Revista Espanola De Salud Publica最新文献

It is estimated that colorectal cancer is the cancer disease with the highest incidence in Spain  due to the increase in life expectancy and changes in the lifestyle of the population . Early detection through disease screening programs allows for more effective treatment and a higher survival rate . Advances in treatment have been made, such as targeted therapies, which focus on specifically attacking cancer cells and preventing their growth . However, much remains to be done in terms of prevention and treatment of colorectal cancer. More research and medical advances are required to combat this disease.

Objective: The set of exposures to chemical substances and their role as a cause of disease gives rise to the concept of the exposome, partially made up of chemical pollutants to which an individual is exposed, which is why, unlike the genome, it is an a priori modifiable factor, its study being crucial in terms of Public Health. The population of the Canary Islands has been studied in terms of its levels of chemical contamination, with numerous biomonitoring studies, which makes it necessary to characterise its exposome and its consequences in terms of disease, in order to implement specific corrective measures to minimize the impact on its health.

Methods: A review of scientific literature (MEDLINE and Scopus) was made, according to PRISMA criteria and PICO methodology, to include studies on biomonitoring of pollutants, or evaluating the effect of pollutants on diseases prevalent in the archipelago.

Results: Twenty-five studies, both population-based and hospital-based, were selected. The results show that the exposome is made up of at least 110 compounds or elements, 99 of which appear to be present from the intrauterine stage. The presence of chlorinated pollutants and metals stands out, which seems to be related to the high incidence of metabolic diseases (diabetes), cardiovascular diseases (hypertension) and certain types of neoplasms (breast cancer). In short, the consequences are conditioned by the genome of the exposed population, reinforcing the enormous importance of genome-exposome interactions in the development of pathologies.

Conclusions: Our results indicate that it is necessary to establish corrective measures on the sources of pollution that modify the exposome of this population.

The last World Breastfeeding Week (SMLM, its initials in spanish) was a proper moment to deliberate on the facts, values and duties that are related to breastfeeding in order to give it value as a human phenomenon capable of providing well-being and creating healthy, emotionally stable and more fair. Along with the indicators that show the consumption of breastmilk in the child population, facts and values of mothers, fathers, civil society are examined; the health system, labor and development models. The duties are organized in optimal outputs that are grouped in the steps of the Initiative for the Humanization of Birth and Breastfeeding Assistance (IHAN, its initials in spanish), the warm chain of support; as well as in the policies of humanization and quality of service of the governing bodies of health. The deliberation shows the mother as the center of attention and her duty in charity for her baby; also the responsibility of health personnel as protagonists of change, supporting, educating and basing the value that breastfeeding has for both development model.

Objective: Knowledge of social and gender determinants, which influence the places where people are exposed to COVID-19, may be relevant in the development of preventive and control strategies. The aim of this paper was to determine the context in which COVID-19 cases were infected (household, work/labor, health, social-health, and social-leisure settings) according to country of origin, occupational social class and gender, which is essential in order to designing public health strategies.

Methods: A cross-sectional study of an epidemiological registry of 56,628 COVID-19 incident cases was made, whose exposure/contagion setting was studied according to the previous variables from June 15 to December 23, 2020, in the Region of Murcia (Spain). An exact Fisher test was used to study the distribution of COVID-19 cases based on the above variables.

Results: The cumulative incidence was higher in people from Africa (5,133.5 cases/100,000 inhabitants) and Latin America (11,351.1) than in non-immigrants (3,145.7). It was also higher in women (3,885.6) than in men (3,572.6). It is noteworthy, that 53.3% of the cases with employment were workers in industry or construction, artisans, agricultural workers, or elementary occupations. In contrast, during the second semester of 2020, 41.3% of the employed population in the Region of Murcia performed such jobs. The household was the main exposure setting (56.5% of cases with a known setting), followed by social-leisure (20.7%) and work/labor (18.2%). The labor settings were more important in immigrants from Africa (28.4%) and Latin America (35.7%) than in non-immigrants (12%), inversely to social-leisure settings. Labor context was more important in women (19.6%) than in men (16.5%) and in manual workers (44.1%) than in non-manual workers (26.6%).

Conclusions: The context in which COVID-19 cases were infected is different according to social inequalities related to country of origin, gender and occupational social class.

Objective: Obesity is an inflammatory disease that is widely distributed in the world's population and is related to the leading causes of death. The use of prebiotics and probiotics can be an alternative treatment against obesity. Although there have been found physiological and biochemical effects of its use, the molecular mechanism remains unclear. The present review analyzed articles that suggested the activation of pathways related to the metabolism of the fatty acids, as well as the impact on anti-inflammatory mechanisms, as part of the mechanism of action of prebiotics and probiotics, to know therefore the possible pathways activated by the prebiotics and probiotics.

Methods: Exhaustive research was made on articles included in the period 2005-2021 related to the effect of prebiotics and probiotics in obesity, inflammatory diseases, and metabolic diseases. Identifying an effect on anti-inflammatory cytokines and PPAR modulation, with a consequent decrease in inflammation and fat degradation.

Results: A total of sixty-three articles were obtained, which were classified as basic information on molecular markers of obesity, the effect of prebiotics and probiotics in obesity, and articles related to anti-inflammatory effects and fatty acid metabolism observed in obesity and other inflammatory diseases.

Conclusions: The effect of prebiotics and probiotics in obesity can be linked to the anti-inflammatory mechanism produced, and this effect leads to an increase in the expression of genes related to fatty acid metabolism.

Objective: Medications errors are a major problem that can cause a harm to inpatients. The main objective of the study was to compared medication errors in pharmacotherapeutic process before and after to carried out an intervention: to implant an automated dispensing cabine with to use Lean Six Sigma methodology. The secondary objective was to assess process performance, sigma level and defects per one million opportunities for medication error.

Methods: Quasi-experimental and randomized study carried out in a Thoracic Surgery Unit of a Spanish Hospital. A pharmaceutic recorded and assesed the medication errors detected during pre-intervention period (july-august 2017) and post-intervention period (march-april 2018). The steps analyzed were dispensing, storage and compounding/administration. The pharmacist observed a third of the medication dispensed, stored and compounded/administered during the study period. The observed medication was randomly selected using AleatorMetod.xls software. To perform the statistical analysis, Student's t test and Mann-Whitney U test were used to compare quantitative variables, and Chi-square test for qualitative variables. A significance level of p<0.05 was considered.

Results: The pharmaceutic recorded 4,538 drugs. After intervention, medication errors were decreased a 49% in total pharmacotherapeutic process (12.06% vs 6.15%; p<0.001). In addition, errors were decreased a 91.6% (4.27% vs 0.36%; p=0.004) in the step of medication storage; and a 75.8% (22.52% vs 5.46%; p<0.001) in the step of drugs compounding/administration. However, medication errors were increased in the step of medication dispensing (4.51% vs 15.29%; p<0.001). The process performance increased a 6% (87.9% vs 93.9%), sigma level increased from 2.67 to 3.04 and defects per one million opportunities for medication error decreased a 49%.

Conclusions: To implant an automated dispensing cabinet with Lean Six Sigma methodology helps create a safer environment for the inpatient, reducing medication errors in the steps of storage and preparation/administration, as well as improving the total process performance and sigma level.

Background: Dementia is a global public health problem. Drugs for this indication have shown limited benefit. The aim of the present study is to synthesize and analyze the available scientific evidence about effectiveness of interventions on diet and / or physical exercise by considering cognitive function as an outcome measure, in people over 45 years of age with mild cognitive impairment (MCI) in their evolution to Alzheimer's disease.

Methods: A bibliographic search of randomized clinical trials, systematic reviews, and meta-analyzes published from May 2008 to May 2019 was carried out in the Medline and The Cochrane Library databases. A total of 169 publications were identified, of which 42 studies that fulfilled inclusion criteria were reviewed.

Results: It was found that scheduled physical exercise of moderate-high intensity, performed 3 to 5 days a week, following a dietary pattern such as Mediterranean diet or DASH diet improve overall cognitive function in subjects with MCI. The results are enhanced when the studies combine both interventions and include cognitive stimulation exercises, allowing increasing the functionality of the subjects.

Conclusions: Intervention on modifiable factors such as physical exercise and diet provides cognitive protection in subjects with MCI, improving their quality of life, functionality and independence. The heterogeneity of the studies makes it difficult to draw up more concrete recommendations.

The purpose of this work is to discuss the importance and possible application of some foundations of quantum mechanics in the health-disease process, considering for this, that the laws and foundations of atomic theory are the same that govern displacement in space and time in human beings. Based on the impossibility of determining the displacement of subatomic particles in a given space and time, as a consequence of not having measuring instruments for said microscales, we propose feasible that the same happens with the uncertainty generated by the times and movements of human beings in really large spaces, reason why the analysis of the temporo-spatial location of a moving subject, in a certain time and space is impossible, fact that we consider, could represent the behavior in Pandemics. The foundations of quantum mechanics that have been considered for this purpose are dynamic systems, the Schrödinger cat paradox, the Heisenberg uncertainty principle, the law of gases, times and movements, and the Maxwell-Boltzmann entropy. On the other hand, it is proposed to consider the adaptation of measurement ecis ecisión statistical procedures (decisión tree and set theory) and finally the implementation of a unitary probabilistic cube is proposed, which allows locating a subject immersed in the health process disease through three axes developed considering the definition of health stipulated by the WHO.

Objective: Phelan-McDermid syndrome is a rare genetic condition caused by a deletion of the terminal end of chromosome 22 in the 13.3 region, as well as, by point mutations within SHANK3 gene. The aims of this research were to determine the prevalence of the disease in the Spanish population, to establish the geographical distribution of the syndrome among the different autonomous communities, to elucidate the age range that affects more patients, to study the disease-sex relationship, as well as the age at diagnosis.

Methods: For the research, patients diagnosed with the disease for twelve years were recruited throughout the Spanish territory. The clinical patient information was obtained from the referral doctors using two standardized questionnaires completed with data from the medical reports and the interview with the parents. The molecular diagnosis of the disease was carried out using different formats of microarrays. Data were processed using Microsoft Excel and Statgraphics Centurion XVII.

Results: Currently in Spain there are 201 people diagnosed with the disease. Currently in Spain there are 201 people diagnosed with the disease, its prevalence being 4x10^-4/10,000 inhabitants. The community with the most diagnosed patients was Madrid and there were no significant differences in terms of sex and disease, the mean age at diagnosis was around 6.67 years.

Conclusions: The prevalence of the disease in Spain is very low, and it can be stated that it is very likely that there are more people with this syndrome in the population.