Effectiveness of copper as a preventive tool in health care facilities: a systematic review

Introduction: Hospital-acquired infections (HAIs) are a significant clinical and economic burden on health systems worldwide. Copper alloys have been certified by the US EPA as solid antimicrobial materials, but their effectiveness in reducing HAIs is not well established Objectives: This systematic review aimed to assess copper surfaces in situ efficacy in reducing health care’s microbial burden compared to control surfaces. Materials and Methods: A literature search was conducted using three electronic databases: Web of Science, PubMed, and Scopus, with the keywords “copper” and “surfaces” and “antimicrobial” and “antibacterial” and “infections.” Studies from 2010 to 2022 were included. The quality of the studies was independently screened and assessed using the Newcastle Ottawa Scale. Results: A total of 56 articles were screened, with 8 included in the review and 7, added from references. Two third of the studies report a significant reduction in the microbial burden on copper objects compared to control objects. The 2 studies with the highest scores on NOS evaluation indicated that using copper or copper alloys in healthcare settings can effectively decrease the number of bacterial contaminations on touch surfaces. Conclusions: The results suggest the potential effectiveness of copper as a preventive tool in healthcare facilities, but further studies and longer trials are needed to establish a relationship between copper and reduced nosocomial infections.This study has received funding from the European Union-NextGeneration EU. RD 289/2021

Reasons for hospital and ambulatory emergencies in Navarre

Fundamento. La demanda de asistencia sanitaria urgente está alcanzando cifras cercanas a la saturación del sistema. El objetivo del trabajo es describir el perfil del demandante de urgencias hospitalarias y extrahospitalarias en Navarra y conocer los factores que motivan la utilización de los servicios de urgencias. Metodología. Estudio multicéntrico transversal. Se utilizó un cuestionario autoadministrado de respuestas múltiples. Se entrevistaron a 2.364 pacientes que acudieron a un servicio de urgencias hospitalario o extrahospitalario (excluidos las visitas domiciliarias) en Navarra, entre el 15 y el 21 de noviembre de 2007. Se recogen datos descriptivos del paciente, razones que le motivan a solicitar asistencia urgente agrupadas en 3 bloques (18 ítems) y sensación de gravedad (leve, moderada, grave) que otorga a su sintomatología. La asociación entre autopercepción de gravedad y acudir a hospital y las otras variables de estudio se analizó mediante regresión logística no condicional. Resultados. La atención extrahospitalaria es la más demandada (62,7%). Las razones principales para usar los servicios son necesidad (66,3%) y comodidad (40,7%). Existen diferencias estadísticamente significativas entre las demandas hospitalaria y extrahospitalaria. Quienes valoran su estado como leve (24,1%), acuden más a su servicio extrahospitalaria (OR:1,4; IC95%:1,1-1,9), su estado de salud habitual es bueno (OR:2,1; IC95%:1,3-3,2) y señalan razones de comodidad (OR:1,6; IC95%:1,3-2) como razones de demanda. Conclusiones. Los usuarios y los médicos deben participar en el debate para intentar incidir en el mal uso de los servicios sanitarios, tanto por exceso como por defecto.Background. The demand for emergency health care is reacting figures that are close to saturating the system. The aim of the paper is to describe the profile of the user of hospital and ambulatory emergency care in Navarre and to determine the factors that motivate use of the emergency services. Methodology. Multicentric transversal study. A self-administered questionnaire with multiple answers was employed. Two thousand three hundred and sixty-four patients who attended a hospital or ambulatory emergency service (excluding home visits) in Navarre between November 15(th) kind 21(st) 2007. We collected descriptive data on the patient, reasons for requesting emergency care grouped into three blocks (18 items) and sensation of seriousness (light, moderate, serious) that he/she attributes to his/her symptomology. The association between self-perception of seriousness and going to hospital and the other variables Studied wits analysed through non-conditional logistic regression. Results. The highest demand wits for ambulatory care (62.7%). The principal reasons for using the services are need (66.3%) and convenience (40.7%). There are statistically significant differences between hospital and outpatient demands. Those who evaluate their state as light (24.1%) attend ambulatory accidents and emergencies more (OR: 1.4; CI95%:1.1-1.9), have a state of health that is normally good (OR:2.1; CI95%: 1.3-3.2), and indicate reasons of convenience (OR: 1.6; CI95%: 1.3-2) as reasons for the demand. Conclusions. Both users and doctors should participate in the debate to try and influence the inappropriate use of the health services, both through excess and by default

Unnecessary radiology in Primary Care

Fundamento: La solicitud de pruebas diagnósticas desde atención primaria presentan un aumento progresivo en el tiempo y una gran variabilidad interpersonal en su solicitud, que sugiere que se están aplicando servicios inefectivos. El objetivo es conocer las características de los demandantes de pruebas radiológicas (radiología general y ecografía) y cuantificar las pruebas innecesarias en atención primaria. Material y métodos: Estudio descriptivo transversal sobre una muestra en cluster de 23 centros de salud de Navarra en el mes de marzo de 2004. Se diseña un cuestionario específico para cumplimentar por el médico solicitante de la prueba diagnóstica. Se realiza análisis multivariante mediante regresión logística para estudiar la asociación entre pruebas innecesarias y las otras variables de estudio. Resultados: Se realizan pruebas al 9 por mil de la población estudiada. La variabilidad interprofesional en la solicitud de pruebas oscila entre 0 y 33,3 por cada 1000 tarjetas sanitarias para la edad infantil. Los estudios radiológicos solicitados con mayor frecuencia fueron los óseos (48,9%, LC: 42,4-55,5). En el 63,2% de las solicitudes no se realizaron modificaciones en el tratamiento previo a la solicitud de la prueba y el 57 % (LC: 52,4-61,7) de las pruebas realizadas se solicitan para descartar patología. El 24,7% (LC: 17,1-29,2) son pruebas innecesarias y en el 15,2 % (LC:10,7-18,2) hubo presión del enfermo en la solicitud. En el análisis multivariante se observan diferencias significativas para Rx de tórax, cambios en el tratamiento y ser presionado por el enfermo. Tras ajustar por las otras variables, la solicitud de una prueba innecesaria es 12,55 veces mayor si el médico se siente presionado por el enfermo. Conclusiones: Debe analizarse la correcta indicación de la radiología, especialmente de la ósea, y se debe potenciar al radiólogo en la decisión última de realizar la prueba diagnóstica.Background. The request for diagnostic tests proceeding from primary care shows a progressive increase over time and a great interpersonal variety in the requests, which suggests that ineffective services are being applied. The aim is to determine the characteristics of the those making requests for radiological tests (general radiology and echography) and to quantify the unnecessary tests in primary care. Methods. Cross-sectional study of a cluster sample of 23 health centres of Navarre in the month of March 2004. A specific questionnaire was designed to be completed by the doctor requesting the diagnostic test. Logistic regression to study the association between unnecessary tests and the other variables of the study was used. Results. Tests were asked for on 9 per thousand of the population studied. The inter-professional variability in the request for tests oscillated between 0 and 33.3 per 1, 000 health cards of children's age. The radiological studies requested with greatest frequency were osseous (48.9%, IC: 42.4-55.5). In 63.2% of the requests no modifications were made to the treatment prior to the request for a test and 57% (IC: 52.4-61.7) of the tests carried out were requested to rule out pathologies. Twenty-four point seven percent (IC: 17.1-29.2) were unnecessary tests and in 15.2% (IC: 10.7-18.2) there was pressure from the patient in the request. In the multivariant analysis significant differences were observed for thorax Rx, changes in the treatment and pressure from the patient. After adjustment for the other variables, the request for an unnecessary test is 12.55 times greater if the doctor feels under pressure from the patient. Conclusions. The correct indication for radiology must be analysed, especially in osseous radiology, and the role of the radiologist in the final decision on carrying out the test must be strengthened

Rachitic deformities of lower members in Congolese children

Objetivo. Analizar algunos factores de riesgo en niños raquíticos congoleños con graves deformidades de miembros inferiores y describir las lesiones. Métodos. Los autores analizaron los parámetros obtenidos en una encuesta a dos grupos de niños: un grupo de 194 niños raquíticos con graves deformidades de los miembros y otro grupo control de 107 niños sanos de edades similares. Se describió el tipo de deformaciones y los grados de raquitismo. Resultados. La deformación más frecuente fue el genuvaro (58,2%), seguida del windsept (23,7%) y genuvalgo (13,9%). Entre 2-4 años el genuvaro predominó en las niñas (p=0,0025). Encontramos un raquitismo florido en el 19,1% de los casos, moderado en el 15,5%, mínimo en el 14,2% y solamente deformidades óseas sin raquitismo activo en el 41,2%. De los parámetros analizados, el factor de riesgo más importante fue ser gemelo (OR=25,43 ; 95% CI=3,76-1098,27), seguido de la falta de sol (OR=18,39, 95% CI=6,69-61,55) y tener un hermano raquítico. La alimentación con leche materna fue un factor de protección (OR=0,94, 95% CI=0,90-0,98). La prematuridad y el bajo peso al nacer no influyeron. La edad de la marcha fue de 15,4 meses en los raquíticos y de 12,4 meses en el grupo control (p<0,01). Conclusión. Las deformaciones graves de miembros inferiores secuelas de raquitismo son frecuentes, están asociadas a la gemelaridad, a la falta de sol y al destete precoz.Background. To analyse risk factors in rachitic Congolese children with serious deformities in their lower members and to describe the lesions. Methods. The authors analysed the parameters obtained in a survey of two groups of children: a group of 194 rachitic children with severe deformities of their members and another control group of 107 healthy children of similar ages. The types of deformity and the degrees of rachitism were described. Results. The most frequent deformity was genu varum (58.2%), followed by windsept (23.7%) and genu valgum (13.9%). Gents varum predominated in girls of between 2-4 years (p=0.0025). We found florid rickets in 19.1% of the cases, moderate in 15.5%, minimal in 14.2% and osseous deformities alone without active rachitism in 41.2%. Of the parameters analysed, the most important risk factor was being a twin (OR=25.43; 95% CI=3.76-1098.27), followed by lack of sunlight (OR=18.39, 95% CI=6.69-61.55) and having a rachitic sibling. Maternal feeding was a protective factor (OR=0.94, 95% CI=0.90-0.98). Premature birth and low weight at birth had no influence. Walking age was 15.4 months in the rachitic cases and 12.4 months in the control group (p < 0.01). Conclusion. Severe deformities of lower members as a sequel to rickets are frequent: they are associated with being a twin, lack of sunlight and precocious weaning