Tamames S.,Servicio de Epidemiologia
Enfermedades Infecciosas y Microbiologia Clinica Monografias | Year: 2015
Seasonal influenza is an annual challenge for health-care systems, due to factors such as co-circulation of 2 influenza A subtypes jointly with 2 influenza B lineages; the antigenic drift of these virus, which eludes natural immunity, as well as immunity conferred by vaccination; together with influenza impact in terms of morbidity and mortality. Influenza vaccines have been available for more than 70 years and they have progressed in formulation, production and delivery route. Recommendations on vaccination are focused on those with a higher probability of severe disease, and have a progressively wider coverage, and classically based on inactivated vaccines, but with an increasing importance of attenuated live vaccines. More inactivated vaccines are becoming available, from adyuvanted and virosomal vaccines to intradermal delivery, cell-culture or quadrivalent. Overall vaccine effectiveness is about 65%, but varies depending on characteristics of vaccines, virus, population and the outcomes to be prevented, and ranges from less than 10% to almost 90%. Future challenges are formulations that confer more extensive and lasting protection, as well as increased vaccination coverage, especially in groups such as pregnant women and health-care professionals, as well as being extended to paediatrics. © 2015 Elsevier España, S.L.U.
Diez M.,Institute Salud Carlos III |
Oliva J.,Institute Salud Carlos III |
Sanchez F.,Institute Salud Carlos III |
Vives N.,Institute Catala dOncologia ICO |
And 3 more authors.
Gaceta Sanitaria | Year: 2012
Objective: To describe the incidence of new HIV diagnoses and its trend in Spain. Methods: All new HIV diagnoses notified to the case-registries of 15 autonomous regions (64% of the total Spanish population) in 2009 were analyzed. To evaluate trends from 2004 to 2009, data from only nine regions were available. Clinical-epidemiological data were obtained from the notification forms. Distributions of new HIV diagnoses and late diagnoses according to several variables were performed. The Poisson distribution was used to evaluate trends. Results: In 2009, 2264 new HIV diagnoses were notified, mostly in men (80%). The median age at diagnosis was 36 years (interquartile range 29-43) and 37.6% of affected individuals were immigrants, mostly from Latin-America and sub-Saharan Africa. The most common transmission category (42.5%) was men who have sex with men (MSM) followed by the heterosexual and parenteral modes of transmission (34.5% and 8.1%, respectively). The median CD4 count at diagnosis was 347 (interquartile range: 152-555), and CD4 count was <350 in 50.2% of patients. From 2004 to 2009, the mean incidence rate of new HIV diagnoses was 91.14 per million inhabitants; an increasing trend for rates in MSM, as well as a decreasing trend for the parenteral mode of transmission, were observed. Conclusions: In Spain, the epidemiology of HIV infection has changed since the mid-1990s. Currently, the most frequent transmission category is sexual transmission, particularly among MSM, and immigrants are an important part of the epidemic. Heterogeneous trends for the three main transmission categories were observed from 2004 to 2009. © 2011 SESPAS.
Rodriguez-Avial I.,Hospital Clinico San Carlos |
Ramos B.,Laboratorio Regional Of Salud Publica |
Rios E.,Hospital Clinico San Carlos |
Cercenado E.,Hospital General Universitario Gregorio Maranon |
And 4 more authors.
Antimicrobial Agents and Chemotherapy | Year: 2011
Among 1,349 Streptococcus pneumoniae invasive isolates, 45 (3.3%) were levofloxacin resistant. Serotype distribution was as follows: 8 (n = 32 isolates), 19A (n = 4 isolates), 7F (n = 3 isolates), 9V (n = 2 isolates), 10A (n = 1 isolate), 19F (n = 1 isolate), 6B (n = 1 isolate), and nontypeable (n = 1 isolate). Levofloxacin-resistant isolates had dual mutations in the gyrA and parC genes. Serotype 8 strains corresponded to a capsular switching of the Sweden15A-25 clone. Levofloxacin resistance was also detected among multiresistant (ST27619A, Spain9V-ST156, ST88 19F, and ST15426B) and among usually antibiotic- susceptible (Netherlands7FST191, ST120119A, and ST263910A) clones. Copyright © 2011, American Society for Microbiology. All Rights Reserved.
Meseguer C.M.,Area de Sistemas de Informacion Farmaceutica |
Galan I.,Servicio de Epidemiologia |
Galan I.,Autonomous University of Madrid |
Herruzo R.,Autonomous University of Madrid |
And 2 more authors.
Revista Espanola de Cardiologia | Year: 2011
Introduction and objectives: Information on trends in physical activity is very scarce in Mediterranean countries, which have the highest sedentariness in Europe. This study describes recent trends in leisure time physical activity (LTPA) and at work in the Madrid region. Methods: The data were taken from representative annual surveys of population aged 18-64 years, between 1995-2008, 28,084 people participated. We calculated total energy, quantified in metabolic equivalent (MET-1 h per week), spent on LTPA and on light LTPA (<3 MET), moderate LTPA (3-6 MET) and vigorous LTPA (>6 MET). The annual change in LTPA was estimated by linear regression, and occupational activity by logistic regression, adjusting for age, gender and educational level. Results: The total amount of LTPA in MET-1 h per week declined by 19.8% (P < .001) between 1995-2008; for both genders, all age groups and educational levels, except for those with the lowest level of education. The adjusted annual change in MET-1 h per week was: -0.21 (P < .001) for total LTPA; -0.1 (P < .001) for light; -0.08 (P < .001) for moderate; and -0.03 (P = .192) for vigorous. This decline is reflected by a shift to the left of the LTPA distribution in the population. Occupational physical inactivity has increased in the general population (odds ratio for annual change = 1.01; 95% confidence interval, 1-1.02); specially in women, young and middle aged, and intermediate educational level. Conclusions: There has been a decline in LTPA, mainly in light and moderate activities, accompanied by greater occupational physical inactivity. This could have contributed to the increase in obesity in the Community of Madrid between 1995-2008. © 2010 Sociedad Española de Cardiología. Publicado por Elsevier España, S.L. Todos los derechos reservados.
Asensio A.,Hospital Universitario Puerta Of Hierro |
Monge D.,Servicio de Epidemiologia
Enfermedades Infecciosas y Microbiologia Clinica | Year: 2012
There has been increasing interest in Clostridium difficile infection (CDI) due its association with healthcare and its impact on morbidity and mortality in the elderly. During the last few years there has been a growing increase in the number of published studies on the incidence, changes on the clinical presentation and on the epidemiology, with the description of new risk factors. The frequency of CDI in Spain is not sufficiently characterised. The available data indicates that incidence is within the range of that of surrounding countries but increasing. Furthermore, the high and growing use of broad spectrum antibiotics, both in our hospitals and in the community setting, are factors that favour the increase of the disease. The hyper-virulent ribotype 027 has not spread in our hospitals. We need to know with enhanced validity and accuracy the incidence of CDI, both community and healthcare-associated, the information on outbreaks, the incidence on certain population groups, the characterisation of circulating ribotypes and the impact of the disease in terms of mortality and health costs. We need to implement programs for the improvement of antibiotic therapy in the hospital, as well as in the community. Furthermore, the knowledge and the performance of standard precautions need to be improved, particularly hand hygiene, and the specific measures to limit the transmission of C. difficile among the healthcare institutions. © 2011 Elsevier España, S.L. All rights reserved.
Rodriguez-Bano J.,Hospital Universitario Virgen Macarena |
Picon E.,Hospital Universitario Virgen Macarena |
Gijon P.,Hospital Universitario Gregorio Maranon |
Hernandez J.R.,Hospital Universitario Virgen Macarena |
And 13 more authors.
Clinical Infectious Diseases | Year: 2010
Background. There is little clinical information about community-onset bloodstream infections (COBSIs) caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (ESBLEC). We investigated the prevalence and risk factors for COBSI due to ESBLEC, and described their clinical features and the impact of COBSI caused by ESBLEC on 14-day mortality. Methods. Risk factors were assessed using a multicenter case-control-control study. Influence of ESBL production on mortality was studied in all patients with COBSI due to E. coli. Isolates and ESBLs were microbiologically characterized. Statistical analysis was performed using multivariate logistic regression. Thirteen tertiary care Spanish hospitals participated in the study. Results. We included 95 case patients with COBSI due to ESBLEC, which accounted for 7.3% of all COBSI due to E. coli. The ESBL in 83 of these (87%) belonged to the CTX-M family of ESBL, and most were clonally unrelated. Comparison with both control groups disclosed association with health care (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.2-3.8), urinary catheter use (OR, 3.1; 95% CI, 1.5-6.5), and previous antimicrobial use (OR, 2.7; 95% CI, 1.5-4.9) as independent risk factors for COBSI due to ESBLEC. Mortality among patients with COBSI due to ESBLEC was lower among patients who received empirical therapy with β-lactam/β-lactam inhibitor combinations or carbapenems (8%-12%) than among those receiving cephalosporins or fluoroquinolones (24% and 29%, respectively). Mortality among patients with COBSI due to E. coli was associated with inappropriate empirical therapy irrespective of ESBL production. Conclusions. ESBLEC is an important cause of COBSI due to E. coli. Clinicians should consider adequate empirical therapy with coverage of these pathogens for patients with risk factors. © 2009 by the Infectious Diseases Society of America. All rights reserved.
Verdejo M.Z.,Instituto Nacional Of Seguridad E Higiene En El Trabajo |
Gomez M.F.G.,Servicio Of Salud Laboral |
Labaca I.G.,Servicio de Epidemiologia
Revista Espanola de Salud Publica | Year: 2010
Background: It is well known the association between cardiovascular risks and life styles. In addition, all these factors could be strongly associated with working conditions. The aim of this study was to describe the association between some cardiovascular risk factors and occupations in order to define strategies focused on health promotion at workplace. Method: 16.048 questionnaires were analysed from the Surveillance System for Non-transmissible Diseases Risk Factors (SIV-FRENT) for Madrid region. The surveys of eight consecutive years (2000-2007) were aggregated and analysed. Seven risk factors for cardiovascular diseases were studied (diet, overweight, sedentary work, physical activity, alcohol and tobacco consumption and high blood pressure). An indicator of exposure was created based on these seven risk factors. The association between cardiovascular risk factors and occupations was calculated for age and gender effects adjustment. Results: Sedentary work (prevalence: 44,2%) and tobacco consumption (prevalence: 33,1%) were the most common risk factors found. To accumulate more than two cardiovascular risk factors was statistically higher in men (27,4%) than in women (15%). The highest risk was found for tree occupations: Drivers (OR:1,78; 95% CI:1,45-2,18), Administrative secretaries (OR:1,83; 95% CI:1,64-2,05) and Direction managers(OR:1,25; 95% CI:1,09-1,44). Conclusions: Drives, Secretaries and Managers seem to have a higher vulnerability for some cardiovascular risk factors.
Sanchez A.L.,Servicio de Epidemiologia |
Benjumeda L.M.R.,Servicio de Epidemiologia |
Sanchez P.C.O.,Servicio de Epidemiologia
Revista Espanola de Salud Publica | Year: 2013
Background: In 2011 in Seville (Spain), measles outbreak affected 1759 people. It began in the neighbourhood of Santa Isabel (city San Juan deAznalfarache), where Roma community resides. We described the outbreak epidemiologically and calculated the risk of disease in the population. Method: Descriptive study of outbreak and cohort study. Exposed population was considered to Barriada resident and not exposed to the rest of the municipality. The data sourceswere: the Institute of Statistics of Andalusia, the social services of San Juan's town and the Epidemiological Surveillance System of Andalusia.We described the outbreak and incidences were calculated and Relative Risk. The cases were confirmed by clinical, laboratory and /or epidemiological. Results: In the neighbourhood the cases were concentrated among the group between 2 and 19 years, while in the rest of the town occurred in children under 2 and over 19 years. The overall incidence of the outbreak was 0,98 per 1.000 inhabitants, 4,94 in San Juan; from 23,15 in the exposed, 2,1 in the unexposed and in the group of 2-19 years 89,58 in the neighbourhood and 5,33 in the rest on the town. Conclusions: The outbreak affected more children under 20 years old, unvaccinated and residents in the neighborhood Santa Isabel. The risk of falling ill with measles in the neighbourhood was 11 and 17 in the group between 2 and 19 years.We need to develop strategies to reduce health inequalities that accompany some outbreaks.
Garcia de Olalla P.,Servicio de Epidemiologia
Revista española de sanidad penitenciaria | Year: 2012
Late presentation of HIV is common. It has been associated with greater risk of AIDS, death, lower immunological response, greater toxicity and a higher probability of transmission. In this study we review the impact of different definitions in terms of mortality and morbidity, associated factors, economic implications, as well as strategies for increasing diagnosis.
Medina-Gomez O.S.,Servicio de Epidemiologia
Gaceta Medica de Mexico | Year: 2016
Introduction: In Mexico there is little research to know the magnitude of mobbing. Objective: To identify the prevalence of mobbing and characteristics associated in workers. Material and Methods: A cross-sectional study of 499 workers who use medical unit. A questionnaire was used to determine the presence of mobbing and various instruments to know the personality, vulnerability to stress, self-esteem and depression. Prevalence odds ratio, dispersion, chi-square and Poisson regression were calculated. Results: A prevalence of 36[%] was found; no significant differences between sex or school level in mobbing presence, 20.2[%], were found. Sixty per cent women are perceived as victims of harassment high relative to men (p = 0.04). Workers with low self-esteem have a greater association with high mobbing (p < 0.001). Conclusion: The prevalence found is higher than reported in previous studies in Mexico, strong associations between mobbing and personality and emotional disorders were identified. © 2016, Academia Nacional de Medicina. All rights reserved.