Correction : Chaparro et al. Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain: Large-Scale Epidemiological Study. J. Clin. Med. 2021, 10, 2885

The authors wish to make the following corrections to this paper [...]

Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain : Large-Scale Epidemiological Study

(1) Aims: To assess the incidence of inflammatory bowel disease (IBD) in Spain, to describe the main epidemiological and clinical characteristics at diagnosis and the evolution of the disease, and to explore the use of drug treatments. (2) Methods: Prospective, population-based nationwide registry. Adult patients diagnosed with IBD-Crohn's disease (CD), ulcerative colitis (UC) or IBD unclassified (IBD-U)-during 2017 in Spain were included and were followed-up for 1 year. (3) Results: We identified 3611 incident cases of IBD diagnosed during 2017 in 108 hospitals covering over 22 million inhabitants. The overall incidence (cases/100,000 person-years) was 16 for IBD, 7.5 for CD, 8 for UC, and 0.5 for IBD-U; 53% of patients were male and median age was 43 years (interquartile range = 31-56 years). During a median 12-month follow-up, 34% of patients were treated with systemic steroids, 25% with immunomodulators, 15% with biologics and 5.6% underwent surgery. The percentage of patients under these treatments was significantly higher in CD than UC and IBD-U. Use of systemic steroids and biologics was significantly higher in hospitals with high resources. In total, 28% of patients were hospitalized (35% CD and 22% UC patients, p < 0.01). (4) Conclusion: The incidence of IBD in Spain is rather high and similar to that reported in Northern Europe. IBD patients require substantial therapeutic resources, which are greater in CD and in hospitals with high resources, and much higher than previously reported. One third of patients are hospitalized in the first year after diagnosis and a relevant proportion undergo surgery

Censo de las Unidades del Dolor en España: Análisis de la estructura organizativa, dotación, cartera de servicios e indicadores de calidad y buenas prácticas

According to the census in the existing Spanish Society of Pain (SED) in February 2012 were recorded 147 Units Pain in Spain. Thanks to the collaboration of the Foundation Signo (Foundation which represents health managers), after comparing their files, with directions of hospitals public and institutions non-public registered by the Ministry of Health, 36 units were added to book entries in the SED, which has identified a total of 183 units in Spain. All of them were asked to collaborate with an online survey hosted on a particular web, order to know the crew and the degree of complexity of each, as well as compliance with the Standards Quality and Best Practices of Pain Units, edited by the Ministry of Health in 2010. One hundred and forty-three responses were considered valid surveys which accounted for 80.3 % of all units surveyed, and thus a very representative sample. In this paper are analyzed the results obtained in terms of the structure, endowment portfolio of services and activities of each and contrasted with the definition of the Units issued by the Ministry. We conclude that it is necessary to reconsider this, and propose a classification according to the actual situation Units that would reflect our strengths and weaknesses and serve as a reference and starting point for improving pain care in our country. To validate the results of an audit conducted by random selection of eight units (5.7 % of respondents), with a varying degree of overlap between 72-100 % in the different sections and a degree of overall match exceeding 86 %, which is the average value of truthfulness we consider for the first Census of pain units in Spain, with a confidence interval ranging between 81 and 90 %.Según el censo existente en la Sociedad Española del Dolor (SED) en febrero de 2012 se contabilizaban 147 Unidades del Dolor. Gracias a la colaboración de la Fundación Signo (fundación que agrupa a los gestores de sanidad), tras cotejar sus ficheros con las direcciones-gerencias de centros hospitalarios públicos y las registradas por el Ministerio de Sanidad en entidades no públicas, se sumaron 36 Unidades a las censadas en la SED, lo que ha permitido identificar un total de 183 Unidades en España. A todas ellas se les solicitó colaborar con una encuesta online hospedada en una hoja web específica, con el objetivo de conocer la dotación y el grado de complejidad de cada una de ellas, así como el cumplimiento de los Estándares de Calidad y Buenas Prácticas de las Unidades del Dolor, editado por el Ministerio de Sanidad en el año 2010. Después de analizar las respuestas se consideraron válidas 143 encuestas, lo que suponía el 80,3 % del total de las Unidades censadas, y por tanto una muestra muy representativa. En este trabajo se analizan los resultados obtenidos en cuanto a la estructura, dotación, cartera de servicios y actividad de cada una de ellas y se contrasta con la tipificación de las Unidades dictada por el Ministerio. Se concluye que es necesario reconsiderar esta clasificación, proponiendo una más acorde con la situación real de las Unidades, que sea fiel reflejo de nuestras fortalezas y debilidades y sirva de referencia y punto de partida para mejorar la atención al dolor en nuestro país. Para validar los resultados obtenidos, una vez recogidas todas las encuestas se realizó una auditoría mediante selección aleatoria de ocho Unidades (5,7 % de las encuestadas), con un grado de coincidencia que oscila entre el 72-100 % en los distintos apartados y un grado de coincidencia global que supera el 86 %, que es el valor medio de veracidad que consideramos para este primer Censo de la Unidades del Dolor en España, con un intervalo de confianza que se sitúa entre el 81 y el 90 %

Estimulación Medular (EEM) en el tratamiento de la enfermedad vascular periférica: Parte II

The Neuromodulation technologies are a not destructive and reversible approach in the treatment of the pain. They are used as a strategy for the control of untreatable pain according to the directives of the OMS and as an alternative of other invasive minor or neuroablatives therapies that have been not effective or that are not indicated. Between them the clinical use of spinal cord stimulation (SCS) has demonstrated its usefulness and efficiency in the treatment of different syndromes of chronic pain. Cook´s and cols. in 1.976, demonstrated in their reports the efficiency of this technique in the clinical manifestation of ischemic pain as well as in the arteriosclerosis, diabetic vasculopaty, or in the ischemic pain related with peripheral vasospasm, in specific pathologies as the Buerguer´s disease, Scleroderma or Raynaud´s syndrome. During the last decade, the utilization of the SCS has spread in the ischemic cardiopathy of untreatable character (refractory angina pectoris, syndrome "X",…) and vascular peripheral pathology, subject of this review. This technique appears as one of the main indications with high levels of efficiency (80%), so much in the clinical aspect for the symptomatic relief as well as in the ischemic physiopatologic benefits that induces the neuroestimulation.Las técnicas de neuromodulación suponen un abordaje no destructivo y reversible en el tratamiento del dolor. Su utilización se establece como estrategia de control del dolor no controlable dentro de las directrices de la O.M.S. y como alternativa a otras terapias invasivas menores o neuroablatibas que no han sido eficaces o que están contraindicadas. De entre ellas el uso clínico de la estimulación eléctrica medular (EEM) o neuroestimulación, demuestra día a día su utilidad y eficacia en el tratamiento de diferentes síndromes de dolor crónico. Estudios de Cook y cols en 1.976, ya demostraron en sus trabajos la efectividad de esta técnica en la manifestación clínica del dolor isquémico así como en la arterioesclerosis o vasculopatía diabética, o en el dolor isquémico producido por vasoespasmo periférico, en entidades específicas como la Enfermedad de Buerguer, Esclerodermia o Síndrome de Raynaud. Durante la última década, se ha extendido la utilización de la EEM en la cardiopatía isquémica de carácter intratable (angina de pecho refractaria a tratamientos, síndrome "X",...) y la patología vascular periférica, objeto de esta revisión. Esta técnica se presenta como una de las principales indicaciones con altos niveles de efectividad (80%), tanto en el aspecto clínico por el alivio sintomático que produce, como en los beneficios isquémicos fisiopatológicos que induce la neuroestimulación