Impact of isolating COVID-19 patients in a supervised community facility on transmission reduction among household members.

BACKGROUND: Isolation of COVID-19 patients has been universally implemented to control transmission of the outbreak. Hotels and other facilities have been adapted to help appropriate isolation be achieved. Our study tested the efficacy of isolating patients in a reconditioned hotel versus isolation in their domiciles to reduce infection transmission. METHODS: Observational cohort study based on a survey to COVID-19 patients between April and June 2020. One cohort had been isolated in a hotel and the other in their domiciles. Multivariate regression models analyzed the factors related to the occurrence of COVID-19 infection among the household members. RESULTS: A total of 229 household members of COVID-19 patients were analyzed, 139 of them belonging to the group of hotel-isolated patients and 90 in the group of domicile-isolated ones. More than half of the household members became infected (53.7%). Higher risk of infection was found in the household members of domicile-isolated patients isolated and in those reporting overcrowding at home, (odds ratio [OR] 1.67, 95% confidence interval [CI] 0.89-3.12) and (OR 1.44, 95% CI 0.81; 2.56), respectively. CONCLUSIONS: The isolation of COVID-19 patients in community-supervised facilities may protect their household members from transmission of the disease. Overcrowded homes may contribute to the transmission of the infection.

Malignant asbestos-related disease in a population exposed to asbestos.

OBJECTIVES: The first asbestos fiber cement plant in Spain operated in Cerdanyola, in the Barcelona metropolitan area, between 1907 and 1997. We describe clinical and epidemiological characteristics of patients diagnosed with the malignant asbestos-related disease (ARD) in the area of the plant between 2007 and 2016. METHODS: A prospective, descriptive study was undertaken in the 12 municipalities of the county of Barcelona most proximate to the plant. We describe malignant ARD cases by time of diagnosis, source of exposure, periods of exposure and latency, and distribution by sex. Cumulative incidence and age-standardized incidence rates (ASIR) are calculated. RESULTS: Of 477 patients diagnosed with ARD between 2007 and 2016, 128 (26%) presented with asbestos-associated malignancy. Pleural mesothelioma was noted in 105 patients (82.0%) with a linear trend Z-score of -0.2 (NS) in men and 2.7 (P < .01) in women. The highest ASIRs for malignant ARD (6.1/100 000 residents/year; 95% confidence interval [CI], 2.2-13.3) and pleural mesothelioma (4.8/100 000 residents/year; 95% CI, 1.5-11.6) occurred in municipalities closest to the focal point of contamination. The origin of malignant ARD was nonoccupational in 32.2% of men and 81.6% of women (P < .001). CONCLUSIONS: More than 20 years after the closure of the fiber cement plant, the grave consequences of exposure to asbestos remain. The detection of cases of pleural mesothelioma in men seems to have plateaued whereas in women an ascending trend continues, which principally has its origin in nonoccupational exposures.

Pleural mesothelioma in relation to meteorological conditions and residential distance from an industrial source of asbestos.

OBJECTIVES: Few studies have focused on pleural mesothelioma and environmental exposure in individuals residing around an industrial source of asbestos. The aim of this study is to determine whether residential distance and wind conditions are related to the risk of developing pleural mesothelioma. METHODS: In this retrospective cohort study carried out in an area of Barcelona province (Catalonia, Spain), 24 environmental pleural mesothelioma cases were diagnosed between 2000 and 2009. We calculated the age-standardised incidence rate ratios of developing this disease in the population studied, taking into account the residential distance from the plant. For cases living within a 500-m radius of the plant, the geographical location in relation to the factory was also assessed. RESULTS: The incidence rate of environmental pleural mesothelioma was higher in the population living within 500 m of the plant than in those living in a radius of 500-2000 m and much higher than those living at 2000-10 000 m. The highest incidence rate ratio for pleural mesothelioma (161.9) was found in the southeast quadrant of the 500-m area, coinciding with the predominant wind direction. CONCLUSIONS: Residential distance from an industrial source of asbestos and local wind conditions have a considerable impact on the risk of developing environmental pleural mesothelioma.

Risk factors associated with asbestos-related diseases: a community-based case-control study.

BACKGROUND: Asbestos is a first level carcinogen. However, few epidemiological studies analyse the risk and protective factors associated with asbestos-related diseases and follow up these conditions in the general population. Pleural mesothelioma, caused by inhalation of asbestos fibres at work, at home or in the environment, is the most representative asbestos-related disease.The objectives of this study are to analyse the risk and protective factors associated with asbestos-related diseases and to investigate the incidence of new clinical manifestations in patients already diagnosed with some form of ARD. METHODS/DESIGN: We have designed a matched case-control study with follow up of both cohorts from a population of a health district of the Barcelona province that has been exposed to asbestos for a period of 90 years. DISCUSSION: A better understanding of asbestos-related diseases should improve i) the clinical and epidemiological follow up of patients with this condition; ii) the design of new treatment strategies; iii) and the development of preventive activities. At the end of the study, the two cohorts created in this study (affected cases and healthy controls) will constitute the basis for future research.

[Mental health consequences of isolation of patients with COVID-19.] / Consecuencias en la salud mental del aislamiento de pacientes con COVID-19.

OBJECTIVE: The COVID-19 pandemic has had a negative effect on the mental health on the population. It is unknown if the different types of patient isolation affect them equally. The objective of the study was to determine if the effect on the psychological discomfort caused by the isolation of the population with COVID-19 in a hotel supervised by health professionals was different compared with those who were isolated at home. METHODS: Patients diagnosed with COVID-19 during the first pandemic wave in Barcelona, consecutively selected from the Primary Care lists. A telephone survey was carried out to collect information about mental health in patients who were isolated in a hotel compared to those isolated at their homes. Descriptive statistics were performed and the study variables were analyzed using mean and standard deviation, count (percentage), Chi-square test, and Student's t-test. Logistic regression models were carried out selecting frustration and anger/irritability as response variables. RESULTS: Of the 89 patients included, 45 (50.6%) were isolated at their homes and 44 (49.4%) at the hotel. Frustration was identified in 48.3% and irritability in 29.2% of the most patients. Most of those who presented frustration were between 45 and 65 years old, while 50% of those who felt irritability were younger. Multivariate models confirmed that patients isolated at home showed a higher risk of frustration (Odds ratio 4,12; 95% Confidence interval 1,60-11,49) and irritability (Odds ratio 3,81; 95% Confidence interval 1,32-12,10), respectively. CONCLUSIONS: Patients isolated at home show a higher risk of presenting feelings of frustration and irritability than isolated patients in supervised hotels.

OBJETIVO: La pandemia de la COVID-19 ha tenido un efecto negativo en la salud mental de la población. Se desconoce si los distintos tipos de aislamiento de los pacientes afecta a estos por igual. El objetivo del estudio fue determinar si el efecto sobre el malestar psíquico originado por el aislamiento de la población con COVID-19 en un hotel supervisado por profesionales sanitarios fue diferente respecto al de las personas aisladas en su domicilio. METODOS: Los sujetos a estudio fueron pacientes diagnosticados de la COVID-19 durante la primera ola pandémica en Barcelona, seleccionados consecutivamente de los listados de Atención Primaria. Se realizó una encuesta telefónica para recoger información sobre salud mental en los pacientes que fueron aislados en un hotel frente a los aislados en sus domicilios. Se realizó estadística descriptiva y las variables de estudio fueron analizadas mediante media y desviación estándar, contaje (porcentaje), test Chi-cuadrado y t-Student. Se llevaron a cabo modelos de regresión logística seleccionando frustración e ira/irritabilidad como variables respuesta. RESULTADOS: De los 89 pacientes incluidos, 45 (50,6%) fueron aislados en sus domicilios y 44 (49,4%) en el hotel. Se identificó frustración en el 48,3% e irritabilidad en el 29,2% de los pacientes. El sentimiento de frustración se concentraba principalmente en la franja de edad entre 45 y 65 años, mientras que el 50% de los que sentían irritabilidad eran todavía más jóvenes. Los modelos multivariados confirmaron que los pacientes en aislamiento domiciliario mostraron mayor riesgo de frustración (Odds ratio 4,12; 95% Intervalo de confianza 1,60-11,49) y de ira (Odds ratio 3,81; 95% Intervalo de confianza 1,32-12,10), respectivamente. CONCLUSIONES: Los pacientes con COVID-19 aislados en su domicilio tienen mayor riesgo de presentar sentimientos de frustración e ira que los aislados en hoteles supervisados por profesionales sanitarios.

Environmental, human health and socioeconomic impacts of Ostreopsis spp. Blooms in the NW Mediterranean.

This paper summarizes the research conducted by the partners of the EU co-funded CoCliME project to ascertain the ecological, human health and economic impacts of Ostreopsis (mainly O. cf. ovata) blooms in the NW Mediterranean coasts of France, Monaco and Spain. This knowledge is necessary to design strategies to prevent, mitigate and, if necessary, adapt to the impacts of these events in the future and in other regions. Ostreopsis proliferations in the Mediterranean have been related to massive mortalities of benthic organisms and to symptoms of respiratory and cutaneous irritation in humans. A six-year epidemiologic study in a Ostreopsis hot spot in Catalonia and the accumulated experience of the French Mediterranean National Ostreopsis Surveillance Network confirm the main effects of these blooms on human health in the NW Mediterranean. The impacts are associated to direct exposure to seawater with high Ostreopsis cell concentrations and to inhalation of aerosols containing unknown irritative chemicals produced under certain circumstances during the blooms. A series of mild acute symptoms, affecting the entire body as well as the ophthalmic, digestive, respiratory and dermatologic systems have been identified. A main remaining challenge is to ascertain the effects of the chronic exposure to toxic Ostreopsis blooms. Still, the mechanisms involved in the deletereous effects of Ostreopsis blooms are poorly understood. Characterizing the chemical nature of the harmful compounds synthesized by Ostreopsis as well as the role of the mucus by which cells attach to benthic surfaces, requires new technical approaches (e.g., metabolomics) and realistic and standardized ecotoxicology tests. It is also necessary to investigate how palytoxin analogues produced by O. cf. ovata could be transferred through the marine food webs, and to evaluate the real risk of seafood poisonings in the area. On the other hand, the implementation of beach monitoring and surveillance systems in the summer constitutes an effective strategy to prevent the impacts of Ostreopsis on human health. In spite of the confirmed noxious effects, a survey of tourists and residents in Nice and Monaco to ascertain the socioeconomic costs of Ostreopsis blooms indicated that the occurrence of these events and their impacts are poorly known by the general public. In relationship with a plausible near future increase of Ostreopsis blooms in the NW Mediterranean coast, this survey showed that a substantial part of the population might continue to go to the beaches during Ostreopsis proliferations and thus could be exposed to health risks. In contrast, some people would not visit the affected areas, with the potential subsequent negative impacts on coastal recreational and touristic activities. However, at this stage, it is too early to accurately assess all the economic impacts that a potentially increasing frequency and biogeographic expansion of the events might cause in the future.

Prospective study of asbestos-related diseases incidence cases in primary health care in an area of Barcelona province.

BACKGROUND: Asbestos related diseases include a number of conditions due to inhalation of asbestos fibres at work, at home or in the environment, such as pleural mesothelioma, asbestosis and calcified pleural plaques. Few epidemiological studies have established the incidence of asbestos related diseases in our area. The present proposal is based on a retrospective study externally funded in 2005 that is currently taking place in the same area and largely carried out by the same research team.The aim of the study is to achieve a comprehensive and coordinated detection of all new cases of Asbestos Related Diseases presenting to primary care practitioners. METHODS/DESIGN: This is a multicentre, multidisciplinary and pluri-institutional prospective study.Setting12 municipalities in the Barcelona province within the catchment area of the health facilities that participate in the study.SampleThis is a population based study, of all patients presenting with diseases caused by asbestos in the study area.MeasurementsA clinical and epidemiological questionnaire will be filled in by the trained researchers after interviewing the patients and examining their clinical reports. DISCUSSION: Data on the incidence of the different Asbestos Related Diseases in this area will be obtained and the most plausible exposure source and space-time-patient profile will be described. The study will also improve the standardization of patient management, the coordination between health care institutions and the development of preventive activities related with asbestos exposure and disease.

The Roses Ocean and Human Health Chair: A New Way to Engage the Public in Oceans and Human Health Challenges.

Involving and engaging stakeholders is crucial for studying and managing the complex interactions between marine ecosystems and human health and wellbeing. The Oceans and Human Health Chair was founded in the town of Roses (Catalonia, Spain, NW Mediterranean) in 2018, the fruit of a regional partnership between various stakeholders, and for the purpose of leading the way to better health and wellbeing through ocean research and conservation. The Chair is located in an area of the Mediterranean with a notable fishing, tourist, and seafaring tradition and is close to a marine reserve, providing the opportunity to observe diverse environmental conditions and coastal and maritime activities. The Chair is a case study demonstrating that local, collaborative, transdisciplinary, trans-sector, and bottom-up approaches offer tremendous opportunities for engaging coastal communities to help support long-lasting solutions that benefit everyone, and especially those living by the sea or making their living from the goods and services provided by the sea. Furthermore, the Chair has successfully integrated most of its experts in oceans and human health from the most prestigious institutions in Catalonia. The Chair focuses on three main topics identified by local stakeholders: Fish and Health; Leisure, Health, and Wellbeing; and Medicines from the Sea. Led by stakeholder engagement, the Chair can serve as a novel approach within the oceans and human health field of study to tackle a variety of environmental and public health challenges related to both communicable and non-communicable diseases, within the context of sociocultural issues. Drawing on the example provided by the Chair, four principles are established to encourage improved participatory processes in the oceans and human health field: bottom-up, "think local", transdisciplinary and trans-sectorial, and "balance the many voices".

Consecuencias en la saludmental del aislamientode pacientes con COVID-19 / Mental health consequences of isolation of patients with COVID-19

FUNDAMENTOS: La pandemia de la COVID-19 ha tenido un efecto negativo en la salud mental de la población. Se desconoce si los distintos tipos de aislamiento de los pacientes afecta a estos por igual. El objetivo del estudio fue determinar si el efecto sobre el malestar psíquico originado por el aislamiento de la población con COVID-19 en un hotel supervisado por profesionales sanitarios fue diferente respecto al de las personas aisladas en su domicilio. MÉTODOS: Los sujetos a estudio fueron pacientes diagnosticados de la COVID-19 durante la primera ola pandémica en Barcelona, seleccionados consecutivamente de los listados de Atención Primaria. Se realizó una encuesta telefónica para recoger información sobre salud mental en los pacientes que fueron aislados en un hotel frente a los aislados en sus domicilios. Se realizó estadística descriptiva y las variables de estudio fueron analizadas mediante media y desviación estándar, contaje (porcentaje), test Chi-cuadrado y t-Student. Se llevaron a cabo modelos de regresión logística seleccionando frustración e ira/irritabilidad como variables respuesta. RESULTADOS: De los 89 pacientes incluidos, 45 (50,6%) fueron aislados en sus domicilios y 44 (49,4%) en el hotel. Se identificó frustración en el 48,3% e irritabilidad en el 29,2% de los pacientes. El sentimiento de frustración se concentraba principalmente en la franja de edad entre 45 y 65 años, mientras que el 50% de los que sentían irritabilidad eran todavía más jóvenes. Los modelos multivariados confirmaron que los pacientes en aislamiento domiciliario mostraron mayor riesgo de frustración (Odds ratio 4,12; 95%Intervalo de confianza 1,60-11,49) y de ira (Odds ratio 3,81; 95% Intervalo de confianza 1,32-12,10), respectivamente. CONCLUSIONES: Los pacientes con COVID-19 aislados en su domicilio tienen mayor riesgo de presentar sentimientos de frustración e ira que los aislados en hoteles supervisados por profesionales sanitarios.(AU)

BACKGROUND: The COVID-19 pandemic has had a negative effect on the mental health on the population. It is unknown if the different types of patient isolation affect them equally. The objective of the study was to determine if the effect on the psychological discomfort caused by the isolation of the population with COVID-19 in a hotel supervised by health professionals was different compared with those who were isolated at home. METHODS: Patients diagnosed with COVID-19 during the first pandemic wave in Barcelona, consecutively selected from the Primary Care lists. A telephone survey was carried out to collect information about mental health in patients who were isolated in a hotel compared to those isolated at their homes. Descriptive statistics were performed and the study variables were analyzed using mean and standard deviation, count (percentage), Chi-square test, and Student’s t-test. Logistic regression models were carried out selecting frustration and anger/irritability as response variables. RESULTS: Of the 89 patients included, 45 (50.6%) were isolated at their homes and 44 (49.4%) at the hotel. Frustration was identified in 48.3% and irritability in 29.2% of the most patients. Most of those who presented frustration were between 45 and 65 years old, while 50% of those who felt irritability were younger. Multivariate models confirmed that patients isolated at home showed a higher risk of frustration (Odds ratio 4,12; 95% Confidence interval 1,60-11,49) and irritability (Odds ratio 3,81; 95% Confidence interval 1,32-12,10), respectively. CONCLUSIONS: Patients isolated at home show a higher risk of presenting feelings of frustration and irritability than isolated patients in supervised hotels.(AU)

Risk Factors of Mortality from All Asbestos-Related Diseases: A Competing Risk Analysis.

BACKGROUND: The mortality from all malignant and nonmalignant asbestos-related diseases remains unknown. The authors assessed the incidence and risk factors for all asbestos-related deaths. METHODS: The sample included 544 patients from an asbestos-exposed community in the area of Barcelona (Spain), between Jan 1, 1970, and Dec 31, 2006. Competing risk regression through a subdistribution hazard analysis was used to estimate risk factors for the outcomes. RESULTS: Asbestos-related deaths were observed in 167 (30.7%) patients and 57.5% of these deaths were caused by some type of mesothelioma. The incidence rate after diagnosis was 3,600 per 100,000 person-years. In 7.5% of patients death was non-asbestos-related, while pleural and peritoneal mesothelioma were identified in 87 (16.0%) and 18 (3.3%) patients, respectively. CONCLUSIONS: Age, sex, household exposure, cumulative nonmalignant asbestos-related disease, and single malignant pathology were identified as risk factors for asbestos-related death. These findings suggest the need to develop a preventive approach to the community and to improve the clinical follow-up process of these patients.

[Asbestos-related diseases in a population near a fibrous cement factory]. / Enfermedad por amianto en una población próxima a una fábrica de fibrocemento.

BACKGROUND AND OBJECTIVE: The first fibrous cement factory in Spain was set up in Cerdanyola, Barcelona, in 1907 and was a source of pollution there until it was closed in 1997. The aim of this study was to determine the clinical and epidemiologic characteristics of the population with by asbestos-related diseases who had worked in the factory and/or lived in the vicinity. MATERIAL AND METHODS: We retrospectively collected information available on patients with asbestos-related diseases who at the time of diagnosis had resided in the area near the fibrous cement factory. Information was obtained from the medical records of the primary care centers of the 12 surrounding towns and the sole referral hospital in the area for cases diagnosed between January 1, 1970 and December 31, 2006. RESULTS: In the 559 patients diagnosed, 1107 cases of asbestos-related diseases were identified. Between 2000 and 2006, the average annual incidence was 9.5 cases per 100,000 inhabitants for the entire study area and 35.5 cases per 100,000 for the area nearest the factory. The prevalence of asbestos-related diseases as of December 31, 2006 was 91 cases per 100,000 inhabitants in the entire study area and 353.4 cases per 100,000 in the area nearest the factory. Of the 1107 asbestos-related disease cases identified, 86.5% were benign and 8.4% pleural mesothelioma. CONCLUSIONS: The factory introduced an important area-wide risk factor for asbestos-related diseases for both workers and for the nearby population. The number of cases of asbestos-related diseases detected annually showed an upward trend. The incidence was extremely high in the period studied.

A mortality study of the last outbreak of yellow fever in Barcelona City (Spain) in 1870.

BACKGROUND: The last outbreak of yellow fever in the city of Barcelona, Spain, was caused by a ship arriving from Cuba. The objective of this study was to describe and analyze the epidemic of 1870 by using the available mortality data. METHODS: The information on 1,235 deaths identified in the parochial registries was analyzed, using statistical and epidemiological procedures for epidemic outbreaks. RESULTS: Mortality due to yellow fever was 549.7 per 100,000 inhabitants. The temporal distribution of the deaths showed two peaks at the end of September and October with the last fatalities occurring in December 1870. The distribution of the fatalities in the city's neighborhoods was unequal. In La Barceloneta, in particular, more fatalities were found in the streets adjacent to the port than in the most remote streets (r=0.83; p<0.0001). CONCLUSIONS: This study reveals a temporal bimodal mortality distribution for yellow fever during the outbreak, with a high impact in adult men and in the La Barceloneta neighborhood.

Estudio de la mortalidad del último brote de fiebre amarilla en la ciudad de Barcelona (España) en 1870 / A mortality study of the last outbreak of yellow fever in Barcelona City (Spain) in 1870

ObjetivoEl último brote de fiebre amarilla en la ciudad de Barcelona, España, se originó a partir de un barco que venía de Cuba. El objetivo de este estudio es describir y analizar esa epidemia ocurrida en 1870, utilizando los datos disponibles de mortalidad.MétodosLa información de las 1235 defunciones identificadas en los registros parroquiales se ha analizado utilizando los procedimientos estadísticos y epidemiológicos para brotes epidémicos.ResultadosLa tasa de mortalidad por fiebre amarilla fue de 549.7 por 100,000 habitantes. La distribución temporal de las muertes tenía dos modas en el final de septiembre y octubre, y los últimos muertos ocurrieron en diciembre de 1870. La distribución de las defunciones según los barrios de la ciudad fue desigual. En La Barceloneta, en particular, hubo mas muertos en las calles adyacentes al puerto que en las más lejanas (r=0,83; p<60;0,0001).ConclusionesEste estudio muestra una distribución bimodal de la mortalidad por fiebre amarilla durante el brote, con un impacto alto en hombres adultos, y en el barrio de La Barceloneta(AU)

Background The last outbreak of yellow fever in the city of Barcelona, Spain, was caused by a ship arriving from Cuba. The objective of this study was to describe and analyze the epidemic of 1870 by using the available mortality data. Methods The information on 1,235 deaths identified in the parochial registries was analyzed, using statistical and epidemiological procedures for epidemic outbreaks. ResultsMortality due to yellow fever was 549.7 per 100,000 inhabitants. The temporal distribution of the deaths showed two peaks at the end of September and October with the last fatalities occurring in December 1870. The distribution of the fatalities in the city's neighborhoods was unequal. In La Barceloneta, in particular, more fatalities were found in the streets adjacent to the port than in the most remote streets (r=0.83; p<60;0.0001). ConclusionsThis study reveals a temporal bimodal mortality distribution for yellow fever during the outbreak, with a high impact in adult men and in the La Barceloneta neighborhood(AU)

Enfermedad por amianto en una población próxima a una fábrica de fibrocemento / Asbestos-Related Diseases in a Population Neara Fibrous Cement Factory

Introducción: En 1907 se instaló en Cerdanyola (Barcelona) la primera fabrica de fibrocemento de España, que actuó como foco contaminante hasta su cierre en 1997. El objetivo del estudio ha sido conocer las características clinico epidemiológicas de la población afectada por enfermedades relacionadas con el amianto (ERA) que había trabajado o/y vivía en el entorno de esta fábrica. Material y métodos: Se trata de un estudio retrospectivo que reúne la información disponible de los pacientes afectados de ERA que residían en el momento del diagnóstico en la zona cercana a la factoría de fibrocemento. La información se obtuvo a partir de la documentación médica de los centros de atención primaria de las 12 poblaciones circundantes y del único hospital de referencia de la zona, para los casos diagnosticados entre el 1 de enero de 1970 y el 31 de diciembre de 2006. Resultados: En los 559 pacientes diagnosticados se identificaron 1.107 casos de ERA. La incidencia anual media entre 2000 y 2006 fue de 9,5 pacientes por 100.000 habitantes para toda la zona, y de 35,5 para la más próxima a la fábrica. La prevalencia de pacientes con ERA a fecha de 31 de diciembre de 2006 fue de 91 por 100.000 personas en toda la zona y de 353,4 en la más próxima a la fábrica. De los 1.107 casos, el 86,5%correspondía a enfermedad benigna y el 8,4%a mesotelioma pleural. Conclusiones: En lazona estudiada, la fábrica supuso un factor de riesgo importante de ERA para sus trabajadores y la población cercana. La detección de casos mostró una tendencia ascendente. La incidencia de ERA fue muy elevada (AU)

Background and Objective: The first fibrous cement factory in Spain was setup in Cerdanyola, Barcelona, in 1907 and was a source of pollution there untilit was closed in 1997. The aim of this study was to determine the clinical and epidemiologic characteristics of the population with by asbestos-related diseases who had worked in the factory and/or lived in the vicinity. Material and Methods: We retrospectively collected information available on patients with asbestos-related diseases who at the time of diagnosis had resided in the are an ear the fibrous cement factory. Information was obtained from the medical records of the primary care centers of the 12 surrounding towns and the sole referral hospital in the area for cases diagnosed between January 1, 1970 and December 31, 2006. Results: In the 559 patients diagnosed, 1107 cases of asbestos-related diseases were identified. Between 2000 and 2006, the average annual incidence was 9.5 cases per 100000 inhabitants for the entire study area and 35.5 cases per 100000 for the area nearest the factory. The prevalence of asbestos-related diseases as of December 31, 2006 was 91 cases per 100000 inhabitants in the entire study area and 353.4 cases per 100000 in the area nearest the factory. Of the 1107 asbestos-related disease cases identified, 86.5% were benignand 8.4%pleural mesothelioma. Conclusions: The factory introduced an important area-wide risk factor for asbestos-related diseases for both workers and for the nearby population. The number of cases of asbestos-related diseases detected annually showed an up ward trend. The incidence was extremely high in the period studied (AU)

Riesgo de fallecer en los enfermos ingresados con diagnóstico de tuberculosis en el Hospital San Juan de Dios Santa Cruz (Bolivia) / Risk of dying among patients admitted to the Hospital San Juan de Dios of Santa Cruz (Bolivia) with a diagnosis of tuberculosis

El principal objetivo del presente trabajo es identificar factores de riesgo de fallecer, durante su hospitalización, en enfermos adultos internados en la sala de neumología del Hospital de San Juan de Dios (HSJD) de Santa Cruz, con el diagnóstico (confirmado o sin confirmar) de tuberculosis (TB). El presente trabajo es un estudio observacional transversal de todos los enfermos internados en la sala de Neumología (Sala 7) con el diagnóstico de ingreso de TB desde Noviembre de 1993 hasta Febrero de 1996. entre los principales resultados tenemos que, se intermaron durante el periódo de estudio 704 enfermos, de los cuales 469 (66.6 o/o) eran varones; la edad media era de 35.4 años (desviación estándar DE(17,3) 118(16.8o/o) enfermos fallecieron durante su tratamiento. El análisis de regresión logística múltiple identificó las siguientes variables asociadas al fallecimiento: otra patología asociada (odds ratio (OR(=2,70; intervalo de confianza del 95o/o (CI(=1,64-4,39), sexo femenino (OR= 1,67; Cl1,04-2,66), número de lóbulos afectados (OR=1,25; Cl= 1,16-11,33, edad (OR= 1,02; Cl= 1,00-1,02), hemoptisis (OR=0,40; Cl=0,2-0,77) y hematocrito (OR=0,97; Cl=0,93-1,00) Estas seis variaciones asociadas a un curso fatal nos permiten identificar a los enfermos con sospecha de padecer TB a su ingreso, deben, de forma prioritaria, internarse para recibir atención hospitalaria. Ante una insuficiencia de camas hospitalarias el personal de salud podrá determinar la presencia de éste grupo de variables a los enfermos antes de su posible ingreso

Accidentes infantiles en Catalunya: estudio transversal sobre la opinión de los pediatras catalanes / Study on the opinion of primary care paediatricians on childhood accidents in Catalonia

Fundamento. La temática de los accidentes infantiles es suficientemente conocida en nuestro país por lo que respecta a los indicadores que miden la mortalitad, la morbilidad y la incapacidad. Faltan por saber diversas cuestiones que pueden interesar a los propios profesionales sanitarios, a las administraciones y al público en general. Objetivo. Conocer la opinión que tienen los pediatras catalanes sobre la problemática de los accidentes infantiles. Método. Mediante un estudio epidemiológico observacional transversal se ha evaluado la opinión de los pediatras catalanes sobre los accidentes infantiles. El instrumento de medida ha sido el Cuestionario de Opinión sobre los Accidentes Infantiles en Cataluña (COAIC-99) empleando una escala de Likert entre 1 y 5, y con un total de 19 preguntas. La población diana ha sido formada por todos los socios de la Sociedad Catalana de Pediatría de la Academia de Ciencias Médicas de Cataluña y Baleares, (n=1439) a quienes se les envió el cuestionario citado. Resultados. Han cumplimentado el cuestionario 247 socios (17.16 por ciento). 50 por ciento eran mujeres. La edad media ha sido de 44.5ñ10.3 años. El 66 por ciento son del sector urbano, el 24 por ciento semi-urbano i el 10 por ciento restante del rural. El 84 por ciento de los profesionales declaran tener una formación suficiente sobre prevención de accidentes infantiles. Conclusiones. La baja participación de los profesionales en este tipo de encuestas anónimas podría interpretarse en parte como un escaso interés real en esta problemática sanitaria. Aún así un 12 por ciento de los que contestan declaran que la prevención de accidentes es nunca o poco motivo de conversación en la consulta. Se detectan algunas contradicciones entre los participantes en materia de educación. (AU)