Revista Espanola De Salud Publica最新文献

Objective: Ocular infections caused by human adenovirus are highly contagious and can cause outbreaks, especially in nursing homes. In this work, we describe the epidemiological and analytical research as well as the control measures carried out for a conjunctivitis outbreak.

Methods: Descriptive epidemiological study. Cases with a symptom onset date prior to oficial communication were analyzed retrospectively. The rest was analyzed prospectively. Conjunctival smears were collected for microbiological study. Virological analysis was performed by detecting adenovirus by PCR and genotyping. A data questionnaire that collected clinical and epidemiological information was designed. Possible risk factors associated with infection were studied by calculating the Odds Ratio.

Results: On June 11, 2019, the Epidemiological Surveillance Section of the Provincial Health Department of Albacete was notified of the existence of a large number of cases of conjunctivitis in a geriatric center. 54 cases were declared: 43 internal residents, 3 day center assistants and 8 workers. Attack rates were 35.8%, 12.5% and 8.4% respectively. Three risk factors were associated with the disease: patient´s lack of autonomy, being a resident at the nursing home and having their room assigned on the first floor. Human adenovirus serotype 8 was detected in the patients' samples.

Conclusions: A high attack rate was observed in internal residents and the disease was associated with patient´s lack of autonomy and having their room assigned on the first floor of the nursing home. The outbreak was caused by human adenovirus serotype 8.

The SARS-CoV-2 pandemic (Covid-19) has had a major impact on residents of assisted-living facilities. While it is plausible that the characteristics of these patients and their special clinical fragility have contributed to their greater vulnerability to infection, other related factors cannot be ruled out, such as the quality of management at these centers and the lack of planning for actions taken before and during the health crisis. Both aspects pertain to the field of public health, where the ethics of the common good conflicts with the autonomy of the individual.

Objective: The Covid-19 pandemic is testing the resistance of health systems, the preservation of health professionals is a priority in processes of this type. The professionals' exposure to suspicious contacts often requires their confinement. The objective was to know the epidemiological characteristics of the primary care professionals who required confinement.

Methods: The research was carried out in the North Metropolitan Primary Care Area of Barcelona, from February 17 to May 3, 2020. 1,418 professionals who required confinement due to the epidemic by Covid-19 participated. The reasons for confinement, symptomatology, the confinement time and the results of PCR tests results were recorded. Univariate descriptive analysis was performed.

Results: 78.8% of the professionals were women and the mean age was 45.2 years. 67.8% were doctors and nurses, in the remaining 32.2% there were different healthcare and non-care professionals. 64.1% of the sample presented symptoms compatible with Covid-19. Participants described multiple symptoms during confinement. 1,050 diagnostic RT- PCR tests were performed, being positive in 323 cases, of which 33 were in asymptomatic people.

Conclusions: The impact of the epidemic by Covid-19 is anticipated in health personnel compared to the general population. The distribution of symptoms in healthcare professionals is similar to that of other studies in the general population. Of the total number of professionals requiring isolation, 22.7% confirmed the diagnosis.

Objective: The use of masks is one of the measures to protect against the Covid-19 pandemic. The type of mask and how to use it during physical exercise has generated controversy. This work aims to analyse the effect of the use of masks in the practice of high intensity physical exercise.

Methods: An exploratory review was conducted by querying the PubMed, Scopus, Google Scholar and CUIDEN databases.

Results: Respiratory physiology at rest and performing intense physical exercise was described, explaining how the use of masks during high-intensity physical exercise affects it in relation to gas exchange.

Conclusions: In case of intense physical exercise, the use of masks is not recommended because of the enhancing effect on PCO₂. It would not allow the complete expulsion of the expired CO₂ and would increase its concentration, along with the typical increase of the breathing rate during the exercise.

Objective: Despite knowing that the practice of physical activity can positively influence the health of older people, there are variables such as the risk of dependency and the level of self-esteem that can mediate people´s quality of life. The objective of this study was to know the relationship between the risk of dependence and level of self-esteem in older people.

Methods: 515 seniors between 60 and 90 years old were interviewed. A single measurement was made, using different scales and validated questionnaires (Rosenberg personal self-esteem scale, Barber test and Modified Baecke PAQ questionnaire). Statistical analyzes (with the SPSS v. 23.0 program) descriptive, ANOVA, linear regression analysis and correlations were performed.

Results: 89.1% had dependency risk, 32.6% were physically active and 43.3% had low self-esteem. The level of physical activity practice showed significant differences (p<0.001) favorable to active people, who had a lower risk of dependence, better self-esteem and lower consumption of medications than sedentary ones.

Conclusions: The practice of physical activity helps reduce drug consumption, which improves the self-esteem of the elderly and decreases the risk of dependence.

Objective: Cardiovascular diseases is one of the most important health problems among population. Most preventable deaths which take place in a context different from the hospital are related to coronary heart diseases. Training the population in cardiopulmonary resuscitation (CPR) may well result in an increase in the survival rate before a cardiorespiratory arrest.

Methods: An observational study -both prospective and analytical- was conducted through a sample of students in the fourth year of compulsory secondary education. They were divided in two groups: a first group was trained with a theoretical-practical course on CPR, the second group only a theoretical course on CPR. Three surveys on CPR knowledge were conducted, the first one prior to a CPR course, the second one after the course and the third carried out two months after completing it. The results were compared between the three surveys to examine the degree of acquisition and maintenance of knowledge.

Results: 326 students, 213 theoretical-practical group and 113 theoretical group, whose average age was 15.6 years (DE=0.7, R 15-17) and 56% were girls. The average scores of the questionnaires were: 5.1 points (DE=1.8, R 0-10) on first exam, 8.2 points (DE=1.6, R 3-10) on second exam of the theoretical-practical group versus 7.7 points (DE=1.9, R 0-10) of the theoretical group, and 7.2 points (DE=3.8, R 1-10) on third exam. In the first exam, 5.2% of them knew the frequency of chest compressions and ventilations in CPR, improving to 68.1% in the second questionnaire of the theoretical-practical group, and a 79.6% of the theoretical group.

Conclusions: Increased knowledge in cardiopulmonary resuscitation reflect in an increase of 3.1 points of average after the theoretical-practical sessions and in 2.1 points two months later. The theoretical-practical group obtain a better score in the post-course exam (8.2 points) compared to the theoretical group (7.7 points).

Objective: Foreign body (FB) ingestion distresses many families who consult the emergency department promptly. The objective of the study is to determine the epidemiological characteristics of children who consult due to suspected FB intake and its consequences.

Methods: Descriptive-observational study, carried out in a third-level maternal and child center. Emergency reports were selected from patients under 18 years of age with a diagnosis of discharge "Ingesta CE" (code 938 CIM-9-MC until May 2018; code T18.9XXA CIM-10-MC later) from 1/1/2017 until 12/31/2018. Miscoded and reconsultations within the same episode were excluded. Data was analysed with the statistics program SPSS 25.0.

Results: 458 cases were included; median age 3.8 years (p25-75: 1.9-6.6 years); 267 (58.3%) males. 78.9% consulted in the first 6 hours after intake. Accidental cause was reported in 98.9% of cases. In 96.7% a single FB was ingested. The most frequent types of object were metallic (46.7%), plastics (16.4%) and food bones/shells (12.9%). The 23.6% of FB involved were sharp/pointed. 49.1% of the patients presented symptoms. A complementary test was performed in 69.4%, especially radiographs (63.5%). Metal detector was used in 10%. 9.6% required endoscopy. 90.4% were discharged from the emergency department, with 12.1% of reconsultations.

Conclusions: Consultations for FB ingestion are relatively frequent in the emergency department and, although most of them are discharged, many patients require complementary tests and a non-negligible number, endoscopy. The patient's profile is that of a preschooler who spontaneously goes to the emergency room due to an accidental ingestion of a blunt metallic object.

Although Spain is a developed country, Tuberculosis (TB) was for years a disease with high incidence rates compared to other European countries, a situation that worsened with the HIV/AIDS epidemic and with the increase of immigration. The Spanish Respiratory Society (SEPAR) created in 2004 the Integrated Research Programs (PII) on respiratory diseases, including TB (PII-TB) which has carried out studies related to the five lines of research that it maintains: clinical / epidemiological, microbiological, technological/clinical management, evaluative, and international cooperation. Following the recommendations on the necessity to evaluate health programs made by international organizations, the evaluation of PII-TB was recently carried out, revealing the situation of the main variables of the disease and their evolution over the time that the program has been working. PII-TB has generated abundant data on the situation of this disease in our country in years when this information has been limited. The fact that the results of the studies have been widely disseminated makes it easier for all professionals involved in the prevention, diagnosis and treatment of TB to implement and/or to improve activities that, finally, will contribute to the control of this disease.