Percepciones de un grupo de inmigrantes sobre el Sistema Nacional de Salud y sus servicios

Objetivo: Conocer la percepción, la utilización y la satisfacción en relación con los servicios sanitarios de un grupo de inmigrantes residentes en Barcelona en relación con su género, procedencia y clase social. Diseno: ˜ Estudio descriptivo transversal. Emplazamiento: Ciudad de Barcelona, Espana. ˜ Participantes: Doscientos veinticinco inmigrantes usuarios de servicios sociosanitarios residentes en la ciudad de Barcelona, de junio a julio del 2012. Mediciones principales: Se analizaron el nivel de acceso y la relación de los inmigrantes residentes con el sistema sanitario público, a partir de una encuesta realizada en población inmigrante. Las respuestas obtenidas fueron analizadas en relación con los ejes: género, edad, clase social, salud autopercibida, país de origen, tiempo desde la llegada y estado civil. Resultados: El 89% de la población encuestada dijo «haber sido tratada con respeto» al acudir a los servicios de salud, siendo considerado este el aspecto más importante. Sin embargo, el 59,4% refirió una percepción de «discriminación hacia los inmigrantes» y el 68,4% manifestó que las diferencias culturales afectan «total o parcialmente» la calidad de la atención recibida. Para el 66,7% la atención sanitaria recibida en Barcelona es mejor que la recibida en su país de origen, principalmente por su calidad científico-técnica y por el acceso universal. Conclusiones: Pese a la buena valoración del sistema sanitario público universal este estudio mostró deficiencias del sistema en cuanto a los aspectos psicosociales de la atención sanitaria a inmigrantes en Barcelona. Es necesario profundizar en el estudio de los conocimientos y percepciones de colectivos minoritarios en el contexto actua

Una vacuna pel virus de l'Ebola : un repte de desenvolupament i comunicació

L'Ebola es una malaltia transmissible, greu i sovint mortal. Els epidemiòlegs controlen les epidèmies d'ebola mitjançant mesures d'aïllament i seguiment de contactes. Quan el nombre de contagis és elevat una vacuna pot ser crucial en la disminució de la transmissió. La necessitat de disposar de vacunes enfront del virus de la ebola ha accelerat el desenvolupament experimental i els assajos clínics. En aquest article s'introdueix el virus de la ebola, s'exposen les fases de desenvolupament de vacunes i les peculiaritats de la comunicació en situacions d'emergència.Ebola disease is highly transmissible, serious and often deadly. Epidemiologists control Ebola epidemics by isolation measures and contact tracing. When the number of infections is high a new vaccine can be crucial in reducing transmission. The need for vaccines against Ebola virus has accelerated the experimental development and clinical trials. In this article we present Ebola virus, the phases of vaccine development and peculiarities of communication in emergency situations

Immunogenicity and immunization costs of adjuvanted versus non-adjuvanted hepatitis B vaccine in chronic kidney disease patients

Hepatitis B virus (HBV) vaccination is recommended for all susceptible chronic pre-hemodialysis and hemodialysis patients. This study assessed the immunogenicity of HBV vaccines (adjuvanted and non-adjuvanted) in chronic kidney disease patients vaccinated at the Hospital Clinic of Barcelona (Spain) between January 2007 and July 2012. In addition, the costs for the health system were evaluated according to the proportion of vaccine responders after receiving either vaccine. Patients receiving three doses of hepatitis B adjuvanted vaccine were three times more likely to seroconvert than patients immunized with non-adjuvanted vaccines, OR 3.56 (95% CI 1.84-6.85). This resulted in fewer patients requiring a second course of HBV vaccination and fewer outpatient visits, saving more than euro9,500 per 100 patients. The higher immunogenicity of the adjuvanted HBV vaccine would counterbalance the lower costs associated with the non-adjuvanted vaccine

Incidence of COVID-19 in patients exposed to chloroquine and hydroxychloroquine: results from a population-based prospective cohort in Catalonia, Spain, 2020

Background: Several clinical trials have assessed the protective potential of chloroquine and hydroxychloroquine. Chronic exposure to such drugs might lower the risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or severe coronavirus disease (COVID-19). Aim: To assess COVID-19 incidence and risk of hospitalisation in a cohort of patients chronically taking chloroquine/hydroxychloroquine. Methods: We used linked health administration databases to follow a cohort of patients with chronic prescription of hydroxychloroquine/chloroquine and a control cohort matched by age, sex and primary care service area, between 1 January and 30 April 2020. COVID-19 cases were identified using International Classification of Diseases 10 codes. Results: We analysed a cohort of 6,746 patients (80% female) with active prescriptions for hydroxychloroquine/chloroquine, and 13,492 controls. During follow-up, there were 97 (1.4%) COVID-19 cases in the exposed cohort and 183 (1.4%) among controls. The incidence rate was very similar between the two groups (12.05 vs 11.35 cases/100,000 person-days). The exposed cohort was not at lower risk of infection compared with controls (hazard ratio (HR): 1.08; 95% confidence interval (CI): 0.83–1.44; p=0.50). Forty cases (0.6%) were admitted to hospital in the exposed cohort and 50 (0.4%) in the control cohort, suggesting a higher hospitalisation rate in the former, though differences were not confirmed after adjustment (HR: 1·46; 95% CI: 0.91–2.34; p=0.10). Conclusions: Patients chronically exposed to chloroquine/hydroxychloroquine did not differ in risk of COVID-19 nor hospitalisation, compared with controls. As controls were mainly female, findings might not be generalisable to a male population

Educating preservice teachers in sustainability: Conceptions, values and attitudes of students and lecturers at the university

The university has the ethical, academic, and peremptory responsibility to train education students and future trainers in sustainability. It is also something that lecturers must be prepared to address. Through a pretest-posttest study, we analyze which sustainability values and attitudes preservice teacher acquire when they work with activities on sustainability. A total of 359 students completed the process. At the same time, we analyze the attitudes and knowledge held by the lecturers who carry out these activities in sustainability education. The findings regarding the difficulty students have in integrating the various aspects of sustainability are discussed, as well as the gaps and resistance of the lecturers who design and develop such processes. Future research could be designed in such a way that causal relationships could be established between the type of instructional design, the results obtained, and the conceptions and beliefs of lecturers regarding sustainability

Factors Influencing the Accuracy of Infectious Disease Reporting in Migrants: A Scoping Review

We conducted a scoping review of literature to improve our understanding of the accuracy of infectious disease monitoring in migrants in the Europe. We searched PubMed for papers relevant to the topic including: case reports, observational and experimental studies, reviews, guidelines or policy documents; published after 1994. We identified 532 papers, 27 of which were included in the review. Legislation and right to access health care influence both the accuracy of rates and risk measures under estimating the at risk population, i.e., the denominator. Furthermore, the number of reported cases, i.e., the numerator, may also include cases not accounted for in the denominator. Both biases lead to an overestimated disease occurrence. Restriction to healthcare access and low responsiveness may cause under-detection of cases, however a quantification of this phenomenon has not been produced. On the contrary, screening for asymptomatic diseases increases ascertainment leading to increased detection of cases. Incompleteness of denominator data underestimates the at-risk population. In conclusion, most studies show a lower probability of under-reporting infectious diseases in migrants compared with native populations

Bevacizumab plus low-dose metronomic oral cyclophosphamide in heavily pretreated patients with recurrent ovarian cancer

Este artículo ha sido publicado en Oncology Basel. Esta versión tiene Licencia Creative Commons CC-BY-NC-ND No puedo enviar el postprint porque no lo tienen disponible o no quieren facilitarmelo, en su lugar he aportado en la descripción del envió dos e mail en los cuales la editorial me da permiso por escrito para su depósito como puede ver en los mimos Adjunto e mails, si tiene ustd alguna otra sugerencia para poder hacer deposito por favor hagamelo saber 2º e mail: Dear Alfonso, Our reply is the written permission to deposit the article in the university’s repository – please find it attached once again. Kind regards, Veronika 1º e mail Veronika Duhovnikova Key Account Manager, Academic & Research Markets +41 61 306 12 43 [email protected] Dear Alfonso, Thank you for your email. As to your query, we are pleased to inform you that Karger permits authors to archive their pre-prints (i.e. pre-peer review) or post-prints (i.e. accepted manuscript after peer review but before production) on their personal or their institution’s internal website. In addition, authors may post their accepted manuscripts in public Open Access repositories and scientific networks (e.g. ResearchGate or Mendeley) no earlier than 12 months following the publication of the publisher’s versions. For all self-archiving options, the posted manuscripts must be - used for non-commercial purposes only - linked to the final version on Karger Publishers - include the following statement: ‘This is the peer-reviewed but unedited manuscript version of the following article: [insert full citation, e.g. Oncology 1 December 2010; 79 (1-2): 98–104, (DOI: 10.1159/000320602)]. The final, published version is available at [https://karger.com/ocl/article-abstract/79/1-2/98/328844/Bevacizumab-plus-Low-Dose-Metronomic-Oral?redirectedFrom=fulltext].’ For papers published online first with a DOI number only, full citation details must be added as soon as the paper is published in its final version. This is important to ensure that citations can be credited to the article. It is the author’s responsibility to fulfil these requirements. Further information about Karger’s Self-Archiving Policy can be found on the Karger website https://karger.com/pages/rights-and-permissions ‘How can I share it?’ and on SherpaRomeo Welcome to Sherpa Romeo - v2.sherpa. Please feel free to contact us again, if you need any further information. Kind regards, Veronika Veronika Duhovnikova Key Account Manager, Academic & Research Markets +41 61 306 12 43 [email protected]: To retrospectively assess the efficacy and safety of bevacizumab plus low-dose metronomic oral cyclophosphamide in heavily pretreated patients with recurrent ovarian cancer. Patients and Methods: Patients with recurrent ovarian cancer and prior treatment with platinum- and taxanebased chemotherapy were included. Treatment consisted of bevacizumab 10 mg/kg intravenously every 2 weeks plus oral cyclophosphamide 50 mg daily until disease progression or unacceptable toxicity. Response rates (RR) were determined according to RECIST criteria and by monitoring the CA 125 serum tumor marker according to Rustin’s criteria.The endpoints were progression-free survival (PFS), RR, overall survival (OS), and safety. Results: Thirty-eight patients were treated; 79% were platinum resistant and 21% were platinum sensitive. The median number of previous treatments was 4 (range 1–8). Seventy-nine percent of patients had received more than 2 previous lines of treatment. Eightyone percent of patients had received gemcitabine, 76% liposomal doxorubicin, and 50% topotecan. A median of 8 (range 1–70) cycles of bevacizumab were administered. The overall RR was a complete response (CR) in 3 patients (8.1%), a partial response (PR) in 12 (32.4%), and stable disease (SD) 6 6 months in 3 (8.1%). The median PFS and OS were 4.5 and 10.7 months, respectively. Thirty-nine percent of patients were progression free for at least 6 months. In an exploratory analysis there was a significant relation of prior platinum response and performance status with the risk of progression.Grade 3–4 toxicities included anemia (1), hypertension (2), hematuria (1), arterial thrombosis in the leg (1), dyspnea (1), and intestinal fistulae (1). There were no cases of gastrointestinal perforation (GIP) or treatment-related deaths. Conclusion: The combination of bevacizumab and metronomic cyclophosphamide was active and well-tolerated in heavily pretreated patients with recurrent ovarian cancer

Turning the Crisis Into an Opportunity: Digital Health Strategies Deployed During the COVID-19 Outbreak

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Digital health; eHealth; Telemedicine; Public healthCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Salud digital; eSalud; Telemedicina; Salud públicaCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Salut digital; eSalut; Telemedicina; Salut públicaDigital health technologies offer significant opportunities to reshape current health care systems. From the adoption of electronic medical records to mobile health apps and other disruptive technologies, digital health solutions have promised a better quality of care at a more sustainable cost. However, the widescale adoption of these solutions is lagging behind. The most adverse scenarios often provide an opportunity to develop and test the capacity of digital health technologies to increase the efficiency of health care systems. Catalonia (Northeast Spain) is one of the most advanced regions in terms of digital health adoption across Europe. The region has a long tradition of health information exchange in the public health care sector and is currently implementin an ambitious digital health strategy. In this viewpoint, we discuss the crucial role digital health solutions play during the coronavirus disease (COVID-19) pandemic to support public health policies. We also report on the strategies currently deployed at scale during the outbreak in Cataloni

Approach to the causes of discharge and health needs of transgender people through the National Hospital Discharge Survey in Spain during the period 2001 to 2013

OBJECTIVE: The health of transgender people is a little studied topic and hospital records can be an opportunity to make an approach. The aim of this study was to describe the cause for admission and the associated comorbidities of transgender people in Spain between 2001 and 2013. METHODS: Retrospective observational study with population-based administrative records (Minimum Basic Data Set). The discharges generated by the transgender in Spanish public and private hospitals were selected using one of the following ICD-9-CM codes in any diagnostic field: Trans-sexualism (302.5), Disorders of psychosexual identity (302.6) and Gender identity disorder in adolescents or adults (302.85). The causes of admission and comorbidity according were described. The qualitative variables were described in their frequency distribution according to their number(n) and proportion(%) and the quantitative variables according to their mean and standard deviation (SD) or median (MD) and interquartile range (RIQ) according to their distribution. RESULTS: A total of 2,010 highs were recorded corresponding to 1,878 patients. The mean age was 33 years (SD = 10). 51% were male, 46% female and 3% undetermined or unspecified. The discharges were motivated in 59% by the process of body modification, followed by HIV (4%) and personality disorders (3%). The most common comorbidities were those associated with body modification (49%), mental health problems (40%) and infectious diseases (15%). CONCLUSIONS: It is necessary to address the health of transgender people in a comprehensive way that takes into account their specific health needs, including bodily modification, mental health, HIV and other infections, through strategies that include improve research, tailor health information systems and develop guidelines and training of healthcare providers in this transgender health.S

Recreational drug use among individuals living with HIV in Europe: review of the prevalence, comparison with the general population and HIV guidelines recommendations.

BACKGROUND: Adherence problems, interactions and higher rate of risk activities have been observed in HIV individuals using recreational drugs. Our aim was to describe recreational drug use in both HIV individuals and general population in Europe, and to assess at what extent HIV guidelines address this issue. METHODS: Data on recreational drug use across Europe were obtained from the European Monitoring Centre for Drugs and Drug Addiction for the general population, and through Pubmed search. for HIV patients. We assessed the incorporation of recreational drug issues in HIV treatment guidelines for the following topics: (a) recreational drugs; (b) adherence to antiretrovirals; (c) interactions; (d) transmission risk. Guidelines included: World Health Organization; European Aids Clinical Society; U.S. Department of Health and Human Services; International Antiviral Society-USA; and seven European national guidelines. RESULTS: 29 countries reported recreational drug use in general population. The highest prevalences were observed for Cannabis (i.e., 8-10% in Spain, France, and Czech Republic) followed by cocaine, amphetamines and ecstasy. The 13 studies selected in the systematic review showed a great variability in recreational drug use on the HIV population. Apart from classical recreational drugs, we found a relevant use of new drugs including sexual experience enhancers. Polydrug consumption was about 50% in some studies. Most guidelines included general information about recreational drugs, showing great variability on the inclusion of the evaluated topics. We found more specific, evidence-based recommendations on interactions, followed by medication adherence and transmission risk. CONCLUSIONS: Available data on the people living with HIV suggest a higher use of recreational drugs than in the general population, which is already relevant. However, recreational drug issues should be included or addressed more thoroughly in most guidelines