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1.
Rev. esp. med. prev. salud pública ; 23(3): 29-39, 2018. ilus
Artigo em Espanhol | IBECS | ID: ibc-180099

RESUMO

Las infecciones de transmisión sexual (ITS) han adquirido una extraordinaria importancia, constituyendo actualmente uno de los principales problemas de salud pública a nivel mundial. La OMS estima que en 2012 hubo alrededor de 350 millones de ITS curables entre hombres y mujeres de 15 a 49 años de edad, de las cuales, más de 78 millones (22,3%) correspondieron a casos de gonococia. Un grave problema, además de las secuelas, complicaciones y elevado coste económico de esta enfermedad, es, desde hace décadas, la capacidad de Neisseria gonorrhoeae de desarrollar resistencia a los distintos antimicrobianos utilizados como tratamiento empírico de primera línea. Con el fin de dar respuesta a esta situación, la OMS puso en marcha un programa, a comienzos de 1990, para vigilar la tendencia de las resistencias antimicrobianas de Neisseria gonorrhoeae, y garantizar la efectividad de los antimicrobianos recomendados para su tratamiento


Sexually transmitted infections (STI) have acquired an extraordinary importance. They are one of the main problems in public health currently worldwide. The WHO estimates that there were around 350 million curable infections in men and women between 15 and 49 years old. Of these, 78 million (22,3%) were gonorrea infections. Besides the multiple complications and the high economic costs of this infectious disease, the resistance developed by Neisseria gonorrhoea to the antimicrobial drugs used against it, has become a major problem. The WHO developed a program in 1990 to observe this resistance of Neisseria gonorrhoea. It was aimed to guarantee the effect of the antimicrobial drugs reccommended for its treatment


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , História Antiga , História Medieval , História do Século XIX , História do Século XX , História do Século XXI , Gonorreia/prevenção & controle , Gonorreia/terapia , Gonorreia/história
2.
Cir Esp ; 95(9): 490-502, 2017 Nov.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29102076

RESUMO

Surgical site infection is one of the most prevalent healthcare-associated infections and presents a considerable morbidity. The aim of this comprehensive narrative review is to describe the evidence and grade of recommendation of the preventive measures developed in the three phases of the surgical process (preoperative, perioperative and postoperative phases), as well as coincidences and divergences between selected Clinical Practice Guidelines (CPG). Four preventive measures were recommended with similar high grade evidence in all CPG: Hair removal, antibiotic prophylaxis, surgical site preparation and normothermia. However, critical points, new preventive measures and bundle implementations by surgical process are under discussion. These results represent a significant progress toward improving programs to prevent surgical site infection and they should be taken into account for improved future interventions in this area.


Assuntos
Infecção da Ferida Cirúrgica/prevenção & controle , Humanos , Guias de Prática Clínica como Assunto
3.
Cir. Esp. (Ed. impr.) ; 95(9): 490-502, nov. 2017. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-168845

RESUMO

La infección de sitio quirúrgico es la infección relacionada con la asistencia sanitaria más prevalente en el entorno sanitario y con una considerable morbilidad. El objetivo de esta exhaustiva revisión narrativa es describir la evidencia y el grado de recomendación de las medidas preventivas desarrolladas en las 3 fases asistenciales del enfermo quirúrgico (preoperatoria, perioperatoria y postoperatoria), así como las coincidencias y divergencias entre las guías de práctica clínica (GPC) seleccionadas. Cuatro de las medidas preventivas fueron recomendadas con similar alto grado de evidencia en todas las GPC: eliminación adecuada del vello, profilaxis antibiótica, preparación del campo quirúrgico y normotermia. Sin embargo, permanecen en debate los puntos críticos de cada intervención, las nuevas medidas preventivas surgidas y su agrupación en paquetes por procedimientos quirúrgicos. Estos resultados representan un progreso significativo de mejora en programas preventivos de las infecciones quirúrgicas y deberían tenerse en cuenta para implementar futuras intervenciones en esta área (AU)


Surgical site infection is one of the most prevalent healthcare-associated infections and presents a considerable morbidity. The aim of this comprehensive narrative review is to describe the evidence and grade of recommendation of the preventive measures developed in the three phases of the surgical process (preoperative, perioperative and postoperative phases), as well as coincidences and divergences between selected Clinical Practice Guidelines (CPG). Four preventive measures were recommended with similar high grade evidence in all CPG: Hair removal, antibiotic prophylaxis, surgical site preparation and normothermia. However, critical points, new preventive measures and bundle implementations by surgical process are under discussion. These results represent a significant progress toward improving programs to prevent surgical site infection and they should be taken into account for improved future interventions in this area (AU)


Assuntos
Humanos , Infecção da Ferida Cirúrgica/prevenção & controle , Antibioticoprofilaxia/métodos , Guias de Prática Clínica como Assunto , Remoção de Cabelo , Fatores de Risco , Precauções Universais/tendências
5.
Artigo em Espanhol | IBECS | ID: ibc-169184

RESUMO

Introducción: La antisepsia de la piel (AP) es un punto clave en la prevención de las infecciones de localización quirúrgica (ILQ) y las bacteriemias asociadas a catéteres (BAC). Existen importantes controversias a las que hemos querido responder en éste documento, que está redactado en un formato resumido de preguntas y respuestas. Material y Métodos: Tras una búsqueda bibliográfica, se han utilizado técnicas de grupo de discusión para redactar las preguntas y respuestas. Se examina el papel de la AP en la prevención de ILQ, BAC y contaminación en la toma de hemocultivos, y la posibilidad de que dicha AP tenga ciertos efectos secundarios: toxicidad en procedimientos neuroaxiales y resistencias a los antisépticos. Resultados y conclusión: Se han formulado y contestado 28 preguntas, con sus correspondientes recomendaciones. Se apoya el baño previo antes de las intervenciones quirúrgicas y cateterismos, así como la no eliminación del vello o bien su corte, pero sin utilizar rasuradora. Se recomienda la solución del 2% de clorhexidina en 70% de isopropanol, antes de la incisión quirúrgica y cateterismos, utilizando preferiblemente aplicadores. Se dan también directrices para el uso seguro de la clorhexidina en procedimientos neuroaxiales y para controlar el posible aumento de las resistencias a los antisépticos


Introduction: Skin antisepsis (AP) is a key point in the prevention of surgical site infections (SSI) and catheter-associated bacteremia (CAB). There are important controversies that we have tried to answer in this document, which is written in a summary format of questions and answers. Material and Methods: After a bibliographic search, group discussion techniques were used to write the questions and answers. The role of skin antisepsis in the prevention of SSI and CAB or blood cultures contamination are examined. Moreover we studied two possible secondary effects of this antisepsis: toxicity in neuroaxial procedures and resistance to antiseptics. Results and conclusion: 28 questions have been formulated and answered, with corresponding recommendations. The previous bath before the surgical interventions and catheterisms is supported, as well as the non-elimination of the hair or its cut without using a razor. A solution of 2% chlorhexidine in 70% isopropanol is recommended prior to surgical incision catheterization or blood culture, preferably by using applicators. Guidelines are given for the safe use of alcohol-chlorhexidine in neuroaxial procedures and for controlling the possible increase in resistance to antiseptics


Assuntos
Humanos , Desinfecção/métodos , Cateterismo/normas , Procedimentos Cirúrgicos Operatórios/normas , Infecção da Ferida Cirúrgica/prevenção & controle , Antissepsia/métodos , Cuidados Pré-Operatórios/métodos , Padrões de Prática Médica , Anti-Infecciosos Locais/uso terapêutico , Clorexidina/uso terapêutico
6.
Rev. esp. quimioter ; 29(2): 76-85, abr. 2016. tab
Artigo em Espanhol | IBECS | ID: ibc-150929

RESUMO

Introducción. El último brote de la enfermedad por el virus del Ébola, constituyó un precedente a la hora de evidenciar la necesaria formación del personal sanitario para posibles eventualidades de casos sospechosos de enfermedades contagiosas. Se precisa estudiar el nivel de cualificación del personal sanitario ante dichas situaciones. Material y métodos. Estudio descriptivo mediante encuesta post-taller al personal sanitario de un departamento de salud de la Comunidad Valenciana sobre los conocimientos y aptitudes adquiridos tras la formación. Resultados y conclusiones. El personal sanitario obtuvo una calificación global de aprobado en la encuesta post-taller, pero con diferencias en cuanto a categorías profesionales y distintos bloques de la formación, cuyas calificaciones podrían ser consideradas como deficientes en algunos casos. Se debería revisar la formación del personal sanitario periódicamente y calibrar dicha formación a los recursos de los que se dispone para una correcta actuación (AU)


Introduction. The last outbreak of the Ebola virus disease, was a precedent to demonstrate the necessary training of healthcare personnel for possible eventualities of suspected cases of infectious diseases. It is required to study the level of qualification of healthcare workers in such situations. Methods. Descriptive study using post-workshop survey of healthcare workers in a Valencian Community health department on acquired knowledge and skills after training. Results and conclusions. Healthcare personnel received an overall passing score on the post-workshop survey, but with differences in occupational categories and different blocks of training. The ratings could be considered deficient in some cases. It should be reviewed periodically training health personnel and calibrate such training to the resources available for proper operation (AU)


Assuntos
Humanos , Masculino , Feminino , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/estatística & dados numéricos , Pessoal de Saúde/educação , Pessoal de Saúde/organização & administração , Pessoal de Saúde/normas , Recursos Humanos , Pessoal de Saúde/organização & administração , Pessoal de Saúde/normas , Estudos Transversais/métodos , Inquéritos e Questionários
7.
Rev Esp Quimioter ; 29(2): 76-85, 2016 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-26888339

RESUMO

OBJECTIVE: The last outbreak of the Ebola virus disease, was a precedent to demonstrate the necessary training of healthcare personnel for possible eventualities of suspected cases of infectious diseases. It is required to study the level of qualification of healthcare workers in such situations. METHODS: Descriptive study using post-workshop survey of healthcare workers in a Valencian Community health department on acquired knowledge and skills after training. CONCLUSIONS: Healthcare personnel received an overall passing score on the post-workshop survey, but with differences in occupational categories and different blocks of training. The ratings could be considered deficient in some cases. It should be reviewed periodically training health personnel and calibrate such training to the resources available for proper operation.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Doença pelo Vírus Ebola , Adulto , Idoso , Atitude do Pessoal de Saúde , Surtos de Doenças , Feminino , Ocupações em Saúde , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/prevenção & controle , Doença pelo Vírus Ebola/transmissão , Humanos , Masculino , Pessoa de Meia-Idade , Espanha , Inquéritos e Questionários
8.
Arch. bronconeumol. (Ed. impr.) ; 50(3): 93-98, mar. 2014. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-119905

RESUMO

Introducción: La vacunación es la medida más efectiva para la prevención de la enfermedad neumocócica invasiva (ENI). Los pacientes con enfermedades predisponentes se podrían beneficiar de esta vacuna si se recomienda durante las visitas médicas. Objetivos: Describir los casos de ENI. Valorar los serotipos más frecuentes y evaluar oportunidades perdidas de vacunación. Métodos: Estudio descriptivo retrospectivo de la incidencia de ENI en Elche durante 5 años. Se ha revisado el estado vacunal y las visitas a atención especializada previas a la enfermedad. También se ha calculado la efectividad vacunal con vacuna antineumocócica 23 valente en nuestra población. Resultados: Desde 2007 a 2011 se han notificado 181 casos de ENI. Las formas clínica más frecuentes son neumonía y sepsis, con una tasa de mortalidad del 12%. El 80% de los serotipos causales son serotipos vacunales. Más de la mitad tenían alguno de los factores de riesgo que indican vacunación. Este porcentaje disminuye hasta el 6,2% en los menores de 65 años con algún factor de riesgo. Conclusiones: Tras 10 años de introducción de la vacuna en el calendario vacunal del adulto sigue siendo baja la cobertura vacunal de pacientes con factores de riesgo. En nuestro estudio, el 75% de los casos no están vacunados. Teniendo en cuenta la efectividad de la vacuna para la prevención de ENI, entre los pacientes que han sido atendidos en el hospital por el especialista previo a su ENI, se podrían haber prevenido en el mejor de los supuestos (85% de efectividad vacunal) 60 casos de ENI


Introduction: Vaccination is the most effective measure in the prevention of invasive pneumococcal disease (IPD). High-risk patients immunized during medical visits would benefit from the vaccine. Objectives: To describe the IPD cases. To assess the most prevalent causative serotypes and to evaluate the missed opportunities for vaccination. Methods: This is a descriptive retrospective study of the incidence of IPD cases in Elche during 5 years. It was reviewed the vaccination status and the visits to specialized care prior to disease. It was also calculated the vaccine effectiveness with the 23-valent pneumococcal vaccine in our population. Results: Between 2007 and 2011 were notified 181 of IPD, the most frequent medical conditions were pneumonia and sepsis, with a mortality rate of 12%. 80% of the causative serotypes are included in the vaccine. More than the half of the cases had at least one of the risk factor for indicating the vaccination. This percentage decreases by 6.2% in cases below 65 years of age with any risk factor. Conclusions: After 10 years of introducing the vaccine into the adult immunization schedule the coverage it is still low among the patients with risk factors. In our study, 75% of the cases were not vaccinated. Taking in count the vaccine effectiveness for preventing IPD, among the patients attended at the hospital by the specialist prior their IPD, it could have been prevented in the best assumption (85% vaccine effectiveness) 60 IPD cases


Assuntos
Humanos , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/administração & dosagem , Fatores de Risco , Grupos de Risco , Risco Ajustado/métodos , Vacinação em Massa/organização & administração
9.
Arch Bronconeumol ; 50(3): 93-8, 2014 Mar.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-24315186

RESUMO

INTRODUCTION: Vaccination is the most effective measure in the prevention of invasive pneumococcal disease (IPD). High-risk patients immunized during medical visits would benefit from the vaccine. OBJECTIVES: To describe the IPD cases. To assess the most prevalent causative serotypes and to evaluate the missed opportunities for vaccination. METHODS: This is a descriptive retrospective study of the incidence of IPD cases in Elche during 5 years. It was reviewed the vaccination status and the visits to specialized care prior to disease. It was also calculated the vaccine effectiveness with the 23-valent pneumococcal vaccine in our population. RESULTS: Between 2007 and 2011 were notified 181 of IPD, the most frequent medical conditions were pneumonia and sepsis, with a mortality rate of 12%. 80% of the causative serotypes are included in the vaccine. More than the half of the cases had at least one of the risk factor for indicating the vaccination. This percentage decreases by 6.2% in cases below 65 years of age with any risk factor. CONCLUSIONS: After 10 years of introducing the vaccine into the adult immunization schedule the coverage it is still low among the patients with risk factors. In our study, 75% of the cases were not vaccinated. Taking in count the vaccine effectiveness for preventing IPD, among the patients attended at the hospital by the specialist prior their IPD, it could have been prevented in the best assumption (85% vaccine effectiveness) 60 IPD cases.


Assuntos
Programas de Imunização , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Comorbidade , Suscetibilidade a Doenças , Educação Médica Continuada , Feminino , Humanos , Programas de Imunização/estatística & dados numéricos , Esquemas de Imunização , Incidência , Lactente , Masculino , Medicina , Pessoa de Meia-Idade , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/microbiologia , Pneumonia Pneumocócica/epidemiologia , Pneumonia Pneumocócica/microbiologia , Pneumonia Pneumocócica/prevenção & controle , Estudos Retrospectivos , Fatores de Risco , Sepse/epidemiologia , Sepse/microbiologia , Sepse/prevenção & controle , Sorotipagem , Espanha/epidemiologia , Streptococcus pneumoniae/classificação , Streptococcus pneumoniae/imunologia , Streptococcus pneumoniae/isolamento & purificação , Vacinas Conjugadas , Adulto Jovem
10.
Metas enferm ; 15(5): 21-25, jun. 2012. tab
Artigo em Espanhol | IBECS | ID: ibc-104663

RESUMO

Objetivo: analizar las exposiciones cutáneo-mucosas a sangre y material biológico en trabajadores sanitarios de la Comunidad Valenciana recogidas en un período de catorce años (1997-2010).Material y método: estudio descriptivo con componente transversal y longitudinal (1997-2010), en el ámbito que corresponde al Hospital General Universitario de Elche (Comunidad Valenciana). Se utilizó la información generada por el sistema de vigilancia epidemiológica EPINETAC, que recoge las exposiciones accidentales a sangre o material biológico y su seguimiento. También se recogieron variables de identificación, laborales, uso de dispositivos de protección, actuación tras exposición, situación vacunal frente al VHB del expuesto y estado serológico de la fuente. Los datos fueron recogidos mediante entrevista personal, revisión de expediente laboral e historia clínica de la fuente. Resultados: las declaraciones de exposiciones cutáneo-mucosa han ido aumentando con el paso de los años. Las enfermeras declararon el 44%,los médicos de plantilla un 17% y los auxiliares de Enfermería un 14%.El lugar de la exposición más habitual fue la habitación del paciente(34%). La sangre fue el fluido más frecuentemente implicado 76%.Conclusiones: la exposición cutáneo-mucosa en los sanitarios depende de muchas variables: características del paciente y trabajo a realizar, los protocolos y material de seguridad utilizado, la dotación y estructuras que se posean en el lugar de trabajo, pero también son muy importantes factores ligados al comportamiento humano y la organización en el trabajo. Estas exposiciones cutáneo-mucosas, aunque menos numerosas que las percutáneas, deben ser tenidas en cuenta a la hora de la prevención y gestión del riesgo (AU)


Objective: to analyze mucocutaneous exposures to blood and biological material in healthcare workers in the Valencian Community collected over a period of fourteen years (1997-2010).Material and methods: descriptive cross-sectional study with longitudinal component (1997-2010), in the catchment area corresponding to the Hospital General Universitario de Elche (Comunidad Valenciana).The information generated by the surveillance system EPINETAC was used, which includes accidental exposures to blood or biological material, and monitoring. Variables were also collected for identification, employment, use of protective devices, actions taken after exposure, vaccination status of the person exposed against HBV and serological status of the source. Data were collected through personal interview, review of employment records and medical history of the source. Results: confirmations of mucocutaneous exposures have been increasing over the years. Nursing reported 44%, staff physicians 17% and nursing assistants 14%. The place of exposure was most frequently the patient´s room (34%). Blood was the most frequently involved fluid 76%.Conclusions: mucocutaneous exposure in health workers depends on many variables: patient characteristics and work to be done, protocols and safety gear used, the equipment and structures in the workplace, but also of outmost importance are factors associated to human behavior and organization at work. These mucocutaneous exposures, though less numerous than the percutaneous, must be taken into account in prevention and risk management planning (AU)


Assuntos
Humanos , Exposição Ocupacional/análise , Contenção de Riscos Biológicos/análise , Derramamento de Material Biológico , Epidemiologia Descritiva , Precauções Universais , Gestão de Riscos , Recursos Humanos em Hospital
11.
Metas enferm ; 13(10): 6-11, dic. 2010. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-94468

RESUMO

Objetivo: presentar el análisis descriptivo de la información obtenida en un período de doce años (EPINETAC 1997/2008) en el Departamento 20 de Salud de Elche (Alicante). Materiales y métodos: se analizó la información obtenida de 2.023 encuestas sobre exposiciones accidentales realizadas desde 01/01/1997 hasta 31/12/2008 del proyecto EPINETAC. Los datos registrados se analizaron con el programa estadístico SPSS15. Resultados: las enfermeras declaran el 42% de los accidentes percutáneos, los médicos un 14,7% y las auxiliaresde Enfermería un 14,6%. Los médicos sufren el accidente en el quirófano o salas de partos en tres de cada cuatro ocasiones (75,3%) mientras que las enfermeras lo hacen en la habitación de los pacientes (42,3%). Las matronas, médicos y MIR sufren alrededor del 90% de las inoculaciones accidentales durante el uso del material. Conclusiones: aproximadamente la mitad de las exposiciones accidentales declaradas durante este período podían haberse evitado (los accidentes ocurridos durante el uso del material (49,6%) son los únicos que se consideran no evitables).El colectivo profesional con mayor asiduidad de exposiciones accidentales a sangre y fluidos biológicos es elde la Enfermería. Las agujas huecas son el material más frecuentemente implicado en exposiciones ocupacionales, siendo las que se asocian a un mayor riesgo de transmisión (AU)


Objetive: the epidemiological surveillance of exposure tobiological risk in the work place is a fundamental basis for the planning and prioritization of any prevention strategy. The objective is to present the descriptive analysis of the information obtained over a 12 year period (EPINETAC 1997/2008)in the 20th Health Department of Elche (Alicante). Materials and methods: the information obtained from 2.023 surveys on accidental exposures that took place between 01/01/1997 to 31/12/2008 of the EPINETAC project. Recorded data are analysed with the SPSS 15 statistical programme. Results: nurses report 42% of percutaneous accidents; physiciansreport 14,7% and nursing aids 14,6%. Physicians experience accidents in operating or labour and delivery room in three of every four occasions (75,3%), whereas nurses report that accidents happen mainly in patient rooms (42,3%). Midwives, physicians and resident medical students suffer close to 90%of accidental inoculations during the use of materials.Conclusions: approximately half of accidental exposures reported during this period could have been avoided (accidents that occurred during the use of materials (49,6%) arethe only ones that are considered unavoidable). Nurses are the professionals with the highest accidental exposure to blood and biologic fluids. Hollow needles are the most frequently involved material in work-related exposures, and are also associated with a higher transmission risk (AU)


Assuntos
Humanos , Resíduos Perigosos/efeitos adversos , Acidentes de Trabalho/prevenção & controle , Ferimentos Penetrantes Produzidos por Agulha/epidemiologia , Pessoal de Saúde/normas , Precauções Universais/estatística & dados numéricos , Sangue
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