[Management of the COVID-19 pandemic in Catalonian old people's homes]. / La gestión de la pandemia de COVID-19 en las residencias geriátricas de Cataluña.

The covid-19 pandemic has exposed the deficiencies in the provision of social and health services, especially in nursing homes in Catalonia. This fact has triggered the debate on the residential model that Catalonia needs for the 21st century has begun.The objective of this article is to describe the management of the COVID-19 pandemic, during the five epidemic waves that affected the nursing homes of Catalonia, from an initial stage of absolute lack of control, to a final stage of pandemic control thanks to the rapid vaccination rate against COVID-19 in this área.

Los boticarios de Cataluña entre los siglos XIII-XVIII. Una visión socioeconómica y de salud pública / The Apothecaries of Catalonia between the XIII-XVIII centuries. A socio-economic and public health vision

Introducción: Este estudio intenta dar una visión global del quehacer profesional y de la relevancia económica, política, social y de salud pública de los boticarios de Cataluña, desde su constitución, en el siglo XIII, hasta su extinción, a finales del siglo XVIII. Previamente es necesario hacer referencia al contexto histórico, al desarrollo de la salud pública durante el periodo de estudio y al origen de la profesión de boticario. Objetivo: Exponer la evolución de los boticarios en Cataluña durante el periodo de estudio. Métodos: Revisión bibliográfica, sobre la evolución de los boticarios en Cataluña, así como sobre el desarrollo de la salud pública y el contexto histórico durante el periodo de estudio. Resultados: El desarrollo de la profesión de boticario en Cataluña se puede dividir en tres etapas bien diferenciadas: el nacimiento de la profesión (siglos XIII-XV), la consolidación de la profesión (siglos XVI- XVII) y la decadencia de la profesión (siglo XVIII)

Introduction: This study tries to give a global vision of the professional task and of the economic, political, social and public health relevance of the Apothecaries of Catalonia, from its constitution, in the XIII century, until its extinction, at the end of the XVIII century. Previously it is necessary to refer to the historical context, the development of public health during the period of study and the origin of the apothecary profession. Objective: To present the evolution of apothecaries in Catalonia during the study period. Methods: Bibliographic review on the evolution of apothecaries in Catalonia, as well as on the development of public health and the historical context during the study period. Results: The development of the apothecary profession in Catalonia can be divided into three distinct stages: the birth of the profession (XIII-XV centuries), the consolidation of the profession (XVI-XVII centuries) and the decline of the profession (XVIII century)

Estudio de la incidencia de listeriosis en España / Incidence study of listeriosis in Spain

Estudio descriptivo retrospectivo, basado en la información documental disponible, sobre los casos de listeriosis ocurridos en España en 2001-2007, con el objetivo de conocer la carga y la evolución de esta enfermedad en nuestro país. Partiendo de diversas fuentes informativas, en total se recogió la información epidemiológica de 1242 casos de listeriosis, lo que supone una tasa de incidencia media de 0,56 casos por 100.000 habitantes y año, que consideramos el valor estimado global para España. La incidencia ha mostrado una tendencia anual ascendente estadísticamente significativa (p <0,001), y ha sido muy superior a la notificada en España (0,16) mediante el Sistema de Información Microbiológica, de carácter voluntario, lo que evidencia la infradeclaración existente. La inclusión de la listeriosis en el Sistema de Enfermedades de Declaración Obligatoria permitiría dimensionar su presencia, así como conocer las características de la afectación humana y mejorar su prevención y control (AU)

We performed a descriptive retrospective study of cases of listeriosis occurring in Spain from 2001 to 2007 to determine the burden and trend of this disease in our setting. Several sources of information were used. Epidemiological information was collected from 1.242 cases of listeriosis, representing a mean incidence rate of 0,56 cases per 100.000 inhabitants per year, which was extrapolated as an overall estimate for Spain. The annual incidence showed a statistically significant increasing trend (p <0,001) over the study period. This figure was higher than that reported in Spain (0,16) by the Microbiological Information System, which is voluntary, showing that underreporting exists. The inclusion of listeriosis in the Mandatory Notification System would allow determination of the distribution and characteristics of this infection in humans, as well as promotion of effective prevention and control (AU)

Las funciones desempeñadas por los farmacéuticos titulares en la provincia de Valencia en 1954 / Functions of the municipal pharmacists in the province of Valencia (Spain) in 1954

Objetivos: Dar a conocer la organización y las funciones realizadas por los Farmacéuticos Titulares de la provincia de Valencia en el año 1954 en un contexto de importantes deficiencias sanitarias y mostrar al mismo tiempo las potencialidades de su labor en la mejora de la sanidad rural. Métodos: Se trata de un estudio descriptivo retrospectivo realizado a partir de las Memorias del Colegio Oficial de Farmacéuticos de Valencia de 1954. Para el estudio descriptivo básico se ha utilizado el paquete estadístico SPSS. Resultados: La provincia de Valencia en 1954 contaba con 116 partidos farmacéuticos y 128 farmacéuticos titulares, de los cuales el 9,4% son mujeres. Las deficiencias sanitarias más destacadas son la falta de alcantarillado (78,4%), de pavimentación de las calles (70,7%) y de distribución suficiente de agua potable (60,3%). Se realizaron un total de 4.995 inspecciones a diversos tipos de establecimientos, 550 desinfecciones, 19.939 análisis clínicos y químicos, 1.848 análisis bromatológicos y 6.312 análisis de la beneficencia. Conclusiones: La intensa labor realizada por los farmacéuticos titulares evidencia el importante potencial en la mejora de la salud pública española. Desgraciadamente con el paso de los años los farmacéuticos titulares tuvieron un papel marginal en la sanidad rural (AU)

Aim: To present the organization and the functions performed by municipal pharmacists in the province of Valencia in 1954 in the context of important health deficiencies and simultaneously to show the potential of their work in improving rural health. Methods: This is a retrospective study carried out from the Memories of the College of Pharmacists of Valencia, 1954. For basic descriptive study has been used the statistical program SPSS. Results: The province of Valencia in 1954 had 116 pharmaceutical areas and 128 municipal pharmacists, of which 9.4% are women. The most significant health deficiencies are: sewage (78.4%),paved street (70.7%) and distribution of drinking water (60.3%). A total of 4,995 inspections of various types of establishments, 55 disinfections, 19,939 clinical and chemical analysis, 1,848 bromatological analysis and 6,312 analysis of the beneficence. Conclusions: The extensive work undertaken by municipal pharmacists evidence the significant potential in improving Spanish public health. Unfortunately over the years the municipal pharmacists had a marginal role in rural health (AU)

[In search of the origin of municipal pharmacists]. / En busca del origen de los farmacéuticos titulares.

The evolution of public health in Spain during the 19th century can be divided into three stages. In the first stage (1812-1833), the reign of Fernando VII prevented the development of the liberal postulates: <>. The second stage (1833-1873), was characterized by the legislative development of sanitary organization in Spain. As a result of this new legislative framework, and in the context of social hygiene (<>), the figures of municipal health professionals appeared, engaged by the city councils to be in charge of the medical assistance of the poor (municipal physician), of the pharmaceutical assistance of the poor (municipal pharmacist), and of the health inspection of meat from the slaughterhouses (municipal veterinarian). The third stage (1873-1904), marked the beginning of a new age (microbiology) and the beginning of the scientific method. Microbiology prompted the creation of municipal laboratories throughout the state and laid the foundations for the creation of the Healthcare Services of Medicine, Pharmacy and Veterinary Science at the beginning of the xx century. These organizations would have a well-defined organizational structure with wider functions.

En busca del origen de los farmacéuticos titulares / In search of the origin of municipal pharmacists

La evolución de la salud pública en España durante el siglo XIX se puede dividir en tres etapas bien diferenciadas. En la primera (1812–1833), el reinado de Fernando VII impidió el desarrollo de los postulados liberales: «la autonomía de los ayuntamientos en materia de higiene y salud pública». La segunda (1833–1873) se caracteriza por el desarrollo legislativo de la organización sanitaria española. Como consecuencia de este nuevo marco legislativo, y en el contexto del higienismo («la desigualdad social como origen de la enfermedad»), aparecen las figuras de los sanitarios locales (facultativos titulares) contratados por los ayuntamientos para encargarse de la asistencia médica de los pobres (médico titular), de la asistencia farmacéutica de los pobres (farmacéutico titular) y de la inspección sanitaria de la carne de los mataderos (veterinario titular). La tercera (1873–1904) viene con el principio de una nueva era (la microbiología) y el inicio del método científico. La microbiología impulsa por todo el Estado la creación de los Laboratorios Municipales, y sienta las bases que darán origen, a principios del siglo XX, a la creación de los Cuerpos Sanitarios de Medicina, Farmacia y Veterinaria con una estructura organizativa bien definida y unas atribuciones más amplias(AU)

The evolution of public health in Spain during the 19th century can be divided into three stages. In the first stage (1812–1833), the reign of Fernando VII prevented the development of the liberal postulates: «the autonomy of the city councils in the matter of hygiene and public health». The second stage (1833–1873), was characterized by the legislative development of sanitary organization in Spain. As a result of this new legislative framework, and in the context of social hygiene («social inequality as the origin of disease»), the figures of municipal health professionals appeared, engaged by the city councils to be in charge of the medical assistance of the poor (municipal physician), of the pharmaceutical assistance of the poor (municipal pharmacist), and of the health inspection of meat from the slaughterhouses (municipal veterinarian). The third stage (1873–1904), marked the beginning of a new age (microbiology) and the beginning of the scientific method. Microbiology prompted the creation of municipal laboratories throughout the state and laid the foundations for the creation of the Healthcare Services of Medicine, Pharmacy and Veterinary Science at the beginning of the xx century. These organizations would have a well-defined organizational structure with wider functions(AU)

[Study of refrigeration towers associated with community outbreaks of legionellosis]. / Estudio de las torres de refrigeración asociadas a brotes comunitarios de legionelosis.

OBJECTIVE: To evaluate the factors of risk of the risk cooling towers associated to a community outbreak of legionellosis according to its characteristics of maintenance and the quality of the water with the purpose of improving the systems of prevention of this one disease. METHOD: To compare the piece of information gathered between the 4 types of cooling towers: control 1, control 2, probable and confirmed. A total of 184 cooling towers have been studied associated to 17 community outbreak of legionellosis of the province of Barcelona (Spain) during the year 2004, of which 112 are control 1, 54 control 2, 8 probable and 10 confirmed. RESULTS: The confirmed towers are characterized by: high levels of conductivity, total aerobes, calcic hardness, total solids in dissolution, temperature and turbidity; low levels of chlorine (< 2 ppm); of use hypochlorite as disinfectant in a 10%; greater degree of breach of the revision program and cleaning of the internal elements of the tower (tray, stuffed and separating of drops); degree of performance of the periodic disinfections and the cleaning of deposits of the 100%. A 47% of the investigated towers do not use the previous treatments of the water in spite of diminishing the parametric values of the quantitatives variables. CONCLUSIONS: Measures of prevention of the legionellosis would be due to guarantee: a good quality of the water and the pursuit of its quantitatives variables; chlorine levels superior to 2 ppm; the evaluation of the individual risk for each installation; the performance of the 100% of the program of revision of the internal elements of the towers.

Estudio de las torres de refrigeración asociadas a brotes comunitarios de legionelosis / Study of refrigeration towers associated with community outbreaks of legionellosis

Objetivo: Evaluar los factores de riesgo de las torres de refrigeración asociadas a un brote comunitario de legionelosis según sus características de mantenimiento y la calidad del agua. Método: Comparar los datos recogidos entre los 4 tipos de torres de refrigeración: control 1, control 2, probable y confirmada. Se han estudiado un total de 184 torres de refrigeración asociadas a 17 brotes comunitarios de legionelosis de la provincia de Barcelona durante el año 2004, de las cuales 112 son control 1, 54 control 2, 8 probables y 10 confirmadas. Resultados: Las torres confirmadas se caracterizan por: niveles elevados de conductividad, aerobios totales, dureza cálcica, sólidos totales en disolución, temperatura y turbidez; concentraciones de cloro deficientes (< 2 ppm); utilización del hipoclorito como desinfectante en un 10% de las instalaciones; mayor grado de incumplimiento del programa de revisión y limpieza de los elementos internos de las torres (bandeja, relleno y separador de gotas); grado de cumplimiento de las desinfecciones periódicas y de la limpieza de depósitos del 100%. Un 47% de las torres investigadas no utilizan los tratamientos previos del agua a pesar de disminuir los valores de las variables fisicoquímicas. Conclusiones: Se deberían establecer medidas de prevención de la legionelosis que garanticen una buena calidad del agua y el seguimiento de sus variables fisicoquímicas, unos niveles de cloro superior a 2 ppm, la evaluación del riesgo individual para cada instalación, y el cumplimiento del 100% del programa de revisión de los elementos internos de las torres

Objetive: To evaluate the factors of risk of the risk cooling towers associated to a community outbreak of legionellosis according to its characteristics of maintenance and the quality of the water with the purpose of improving the systems of prevention of this one disease. Method: To compare the piece of information gathered between the 4 types of cooling towers: control 1, control 2, probable and confirmed. A total of 184 cooling towers have been studied associated to 17 community outbreak of legionellosis of the province of Barcelona (Spain) during the year 2004, of which 112 are control 1, 54 control 2, 8 probable and 10 confirmed. Results: The confirmed towers are characterized by: high levels of conductivity, total aerobes, calcic hardness, total solids in dissolution, temperature and turbidity; low levels of chlorine (< 2 ppm); of use hypochlorite as disinfectant in a 10%; greater degree of breach of the revision program and cleaning of the internal elements of the tower (tray, stuffed and separating of drops); degree of performance of the periodic disinfections and the cleaning of deposits of the 100%. A 47% of the investigated towers do not use the previous treatments of the water in spite of diminishing the parametric values of the quantitatives variables. Conclusions: Measures of prevention of the legionellosis would be due to guarantee: a good quality of the water and the pursuit of its quantitatives variables; chlorine levels superior to 2 ppm; the evaluation of the individual risk for each installation; the performance of the 100% of the program of revision of the internal elements of the towers

[The use of the Framingham-REGICOR equation in a primary care centre. Impact on primary prevention of cardiovascular diseases]. / Utilización de la ecuación de Framingham-REGICOR en un centro de atención primaria. Impacto sobre la prevención primaria de las enfermedades cardiovasculares.

OBJECTIVES: To evaluate the adequacy of cardiovascular primary prevention by calculating cardiovascular risk (CVR) with 2 different equations and to evaluate the economic impact of the resulting drug expenditure. DESIGN. By means of a transversal study of all the new cases of lipaemia diagnosed, patients were classified in 2 CVR categories (> or =20% and <20%). The Framingham-Wilson (FW) and Framingham-REGICOR (FR) equations were used to analyse the difference between observed treatments (really prescribed) and expected treatments. Costs were compared. SETTING: Barceloneta PCC, Barcelona, Spain. PATIENTS: Ninety-two cases of lipaemia (2002 and 2003) that met the following inclusion criteria: no coronary history, no taking of lipid-lowering drugs, and age between 35 and 74. There were 10 losses in the 92 individuals through lack of a variable for calculating CVR. RESULTS: According to the clinical criterion, 22 of the 82 patients were treated with medication (26.82%). The expected proportion of patients treated when the FW equation was used was 24.39% (20/82); and was 0% (0/82) with the FR equation. On applying the FW equation, it was seen that 12 of 22 patients treated and 10 of 60 patients not treated did not receive the correct drug treatment. If the mean cost per patient treated and per year at the PCC is applied to the new cases, there is a 9.09% reduction (euro 479.2) for the FW equation and 100% (euro 5271.2) for the FR equation. CONCLUSIONS: The use of one or other algorithm for calculating CVR entails pertinent differences in clinical practice and expenditure. All patients in primary prevention must receive non-pharmacological treatment.

Utilización de la ecuación de Framingham-REGICOR en un centro de atención primaria. Impacto sobre la prevención primaria de las enfermedades cardiovasculares / The use of the Framingham-REGICOR equation in a Primary Care Centre. Impact on primary prevention of cardiovascular diseases

El estudio que aquí se presenta corresponde a un trabajo de tesina del Máster de Salud Pública de la UPF (edición 2002-2004). Este estudio no ha sido presentado ni publicado en ninguna revista científica y únicamente ha sido expuesto al tribunal del Máster. Objetivos. Evaluar la adecuación de la prevención primaria cardiovascular mediante la estimación del riesgo cardiovascular (RCV) según 2 ecuaciones diferentes y evaluar el impacto económico del gasto farmacológico consecuente. Diseño. Estudio transversal. Emplazamiento. Centro de atención primaria de la Barceloneta (CAP Barceloneta) en Barcelona. Pacientes. Se incluyó a 92 casos incidentes de dislipidemia (años 2002 y 2003) que cumplían los siguientes criterios de inclusión: sin antecedentes coronarios, no tomar fármacos hipolipidemiantes y edad entre 35 y 74 años. De los 92 individuos se produjeron 10 pérdidas por falta de alguna variable para calcular el RCV. Mediciones. Los pacientes se clasifican en 2 categorías de RCV (≥ 20% y < 20%) mediante la aplicación de las ecuaciones de Framingham-Wilson (FW) y Framingham-REGICOR (FR). Se analiza la diferencia entre tratamientos observados (realmente prescritos) y esperados según una u otra ecuación. Se compara el coste. Resultados. Se observa que, según el criterio clínico, 22 de los 82 pacientes incidentes son tratados con fármacos (26,82%). La proporción esperada de pacientes tratados si se aplica la ecuación de FW es del 24,39% (20/82), y del 0% (0/82) para la ecuación FR. Al aplicar la ecuación FW se observa que 12 de los 22 pacientes tratados y 10 de los 60 pacientes no tratados no reciben correctamente el tratamiento farmacológico. Si el coste medio por paciente tratado y año en el CAP se aplica a los casos nuevos, se observa una reducción del 9,09% (479,2 euros) para la ecuación FW y del 100% (5.271,2 3 euros) para la ecuación FR. Conclusiones. La aplicación de uno u otro algoritmo de cálculo del RCV comporta diferencias relevantes en la práctica clínica y en los costes derivados. Todos los pacientes en prevención primaria deben recibir tratamiento no farmacológico

Objectives. To evaluate the adequacy of cardiovascular primary prevention by calculating cardiovascular risk (CVR) with 2 different equations and to evaluate the economic impact of the resulting drug expenditure. Design. By means of a transversal study of all the new cases of lipaemia diagnosed, patients were classified in 2 CVR categories (≥20% and <20%). The Framingham-Wilson (FW) and Framingham-REGICOR (FR) equations were used to analyse the difference between observed treatments (really prescribed) and expected treatments. Costs were compared. Setting. Barceloneta PCC, Barcelona, Spain. Patients. Ninety-two cases of lipaemia (2002 and 2003) that met the following inclusion criteria: no coronary history, no taking of lipid-lowering drugs, and age between 35 and 74. There were 10 losses in the 92 individuals through lack of a variable for calculating CVR. Results. According to the clinical criterion, 22 of the 82 patients were treated with medication (26.82%). The expected proportion of patients treated when the FW equation was used was 24.39% (20/82); and was 0% (0/82) with the FR equation. On applying the FW equation, it was seen that 12 of 22 patients treated and 10 of 60 patients not treated did not receive the correct drug treatment. If the mean cost per patient treated and per year at the PCC is applied to the new cases, there is a 9.09% reduction (€479.2) for the FW equation and 100% (€5271.2) for the FR equation. Conclusions. The use of one or other algorithm for calculating CVR entails pertinent differences in clinical practice and expenditure. All patients in primary prevention must receive non-pharmacological treatment