTIVES: The excess of weight, mainly obesity, during childhood and adolescence increases morbimortality risk in adulthood. The aim of this article is to estimate both the overall prevalence, as well as according to age and gender, of underweight, overweight, obesity and abdominal obesity among schoolchildren aged between 6-15-years-old in the school year 2013-2014. MATERIAL AND METHODS: Data were taken from a cross-sectional community-based study carried out on a representative sample, by gender and age, of the Galician population aged between 6 and 15 years-old. The prevalence of underweight, overweight, and obese children (Cole's cut-off criteria) and abdominal obesity (Taylor's cut-off criteria) were estimated after performing objective measurements of height, weight and waist circumference at school. RESULTS: A total of 7,438 students were weighed and measured in 137 schools. The prevalence of overweight and obese individuals was 24.9% and 8.2%, respectively. The prevalence of abdominal obesity was 25.8%, with 4% of children with normal weight having abdominal obesity. CONCLUSIONS: These data highlight the need to promote primary prevention measures at early ages in order to decrease the occurrence of the premature onset of disease in the future. The prevalence of excess weight is underestimated if abdominal obesity is not taken into consideration.