Gripe 2014 / Flu 2014

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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)

El estudio de prevalencia de las infecciones nosocomiales en España Epine-EPPS 2012 / No disponible

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Particle counting and microbiological air sampling: Results of the simultaneous use of both procedures in different types of hospital rooms

Introduction In order to assess the relationship between the concentrations of airborne fungi and particles, particle counting was combined with fungal air sampling in several rooms of a hospital. Methods Concentrations of ≥0.5μm particles (P05) and ≥1μm particles (P1) were measured using a particle counter; fungal air sampling was performed with volumetric air samplers, which impacted air on Rodac plates with Sabouraud chloramphenicol agar. Particle counts were categorised according to ISO 14644-1 standard cut-off points; their association with fungal detection was assessed with Fisher's exact test. Results Forty-two simultaneous samplings were carried out: 24 in operating rooms, 13 in rooms for burns or haematology patients, 3 in pharmacy clean rooms, and two in other procedure rooms. Filamentous fungi were recovered in 5 samples, which also had higher particle counts. No fungi were detected in 12 samplings with both P05 and P1 concentrations below the maximum for class 6 clean rooms; 4 of 7 samplings with both concentrations within the range for class 8 clean rooms were positive for fungi. The association between fungal detection and higher particle counts was statistically significant, both for P05 (p=.004) and P1 (p=.003). There was a partial overlap between the concentrations of particles of samplings which were positive or negative for fungi. Conclusions There is a relationship between the concentrations of P05 and P1 and airborne fungi in hospital rooms. When both P05 and P1 concentrations are below the maximum for class 6 clean rooms, a negative fungal detection can be predicted (AU)

Introducción Para evaluar la relación entre las concentraciones de esporas de hongos y de partículas vehiculados por aire, el recuento de partículas se añadió al estudio microbiológico del aire de varias salas de un hospital. Métodos Las concentraciones de partículas ≥0,5μm (P05) y ≥1μm (P1) se midieron con contador de partículas; el muestreo para estudio microbiológico se efectuó con aspiradores volumétricos que impactaban aire sobre placas Rodac con agar Sabouraud cloranfenicol. Los recuentos de partículas se categorizaron según puntos de corte de norma ISO 14644-1; su asociación con la detección de hongos se evaluó con la prueba exacta de Fisher. Resultados Se realizaron 42 muestreos simultáneos: 24 en quirófanos, 13 en habitaciones para pacientes quemados o hematológicos, 3 en salas blancas de farmacia y 2 en salas para otros procedimientos. Se aislaron hongos filamentosos en 5 muestreos, cuyas concentraciones de partículas fueron superiores. No se detectaron hongos en 12 muestreos con concentraciones de clase 6 de P05 y P1; sí se detectaron en 4 de 7 muestreos con concentraciones de ambas partículas de clase 8. La asociación entre detección de hongos y recuentos elevados de partículas fue estadísticamente significativa para P05 (p=0,004) y P1 (p=0,003). Hubo una superposición parcial de las concentraciones de partículas de los muestreos con y sin detección de hongos. Conclusiones En salas hospitalarias hay una asociación entre concentraciones de P05, P1 y hongos en aire. Concentraciones de P05 y P1 inferiores al máximo para salas de clase 6 pueden predecir ausencia de detección de hongos (AU)

Particle counting and microbiological air sampling: results of the simultaneous use of both procedures in different types of hospital rooms.

INTRODUCTION: In order to assess the relationship between the concentrations of airborne fungi and particles, particle counting was combined with fungal air sampling in several rooms of a hospital. METHODS: Concentrations of ≥0.5µm particles (P05) and ≥1µm particles (P1) were measured using a particle counter; fungal air sampling was performed with volumetric air samplers, which impacted air on Rodac plates with Sabouraud chloramphenicol agar. Particle counts were categorised according to ISO 14644-1 standard cut-off points; their association with fungal detection was assessed with Fisher's exact test. RESULTS: Forty-two simultaneous samplings were carried out: 24 in operating rooms, 13 in rooms for burns or haematology patients, 3 in pharmacy clean rooms, and two in other procedure rooms. Filamentous fungi were recovered in 5 samples, which also had higher particle counts. No fungi were detected in 12 samplings with both P05 and P1 concentrations below the maximum for class 6 clean rooms; 4 of 7 samplings with both concentrations within the range for class 8 clean rooms were positive for fungi. The association between fungal detection and higher particle counts was statistically significant, both for P05 (p=.004) and P1 (p=.003). There was a partial overlap between the concentrations of particles of samplings which were positive or negative for fungi. CONCLUSIONS: There is a relationship between the concentrations of P05 and P1 and airborne fungi in hospital rooms. When both P05 and P1 concentrations are below the maximum for class 6 clean rooms, a negative fungal detection can be predicted.

[Transmissibility and severity of the pandemic influenza A (H1N1) 2009 virus in Spain]. / Transmisibilidad y gravedad de la pandemia de gripe A(H1N1)2009 en España.

OBJECTIVES: To estimate the value of the basic reproduction number for the pandemic wave of influenza A (H1N1) 2009 in Spain and to assess its impact on morbidity and mortality in the Spanish population compared with those in the previous influenza season. METHODS: Data on the incidence of influenza and viral detections were obtained from the Spanish Influenza Surveillance System. Deaths from pandemic influenza were obtained from the Coordinating Center for Health Alerts and Emergencies of the Spanish Ministry of Health and Social Policy, and deaths from seasonal influenza during the period 2003-2008 were obtained from the National Statistics Institute. The reproduction number was estimated by two methods: firstly, by using the growth rate of the cumulative incidence of influenza during the exponential growth phase of the pandemic wave, and secondly (maximum likelihood estimation), through analysis the dates of onset of symptoms observed in pairs of cases based on generation time distribution. We calculated the fatality rate and mortality from influenza by comparing potential years of life lost in the pandemic season with those in previous interpandemic seasons. RESULTS: The start of the pandemic wave occurred in Spain earlier in week 40/2009 (from 4 to 10 October), with an absolute predominance of the new strain in the pattern of circulating viruses. The value of R(0) in the growth phase of the wave was 1.29 (95% CI: 1.25-1.33), estimated with the first method, and was 1.01 (95% CI: 0.99-1.03) with the second method. During the pandemic season, there were 318 deaths from pandemic influenza, affecting younger age groups than in previous interpandemic seasons. Consequently, the number of potential years of life lost in the pandemic season (11,612) was estimated at six times the adjusted annual average of the interpandemic influenza seasons for comparison (1,802). CONCLUSIONS: The estimates of R(0) for the growth phase of the pandemic wave were in the lower range of estimates of this parameter in previous pandemics. Mortality indicators calculated in the pandemic period showed an increase in deaths compared with previous interpandemic seasons, which was most pronounced in young patients.

Gripe A (H1N1) 2009: Perspectiva final de la pandemia / Influenza A (H1N1) 2009: a perspective at the ende of the pandemic

Fundamento. La gripe es una enfermedad importante en salud pública, con una alta morbilidad y elevados costes sanitarios. Desde principios del siglo XX se han producido cuatro pandemias de gripe; la última ha sido la del 2009, causada por un nuevo subtipo de virus influenza A (H1N1). Objetivo. Presentar los datos epidemiológicos más relevantes de la pandemia de gripe A (H1N1) 2009. Método. Revisión de fuentes oficiales y de las principales publicaciones sobre el tema. Grip A (H1N1) 2009: perspectiva final de la pandèmia Magda Campins Martí, Roser González Baulies, Josep Vaqué Rafart Servei de Medicina Preventiva i Epidemiologia. Hospital Universitari Vall d’Hebron. Universitat Autònoma de Barcelona. Barcelona Resultados. La pandemia de gripe A (H1N1) se ha presentado en forma de dos olas: la primera desde abril hasta agosto y la segunda a partir de septiembre, y se ha dado por finalizada en diciembre en la mayor parte de países. Los grupos de edad más afectados han sido los niños y adultos jóvenes, con escasa afectación de la población mayor de 65 años. Su letalitat ha sido menor que la de la gripe estacional, y más alta en personas mayores de 50 años, aunque el mayor número de muertes se ha producido en adultos de 20 a 59 años. La vacunación es la principal medida de prevención. Los estudios de vigilancia postcomercialización indican que la vacuna es segura. Conclusiones. La gripe pandémica tiene unas características epidemiológicas diferentes de la estacional, respecto a los grupos de población más afectados y con mayor riesgo de complicaciones(AU)

Background. Influenza is an important illness from a public health perspective, with high morbidity and health costs. From the start of the XXth century there have been four influenza pandemics, the last one being in 2009, caused by a new strain of influenza A (H1N1) virus. Objective. To present the most relevant epidemiological data concerning influenza A (H1N1) 2009 pandemic. Method. Review of official sources and the main scientific publications about this subject. Results. Two pandemic waves occurred in 2009; the first one started in April and ended in August, and the second one started in September and ended in December in the majority of the countries. Children and young adults were the most affected groups and people older than 65 years were the least affected. The mortality rate was lower than seasonal influenza, with the highest rates occurring in people older than 50, although the highest number of deaths was reported among adults aged 20-59. Vaccination is the most important preventive measure. Post commercialization surveillance studies demonstrate that pandemic vaccines are safe. Conclusions. Pandemic influenza has different epidemiologic characteristics than seasonal influenza, with differences in the age groups most frequently affected and those with higher risk of complications(AU)

Epidemiología de la gripe A (H1N1) en el mundo y en España / Epidemiology of influenza A (H1N1) worldwide and in Spain

El 11 de junio de 2009, la Organización Mundial de la Salud declaró establecida la situación de pandemiadebida a un nuevo virus influenza A (H1N1) de origen porcino. El virus empezó a producir casos de gripeen el mes de marzo en México, y a partir de mediados de abril en 6 semanas se extendió por todo el mundo.Su transmisibilidad es ligeramente superior a la de la gripe estacional; en cambio, su patogenicidad y virulenciason bajas. Los grupos más afectados han sido los niños, jóvenes y adultos de menos de 30 años. Lamortalidad se ha concentrado en las personas de 20 a 50 años.La pandemia ha producido en los países de clima templado 2 ondas epidémicas. La primera se desarrollódesde mediados de abril hasta mediados de agosto y afectó, en primer a lugar, a México, Estados Unidos yluego a España, Reino Unido, Japón y otros países del hemisferio norte. Unas semanas después, coincidiendocon el inicio de la estación gripal, afectó a los países del hemisferio sur, en especial Argentina, Chile,Australia y Nueva Zelanda, en los que concluyó a finales de septiembre u octubre.La segunda ola se ha desarrollado en el hemisferio norte, iniciándose a comienzos de septiembre en EstadosUnidos y México, y unas semanas más tarde en los países europeos; a mediados de diciembre se hadado por concluida, aunque la actividad gripal persiste. Esta segunda ola ha sido mucho más intensa que laprimera(AU)

On June 11, 2009, the World Health Organization declared an established pandemic due to a new influenzavirus A (H1N1) of swine origin. Initial cases were detected in Mexico in March and within 6 weeks thevirus had spread worldwide.The transmissibility of influenza A (H1NA) is slightly higher than that of the seasonal virus, but itspathogenicity and virulence are low. The main target groups of this new virus have been children andyoung adults under 30 years old. Mortality has affected mainly persons aged between 20 and 50 years old.In areas with temperate climates, two epidemic waves have occurred. The first one, from mid-April to mid-August, affected Mexico, the United States and, consecutively, Spain, England, Japan, and other countries inthe northern hemisphere. A few weeks later, coinciding with the beginning of the influenza season, theH1N1 epidemic started in the southern hemisphere countries, especially Argentina, Chile, Australia andNew Zealand; in these countries, the epidemic finished at the end of September or October.The second wave affected the northern hemisphere, starting in the United States and Mexico at thebeginning of September, and a few weeks later in European countries. In mid-December, this wave wasconsidered to have ended, although some influenza activity persists. The intensity of this second wave washigher compared to the first one(AU)

Vacunación antigripal en gestantes. Cobertura vacunal y conocimientos y prácticas de los obstetras / Influenza vaccination in pregnant women. Coverage, practices and knowledge among obstetricians

Fundamento y objetivo: El embarazo es un factor de riesgo independiente para presentar una forma clínica grave de gripe. Múltiples organismos nacionales e internacionales incluyen en sus recomendaciones oficiales la administración de vacunación antigripal a gestantes. El objetivo de este trabajo fue estimar las coberturas de vacunación antigripal en una muestra amplia de mujeres atendidas por parto en un hospital de tercer nivel y conocer los conocimientos y prácticas de los obstetras en relación con la indicación de la vacuna. Métodos: Estudio descriptivo transversal mediante 2 encuestas: una administrada a las puérperas atendidas por parto entre diciembre de 2007 y febrero de 2008, y otra dirigida a los obstetras que trabajaban en este hospital o en centros de atención primaria del área de referencia. Resultados: La cobertura vacunal en las puérperas del estudio fue de un 4,1%. El 80,5% de las mujeres no presentaba comorbilidad asociada. La cobertura vacunal en el grupo con comorbilidad fue del 3,3%. El profesional que recomendó más frecuentemente la vacuna fue la comadrona (28,9%) y la enfermera (18,4%). Entre los obstetras, sólo el 20% conocía la indicación de la vacunación antigripal en gestantes durante el primer trimestre, y el 65,1%, en el segundo o tercer trimestre. Sólo el 7% manifestó prescribir la vacuna en el primer trimestre y un 20,9%, en el segundo o tercer trimestre. Conclusiones: La cobertura vacunal en las gestantes de nuestro estudio es muy baja. Los obstetras encuestados presentaron un bajo nivel de conocimiento de las recomendaciones vigentes, en especial la de la inmunización durante el primer trimestre del embarazo, y muy pocos la prescriben (AU)

Background and objectives: Women who are pregnant during influenza season have an increased risk of infection and severe clinical disease. Several national and international organizations currently recommend vaccination for pregnant women. We intended to estimate the influenza vaccination rate in a population of postpartum women attended in a tertiary hospital in Barcelona. Moreover, we assessed the knowledge and practice of obstetricians about influenza vaccination during pregnancy. Methods: Two cross-sectional surveys were performed. Postpartum women who delivered from December 2007 to February 2008 were included. The sample of obstetricians was constituted by those who were working in hospital or primary care reference areas. Results: Influenza vaccination rate was 4.1%. Healthy women represented 80.5% of our population. The vaccination rate in the group with comorbidities was 3.3%. The providers who recommended the vaccine more frequently were the midwife in 28.9% and the nurse in 18.4%. Among the obstetricians, 20.9% responded that the influenza vaccine was recommended in the first trimester of pregnancy and 65.1% said that it was recommended in the second or third trimester. In relation to practice, only 7% offered the vaccine in the first trimester and 20,9% in the second or third trimester. Conclusions: The influenza vaccination rate in pregnant women in our study is very low. Obstetricians showed a low level of knowledge about the current influenza vaccination recommendations, mainly in the case of first trimester of pregnancy and only few offered the vaccine in their practice (AU)

[Influenza vaccination in pregnant women. Coverage, practices and knowledge among obstetricians]. / Vacunación antigripal en gestantes. Cobertura vacunal y conocimientos y prácticas de los obstetras.

BACKGROUND AND OBJECTIVES: Women who are pregnant during influenza season have an increased risk of infection and severe clinical disease. Several national and international organizations currently recommend vaccination for pregnant women. We intended to estimate the influenza vaccination rate in a population of postpartum women attended in a tertiary hospital in Barcelona. Moreover, we assessed the knowledge and practice of obstetricians about influenza vaccination during pregnancy. METHODS: Two cross-sectional surveys were performed. Postpartum women who delivered from December 2007 to February 2008 were included. The sample of obstetricians was constituted by those who were working in hospital or primary care reference areas. RESULTS: Influenza vaccination rate was 4.1%. Healthy women represented 80.5% of our population. The vaccination rate in the group with comorbidities was 3.3%. The providers who recommended the vaccine more frequently were the midwife in 28.9% and the nurse in 18.4%. Among the obstetricians, 20.9% responded that the influenza vaccine was recommended in the first trimester of pregnancy and 65.1% said that it was recommended in the second or third trimester. In relation to practice, only 7% offered the vaccine in the first trimester and 20,9% in the second or third trimester. CONCLUSIONS: The influenza vaccination rate in pregnant women in our study is very low. Obstetricians showed a low level of knowledge about the current influenza vaccination recommendations, mainly in the case of first trimester of pregnancy and only few offered the vaccine in their practice.

Principales características de la pandemia por el nuevo virus influenza A (H1N1) / Main features of the new influenza virus a pandemic (H1N1)

A finales de marzo de 2009 fue aislado un nuevo virus influenza A (H1N1) de origen porcino en 2 niños de California con síntomas de gripe. Dicho virus se diseminó inicialmente por México y EE.UU., y después internacionalmente. A primeros de junio la infección había alcanzado 74 países, producido cerca de 30.000 casos y 145 muertes y poseía una propagación comunitaria sostenida en 6 países. El 11 de junio la Organización Mundial de la Salud (OMS) declaró establecida la situación de pandemia. La combinación de segmentos genéticos del nuevo virus nunca había sido vista antes. Contiene 5 segmentos de origen porcino, 2 aviares y 1 humano, y posee una hemaglutinina HA adaptada a la transmisión humana, que genética y antigénicamente diverge respecto a la del virus H1N1 hasta ahora circulante. Su transmisibilidad es ligeramente superior a la de la gripe estacional, y equivalente a la de las anteriores pandemias. Su patogenicidad y virulencia son bajas. El cuadro clínico es similar al típico de la gripe estacional, con curación espontánea, si bien el espectro clínico es extenso, pues va desde casos asintomáticos hasta neumonía grave o mortal. La población afectada ha sido predominantemente joven, de menos de 30 años. Menos de la mitad de los pacientes hospitalizados en EE.UU. y de los casos mortales en México presentaban enfermedades crónicas o procesos de base concomitantes. Para la prevención y control de la infección, a través de la reducción de susceptibles, se ha dispuesto el uso de una vacuna monovalente específica contra el virus (AU)

At the end of March 2009, a new influenza virus A (H1N1) of porcine origin was isolated in two children from California presenting flu-like clinical syndrome. This virus was initially disseminated in Mexico and US and then worldwide. Eight weeks later, it had reached 74 countries with almost 30,000 cases and had caused 145 deaths. The virus had also sustained community transmission in 6 countries. On June 11th, WHO stated the onset of a pandemic. The genetic combination of this virus is completely new, containing five segments of porcine origin, two avian, one human and a HA hemaglutinin adapted for human transmission, which is genetically and antigenically different compared with the H1N1 seasonal virus. Its transmissibility is slightly higher than the one observed in seasonal influenza and similar to previous pandemics. Its pathogenicity and virulence are low. Clinical manifestations are similar to seasonal influenza, with spontaneous resolution. Nevertheless, the variety of symptoms is large and range from asymptomatic to severe fatal pneumonia. The affected population is mainly young, aged under 30 years. Less than a half of the hospitalized patients in US and of the fatal cases in Mexico had concomitant chronic diseases or other baseline conditions. A specific monovalent vaccine against the virus is currently being produced in order to prevent and control the infection through the reduction of susceptible population (AU)

Gripe por el virus influenza A (H1N1) 2009: baja virulencia, pero claras características pandémicas / Influenza caused by A(H1N1)2009 virus: low virulence but typical pandemic

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[Main features of the new influenza virus a pandemic (H1N1)]. / Principales características de la pandemia por el nuevo virus influenza A (H1N1).

At the end of March 2009, a new influenza virus A (H1N1) of porcine origin was isolated in two children from California presenting flu-like clinical syndrome. This virus was initially disseminated in Mexico and US and then worldwide. Eight weeks later, it had reached 74 countries with almost 30,000 cases and had caused 145 deaths. The virus had also sustained community transmission in 6 countries. On June 11th, WHO stated the onset of a pandemic. The genetic combination of this virus is completely new, containing five segments of porcine origin, two avian, one human and a HA hemaglutinin adapted for human transmission, which is genetically and antigenically different compared with the H1N1 seasonal virus. Its transmissibility is slightly higher than the one observed in seasonal influenza and similar to previous pandemics. Its pathogenicity and virulence are low. Clinical manifestations are similar to seasonal influenza, with spontaneous resolution. Nevertheless, the variety of symptoms is large and range from asymptomatic to severe fatal pneumonia. The affected population is mainly young, aged under 30 years. Less than a half of the hospitalized patients in US and of the fatal cases in Mexico had concomitant chronic diseases or other baseline conditions. A specific monovalent vaccine against the virus is currently being produced in order to prevent and control the infection through the reduction of susceptible population.

[Polymyositis-dermatomyositis: incidence in Spain (1997-2004)]. / Polimiositis y dermatomiositis: incidencia en España (1997-2004).

BACKGROUND AND OBJECTIVE: Epidemiologic studies of polymyositis-dermatomyositis incidence in Spain are lacking. The aim of the study was to determine the incidence rates of dermatomyositis-polymyositis and their distribution in our country. MATERIAL AND METHOD: Observational and descriptive study. Data was obtained from hospital discharge code (CMBD) during the period 1997-2004. Sex, region and age were analysed. Raw and standardized incidence rates for each region studied were calculated as new cases/million population/year with 95% confidence interval (CI). Trend odds ratio (OR) was calculated by means of a logistic regression. RESULTS: Global incidence rate in polymyositis-dermatomyositis was 8.9 new cases/million population/year (CI 95%, 8.6-9.2); 3.9 (CI 95%, 3.7-4.1) for polymyositis and 4.9 (CI 95%, 4.7-5.2) for dermatomyositis. Rate differences between both diseases reached statistical significance (p < 0.001). Annual incidence rate decreased significantly across the period studied in both diseases with a trend OR of 0.95 (CI 95%, 0.93-0.97; p < 0.001) in dermatomyositis and 0.96 (CI 95%, 0.93-0.97; p < 0.001) in polymyositis. Both diseases were significantly more frequent in females (p < 0.001). The incidence rates for each region varies between 2.2 and 10.6 cases/million population/year in polymyositis and between 2.9 and 8.6 cases/million population/year in dermatomyositis. CONCLUSIONS: Incidence of dermatomyositis-polymyositis in Spain is similar to other countries. Decreased incidence observed across the period and the higher incidence of dermatomyositis could be explained because of a better diagnosis of these entities.

Polimiositis y dermatomiositis: incidencia en España (1997-2004) / Polymyositis-dermatomyositis: incidence in Spain (1997-2004)

Fundamento y objetivo: No existen estudios epidemiológicos sobre la incidencia de miopatía inflamatoria en España. El objetivo de este estudio fue determinar las tasas de incidencia de dermatomiositis y polimiositis y su distribución en el territorio español. Material y método: Estudio descriptivo observacional a partir de los datos del Conjunto Mínimo Básico de Datos de Altas Hospitalarias en el período 1997-2004. Se analizaron las variables sexo, comunidad autónoma y edad. Se calcularon las tasas de incidencia de hospitalización en casos por millón de habitantes y año brutas y estandarizadas y su intervalo de confianza (IC) del 95%, en total y por comunidad autónoma. Para el análisis de tendencia del período estudiado, se calculó la odds ratio (OR) de tendencia mediante regresión logística. Resultados: La tasa de incidencia total del conjunto de dermatomiositis y polimiositis fue de 8,9 (IC del 95%, 8,6-9,2) nuevos casos por millón de habitantes y año; la de polimiositis, 3,9 (IC del 95%, 3,7-4,1), y la dermatomiositis, 4,9 (IC del 95%, 4,7-5,2). La diferencia entre las tasas de ambas enfermedades fue estadísticamente significativa (p < 0,001). La tasa de incidencia anual de ambas enfermedades disminuyó de forma significativa durante el período (dermatomiositis, OR de tendencia = 0,95; IC del 95%, 0,93-0,97; p < 0,001; polimiositis, OR = 0,96; IC del 95%, 0,93-0,97; p < 0,001). La incidencia de ambas enfermedades fue significativamente superior en mujeres. Las tasas de incidencia de polimiositis oscilaban en las diferentes comunidades autónomas entre 2,2 y 10,6 casos por millón de habitantes y año y las de la dermatomiositis, entre 2,9 y 8,6 casos por habitantes y año. Conclusiones: La incidencia de dermatomiositis y polimiositis en España es similar a la observada en otras zonas del mundo. La disminución de la incidencia mantenida a lo largo del período y la incidencia más alta de dermatomiositis podrían explicarse por una mejor categorización de estas enfermedades

Background and objective: Epidemiologic studies of polymyositis-dermatomyositis incidence in Spain are lacking. The aim of the study was to determine the incidence rates of dermatomyositis-polymyositis and their distribution in our country. Material and method: Observational and descriptive study. Data was obtained from hospital discharge code (CMBD) during the period 1997-2004. Sex, region and age were analysed. Raw and standardized incidence rates for each region studied were calculated as new cases/million population/year with 95% confidence interval (CI). Trend odds ratio (OR) was calculated by means of a logistic regression. Results: Global incidence rate in polymyositis-dermatomyositis was 8.9 new cases/million population/year (CI 95%, 8.6-9.2); 3.9 (CI 95%, 3.7-4.1) for polymyositis and 4.9 (CI 95%, 4.7-5.2) for dermatomyositis. Rate differences between both diseases reached statistical significance (p < 0.001). Annual incidence rate decreased significantly across the period studied in both diseases with a trend OR of 0.95 (CI 95%, 0.93-0.97; p < 0.001) in dermatomyositis and 0.96 (CI 95%, 0.93-0.97; p < 0.001) in polymyositis. Both diseases were significantly more frequent in females (p < 0.001). The incidence rates for each region varies between 2.2 and 10.6 cases/million population/year in polymyositis and between 2.9 and 8.6 cases/million population/year in dermatomyositis. Conclusions: Incidence of dermatomyositis-polymyositis in Spain is similar to other countries. Decreased incidence observed across the period and the higher incidence of dermatomyositis could be explained because of a better diagnosis of these entities

Indicadores sobre infecciones nosocomiales elaborados a partir de la bae de datos epine / No disponible

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[Safety-engineered devices to prevent percutaneous injuries: cost-effectiveness analysis on prevention of high-risk exposure]. / Análisis coste-efectividad de dispositivos sanitarios diseñados para prevenir exposiciones percutáneas.

OBJECTIVE: To assess the efficiency of the replacement of several medical devices by engineered sharp injury (SI) prevention devices (ESIPDs). METHODS: The cost-effectiveness ratios of the replacement of medical devices in use by ESIPDs were estimated: their purchasing costs and the direct costs of sharp injury care were taken into account; the number of SI avoidable by each ESIPD was estimated from the 252 occupational SI notified by healthcare workers at a 1,300 bed hospital from March 2002 to February 2003. The relationship between ESIPD additional costs and the number of high-risk SI was estimated (SI were classified as high-risk if they met two or more of the following criteria: moderately-deep or deep injury, injury with a device previously inserted in an artery or vein, or with a device exposed to blood). RESULTS: ESIPDs order according to cost-effectiveness ratio: safety needle for implanted ports (-2.65 euro/SI avoided), followed by syringes with protective shield (869.79 euro/SI), resheathable winged steel needles, needleless administration sets, and short catheters with protective encasement. ESIPDs order according to relationship between additional costs and number of high-risk sharp injuries avoided: safety needles for implanted ports, followed by winged steel needles, hypodermic syringes, short catheter and needleless administration sets. CONCLUSIONS: Savings in SI care outweigh additional costs of certain ESIPDs. Cost-effectiveness analysis is useful in assigning priorities; however the risks of SI by every device must be taken into account.