Consenso sobre la vacunación frente a la gripe en el personal sanitario

Health care workers (HCW) are included each year among risk groups for vaccination against influenza. However, vaccination coverage among this group in our country is very low, not exceeding 25%. Convinced that one of the best tools to increase this coverage among professionals in our country are the scientific evidence, 19 scientific societies and associations professionals bringing together health professionals more directly related to influenza as an health problem, and the General Nursing Council, met to discuss and develop this consensus document in order to inform HCW about the appropriateness of their vaccination against influenza and the benefits that flow from it for themselves, for their patients and for the rest of the population. This recommendation is based on 3 pillars: argument of necessity, ethics and exemplary

Foot Health Status Questionnaire (FHSQ) in Spanish People with Type 2 Diabetes Mellitus: Preliminary Values Study

Background and objectives: Type 2 Diabetes Mellitus (T2DM) is a chronic disease characterized by hyperglycemia. T2DM affects millions of people, and has a lot of complications such as impaired sensation in the feet. Moreover, it is important to know the health of the feet of people with T2DM. The aim of this study is to know the preliminary values of the Foot Health Status Questionnaire (FHSQ) in people with T2DM. Materials and Methods: A total of 87 patients with T2DM with an average age of 65.56 years, divided in 54 men and 33 women, participated in this cross-sectional study. The main outcome was the health of the foot as measured by the FHSQ questionnaire. This questionnaire collects data on eight dimensions: Foot Pain, Foot Function, Shoe, General Foot Health, General Health, Physical Activity, Social Capacity, and Vigor. Results: Patients with T2DM have lower values in Foot Pain; median values in General Foot Health and high values in Foot Function, Shoe, Physical Activity and Social Capacity. Some of these dimensions are affected by age, diabetes control, Body Mass Index (BMI), and years of diagnosis. Females with T2DM have more problems than males in the Shoe, General Foot Health, Physical Activity and Vigor dimensions. Conclusions: this research gives us preliminary values of the FHSQ in Spanish patients with T2DM and divided by gender, age, diabetes control, BMI, and years of diagnosis in people with T2DM

Segundo documento de consenso sobre uso de antimicrobianos en la exacerbación de la enfermedad pulmonar obstructiva crónica

En el año 2000, expertos de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR), la Sociedad Española de Quimioterapia (SEQ) y la Sociedad Española de Medicina Familiar y Comunitaria (SEMFyC), conscientes de la importancia de la enfermedad pulmonar obstructiva crónica (EPOC), elaboraron un documento-consenso que pudiera servir como base para el control de la enfermedad, mediante un adecuado uso de antimicrobianos. Ahora, 3 años después, y con motivo de importantes avances científicos, se plantea una profunda revisión, que en realidad constituye el Segundo Documento de Consenso sobre Uso de antimicrobianos en la exacerbación de la enfermedad pulmonar obstructiva crónica. Por un lado, diferentes sociedades científicas han demostrado interés en adherirse al proyecto y trabajar en él: Sociedad Española de Medicina de Urgencias y Emergencias (SEMES), Sociedad Española de Medicina General (SEMG) y Sociedad Española de Medicina Rural y Generalista (SEMERGEN), lo cual, conjuntamente con la declinación de la SEMFyC, obliga a cambiar la estructura y algunos contenidos del documento. Por otra parte, en el momento presente se ha incorporado al arsenal terapéutico del médico un nuevo grupo de antimicrobianos (los cetólidos) con un único representante hasta ahora, la telitromicina, que permite considerarlo no sólo como terapia alternativa sino de elección, incluso en determinadas circunstancias clínicas que se analizan en el documento. Éstos son los dos aspectos más significativos que, sumados a otros, como la cada vez más aceptada actividad de levofloxacino sobre Pseudomonas aeruginosa y la constante actividad que demuestra amoxicilina-ácido clavulánico cuando se administra a las dosis recomendadas cada 8 horas, ofrecen nuevos patrones antibióticos para el tratamiento de esta enfermedad. Por último, se analizan científicamente otros grupos de antimicrobianos (macrólidos, cefalosporinas orales, etc.) y se ofrecen normas de empleo de estos agentes, tanto por parte de los especialistas como de los médicos de atención primaria

Cost-Effectiveness of a Whole-Body Vibration Program in Patients with Type 2 Diabetes: A Retrospective Study Protocol

Background: Type 2 diabetes mellitus (T2DM) is a chronic disorder, with patients exhibiting hyperglycemia in fasting and postprandial states. T2DM has several complications, including loss of sensation in more distal body parts. Good peripheral sensitivity is essential as this affects different parameters related to activities of daily living, such as leg strength and balance. The objectives of this project were to assess the effects of an 8-week whole-body vibration (WBV) training program on (1) vibration perception threshold (VPT), (2) balance, (3) strength, (4) lipidic profile, (5) health-related quality of life, (6) diabetic neuropathy, and (7) body composition in T2DM patients. Methods/Design: A double-blind, randomized controlled study, with WBV and placebo groups, was carried out. Both groups performed 8 weeks of intervention, with 3 sessions per week, completing a total of 24 sessions. There were two groups: the experimental group, i.e., the WBV group, who received WBV therapy; and the placebo group, who completed a simulated training program that was developed on a Galileo Fitness platform, connected to software displayed on a screen. The participant could see the parameters of the simulated vibration training (duration, amplitude, and frequency), but it was the software that controlled the speakers placed inside the vibration platform. Ninety patients with T2DM (56 males and 34 females) were recruited for the intervention. Participants were assigned equally to the WBV (n = 45) and placebo (n = 45) groups. Primary outcome measures were (1) HbA1c and (2) vibration threshold. Secondary measures were (1) health-related quality of life, (2) balance, (3) strength, (4) body composition, (5) blood pressure, (6) diabetic neuropathy, and (7) lipidic profile. Statistical analysis was carried out by treatment intention and protocol. Discussion: This project aimed to investigate the effects of WBV training on HbA1c, vibration threshold, and incremental cost-effectiveness ratio in T2DM patients. In future, guidelines will be provided for the incorporation of the main obtained conclusions into the social-sanitary system and businesses

Eliminación de la hepatitis C. Documento de posicionamiento de la Asociación Española para el Estudio del Hígado (AEEH)

[EN]: The Spanish Association for the Study of the Liver (AEEH) is convinced that the elimination of hepatitis C virus (HCV) in Spain is possible as long as we are able to use the resources and tools necessary for it. This document reflects the position of the AEEH regarding the elimination of HCV, establishing a wide range of recommendations that can be grouped into five categories: 1) Screening of HCV according to age, of the existence of classic acquisition risk factors of infection, active search of previously diagnosed patients and development of micro-elimination strategies in vulnerable populations; 2) Simplification of HCV diagnosis (one-step diagnosis and diagnosis at the point of patient care); 3) Simplification of patient treatment and improvement of care circuits; 4) Health policy measures, and, finally, 5) Establishment of HCV elimination indicators.[ES]: La Asociación Española para el Estudio del Hígado (AEEH) está convencida de que la eliminación de la hepatitis C en España es posible siempre y cuando seamos capaces de emplear los recursos y las herramientas necesarias para la misma. Este documento refleja la posición de la AEEH respecto a la eliminación del virus de la hepatitis C (VHC), estableciendo una amplia serie de recomendaciones que se pueden agrupar en cinco categorías: 1) cribado del VHC en función de la edad, de la existencia de factores de riesgo clásicos de adquisición de la infección, búsqueda activa de pacientes diagnosticados con anterioridad y desarrollo de estrategias de microeliminación en poblaciones vulnerables; 2) simplificación del diagnóstico del VHC (diagnóstico en un solo paso y diagnóstico en el punto de atención del paciente); 3) simplificación del tratamiento de los pacientes y mejora de los circuitos asistenciales; 4) medidas de política sanitaria, y, finalmente, 5) establecimiento de indicadores de eliminación del VHC