Hip fracture in hospitalized medical patients

BACKGROUND: The aim of the present study is to analyze the incidence of hip fracture as a complication of admissions to internal medicine units in Spain. METHODS: We analyzed the clinical data of 2,134,363 adults who had been admitted to internal medicine wards. The main outcome was a diagnosis of hip fracture during hospitalization. Outcome measures included rates of in-hospital fractures, length of stay and cost. RESULTS: A total of 1127 (0.057%) admittances were coded with an in-hospital hip fracture. In hospital mortality rate was 27.9% vs 9.4%; p < 0.001, and the mean length of stay was significantly longer for patients with a hip fracture (20.7 days vs 9.8 days; p < 0.001). Cost were higher in hip-fracture patients (6927€ per hospitalization vs 3730€ in non fracture patients). Risk factors related to fracture were: increasing age by 10 years increments (OR 2.32 95% CI 2.11-2.56), female gender (OR 1.22 95% CI 1.08-1.37), admission from nursing home (OR 1.65 95% CI 1.27-2.12), dementia (1.55 OR 95% CI1.30-1.84), malnutrition (OR 2.50 95% CI 1.88-3.32), delirium (OR 1.57 95% CI 1.16-2.14), and anemia (OR 1.30 95%CI 1.12-1.49). CONCLUSIONS: In-hospital hip fracture notably increased mortality during hospitalization, doubling the mean length of stay and mean cost of admission. These are reasons enough to stress the importance of designing and applying multidisciplinary plans focused on reducing the incidence of hip fractures in hospitalized patients

Social Restrictions versus Testing Campaigns in the COVID-19 Crisis: A Predictive Model Based on the Spanish Case

The global COVID-19 spread has forced countries to implement non-pharmacological interventions (NPI) (i.e., mobility restrictions and testing campaigns) to preserve health systems. Spain is one of the most severely impacted countries, both clinically and economically. In an effort to support policy decision-making, we aimed to assess the impacts of different NPI on COVID-19 epidemiology, healthcare costs and Gross Domestic Product (GDP). A modified Susceptible-Exposed-Infectious-Removed epidemiological model was created to simulate the pandemic evolution. Its output was used to populate an economic model to quantify healthcare costs and GDP variation through a regression model which correlates NPI and GDP change from 42 countries. Thirteen scenarios combining different NPI were consecutively simulated in the epidemiological and economic models. Both increased testing and stringency could reduce cases, hospitalizations and deaths. While policies based on increased testing rates lead to higher healthcare costs, increased stringency is correlated with greater GDP declines, with differences of up to 4.4% points. Increased test sensitivity may lead to a reduction of cases, hospitalizations and deaths and to the implementation of pooling techniques that can increase throughput testing capacity. Alternative strategies to control COVID-19 spread entail differing economic outcomes. Decision-makers may utilize this tool to identify the most suitable strategy considering epidemiological and economic outcomes

An approach for identifyation of areas with higher expected damage and definition of priority levels for prevention plans in Murcia Province (SE Spain)

The Murcia Region is one of the most active zones in Spain, where three earthquakes took place in 1999, 2002 and 2005. In spite of their low magnitudes (Mw 4.8), these earthquakes caused important damage, the last one reaching an EMS-98 intensity of VII. After that event, the RISMUR project started, aimed at providing a general picture of the seismic risk, which allows us to identify zones requiring a more detailed analysis of where prevention plans should be prioritized. A multidisciplinary study, starting with the seismic hazard assessment, which follows the Probabilistic Seismic Hazard Assessment methodology has been carried out at a regional scale. The expected ground motion (rock sites), for a return period of 475 years, has been characterized in terms of PGA and spectral ordinates and the corresponding maps have been drawn. In addition, a regional geotechnical study has been done and a classification of eight types of soils has been proposed, with the corresponding amplification factors. The combination of previous maps and factors, gives a new hazard map which already includes local effects. In parallel, a vulnerability assessment of the Murcian building stock is carried out, based fundamentally on the age of construction and following the EMS-98 criteria. Taking into account the expected ground motions and building vulnerabilities, the distribution of expected damage is estimated by the application of probability damage matrixes. A suite of maps representing seismic risk in terms of damage parameters for the entire region and from which we can identify the locations with higher expected damage have been obtained. We use the Coulomb stress transfer map of the region as additional criteria for defining priority areas where detailed studies should be performed. This gives information about the zones with stress load due to the previous seismicity and where new events could be triggered. The superposition of this map with the active faults of the region and the locations with higher expected damage allows us to establish a four-level priority ranking where future local-scale analyses should be made

Adenopatía inguinal a estudio: ¿debemos incluir siempre el linfogranuloma venéreo en el diagnóstico diferencial?

Lymphogranuloma venereum is a disease with a significant increase in prevalence in Spain in recent years, so it must be taken into account in the screening of sexually transmitted diseases. In this case, a patient with the presence of a unilateral inguinal adenopathy that denied risky sexual relations is shown. After the histological study of the adenopathy, which shows granulomatosis, and discarding tuberculosis, among other entities, Chlamydia trachomatis serology was requested, being positive, with a good clinical and serological response to the treatment.El linfogranuloma venéreo es una enfermedad con un importante aumento de prevalencia en España en los últimos años, de forma que debe tenerse en cuenta en el cribado de enfermedades de transmisión sexual. En este caso, se muestra un paciente con presencia únicamente de una adenopatía inguinal unilateral que negaba relaciones sexuales de riesgo. Tras el estudio histológico de la adenopatía, que mostraba granulomatosis, y tras descartar tuberculosis, entre otras entidades, se solicitó serología de Chlamydia trachomatis, que resultó positiva, con buena respuesta clínica y serológica al tratamiento.

Temporal series analysis of population cycle threshold counts as a predictor of surge in cases and hospitalizations during the SARS-CoV-2 pandemic

Tools to predict surges in cases and hospitalizations during the COVID-19 pandemic may help guide public health decisions. Low cycle threshold (CT) counts may indicate greater SARS-CoV-2 concentrations in the respiratory tract, and thereby may be used as a surrogate marker of enhanced viral transmission. Several population studies have found an association between the oscillations in the mean CT over time and the evolution of the pandemic. For the first time, we applied temporal series analysis (Granger-type causality) to validate the CT counts as an epidemiological marker of forthcoming pandemic waves using samples and analyzing cases and hospital admissions during the third pandemic wave (October 2020 to May 2021) in Madrid. A total of 22,906 SARS-CoV-2 RT-PCR-positive nasopharyngeal swabs were evaluated; the mean CT value was 27.4 (SD: 2.1) (22.2% below 20 cycles). During this period, 422,110 cases and 36,727 hospital admissions were also recorded. A temporal association was found between the CT counts and the cases of COVID-19 with a lag of 9–10 days (p ≤ 0.01) and hospital admissions by COVID-19 (p < 0.04) with a lag of 2–6 days. According to a validated method to prove associations between variables that change over time, the short-term evolution of average CT counts in the population may forecast the evolution of the COVID-19 pandemic

Iberfault 2022. IV Reunión Ibérica sobre Fallas Activas y Paleosismología. Volumen de resúmenes, Teruel, 7 al 10 de septiembre de 2022

SESIÓN 1: Tectónica activa y paleosismología de las Cordilleras Béticas (I) SESIÓN 2: Tectónica activa y paleosismología del resto de la Península Ibérica SESIÓN 3: Sismología y sismicidad inducida SESIÓN 4: Arqueosismología SESIÓN 5: Tectónica activa y paleosismología de las Cordilleras Béticas (II) SESIÓN 6: Tectónica activa en el medio marino SESIÓN 7: Geodesia aplicada a tectónica activa SESIÓN 8: Modelización sismotectónic

The Raman laser spectrometer ExoMars simulator (RLS Sim): A heavy‐duty Raman tool for ground testing on ExoMars

Producción CientíficaThe Raman laser spectrometer (RLS) instrument onboard the Rosalind Franklin rover of the ExoMars 2022 mission will analyze powdered samples on Mars to search for traces of life. To prepare for the mission, the RLS scientific team has developed the RLS ExoMars Simulator (RLS Sim), a flexible model of RLS that operates similarly to the actual instrument, both in laboratory and field conditions, while also emulating the rover operational constraints in terms of sample distribution that are relevant to the Raman analysis. This system can operate autonomously to perform RLS-representative analysis in one or several samples, making it very useful to perform heavy experimental tasks that would otherwise be impossible using a flight-representative model of the instrument. In this work, we introduce the current configuration of the RLS Sim that has incorporated new hardware elements such as the RAman Demonstrator 1 (RAD1) spectrometer with the objective of approaching its performance to that of the actual RLS instrument. To evaluate the scientific capability of the RLS Sim, we have compared it with a replica model of RLS, the RLS Flight Spare (FS). Several acquisition aspects have been evaluated based on the analysis of select samples, assessing the performance in terms of spectral range and resolution and also studying several issues related to the evolution of signal-to-noise ratio (SNR) with different acquisition parameters, especially the number of accumulations. This performance analysis has shown that the RLS Sim in its updated configuration will be a key model to perform support science for the ExoMars mission and the RLS instrument on the Rosalind Franklin rover. Designed to work intensively, the use of the RLS Sim in combination with the RLS FS will facilitate maximizing the scientific return of the RLS spectrometer during Martian operations.Secretaría de Estado de Investigación, Desarrollo e Innovación (grant PID2019-107442RBC31)European Union’s Horizon 2020 research and innovation program (grant 687302

Virological Correlates of IgM–IgG Patterns of Response to SARS-CoV-2 Infection According to Targeted Antigens

The virological meaning of the different patterns of serology in COVID-19 has been little examined in clinical settings. Asymptomatic subjects with IgM-spike (S) and IgG-nucleocapsid (N) determinations by chemiluminescence were studied for SARS-CoV-2 shedding in respiratory secretions by transcription-mediated amplification (TMA). In subjects showing IgM-S positive and IgG-N negative, IgG-S was determined by lateral flow assay. A total of 712 individuals were tested: 30.0% presented IgM-S(+)/IgG-N(−), 25.8% had IgM-S(+)/IgG-N(+) and 44.2% had IgM-S(−)/IgG-N(+); the proportion with TMA(+) were comparable in these three groups: 12.1, 8.7 and 10.5%, respectively. In individuals with IgM-S(+)/IgG-N(−), IgG-S(+) was detected in 66.5%. The frequency of IgM-S(+)/IgG-S(−) in the total population was 10.0%, of whom 24.1% had TMA(+); the chances for TMA(+) in subjects with an IgM-S(+) alone pattern were 2.4%. Targeting of the same SARS-CoV-2 antigen seems to be better for the characterization of IgM/IgG patterns of response. IgM-S(+) alone reactivity is rare, and a small proportion is associated with viral shedding

Red GPS ZFESNET para el estudio de la evolución del ciclo sísmico de deformaciones y esfuerzos asociado a la zona de falla de El Salvador

El Salvador se caracteriza por la presencia de fallas de desgarre sísmicamente activas subparalelas a la zona de subducción. Estas estructuras han sido las responsables de la mayoría de los terremotos destructivos que han tenido lugar a lo largo de la costa Pacífica en el arco volcánico centroamericano, desde Guatemala hasta Costa Rica. La Zona de Falla de El Salvador (ZFES) es una de las principales estructuras tectónicas de la región estudiada, y posiblemente la estructura donde se está acomodando la mayor parte del movimiento paralelo a la zona de subducción. En este trabajo se presenta la Red GPS ZFESNET, establecida en 2007 con el fin de cuantificar la deformación que se está produciendo actualmente asociada a la ZFES. La determinación de deformaciones y esfuerzos acumulados a partir de datos GPS permitirá complementar los datos geológicos existentes y contribuir a una correcta evaluación de la peligrosidad sísmica para esta zona, así como al mejor entendimiento de los datos de sismicidad histórica y paleosismicidad

New evidences of historical surface rupture on the Alhama de Murcia fault: implications for seismic hazard

Reunión Ibérica sobre Fallas Activas y Paleosismología (3ª. 2018. Alicante). - Texto en inglés con resumen y palabras claves en inglés y españolThe date of the last large event occurred in a fault segment is of great importance in seismic hazard assessment, especially when time-dependent models are considered. Eight of the twelve destructive earthquakes occurred in the eastern Betic Cordillera since 16th century, are located less than 10 km away from the Alhama de Murcia fault (AMF). Up to now, ground surface geological evidence to associate these events with the activity of specific fault segments has not been identified. In this work we present the first geological evidence of the catastrophic 1674 event occurred at Lorca (SE Spain). The excavations at La Torrecilla creek exposed archaeological remains from the Islamic period affected by 55+/-20 cm offset by the AMF fault. This supports the occurrence of earthquakes with surface rupture in the historical period on the Alhama de Murcia Fault and reinforces the results obtained in the previous paleoseismological works. The theoretical scenarios of maximum magnitudes and recurrence time obtained by combining this historical event with the fault slip rate, given the accumulated slip deficit, support that the seismic hazard associated with maximum magnitude events in this section of AMF could be greater than previously thought = La edad del último gran terremoto en un segmento de una falla sismogénica es un parámetro clave para los cálculos de peligrosidad sísmica, especialmente en los cálculos basados en modelos dependientes del tiempo. Ocho de los doce terremotos destructivos ocurridos en las cordilleras Béticas orientales desde el siglo XVI están localizados a menos de 10 km de la traza superficial de la Falla de Alhama de Murcia (AMF). Hasta ahora no se han identificado evidencias geológicas de ruptura superficial asociada a estos eventos que permitan asociarlos a segmentos específicos de la AMF. En este trabajo se presentan evidencias geológicas de ruptura superficial asociada al terremoto de Lorca de 1674. Las excavaciones paleosísmicas realizadas en la rambla de La Torrecilla han expuesto restos de una acequia datada como del periodo árabe que aparece afectada por un desplazamiento de 55+/-20 cm de la falla AMF. Esto apoya la ocurrencia de eventos con ruptura superficial en época histórica a lo largo de la AMF y refuerza las observaciones obtenidas en estudios paleosísmicos previos. Los escenarios teóricos de eventos de magnitud máxima e intervalos de recurrencia, combinando este evento histórico con los valores de tasa de desplazamiento de la AMF disponibles, considerando el déficit de desplazamiento acumulado, apoyan que la peligrosidad sísmica asociada a eventos de magnitud máxima en esta sección de la AMF puede ser mayor de la considerada hasta ahora.Departamento de Geodinámica, Estratigrafía y Paleontología, Universidad Complutense de Madrid, EspañaInstituto de Geociencias, Consejo Superior de Investigaciones Científicas, EspañaInstituto de Geociencias, Universidad Complutense de Madrid, EspañaDepartamento de Geología y Geoquímica, Universidad Autónoma de Madrid, EspañaInstituto Geológico y Minero de España, EspañaDepartamento de Ingeniería Topográfica y Cartografía, Universidad Politécnica de Madrid, EspañaGrupo RISKNAT, Departament de Dinàmica de la Terra i de l’Oceà, Universitat de Barcelona, EspañaAIA Estudio, Españ