81 research outputs found

    SARS-CoV-2 Catalonia contact tracing program : evaluation of key performance indicators

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    Background: Guidance on SARS-CoV-2 contact tracing indicators have been recently revised by international public health agencies. The aim of the study is to describe and analyse contact tracing indicators based on Catalonia's (Spain) real data and proposing to update them according to recommendations. Methods: Retrospective cohort analysis including Catalonia's contact tracing dataset from 20 May until 31 December 2020. Descriptive statistics are performed including sociodemographic stratification by age, and differences are assessed over the study period. Results: We analysed 923,072 contacts from 301,522 SARS-CoV-2 cases with identified contacts (67.1% contact tracing coverage). The average number of contacts per case was 4.6 (median 3, range 1-243). A total of 403,377 contacts accepted follow-up through three phone calls over a 14-day quarantine period (84.5% of contacts requiring follow-up). The percentage of new cases declared as contacts 14 days prior to diagnosis evolved from 33.9% in May to 57.9% in November. All indicators significantly improved towards the target over time (p < 0.05 for all four indicators). Conclusions: Catalonia's SARS-CoV-2 contact tracing indicators improved over time despite challenging context. The critical revision of the indicator's framework aims to provide essential information in control policies, new indicators proposed will improve system delay's follow-up. The study provides information on COVID-19 indicators framework experience from country's real data, allowing to improve monitoring tools in 2021-2022. With the SARS-CoV-2 pandemic being so harmful to health systems and globally, is important to analyse and share contact tracing data with the scientific community

    Cut-offs and response criteria for the Hospital Universitario la Princesa Index (HUPI) and their comparison to widely-used indices of disease activity in rheumatoid arthritis

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    Objective To estimate cut-off points and to establish response criteria for the Hospital Universitario La Princesa Index (HUPI) in patients with chronic polyarthritis. Methods Two cohorts, one of early arthritis (Princesa Early Arthritis Register Longitudinal PEARL] study) and other of long-term rheumatoid arthritis (Estudio de la Morbilidad y Expresión Clínica de la Artritis Reumatoide EMECAR]) including altogether 1200 patients were used to determine cut-off values for remission, and for low, moderate and high activity through receiver operating curve (ROC) analysis. The areas under ROC (AUC) were compared to those of validated indexes (SDAI, CDAI, DAS28). ROC analysis was also applied to establish minimal and relevant clinical improvement for HUPI. Results The best cut-off points for HUPI are 2, 5 and 9, classifying RA activity as remission if =2, low disease activity if >2 and =5), moderate if >5 and <9 and high if =9. HUPI''s AUC to discriminate between low-moderate activity was 0.909 and between moderate-high activity 0.887. DAS28''s AUCs were 0.887 and 0.846, respectively; both indices had higher accuracy than SDAI (AUCs: 0.832 and 0.756) and CDAI (AUCs: 0.789 and 0.728). HUPI discriminates remission better than DAS28-ESR in early arthritis, but similarly to SDAI. The HUPI cut-off for minimal clinical improvement was established at 2 and for relevant clinical improvement at 4. Response criteria were established based on these cut-off values. Conclusions The cut-offs proposed for HUPI perform adequately in patients with either early or long term arthritis

    Inhibition of Gastric Lipase as a Mechanism for Body Weight and Plasma Lipids Reduction in Zucker Rats Fed a Rosemary Extract Rich in Carnosic Acid

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    BACKGROUND: Rosemary (Rosmarinus officinalis L.) extracts (REs) exhibit hepatoprotective, anti-obesity and anti-inflammatory properties and are widely used in the food industry. REs are rich in carnosic acid (CA) and carnosol which may be responsible for some of the biological activities of REs. The aim of this study was to investigate whether inhibition of lipase activity in the gut may be a mechanism by which a RE enriched in CA (40%) modulates body weight and lipids levels in a rat model of metabolic disorders and obesity. METHODS AND PRINCIPAL FINDINGS: RE was administered for 64 days to lean (fa/+) and obese (fa/fa) female Zucker rats and body weight, food intake, feces weight and blood biochemical parameters were monitored throughout the study. Lipase activity (hydrolysis of p-nitrophenylbutyrate) was measured in the gastrointestinal tract at the end of the study and the contents of CA, carnosol and methyl carnosate were also determined. Sub-chronic administration of RE moderately reduced body weight gain in both lean and obese animals but did not affect food intake. Serum triglycerides, cholesterol and insulin levels were also markedly decreased in the lean animals supplemented with RE. Importantly, lipase activity was significantly inhibited in the stomach of the RE-supplemented animals where the highest content of intact CA and carnosol was detected. CONCLUSIONS: Our results confirm that long-term administration of RE enriched in CA moderates weight gain and improves the plasma lipids profile, primarily in the lean animals. Our data also suggest that these effects may be caused, at least in part, by a significant inhibition of gastric lipase and subsequent reduction in fat absorption

    Programas de optimización del uso de antimicrobianos en hospitales: guía de recomendaciones de expertos para actividades en poblaciones específicas, síndromes y otros aspectos (PROA-2) de la SEIMC, SEFH, SEMPSPGS, SEMICYUC y SEIP

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    [EN] In 2012, The Spanish Societies of Infectious Diseases and Clinical Microbiology (SEIMC), Hospital Pharmacy (SEFH), and Preventive Medicine, Public Health and Healthcare Management (SEMPSGS) lead a consensus document including recommendations for the implementation of antimicrobial stewardship (AMS) programs (AMSP; PROA in Spanish) in acute care hospitals in Spain. While these recommendations were critical for the development of these programs in many centres, there is a need for guidance in the development of AMS activities for specific patient populations, syndromes or other specific aspects which were not included in the previous document or have developed significantly since then. The objective of this expert recommendation guidance document is to review the available information about these activities in these patient populations or circumstances, and to provide guidance recommendations about them. With this objective the SEIMC, SEFH, SEMPSPGS, the Spanish Society of Intensive Care Medicine (SEMICYUC) and the Spanish Pediatric Infectious Disease Society (SEIP) selected a panel of experts who chose the different aspects to include in the document. Because of the lack of high-level evidence in the implementation of the activities, the panel opted to perform a narrative review of the literature for the different topics for which recommendations were agreed by consensus. The document was open to public consultation for the members of these societies for their comments and suggestions, which were reviewed and considered by the panel.[ES] En 2012, las Sociedades Españolas de Enfermedades Infecciosas y Microbiología Clínica (SEIMC), Farmacia Hospitalaria (SEFH) y Medicina Preventiva, Salud Pública y Gestión Sanitaria (SEMPSPGS) lideraron un documento de consenso que incluía recomendaciones para la implementación de Programas de optimización del uso de antimicrobianos (PROA) en hospitales de agudos en España. Si bien estas recomendaciones fueron críticas para el desarrollo de estos programas en muchos centros, actualmente es necesario establecer unas guías para la implementación de las actividades de los PROA en determinadas poblaciones de pacientes, síndromes clínicos y otros aspectos específicos que no se incluyeron en el documento previo o que desde entonces se han desarrollado significativamente. El objetivo de esta guía de recomendaciones de expertos es revisar la información disponible acerca de esas actividades en estas poblaciones o circunstancias de pacientes y proporcionar unas recomendaciones que sirvan de guía sobre ellas. Con este objetivo, la SEIMC, la SEFH y la SEMPSPGS, así como la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC) y la Sociedad Española de Infectología Pediátrica (SEIP), seleccionaron un panel de expertos que eligieron los diferentes aspectos a incluir en el documento. Debido a la ausencia de evidencia de alto nivel en la implementación de las diferentes actividades, el panel optó por realizar una revisión narrativa de la literatura de los diferentes aspectos, en los que las recomendaciones se acordaron por consenso. El documento se abrió para consulta pública a los miembros de estas sociedades para sus comentarios y sugerencias, que fueron revisadas y consideradas por el panel.Peer reviewe

    Medios de comunicación y derecho a la información en Jalisco, 2021

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    Este volumen de la serie de "Medios de comunicación y derecho a la información en Jalisco", escrito por académicos y estudiantes, ofrece información sobre cinco temas generales: artículos sobre la comunicación política durante las elecciones locales de 2021; un informe dedicado a los medios de comunicación en Jalisco: otro artículo sobre el derecho a la información, una investigación académica sobre las inequidades de género en las coberturas periodísticas en el ámbito global y en la sección de las y los que se fueron, ofrece semblanzas de dos personajes importantes para el estado de Jalisco: el periodista radiofónico Marcos Arana y el fotoperiodista José Hernández Claire.ITESO, A.C

    Consenso mexicano sobre probióticos en gastroenterología

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    Introducción: El uso de los probióticos es común en la práctica clínica. Existe un número signi-ficativo de estudios que apoyan la eficacia de los probióticos en algunos trastornos digestivos.Sin embargo, el desconocimiento de la evidencia científica y las diferentes presentaciones ycomposiciones microbianas de los probióticos disponibles dificultan su prescripción.Objetivo: Proveer al clínico de una revisión consensuada sobre los probióticos y recomendacio-nes de su uso en gastroenterología.Material y métodos: Se seleccionaron los ensayos clínicos controlados, metaanálisis y revisio-nes sistemáticas publicados hasta 2015, usando los términos MESH: probiotics, gastrointestinaldiseases, humans, adults and children. Se utilizó la metodología Delphi. Diecisiete gastroente-rólogos de adultos y 12 de ni˜nos elaboraron enunciados los cuales fueron votados hasta obteneracuerdo > 70%. Para cada enunciado se evaluó el nivel de evidencia basado en el sistema GRADE.Resultados y conclusiones: Se generaron 11 enunciados sobre conceptos generales de probió-ticos y 27 enunciados sobre uso de probióticos en enfermedades gastrointestinales tanto enni˜nos como en adultos. El grupo de consenso recomienda el uso de probióticos en las siguientescondiciones clínicas: prevención de la diarrea asociada a antibióticos, tratamiento de la diarreaaguda infecciosa, prevención de infección por Clostridium difficile y enterocolitis necrosante,para disminuir los eventos adversos de la terapia de erradicación del Helicobacter pylori, elalivio de los síntomas del síndrome de intestino irritable, en el estre˜nimiento funcional deladulto, para inducir y mantener la remisión en pacientes con colitis ulcerosa crónica idiopáticay pouchitis, y en la encefalopatía hepática oculta y manifiesta.© 2016 Asociaci´on Mexicana de Gastroenterolog´ıa. Publicado por Masson Doyma M´exico S.A.Este es un art´ıculo Open Access bajo la licencia CC BY-NC-ND (http://creativecommons.org/licenses/by-nc-nd/4.0/). ASTRACT Introduction: Probiotics are frequently prescribed in clinical practice. Their efficacy in treatinggastrointestinal disorders is supported by a significant number of clinical trials. However, thecorrect prescription of these agents is hampered due to a lack of knowledge of the scientificevidence and to the different presentations and microbial compositions of the probiotics thatare currently available.Aim: To provide the clinician with a consensus review of probiotics and recommendations fortheir use in gastroenterology.Materials and methods: Controlled clinical trials, meta-analyses, and systematic reviewspublished up to 2015 were selected, using the MESH terms: probiotics, gastrointestinal diseases,humans, adults, AND children. The Delphi method was employed. Eighteen gastroenterologiststreating adult patients and 14 pediatric gastroenterologists formulated statements that werevoted on until agreement > 70% was reached. The level of evidence based on the GRADE systemwas evaluated for each statement.Results and conclusions: Eleven statements on the general concepts of probiotics and 27 sta-tements on the use of probiotics in gastrointestinal diseases in both adults and children wereformulated. The consensus group recommends the use of probiotics under the following clini-cal conditions: the prevention of diarrhea associated with antibiotics, the treatment of acuteinfectious diarrhea, the prevention of Clostridium difficile infection and necrotizing enteroco-litis, the reduction of adverse events from Helicobacter pylori eradication therapy, relief fromirritable bowel syndrome symptoms, the treatment of functional constipation in the adult, and the induction and maintenance of remission in patients with ulcerative colitis and pouchitis,and the treatment of covert and overt hepatic encephalopathy.© 2016 Asociaci´on Mexicana de Gastroenterolog´ıa. Published by Masson Doyma M´exico S.A. Thisis an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

    Programa de vigilància de les infeccions relacionades amb l’atenció sanitària de Catalunya (VINCat): manual VINCat

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    Atenció sanitària; Infeccions; Enquesta; MetodologiaAtención sanitaria; Infecciones; Encuesta; MetodologíaHealth care; Infections; Poll; MethodologyEl compliment d’aquest objectiu es fa mitjançant una enquesta puntual de prevalença. L’objectiu del protocol de prevalença de les infeccions relacionades amb l'atenció sanitària (IRAS) és que aquest es pugui implementar a tots els centres, sense necessitat d’afegir-hi recursos especials. La Comissió d’Infeccions de cada centre ha de designar el personal encarregat de l’estudi i ha de treballar amb l’ajuda del personal de medicina i d’infermeria assistencial responsable del malalt, i amb la col·laboració de serveis centrals com el de microbiologia. És important que els professionals que recullen les dades tinguin experiència en vigilància de les IRAS i coneguin les definicions i la metodologia de treball. Recomanem que hi hagi un coordinador que assumeixi les tasques d’informació, formació i validació de les dades, que ha de ser un membre del Grup de Control de la Infecció

    Programa de vigilància de les infeccions relacionades amb l’atenció sanitària de Catalunya (VINCat): manual VINCat

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    Atenció sanitària; Infeccions; Enquesta; MetodologiaAtención sanitaria; Infecciones; Encuesta; MetodologíaHealth care; Infections; Poll; MethodologyEl VINCat és un programa del Servei Català de la Salut que estableix un sistema de vigilància unificat de les infeccions relacionat amb l’atenció sanitària (IRAS) als centres de salut de Catalunya. La seva missió és contribuir a reduir les taxes d’aquestes infeccions mitjançant la vigilància epidemiològica activa i continuada. El programa es fonamenta en la tasca que porten a terme els professionals dels equips multidisciplinaris de control d’infecció dels centres de salut catalan
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