Impact of the effects of heat waves on mortality in the city of Madrid, Spain during the period 1990-2009

Fundamentos: Después de la ola de calor del año 2003 muchos países europeos implementaron planes para la vigilancia y control de los efectos de las olas de calor (PVCEOC), sin embargo, son pocos los países que han evaluado su impacto. El objetivo de trabajo es evaluar el impacto del PVEOC en la mortalidad atribuida al calor. Método: Para evaluar en la ciudad de Madrid la mortalidad atribuida al calor durante el período 1990-2009 se realizó un análisis de series temporales utilizando modelos ARIMA con una variable exógena, la temperatura.Se analizó el impacto de las altas temperaturas sobre la mortalidad antes y después de 2004, año de la implementación del PVCEOC. Resultados: El impacto atribuible a la ola de calor en el año 2003 fue del 22,39 % de incremento de mortalidad por cada oC que se superó la temperatura umbral, con una intensidad de 8,2 oC. Algunas olas de calor previas al 2003 fueron superiores en intensidad, así durante los años 1991, 1992 y 1995 la intensidad de las olas de calor fue de 25,9 oC, 8,3 oC y 12,5 oC respectivamente. Las olas de calor posteriores al 2003 presentaron menor intensidad y en 2005 con una ola de calor de 4,5 oC de intensidad se observó un impacto de 45,71% de incremento de la mortalidad por cada oC en que se superó la temperatura umbral. Conclusiones: Con la metodología utilizada no se puede afirmar que en Madrid la puesta en marcha del PVEOC se traduzca en una disminución de la mortalidad atribuible a las altas temperaturas .S

Effects of COVID-19 vaccination on disease activity in patients with rheumatoid arthritis and psoriatic arthritis on targeted therapy in the COVIDSER study

COVID-19; Artritis psoriásica; VacunaciónCOVID 19; Artritis psoriàsica; VacunacióCOVID-19; Psoriatic arthritis; VaccinationObjective: To investigate the influence of COVID-19 vaccination on disease activity in rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients under targeted therapies. Patients and methods: 1765 vaccinated patients COVID-19, 1178 (66.7%) with RA and 587 (33.3%) with PsA from the COVID-19 registry in patients with rheumatic diseases (COVIDSER) project, were included. Demographics, disease characteristics, Disease Activity Score in 28 joints (DAS28) and targeted treatments were collected. DAS28-based flare rates and categorised disease activity distribution prevaccination and post vaccination were analysed by log-linear regression and contingency analyses, respectively. The influence of vaccination on DAS28 variation as a continuous measure was evaluated using a random coefficient model. Results: The distribution of categorised disease activity and flare rates was not significantly modified by vaccination. Log-linear regression showed no significant changes in the rate of flares in the 6-month period after vaccination compared with the same period prior to vaccination in neither patients with RA nor patients with PsA. When DAS28 variations were analysed using random coefficient models, no significant variations in disease activity were detected after vaccination for both groups of patients. However, patients with RA treated with Janus kinase inhibitors (JAK-i) (1) and interleukin-6 inhibitor (IL-6-i) experienced a worsening of disease activity (1.436±0.531, p=0.007, and 1.201±0.550, p=0.029, respectively) in comparison with those treated with tumour necrosis factor inhibitor (TNF-i). Similarly, patients with PsA treated with interleukin-12/23 inhibitor (IL-12/23-i) showed a worsening of disease activity (4.476±1.906, p=0.019) compared with those treated with TNF-i. Conclusion: COVID-19 vaccination was not associated with increased rate of flares in patients with RA and PsA. However, a potential increase in disease activity in patients with RA treated with JAK-i and IL-6-i and in patients with PsA treated with IL-12/23-i warrants further investigation

Ratio of the Dead to Wounded (D/W) Indicators and Associated Factors in Major Earthquakes of America from 1960 to 2011

Corrigendum to “Ratio of the Dead to Wounded (D/W) Indicators and Associated Factors in Major Earthquakes of America from 1960 to 2011”. Journal of Earthquakes 2015; 436960, http://dx.doi.org/10.1155/2015/436960.The paper presented deals with the casualties, mortality, and morbidity occurred during the major earthquakes of America during a period of 51 years. The work provides statistical evidence that the deaths/wounded (D/W) ratio used for many agencies in the planning of the preparation and response activities to earthquakes does not fit the relation 1 : 3. In addition, a model is presented in order to evaluate the possible association between different analysis variables such as the subregion of the American continent affected, population density, HDI, and the time and magnitude of the earthquake and the effects of these on the death toll, the number of the wounded, and the D/W indexes. Although the model generated it is not robust enough for decision making, it could be useful and improvable in order to apply it in the planning and management of these kinds of natural disasters. For these reasons, we think that it would be interesting to do further progress in this line of research by making a more comprehensive study of the variables associated with mortality and morbidity, using a more representative sample of earthquakes that sure will confirm the results presented in this work.This work was funded by the Spanish Field Epidemiology Training Program and was done as part of research activities of Ana Ayuso-Alvárez, M.S., Marcello S. Rossi S., D.S., and Dante Culqui, M.S., in the Spanish Field Epidemiology Training Program.S

Mortality due to COVID-19 in Spain and its association with environmental factors and determinants of health

The objective of this study was to identify which air pollutants, atmospheric variables and health determinants could infuence COVID-19 mortality in Spain. This study used information from 41 of the 52 provinces in Spain (from Feb. 1, to May 31, 2021). Generalized Linear Models (GLM) with Poisson link were carried out for the provinces, using the Rate of Mortality due to COVID-19 (CM) per 1,000,000 inhabitants as dependent variables, and average daily concentrations of PM10 and NO2 as independent variables. Meteorological variables included maximum daily temperature (Tmax) and average daily absolute humidity (HA). The GLM model controlled for trend, seasonalities and the autoregressive character of the series. Days with lags were established. The relative risk (RR) was calculated by increases of 10 g/m3 in PM10 and NO2 and by 1 ℃ in the case of Tmax and 1 g/m3 in the case of HA. Later, a linear regression was carried out that included the social determinants of health.The authors would like to thank the Carlos III Health Institute for their fnancial support Project ENPY 221/20. This work was carried out with funds of the ENPY 221/20 project

Demographic and health attributes of the Nahua, initial contact population of the Peruvian Amazon.

We present the case of the Nahua population of Santa Rosa de Serjali, Peruvian Amazon's population, considered of initial contact. This population consists of human groups that for a long time decided to live in isolation, but lately have begun living a more sedentary lifestyle and in contact with Western populations. There are two fully identified initial contact groups in Peru: the Nahua and the Nanti. The health statistics of the Nahua are scarce. This study offers an interpretation of demographic and epidemiological indicators of the Nahua people, trying to identify if a certain degree of health vulnerability exists. We performed a cross sectional study, and after analyzing their health indicators, as well as the supplemental qualitative analysis of the population, brought us to conclude that in 2006, the Nahua, remained in a state of health vulnerability.Revisión por pare

Outbreak of persistent cutaneous abscesses due to Mycobacterium chelonae after mesotherapy sessions, Lima, Peru

Surtos de micobactérias de crescimento rápido têm sido relatados ocasionalmente. O estudo relata um surto de abscessos cutâneos por Mycobacterium chelonae após sessões de mesoterapia em Lima, Peru. De dezembro de 2004 a janeiro de 2005, 35 pessoas que haviam passado por sessões de mesoterapia apresentaram esses abscessos cutâneos. Treze (37%) desses casos suspeitos concordaram em realizar exames clínicos. Foram realizadas biópsias de punção de pele de lesões suspeitas e examinadas substâncias injetadas durante a mesoterapia. Os casos suspeitos eram predominantemente mulheres jovens e as lesões incluíram nódulos subcutâneos, abscessos e úlceras. Mycobacterium chelonae foi isolada de quatro pacientes e de um frasco de procaína. Em conclusão, é importante considerar a mesoterapia como fonte potencial de infecções de micobactérias de crescimento rápido.Outbreaks of rapidly growing mycobacteria have been occasionally described. The article reports an outbreak of cutaneous abscesses due to Mycobacterium chelonae following mesotherapy in Lima, Peru. From December 2004 through January 2005, 35 subjects who had participated in mesotherapy training sessions presented with persistent cutaneous abscesses. Thirteen (37%) of these suspected cases consented to underwent clinical examination. Skin punch-biopsies were collected from suspicious lesions and substances injected during mesotherapy were analyzed. Suspected cases were mainly young women and lesions included subcutaneous nodules, abscesses and ulcers. Mycobacterium chelonae was isolated from four patients and from a procaine vial. In conclusion, it is important to consider mesotherapy as a potential source of rapidly growing mycobacteria infections

Effects of local factors on adaptation to heat in Spain (1983–2018)

The European Union is currently immersed in policy development to address the effects of climate change around the world. Key plans and processes for facilitating adaptation to high temperatures and for reducing the adverse effects on health are among the most urgent measures. Therefore, it is necessary to understand those factors that influence adaptation. The aim of this study was to provide knowledge related to the social, climate and economic factors that are related to the evolution of minimum mortality temperatures (MMT) in Spain in the rural and urban contexts, during the 1983–2018 time period. For this purpose, local factors were studied regarding their relationship to levels of adaptation to heat.The authors gratefully acknowledge the grants for projects ENPY107/18; ENPY 376/18, ENPY 470/19 and ENPY 340/20 from the Carlos III Institute of Health, and is supported by the Biodiversity Foundation of the Ministry for Ecological Transition and Demographic Challenge

Gender differences in adaptation to heat in Spain (1983-2018)

In Spain the average temperature has increased by 1.7 °C since pre-industrial times. There has been an increase in heat waves both in terms of frequency and intensity, with a clear impact in terms of population health. The effect of heat waves on daily mortality presents important territorial differences. Gender also affects these impacts, as a determinant that conditions social inequalities in health. There is evidence that women may be more susceptible to extreme heat than men, although there are relatively few studies that analyze differences in the vulnerability and adaptation to heat by sex. This could be related to physiological causes. On the other hand, one of the indicators used to measure vulnerability to heat in a population and its adaptation is the minimum mortality temperature (MMT) and its temporal evolution. The aim of this study was to analyze the values of MMT in men and women and its temporal evolution during the 1983-2018 period in Spain's provinces. An ecological, longitudinal retrospective study was carried out of time series data, based on maximum daily temperature and daily mortality data corresponding to the study period. Using cubic and quadratic fits between daily mortality rates and the temperature, the minimum values of these functions were determined, which allowed for determining MMT values. Furthermore, we used an improved methodology that provided for the estimation of missing MMT values when polynomial fits were inexistent. This analysis was carried out for each year. Later, based on the annual values of MMT, a linear fit was carried out to determine the rate of evolution of MMT for men and for women at the province level. Average MMT for all of Spain's provinces was 29.4 °C in the case of men and 28.7 °C in the case of women. The MMT for men was greater than that of women in 86 percent of the total provinces analyzed, which indicates greater vulnerability among women. In terms of the rate of variation in MMT during the period analyzed, that of men was 0.39 °C/decade, compared to 0.53 °C/decade for women, indicating greater adaptation to heat among women, compared to men. The differences found between men and women were statistically significant. At the province level, the results show great heterogeneity. Studies carried out at the local level are needed to provide knowledge about those factors that can explain these differences at the province level, and to allow for incorporating a gender perspective in the implementation of measures for adaptation to high temperatures.The authors wish to thank the funding provided by the ENPY 304/20, ENPY 376/18 and ENPY 107/18 projects of the Carlos III Health Institute III (ISCIII). They also wish to thank the UNED for funding this publication in open access.S

Gender differences in adaptation to heat in Spain (1983–2018)

In Spain the average temperature has increased by 1.7 °C since pre-industrial times. There has been an increase in heat waves both in terms of frequency and intensity, with a clear impact in terms of population health. The effect of heat waves on daily mortality presents important territorial differences. Gender also affects these impacts, as a determinant that conditions social inequalities in health. There is evidence that women may be more susceptible to extreme heat than men, although there are relatively few studies that analyze differences in the vulnerability and adaptation to heat by sex. This could be related to physiological causes. On the other hand, one of the indicators used to measure vulnerability to heat in a population and its adaptation is the minimum mortality temperature (MMT) and its temporal evolution.The authors wish to thank the funding provided by the ENPY 304/20, ENPY 376/18 and ENPY 107/18 projects of the Carlos III Health Institute III (ISCIII)

Efectos de factores locales en la evolución de las temperaturas de mínima mortalidad en España (1983-2018)

Ponencia presentada en: XII Congreso de la Asociación Española de Climatología celebrado en Santiago de Compostela entre el 19 y el 21 de octubre de 2022.[ES]En la actualidad la Unión Europea se encuentra inmersa en decisiones políticas para combatir el cambio climático. Entre las medidas urgentes para abordar la emergencia climática se encuentran los planes y procesos claves para facilitar la adaptación a las altas temperaturas y reducir los efectos adversos en la salud de los habitantes. El objetivo de este estudio es conocer qué factores sociales, climáticos y económicos se han relacionado con la evolución de las temperaturas de mínima mortalidad (TMM) en España en los contextos rural y urbano, durante el periodo 1983-2018. Para ello, se estudiaron los factores locales en cuanto a su relación con los niveles de adaptación al calor.[EN]The European Union is currently engaged in policy decisions to combat climate change. Among the urgent measures to address the climate emergency are key plans and processes to facilitate adaptation to high temperatures and reduce adverse effects on people's health. The aim of this study was to provide knowledge related to the social, climate and economic factors that are related to the evolution of minimum mortality temperatures (MMT) in Spain in the rural and urban contexts, during the 1983–2018 time period. For this purpose, local factors were studied regarding their relationship to levels of adaptation to heat.Los autores agradecen las subvenciones para los proyectos ENPY107/18, ENPY 376/18 y ENPY 470/19 del Instituto de Salud Carlos III (ISCIII) con número de expediente ENPY 470/19, cuenta con el apoyo de la Fundación Biodiversidad, del Ministerio para la Transición Ecológica y el Reto Demográfico