A Questionnaire Survey of Personal and Occupational Variables Associated With SARS-COV-2 Infection in Health Care Personnel of the Spanish Central Military Hospital.

INTRODUCTION: Spain is the country with the highest number of health care workers affected by coronavirus disease 2019 (COVID-19) in the world. The aim of this study was to describe the epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection in health care worker (HCW) at the Gómez Ulla Military Hospital (HCDGU). MATERIALS AND METHODS: A case-control study was conducted during the first outbreak of COVID 19 at GUMH. The study was extended to the total number of HCW in the hospital who met the inclusion criteria. Health care worker of the HCDGU were civilian and military personnel that included nursing and medicine students of Spanish Military Academy, medicine specialty residents, and nursing residents of Medical Surgical Specialty in Operations (EMQO). A questionnaire of 33 items was prepared. The questionnaire was sent by e-mail to the entire population of study. With this questionnaire personnel were classified into sick (cases) or healthy. RESULTS AND CONCLUSIONS: One hundred fifty professionals answered the questionnaire. Cases were defined as those who tested positive in the diagnostic tests (n = 28, 20.7%) and no cases were those who tested negative (n = 107, 79.3%). Therefore, the percentage of SARS-CoV-2 in the GUMH was 20.7%. Of the total number of cases, 64.3% were men (P < .05), with a mean age of 47.1 years (SD 13.3), a mean BMI of 25.3 (SD 3.8), and 48.2% being overweight. Of the total cases, 59.3% had "A" blood group type and 69.2% were Rh positive. 50% were physicians, 32.1% were nurses, and 17.9% were auxiliary nurses (P < .05). Cases and controls with vitamin D deficiency and who took supplements had a lower risk of suffering COVID-19, with significant differences. Fever, cough, and diarrhea were found in at least 50% of the samples with significant differences.

Risk factors associated with sarcopenia in elderly persons in military Hospital Central de la Defensa «Gómez Ulla»

Antecedents and objectives: Sarcopenia is a syndrome characterized by the progressive and generalized decrease in skeletal muscle mass, strength and decreased physical performance. Associated factors are age, diet, sedentary lifestyle and chronic diseases. Very few studies have been conducted on the epidemiology of sarcopenia in hospitalized elderly. The objective of the study was to describe the prevalence of sarcopenia and identify the associated factors among elderly patients hospitalized in Madrid, Spain.Material y Methods:A cross-sectional study was conducted at the Hospital Central de la Defensa “Gómez Ulla” during the period from March to September 2018. 295 patients with ages greater than or equal to 65 participated. Sarcopenia was defined according to the EWGSOP2 criterion measuring muscle mass, muscle strength and functionality.Results:The prevalence of sarcopenia was 28.5% (95% CI 23.3-33.7), without significant differences between men and women. The Body Mass Index, hospital stay, alcohol consumption, smoke, physical activity, frequency of physical activity and strength of muscle mass, muscle strenght and funcionality presented an association with the sarcopenia.Conclusions:The prevalence was higher than other studies. The body mass index was significantly higher in subjects with sarcopenia. A higher proportion of smoking was found in subjects without sarcopenia. Likewise, an association was found between physical exercise and a lower prevalence of sarcopenia. (AU)

Antecedentes y objetivos: La sarcopenia es un síndrome caracterizado por la disminución progresiva y generalizada de la masa muscular esquelética, la fuerza y ​​la disminución del rendimiento físico. Los factores asociados son la edad, la dieta, el sedentarismo y las enfermedades crónicas. Se han realizado muy pocos estudios sobre la epidemiología de la sarcopenia en ancianos hospitalizados. El objetivo del estudio fue describir la prevalencia de sarcopenia e identificar los factores asociados entre pacientes ancianos hospitalizados en Madrid, España.Material y Métodos:Se realizó un estudio transversal en el Hospital Central de la Defensa «Gómez Ulla» durante el periodo de marzo a septiembre de 2018. Participaron 295 pacientes con edades mayores o iguales a 65 años. La sarcopenia se definió según el criterio EWGSOP2 que mide la masa muscular, la fuerza muscular y la funcionalidad.Resultados:La prevalencia de sarcopenia fue del 28,5 % (IC 95 % 23,3-33,7), sin diferencias significativas entre hombres y mujeres. El índice de masa corporal, estancia hospitalaria, consumo de alcohol, tabaquismo, actividad física, frecuencia de actividad física y fuerza de masa muscular, fuerza muscular y funcionalidad presentaron asociación con sarcopenia.Conclusiones:La prevalencia fue superior a otros estudios. El índice de masa corporal fue significativamente mayor en sujetos con sarcopenia. Se encontró una mayor proporción de fumadores en sujetos sin sarcopenia. Asimismo, se encontró asociación entre el ejercicio físico y una menor prevalencia de sarcopenia. (AU)

Compliance with preventive measures against malaria of personnel treated in the centre of international vaccination of the Minister of Defence (Spain).

OBJECTIVE: This study evaluated the compliance with preventive measures against malaria of the personnel treated in the Spanish Defence International Vaccination Centre (CVI). METHODS: A retrospective study was conducted from November to December 2017. The population was 534 individuals. All were treated in CVI, prior to their deployment on endemic areas of malaria, with prevention measures type C and D. A questionnaire of 23 items was elaborated. RESULTS: The percentage of response to the questionnaire was 36.9% (n=194), 100% were male. Air conditioner was the most used protection measure 93.8% (IC 95% 90.4-97.2). Only 35.5% (95% CI: 28.8-42.2) of them, showed good adherence to medication. The factors that influenced in the adherence were the country and the length of deployment. It was not established a direct relationship between the occurrence of adverse reactions and low adherence to treatment. CONCLUSIONS: The general protection measures against malaria were met in a high percentage, whilst the use of chemoprophylaxis was very low. These epidemiological data allowed us to know the validity of the health education that is provided in the traveller's care consultation. It also allowed being aware of the possibilities of infection and import of malaria by personnel of the Spanish Armed Forces. The traveller's office will reinforce the importance of taking the adequate chemo-prophylaxis trough conferences and informative diptychs..

Factores determinantes de la no vacunación de gripe en el cuerpo militar de sanidad (2016-2017) / Factors of non influenza vaccination in health Spanish military personnel (2016-2017)

ANTECEDENTES Y OBJETIVOS: La gripe es una de las enfermedades inmunoprevenibles más prevalentes en los países desarrollados. El personal que trabaja en centros sanitarios es un grupo en el que está indicada la vacunación antigripal. Los objetivos de este estudio fueron: describir la cobertura vacunal antigripal, analizar los factores que motivaron la no vacunación de los profesionales sanitarios y describir las reacciones adversas a medicamentos (RAM), asociadas a la vacuna. MATERIAL Y MÉTODOS: Estudio descriptivo transversal de febrero a marzo de 2017. La población a estudio (n= 1750) fue el personal incluido en el Cuerpo Militar de Sanidad de las Fuerzas Armadas (64,0 % hombres, 36,0 % mujeres). Las principales variables estudiadas fueron: haber recibido vacuna antigripal, sexo, fecha de nacimiento, especialidad fundamental, tiempo de trabajo y existencia y tipo de reacciones adversas. Se calculó la tasa global de cobertura vacunal, frecuencias absolutas y relativas, prueba de Chi cuadrado de Pearson así como sus intervalos de confianza (95 % p < 0,05). RESULTADOS: Se obtuvo una tasa de respuesta del 15,8 % y una cobertura vacunal del 7,0 %, siendo superior en hombres (8,3 %) y especialidad fundamental medicina (8,7 %). El factor más frecuente de no vacunación fue no creer estar en disposición de enfermar (21,3 %). El 10,0 % de los individuos presentó reacciones adversas, siendo todas locales. CONCLUSIONES: La cobertura vacunal fue muy baja, siendo superior en hombres pertenecientes a la especialidad fundamental de medicina y que desarrolló su actividad en hospitales

ANTECENDENT AND OBJETIVES: Influenza is one of the most prevalent vaccine-preventable diseases in developed countries. Staff working in health are an important risk group that influenza vaccination is indicated. The aims of this study were: describe influenza vaccination coverage according to sex, specialty and activity; analyze non-vaccination factors and adverse reactions to medications. Material and Methods: Descriptive cross-sectional study from February to March 2017. The population under study (n = 1750) was officers military health Spanish corps (64.0 % men, 36.0 % women). The main variables were: vaccinated against influenza, sex, date of birth, specialty, work history and adverse reactions. Overall rate of vaccination coverage, absolute and relative frequencies, Pearson Chi square test as well as their confidence intervals (95 % p <0.05) were calculated. Results: The response rate was 15.8 % and vaccine coverage of 7.0 % was obtained. It was major in men (8.3 %) and medical specialty (8.7 %). The most frequent non-vaccination factor was low perception of sickness (21.3 %). Only 10.0 % reported adverse reactions. All reactions were local. Conclusions: The vaccination coverage was very low, being superior in men (specialty of medicine) with developed activity in hospitals

Manejo de lesión traumática de arteria femoral con injerto autólogo de vena safena en zona de operaciones / Management of traumatic injury of femoral artery with autologous saphenous vein graft in area of operations

Tanto en el ámbito civil como en el militar, las lesiones vasculares de las extremidades inferiores son frecuentes y potencialmente mortales. Las medidas de soporte iniciales para combatir el shock, una actitud quirúrgica técnicamente correcta encaminada a reparar precozmente la vascularización del miembro y un control postoperatorio estricto y continuo son los pilares básicos del tratamiento. En condiciones óptimas, las tasas de amputación y de mortalidad se hallan por debajo del 10 y del 4%, respectivamente. Presentamos a continuación un caso de un militar afgano con una lesión con pérdida de substancia de la arteria femoral en el que se consiguió una revascularización inicial con un shunt temporal. Tras ser estabilizado y evacuado al ROLE 2 de Herat, se realizó un injerto autólogo de la vena safena contralateral

In both the military and civilian settings, traumatic vascular extremity trauma is an uncommon but potentially fatal injury. Principles of treatment involve correcting shock, rapid surgical restoration of blood flow, and strict postoperative surveillance. Under optimal conditions for these injuries, the rate of amputation and mortality are below 10% and 4%, respectively. We present a case of an Afghan soldier who suffered a major traumatic extremity injury in an austere environment. Early revascularization was temporized with an arterial shunt. After his condition stabilized, he was evacuated to the next echelon of care, where a definitive an autologous reverse saphenous vein bypass was performed