Hospitalizaciones por y con enfermedad pulmonar obstructiva crónica en Galicia: 20 años de evolución / Hospitalizations due to and with chronic obstructive pulmonary disease in Galicia: 20 years of evolution

Objetivo Analizar la evolución de las hospitalizaciones relacionadas con enfermedad pulmonar obstructiva crónica (EPOC) en Galicia en el período 1996-2018, tanto como causa principal del ingreso (POR EPOC) como si se codificaba en cualquier posición diagnóstica (CON EPOC), estudiando la influencia de la edad, el sexo, la estacionalidad u otras causas principales del ingreso. Metodología Se realizó un análisis del conjunto mínimo básico de datos (CMBD) de Galicia sobre el primer ingreso por EPOC entre 1996 y 2018. Se calcularon tasas brutas, específicas y estandarizadas tanto globales como por sexo y por grupos de edad. Resultados En el período 1996-2018 se produjeron en Galicia 310.883 primeros ingresos CON EPOC, de los que el 29,6% fueron POR EPOC. Las tasas de ingresos tanto CON EPOC como POR EPOC aumentaron, fundamentalmente en varones. Existe una clara estacionalidad de los ingresos, especialmente relevante POR EPOC. La razón de masculinidad media es aproximadamente 4 en ambos escenarios, si bien es inferior en los grupos etarios extremos, sin cambios a lo largo del tiempo. La edad media al ingreso ha aumentado tres años en este período en los varones; en las mujeres no hubo variaciones. Las causas principales del ingreso cuando no es POR EPOC son insuficiencia cardíaca y neumonía. Conclusión La evaluación combinada de los registros de ingresos hospitalarios CON y POR EPOC aporta información complementaria para un mejor conocimiento de las tendencias de esta enfermedad y establecer hipótesis que expliquen los resultados descritos, aportando información para una mejor planificación sanitaria (AU)

Objective This work aims to analyze the evolution of COPD-related hospitalizations in Galicia from 1996 to 2018 both as main cause of admission (DUE TO COPD) or when coded in any diagnostic order (WITH COPD), assessing the influence of age, sex, seasonality, and other main causes of the hospitalization. Methods An analysis was conducted of administrative healthcare database (CMBD) data on index COPD-related hospitalizations in Galicia from 1996 to 2018. Crude, specific, and standardized rates were calculated for the entire sample and according to age and sex groups. Results In the period from 1996 to 2018, there were 310,883 index admissions WITH COPD in Galicia, of which 29.6% were DUE TO COPD. Both WITH COPD and DUE TO COPD admission rates increased, mainly in men. There was a clear seasonality that was especially relevant in the DUE TO COPD group. The mean male-to-female ratio was approximately 4:1 in both groups, although it was lower in the extreme age groups, with no change over time. The mean age at admission increased three years in men during this period; there were no changes among women. The main causes of admission in those not hospitalized DUE TO COPD were heart failure and pneumonia. Conclusion The combined evaluation of records of hospital admissions WITH COPD and DUE TO COPD offers additional information for a better understanding of the trends of this disease and allows for establishing hypotheses that explain the results described, providing information for better healthcare planning (AU)

Hospitalizations due to and with chronic obstructive pulmonary disease in Galicia: 20 years of evolution.

OBJECTIVE: This work aims to analyze the evolution of COPD-related hospitalizations in Galicia from 1996 to 2018 both as main cause of admission (DUE TO COPD) or when coded in any diagnostic order (WITH COPD), assessing the influence of age, sex, seasonality, and other main causes of the hospitalization. METHODS: An analysis was conducted of administrative healthcare database (CMBD) data on index COPD-related hospitalizations in Galicia from 1996 to 2018. Crude, specific, and standardized rates were calculated for the entire sample and according to age and sex groups. RESULTS: In the period from 1996 to 2018, there were 310,883 index admissions WITH COPD in Galicia, of which 29.6% were DUE TO COPD. Both WITH COPD and DUE TO COPD admission rates increased, mainly in men. There was a clear seasonality that was especially relevant in the DUE TO COPD group. The mean male-to-female ratio was approximately 4:1 in both groups, although it was lower in the extreme age groups, with no change over time. The mean age at admission increased three years in men during this period; there were no changes among women. The main causes of admission in those not hospitalized DUE TO COPD were heart failure and pneumonia. CONCLUSION: The combined evaluation of records of hospital admissions WITH COPD and DUE TO COPD offers additional information for a better understanding of the trends of this disease and allows for establishing hypotheses that explain the results described, providing information for better healthcare planning.

Mantenimiento del consumo de pescado rico en metilmercurio durante el embarazo: prevalencia, consejo profesional y características maternas asociadas / Maintaining methylmercury-rich fish consumption during pregnancy: prevalence, professional advice and associated maternal characteristics

Introducción: los objetivos de este estudio fueron estimar la prevalencia del consumo de pescado rico en metilmercurio (MeHg) durante el embarazo, la proporción de mujeres que recibieron recomendaciones sanitarias para evitar su consumo e identificar los factores asociados al mantenimiento del consumo. Material y métodos: en 2016 se realizó un estudio transversal siendo la población objetivo mujeres que habían dado a luz entre septiembre de 2015 y agosto de 2016 en Galicia (España). La información sobre el estado de la mujer seis meses antes del embarazo, durante el embarazo, en el momento del parto y en el momento de la encuesta se obtuvo con una entrevista telefónica estructurada. La prevalencia de consumo de pescados ricos en MeHg se estimó antes y durante la gestación y se ajustó un modelo de regresión logística para conocer las variables asociadas con el mantenimiento. Resultados: el consumo de pescado rico en MeHg fue del 30% durante los seis meses previos a la gestación y disminuyó a 7% durante esta. El mantenimiento del consumo se asoció con no vivir en entorno urbano, multiparidad, consumir más de una porción de pescado rico en MeHg/semana antes de la gestación y con no haber recibido recomendaciones profesionales para evitar el consumo; 5 de cada 10 mujeres recibieron estas recomendaciones durante los controles prenatales. Conclusiones: algunos factores asociados con continuar consumiendo pescados ricos en MeHg durante el embarazo son modificables y deben ser considerados en la elaboración de mensajes de salud pública destinados a promover una alimentación adecuada durante el embarazo (AU)

Introduction: Our aims were to estimate the prevalence of MeHg-rich fish consumption, the proportion of women who received healthcare recommendations to avoid their consumption and to identify the factors associated with the maintenance of consumption during pregnancy.Material and methods: In 2016, a cross-sectional study based on a random sampling of all the women who had given birth between September 2015 and August 2016 was conducted in Galicia, Spain. Information was collected through a structured telephone interview 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 MeHg-rich fish consumption, was estimated before and during pregnancy and a logistic regression model was adjusted to ascertain variables associated with maintaining consumption during pregnancy.Results: The consumption of swordfish or bluefin, was 30% during the 6 months prior to pregnancy and decreased to 7% during pregnancy. Maintenance of MeHg-rich fish consumption during pregnancy was associated with not living in an urban environment, multiparity, consumption of over 1 portion of MeHg-rich fish per week prior pregnancy, and with not having received professional recommendations in order to avoid consumption; 5 out of 10 women received these recommendations during the prenatal check-ups.Conclusions: Some of the factors associated with continuing the consumption during pregnancy are modifiable and should be considered in the development of public health messages intended to promote an adequate diet during pregnancy. (AU)

Definición de caso sospechoso de gripe A(H1N1) 2009: razones para la discordancia / No disponible

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[Results of a study on the under-detection of meningococcus in vaccinated subjects in Galicia]. / Resultados del estudio de subdetección del meningococo en sujetos vacunados en Galicia.

BACKGROUND: On the basis of active surveillance and the monitoring of Meningococcal Disease (MD) following the vaccination campaign carried out in Galicia, it was observed that the proportion of isolations of the serogroups responsible for the disease among individuals suspected of Meningococcal Disease (SMD) who had been vaccinated was lower than among unvaccinated individuals. In view of this situation, a study was made in order to determine whether in the origin of those SMDs that were not isolated, we would find N. Meningitidis serogroup C, and to quantify the significance of the sub-detection of same. METHODS: For this purpose, and during the period under study (from the 26th week of 1997 to the 14th week of 1999), blood and cephalorachidian fluid samples were taken from the SMDs without isolation for their study with C protein reagent for type and serogroup. The analysis of the samples was performed by the microbiology laboratory of the Clinical Hospital of Santiago de Compostela. RESULTS: Of the 120 cases notified during the period under study, 65 were analysed by C protein reagent (38 vaccinated and 27 unvaccinated), with a positive reading for N. meningitidis in 65% (42 samples) 74% in vaccinated individuals and 52% in unvaccinated. By estimating, on the basis of the cases studied, the results for the total, and excluding the C protein reagent negative cases, we find that, for serogroup C, in only 27% of the cases occurring in vaccinated individuals was it possible to isolate it, in comparison with 80% in the case of unvaccinated subjects (p < 0.0001). These percentages are, in the case of serogroup B, 59% and 71%, respectively, a difference which is not statistically significant. CONCLUSIONS: The vaccine brought about an true sub-detection of serogroup C meningococci in the vaccinated cases.

[Meningococcal C disease epidemic in Galicia 1996: the decision making process]. / El procedimiento de toma de decisión para controlar la epidemia de meningitis C en Galicia en 1996.

In this article we describe the decision making process used to choose the best alternative for bringing under control an epidemic of meningococcal C disease, which occurred in Galicia in 1996. In the decision making process, we used a methodology which consisted on the identification and definition of a problem, in order to identify alternative solutions and to select one, and finally implement and evaluate it. The health problem was detected studying the data obtained from a survey conducted following an outbreak of meningococcal C disease in february 1995 and from the active epidemiological surveillance system created thereafter. Because this was a new, complex and severe problem, with far-reaching social consequences, critical for our organization, and with long-term implications, and because it was considered important to take the decision as objectively as possible and to clearly explain it, the methodology chosen to solve the problem was a non-programmed, multicriteria making decision process, carried out by a working group using a criterion weighting approach. This working group was created within the General Directorate of Public Health, composed of specialist and of people responsible for the different areas involved. The working group put into practice the different steps of the methodology. The assessment criteria and their respective weights were: effect (efficacy measured by the number of cases we could have prevented if the alternatives were applied in the previous season) 40%; cost (in millions of pesetas) 15%; acceptability (acceptance of and response to each strategy from different groups: general population, health care professionals, other Administrations with competency in Public Health) 30%; and coherence (adherence to the currently accepted strategies for disease control in other countries)15%. When these criteria were applied to the ten alternatives considered, a score was obtained for each one of them. The highest scoring alternative corresponded to the massive vaccination of the total population of Galicia between 18 months and 19 years of age.