7 research outputs found
Digital Covid Certificates as Immunity Passports: An Analysis of Their Main Ethical, Legal, and Social Issues
Digital COVID certificates are a novel public health policy to tackle the COVID-19 pandemic. These immunity certificates aim to incentivize vaccination and to deny international travel or access to essential spaces to those who are unable to prove that they are not infectious. In this article, we start by describing immunity certificates and highlighting their differences from vaccination certificates. Then, we focus on the ethical, legal, and social issues involved in their use, namely autonomy and consent, data protection, equity, and international mobility from a global fairness perspective. The main conclusion of our analysis is that digital COVID certificates are only acceptable if they meet certain conditions: that they should not process personal data beyond what is strictly necessary for the aimed goals, that equal access to them should be guaranteed, and that they should not restrict people’s autonomy to access places where contagion is unlikely. We conclude that, if such conditions are guaranteed, digital COVID certificates could contribute to mitigating some of the most severe socioeconomic consequences of the pandemic.Funding for open access charge: Universidad de Granada / CBUA European Commission (H2020 SWAFS Programme, PANELFIT Project, research grant number 788039), Eusko Jaurlaritza (Ayudas a Grupos de Investigación IT-106616), and La Caixa Foundation (LCF/BQ/ DR20/11790005)
Digital Covid Certificates as Immunity Passports: An Analysis of Their Main Ethical, Legal, and Social Issues
Digital COVID certificates are a novel public
health policy to tackle the COVID-19 pandemic. These
immunity certificates aim to incentivize vaccination and
to deny international travel or access to essential spaces
to those who are unable to prove that they are not
infectious. In this article, we start by describing immunity
certificates and highlighting their differences from
vaccination certificates. Then, we focus on the ethical,
legal, and social issues involved in their use, namely
autonomy and consent, data protection, equity, and international
mobility from a global fairness perspective.
The main conclusion of our analysis is that digital
COVID certificates are only acceptable if they meet
certain conditions: that they should not process personal
data beyond what is strictly necessary for the aimed
goals, that equal access to them should be guaranteed,
and that they should not restrict people’s autonomy to
access places where contagion is unlikely.We conclude
that, if such conditions are guaranteed, digital COVID
certificates could contribute to mitigating some of the
most severe socioeconomic consequences of the
pandemic.Universidad de Granada/CBUA European Commission 788039La Caixa Foundation LCF/BQ/DR20/11790005Ayudas a Grupos de Investigacion IT-10661
Multiple vertebral fractures after suspension of denosumab. A series of 56 cases
Background: Denosumab is a monoclonal antibody approved for the treatment of postmenopausal osteoporosis. The withdrawal of denosumab produces an abrupt loss of bone mineral density and may cause multiple vertebral fractures (MVF).
Objective: The objective of this study is to study the clinical, biochemical, and densitometric characteristics in a large series of postmenopausal women who suffered MVF after denosumab withdrawal. Likewise, we try to identify those factors related to the presence of a greater number of vertebral fractures (VF).
Patients and methods: Fifty-six patients (54 women) who suffered MVF after receiving denosumab at least for three consecutive years and abruptly suspended it. A clinical examination was carried out. Biochemical bone remodelling markers (BBRM) and bone densitometry at the lumbar spine and proximal femur were measured. VF were diagnosed by magnetic resonance imaging MRI, X-ray, or both at dorsal and lumbar spine.
Results: Fifty-six patients presented a total of 192 VF. 41 patients (73.2%) had not previously suffered VF. After discontinuation of the drug, a statistically significant increase in the BBRM was observed. In the multivariate analysis, only the time that denosumab was previously received was associated with the presence of a greater number of VF (P = .04).
Conclusions: We present the series with the largest number of patients collected to date. 56 patients accumulated 192 new VF. After the suspension of denosumab and the production of MVF, there was an increase in the serum values of the BBRM. The time of denosumab use was the only parameter associated with a greater number of fractures
Spanish National Hip Fracture Registry (RNFC) : First-year results and comparison with other registries and prospective multi-centric studies from Spain
Fundamentos: El Registro Nacional de Fracturas de Cadera (RNFC) es un registro español multicéntrico, prospectivo y continuo, que comenzó en 2017. El objetivo de este artículo fue presentar los datos del primer informe anual y compararlos con los registros autonómicos y los estudios multicéntricos realizados recientemente en España. Métodos: Se incluyeron las personas de 75 años o más atendidas con el diagnóstico de fractura de cadera por fragilidad en alguno de los hospitales participantes en el RNFC, entre enero y octubre de 2017. En el análisis estadístico se utilizó la media y desviación estándar o mediana y rangos intercuartílicos para las variables numéricas y los porcentajes para las variables categóricas. Se realizó un análisis descriptivo global de la casuística y se comparó con los datos disponibles de los estudios previos mencionados. Resultados: Se registraron 7.208 personas de 54 hospitales, con una edad media de 86,7 años (DE 5,6). El 75,4% fueron mujeres y el 36,4% presentaron deterioro cognitivo previo. La demora quirúrgica media fue de 75,7 horas (DE 63,6) y la estancia media fue de 10,9 días (DE 6,7). De las personas que vivían en un domicilio antes de la fractura (75,4%), menos de la mitad (37,0%) volvieron a él tras el alta hospitalaria. Al mes, había fallecido el 7,1%. La comparación con los otros estudios mostró algunas diferencias importantes, sobre todo en la ubicación previa, en el porcentaje de pacientes institucionalizados de novo (7,7-29,4%) y en el porcentaje con tratamiento antiosteoporótico al alta (14,5-36,7%). Conclusiones: El RNFC es la mayor base de datos prospectiva que aporta datos sobre el perfil de los pacientes hospitalizados por fractura de cadera en España. La comparación con otros estudios recientes muestra algunas diferencias importantes.OBJECTIVE: The Spanish National Hip Fracture Registry (Registro Nacional de Fracturas de Cadera or RNFC) is a Spanish, prospective, multi- centric registry, commenced in 2017. The goal of this paper is to present the data from the first annual report and to compare them with autonomic registries and recent prospective multi-centric studies performed in Spain. METHODS: We included persons 75 years or older treated for fragility hip fractures in any of the centers participating in the RNFC between January and October 2017. The descriptive statistics of each variable used the mean (and standard deviation) or the median (and interquartile ranges) for the ordinal variables and the percentage for the categoric variables. A descriptive analysis of the casemix was performed and compared with available data from the aforementioned studies. RESULTS: The RNFC included 7.208 patients from 54 hospitals, with a mean age of 86.7 (SD 5.6) years; 75.4% were women, and 36.4% showed cognitive decline. Mean surgical delay was 75.7 (SD 63.6) hours, and length of stay averaged 10.9 (SD 6.7) days. Of the patients who lived at home (75.4%), less than half (37.0%) returned home at discharge. One-month mortality was 7.1%. Comparison with other studies showed important differences, especially regarding patients newly sent to nursing homes (7.7-29.4%) and with antiosteoporotic treatment at discharge (14.5-36.7%). CONCLUSIONS: The RNFC is the largest prospective database to date that offers data regarding the characteristics of patients hospitalized for hip fractures in Spain. Comparison with recent studies showed some important differences
Registro Nacional de Fracturas de Cadera (RNFC): Resultados del primer año y comparación con otros registros y estudios multicéntricos españoles
Background: The Spanish National Hip
Fracture Registry (Registro Nacional de Fracturas
de Cadera or RNFC) is a Spanish, prospective, multi-
centric registry, commenced in 2017. The goal of
this paper is to present the data from the first annual
report and to compare them with autonomic registries
and recent prospective multi-centric studies
performed in Spain.
Methods: We included persons 75 years of age
or older treated for fragility hip fractures in any
of the centers participating in the RNFC between
January and October 2017. The descriptive statistics
of each variable used the mean (and standard
deviation) or the median (and interquartile ranges)
for the ordinal variables and the percentage for the
categoric variables. A descriptive analysis of the casemix
was performed and compared with available
data from the aforementioned studies.
Results: The RNFC included 7.208 patients
from 54 hospitals, with a mean age of 86.7 (SD
5.6) years; 75.4% were women, and 36.4% showed
cognitive decline. Mean surgical delay was 75.7
(SD 63.6) hours, and length of stay averaged 10.9
(SD 6.7) days. Of the patients who lived at home
(75.4%), less than half (37.0%) returned home
at discharge. One-month mortality was 7.1%.
Comparison with other studies showed important
differences, especially regarding patients newly
sent to nursing homes (7.7-29.4%) and with antiosteoporotic
treatment at discharge (14.5-36.7%).
Conclusions: The RNFC is the largest prospective
database to date that offers data regarding
the characteristics of patients hospitalized for hip
fractures in Spain. Comparison with recent studies
showed some important differencesFundamentos: El Registro Nacional de
Fracturas de Cadera (RNFC) es un registro español
multicéntrico, prospectivo y continuo, que comenzó
en 2017. El objetivo de este artículo fue presentar
los datos del primer informe anual y compararlos
con los registros autonómicos y los estudios
multicéntricos realizados recientemente en España.
Métodos: Se incluyeron las personas de 75
años o más atendidas con el diagnóstico de fractura
de cadera por fragilidad en alguno de los hospitales
participantes en el RNFC, entre enero y octubre de
2017. En el análisis estadístico se utilizó la media y
desviación estándar o mediana y rangos intercuartílicos
para las variables numéricas y los porcentajes
para las variables categóricas. Se realizó un análisis
descriptivo global de la casuística y se comparó
con los datos disponibles de los estudios previos
mencionados.
Resultados: Se registraron 7.208 personas de
54 hospitales, con una edad media de 86,7 años
(DE 5,6). El 75,4% fueron mujeres y el 36,4%
presentaron deterioro cognitivo previo. La demora
quirúrgica media fue de 75,7 horas (DE 63,6)
y la estancia media fue de 10,9 días (DE 6,7). De
las personas que vivían en un domicilio antes de la
fractura (75,4%), menos de la mitad (37,0%) volvieron
a él tras el alta hospitalaria. Al mes, había
fallecido el 7,1%. La comparación con los otros estudios
mostró algunas diferencias importantes, sobre
todo en la ubicación previa, en el porcentaje de
pacientes institucionalizados de novo (7,7-29,4%)
y en el porcentaje con tratamiento antiosteoporótico
al alta (14,5-36,7%).
Conclusiones: El RNFC es la mayor base de
datos prospectiva que aporta datos sobre el perfil
de los pacientes hospitalizados por fractura de cadera
en España. La comparación con otros estudios
recientes muestra algunas diferencias importantesThe RNFC has been financed through donations by AMGEN SA, UCB Pharma, Abbott Laboratories and FAES Farma, as well as a Research Grant from the Fundación Mutua Madrileña (AP169672018)
Registro Nacional de Fracturas de Cadera (RNFC): resultados del primer año y comparación con otros registros y estudios multicéntricos españoles
[EN] Background: The Spanish National Hip Fracture Registry (Registro Nacional de Fracturas de Cadera or RNFC) is a Spanish, prospective, multi-centric registry, commenced in 2017. The goal of this paper is to present the data from the first annual report and to compare them with autonomic registries and recent prospective multi-centric studies performed in Spain. Methods: We included persons 75 years of age or older treated for fragility hip fractures in any of the centers participating in the RNFC between January and October 2017. The descriptive statistics of each variable used the mean (and standard deviation) or the median (and interquartile ranges) for the ordinal variables and the percentage for the categoric variables. A descriptive analysis of the casemix was performed and compared with available data from the aforementioned studies. Results: The RNFC included 7.208 patients from 54 hospitals, with a mean age of 86.7 (SD 5.6) years; 75.4% were women, and 36.4% showed cognitive decline. Mean surgical delay was 75.7 (SD 63.6) hours, and length of stay averaged 10.9 (SD 6.7) days. Of the patients who lived at home (75.4%), less than half (37.0%) returned home at discharge. One-month mortality was 7.1%. Comparison with other studies showed important differences, especially regarding patients newly sent to nursing homes (7.7-29.4%) and with antiosteoporotic treatment at discharge (14.5-36.7%). Conclusions: The RNFC is the largest prospective database to date that offers data regarding the characteristics of patients hospitalized for hip fractures in Spain. Comparison with recent studies showed some important differences. [ES] Fundamentos: El Registro Nacional de Fracturas de Cadera (RNFC) es un registro español multicéntrico, prospectivo y continuo, que comenzó en 2017. El objetivo de este artículo fue presentar los datos del primer informe anual y compararlos con los registros autonómicos y los estudios multicéntricos realizados recientemente en España. Métodos: Se incluyeron las personas de 75 años o más atendidas con el diagnóstico de fractura de cadera por fragilidad en alguno de los hospitales participantes en el RNFC, entre enero y octubre de 2017. En el análisis estadístico se utilizó la media y desviación estándar o mediana y rangos intercuartílicos para las variables numéricas y los porcentajes para las variables categóricas. Se realizó un análisis descriptivo global de la casuística y se comparó con los datos disponibles de los estudios previos mencionados. Resultados: Se registraron 7.208 personas de 54 hospitales, con una edad media de 86,7 años (DE 5,6). El 75,4% fueron mujeres y el 36,4% presentaron deterioro cognitivo previo. La demora quirúrgica media fue de 75,7 horas (DE 63,6) y la estancia media fue de 10,9 días (DE 6,7). De las personas que vivían en un domicilio antes de la fractura (75,4%), menos de la mitad (37,0%) volvieron a él tras el alta hospitalaria. Al mes, había fallecido el 7,1%. La comparación con los otros estudios mostró algunas diferencias importantes, sobre todo en la ubicación previa, en el porcentaje de pacientes institucionalizados de novo (7,7-29,4%) y en el porcentaje con tratamiento antiosteoporótico al alta (14,5-36,7%). Conclusiones: El RNFC es la mayor base de datos prospectiva que aporta datos sobre el perfil de los pacientes hospitalizados por fractura de cadera en España. La comparación con otros estudios recientes muestra algunas diferencias importantes.The RNFC has been financed through donations by AMGEN SA, UCB Pharma, Abbott Laboratories and FAES Farma, as well as a Research Grant from the Fundación Mutua Madrileña (AP169672018). The sponsors did not influence any aspect of the project nor of the drafting of this manuscript.S