Cambios en el consumo de tabaco: auge del tabaco de liar e introducción de los cigarrillos electrónicos

ResumenObjetivoValorar los cambios en el consumo de tabaco y estudiar de forma detallada el consumo de tabaco de liar y de cigarrillos electrónicos en la población gallega desde 2007 hasta 2015.MétodosInformación aportada por cinco estudios transversales, independientes, realizados entre 2007 y 2015 en mayores de 15 años (n=8000/año). Se estimaron prevalencias de consumo, acompañadas de sus intervalos de confianza del 95%, global, en función del sexo y en grupo de edad, ámbito de residencia y nivel de estudios.ResultadosLa prevalencia de consumo de tabaco fue del 25,4% en 2007 y del 21,8% en 2015. En 2007, el 1,8% de los fumadores consumían tabaco de liar, y en 2015 eran el 18,6%. El consumo del tabaco de liar entre fumadores aumentó en todos los grupos estudiados. La prevalencia de consumo de cigarrillos electrónicos fue, en 2014 y 2015, del 0,7%. En el ámbito urbano es donde se observan prevalencias más altas de consumo de cigarrillos electrónicos.ConclusiónEntre 2007 y 2015, la prevalencia de consumo de tabaco ha disminuido en Galicia y ha aumentado la prevalencia de fumadores que consumen tabaco de liar. El uso de cigarrillos electrónicos es bajo y más frecuente entre los fumadores, aunque no exclusivo. El auge del tabaco de liar y la introducción de los cigarrillos electrónicos reflejan la importancia de mantener sistemas de vigilancia que puedan identificar de forma inmediata cambios de comportamiento asociados al consumo de tabaco.AbstractObjectiveTo assess changes in smoking prevalence and study roll-your-own (RYO) tobacco and e-cigarette use in the Galician population between 2007 and 2015.MethodsData were obtained from five independent, cross-sectional studies carried out in Galicia (Spain) between 2007-2015 in the population aged 16 and over (n=8,000/year). Prevalence of use was estimated, with 95% confidence intervals, overall, according to sex and by age group, area of residence and level of education.ResultsSmoking prevalence decreased from 25.4% in 2007 to 21.8% in 2015. In 2007, 1.8% of current smokers declared that they had smoked RYO tobacco, compared to 18.6% in 2015. Among smokers, RYO tobacco consumption increased across all demographic groups. In both 2014 and 2015, ever use of e-cigarettes was 0.7%. E-cigarette use was more frequent in urban settings.ConclusionSmoking prevalence decreased in Galicia between 2007 and 2015, and there has been rapid growth in the prevalence of RYO tobacco use. Although smokers are more likely to use e-cigarettes, both former and never smokers declared their use. The boom of RYO cigarettes and the emergence of e-cigarettes highlight the importance of having continuous surveillance systems to identify smoking behavioural changes

Analysis of Arterial Blood Gas Values Based on Storage Time Since Sampling: An Observational Study

[Abstract] Aim: To evaluate the influence of time on arterial blood gas values after artery puncture is performed. Method: Prospective longitudinal observational study carried out with gasometric samples from 86 patients, taken at different time intervals (0 (T0), 15 (T15), 30 (T30) and 60 (T60) min), from 21 October 2019 to 21 October 2020. The study variables were: partial pressure of carbon dioxide, bicarbonate, hematocrit, hemoglobin, potassium, lactic acid, pH, partial pressure of oxygen, saturation of oxygen, sodium and glucose. Results: The initial sample consisted of a total of 90 patients. Out of all the participants, four were discarded as they did not understand the purpose of the study; therefore, the total number of participants was 86, 51% of whom were men aged 72.59 on average (SD: 16.23). In the intra-group analysis, differences in PCO2, HCO3, hematocrit, Hb, K+ and and lactic acid were observed between the initial time of the test and the 15, 30 and 60 min intervals. In addition, changes in pH, pO2, SO2, Na and glucose were noted 30 min after the initial sample had been taken. Conclusions: The variation in the values, despite being significant, has no clinical relevance. Consequently, the recommendation continues to be the analysis of the GSA at the earliest point to ensure the highest reliability of the data and to provide the patient with the most appropriate treatment based on those results

Incidence of COVID-19 in Children and Young People Who Play Federated Football

[Abstract] Aim: To determine the incidence of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection in children and young people who play federated football. Methods: Prospective study, from October 2020 to January 2021, in players aged 4 to 19 years from federated football clubs in Galicia, Spain (N = 23,845). Outbreaks and cases of SARS-CoV-2 infection were recorded. The cumulative incidence was compared with the incidence registered in Galicia in the same age range. Results: The cumulative incidence was 29.8 cases per 10,000 licenses in 4 months, lower than the incidence registered in the general population for all ages and both sexes (283.7 per 10,000 inhabitants; rate ratio = 9.5). It was higher in January (40.7 per 10,000), coinciding with the population peak. More cases were registered in futsal (42.9 vs 27.5 per 10,000) and competitions with periodic screenings (127.4 vs 9.1 per 10,000). There were 2 outbreaks in 2389 teams (0.08%). Conclusion: The results support the safety of football practice in children and young people with prevention protocols

Evaluation, correction and impact of non-response in studies of childhood obesity

Objetivo: Evaluar y corregir, usando escalas de siluetas corporales, el impacto de la no respuesta en las prevalencias de bajo peso, sobrepeso y obesidad en ninos/as ˜ de 6-15 anos ˜ de edad. Método: Estudio transversal realizado en 2013 con 8145 escolares gallegos/as de 6-15 anos. ˜ Quienes aceptaron participar fueron pesados/as y medidos/as, y a partir del índice de masa corporal se estimaron las prevalencias de bajo peso, sobrepeso y obesidad. Los/las profesores/as valoraron a todo el alumnado mediante escalas de siluetas corporales, y las valoraciones se usaron para estimar las prevalencias corregidas por la no respuesta.Aplicando elteorema de Bayes se estimaron las tasas de participación en función del estado ponderal. Resultados: La tasa de participación fue del 92,3% para los/las de 6-11 anos ˜ y del 90% para los/las de 12-15 anos. ˜ En ambos grupos, las prevalencias de bajo peso y sobrepeso fueron similares entre participantes y no participantes, pero la obesidad fue mayor entre los no participantes, sobre todo a los 12-15 anos ˜ (6,3% vs. 12,2%; p < 0,05). Las prevalencias no variaron al ser corregidas con las valoraciones. La tasa de participación de los/las escolares obesos/as fue inferior a la global (82% vs. 90% a los 12-15 anos; ˜ p < 0,05). Conclusiones: Se confirma la presencia de sesgo de participación, mayor a los 12-15 anos, ˜ aunque su impacto en las prevalencias fue despreciable debido a la alta tasa de participación. En los estudios de obesidad con medidas objetivas es fundamental cuantificar la no respuesta, así como valorar el impacto que tiene y corregirlo.Objective: To evaluate and correct the impact of non-response in the prevalence of underweight, overweight and obesity in children aged 6 to 15 years old using silhouette scales. Method: Cross-sectional study carried out in 2013 among 8,145 Galician schoolchildren aged 6-15 years old. The students who agreed to participate were weighed and measured and, based on body mass index, the prevalence of underweight, overweight and obesity was estimated. Teachers rated all students using silhouette scales. The valuations were used to estimate the prevalence corrected by non-response. Using the Bayes theorem, participation rates were estimated according to weight status. Results: The participation rate was 92.3% in the 6 -to 11-year-old group, and 90% in the 12- to 15-year old age group. In both groups, the prevalence of underweight and overweight were similar between participants and non-participants. However, obesity was higher among non-participants, especially at 12 to 15 years of age (6.3% vs. 12.2% ; p < 0.05). The prevalence did not change when corrected by the teacher’s valuation. The participation rate of obese students was lower than the overall rate (82% vs. 90% at 12 to 15 years old; p < 0.05). Conclusions: The presence of participation bias, which was greater at 12-15 years old, was confirmed. However,the impact ofthe bias on prevalence was negligible due to the high participation rate. In obesity studies with objective measures, itis essentialto quantify non-participation, as well as to assess its impact and correct it.S

Exploratory study of an oral screening dysplasia program for HIV-infected men who have sex with men

Dysplasia; Screening; HIV-infectedDisplasia; Cribado; Infectado por el VIHDisplàsia; Cribratge; Infectat pel VIHBackground: HIV-infected men who have sex with men (MSM) are at high risk to develop human papilloma virus (HPV)-related oropharyngeal cancer. The aim of our study was to assess the usefulness of a pilot oral dysplasia screening program and its correlation with an anal dysplasia screening program. Methods: This was a prospective study with HIV-infected MSM. Oral and anal screenings were performed based on HPV determination, liquid cytology, direct and microscopy oral examinations, high-resolution anoscopy and biopsies, if necessary. Results: A total of 103 patients were included. The mean age of the patients was 44.6 years, 55.3% were smokers, and 57.3% had a history of previous anal high-grade squamous intraepithelial lesions (HSILs). The prevalence of oral HPV infections was 14% (9% HPV-high risk), the prevalence of abnormal cytology was 25.2%, and in 4.8% of the patients, oral examinations showed suspicious HSILs. Oral microscopy did not detect additional lesions that visual inspection. Five oral biopsies were performed and the results were normal. No risk factors for oral HPV infections were identified. The prevalence of anal HPV infections was 88.3% (76.7% HPV-high risk), 52.9% of the patients had altered cytology, and in 45.6% anoscopy showed changes suggestive of HSILs. Seventy-two anal biopsies were performed, detecting 25 cases of HSILs (24.3%). A poor correlation was observed between oral and anal HPV infections (κ = 0.037). Conclusions: The prevalence of oral HPV infections, abnormal cytology and lesions in HIV-infected MSM was low, and their correlation with anal HPV-related lesions was slight. These results confirm the current barriers to oral dysplasia screening techniques.Study funded by program MISP of MSD (Merck HPV Investigator Study Program). MISP project code 58237

Impact of very early antiretroviral therapy during acute HIV infection on long-term immunovirological outcomes

Acute HIV infection; Antiretroviral treatment; Immune recoveryInfección aguda por VIH; Tratamiento antirretroviral; Recuperación inmunitariaInfecció aguda per VIH; Tractament antiretroviral; Recuperació immunitàriaObjectives We aimed to determine if starting antiretroviral therapy (ART) in the first 30 days after acquiring HIV infection has an impact on immunovirological response. Methods Observational, ambispective study including 147 patients with confirmed acute HIV infection (January/1995-August/2022). ART was defined as very early (≤30 days after the estimated date of infection), early (31-180 days), and late (>180 days). We compared time to viral suppression (viral load [VL] <50 copies/ml) and immune recovery (IR) (CD4+/CD8+ ratio ≥1) according to the timing and type of ART using survival analysis. Results ART was started in 140 (95.2%) patients. ART was very early in 24 (17.1%), early in 77 (55.0%), and late in 39 (27.9%) cases. Integrase strand transfer inhibitor (INSTI)-based regimens were the most used in both the overall population (65%) and the very early ART group (23/24, 95.8%). Median HIV VL and CD4+/CD8+ ratio pre-ART were higher in the very early ART group (P <0.05). Patients in the very early and early ART groups and treated with INSTI-based regimens achieved IR earlier (P <0.05). Factors associated with faster IR were the CD4+/CD8+ ratio pre-ART (hazard ratio: 9.3, 95% CI: 3.1-27.8, P <0.001) and INSTI-based regimens (hazard ratio: 2.4, 95% CI: 1.3-4.2, P = 0.003). Conclusions The strongest predictors of IR in patients who start ART during AHI are the CD4+/CD8+ ratio pre-ART and INSTI-based ART regimens.This work was founded by Instituto de Salud Carlos III (Acción Estratégica en Salud) and Fondo Europeo de Desarrollo Regional (FEDER) through grant PI20/00823. The study was also supported by the Spanish Network for AIDS Research (RIS) through the Instituto de Salud Carlos III – Red Temática de Investigación Cooperativa en Sida (RD06/006, RD12/0017/0018 and RD16/0002/0006) as part of the Plan Nacional R+D+I and by ISCIII Subdirección General de Evaluación and Fondo Europeo de Desarrollo Regional (FEDER). For this project, PS has received a grant from the Catalan Society of Infectious Diseases and Clinical Microbiology (SCMIMC) funded by ViiV Healthcare. MJB is supported by the Miguel Servet program funded by the Spanish Health Institute Carlos III (CPII22/00005). The funders had no role in the study design, data collection, and interpretation, or the decision to submit the work for publication

Inactividad física en Galicia: tendencia e impacto de cambios en la definición

Objetivo: El objetivo de este trabajo fue estimar la prevalencia de la inactividad física en Galicia en el tiempo libre en 2007-2011, así como el impacto que supone en ella el considerar otras actividades cotidianas. Métodos: Estudios transversales en mayores de 15 años (n = 19235). La actividad física se caracterizó mediante el cuestionario Minnesota. En el año 2011 se estimó la inactividad física considerando otras actividades cotidianas. Resultados: Entre 2007 y 2011, la prevalencia de inactividad física en el tiempo libre en Galicia fue estable (p = 0,249), próxima al 50%, y más alta en las mujeres y en la población que trabaja o estudia. La inactividad física disminuyó (47% a 16%) cuando se tuvieron en cuenta las actividades cotidianas. Conclusiones: La prevalencia de inactividad física fue alta y estable en los años estudiados. Tener en cuenta otras actividades de la vida cotidiana hizo disminuir de forma importante esta prevalencia

¿Cuántos niños hay con exceso de peso en Galicia? ¿Qué información debemos comunicar?

ABSTRACT Background: In epidemiological studies, there is no consensus on which references should be used to characterize the weight status of schoolchildren after estimating their body mass index. The aim of this study is to evaluate the influence that different criteria have on the characterization of the weight status of Galician schoolchildren from 6 to 15 years old and to identify the criterion that best characterizes central obesity. Methods: Cross-sectional study on a sample of 7.438 schoolchildren representative by sex and age of the Galician population of 6 to 15 year olds. The prevalence of central obesity and underweight, normal weight, overweight and obesity was estimated using the reference standards of the World Health Organization (WHO), Cole, Orbegozo-2011 and the Enkid study. In order to identify the criterion that best characterizes central obesity, the positive predictive values of obesity and the negative ones of overweight and obesity were calculated. Results: The characterization of schoolchildren according to their weight status was different depending on the reference used with estimates that vary by 20.4 percentage points being prevalence of excess weight using WHO references 41.5% while with Enkid it is 21.1%. The reference with the best predictive capacity of central obesity was those proposed by Cole. Conclusions: The variability observed in the characterization of the weight status of schoolchildren associated with the use of different reference criteria is very important. If central obesity is a good indicator of excess of weight, the reference proposed by Cole would be the one with the best capacity to characterize the child and youth population, related to the best predictive capacity.RESUMEN Fundamentos: En los estudios epidemiológicos, no hay consenso sobre cuáles son las referencias que se deben emplear para caracterizar el estado ponderal de los escolares después de estimar su índice de masa corporal. El objetivo de este trabajo fue valorar como influyen diferentes criterios en la caracterización del estado ponderal de escolares gallegos de 6 a 15 años e identificar el criterio que mejor caracteriza la obesidad central. Métodos: Estudio transversal en una muestra de 7.438 escolares de 6 a 15 años representativa por sexo y edad. Se estimó la prevalencia de obesidad central y de bajo peso, normopeso, sobrepeso y obesidad utilizando los criterios de referencia de la Organización Mundial de la Salud (OMS), Cole, Orbegozo-2011 y del estudio Enkid. Para identificar el criterio que mejor caracteriza la obesidad central se calcularon valores predictivos positivos de obesidad y negativos de sobrepeso y obesidad. Resultados: La caracterización de los escolares en función de su estado ponderal varió en función de la referencia empleada con estimaciones que oscilaban en 20,4 puntos porcentuales cuando se comparaba el exceso de peso según criterios de la OMS, 41,5%, y Enkid, 21,1%. El criterio que presentó mejor capacidad predictiva de obesidad central fue el propuesto por Cole. Conclusiones: La variabilidad que se observa en la caracterización del estado ponderal de los escolares asociada al uso de distintos criterios de referencia es muy importante. Si se considera a la obesidad central como indicador de exceso de peso, la referencia de Cole es la que mejor caracteriza a los escolares, ya que es la que tiene mejor capacidad predictiva